bluuebunny/crossref_metadata_2025 huggingface dataset:
Reabilitação bucal com prótese obturadora maxilar após excisão de carcinoma adenoide cístico
Authors: Costa Elizabeth  Gomes da , Lima Bruno Maia de , Mata Rayane Torres da , Dias Sybilla Torres , Nichthauser Brigitte , Leal Cristiane Maria Brasil
Published: September 2021

A prótese obturadora constitui o principal método para a reabilitação de grandes defeitos maxilares. Tem como objetivo fechar o defeito, separar a cavidade oral da cavidade nasal, prevenir a fala anasalada e a regurgitação nasal de alimentos e líquidos e dar sustentação ao perfil facial. Este artigo visa relatar um caso de reabilitação com prótese obturadora maxilar após maxilectomia parcial. Paciente do gênero feminino, 72 anos, diagnosticada com carcinoma adenoide cístico na região de palato, foi submetida a maxilectomia parcial que resultou em extenso defeito maxilar e comunicação bucosinusal. Após anamnese, exames extra, intraorais e radiográfico, foi planejado para o período cicatricial e de uso da sonda nasogástrica, a confecção de uma placa obturadora para melhorar a deglutição e fala. Em seguida, confecção de uma prótese total obturadora superior e prótese parcial removível inferior. A placa obturadora foi confeccionada e utilizada até a remoção da sonda e instalação das próteses. Após moldagem das duas arcadas, foram obtidos modelos funcionais que foram montados em articulador após os ajustes dos planos de orientação e registro das relações intermaxilares. Foram realizadas provas estéticas e funcionais dos dentes artificiais e ajustes necessários. Posteriormente à acrilização, as próteses foram instaladas e o ajuste oclusal executado. Para obter retenção e estabilidade satisfatórias durante a utilização da prótese obturadora superior foi sugerido o uso de adesivo para dentadura. Três proservações foram realizadas. A prótese obturadora reabilitou a estética, fonética, função mastigatória e deglutição restabelecendo a autoestima e a ressocialização da paciente.
Malocclusion indices and their applications in public health: a review study
Authors: Moimaz Suzely Adas Saliba , Gonçalves Cláudia Silva , Chiba Fernando Yamamoto , Garbin Artênio José isper , Saliba Tânia Adas
Published: September 2021

Health indices are important to measurement of the presence and severity of diseases. The objective of this study was to perform a literature review about malocclusion indices and analyze their applications in the public health field. The research was performed by consulting Pubmed, SciELO, Web of Science, Scopus, Bireme and Embase databases, using the following terms: public health, epidemiological methods, indices, epidemiological surveys, preventive dentistry, malocclusion, and orthodontics. Publications on the development and use of malocclusion indices in clinical and epidemiological studies were included, without restrictions of methodology and language. Fifty-two indices and their variations were identified. Of these, most were intended for individual assessments and their use in public health was difficult due to the requirements for their application, including the need for specialists, plaster models analysis, complementary exams such as cephalometric radiographs and photographs, specific equipment, the need for longitudinal monitoring of cases, and exclusively objective or subjective assessments. Some malocclusion indices present positive aspects and partially evaluate physical, functional, psychological, and social conditions. However, it is still challenging to find a unanimous index that fulfills the requirements for assessing the severity, treatment need, and impact of malocclusions on the individual’s quality of life with applicability in public health.
Terapia a laser de baixa potência no tratamento de lesões periféricas do nervo trigêmio em Odontologia: revisão de literatura
Authors: Souza Ana Vitórya Alves de , Fernandes Probst Lívia , Gaetti Jardim Ellen Cristina , Leite da Silva Julio Cesar
Published: September 2021

A parestesia é um distúrbio neurossensorial decorrente de lesão nervosa que ocorre após uma intervenção odontológica e leva à perda de sensibilidade prolongada de uma região específica da face, além de outros sintomas, podendo ser resolvida espontaneamente após alguns dias ou meses, mas dependendo da extensão e tipo de lesão nervosa, este dano pode ser permanente. Com o avanço da tecnologia, os lasers vêm se popularizando na Odontologia, juntamente com os avanços em pesquisas. A terapia de fotobiomodulação com laser de baixa potência tem se mostrado como uma opção favorável ao tratamento de distúrbios neurossensoriais e aceleração do processo de reparo tecidual. Foi realizada uma revisão da literatura, a partir de buscas nas bases de dados do PubMed/MEDLINE, Biblioteca Virtual em Saúde (BVS), The Cochrane Library e Scielo, entre os anos de 2010 a 2020. O presente estudo tem como objetivo analisar a eficácia, a utilização terapêutica, e os mecanismos de ação da terapia a laser de baixa potência (LLLT), como também causas e fatores de risco relacionados aos procedimentos mais comuns de injúria nervosa. As recentes pesquisas envolvendo o uso da terapia de fotobiomodulação evidenciam a capacidade do laser em promover aceleração do processo de reparo tecidual, com fenômenos analgésicos, anti-inflamatórios, cicatrizantes e regenerativos. Embora tenha havido grandes descobertas nos últimos anos, a literatura ainda carece de protocolos e ensaios clínicos sobre o uso do laser, verificando e comprovando seus efeitos sobre lesões nervosas, devendo este ser o foco de pesquisas futuras.
Equality of admission tests using kernel equating under the non-equivalent groups with covariates design
Authors: ALTINTAŞ Özge , WALLIN Gabriel
Published: September 2021

Educational assessment tests are designed to measure the same psychological constructs over extended periods of time. This feature is important considering that test results are often used in the selection process for admittance to university programs. To ensure fair assessments, especially for those whose results weigh heavily in selection decisions, it is necessary to collect evidence demonstrating that the assessments are not biased, and to confirm that the scores obtained from different test forms have statistical equality. For this purpose, test equating has important functions, as it prevents bias generated by differences in the difficulty levels of different test forms, allows the scores obtained from different test forms to be reported on the same scale, and ensures that the reported scores communicate the same meaning. In this study, these important functions were evaluated using real college admission test data from different test administrations. The kernel equating method under the non-equivalent groups with covariates design was applied to determine whether the scores obtained from different time periods but measuring the same psychological constructs were statistically equivalent. The non-equivalent groups with covariates design was specifically used because the test groups of the admission test are non-equivalent and there are no anchor items. Results from the analyses showed that the test forms had different score distributions, and that the relationship was non-linear. The equating procedure was thus adjusted to eliminate these differences and thereby allow the tests to be used interchangeably.
Elastic photon-initiated production at the LHC: the role of hadron-hadron interactions
Authors: Harland-Lang Lucian , Khoze Valeri , Ryskin Mikhail G.
Published: September 2021

We analyse in detail the role of additional hadron–hadron
interactions in elastic photon–initiated (PI) production at the LHC,
both in pp
and heavy ion collisions. We first demonstrate that the source of
difference between our predictions and other results in the literature
for PI muon pair production is dominantly due to an unphysical cut that
is imposed in these latter results on the dimuon–hadron impact
parameter. We in addition show that this is experimentally disfavoured
by the shape of the muon kinematic distributions measured by ATLAS in
ultraperipheral PbPb collisions. We then consider the theoretical
uncertainty due to the survival probability for no additional
hadron–hadron interactions, and in particular the role this may play in
the tendency for the predicted cross sections to lie somewhat above
ATLAS data on PI muon pair production, in both
pp
and PbPb collisions. This difference is relatively mild, at the
\sim 10\%∼10%
level, and hence a very good control over the theory is clearly
required. We show that this uncertainty is very small, and it is only by
taking very extreme and rather unphysical variations in the modelling of
the survival factor that this tension can be removed. This underlines
the basic, rather model independent, point that a significant fraction
of elastic PI scattering occurs for hadron–hadron impact parameters that
are simply outside the range of QCD interactions, and hence this sets a
lower bound on the survival factor in any physically reasonable
approach. Finally, other possible origins for this discrepancy are
discussed.
Towards the renormalisation of the Standard Model effective field theory to dimension eight: Bosonic interactions I
Authors: Chala Mikael , Guedes Guilherme , Ramos Maria , Santiago Jose
Published: September 2021

We compute the one-loop renormalisation group running of the bosonic
Standard Model effective operators to order
v^4/\Lambda^4v4/Λ4,
with v\sim 246v∼246
GeV being the electroweak scale and \LambdaΛ
the unknown new physics threshold. We concentrate on the effects
triggered by pairs of the leading dimension-six interactions, namely
those that can arise at tree level in weakly-coupled ultraviolet
completions of the Standard Model. We highlight some interesting
consequences, including the interplay between positivity bounds and the
form of the anomalous dimensions; the non-renormalisation of the
SS
and UU
parameters; or the importance of radiative corrections to the Higgs
potential for the electroweak phase transition. As a byproduct of this
work, we provide a complete Green basis of operators involving only the
Higgs and derivatives at dimension-eight, comprising 13 redundant
interactions.
Impact of the COVID-19 pandemic and New Normal implementation on credit risk and profitability of Indonesian banking institutions
Authors: Wahyuni Sri , Pujiharto  , Nur Azizah Siti , Zulfikar Zulfikar
Published: September 2021

This study aims to compare the credit risk and profitability of banks in Indonesia. For this, the descriptive-quantitative method is used. The sample collection is based on the purposive sampling method. The study involved 71 Indonesian banks listed on the Indonesian Stock Exchange and Financial Services Authority, both conventional and Sharia. The research data are secondary data that include published results of quarterly financial reports of both conventional and sharia banks obtained from the website of the Financial Services Authority or the official websites of banks. The profitability of banks in making profit is measured by the Return on Assets ratio. The method of analysis used is the paired sample t-test. The results show significant differences in nonperforming loans (NPL) before and after the COVID-19 pandemic in conventional banking. However, there is no significant difference in Sharia banking. Moreover, there is no significant difference in profitability before and after the new normal implementation. This study provides empirical evidence that Indonesia’s banking restructuring policies to anticipate the impact of COVID-19 did not work optimally. The study is expected to help bank managers and the Financial Services Authority as a basis for evaluating the implementation of government policies to restructure the banking system.
Is the endowment fund a panacea for the financial autonomy of classical universities in Ukraine?
Authors: Petlenko Yulia , Stavytskyy Andriy , Kharlamova Ganna
Published: September 2021

The COVID-19 has put higher education institutions in a new situation and identified bottlenecks in the financial structure of institutions and education systems in general. However, for Ukrainian universities, this situation can be seen as an opportunity to achieve financial autonomy. This study is devoted to the consideration of a possible tool for the financial autonomy of Ukrainian classical universities, most of which are state-funded. The paper considers the methodology of a possible tool for the accumulation of external financing – the endowment fund. The case analysis and analytical consideration of world practice are applied. As a result, a model for financing the university in its transition to the innovation and entrepreneurship model is proposed as the chain “endowment fund – development of start-ups”. This example can become the basis of the road map for other national HEIs, as well as the practice of wider use in the field of higher education. However, despite most of the national classical universities have declared a course to an innovative development, which further raised the necessity of external funding, top management and general economic situation require more attention. As this transition to a new model of the university is taking place along with the financial stabilization and under economic and social upheavals, the formation of a new culture of online communication is necessary. Thus, the proposed model is the practical guideline of possible decisions but mostly the start-point for further discussion and research.
AcknowledgmentThis paper is done in the framework of the grant project “Financial stabilization of classical universities in the context of the global consequences of the COVID-19 pandemic” funded by the National Research Foundation of Ukraine “Science for Human Security and Society” (2020-2021).
Assessment on the economic damage of trading households due to urban inundation
Authors: Hung B. V. , Diep N. N.
Published: September 2021

Floods impact most of the subjects living and producing in Ho Chi Minh City (HCMC). Trading households are one of the important economic sectors in the economic development of HCMC. This sector contributes greatly to development from GDP to creating jobs and attracting a large workforce cooperating with them such as goods traffic and business services. Because the trading households are of small business scale and very diverse, they are often scattered in residential areas, along roads. They are also adversely affected and suffer economic losses due to inundation, like citizens. The determination of damage level to all objects including trading households is one of the flood management activities and the basis for infrastructure development projects as well as social support policies of the city. Through a direct survey of more than 3,419 trading households and applying the economic loss curve method, this research has established a correlative function for economic losses due to inundation with flood depth and duration. With the correlative function of flood damage for trading households, the district and city's agencies will have a new tool to assess and analyze the damage level of trading households selling in the area.
Treatment Options in Multiple Sclerosis and Neuromyelitis Optica Spectrum
Disorders
Authors: Rommer Paulus , Zettl Uwe K.
Published: September 2021

:

There are few diseases where as much therapeutic progress has been made in recent years as in multiple
sclerosis. Nine different drug classes with more than a dozen approved therapies are now available. Similarly,
there have been unimaginable advances in understanding neuromyelitis optica (now neuromyelitis optica
spectrum disorder [NMOSD]) over the past 15 years. Building on the knowledge gained, the first therapies
have been approved in recent years. In this review, we aim to present all therapies approved for the treatment of
MS or NMOSD. The different forms of application, different approval criteria and most important side effects
will be presented. This work is intended for physicians who are interested in MS and NMOSD therapies and
want to get a first overview and does not replace the respective guidelines of the regulatory authorities.
The Role of Epigenetics in the Pathogenesis and Potential Treatment of
Attention Deficit Hyperactivity Disorder
Authors: Peedicayil Jacob
Published: September 2021

:

There is increasing evidence that dsyregulated epigenetic mechanisms of gene expression are involved in the pathogenesis of attention deficit hyperactivity disorder (ADHD). This review presents a comprehensive summary of the current state of research on the role of epigenetics in the pathogenesis of ADHD. The potential role of epigenetic drugs in the treatment of ADHD is also reviewed. Several studies suggest there are epigenetic abnormalities in preclinical models of ADHD and in ADHD patients. Regarding DNA methylation many studies have reported DNA hypermethylation. There is evidence that there is increased histone deacetylation in ADHD patients. Abnormalities in the expression of microRNAs (miRNAs) in ADHD patients have also been found. Some currently used drugs for treating ADHD, in addition to their more well established mechanisms of action, have been shown to alter epigenetic mechanisms of gene expression. Clinical trials of epigenetic drugs in patients with ADHD are reporting favorable results. These data suggest that abnormal epigenetic mechanisms of gene expression may be involved in the pathogenesis of ADHD. Drugs acting on epigenetic mechanisms may be a potential new class of drugs for treating ADHD.
Dibromination of Cinnamamides with CBr4 Under Mild Conditions
Authors: Luo Zaigang , Liu Shuai , Peng Chengtong , Wang Xiuxiu , Xu Xuemei
Published: September 2021

:

A novel, mild and efficient protocol to synthesize dibrominated propanamides has been developed. The presented methodology provides several merits, such as easy-to-handle and stable brominated substrate, catalyst-free, additive free and facile experimental operation. The preliminary mechanism study indicated that a free radical pathway might be involved in the presented reaction.
In silico Repurposing of Anticancer Drug (5-Fluorouracil) as an Antibacterial Agent against Klebsiella pneumoniae
Authors: Sharma Amey , Rana Apoorva , Mangtani Lakshya , Kalra Aakanksha , Niraj Ravi Ranjan Kumar
Published: September 2021

Background:

Infections caused by drug-resistant microorganisms have been increasing
worldwide, thereby being one of the major causes of morbidity in the 21st century. Klebsiella pneumoniae
is one such bacteria causing lung inflammation, lung injury and death. The emergence of hyper-virulent
and drug-resistant species, such as ESBL and CRKP, has made this microbe a serious and urgent threat.
The pace of emergence of these species is outgrowing the development of novel drug and vaccine candidates,
thereby shifting the research focus towards the drug repurposing approach.

Objective:

The study aimed at Homology Modeling of Thymidylate Synthase, verification of modeled
structure, Molecular Docking and Molecular Dynamic Simulation of the docked complex, and finally, in
vitro analysis of 5-FU activity against Klebsiella pneumonia.

Methods:

The 3D structure of Thymidylate Synthase was predicted using the Swiss model server and
validated by in silico approaches. The protein-protein interactions were determined using the STRING
database. Molecular Docking has been carried out and MD simulations of 5-FU with the predicted structure
of thymidylate synthase have been conducted. Finally, in vitro antimicrobial drug sensitivity assay
has been carried out at different concentrations.

Result:

Hydrogen bond was observed in Molecular Docking, protein-ligand complex remained stable
during simulation, while 5-FU showed antimicrobial activity against Klebsiella pneumonia during the in
vitro study.

Conclusion:

Both in silico as well as in vitro analysis have indicated that 5-FU can potentially be developed
as an antimicrobial agent towards Klebsiella pneumonia.
Silver Nanoparticle Enhances Secretion of Exosomes in SH-SY5Y Cells:
Potential Therapeutic Strategy for Human Neuroblastoma Cancer
Authors: Gurunathan Sangiliyandi , Kim Jin-Hoi , Kang Min-Hee
Published: September 2021

Background:

Exosomes-a subset of extracellular vesicles (EVs)-are secreted by virtually
all cells, including human neuroblastoma cancer (SH-SY5Y) cells, into bodily fluids. Oxidative
stress is critically involved in exosome biogenesis and release. Silver nanoparticles (AgNPs) induce
cytotoxicity, oxidative stress, and apoptosis in cancer and non-cancer cells.

Methods:

Here, we studied whether AgNPs-induced oxidative stress could enhance exosome biogenesis
and release under low serum conditions in the presence of AgNPs. Although several studies
have reported various mechanisms that contribute to EV biogenesis and release from cells, none
exists on the involvement of external stimuli by controlling acetylcholinesterase (AChE) and neutralsphingomyelinase
(n-SMase) activities, total protein concentration of exosomes, and exosome count.

Results:

Owing to cytotoxic and oxidative stresses, AgNPs-treated cells and exosome release were
significantly facilitated, which strongly correlated with the AgNPs-induced oxidative stress. Moreover,
the expression levels of some important exosome biomarkers were found to be significant under
oxidative stress conditions. N-acetylcysteine prevented oxidative stress-induced exosome biogenesis
and release. Furthermore, we identified the involvement of the ceramide pathway in exosome functions
by inhibiting AChE and n-SMase activities, and exosome protein/counts. These data contribute
to the understanding of how AgNPs and intracellular molecular pathways affect exosome biogenesis
and release in SH-SY5Y cells.

Conclusion:

To the best of our knowledge, this is the first study showing that AgNPs stimulate
exosome biogenesis and release by inducing oxidative stress and ceramide pathways.
Gut instincts
Authors:   AOCS, Guenard Rebecca
Published: September 2021

Mucosal membranes act as a network that provides a connection between the gut and vital organs, like the lungs or the brain, but presumably the entire body. Short-chain fatty acids are formed in the colon through the fermentation of soluble fiber, and researchers are interested in finding out more about their role as signaling compounds. More research is needed to decisively say that one diet is better for the microbiome over another.
Breastfeeding and adherence to ARV treatment with mother-to-child transmission of HIV at Sosodoro Djatikoesoemo Hospital, Bojonegoro
Authors: Wulandari Endah Sri , Wiwaningtyas Ayu
Published: September 2021

Background: The HIV can be transmitted from an HIV-infected mother to her child during pregnancy, childbirth, and while breastfeeding. HIV that occurs in children is acquired because of transmission from mothers who do not comply with anti-retroviral drugs or during breastfeeding. Prevention of mother-to-child transmission of HIV is an effort aimed at preventing mother-to-child transmission in an integrated and comprehensive manner with other programs related to HIV control.

Objectives: The study aimed to determine the relationship between breastfeeding and adherence to ARV treatment with mother-to-child transmission of HIV at Sosodoro Djatikoesoemo Hospital, Bojonegoro.

Methods: The variables in the study were the independent variables of breastfeeding and adherence to ARV treatment in mothers and the dependent variable of HIV status in children under five. This type of research used a correlational analysis with a cross sectional design, with a population of 25 mothers who had babies aged 0-6 months and a sample of 25 respondents. Non-probability sampling technique, total sampling with research instruments using a questionnaire, and statistical tests using the chi-square test.

Results: The results showed the significance value of breastfeeding, namely p = 0.001, while the significance value of adherence to ARV treatment was p = 0.009. This means that in this study the most dominant influence on HIV status in toddlers is breastfeeding.

Conclusions: This study can analyze efforts to address maternal problems with HIV status to increase awareness of mothers with HIV status to keep checking both during pregnancy and after delivery to minimize transmission to their toddlers
Chemical features of rejected taro tuber flour (Colocasia esculenta L. Schott) and its effect on productive performance in post-weaning pigs
Authors: Caicedo Willan Orlando , Alves Ferreira Felipe Norberto , Pérez Quintana Manuel Lázaro , Silva Neta Clarice Speridião , Motta Ferreira Walter
Published: September 2021

This study evaluated the effect of the inclusion of rejected taro tuber flour (RTTF) on the productive performance in commercial hybrid pigs (Landrace × Duroc × Pietrain) during their post-weaning period. The experiment was established under a completely randomized design, comprising four treatments (0, 10, 20, and 30% inclusion of RTTF in the diet), using a total of 60 piglets with 15 repetitions each. The average daily feed intake (ADFI), average daily gain (ADG), feed conversion (FC), final body weight (BW), presence of diarrheas, mortality, and production cost, were determined. RTTF showed a high dry matter content, nitrogen-free extracts, gross energy, aspartic acid, glutamic acid, potassium, iron, polyphenols, and antioxidant activity. RTTF inclusion in the diet of pigs in the entire period (30-58 d) did not cause diarrhea or deaths and showed a quadratic effect on BW (p < 0.001) and ADFI (p < 0.001) and produced a linear effect on ADG (p = 0.006), FC (p = 0.003) and production cost (p < 0.001). In conclusion, the inclusion of RTTF in the diet of pigs after weaning (30-58 d) ranging between 0 and 30 % showed no effect on BW and ADFI, with a slight decrease in ADG and FC and a linear effect on production cost reduction.
The Role of Physicians in Digitalizing Health Care Provision: Web-Based Survey Study
Authors: Burmann Anja , Tischler Max , Faßbach Mira , Schneitler Sophie , Meister Sven
Published: September 2021

Background

Digitalization affects all areas of society, including the health care sector. However, the digitalization of health care provision is progressing slowly compared to other sectors. In the professional and political literature, physicians are partially portrayed as digitalization sceptics. Thus, the role of physicians in this process requires further investigation. The theory of “digital natives” suggests a lower hurdle for younger generations to engage with digital technologies.

Objective

The objective of this study was to investigate the role of physicians in the process of digitalizing health care provision in Germany and to assess the age factor.

Methods

We conducted a large-scale study to assess the role of this professional group in the progress of the digital transformation of the German health care sector. Therefore, in an anonymous online survey, we inquired about the current digital penetration of the personal working environment, expectations, attitude toward, and concerns regarding digitalization. Based on these data, we studied associations with the nominal variable age and variations across 2 age groups.

Results

The 1274 participants included in the study generally showed a high affinity towards digitalization with a mean of 3.88 on a 5-point Likert scale; 723 respondents (56.75%) stated they personally use mobile apps in their everyday working life, with a weak tendency to be associated with the respondents’ age (η=0.26). Participants saw the most noticeable existing benefits through digitalization in data quality and readability (882/1274, 69.23%) and the least in patient engagement (213/1274, 16.72%). Medical practitioners preponderantly expect further improvements through increased digitalization across almost all queried areas but the most in access to medical knowledge (1136/1274, 89.17%), treatment of orphan diseases (1016/1274, 79.75%), and medical research (1023/1274, 80.30%).

Conclusions

Respondents defined their role in the digitalization of health care provision as ambivalent: “scrutinizing” on the one hand but “active” and “open” on the other. A gap between willingness to participate and digital sovereignty was indicated. Thus, education on digitalization as a means to support health care provision should not only be included in the course of study but also in the continuing process of further and advanced training.
Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study (Preprint)
Authors: Li Ji-Bin , Feng Li-Fen , Wu Anise M S , Mai Jin-Chen , Chen Yu-Xia , Mo Phoenix K H , Lau Joseph T F
Published: September 2021

BACKGROUND

The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched.

OBJECTIVE

We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents.

METHODS

A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent–adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models.

RESULTS

The association between △SFUI and △CES-D was partially mediated by △mother–adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of –0.011 (P=.003), –0.009 (P=.003), and –0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of –0.036 (P<.001) and –0.039 (P<.001), respectively.

CONCLUSIONS

The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother–adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.
Development of Deep Learning Models for Predicting In-Hospital Mortality Using an Administrative Claims Database: Retrospective Cohort Study (Preprint)
Authors: Matsui Hiroki , Yamana Hayato , Fushimi Kiyohide , Yasunaga Hideo
Published: September 2021

BACKGROUND

Administrative claims databases have been used widely in studies because they have large sample sizes and are easily available. However, studies using administrative databases lack information on disease severity, so a risk adjustment method needs to be developed.

OBJECTIVE

We aimed to develop and validate deep learning–based prediction models for in-hospital mortality of acute care patients.

METHODS

The main model was developed using only administrative claims data (age, sex, diagnoses, and procedures on the day of admission). We also constructed disease-specific models for acute myocardial infarction, heart failure, stroke, and pneumonia using common severity indices for these diseases. Using the Japanese Diagnosis Procedure Combination data from July 2010 to March 2017, we identified 46,665,933 inpatients and divided them into derivation and validation cohorts in a ratio of 95:5. The main model was developed using a 9-layer deep neural network with 4 hidden dense layers that had 1000 nodes and were fully connected to adjacent layers. We evaluated model discrimination ability by an area under the receiver operating characteristic curve (AUC) and calibration ability by calibration plot.

RESULTS

Among the eligible patients, 2,005,035 (4.3%) died. Discrimination and calibration of the models were satisfactory. The AUC of the main model in the validation cohort was 0.954 (95% CI 0.954-0.955). The main model had higher discrimination ability than the disease-specific models.

CONCLUSIONS

Our deep learning–based model using diagnoses and procedures produced valid predictions of in-hospital mortality.
Examining How Internet Users Trust and Access Electronic Health Record Patient Portals: Survey Study (Preprint)
Authors: Yin Rong , Law Katherine , Neyens David
Published: September 2021

BACKGROUND

Electronic health record (EHR) patient portals are designed to provide medical health records to patients. Using an EHR portal is expected to contribute to positive health outcomes and facilitate patient-provider communication.

OBJECTIVE

Our objective was to examine how portal users report using their portals and the factors associated with obtaining health information from the internet. We also examined the desired portal features, factors impacting users’ trust in portals, and barriers to using portals.

METHODS

An internet-based survey study was conducted using Amazon Mechanical Turk. All the participants were adults in the United States who used patient portals. The survey included questions about how the participants used their portals, what factors acted as barriers to using their portals, and how they used and how much they trusted other web-based health information sources as well as their portals. A logistic regression model was used to examine the factors influencing the participants’ trust in their portals. Additionally, the desired features and design characteristics were identified to support the design of future portals.

RESULTS

A total of 394 participants completed the survey. Most of the participants were less than 35 years old (212/394, 53.8%), with 36.3% (143/394) aged between 35 and 55 years, and 9.9% (39/394) aged above 55 years. Women accounted for 48.5% (191/394) of the survey participants. More than 78% (307/394) of the participants reported using portals at least monthly. The most common portal features used were viewing lab results, making appointments, and paying bills. Participants reported some barriers to portal use including data security and limited access to the internet. The results of a logistic regression model used to predict the trust in their portals suggest that those comfortable using their portals (odds ratio [OR] 7.97, 95% CI 1.11-57.32) thought that their portals were easy to use (OR 7.4, 95% CI 1.12-48.84), and frequent internet users (OR 43.72, 95% CI 1.83-1046.43) were more likely to trust their portals. Participants reporting that the portals were important in managing their health (OR 28.13, 95% CI 5.31-148.85) and that their portals were a valuable part of their health care (OR 6.75, 95% CI 1.51-30.11) were also more likely to trust their portals.

CONCLUSIONS

There are several factors that impact the trust of EHR patient portal users in their portals. Designing easily usable portals and considering these factors may be the most effective approach to improving trust in patient portals. The desired features and usability of portals are critical factors that contribute to users’ trust in EHR portals.

CLINICALTRIAL
A Practical 10-Step Guide to Conducting Digital Survey Research (Preprint)
Authors: Helmer-Smith Mary , McCutcheon Tess , Mitchell Rhea , Karunananthan Sathya , Keely Erin , Liddy Clare
Published: September 2021

BACKGROUND

Background: The use of digital surveys for research in clinical settings is increasing, particularly during the COVID-19 pandemic when much data collection planned to be done in-person is now occurring digitally. Successfully preparing and conducting a digital survey can be challenging for even the most experienced researcher, given the number of platforms available to choose from, intricacies of designing an effective and user-friendly tool, and factors affecting participant response rates.

OBJECTIVE

Objective: In this article, we present a practical, step-by-step guide to conduct digital survey research.

METHODS

Methods: Over time, our clinician-led research team has developed a standard process and tools for conducting digital survey research, which we have synthesized into a single resource accessible to all team members. Specific considerations and recommendations unique to digital surveys are included.

RESULTS

Results: The step-by-step guide has been used successfully by our team to design and carry out high-quality survey research. It can guide the novice or experienced researcher from protocol development through to data collection and knowledge dissemination.

CONCLUSIONS

Conclusion: We present a practical guide for digital survey research, based on the experience of a clinician-led research team. Researchers, trainees, students, and others conducting health research may find our process and resources helpful to inform their work. Communication templates and tools are provided (see Appendices).
Harnessing Neuroplasticity to Promote Brain Health in Aging Adults: Protocol for the MOVE-Cog Intervention Study (Preprint)
Authors: Cabral Danylo F , Hinchman Carrie A , Nunez Christina , Rice Jordyn , Loewenstein David A , Cahalin Lawrence P , Rundek Tatjana , Pascual-Leone Alvaro , Gomes-Osman Joyce
Published: September 2021

BACKGROUND

Extensive evidence supports a link between aerobic exercise and cognitive improvements in aging adults. A major limitation with existing research is the high variability in cognitive response to exercise. Our incomplete understanding of the mechanisms that influence this variability and the low adherence to exercise are critical knowledge gaps and major barriers for the systematic implementation of exercise for promoting cognitive health in aging.

OBJECTIVE

We aimed to provide an in-person and remotely delivered intervention study protocol with the main goal of informing the knowledge gap on the mechanistic action of exercise on the brain by characterizing important mechanisms of neuroplasticity, cardiorespiratory fitness response, and genetics proposed to underlie cognitive response to exercise.

METHODS

This is an open-label, 2-month, interventional study protocol in neurologically healthy sedentary adults. This study was delivered fully in-person and in remote options. Participants underwent a total of 30 sessions, including the screening session, 3 pretest (baseline) assessments, 24 moderate-to-vigorous aerobic exercise sessions, and 3 posttest assessments. We recruited participants aged 55 years and above, sedentary, and cognitively healthy. Primary outcomes were neuroplasticity, cognitive function, and cardiorespiratory fitness. Secondary outcomes included genetic factors, endothelium function, functional mobility and postural control, exercise questionnaires, depression, and sleep. We also explored study feasibility, exercise adherence, technology adaptability, and compliance of both in-person and remote protocols.

RESULTS

The recruitment phase and data collection of this study have concluded. Results are expected to be published by the end of 2021 or in early 2022.

CONCLUSIONS

The data generated in these studies will introduce tangible parameters to guide the development of personalized exercise prescription models for maximal cognitive benefit in aging adults. Successful completion of the specific aims will enable researchers to acquire the appropriate expertise to design and conduct studies by testing personalized exercise interventions in person and remotely delivered, likely to be more effective at promoting cognitive health in aging adults.

CLINICALTRIAL

ClinicalTrials.gov NCT03804528; http://clinicaltrials.gov/ct2/show/NCT03804528

INTERNATIONAL REGISTERED REPORT

RR1-10.2196/33589
OptimalMe Intervention for Healthy Preconception, Pregnancy, and Postpartum Lifestyles: Protocol for a Randomized Controlled Implementation Effectiveness Feasibility Trial (Preprint)
Authors: Harrison Cheryce L , Brammall Bonnie R , Garad Rhonda , Teede Helena
Published: September 2021

BACKGROUND

Reproductive-aged women are a high-risk population group for accelerated weight gain and obesity development, with pregnancy recognized as a critical contributory life-phase. Healthy lifestyle interventions during the antenatal period improve maternal and infant health outcomes, yet translation and implementation of such interventions into real-world health care settings remains limited.

OBJECTIVE

We aim to generate key implementation learnings to inform the feasibility of future scale up and determine the effectiveness of intervention delivery methods on engagement, experience, acceptability, knowledge, risk perception, health literacy, and modifiable weight-related health behaviors in women during preconception, pregnancy, and postpartum periods.

METHODS

This randomized hybrid implementation effectiveness study will evaluate the penetration, reach, feasibility, acceptability, adoption, and fidelity of a healthy lifestyle intervention (OptimalMe) implemented into, and in partnership with, private health care. Individual health outcomes associated with implementation delivery mode, including knowledge, risk perception, health literacy, self-management, and health behaviors, are secondary outcomes. A total of 300 women aged 18 to 44 years, who are not pregnant but wish to conceive within the next 12 months, and with access to the internet will be recruited. All participants will receive the same digital lifestyle intervention, OptimalMe, which is supported by health coaching and text messages during preconception, pregnancy, and postpartum periods. We will use a parallel 2-arm design to compare telephone with videoconference remote delivery methods for health coaching. Methods are theoretically underpinned by the Consolidated Framework for Implementation Research and outcomes based on the Reach, Engagement, Adaptation, Implementation and Maintenance framework.

RESULTS

The study was approved on August 16, 2019 and has been registered. Recruitment commenced in July 2020, and data collection is ongoing. Results are expected to be published in 2022.

CONCLUSIONS

The study’s design aligns with best practice implementation research. Results will inform translation of evidence from randomized controlled trials on healthy lifestyle interventions into practice targeting women across preconception, pregnancy, and postpartum periods. Learnings will target consumers, program facilitators, health professionals, services, and policy makers to inform future scale up to ultimately benefit the health of women across these life-phases.

CLINICALTRIAL

Australian and New Zealand Clinical Trial Registry ACTRN12620001053910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378243&isReview=true

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/33625
A Novel Risk and Crisis Communication Platform to Bridge the Gap Between Policy Makers and the Public in the Context of the COVID-19 Crisis (PubliCo): Protocol for a Mixed Methods Study (Preprint)
Authors: Spitale Giovanni , Merten Sonja , Jafflin Kristen , Schwind Bettina , Kaiser-Grolimund Andrea , Biller-Andorno Nikola
Published: September 2021

BACKGROUND

Since the end of 2019, COVID-19 has had a significant impact on people around the globe. As governments institute more restrictive measures, public adherence could decrease and discontent may grow. Providing high-quality information and countering fake news are important. However, we also need feedback loops so that government officials can refine preventive measures and communication strategies. Policy makers need information—preferably based on real-time data—on people’s cognitive, emotional, and behavioral reactions to public health messages and restrictive measures. PubliCo aims to foster effective and tailored risk and crisis communication as well as provide an assessment of the risks and benefits of prevention and control measures, since their effectiveness depends on public trust and cooperation.

OBJECTIVE

Our project aims to develop a tool that helps tackle the COVID-19 infodemic, with a focus on enabling a nuanced and in-depth understanding of public perception. The project adopts a transdisciplinary multistakeholder approach, including participatory citizen science.

METHODS

We aim to combine a literature and media review and analysis as well as empirical research using mixed methods, including an online survey and diary-based research, both of which are ongoing and continuously updated. Building on real-time data and continuous data collection, our research results will be highly adaptable to the evolving situation.

RESULTS

As of September 2021, two-thirds of the proposed tool is operational. The current development cycles are focusing on analytics, user experience, and interface refinement. We have collected a total of 473 responses through PubliCo Survey and 22 diaries through PubliCo Diaries.

CONCLUSIONS

Pilot data show that PubliCo is a promising and efficient concept for bidirectional risk and crisis communication in the context of public health crises. Further data are needed to assess its function at a larger scale or in the context of an issue other than COVID-19.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/33653
Digital Technology In Psychiatry: Expectations, Barriers And Understanding Of Clinicians (Preprint)
Authors: Sterling William Andrew , Sobolev Michael , Van Meter Anna , Guinart Daniel , Birnbaum Michael , Rubio Jose M , Kane John M
Published: September 2021

BACKGROUND

Digital technology has the potential to transform psychiatry, but adoption has been limited. The proliferation of telepsychiatry during COVID increases urgency of optimizing technology for clinical practice. Understanding clinician attitudes and preferences is crucial to effective implementation and patient benefit.

OBJECTIVE

Our objective was to elicit clinician perspectives on emerging digital technology.

METHODS

Clinicians in a large psychiatry department (inpatient and outpatient) were invited to complete an online survey about their attitudes towards digital technology in practice, focusing on implementation, clinical benefits, and expectations about patients’ attitudes. The survey consisted of 23 questions that could be answered on either a 3-point or 5-point Likert scale. We report frequencies and percentages of responses.

RESULTS

139 clinicians completed the survey. They represented a variety of years-experience, credentials and diagnostic sub-specialties (response rate of 69.5%). Eighty-three percent (n=116) stated that digital data could improve their practice. Twenty-three percent of responders reported that they had viewed patients’ profiles on social media (n=32). Among anticipated benefits, clinicians rated symptom self-tracking (n=101, 72.7%) as well as clinical intervention support (n=90, 64.7%) as most promising. Among anticipated challenges, clinicians mostly expressed concerns over greater time demand (n=123, 88.5%) and whether digital data would be actionable (n=107, 77%). Ninety-five percent (n=132) of clinicians expected their patients to share digital data.

CONCLUSIONS

Overall, clinicians reported a positive attitude toward the use of digital data to improve patient outcomes but also highlight significant barriers that implementation need to overcome. Although clinicians’ self-reported attitudes about digital technology may not necessarily translate into behavior, results suggest that technologies that reduce clinician burden and are easily interpretable have the greatest likelihood of uptake.