bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact on Prostate Cancer Clinical Presentation After Non-Screening Policies at a Tertiary-Care Medical Center.
Authors: Ajami Tarek , Durruty Jaime , Mercader Claudia , Rodriguez Leonardo , Ribal Maria , Alcaraz Antonio , Vilaseca Antoni
Published: November 2020

BACKGROUND:In May 2012 the US Preventive Task Force (USPTF) issued a ‘D’ recommendation for routine PSA-based prostate cancer early detection. This recommendation was implemented progressively in our health system. The aim of this study is to define its impact at a tertiary care institution. METHODS:A retrospective analysis was performed from 2012 till 2015 at a single center. We analyzed the total number of biopsies performed per year and the positive biopsy rate. For those patients with positive biopsies we recorded diagnostic PSA, clinical stage, ISUP grade group, nodal involvement and metastatic status at diagnosis. RESULTS:A total of 1686 biopsies were analyzed. The positive biopsy rate (PBR) increased from 25% in 2012 to 40% in 2015 (p<0.05). No change in median PSA was noticed (p=0.627). Biopsies detected higher ISUP grades (p=0.000). In addition, newly diagnosed prostate cancer presented higher clinical stage (p=0.005), higher metastatic rates (p=0.03) and a tendency to higher lymph node involvement although not statistically significant (p=0.09).CONCLUSION:After the 2012 recommendation, patients presented higher probability of diagnosing prostate cancer, with more adverse ISUP group, clinical stage and metastatic disease. These results should be considered to implement a risk adapted strategy for prostate cancer screening.
Ge-doped Hematite for an Unassisted Water Splitting System with Enhanced Efficiency
Authors: Yoon Ki-Yong , Park Juhyung , Jung Minsu , Ji Sang-Geun , Lee Hosik , Seo Ji , Kwak Myung-Jun , Seok Sang Il , Lee Jun Hee , Jang Ji-Hyun
Published: November 2020

To boost the photoelectrochemical water oxidation performance of a hematite photoanode, high temperature annealing has been widely applied to enhance crystallinity and remove the physical interface between the hematite and the fluorine doped thin oxide (FTO) substrate. However, the high temperature also results in unintentional Sn-doping due to thermal diffusion from the bottom FTO substrate. Therefore, when using additional dopants and the subsequent high temperature annealing process to enhance performance, the procedure should more precisely be considered co-doping of the hematite photoanode. However, at present, the interaction between the unintentional Sn and intentional dopant is poorly understood. Here, using germanium (Ge), which has been proven a promising dopant in previously reported simulations, we investigated how Sn diffusion affects overall PEC performance in Sn:Ge co-doped systems. After revealing the negative interaction of Sn and Ge dopants, we developed a facile Ge-doping method which suppresses Sn diffusion from the FTO substrate, significantly improving hematite performance. The Sn:Ge-hematite photoanode showed a photocurrent density of 4.6 mA cm− 2 at 1.23 VRHE with an excellent low turn-on voltage. After combining with a perovskite solar cell, our tandem system achieved outstanding 4.8% solar-to-hydrogen conversion efficiency (3.9 mA cm− 2 in an unassisted water splitting system). Our work provides important insights on a promising diagnostic tool for future co-doping system design.
Properties of corn husk fibre reinforced epoxy composites fabricated using vacuum-assisted resin infusion
Authors:   Taylor’s University Malaysia, Chun Koay Seong , Maimunah Tengku ,   Taylor’s University Malaysia, Yeng Chan Ming ,   Imperium International College, Malaysia, Yeow Tshai Kim ,   University of Nottingham Malaysia, Kiat Ong Thai ,   Tunku Abdul Rahman University College, Malaysia
Published: November 2020

Corn husk is a non-fruit part of the corn and an agricultural waste. This research focuses on fabricating composite material from the corn husk fibre by using a vacuum assisted resin infusion (VARI) technique. The corn husk fibre was extracted using water retting method and treated with alkali and bleaching treatments using sodium hydroxide (NaOH) and hydrogen peroxide (H2O2). Then, those fibres were made into nonwoven fibre mat using water laid method. The fibre mat was infused with epoxy resin to make a composite. The mechanical result has shown that the composite with 20% of fibre has higher tensile strength and modulus compared to neat epoxy. Both treatments have removed the non-cellulose content, such as hemicellulose and lignin. Moreover, the treatments also promoted better interfacial adhesion between fibre and matrix. Thus, the NaOH treated and H2O2 treated composites showed approximately 56% and 82%, respectively, higher tensile strength than untreated composite. Both treated composites were also stiffer and exhibited lower water absorption compared to untreated composite.
Structural and electrical studies on zinc added magnesium oxide nanoparticles
Authors:   St. John’s College, India, P. Sumithraj Premkumar
Published: November 2020

Magnesium oxide (MgO, pure) and zinc added MgO nanoparticles were synthesised by a simple microwave assisted solvothermal method. The concentrations of impurity used in the present work were 0.25 M and 0.50 M. All samples were annealed at 400°C for 1 h to improve the ordering. The prepared pure and zinc added magnesium oxide nanoparticles were characterised by powder X-ray diffraction (PXRD), energy dispersive spectroscopy (EDS) and scanning electron microscopy (SEM). PXRD studies of pure and zinc added MgO nanoparticles showed that all samples belong to crystalline nature with cubic structure. The grain size of all samples were determined from the XRD results and it belongs to nano meter scale. The EDS confirmed the presence of zinc, magnesium and oxide elements in the respective prepared samples. The scanning electron microscope images confirmed that the prepared samples possess nanometer dimensions. The electrical properties such as AC conductivity, dielectric constant and dielectric loss were measured at different temperatures in the different frequency range by involving the impedance analyser of all the prepared samples.
Electro-optical effect of the nCOOCB liquid crystal molecules under the terahertz frequency range: A theoretical approach
Authors:   Babasaheb Bhimrao Ambedkar University, India, Kumar Narinder , Singh Pawan ,   Babasaheb Bhimrao Ambedkar University, India, Thapa Khem B. ,   Babasaheb Bhimrao Ambedkar University, India, Kumar Devesh ,   Babasaheb Bhimrao Ambedkar University, India
Published: November 2020

The homologous series of 4-cyano-4'-phenyl-phenol-alkanoates (nCOOCB) was studied under the influence of terahertz (THz) frequency range. The nCOOCB series has a re-entrant nematic phase, which is suitable for electro-optical properties under the THz frequency. The birefringence and order parameter expresses the twisting of the nematic phase at the higher frequency range. The director angle has fluctuated at a higher frequency range. The refractive index has remained constant at a higher frequency. The ionisation potential, electron affinity and Homo-Lumo energy gap continuously decrease with an extension of alkyl chain length; however, the dipole moment increases. The Homo-Lumo energy bandgap is reciprocal to the dipole moment.
Shot noise distinguishes Majorana fermions from vortices injected in the edge mode of a chiral p-wave superconductor
Authors: Beenakker Carlo , Oriekhov Dmytro
Published: November 2020

The chiral edge modes of a topological superconductor support two
types of excitations: fermionic quasiparticles known as Majorana
fermions and \bm\pi𝛑-phase
domain walls known as edge vortices. Edge vortices are injected pairwise
into counter-propagating edge modes by a flux bias or voltage bias
applied to a Josephson junction. An unpaired edge mode carries zero
electrical current on average, but there are time-dependent current
fluctuations. We calculate the shot noise power produced by a sequence
of edge vortices and find that it increases logarithmically with their
spacing — even if the spacing is much larger than the core size so the
vortices do not overlap. This nonlocality produces an anomalous
\bm{V\ln V}𝐕ln𝐕
increase of the shot noise in a voltage-biased geometry, which serves as
a distinguishing feature in comparison with the
linear-in-\bm V𝐕
Majorana fermion shot noise.
Using of telemedicine in treatment of severe community-acquired pneumonia in Krasnoyarsk state
Authors: Gordeeva N. V. , Demko I. V. , Korchagin E. E. , Soloveva I. A. , Kraposhina A. Yu. , Mamaeva M. G. , Verbitskaya E. A.
Published: November 2020

Introducrion. Due to the peculiarities of the Krasnoyarsk krai (a huge territory, low population density, different levels of health development in the districts, personnel shortage), there is a need to increase the availability and quality of medical care to district patients. For this purpose, since 2016, the Regional telemedicine system has started functioning online monitoring for patients with severe pneumonia, which provides full-fledged curation of patients from all over the region.

Objective. To evaluate the results of RTS monitoring of patients with severe pneumonia.

Materials and methods. 770 cases of severe community-acquired pneumonia registered in RTS from 2016 to 2018 were analyzed. Statistical data processing was performed using variational statistics using the “Excel-7” software package. For all values, the minimum significance level (p) of 0.05 was taken into account.

Results. The risk factor for severe flow was male. Among comorbid diseases, cardiovascular and bronchopulmonary diseases, diabetes, alcoholism and HIV infection prevailed. The lack of flu vaccination in 97% of patients increased the number of deaths by 4.5 times. The greatest need for consultation arose in the Central district hospitals of low capacity. The majority of patients are registered in the system on the first day of hospitalization and are consulted by a pulmonologist of the Regional clinical hospital within 2 hours. Air ambulance of the Regional clinical hospital evacuated 174 patients, the need for flights decreased by 3.5 times. The main mistakes of district hospitals in the management of patients were the irrational selection of antibacterial drugs, the volume of detoxification therapy, the late start of antiviral therapy and ventilators, and the lack of prescription of anticoagulants.

Conclusions. Along with the presence of comorbidities, the outcome of the EAP is affected by the quality of medical care, which depends on the professional training of medical workers, continuity in the work of regional medical institutions and air ambulance, which causes difficulties, given the specifics of the region. RTS allows you to solve this problem at minimal cost.
Рossibilities of clinical application of modern nebulizers
Authors: Belotserkovskaya Yu. G.
Published: November 2020

The simplicity of converting medicinal solutions and suspensions into aerosols using mechanical and thermal energy, convenient delivery to the airways allows nebulizers to take a worthy place in the treatment of hospitalized and outpatient patients. Different types of nebulizers are available for use in the home and in medical settings (jet, ultrasound, membrane), and researches show that the performance and characteristics of the aerosol vary between different devices and manufacturers. Jet nebulizers are still the most used devices that do not require coordination of inhale and delivery of aerosol to the respiratory tract. To reduce the consumption of medicinal aerosol and optimize the air flow, virtual valve technology (V.V.T.) is being improved, and breath-actuated nebulizers are being created. The advantage of nebulizer therapy is the ability to apply large doses of medications, use substances that exist only in inhaled form. The choice falls on the nebulizer in cases where the patient can not use other delivery devices, for example, if the patient is unable to coordinate the inhalation and intake of the drug into the respiratory tract, with a severe exacerbation of obstructive disease, in the presence of motor disorders. The optimal delivery device for children of any age, including newborns, is a nebulizer. The most common indication for nebulizer therapy is the delivery of bronchodilators and inhaled corticosteroids for asthma or chronic obstructive pulmonary disease, as well as the treatment of upper respiratory tract diseases, in particular croup in children. An important place is given to nebulizers when it is necessary to prescribe certain mucolytics and antibiotics. In the treatment of emergency conditions, inhalation administration of drugs may be required, including situations when the patient is on mechanical ventilation or has a tracheostomy installed. The significance of nebulizers in the treatment of cystic fibrosis, pulmonary arterial hypertension, and alpha-1-antitrypsin deficiency is being studied. The possibilities of endobronchial delivery of heparin, insulin, and monoclonal antibodies are evaluated.
Predicting the duration of inpatient treatment for COVID-19 patients
Authors: Tsvetkov V. V. , Tokin I. I. , Lioznov D. A. , Venev E. V. , Kulikov A. N.
Published: November 2020

Introduction. In the context of a high load on all links in the structure of providing medical care to patients with COVID-19, solving the issue of effective triage of patients seems to be extremely urgent. The duration of inpatient treatment is one of the most objective and unambiguously interpreted indicators that can be used to indirectly assess the severity of the patient’s condition.

Objective. Develop a machine learning model to predict the duration of inpatient care for patients with COVID-19 based on routine clinical indicators assessed at the prehospital stage.

Materials and methods. A total of 564 patients were examined with diagnoses: U07.1 COVID-19, virus identified (n = 367) and U07.2 COVID-19, virus not identified (n = 197). The study included 270 patients, of whom in 50.37% of patients the duration of inpatient treatment did not exceed 7 days, in 49.63% of patients the duration of inpatient treatment was more than 10 days. Eleven clinical parameters were chosen as the most important predictors for predicting the duration of inpatient treatment: age, height and weight of the patient, SpO2 level, body temperature, body mass index, pulse rate, number of days from the onset of illness, respiratory rate, systolic and diastolic arterial pressure.

Results. The accuracy of our machine learning model for predicting the duration of inpatient treatment more than 10 days was 83.75% (95% CI: 73.82–91.05%), sensitivity — 82.50%, specificity — 85.00%. AUC = 0.86.

Conclusion. The method developed by us based on machine learning is characterized by high accuracy in predicting the duration of inpatient treatment of patients with COVID-19, which makes it possible to consider it as a promising new tool to support medical decisions on further tactics of patient management and to resolve the issue of the need for hospitalization.
Features of Cooperation of Investigator with Public Authorities During the Investigation of Environmental Crimes
Authors: Vasileva Mariia Aleksandrovna
Published: November 2020

Public authorities, providing control and supervision over environment, and scientific and educational institutions of ecological aspect as the subjects of cooperation with investigator during the investigation of environmental crimes are examined in the present article. The variants of their support in such investigations are considered.
Exemption from Criminal Liability for Inappropriate Use of Public Funds with Court Fining
Authors: Kulii Leonid Aleksandrovich , Kozyr German Igorevich
Published: November 2020

The issue of exemption from criminal liability based on specific elements of a crime is relevant to an array of crimes. The exemption with court fining is relatively new in the criminal law. Considering the peculiarity of dispositions of the articles 285.1, 285.2 of the Criminal Code of Russia the establishment of the application of the fine for specific crimes remains dubious. The present issue is not covered sufficiently in the theory of the criminal law. Based on scientific researches and case law, specific problems involved in the implementation of the article 72.2 in relation to inappropriate use of public and state non-budgetary funds are established in the present article.
Cálculo integral aplicado a las ciencias empresariales y económicas
Authors: Hernández Sastoque Eric , Barros Troncoso José , Escorcia Caballero Edgardo
Published: November 2020

El libro Cálculo integral aplicado a las ciencias empresariales y económicas se concibe como parte de los fundamentos matemáticos para estudiantes adscritos a programas del campo de las ciencias empresariales y económicas. El propósito de esta publicación es contribuir con el trabajo en el aula de clase y con los procesos de aprendizaje de los estudiantes en su trabajo autónomo para el desarrollo de la asignatura de Cálculo Integral. Los capítulos de este libro presentan la siguiente estructura: El capítulo uno presenta el concepto de antiderivada y de integral indefinida con sus propiedades y fórmulas básicas de integración. El capítulo dos presenta algunas técnicas de integración como: sustitución de la variable (cambio de variable), integración por partes e integración mediante fracciones parciales. En el capítulo tres se estudia el cálculo de área entre curvas como una de las aplicaciones de la integral definida. Entre los contextos que se utilizan para el desarrollo de problemas se encuentran el de variación total, el excedente del consumidor y el del productor, la maximización de la utilidad con respecto al tiempo y costo promedio, entre otros. El capítulo cuatro presenta el tema sobre ecuaciones diferenciales. Se introducen técnicas para resolver ecuaciones diferenciales básicas y de variables separables.
Halide Edib Adıvar’ın Ateşten Gömlek Adlı Romanında Kadının Milliyetçiliği
Authors: Albay Neslihan
Published: November 2020

Kurtuluş Savaşı’nın önemli ve içten bir tanığı olarak öne çıkan istisnai romanlardan biri olan Ateşten Gömlek, bir ulusun yeniden varoluş mücadelesi, anlatıcı Peyami’nin sayıklamalarıyla dile getirilmiştir. Bağımsızlık savaşımızı ve bu mücadelede omuz omuza savaştığı silah arkadaşlarını, içtenlikle anlatan Halide Edib Adıvar, Ateşten Gömlek adlı romanıyla Kurtuluş Savaşı’nın ateşten gömleği’ni bütün canlılığıyla gözler önüne sermiştir. İzmir’in ve kurtuluşunun sembolü haline gelen Ayşe, gittikçe kendisine bağlanan İhsan ve Peyami için ateşten gömlek olur. Her ikisi de İzmir yolunda, İzmir kızının peşinden giderek ölmeye ant içmişlerdir. Bir yandan düşmanla, bir yandan da kendi duygularıyla savaşan İhsan, cephede şehit düşer. Türklük şuuru ve mücadele azmiyle dolu olan Ayşe, milli mücadeleye hemşire olarak katılır ve İstanbullu gençlere ilham olur. Vatanın bağımsızlığı uğrunda kadınlar da erkeklerle yarışacak derecede çeşitli roller alarak mücadele etmeye hazırdır ve muktedirdir. Ateşten Gömlek’ te bir ulusun yeniden var oluş mücadelesini aşk ve dava ikilemi içerisinde irdeleyen romancı hem toplumsal hem ulusal hem de bireysel özgürlük mücadelesini, ateşten gömlek benzetmesiyle daha da somut bir hale getirmiştir. Kişisel tercih ve duyguların önüne geçen milli dava uğrunda verilen fedakarlıklar söz konusu olduğunda, kadınların rolü en az erkeklerinki kadar büyüktür. Bu çalışmanın amacı, İzmir’in kurtuluşunu tek aşkı ve hayali yapan Ayşe’nin milli mücadele ruhuyla hareket ederken, Kurtuluş Savaşı sırasında yaşanan aşk ve ilişkilerin sanki bir “Ateşten Gömlek” olduğunu fark Edib, önceliğini nasıl milli davaya verdiğini göstermektir.
Modulation of Matrix Metalloproteinases by Plant-derived Products
Authors: Anuar Nur Najmi Mohamad , Zulkafali Nurul Iman Natasya , Ugusman Azizah
Published: November 2020

Matrix metalloproteinases (MMPs) are a group of zinc-dependent metalloendopeptidases
that are responsible for the degradation, repair, and remodeling of extracellular matrix components.
MMPs play an important role in maintaining a normal physiological function and preventing
diseases, such as cancer and cardiovascular diseases. Natural products derived from plants have
been used as traditional medicine for centuries. Its active compounds, such as catechin, resveratrol
and quercetin, are suggested to play an important role as MMPs inhibitors, thereby opening new insights
into their applications in many fields, such as pharmaceutical, cosmetic, and food industries.
This review summarises the current knowledge of plant-derived natural products with MMP-modulating
activities. Most of the reviewed plant-derived products exhibit an inhibitory activity on
MMPs. Amongst MMPs, MMP-2 and MMP-9 are the most studied. The expression of MMPs is inhibited
through respective signaling pathways, such as MAPK, NF-κB and PI3 kinase pathways,
which contribute to the reduction in cancer cell behaviors, such as proliferation and migration.
Most studies have employed in vitro models, but a limited number of animal studies and clinical
trials have been conducted. Even though plant-derived products show promising results in modulating
MMPs, more in vivo studies and clinical trials are needed to support their therapeutic applications
in the future.
Development and External Validation of a Machine Learning Tool to Rule Out COVID-19 Among Adults in the Emergency Department Using Routine Blood Tests: A Large, Multicenter, Real-World Study
Authors: Plante Timothy B , Blau Aaron M , Berg Adrian N , Weinberg Aaron S , Jun Ik C , Tapson Victor F , Kanigan Tanya S , Adib Artur B
Published: November 2020

Background

Conventional diagnosis of COVID-19 with reverse transcription polymerase chain reaction (RT-PCR) testing (hereafter, PCR) is associated with prolonged time to diagnosis and significant costs to run the test. The SARS-CoV-2 virus might lead to characteristic patterns in the results of widely available, routine blood tests that could be identified with machine learning methodologies. Machine learning modalities integrating findings from these common laboratory test results might accelerate ruling out COVID-19 in emergency department patients.

Objective

We sought to develop (ie, train and internally validate with cross-validation techniques) and externally validate a machine learning model to rule out COVID 19 using only routine blood tests among adults in emergency departments.

Methods

Using clinical data from emergency departments (EDs) from 66 US hospitals before the pandemic (before the end of December 2019) or during the pandemic (March-July 2020), we included patients aged ≥20 years in the study time frame. We excluded those with missing laboratory results. Model training used 2183 PCR-confirmed cases from 43 hospitals during the pandemic; negative controls were 10,000 prepandemic patients from the same hospitals. External validation used 23 hospitals with 1020 PCR-confirmed cases and 171,734 prepandemic negative controls. The main outcome was COVID 19 status predicted using same-day routine laboratory results. Model performance was assessed with area under the receiver operating characteristic (AUROC) curve as well as sensitivity, specificity, and negative predictive value (NPV).

Results

Of 192,779 patients included in the training, external validation, and sensitivity data sets (median age decile 50 [IQR 30-60] years, 40.5% male [78,249/192,779]), AUROC for training and external validation was 0.91 (95% CI 0.90-0.92). Using a risk score cutoff of 1.0 (out of 100) in the external validation data set, the model achieved sensitivity of 95.9% and specificity of 41.7%; with a cutoff of 2.0, sensitivity was 92.6% and specificity was 59.9%. At the cutoff of 2.0, the NPVs at a prevalence of 1%, 10%, and 20% were 99.9%, 98.6%, and 97%, respectively.

Conclusions

A machine learning model developed with multicenter clinical data integrating commonly collected ED laboratory data demonstrated high rule-out accuracy for COVID-19 status, and might inform selective use of PCR-based testing.
Importance of Multiple Reinforcing Comments and Areas for Change in Optimizing Dietary and Exercise Self-Monitoring Feedback in Behavioral Weight Loss Programs: Factorial Design (Preprint)
Authors: Krukowski Rebecca , Kim Hyeonju , Stansbury Melissa , Li Qian , Sen Saunak , Farage Gregory , West Delia
Published: November 2020

BACKGROUND

Individualized dietary and physical activity self-monitoring feedback is a core element of behavioral weight loss interventions and is associated with clinically significant weight loss. To our knowledge, no studies have evaluated individuals’ perspectives on the composition of feedback messages or the effect of feedback composition on the motivation to self-monitor.

OBJECTIVE

This study aims to assess the perceptions of feedback emails as a function of the number of comments that reinforce healthy behavior and the number of areas for change (ie, behavioral changes that the individual might make to have an impact on weight) identified.

METHODS

Emailed feedback followed a factorial design with 2 factors (ie, reinforcing comments and areas for change), each with 3 levels (ie, 1, 4, or 8 comments). A total of 250 adults with overweight or obesity who were interested in weight loss were recruited from the Qualtrics research panel. Participants read 9 emails presented in a random order. For each email, respondents answered 8 questions about the likelihood to self-monitor in the future, motivation for behavioral change, and perceptions of the counselor and the email. A mixed effects ordinal logistic model was used to compute conditional odds ratios and predictive margins (ie, average predicted probability) on a 5-point Likert response scale to investigate the optimal combination level of the 2 factors.

RESULTS

Emails with more reinforcing comments or areas for change were better received, with small incremental benefits for 8 reinforcing comments or areas for change versus 4 reinforcing comments or areas for change. Interactions indicated that the best combination for 3 of 8 outcomes assessed (ie, motivation to make behavioral changes, counselor’s concern for their welfare, and the perception that the counselor likes them) was the email with 8 reinforcing comments and 4 areas for change. Emails with 4 reinforcing comments and 4 areas for change resulted in the highest average probability of individuals who reported being very likely to self-monitor in the future.

CONCLUSIONS

The study findings suggest how feedback might be optimized for efficacy. Future studies should explore whether the composition of feedback email affects actual self-monitoring performance.
Informal and Formal Peer Teaching in the Medical School Ecosystem: Perspectives From a Student-Teacher Team (Preprint)
Authors: Tong Anson Hei Ka , See Christopher
Published: November 2020

UNSTRUCTURED

These personal views, drawn from the experiences of a medical student and a medical school lecturer, advocate caution of the current trend for formal adoption of peer teaching into medical school curricula. Using a metaphor from physics, we highlight the need for cautious deeper exploration of the informal world of peer-teaching in medical schools, which is a complex part of the educational ecosystem, prior to incorporating such activities into faculty-led initiatives. We support a measured approach to the introduction of compulsory peer-teaching activities given the recognized theoretical and pedagogical benefits.
Telepsychiatry Consultation for Primary Care Treatment of Children and Adolescents Receiving Child Protective Services in Chile: Mixed Methods Feasibility Study (Preprint)
Authors: Mundt Adrian P , Irarrázaval Matías , Martínez Pablo , Fernández Olga , Martínez Vania , Rojas Graciela
Published: November 2020

BACKGROUND

Children and adolescents living under the supervision of child protective services have complex mental health care needs. The scarcity and uneven distribution of specialized mental health teams in Chile may limit the provision and quality of care for this vulnerable population. Telepsychiatry can address such health inequities.

OBJECTIVE

The objective of this study was to evaluate the feasibility of a telepsychiatry consultation program for primary health care (PHC) treatment of children and adolescents living under the supervision of child protective services.

METHODS

We developed a telepsychiatry consultation program for two rural PHC clinics located in central Chile (Valparaíso Region) and evaluated its implementation using a mixed methods study design. The program consisted of videoconferencing mental health consultation sessions scheduled twice per month (each 90 minutes long), over a 6-month period, delivered by child and adolescent psychiatrists based in Santiago, Chile. We described the number of mental health consultation sessions, participant characteristics, perceived usefulness and acceptability, and experiences with the telepsychiatry consultation program.

RESULTS

During the 6-month study period, 15 videoconferencing mental health consultation sessions were held. The telepsychiatry consultation program assisted PHC clinicians in assigning the most adequate diagnoses and making treatment decisions on pharmacotherapy and/or psychotherapy of 11 minors with complex care needs. The intervention was perceived to be useful by PHC clinicians for improving the resolution capacity in the treatments of this patient population. Limitations such as connectivity issues were resolved in most sessions.

CONCLUSIONS

The telepsychiatry consultation program was feasible and potentially useful to support PHC clinicians in the management of institutionalized children and adolescents with complex psychosocial care needs living in a poorly resourced setting. A larger scale trial should assess clinical outcomes in the patient population. Regulations and resources for this service model are needed to facilitate sustainability and large-scale implementation.
Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Wang Aiwei , Gao Yang , Wang Jingjing , Tong Tomas K , Sun Yan , Yu Siyue , Zhao Hong , Zou Daozhi , Zhang Ziheng , Qi Yuling , Zuo Nan , Bu Danran , Zhang Dexing , Xie Yaojie , Baker Julien S
Published: November 2020

BACKGROUND

Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers.

OBJECTIVE

The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population.

METHODS

The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game–based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG.

RESULTS

This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021.

CONCLUSIONS

The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability.

CLINICALTRIAL

ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/25838
Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study (Preprint)
Authors: Cohen-Mansfield Jiska , Muff Aline , Meschiany Guy , Lev-Ari Shahar
Published: November 2020

BACKGROUND

Senior centers and other types of clubs provide activities for older adults to address boredom, social isolation, and loneliness. Due to the COVID-19 pandemic, most of these activities have been cancelled. A limited range of web-based activities have been offered as alternatives. However, the effectiveness of these web-based group activities for older adults has scarcely been researched.

OBJECTIVE

We aimed to understand the extent to which web-based activities for older adults provide an adequate substitute for in-person activities.

METHODS

In this telephone survey, we interviewed 105 older adults in Israel who had been offered the opportunity to participate in web-based activities after routine activities closed due to the COVID-19 pandemic. Of the total sample, 49/105 (46.7%) participated in the activities and 56/105 (53.3%) did not. We inquired about the respondents’ background characteristics, satisfaction with the activities, and reasons for participation or nonparticipation.

RESULTS

The respondents who participated in the web-based activities tended to be highly satisfied with at least some of them. They rated the enjoyment derived from the content of the activity as the most important motivator, followed by maintaining a routine and by enjoying the group and the presence of others. Over 50% of the participants (28/49, 57%) wished to continue with the exercise programming after the end of the COVID-19 pandemic, and 41% (20/49) wished to continue with the web-based lectures. Participants were more likely to report partaking in alternative activities than nonparticipants (P=.04). The most common reasons cited by nonparticipants were being unaware of the web-based program (24/56, 43%) despite a notification having been sent to the entire sample, lack of interest in the content (18/56, 32%), and technical issues (13/56, 23%), such as not owning or being able to fully use a computer. Both participants and nonparticipants were interested in a wide range of topics, with many being very particular about the topics they wished to access. Approximately half expressed willingness to pay for access; those who were willing to pay tended to have more years of education (P=.03).

CONCLUSIONS

Our findings suggest a need for web-based activities for countering boredom and feelings of isolation. The main factors that influence the use, efficacy, and sustainability of online activities are access, motivational and need-fulfilling factors, and whether the activities are sufficiently tailored to individuals’ preferences and abilities. Challenges in substituting in-person services are promoting social relationships that are currently not sufficiently incorporated into most web-based programs, accommodating a wider range of topics, and increasing the accessibility of current programs to older adults, especially those who are homebound, both during and after the COVID-19 pandemic.
Conflicts of Interest Among Authors of Systematic Reviews and Meta-analyses Investigating Interventions for Melanoma: Cross-sectional Literature Study (Preprint)
Authors: Rulon Zane , Powers Kalyn , Anderson J Michael , Weaver Michael , Johnson Austin , Hartwell Micah , Vassar Matt
Published: November 2020

BACKGROUND

Previous studies have highlighted the potential influence that industry relationships may have on the outcomes of medical research.

OBJECTIVE

We aimed to determine the prevalence of author conflicts of interest (COIs) in systematic reviews focusing on melanoma interventions, as well as to determine whether the presence of these COIs were associated with an increased likelihood of reporting favorable results and conclusions.

METHODS

This cross-sectional study included systematic reviews with or without meta-analyses focusing on interventions for melanoma. We searched MEDLINE and Embase for eligible systematic reviews published between September 1, 2016, and June 2, 2020. COI disclosures were cross-referenced with information from the CMS (Centers for Medicare & Medicaid Services) Open Payments database, Dollars for Profs, Google Patents, the United States Patent and Trademark Office, and previously published COI disclosure statements. Results were quantified using descriptive statistics, and relationships were evaluated by Fisher exact tests.

RESULTS

Of the 23 systematic reviews included in our sample, 12 (52%) had at least one author with a COI. Of these 12 reviews, 7 (58%) reported narrative results favoring the treatment group and 9 (75%) reported conclusions favoring the treatment group. Of the 11 systematic reviews without a conflicted author, 4 (36%) reported results favoring the treatment group and 5 (45%) reported conclusions favoring the treatment group. We found no significant association between the presence of author COIs and the favorability of results (P=.53) or conclusions (P=.15).

CONCLUSIONS

Author COIs did not appear to influence the outcomes of systematic reviews regarding melanoma interventions. Clinicians and other readers of dermatology literature should be cognizant of the influence that industry may have on the nature of reported outcomes, including those from systematic reviews and meta-analyses.
Gender Differences in State Anxiety Related to Daily Function Among Older Adults During the COVID-19 Pandemic: Questionnaire Study (Preprint)
Authors: Rosenblum Sara , Cohen Elimelech Ortal
Published: November 2020

BACKGROUND

The COVID-19 pandemic poses a challenge to people’s day-to-day functioning and emotional and physical health, especially among older adults.

OBJECTIVE

The aim of this study is to analyze gender differences in state anxiety, daily functional self-actualization, and functional cognition as well as the relationships among those factors in older adults during the COVID-19 pandemic lockdown.

METHODS

We collected data on the web from a sample of 204 people (102 men and 102 women) aged 60 years and older. In addition to a demographic questionnaire, we used the State-Trait Personality Inventory to assess state anxiety, the Daily Functional Actualization questionnaire to evaluate daily functional self-actualization, and the Daily Living Questionnaire to measure functional cognition.

RESULTS

Significant gender differences were found for state anxiety (t202=−2.36, P=.02); daily functional self-actualization (t202=2.15, P=.03); and the functional cognition components: complex tasks (Z=−3.07, P=.002); cognitive symptoms that might be interfering (Z=−2.15, P=.028); executive functions (Z=−2.21, P=.024); and executive function monitoring (Z=−2.21, P=.027). Significant medium correlations were found between both state anxiety level and daily functional self-actualization (r=−0.62, P<.001) and functional cognition (r=0.37-0.40, P<.001). Gender predicted 3% of the variance in state anxiety level, while daily functional self-actualization predicted 41% and complex activities (Daily Living Questionnaire) predicted an additional 3% (F3,200=58.01, P<.001).

CONCLUSIONS

In older adults, anxiety is associated with cognitive decline, which may harm daily functional abilities and lead to social isolation, loneliness, and decreased well-being. Self-awareness and knowledge of gender differences and relationships between common available resources of daily functional self-actualization and functional cognition with anxiety may be strengthening factors in crisis periods such as the COVID-19 pandemic.
Developing a Risk Governance Framework on Radiological Emergency, Preparedness, and Response for Emergency Responders: Protocol for a Mixed Methods Study (Preprint)
Authors: Abd Rahman Anita , Abdul Manaf Rosliza , Lim Poh Ying , Suppiah Subapriya , Juni Muhammad Hanafiah
Published: November 2020

BACKGROUND

Risk governance involves processes and mechanisms to understand how risk decisions are taken and executed. This concept has gained a reputation over time as being essential for emerging comprehensive management that defines the success of an organization. While guiding documents that explain the use of risk management related to nuclear safety and security are available worldwide, few locally conducted studies have explained risk governance practices in areas where hazard usage is known, such as in radiological emergencies.

OBJECTIVE

This paper describes a protocol that was used to determine several factors that influence emergency responders’ perceptions toward radiological risk practices and visualize the risk radiological framework for emergency preparedness and response.

METHODS

A mixed methods study with a convergent design was performed. A qualitative analysis was performed using a case study approach where 6 key informants were purposely sampled for in-depth interview, and a cross-sectional study involving a self-administered questionnaire was conducted among approximately 260 emergency respondents from national regulatory, research, and services organizations. NVivo (version 12, QSR International) was used to analyze the interview transcripts and emerging themes were identified through abductive coding. Simultaneously, multiple logistic regression analysis was used to determine significant predictors that form the equation model.

RESULTS

The study is still underway. Qualitative findings were based on transcript-coding that informed the relevant thematic analysis, while statistical analyses including multiple logistic regression analysis measured the adjusted odds ratio of significant variables for the equation model. The study is expected to conclude in late 2021.

CONCLUSIONS

Important emerging themes and significant factors that are related to the emergency responders’ perceptions regarding radiological governance practices were determined through the convergent design. This potentially facilitated the development of a plausible radiological risk governance framework. Furthermore, our results will provide key insights that can be used in future studies.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/25877
Usability and Acceptance of the Embodied Conversational Agent Anne by People with Dementia and their Caregivers: an exploratory study in home environment settings (Preprint)
Authors: Stara Vera , Vera Benjamin , Bolliger Daniel , Rossi Lorena , Felici Elisa , Di Rosa Mirko , de Jong Michiel , Paolini Susy
Published: November 2020

BACKGROUND

Information and Communication Technologies are seen as tools able to support cognitive functions, monitor health and movements, provide reminders to maintain residual memory abilities and promote social support, especially among patients with dementia. Among these technologies, Embodied Conversational Agents (ECAs) are seen as screen-based entities, designed to stimulate human face-to-face conversation skills and thus allow for natural human-machine interaction. Unfortunately, the efficacy of ECA in supporting people affected by dementia and their caregivers is not yet well studied. Therefore, research in this area is essential for the entire scientific community.

OBJECTIVE

This study aims to evaluate the usability and acceptance of the ECA Anne by seniors affected with dementia. The study is also designed to assess the ability of target users to utilize the system independently and receive valuable information from it.

METHODS

A 4-week trial was conducted involving 20 older adults with dementia and 14 family caregivers in home environment settings in Italy. This study used a mixed method approach, balancing quantitative and qualitative instruments to gather data from users. Telemetry data was also collected.

RESULTS

It emerges that older users were particularly engaged in providing significant responses and participated in system improvements. Some of them clearly discussed how technical problems related to speech recognition negatively impacted on the intention to use, adaptiveness, usefulness and trust. Moreover, the usability of the system achieved an encouraging score and the half of the sample recognized a role in the ECA. This study confirms that the quality of automatic speech recognition and synthesis is still a technical issue and has room for improvement, whereas touchscreen modality is almost stable and positively used by patients with dementia.

CONCLUSIONS

This specific field of research is novel and poorly discussed in the scientific community. This could be due to its newness, yet there is an urgent need to strengthen data, research and innovation to accelerate the implementation of ECA as a future way to offer non-pharmacological support to community-dwelling persons with dementia.