bluuebunny/crossref_metadata_2025 huggingface dataset:
Fate, occurrence, and removal of estrogens in livestock wastewaters
Authors: Gomes Fernanda Bento Rosa , Fernandes Pedro Antônio Alves , Bottrel Sue Ellen Costa , Brandt Emanuel Manfred Freire , Pereira Renata de Oliveira
Published: August 2022

During the last decades, livestock and animal feeding operations have been expanded. In parallel, these activities are among the major sources of estrogens in the environment. Thus, considering the environmental and health risks associated with estrogenic compounds, this work reviews the fate, occurrence, and removal of free and conjugated E1, E2, and E3 in livestock wastewaters. A systematic literature review was carried out, and after applying the eligibility criteria, 66 peer-reviewed papers were selected. Results suggest high estrogen concentrations and, consequently, high estrogenic activity, especially in samples from swine farming. E1 and E2 are frequently found in wastewaters from bovine, swine, and other livestock effluents. Aerobic treatment processes were more efficient for estrogen removal, whereas anaerobic systems seem poorly effective. Removal efficiencies of estrogens and estrogenic activity of up to 90% were reported for constructed wetlands, advanced pond systems, trickling filters, membrane bioreactors, aerated and nitrifying reactors, combined air flotation, and vegetable oil capture processes. High concentrations found in wastewaters from livestock allied to the removal efficiencies reported for anaerobic processes (usually used to treat livestock wastewaters) evidence the importance of monitoring these compounds in environmental matrices.
Eficacia de una intervención educativa sobre conocimiento, control y prevención de tuberculosis en personal de salud del Callao.
Authors: Gonzales Gonzalez Gabby , Ayala Mendívil Ronald Espíritu
Published: August 2022

Objetivo: Determinar la eficacia de una intervención educativa sobre el nivel de conocimiento del Control y Prevención de la Tuberculosis en el personal del Centro de Salud Carmen de la Legua, 2021. Materiales y métodos: Investigación experimental (Pre prueba – Post prueba), prospectivo longitudinal, con instrumento de prueba de nivel de conocimiento y prevención de tuberculosis. A los 56 participantes, que son la población total del Centro de Salud Carmen de la Legua, primero se les aplicó el consentimiento informado, luego el instrumento de prueba (Pre Test) posteriormente se realizó la intervención educativa, al término, se aplicó el mismo instrumento de prueba (Post test). Resultados: Previo al inicio de la intervención educativa, las calificaciones del Pre Test, señalan que el 64,3% tuvo una mala calificación (0 a 6 puntos), el 35,7% regular (7 a 13 puntos), ningún tuvo buena calificación (14 a 20 puntos); posteriormente, las calificaciones del Post Test, no hubieron malas calificaciones, el 16,1% fue regular y el 83,9% buena calificación, aplicando la prueba de normalidad se obtuvo que p-valor 0.020<0.05, esto indica que no hay índice de normalidad. Se aplicó la prueba de rangos de Wilcoxon (Z(cal) 4.602 > 1.906 Z1- α/2 Z(cal). Conclusiones: Se determinó que la aplicación de la intervención educativa realizada fue eficaz sobre el nivel de conocimiento en el Control y Prevención de la Tuberculosis en el personal del Centro de Salud Carmen de la Legua del Callao.
Estrategias de marketing digital en la empresa CORPIEL S.A.C. – Lima, 2022
Authors: Seminario Unzueta Randall Jesús , Gabino Andrade Mayli Patricia , Huayama Abad Anabel
Published: August 2022

Objetivo: Determinar las estrategias de marketing digital en el área comercial de la empresa CORPIEL S.A.C – Lima, 2022. Materiales y métodos: El estudio es de enfoque cuantitativo, tipo aplicada, su diseño es no experimental, correlacional y de corte transversal, contando con una población de 300 clientes que visitarán la tienda CORPIEL S.A.C, la técnica de recolección de datos fue la encuesta y el instrumento de recolección de datos fue un cuestionario, comprendido por 24 ítems agrupados en 4 dimensiones. Resultados: La estrategia de marketing digital relacionadas en función del contenido se encuentra en nivel muy alto con 65%, en función a los consumidores se encuentra en un nivel muy alto con 68%, en función a la conexión un 67% con nivel muy alto y en función a la comunidad se encuentra en un nivel muy alto con 70%. Conclusiones: En cuanto a la estrategia de marketing digital relacionado al contenido se tiene que trabajar para que los clientes encuentren una información clara y precisa de los productos y el servicio que le brindamos presencial y online.
Actitudes hacia la investigación en estudiantes de enfermería de una universidad privada de Lima Norte
Authors: Colquehuanca Huamani Lumy Denisse
Published: August 2022

Objetivo: Determinar las actitudes hacia la investigación en estudiantes de enfermería de una Universidad Privada de Lima Norte.

Materiales y métodos: El estudio es de enfoque cuantitativo, decriptivo y transversal. Se contó con una población de 140 estudiantes de enfermería de la Universidad de Ciencias y Humanidades. La técnica de recolección de datos fue la encuesta y el instrumento utilizado fue la escala de actitudes hacia la investigación desarrollado por Papanastasiou.

Resultados: En cuanto a las actitudes hacia la investigación predomino el medianamente favorable con 77,5% (n=104), seguido del nivel favorable con 18,9% (n=30) y finalmente el desfavorable con 3,6% (n=6), entre sus dimensiones más afectadas fueron la dificultad de investigación con 25,0% (n=35) y ansiedad de investigación con 14,3% (n=20).

Conclusiones: En las actitudes hacia la investigación predomino el medianamente favorable y sus dimensiones más afectadas fueron la dificultad de investigación y la ansiedad de investigación.
La multimodalidad en el material didáctico de ELE: una perspectiva práctica
Authors:   Pontificia Universidad Católica de Valparaíso, Soliman Maha
Published: August 2022

Ante la ausencia de trabajos previos que abordan los elementos multisemióticos en el material didáctico de los cursos de español como lengua extranjera (ELE), en este trabajo se pretende ofrecer una imagen completa sobre el uso del elemento multimodal en los textos didácticos. En este orden de ideas, el presente trabajo tiene como objetivo determinar los sistemas semióticos que conforman los textos de cuatro cursos que se dictan en el contexto de un programa de intercambio estudiantil en la V Región en Chile especializado en la enseñanza de español como lengua extranjera. Para lograr este objetivo se adopta un enfoque cualitativo con alcance descriptivo y exploratorio y se realiza un análisis de los artefactos multimodales que conforman 64 textos de cursos de Historia y Literatura. El análisis de materiales se complementa con entrevistas semiestructuradas con los cuatro docentes a cargo de los cursos de ambas disciplinas en donde se profundiza sobre las razones de ausencia o presencia de la multimodalidad en este material. Los datos se interpretan mediante un análisis de contenido realizado en el programa Nvivo 12. Los resultados del análisis muestran una predominancia del sistema semiótico verbal en el material didáctico que se debe a descartarlos por parte del profesorado.
Bosques: Más allá de la madera
Authors: Arce Rodrigo
Published: August 2022

El presente artículo tiene como propósito reflexionar sobre las implicancias del reconocimiento del valor intrínseco de la vida en los bosques y para tal efecto se plantea una visión forestal más allá de la madera; se toma como referencia los aportes de filósofo colombiano Carlos Maldonado y se complementa con los aportes del proceso “Hacia una nueva Política Forestal para el Perú” en la que el autor actuó como sistematizador. Se encuentra que la denominación de recursos forestales obedece a una concepción economicista sustentada por una forma disyuntiva de relación humana con los bosques. Las corrientes de conservación de la naturaleza indican que hay un giro biocéntri­co que supera la ética antropocéntrica que ha primado a la fecha. De ahí la necesidad de ampliar la concepción forestal reducida a la madera. De la reflexión se concluye que la incorporación de una visión ampliada de las ciencias forestales incluye el reconocimiento del valor de la vida no humana en los bosques, un proceso novedoso y transformador acorde con la evolución del entendimiento de las relaciones entre la naturaleza (los bosques) y los seres humanos. El mantenimiento, de un lado, de unas ciencias forestales con fuerte carácter reduccionista, disyuntivo, mecanicista, deter­minista, y de otro lado el sesgo maderero, ha privado un mayor desarrollo en otros importantes campos del bienestar humano y la seguridad humana, en sintonía con el avance del reconocimien­to de los derechos de la naturaleza, de los derechos de los animales y el reconocimiento de la sen­sibilidad e inteligencia en las plantas.
Fitosociología del bosque de galería del río Conceição en el Ecomuseo del Cerrado, Goiás (Brasil)
Authors: Imaña-Encinas José , Antunes Santana Otacilio , Riesco Muñoz Guillermo
Published: August 2022

El Cerrado es un vasto bioma (1,8 millones de km²) de gran riqueza y heterogeneidad, siendo además uno de los ecosistemas más amenazados del mundo. Su conservación depende de estu­dios que orienten una gestión racional. Dentro del Cerrado, el bosque de galería tiene gran valor ambiental y extensión pero está muy degradado. Se procedió a la medición del diámetro normal y a la identificación botánica del arbolado vivo en dos parcelas de muestreo (2000 m2) de bosque de galería en un área protegida del Cerrado. Se censaron 279 árboles, de 32 familias, 46 géneros y 54 especies. El 30% de las especies pertenecían solo a tres familias (Rubiaceae, Chrysobalana­ceae y Myrtaceae). El índice de diversidad de Shannon-Wiener (H’ = 3,09 nats/ind.) fue inferior a otras referencias y la distribución de los ejemplares por especies fue relativamente homogénea (ecuabilidad igual a 0,77). Nueve especies acumulaban el 52% del índice de valor de abundancia (IVI) total, destacando Hirtella gracilipes y Licania apetala, que sumaban más del 35% de los indi­viduos. El área basal (27 m²/ha), densidad (1395 ind./ha) y diámetro medio cuadrático (15,8 cm) fueron similares o inferiores a los citados para otros bosques de galería brasileños. La distribución diamétrica total era decreciente, con diámetros normales generalmente inferiores a 20 cm. Se trata de una comunidad joven y con capacidad de regeneración natural, aunque apenas se encontraron distribuciones diamétricas decrecientes por especie. Se esperan cambios por reducción de la presencia de especies con regeneración insuficiente (Calophyllum brasiliense, Guettarda viburnoides, Sclerolobium paniculatum y Xylopia emarginata).
Kualitas Hidup Masyarakat Desa Wisata Adat Ngadas Kecamatan Poncokusumo Kabupaten Malang
Authors:   Jurusan Perencanaan Wilayah dan Kota, Fakultas Teknik, Universitas Brawijaya, Santosa Satria Arif , Dinanti Dian , Sari Nindya
Published: August 2022

Desa Wisata Adat Ngadas merupakan salah satu desa wisata berlokasi di Kecamatan Poncokusumo Kabupaten Malang. Keanekaragaman bentang alam dan tempat bermukimnya suku Tengger yang memegang teguh adat dan tradisi yang menjadikan daya tarik wisata Desa Ngadas. Seiring berjalanannya waktu wisatawan berkunjung semakin meningkat, hal ini memberikan pengaruh terhadap kualitas hidup masyarakat setempat. Tujuan dari penelitian ini adalah mengetahui tingkat kualitas hidup berdasarkan persepsi masyarakat dan identifikasi faktor yang memiliki pengaruh signifikan terhadap kualitas hidup. Metode analisis yang digunakan adalah statistik deskriptif dan analisis faktor konfimatori (CFA). Berdasarkan hasil analisis statistik desripitf dapat diketahui kualitas hidup masyarakat bernilai 3,63 dengan kategori sedang serta faktor yang mempengaruhi kualitas hidup masyarakat adalah material well-being dan health and safety well-being.
Tingkat Perubahan Bangunan Hindia Belanda di Kawasan Cagar Budaya Kotabaru, Kota Yogyakarta
Authors:   Jurusan Perencanaan Wilayah dan Kota, Fakultas Teknik, Universitas Brawijaya, Fauzia Vionna Ariella , Kurniawan Eddi Basuki , Wijaya I Nyoman Suluh
Published: August 2022

Kota Yogyakarta merupakan kota pusaka yang memiliki enam kawasan cagar budaya. Pemerintah Daerah Istimewa Yogyakarta melalui Keputusan Gubernur Daerah Istimewa Yogyakarta 186/KEP/2011 tentang Penetapan Cagar Budaya menetapkan kawasan cagar budaya yang salah satunya adalah Kawasan Cagar Budaya Kotabaru. Kawasan Cagar Budaya Kotabaru memiliki karakteristik kawasan yang menerapkan konsep garden city dengan langgam bangunan kolonial dan indis serta memiliki pola radial konsentris. Seiring dengan perkembangan zaman, Kawasan Cagar Budaya Kotabaru yang semula difungsikan untuk permukiman berubah menjadi zona perdagangan dan jasa serta zona perkantoran. Perubahan fungsi bangunan ini menyebabkan pengelola/pemilik bangunan memiliki peluang untuk merubah fasad bangunan hindia belanda yang disesuaikan dengan tren yang lebih modern. Lebih dari 40% bangunan hindia belanda di Kawasan Cagar Budaya Kotabaru mengalami perubahan dan masih terus berlangsung. Penelitian ini bertujuan untuk mengidentifikasi tipologi bangunan hindia belanda dan mengetahui tingkat perubahan bangunan hindia belanda di Kawasan Cagar Budaya Kotabaru. Data penelitian diperoleh dari observasi dan wawancara yang akan diolah menggunakan architectural micro analysis dan analisis tingkat perubahan bangunan. Hasil penelitian menunjukkan bahwa tingkat perubahan elemen bangunan memiliki rata-rata tingkat perubahan yang kecil dan bahkan tidak ada perubahan.
Nurses’ stress, anxiety, depression, and burnout in the workplace: A correlational study
Authors:   College of Nursing and Graduate Studies, Angeles University Foundation, Angeles, Philippines, et al. Feliciano
Published: August 2022

Nursing burnout has been linked to stress, anxiety, and depression. Increased stress and anxiety have been closely related to burnout. This study's major goal has been to determine the association of these variables in the context of nursing practice. This descriptive correlational study aimed at determining the relationship between stress, anxiety, and depression with burnout among the 307 purposive nurse samples from participating government and private hospitals in Manila, Pampanga, and Tarlac, Philippines collected between March and June 2020 using a 21-item Depression Anxiety Stress Scale (DASS-21) and a 16-item Oldenburg Burnout Inventory (OLBI) instruments. Mostly with a normal level of stress, anxiety, and depression, the nurses had been also found to have a moderate level of overall burnout and were moderately disengaged, and exhausted. Using IBM SPSS v.26, the study utilized Pearson product-moment correlation which found that nurses’ stress had significant relationships (p=.000) with burnout, disengagement, and exhaustion; anxiety to burnout, disengagement, and exhaustion; and depression with burnout, disengagement, and exhaustion. The degree of stress, anxiety, and depression has significantly shown direct correspondence which calls for a deeper examination of sources and factors. Nurses' experience of burnout is associated with the service-oriented features of the profession. The emphasis is on the need for treatments to guarantee that burnout does not lead to higher staff turnover, degraded health care, decreased productivity, and decreased professional fulfillment. A systems approach to burnout prevention and treatment should investigate the relevant factors that are addressed in the organizational, group, and individual efforts. This study offers a remarkable hypothetical underpinning for nurses' ability to handle stressful workplace situations with resilience and professionalism.
Assessing the Generalizability of Deep Learning Models Trained on Standardized and Nonstandardized Images and Their Performance Against Teledermatologists: Retrospective Comparative Study
Authors: Oloruntoba Ayooluwatomiwa I , Vestergaard Tine , Nguyen Toan D , Yu Zhen , Sashindranath Maithili , Betz-Stablein Brigid , Soyer H Peter , Ge Zongyuan , Mar Victoria
Published: August 2022

Background

Convolutional neural networks (CNNs) are a type of artificial intelligence that shows promise as a diagnostic aid for skin cancer. However, the majority are trained using retrospective image data sets with varying image capture standardization.

Objective

The aim of our study was to use CNN models with the same architecture—trained on image sets acquired with either the same image capture device and technique (standardized) or with varied devices and capture techniques (nonstandardized)—and test variability in performance when classifying skin cancer images in different populations.

Methods

In all, 3 CNNs with the same architecture were trained. CNN nonstandardized (CNN-NS) was trained on 25,331 images taken from the International Skin Imaging Collaboration (ISIC) using different image capture devices. CNN standardized (CNN-S) was trained on 177,475 MoleMap images taken with the same capture device, and CNN standardized number 2 (CNN-S2) was trained on a subset of 25,331 standardized MoleMap images (matched for number and classes of training images to CNN-NS). These 3 models were then tested on 3 external test sets: 569 Danish images, the publicly available ISIC 2020 data set consisting of 33,126 images, and The University of Queensland (UQ) data set of 422 images. Primary outcome measures were sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Teledermatology assessments available for the Danish data set were used to determine model performance compared to teledermatologists.

Results

When tested on the 569 Danish images, CNN-S achieved an AUROC of 0.861 (95% CI 0.830-0.889) and CNN-S2 achieved an AUROC of 0.831 (95% CI 0.798-0.861; standardized models), with both outperforming CNN-NS (nonstandardized model; P=.001 and P=.009, respectively), which achieved an AUROC of 0.759 (95% CI 0.722-0.794). When tested on 2 additional data sets (ISIC 2020 and UQ), CNN-S (P<.001 and P<.001, respectively) and CNN-S2 (P=.08 and P=.35, respectively) still outperformed CNN-NS. When the CNNs were matched to the mean sensitivity and specificity of the teledermatologists on the Danish data set, the models’ resultant sensitivities and specificities were surpassed by the teledermatologists. However, when compared to CNN-S, the differences were not statistically significant (sensitivity: P=.10; specificity: P=.053). Performance across all CNN models as well as teledermatologists was influenced by image quality.

Conclusions

CNNs trained on standardized images had improved performance and, therefore, greater generalizability in skin cancer classification when applied to unseen data sets. This finding is an important consideration for future algorithm development, regulation, and approval.
The Apple Watch for Monitoring Mental Health–Related Physiological Symptoms: Literature Review
Authors: Lui Gough Yumu , Loughnane Dervla , Polley Caitlin , Jayarathna Titus , Breen Paul P
Published: August 2022

Background

An anticipated surge in mental health service demand related to COVID-19 has motivated the use of novel methods of care to meet demand, given workforce limitations. Digital health technologies in the form of self-tracking technology have been identified as a potential avenue, provided sufficient evidence exists to support their effectiveness in mental health contexts.

Objective

This literature review aims to identify current and potential physiological or physiologically related monitoring capabilities of the Apple Watch relevant to mental health monitoring and examine the accuracy and validation status of these measures and their implications for mental health treatment.

Methods

A literature review was conducted from June 2021 to July 2021 of both published and gray literature pertaining to the Apple Watch, mental health, and physiology. The literature review identified studies validating the sensor capabilities of the Apple Watch.

Results

A total of 5583 paper titles were identified, with 115 (2.06%) reviewed in full. Of these 115 papers, 19 (16.5%) were related to Apple Watch validation or comparison studies. Most studies showed that the Apple Watch could measure heart rate acceptably with increased errors in case of movement. Accurate energy expenditure measurements are difficult for most wearables, with the Apple Watch generally providing the best results compared with peers, despite overestimation. Heart rate variability measurements were found to have gaps in data but were able to detect mild mental stress. Activity monitoring with step counting showed good agreement, although wheelchair use was found to be prone to overestimation and poor performance on overground tasks. Atrial fibrillation detection showed mixed results, in part because of a high inconclusive result rate, but may be useful for ongoing monitoring. No studies recorded validation of the Sleep app feature; however, accelerometer-based sleep monitoring showed high accuracy and sensitivity in detecting sleep.

Conclusions

The results are encouraging regarding the application of the Apple Watch in mental health, particularly as heart rate variability is a key indicator of changes in both physical and emotional states. Particular benefits may be derived through avoidance of recall bias and collection of supporting ecological context data. However, a lack of methodologically robust and replicated evidence of user benefit, a supportive health economic analysis, and concerns about personal health information remain key factors that must be addressed to enable broader uptake.
Using the Positive Peers Mobile App to Improve Clinical Outcomes for Young People With HIV: Prospective Observational Cohort Comparison
Authors: Step Mary M , McMillen Smith Jennifer , Lewis Steven A , Avery Ann K
Published: August 2022

Background

Disparities in HIV outcomes persist among racial, gender, and sexual minorities in the United States. Younger people face a greater risk of contracting HIV, often living without knowledge of their HIV status for long periods. The Positive Peers App (PPA) is a multifunctional HIV support tool designed to improve HIV-related clinical outcomes for young people with HIV. The app was designed according to the specifications of an in-care young adult HIV community in Northeast Ohio. Data provided in this study provide preliminary evidence of the usefulness of PPA as a relevant tool for engaging this clinical patient population in care and facilitating viral suppression.

Objective

In this study, we aimed to describe variations in PPA use and examine the associations between use and HIV clinical outcomes between self-selected user and nonuser cohorts in the same clinical population.

Methods

The PPA was offered free of charge to persons with HIV, aged 13 to 34 years of age, diagnosed with HIV within the last 12 months, out of care for 6 months during the last 24 months, or not virally suppressed (HIV viral load >200 copies/mL) in the prior 24 months. Baseline and 6- and 12-month surveys were administered via an audio computer-assisted self-interviewing system to all participants. The app’s user activity was tracked natively by the app and stored in a secure server. Participant demographic and HIV care data were extracted from clinical records within 12 months before the start of the study and across the duration of the study period. HIV care outcomes of PPA users (n=114) were compared with those of nonusers (n=145) at the end of the study period (n=259).

Results

The analysis showed that younger PPA users (aged 13-24 years) were more likely to obtain HIV laboratories (adjusted odds ratio 2.85, 95% CI 1.03-7.90) and achieve sustained viral suppression than nonusers (adjusted odds ratio 4.2, 95% CI 1.2-13.9).

Conclusions

The PPA appears to help younger users sustain HIV suppression. The app offers an important tool for addressing this critical population. The PPA remains in the field and is currently being adopted by other localities to facilitate their efforts to end the HIV epidemic. Although our reported observational results require additional validation and stringent ongoing surveillance, the results represent our best efforts in a pilot study to provide a measure of efficacy for the PPA. Next steps include a large-scale evaluation of the PPA acceptability and effectiveness. Given the building evidence of user reports and outcomes, the freely available PPA could be a helpful tool for achieving Ending the HIV Epidemic goals.
Real-world Implementation of an eHealth System Based on Artificial Intelligence Designed to Predict and Reduce Emergency Department Visits by Older Adults: Pragmatic Trial
Authors: Belmin Joël , Villani Patrick , Gay Mathias , Fabries Stéphane , Havreng-Théry Charlotte , Malvoisin Stéphanie , Denis Fabrice , Veyron Jacques-Henri
Published: August 2022

Background

Frail older people use emergency services extensively, and digital systems that monitor health remotely could be useful in reducing these visits by earlier detection of worsening health conditions.

Objective

We aimed to implement a system that produces alerts when the machine learning algorithm identifies a short-term risk for an emergency department (ED) visit and examine health interventions delivered after these alerts and users’ experience. This study highlights the feasibility of the general system and its performance in reducing ED visits. It also evaluates the accuracy of alerts’ prediction.

Methods

An uncontrolled multicenter trial was conducted in community-dwelling older adults receiving assistance from home aides (HAs). We implemented an eHealth system that produces an alert for a high risk of ED visits. After each home visit, the HAs completed a questionnaire on participants’ functional status, using a smartphone app, and the information was processed in real time by a previously developed machine learning algorithm that identifies patients at risk of an ED visit within 14 days. In case of risk, the eHealth system alerted a coordinating nurse who could then inform the family carer and the patient’s nurses or general practitioner. The primary outcomes were the rate of ED visits and the number of deaths after alert-triggered health interventions (ATHIs) and users’ experience with the eHealth system; the secondary outcome was the accuracy of the eHealth system in predicting ED visits.

Results

We included 206 patients (mean age 85, SD 8 years; 161/206, 78% women) who received aid from 109 HAs, and the mean follow-up period was 10 months. The HAs monitored 2656 visits, which resulted in 405 alerts. Two ED visits were recorded following 131 alerts with an ATHI (2/131, 1.5%), whereas 36 ED visits were recorded following 274 alerts that did not result in an ATHI (36/274, 13.4%), corresponding to an odds ratio of 0.10 (95% IC 0.02-0.43; P<.001). Five patients died during the study. All had alerts, 4 did not have an ATHI and were hospitalized, and 1 had an ATHI (P=.04). In terms of overall usability, the digital system was easy to use for 90% (98/109) of HAs, and response time was acceptable for 89% (98/109) of them.

Conclusions

The eHealth system has been successfully implemented, was appreciated by users, and produced relevant alerts. ATHIs were associated with a lower rate of ED visits, suggesting that the eHealth system might be effective in lowering the number of ED visits in this population.

Trial Registration

clinicaltrials.gov NCT05221697; https://clinicaltrials.gov/ct2/show/NCT05221697.
A hypothesis-free data science approach to identifying novel patterns of clinical interest in clinicians' treatment preferences: clusters of high Pericyazine and Promazine use in England (Preprint)
Authors: MacKenna Brian , Curtis Helen J , Walker Alex J , Croker Richard , Macdonald Orla , Evans Stephen JW , Inglesby Peter , Evans Dave , Morley Jessica , Bacon Sebastian CJ , Goldacre Ben
Published: August 2022

BACKGROUND

Data analysis can be used to identify signals suggestive of variation in treatment choice or
clinical outcome. Analyses to date have generally focused on an hypothesis-driven
approach.

OBJECTIVE

Develop hypothesis-blind data driven approaches to identify outlier prescribing behaviour.

METHODS

Here we report an innovative hypothesis-blind approach (calculating chemical-class
proportions for every chemical substance prescribed in each Clinical Commissioning Group
and ranking chemicals by (a) their kurtosis and (b) a ratio between inter-centile differences)
applied to England’s national prescribing data, and demonstrate how this identified unusual
prescribing of two antipsychotics.

RESULTS

We identified that, while promazine and pericyazine are barely used by most clinicians, they
make up a substantial proportion of all antipsychotic prescribing in two small geographic
regions in England.

CONCLUSIONS

Data-driven approaches can be effective at identifying unusual clinical choices. More
widespread adoption of such approaches, combined with clinician and decision-maker
engagement could lead to better optimised patient care.

CLINICALTRIAL

n/a
Applying the UTAUT2 Model to Smart Eyeglasses to Detect and Prevent Falls Among Older Adults and Examination of Associations With Fall-Related Functional Physical Capacities: Survey Study (Preprint)
Authors: Hellec Justine , Hayotte Meggy , Chorin Frédéric , Colson Serge S , d'Arripe-Longueville Fabienne
Published: August 2022

BACKGROUND

As people age, their physical capacities (eg, walking and balance) decline and the risk of falling rises. Yet, classic fall detection devices are poorly accepted by older adults. Because they often wear eyeglasses as they go about their daily activities, daily monitoring to detect and prevent falls with smart eyeglasses might be more easily accepted.

OBJECTIVE

On the basis of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study evaluated (1) the acceptability of smart eyeglasses for the detection and prevention of falls by older adults and (2) the associations with selected fall-related functional physical capacities.

METHODS

A total of 142 volunteer older adults (mean age 74.9 years, SD 6.5 years) completed the UTAUT2 questionnaire adapted for smart eyeglasses and then performed several physical tests: a unipodal balance test with eyes open and closed, a 10-m walk test, and a 6-minute walk test. An unsupervised analysis classified the participants into physical performance groups. Multivariate ANOVAs were performed to identify differences in acceptability constructs according to the performance group.

RESULTS

The UTAUT2 questionnaire adapted for eyeglasses presented good psychometric properties. Performance expectancy (β=.21, P=.005), social influence (β=.18, P=.007), facilitating conditions (β=.17, P=.04), and habit (β=.40, P<.001) were significant contributors to the behavioral intention to use smart eyeglasses (R²=0.73). The unsupervised analysis based on fall-related functional physical capacities created 3 groups of physical performance: low, intermediate, and high. Effort expectancy in the low performance group (mean 3.99, SD 1.46) was lower than that in the other 2 groups (ie, intermediate: mean 4.68, SD 1.23; high: mean 5.09, SD 1.41). Facilitating conditions in the high performance group (mean 5.39, SD 1.39) were higher than those in the other 2 groups (ie, low: mean 4.31, SD 1.68; intermediate: mean 4.66, SD 1.51).

CONCLUSIONS

To our knowledge, this study is the first to examine the acceptability of smart eyeglasses in the context of fall detection and prevention in older adults and to associate acceptability with fall-related functional physical capacities. The older adults with higher physical performances, and possibly lower risks of falling, reported greater acceptability of smart eyeglasses for fall prevention and detection than their counterparts exhibiting low physical performances.
ConBERT: A concatenation of bidirectional transformers for the standardization of operative reports from electronic medical records (Preprint)
Authors: Park Sangjee , Bong Jun Woo , Kang Sanghee , Park Inseo , Lee Hwamin , Choi Jiyoun , Kim Yoon , Choi Hyunsoo
Published: August 2022

BACKGROUND

An operative report is a document containing the details of the surgery. The standardization of the medical terminology appearing in the operative report that is written in free text is important for medical research and the establishment of insurance systems by allowing the accurate sharing of information on treatment. However, the standardization of operative reports is a labor-intensive task with a risk of induced errors.

OBJECTIVE

We propose a concatenated bidirectional encoder representation from transformers (ConBERT) model for predicting the International Classification of Disease (ICD)-9 code from operative reports and diagnoses recorded in free-text to automatically standardize the operative report.

METHODS

We compared the pre-trained BERT and Character BERT models and created a new model by concatenating the combinations of each model.

RESULTS

Our proposed ConBERT showed a micro F1 score of 0.7610, a precision of 0.8164, and a recall of 0.7125. We also developed a publicly accessible web-based application to demonstrate the performance and provide the functions of our model.

CONCLUSIONS

The ConBERT model showed an acceptable performance to standardize operative reports to ICD-9 codes. This model can automate the manual standardizing process and can be further utilized in mapping operation data to CDM.
Understanding Patient Beliefs in Using Technology to Manage Diabetes: Path Analysis Model From a National Web-Based Sample (Preprint)
Authors: Zahed Karim , Mehta Ranjana , Erraguntla Madhav , Qaraqe Khalid , Sasangohar Farzan
Published: August 2022

BACKGROUND

 With 425 million individuals globally living with diabetes, it is critical to support the self-management of this life-threatening condition. However, adherence and engagement with existing technologies are inadequate and need further research.

OBJECTIVE

 The objective of our study was to develop an integrated belief model that helps identify the significant constructs in predicting intention to use a diabetes self-management device for the detection of hypoglycemia.

METHODS

 Adults with type 1 diabetes living in the United States were recruited through Qualtrics to take a web-based questionnaire that assessed their preferences for a device that monitors their tremors and alerts them of the onset of hypoglycemia. As part of this questionnaire, a section focused on eliciting their response to behavioral constructs from the Health Belief Model, Technology Acceptance Model, and others.

RESULTS

 A total of 212 eligible participants responded to the Qualtrics survey. Intention to use a device for the self-management of diabetes was well predicted (R2=0.65; F12,199=27.19; P<.001) by 4 main constructs. The most significant constructs were perceived usefulness (β=.33; P<.001) and perceived health threat (β=.55; P<.001) followed by cues to action (β=.17; P<.001) and a negative effect from resistance to change (β=−.19; P<.001). Older age (β=.025; P<.001) led to an increase in their perceived health threat.

CONCLUSIONS

For individuals to use such a device, they need to perceive it as useful, perceive diabetes as life-threatening, regularly remember to perform actions to manage their condition, and exhibit less resistance to change. The model predicted the intention to use a diabetes self-management device as well, with several constructs found to be significant. This mental modeling approach can be complemented in future work by field-testing with physical prototype devices and assessing their interaction with the device longitudinally.
The mediating role of general academic emotions in burnout and procrastination among Chinese medical undergraduates during the COVID-19 pandemic: A cross-sectional study (Preprint)
Authors: Qu Ruoyi , Ding Ning , Li Honghe , Song Xinzhi , Cong Zhangzhao , Cai Ruoxin , Zhu Yaxin , Wen Deliang
Published: August 2022

BACKGROUND

Academic procrastination has become more prevalent during the COVID-19 pandemic due to teaching/learning changes. This phenomenon induces academic burnout, which is already serious among medical students. However, the underlying mechanism of academic emotion, which is the factor most vulnerable to changes in the academic environment, is still unknown.

OBJECTIVE

Therefore, the current study aimed to investigate the mediating role of general academic emotions in procrastination and burnout among Chinese medical students during the COVID-19 pandemic.

METHODS

This cross-sectional study enrolled 995 medical students from China Medical University. We applied the Chinese version of the Maslach Burnout Inventory Student Survey (MBI-SS), the Aitken Procrastination Inventory (API) and the General Academic Emotion Questionnaire for College Students (GAEQ) to evaluate the variables of interest. We examined the mediation effects of GAEs by hierarchical linear regression analysis.

RESULTS

This cross-sectional study enrolled 995 medical students from China Medical University. We applied the Chinese version of the Maslach Burnout Inventory Student Survey (MBI-SS), the Aitken Procrastination Inventory (API) and the General Academic Emotion Questionnaire for College Students (GAEQ) to evaluate the variables of interest. We examined the mediation effects of GAEs by hierarchical linear regression analysis.

CONCLUSIONS

The results indicate that academic emotions had mediating effects on procrastination and anxiety. Medical students’ worries about the uncertainty of the learning environment may have exacerbated academic burnout. The results of the present study provide empirical support for intervention strategies for implementing medical education while preventing and controlling the infection.
Implementation of Measurement Based Care in the Context of Telemedicine: Qualitative Study (Preprint)
Authors: Van Tiem Jen , Wirtz Elizabeth , Suiter Natalie , Heeren Amanda , Fuhrmeister Lindsey , Fortney John , Reisinger Heather , Turvey Carolyn
Published: August 2022

BACKGROUND

The Measurement Based Care (MBC) in Mental Health (MH) Initiative launched by the Department of Veterans Affairs (VA) in 2016 is an example of an evidence-based practice that uses patient-reported outcome measures (PROMs) to improve patient outcomes. Acceptance of MBC among VA providers is relatively high, though utilization is low and varies by discipline. Health information technologies might afford opportunities to address some of the barriers related to uptake of MBC.

OBJECTIVE

This manuscript reports on an implementation effort to integrate MBC into clinical telehealth practice using e-health solutions.

METHODS

Qualitative data were generated from 22 semi-structured interviews with psychiatrists (n = 4), psychologists (n=3), social workers (n=3), nurses (n=6), a pharmacist (n=1), and administrative staff (n=5) who provide telemental health care through a community-based outpatient clinic in the rural Midwestern United States. The interviews were conducted during the pilot phase of an implementation initiative to increase adoption of MBC by revising clinic workflows to integrate the use of e-health technologies. Data were analyzed using thematic analysis.

RESULTS

Time burden and workflow issues were the most common barrier to provider adoption of MBC; sharing and reviewing pencil and paper measures and results in the same room was no longer possible in novel telehealth workflows necessitated by the COVID-19 pandemic. Providers voiced concerns about how long it would take to adequately score, interpret, share, and document the PROMs during the medical visit. Concerns about time might also correspond to a gap in providers’ familiarity with these assessments, greater comfort in assessing symptoms through clinical interviews, and being accustomed to using the assessments as screening tools more so than longitudinal outcome measures. Providers were also uncertain about the recommended timing and frequency of assessments, what was most appropriate for their subspecialty, and how to balance all of this in the context of team-based care, where providers often share patients. Capacities associated with e-health technologies may address workflow concerns and promote providers’ understanding of the measures as tracking tools.

CONCLUSIONS

The need to use limited appointment time well is top of mind for telemental health providers. e-Health technologies provided operative supports that protect time in appointments by shifting when and how PROMs are collected. Bolstering providers’ familiarity with how to use PROMs may impact providers’ buy-in by encouraging them to reconsider how sharing and acting on PROMs could be time well spent.
Contribution of Employee’s Job Satisfaction on Organization Performance: A Case Study of Mkombozi Bank, Dar es Salaam
Authors: Mziwao Sabina , Mbogo Crispin John
Published: August 2022

In recent times, the issue of employee job satisfaction has been crucial for developing and achieving the aims and goals of organizations. This study examines contribution of employee’s job satisfaction on organization performance with particular reference to Mkombozi Bank in Dar es Salaam. Specifically, the study aimed to investigate the impact of talent development, to determine how reward influences employee job satisfaction and lastly the study examined how career promotion of employees affected Mkombozi Bank performance. Descriptive research study was carried out, the research used a sample size of 30 workers. The data for the study is largely obtained via semi-structured questionnaires. The study employed analytical descriptive statistical approaches for analyzing the relationship between the indicators of employees’ job satisfaction and organization performance. Inferential statistics, particularly correlation matrix and multi-regression were the statistical instruments employed for the study analysis. Findings of the study document a weak or no relationship between employee job satisfaction and organization performance. These findings might contravene by other background variables like age of employees, gender, experience, type of jobs, education, etc.) or measurement methods. Depending on the outcomes of this study, the management need to understand that, there is a connection between employee job satisfaction and organization performance. Even though the link has been found to be weak here, it was simply contravened by other variables and measurement methods employed. The management is advised to look at these findings as an eye opener for it to reflect and work on the employee job satisfaction factors in the efforts of improving organizational performance.
La lucha sigue y sigue. Organización popular en la Frailesca
Authors:   PROIMMSE-UNAM, Camacho Velásquez Dolores
Published: August 2022

El texto sistematiza y presenta de manera ordenada y rigurosa, resultados de investigación regional en la Frailesca, una de las regiones menos estudiadas de Chiapas, en un perIodo (1994-2002) donde los pueblos indígenas y el movimiento zapatista se convirtieron en el principal foco de atención para la realización de investigación social en Chiapas. En este libro la autora analiza y reflexiona tanto teórica como metodológicamente sobre los movimientos populares, tomando como punto de partida el seguimiento de un movimiento popular surgido en 1995 en la Frailesca
Editorial
Authors: Paíno Perdomo Omar
Published: August 2022

No se necesita de un resumen.
Tendencias en la modelación matemática de biorreactores con membranas sumergidas para el tratamiento de aguas residuales
Authors: Jauregui Haza Ulises , González Hernández Yusmel
Published: August 2022

En las últimas dos décadas, las tecnologías de los Biorreactores con Membranas Sumergidas han crecido exponencialmente debido a las ventajas que ofrecen sobre los procesos convencionales de tratamiento de aguas residuales, tales como: menor impacto ambiental, mejor calidad de los efluentes y un mejor control de los procesos; sin embargo, la principal desventaja de esta tecnología lo constituyen los costos asociados al proceso de colmatación de la membrana. La experimentación en estos sistemas demanda de un consumo considerable de recursos, tiempo y esfuerzos, razón por la cual la modelación matemática constituye una alternativa para la optimización de estos sistemas con un considerable ahorro de recursos y de tiempo. En el presente trabajo se realiza un análisis de la evolución de la modelación matemática de esos sistemas, específicamente de los modelos que integran los procesos biológicos con los procesos de filtración. Estos modelos integrados están constituidos por una versión extendida de los modelos de lodos activados (ASM), enlazados con modelos empíricos y/o determinísticos que describen la deposición de lodo sobre la membrana, que permiten predecir el comportamiento de la presión transmembranal. El enlace entre el sistema biológico y el sistema de colmatación de la membrana se realiza teniendo en cuenta la influencia de los sólidos suspendidos totales y de las sustancias poliméricas extracelulares solubles y enlazadas al flóculo en el proceso de colmatación de la membrana.
Contribution to Competing Species Modeling with Distributed Delay
Authors: Cavani Mario
Published: August 2022

In this paper a competing species model is analyzed taking into account the seminal paper of Hsu, Hubbell and Waltman (1978), where two predators compete for a common prey without interference between rivals. Here a distributed delay is introduced in each one of the equations of the predator populations in the same way as suggested by Wolkowicz, Xia & Ruan (1997), in order to model the conversion time lag of consumed prey biomass into predator biomass. Using the linear trick chain technique, the solutions are analyzed from an “equivalent system” of ordinary differential equations looking to answer under what conditions will neither, one, or both species of predator populations survive, giving the appropriate insight of the biological point of view.
Probiotics: Lactic Acid Bacteria have Antibacterial Activity and Downregulate Biofilm Genes of Uropathogenic E. coli
Authors: Dawwam Ghada E. , Saber Israa I. , Yassin M. Hisham , Ibrahim Hanan F.
Published: August 2022

Urinary tract infections (UTIs) are regarded as one of the most serious infections worldwide. Uro Pathogenic E. coli (UPEC) accounts for nearly 80% of UTI infections in females. This study investigated the antibacterial and antibiofilm effects of Lactobacillus acidophilus (l. acidophilus) and Lactobacillus plantarum (lb. plantarum) on multidrug-resistant E. coli obtained from urine samples. Complete bacteriological identification was conducted on 45 E. coli isolated from 80 urine samples of females with UTIs. Antibiotic susceptibility test was performed on all isolates by nine antibiotics. Ten out of the 45 isolates exhibited multidrug resistance (MDR). L. acidophilus and Lb. plantarum showed marked inhibition of MDR E. coli isolates on agar by a diffusion method (16 ± 0.04: 23 ± 0.05 mm). Moreover, L. acidophilus and Lb. plantarum strains inhibited the ability of UPEC to form a biofilm by 56.3% and 39.63%, respectively. The expression of biofilm genes of E. coli are as follows: csgA, crl, csgD showed remarkable downregulation after treatment with probiotics suspension: 0.00364: 0.19078 fold, 0.0005: 0.1894 fold, and 0.0490: 0.0883 for L. acidophilus, respectively. On the other hand, downregulation of biofilm gene expression for csgA, crl, csgD after treatment with Lb. plantarum suspension were expressed by fold changes as follows: 0.0769: 0.3535 fold, 0.05440: 0.12940 fold, and 0.06745: 0.4146, respectively. These findings show that L. acidophilus and Lb. plantarum exhibit potent antibacterial and antibiofilm action against MDR UPEC at both genotypic and phenotypic levels, and appear to be a promising solution in therapeutic applications for recurrent and persistent UTIs.