bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Directed Learning: A Paradigm Shift for Physiotherapy Education
Authors:   Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana / School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands / Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK, Quartey Jonathan , Eksteen Carina ,   Department of Physiotherapy, School of Healthcare Sciences, Sefako, Makgatho Health Sciences University, Pickworth Glynis ,   Department of Physiotherapy, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria., Bello Ajediran ,   Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana., Ahenkorah Josephine ,   Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana.
Published: November 2020

Training physiotherapists to a level where they can influence the standard of health care practice could be a complex process. Entry-level physiotherapy education in Ghana is a continuum between academic and clinical training during which they have to integrate the application and development of skills in communication, collaboration, advocatory and leadership. Self-directed learning is considered by many as one of the appropriate methodologies to allow practitioners to stay up-to-date and knowledgeable of the current literature. A teacher-centered approach is characterized by lecturing and hands-on skills training as the main or only way of facilitating student learning. Students who qualify as physiotherapists from teacher-centered tertiary institutions need to be self-directed life-long learners to be able to meet the demands of a complex work environment in the field of physiotherapy and professional health care delivery. The teacher-centered traditional approach to teaching and learning appears to be the predominant form of teaching among most universities in Ghana. Since a student-centered teaching approach has been widely recommended as the approach of choice, especially in the education of health care professionals, there is a need to determine if it is possible to design and implement physiotherapy based modules that include student-centered approaches such as Self-directed learning which may address minimal guidance that is usually associated with teacher centered tertiary training in Ghana. Keywords: Self-directed learning; teacher-centred; Physiotherapy, student-centredAbstract
Retrospective Review of Injury Patterns Among Ghanaian Footballers During the 2009-2010 League Season
Authors:   Physiotherapist Department of physiotherapy, Komfo Anokye Teaching Hospital, Kumasi, Ashanti Region, Ghana,, Larwch Maxwell , Quartey Jonathan ,   Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana/ School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands / Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis,, Kwakye Samuel Koranteng ,   West Africa Football Academy, Sogakope, Ghana.
Published: November 2020

BackgroundThe increased popularity of football in addition to the physical and mental demands placed on players increase the risk of soccer injuries. We set out to identify injury patterns among footballers involved in selected Glo sponsored Ghana premier league games during the 2009/2010 season.MethodologyDigital video compact discs (DVDs) of thirty randomly selected 2009/2010 matches were acquired for the study from the Ghana Football Association. A Samsung DVD player and television set were used to playback and watch the matches. The researchers stopped the video immediately an injury occurred and the disc was then put in slow playback movement whilst the occurrence of injury was recorded on an injury report form.All statistical analyses were performed using SPSS version 20.ResultsA total of 139 injuries were recorded during the study with an average injury incidence of 4.63±1.99 injuries per match. Tackling attempts (51.1%) was the predominant mechanism of injury with the ankle (26.6%) being the most injured body part. There was a significant association between player position and number of injuries suffered (p=0.038) and a significant association observed between player position and severity of injuries (p = 0.042). The uses of icepack (34.5%) and vapocoolant spray (32.4%) were the most common first aid treatment for the injuries sustained.ConclusionThe study indicated that professional football players in Ghana are exposed to high injury risks as evident by the relatively high injury incidence. Keywords: Football, footballers,playback, injuries, digital video compact discs
EXTENSÃO UNIVERSITÁRIA EM TEMPOS DE COVID-19: UM RELATO DE EXPERIÊNCIA NO PROJETO (TUTOR)
Authors: De Lima Dias Maria Sara , Caldas Brognoli Paula , Ricarte de Figueiredo Hamm Larissa , Moreira da Silva Neto Pedro
Published: November 2020

Este artigo é um relato de experiência sobre o projeto de extensão Tecnologia Universidade e Orientação Profissional o TUTOR, o projeto em curso desde 2017 realizado junto a Universidade Tecnologica Federal do Paraná. Como extensão objetivou-se estudar a constituição da subjetividade em diferentes momentos da vida escolar e apoiar os alunos enquanto sujeitos históricos que emergem no paradigma da educação para o trabalho em sua escolha profissional. Com o advento do COVD 19 as ações realizadas pelo projeto se modificaram e passaram a ser realizadas de modo remoto. Acreditamos que as escolhas profissionais dos alunos e professores passam a ter um curso mediado pela tecnologia. Assim é urgente orientar as pessoas que estão hoje na universidade bem como aquelas que pretendem ingressar sobre novos habitos de vida e estudo, que lhes permitam materem-se ativas durante a pandemia. Tal orientação é fundamental enquanto um projeto de vida e tem grande influência na saúde mental e na vida profissional e pessoal das pessoas envolvidas na Universidade.
RELATO DE EXPERIÊNCIA SOBRE AÇÕES DE PREVENÇÃO AO NOVO CORONAVÍRUS (COVID-19) POR UMA EQUIPE DE SAÚDE DA FAMÍLIA NO RIO GRANDE DO NORTE
Authors: Oliveira Franklin Learcton Bezerra de , Vanderley Francileide , Dos Santos Juciara , Barros Wysterlânyo
Published: November 2020

Em janeiro de 2020, o novo coronavirus se espalhou para outros países da Ásia e Europa, onde a Organização Mundial da Saúde (OMS) declarou emergência em saúde pública de interesse internacional. Em março de 2020, a OMS classificou a doença causada pelo novo coronavirus como pandemia. O presente trabalho tem como objetivo relatar experiência vivenciada por parte de uma equipe de saúde da família do município de Equador no Estado do Rio Grande do Norte em ações de prevenção e combate a COVID-19. O processo de trabalho da equipe, observando o comportamento do novo coronavírus, fez pensar em estratégias que evitassem a contaminação tanto pelos profissionais quanto pela população. Além do mais, está gerando um novo modelo de atendimento e comportamento dos usuários na atenção básica.
Współczesne wyzwanie dla podmiotowości – w stronę człowieka nieokreślonego
Authors: Warzyński Sylwester
Published: November 2020

Artykuł traktuje o współczesnym zakwestionowaniu nowożytnej wizji człowieka jako podmiotu. Ukazuje, w jaki sposób takie myślenie stało się swego rodzaju ponowoczesną dominantą, a odnosząc się do kilku konkretnych koncepcji filozoficznych, tłumaczy jak należy rozumieć idę „śmierć człowieka” i jakie są jej konsekwencje. W pierwszej części autor ukazuje, że nowożytne kreowanie podmiotu na szczególnego rodzaju suwerena, władcę siebie i świata, w konsekwencji doprowadza do jego „śmierci”. „Śmierci”, która w pewien sposób została sprowokowana przez samych rzeczników podmiotowości, przez ich pomysł ubóstwienia podmiotu, uczynienia go absolutnie niezależnym, autonomicznym, niczym nieskrępowanym.W drugiej części, odwołując się do takich filozofów jak Nietzsche, Heidegger, Sartre, Derrida, Foucault, autor tłumaczy, z czym wiąże się ponowoczesna idea „śmierci człowieka”. Uzasadnia, że każdy z tych filozofów, porzucając metafizykę, kwestionując nowożytne rozumienie podmiotowości, proponuje wizję człowieka, który przestaje być „jakiś”, jakoś określony, stale obecny, zdefiniowany. Zgodnie z takim myśleniem człowiek staje się całkowicie nieokreślony. Na koniec, odwołując się do myślenia Michela Foucaulta, autor ukazuje istotne znamiona kultury, w której żyjemy, jako konsekwencje przyjęcia pewnych ponowoczesnych założeń w myśleniu o człowieku. Mówi więc o „kulturze niedialektycznej”, „kulturze dobrego funkcjonowania” oraz „kulturze oporu”.
Sprawozdanie z międzynarodowej konferencji naukowej nt. "Przyrodoznawstwo – Filozofia – Teologia. Obszary i perspektywy dialogu", Uniwersytet Kardynała Stefana Wyszyńskiego, Warszawa, 15–16 października 2019 r.
Authors: Kobyliński Andrzej
Published: November 2020

W dniach 15–16 października 2019 roku na Uniwersytecie Kardynała Stefana Wyszyńskiego w Warszawie miało miejsce międzynarodowe sympozjum naukowe pt. "Przyrodoznawstwo – filozofia – teologia. Obszary i perspektywy dialogu". W konferencji wzięło udział ponad dwudziestu naukowców z dziesięciu krajów.
Classification of Pharynx from MRI Using a Visual Analysis Tool to Study Obstructive Sleep Apnea
Authors: Shahid Muhammad Laiq Ur Rahman , Mir Junaid , Shaukat Furqan , Saleem Muhammad Khurram , Tariq Muhammad Atiq Ur Rehman , Nouman Ahmed
Published: November 2020

Background:

Obstructive sleep apnea (OSA) is a chronic sleeping disorder. The analysis of the pharynx and its surrounding tissues can play a vital role in understanding the pathogenesis of OSA. Classification of the pharynx is a crucial step in the analysis of OSA.

Methods:

A visual analysis-based classifier is developed to classify the pharynx from MRI datasets. The classification pipeline consists of different stages, including pre-processing to select the initial candidates, extraction of categorical and numerical features to form a multidimensional features space, and a supervised classifier trained by using visual analytics and silhouette coefficient to classify the pharynx.

Results:

The pharynx is classified automatically and gives an approximately 86% Jaccard coefficient by evaluating the classifier on different MRI datasets. The expert’s knowledge can be utilized to select the optimal features and their corresponding weights during the training phase of the classifier.

Conclusion:

The proposed classifier is accurate and more efficient in terms of computational cost. It provides additional insight to better understand the influence of different features individually and collectively. It finds its applications in epidemiological studies where large datasets need to be analyzed.
Experimental and Numerical Investigation of Old Masonry Wall Using a Macro-Modeling Approach
Authors: Kumar Ambareesh , Pallav Kumar
Published: November 2020

Background:

A 3-D finite element model of the internal masonry wall of a 103-year-Old Senate hall, Allahabad University, has been modeled using macro-modeling approaches. The masonry wall is an excellent example of Indo-Saracenic style architecture used by Britishers during the late 19th Century, which is a unification of the Mughal and Colonial architecture.

Methods:

Non-destructive Test (NDT) has been conducted to estimate is compressive strength and Young’s modulus of the wall. Compressive strength of the brick masonry and stone arch was estimated in the range of 10.5-12.5 MPa and 18.6-21.2 MPa, respectively, whereas Young’s Modulus was estimated in the range of 1800-5000 MPa and 5500-8000 MPa (outlier not considered). Finite Element model was prepared using the macro-modeling approach.

Results:

The gravity load analysis shows that the wall is stable, and its geometrical configuration is safe with maximum Von-Mises stress of 5.38 MPa and deformation of 2.27 mm. The results of the first six modes are presented. Further, in the absence of a recorded ground motion for the Prayag city, synthetic ground motion is simulated for 25th April 2015 Nepal earthquake (Mw) using a stochastic finite fault model.

Conclusion:

Evaluated behaviour of the internal masonry wall is shown in the form of acceleration, deformation and stress response.
Fermentation of Sweet Sorghum Syrup Under Reduced Pressure for Bioethanol Production
Authors: Volodko Oleksii I. , Ivanova Tetiana S. , Kulichkova Ganna I. , Lukashevych Kostyantyn M. , Blume Yaroslav B. , Tsygankov Sergii P.
Published: November 2020

Background:

Production of bioethanol from sweet sorghum (Sorghum saccharatum) is a promising “green” energy source that can help to reduce energy dependence on petroleum products, to decrease greenhouse gas emissions, and fight environmental pollution. As an additional benefit, it can promote the exploitation of new uncultivated agricultural lands and favor establishing integrated agro-industrial energy independent enterprises. The alcoholic fermentation under reduced pressure may prevent the accumulation of high ethanol concentrations in the cultured broth and thus may create favorable conditions for the highest productivity of yeastSaccharomyces cerevisiae.

Objective:

Elaboration of optimal conditions for sweet sorghum syrup fermentation under reduced pressure.

Aim:

To determine the parameters of sweet sorghum syrup fermentation byS. cerevisiaeunder the conditions of constant and periodic reduced pressure for the highest bioethanol production efficiency.

Methods:

The sweet sorghum was grown in a temperate continental climate region of Northern Ukraine. The parameters of diluted stem syrup andS. cerevisiaefermentation under reduced and atmospheric pressure were established and controlled by chemical, biochemical and physicochemical methods. The yeast cells were dyed with methylene blue and counted using a microscope and a Neubauer counting chamber. The obtained data have been statistically analyzed.

Results:

It has been established that a periodic vacuum extraction with short-term heating of the medium to the boiling point is the most promising procedure for bioethanol production. Periodically reduced pressure fermentation of sweet sorghum diluted syrup resulted in 55% higher bioethanol productivity compared to atmospheric pressure fermentation. Such treatment enables to maintain the concentration of ethanol in the medium below 5.5% vol., which does not significantly inhibit the productivity of industrial yeast strains and allows adding a nutrient with the subsequent continuation of the cultivation process. The resulting distillate requires less energy for further dehydration.

Conclusion:

The sweet sorghum syrup does not contain substances that inhibit yeast cells although nitrogen and phosphorus supplements are required to support efficientS. cerevisiaegrowth. The optimal technology, elaborated in this research, consists of repeated cycles of fermentation under reduced pressure (to the level of vacuum) for boiling the cultured broth. This technology provides the highest bioethanol output, high efficiency, and productivity of the overall process.
Efficiency of Switchgrass (Panicum virgatum L.) Cultivation in the Ukrainian Forest-Steppe Zone and Development of Its New Lines
Authors: Rakhmetovа Svitlana O. , Vergun Olena M. , Kulyk Maksym I. , Blume Rostislav Y. , Bondarchuk Oleksandr P. , Blume Yaroslav B. , Rakhmetov Dzhamal B.
Published: November 2020

Background:

Switchgrass (Panicum virgatum L.) is a promising C4-photosynthetising perennial grass and an important energy crop. It is resistant to drought, cold and winter frost, endures flooding and shows high performance at minimal energy consumption for cultivation.

Methods:

The purpose of the work was to develop and introduce high-yielding genotypes of switchgrass and develop effective cultivation technologies for the Forest-Steppe zone of Ukraine. The objective of the study was to evaluate the introduction potential of switchgrass, to establish biologically productive parameters and energy values of different genotypes and the effectiveness of cultivation techniques in the specific geo-climatic zone of Ukraine. To achieve the objectives, a wide range of introductory, biological-morphological, breeding-biotechnological, and agronomic methods have been used.

Results:

The gene pool of P. virgatum was collected (33 accessions), ten of which have been investigated, including both introduced genotypes and newly developed breeding lines. The bio-morphological, ecological features, the biochemical composition of plants have been evaluated. The productivity of the above-ground biomass and seeds, as well as the energy value of plants, has been evaluated. High-performance forms with specified yield parameters, biomass sugars, total energy and biofuel output per unit area have been determined.

Conclusion:

A new variety of P. virgatum (cv. Zoriane) has been introduced for cultivation. Among the accessions of newly developed genotypes, the most productive lines have been identified. New efficient technologies have been developed to increase the yield potential of switchgrass as a source of raw materials for biofuel production.
A Brief Survey of Assessment Models to Predict Stress Level of Heavy Metals in Soil
Authors: Annam Sangeetha , Singla Anshu
Published: November 2020

Soil is a major and important natural resource, which not only support human life but also
furnish commodities for ecological and economic growth. Ecological risk, such as degradation of
soil pose a serious threat to the ecosystem. The high-stress level of heavy metals like chromium,
copper, cadmium, etc., produce ecological risks, which include: decrease in the fertility of the soil;
reduction in crop yield and degradation of metabolism of living beings, and hence ecological health.
The ecological risk associated demands the assessment of heavy metal stress levels in soils. As the
rate of stress level of heavy metals is exponentially increasing in recent times, it is apparent to assess
or predict heavy metal contamination in soil. The assessment will help the concerned authorities
to take corrective as well as preventive measures to enhance the ecological, and hence economic
growth. This study reviews the efficient assessment models to predict contamination of soil due to
heavy metal.
THE RELATIONSHIP FAMILY EMOTIONAL SUPPORT WITH ANXIETY OF PREECLAMPSIA PREGNANT MOTHER
Authors: Huda Lidya Amal , Kurniawati Dini , Juliningrum Peni Perdani
Published: November 2020

Preeclampsia pregnant mothers are high risk population due to risk of physical andpsychological disorders. The study aimed to analyze the relationship between theemotionally family support and at the mother and child hospital of the IBI regency ofJember. The study used correlational with cross-sectional study design. The sample sizewas 57pregnant women with preeclampsia using purposive sampling. Data were obtainedby using family emotional support (validity value 0.467 and reliability value 0.9965) andHamilton Anxiety Rating Scale questionnaire (validity value 0.93 and reliability value0.97). Data analysis used the Spearman test. The results of this study showed that the29 respondents have high family`s emotionally support and 40 respondents have mildanxiety. The results show that there is a relationship between the emotional support ofthe family with anxiety mother (p-value = 0.041) and strength (r= -0.0272). The studyshowed that the higher the family`semotional support, the lower the mother`s anxietylevel. Family`s emotional supportfacilitating mother to more comfort and keep positivebehaviour.
DIFFERENCES EFFECT OF LANGUAGE STIMULATION USING "WAYANG KERTAS" AND STORY BOOKS ON CHILDREN'S SPEAKING SKILLS (4-5 YEARS)
Authors: Audia Shynta Dinar , Rohmi Faizatur , Sekarini Sekarini
Published: November 2020

Language ability is one of the basic abilities that must be possessed and studied by all children aged 4-5 years. The giving of learning media is the stimulation that most influences the language skills of preschoolers. Some suitable learning media are Wayang Kertas media and picture story books. This study aims to determine the differences between language stimulation using Wayang Kertas media and picture story books on the language skills of preschoolers (4-5 years).This study used Experimental Design with the One-Shot Case and Equivalent Control Group method. The sample were 36 respondents. Sample collection technique was obtained using Simple Random Sampling with statistical T test unpaired. Data was collected using an observation sheet that the indicators were language skills of preschoolers (4-5 years).The results showed that there was an influence of language skills with the average of Wayang Kertas media groups 24.22 while the picture book media group 22.94 after they were given language stimulation using Wayang Kertas media and picture story books. Statistical test results showed that there were differences between the effect of language stimulation using paper puppet media and picture story books on language skills in preschool children (4-5 years) with a p value = 0.013 (0.013 <0.05).In conclusion, there were differences between the influence of language stimulation using Wayang Kertas media and picture story books on language stimulation of language skills, providing appropriate and regular language stimulation because Wayang Kertas media can give auditory and visual stimulation as one of the factors that influence the language ability. The used of Wayang Kertas media can make language skills more optimal.
Tendencias y perspectivas de la ciencia financiera: Un artículo de revisión
Authors: Merton Robert Cox , Venegas-Martínez Francisco
Published: November 2020

Las contribuciones de Robert C. Merton cobran vigencia actual. Con respecto del diseño de los planes para el retiro, en un marco de sistemas deficientes de pensiones, las investigaciones de Merton (1969) y (1971) sobre reglas óptimas de consumo y portafolio durante y después de la vida laboral cobran vigencia contemporánea. Asimismo, Bodie y Merton (2002) proponen el uso de productos derivados, en el ámbito internacional, para diversificar los riesgos de los sistemas de pensiones justo en el momento en que muchos de éstos, en economías subdesarrolladas e industrializadas, están en la antesala de colapso; además de que varios de estos sistemas sólo garantizan una proporción exigua del salario. Por último, la teoría racional de valuación de opciones de Merton (1973) se retoma para crear oleoductos y plantas generadoras de energía sintéticas mediante el uso de contratos derivados. Este trabajo pretende realizar una revisión de las tendencias y perspectivas de la ciencia financiera y las finanzas matemáticas, en el marco de las contribuciones pioneras de Robert Cox Merton, resaltando áreas prioritarias que ofrecen oportunidades para realizar investigación con impactos social y global.
Potential of HIV Self-Sampling to Increase Testing Frequency Among Gay, Bisexual, and Other Men Who Have Sex With Men, and the Role of Online Result Communication: Online Cross-Sectional Study
Authors: Maté Tomás , Hoyos Juan , Guerras Juan Miguel , Agustí Cristina , Chanos Sophocles , Kuske Matthias , Fuertes Ricardo , Stefanescu Roxana , Pulido Jose , Sordo Luis , de la Fuente Luis , Belza María José ,   EURO HIV EDAT Group
Published: November 2020

Background

Late HIV diagnosis remains frequent among the gay, bisexual, and other men who have sex with men (GBMSM) population across Europe. HIV self-sampling could help remove barriers and facilitate access to testing for this high-risk population.

Objective

We assessed the capacity of HIV self-sampling to increase the testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania, and Spain, and evaluated the role of new technologies in the result communication phase.

Methods

We analyzed a convenience sample of 5019 GBMSM with prior HIV testing experience who were recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We constructed a Poisson regression model for each country to calculate prevalence ratios and 95% CIs of factors associated with an increase of testing frequency as a result of self-sampling availability.

Results

Overall, 59% (between country range 54.2%-77.2%) of the participants considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting a higher number of unprotected anal intercourse events in all countries except for Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal, and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal, and Spain; and for those that took their last test more than 3 months previously in Germany, Portugal, Romania, and Spain. In addition, 58.4% (range 40.5%-73.6%) of the participants indicated a preference for learning their result through one-way interaction methods, mainly via email (25.6%, range 16.8%-35.2%) and through a secure website (20.3%, range 7.3%-23.7%). Almost two thirds (65%) of GBMSM indicated preferring one of these methods even if the result was reactive.

Conclusions

Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially for the hidden, high-risk, and undertested GBMSM population. Online-based technologies without any personal interaction were preferred for the communication of the results, even for reactive results.
Effective Use of Mobile Electronic Medical Records by Medical Interns in Real Clinical Settings: Mixed Methods Study
Authors: Kim SuJin , Ku Seulji , Kim Taerim , Cha Won Chul , Jung Kwang Yul
Published: November 2020

Background

In South Korea, most graduated medical students undertake a 1-year internship before beginning residency and specialization. Interns usually work in a tertiary hospital and rotate between different, randomly assigned departments to be exposed to different medical specialties. Their jobs are mostly simple and repetitive but are still essential for the patient care process. However, owing to the lack of experience and overwhelming workload, interns at tertiary hospitals in South Korea are usually inefficient, often delaying the entire clinical process. Health care providers have widely adopted mobile electronic medical records (mEMRs) as they have been shown to improve workflow efficiency.

Objective

This study investigates the association between the frequency of mEMR usage and the clinical task completion interval time among interns in a tertiary hospital.

Methods

This mixed methods study was conducted at the Samsung Medical Center, Seoul, South Korea. Interns who worked at the Samsung Medical Center from March 2018 to February 2019 were included. The hospital electronic medical record (EMR) system known as DARWIN (Data Analysis and Research Window for Integrated kNowledge) was launched with PC and mobile. Both versions are actively used in hospitals by personnel in various positions. We collected the log data from the mEMR server and the intern clinical task time-series data from the EMR server. Interns can manage the process of identifying patients, assigning the clinical task, finishing the requested clinical intern tasks, etc, through the use of the mEMR system. We compared the clinical task completion interval among 4 groups of interns divided by the mEMR frequency quantile. Then, System Usability Score (SUS) questionnaires and semistructured interviews were conducted.

Results

The regular mEMR users were defined as those who logged in more than once a day on average and used the mEMR until the level after login. Among a total of 87 interns, 84 used the mEMR to verify the requested clinical tasks. The most frequently used item was “Intern task list.” Analysis of the 4 intern groups revealed an inverse relationship between the median time of the task completion interval and the frequency of mEMR use. Correlation analysis showed that the intern task completion time interval had a significant inverse relationship with the individual frequency of mEMR usage (coefficient=-0.27; 95% CI -0.46 to -0.04; P=.02). In the additional survey, the mean SUS value was 81.67, which supported the results of the data analysis.

Conclusions

Our findings suggest that frequent mEMR use is associated with improved work efficiency in hospital interns with good usability of the mEMR. Such finding supports the idea that the use of mEMR improves the effectiveness and workflow efficiency of interns working in hospitals and, more generally, in the context of health care.
Use of the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for Processing Free Text in Health Care: Systematic Scoping Review
Authors: Gaudet-Blavignac Christophe , Foufi Vasiliki , Bjelogrlic Mina , Lovis Christian
Published: November 2020

Background

Interoperability and secondary use of data is a challenge in health care. Specifically, the reuse of clinical free text remains an unresolved problem. The Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) has become the universal language of health care and presents characteristics of a natural language. Its use to represent clinical free text could constitute a solution to improve interoperability.

Objective

Although the use of SNOMED and SNOMED CT has already been reviewed, its specific use in processing and representing unstructured data such as clinical free text has not. This review aims to better understand SNOMED CT's use for representing free text in medicine.

Methods

A scoping review was performed on the topic by searching MEDLINE, Embase, and Web of Science for publications featuring free-text processing and SNOMED CT. A recursive reference review was conducted to broaden the scope of research. The review covered the type of processed data, the targeted language, the goal of the terminology binding, the method used and, when appropriate, the specific software used.

Results

In total, 76 publications were selected for an extensive study. The language targeted by publications was 91% (n=69) English. The most frequent types of documents for which the terminology was used are complementary exam reports (n=18, 24%) and narrative notes (n=16, 21%). Mapping to SNOMED CT was the final goal of the research in 21% (n=16) of publications and a part of the final goal in 33% (n=25). The main objectives of mapping are information extraction (n=44, 39%), feature in a classification task (n=26, 23%), and data normalization (n=23, 20%). The method used was rule-based in 70% (n=53) of publications, hybrid in 11% (n=8), and machine learning in 5% (n=4). In total, 12 different software packages were used to map text to SNOMED CT concepts, the most frequent being Medtex, Mayo Clinic Vocabulary Server, and Medical Text Extraction Reasoning and Mapping System. Full terminology was used in 64% (n=49) of publications, whereas only a subset was used in 30% (n=23) of publications. Postcoordination was proposed in 17% (n=13) of publications, and only 5% (n=4) of publications specifically mentioned the use of the compositional grammar.

Conclusions

SNOMED CT has been largely used to represent free-text data, most frequently with rule-based approaches, in English. However, currently, there is no easy solution for mapping free text to this terminology and to perform automatic postcoordination. Most solutions conceive SNOMED CT as a simple terminology rather than as a compositional bag of ontologies. Since 2012, the number of publications on this subject per year has decreased. However, the need for formal semantic representation of free text in health care is high, and automatic encoding into a compositional ontology could be a solution.
Guidelines for Conducting Virtual Cognitive Interviews During a Pandemic
Authors: Shepperd James A , Pogge Gabrielle , Hunleth Jean M , Ruiz Sienna , Waters Erika A
Published: November 2020

The COVID-19 pandemic has challenged researchers working in physical contact with research participants. Cognitive interviews examine whether study components (most often questionnaire items) are worded or structured in a manner that allows study participants to interpret the items in a way intended by the researcher. We developed guidelines to conduct cognitive interviews virtually to accommodate interviewees who have limited access to the internet. The guidelines describe the essential communication and safety equipment requirements and outline a procedure for collecting responses while maintaining the safety of the participants and researchers. Furthermore, the guidelines provide suggestions regarding training of participants to use the technology, encouraging them to respond aloud (a potential challenge given that the researcher is not physically present with the participant), and testing and deploying the equipment prior to the interview. Finally, the guidelines emphasize the need to adapt the interview to the circumstances and anticipate potential problems that might arise.
Potential of HIV Self-Sampling to Increase Testing Frequency Among Gay, Bisexual, and Other Men Who Have Sex With Men, and the Role of Online Result Communication: Online Cross-Sectional Study (Preprint)
Authors: Maté Tomás , Hoyos Juan , Guerras Juan Miguel , Agustí Cristina , Chanos Sophocles , Kuske Matthias , Fuertes Ricardo , Stefanescu Roxana , Pulido Jose , Sordo Luis , de la Fuente Luis , Belza María José ,   EURO HIV EDAT Group
Published: November 2020

BACKGROUND

Late HIV diagnosis remains frequent among the gay, bisexual, and other men who have sex with men (GBMSM) population across Europe. HIV self-sampling could help remove barriers and facilitate access to testing for this high-risk population.

OBJECTIVE

We assessed the capacity of HIV self-sampling to increase the testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania, and Spain, and evaluated the role of new technologies in the result communication phase.

METHODS

We analyzed a convenience sample of 5019 GBMSM with prior HIV testing experience who were recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We constructed a Poisson regression model for each country to calculate prevalence ratios and 95% CIs of factors associated with an increase of testing frequency as a result of self-sampling availability.

RESULTS

Overall, 59% (between country range 54.2%-77.2%) of the participants considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting a higher number of unprotected anal intercourse events in all countries except for Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal, and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal, and Spain; and for those that took their last test more than 3 months previously in Germany, Portugal, Romania, and Spain. In addition, 58.4% (range 40.5%-73.6%) of the participants indicated a preference for learning their result through one-way interaction methods, mainly via email (25.6%, range 16.8%-35.2%) and through a secure website (20.3%, range 7.3%-23.7%). Almost two thirds (65%) of GBMSM indicated preferring one of these methods even if the result was reactive.

CONCLUSIONS

Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially for the hidden, high-risk, and undertested GBMSM population. Online-based technologies without any personal interaction were preferred for the communication of the results, even for reactive results.
An Image Turing Test on Realistic Gastroscopy Images Generated by using the Progressive Growing of Generative Adversarial Networks (Preprint)
Authors: Shin Keewon , Lee Jung Su , Lee Ji Young , Lee Hyunsu , Kim Jeongseok , Jang Miso , Byeon Jeong-Sik , Jung Hwoon-Yong , Kim Do Hoon , Kim Namkug
Published: November 2020

BACKGROUND

Generative adversarial networks(GAN) in medicine is a valuable technique for augmenting unbalanced data, anomaly detection, learning representation, and avoiding patient privacy issues. However, there were limitations in generating highly realistic endoscopic images with various characteristics, such as peristalsis, viewpoints, light sources, artifacts, and mucous patterns.

OBJECTIVE

The purpose of this study is to evaluate the ability to generate gastrointestinal images using a progressive growing GAN(PGGAN) within the distribution of a normal dataset and to investigate obstacles of PGGAN in compositing high-quality endoscopic images.

METHODS

We trained the PGGAN with 107,060 normal gastroscopy images obtained from 4,165 normal patients 5122 pixels images. For the evaluation, visual Turing tests were conducted by endoscopists on 200 images(randomly selected 100 real and 100 synthetics) to distinguish the authenticity of the images. Nineteen endoscopists were divided into three groups to determine differences in discernment based on clinical experience.(Twelve endoscopists with 0-5 yrs experience[Group I], three endoscopists with 5-10 yrs experience[Group II], four endoscopists more than 10 yrs experience[Group III]). In addition, subgroup analysis by anatomical structures was performed to analyze 100 generated images.

RESULTS

The overall accuracy, sensitivity, and specificity of the nineteen endoscopists were 61.3, 70.3, and 52.4%, respectively. The mean accuracy of the three endoscopist groups was 62.4[Group I], 59.8[Group II], and 59.1 %[Group III], which was not shown a meaningful difference(P=.73). There were no statistical differences in the locations and forward/retroflexion view of the stomach. However, in sensitivity to anatomical landmarks, the sensitivity to the pylorus was higher than in other locations(P=.002). The discontinuous gastric folds in the stomach were the main reason for endoscopists to detect the generated image as a fake image.

CONCLUSIONS

The images generated by PGGAN showed highly realistic depictions that were difficult to distinguish for 5122 pixels images. However, it has limitations in generating gastric folds in high-resolution images.

CLINICALTRIAL
A Care Knowledge Management System Based on an Ontological Model of Caring for People With Dementia: Knowledge Representation and Development Study (Preprint)
Authors: Kim Gyungha , Jeon Hwawoo , Park Sung Kee , Choi Yong Suk , Lim Yoonseob
Published: November 2020

BACKGROUND

Caregivers of people with dementia find it extremely difficult to choose the best care method because of complex environments and the variable symptoms of dementia. To alleviate this care burden, interventions have been proposed that use computer- or web-based applications. For example, an automatic diagnosis of the condition can improve the well-being of both the person with dementia and the caregiver. Other interventions support the individual with dementia in living independently.

OBJECTIVE

The aim of this study was to develop an ontology-based care knowledge management system for people with dementia that will provide caregivers with a care guide suited to the environment and to the individual patient’s symptoms. This should also enable knowledge sharing among caregivers.

METHODS

To build the care knowledge model, we reviewed existing ontologies that contain concepts and knowledge descriptions relating to the care of those with dementia, and we considered dementia care manuals. The basic concepts of the care ontology were confirmed by experts in Korea. To infer the different care methods required for the individual dementia patient, the reasoning rules as defined in Semantic Web Rule Languages and Prolog were utilized. The accuracy of the care knowledge in the ontological model and the usability of the proposed system were evaluated by using the Pellet reasoner and OntOlogy Pitfall Scanner!, and a survey and interviews were conducted with caregivers working in care centers in Korea.

RESULTS

The care knowledge model contains six top-level concepts: care knowledge, task, assessment, person, environment, and medical knowledge. Based on this ontological model of dementia care, caregivers at a dementia care facility in Korea were able to access the care knowledge easily through a graphical user interface. The evaluation by the care experts showed that the system contained accurate care knowledge and a level of assessment comparable to normal assessment tools.

CONCLUSIONS

In this study, we developed a care knowledge system that can provide caregivers with care guides suited to individuals with dementia. We anticipate that the system could reduce the workload of caregivers.
Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review (Preprint)
Authors: Kim Chan Mi , van der Heide Esther M , van Rompay Thomas J L , Verkerke Gijsbertus J , Ludden Geke D S
Published: November 2020

BACKGROUND

Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction.

OBJECTIVE

This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies?

METHODS

A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor–related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form.

RESULTS

A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements).

CONCLUSIONS

Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium.

CLINICALTRIAL

PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874
Investigating Individuals’ Perceptions Regarding the Context Around the Low Back Pain Experience: Topic Modeling Analysis of Twitter Data (Preprint)
Authors:   Robert, Delir Haghighi Pari , Burstein Frada , Urquhart Donna , Cicuttini Flavia
Published: November 2020

BACKGROUND

Low back pain (LBP) remains the leading cause of disability worldwide. A better understanding of the beliefs regarding LBP and impact of LBP on the individual is important in order to improve outcomes. Although personal experiences of LBP have traditionally been explored through qualitative studies, social media allows access to data from a large, heterogonous, and geographically distributed population, which is not possible using traditional qualitative or quantitative methods. As data on social media sites are collected in an unsolicited manner, individuals are more likely to express their views and emotions freely and in an unconstrained manner as compared to traditional data collection methods. Thus, content analysis of social media provides a novel approach to understanding how problems such as LBP are perceived by those who experience it and its impact.

OBJECTIVE

The objective of this study was to identify contextual variables of the LBP experience from a first-person perspective to provide insights into individuals’ beliefs and perceptions.

METHODS

We analyzed 896,867 cleaned tweets about LBP between January 1, 2014, and December 31, 2018. We tested and compared latent Dirichlet allocation (LDA), Dirichlet multinomial mixture (DMM), GPU-DMM, biterm topic model, and nonnegative matrix factorization for identifying topics associated with tweets. A coherence score was determined to identify the best model. Two domain experts independently performed qualitative content analysis of the topics with the strongest coherence score and grouped them into contextual categories. The experts met and reconciled any differences and developed the final labels.

RESULTS

LDA outperformed all other algorithms, resulting in the highest coherence score. The best model was LDA with 60 topics, with a coherence score of 0.562. The 60 topics were grouped into 19 contextual categories. “Emotion and beliefs” had the largest proportion of total tweets (157,563/896,867, 17.6%), followed by “physical activity” (124,251/896,867, 13.85%) and “daily life” (80,730/896,867, 9%), while “food and drink,” “weather,” and “not being understood” had the smallest proportions (11,551/896,867, 1.29%; 10,109/896,867, 1.13%; and 9180/896,867, 1.02%, respectively). Of the 11 topics within “emotion and beliefs,” 113,562/157,563 (72%) had negative sentiment.

CONCLUSIONS

The content analysis of tweets in the area of LBP identified common themes that are consistent with findings from conventional qualitative studies but provide a more granular view of individuals’ perspectives related to LBP. This understanding has the potential to assist with developing more effective and personalized models of care to improve outcomes in those with LBP.