bluuebunny/crossref_metadata_2025 huggingface dataset:
Eksplorasi Motivasi Berbelanja Menggunakan Aplikasi Belanja Online di Indonesia
Authors:   School of Business and Economics Universitas Prasetiya Mulya JL. RA. Kartini (TB Simatupang), Cilandak Barat Jakarta Selatan, Jakarta 12430 Indonesia., Budi Santoso Arief , Prabowo Fuad ,   School of Business and Economics Universitas Prasetiya Mulya JL. RA. Kartini (TB Simatupang), Cilandak Barat Jakarta Selatan, Jakarta 12430 Indonesia., Homsani Homsani ,   School of Business and Economics Universitas Prasetiya Mulya JL. RA. Kartini (TB Simatupang), Cilandak Barat Jakarta Selatan, Jakarta 12430 Indonesia., Yusuf Wira Dharma Muhamad ,   School of Business and Economics Universitas Prasetiya Mulya JL. RA. Kartini (TB Simatupang), Cilandak Barat Jakarta Selatan, Jakarta 12430 Indonesia., Yulianto Yulianto
Published: July 2021

Penelitian ini bertujuan untuk mengeksplorasi dan menganalisis hubungan antara motivasi berbelanja yang menggunakan aplikasi belanja online dengan faktor sosiodemografi: usia, jenis kelamin, pendidikan, pekerjaan, lokasi tempat tinggal dan preferensi moda belanja seseorang di Indonesia. Kuesioner ‘Shopping Motivational Value Questionnaire” (SMVQ) dalam penelusuran studi pustaka merupakan salah satu alat ukur terbaru yang valid dan reliabel untuk menilai hal tersebut. Penelitian yang mengeksplorasi motivasi berbelanja dengan aplikasi belanja online menggunakan kuesioner yang valid dan reliabel belum pernah dilakukan di Indonesia. Implikasi alat ukur ini dapat digunakan lebih luas dalam menggali motivasi seseorang dengan faktor terkait lainnya.
Does the coastal location of municipalities influence their innovation development?
Authors:   Immanuel Kant Baltic Federal University, Mikhaylova Anna A. , Gorochnaya Vasilisa V. ,   Southern Federal University, Gumenyuk Ivan S. ,   Immanuel Kant Baltic Federal University, Plotnikova Angelina P. ,   Immanuel Kant Baltic Federal University, Mikhaylov Andrey S. ,   Immanuel Kant Baltic Federal University,   Institute of Geography of Russian Academy of Sciences
Published: July 2021

The coastal regions are increasingly in the focus of contemporary academic research as economically favorable territories with high innovative potential. The coastalization factor gets individual attention, the influence of which is registered in various countries of the world as a tendency of the population and economic activity to concentrate in the coastal zone. However, there is significant heterogeneity between the coastal areas, due to natural and climatic features and affecting their economic development. This paper focuses on assessing the differences in the readiness of the coastal regions of the European part of Russia to the innovation economy, taking into account their geographical location (northern, northwestern, southern). The study is conducted at the level of municipalities across 6 regions of Russia: Murmansk, Arkhangelsk, Leningrad, Kaliningrad, Rostov regions, and Krasnodar Krai. The research methodology included an assessment of 4 most important components of an innovative economy: human capital, business environment, knowledge production, and technological equipment. The results of the study showed a high degree of spatial divergence in terms of the level of readiness for the development of an innovative economy both between the regions of the sample and within them in the inter-municipal context. It is revealed that the concentration of innovative potential within the coastal region is largely the result of the cross-influence of the agglomeration and the coastalization factors. In the case of their complementary influence on coastal municipalities, the latter are characterized by a relatively higher level of readiness for the development of an innovative economy than inland ones. This is true for both the northern, northwestern, and southern coastal regions of the European part of Russia.
Outburst hazard of little-studied lakes assessment at the Mongun-Taiga massif
Authors:   St. Petersburg State University, Rasputina Valeriia A. , Ganyushkin Dmitry A. ,   St. Petersburg State University, Bantcev Dmitrii V. ,   St. Petersburg State University, Pryakhina Galina V. ,   St. Petersburg State University, Vuglinsky Valery S. ,   State Hydrological Institute,   St. Petersburg State University, Svirepov Stepan S. ,   St. Petersburg State University, Paniutin Nikolai A. ,   St. Petersburg State University, Volkova Daria D. ,   St. Petersburg State University, Nikolaev Mihail R. ,   St. Petersburg State University, Siroezhko Evgenii V. ,   St. Petersburg State University
Published: July 2021

There is a reduction in the area of glaciation of mountain massifs as a result of climate warming, which leads to the formation of lake-glacial complexes in areas of glaciation degradation. These complexes are dynamic systems that are rapidly changing over time, therefore, unstable and potentially outburst. Moraine and periglacial lakes outbursts are dangerous hydrological phenomena. As a result of outbursts catastrophic floods and mudflows can form, causing serious damage to the infrastructure of settlements located downstream and often leading to human toll. Therefore, the study of outburst-hazardous lakes is necessary and is an important applied problem associated with forecasting natural hazards. In this paper an the outburst hazard of little-studied moraine and periglacial lakes at the Mongun-Taiga mountain massif (Tyva Republic, Russian Federation) assessment was carried out using the scoring method, supplemented taking into account regional characteristics, using data from remote sensing of the Earth. The performed assessment according to satellite images showed that most of the massif's lakes have a high outburst hazard. Based on the assessment results a group of lakes was selected located in the right branch upstream of the river “Tolaity” for the purpose of a more detailed field survey (hydrological and geophysical studies were carried out). Field work carried out on the selected group of lakes allowed us to correct the performed assessment. In paper the applicability of the method based on comparing field data and data obtained from satellite images was estimated.
Two stage of gold-bearing sulfide ores of early Proterozoic gabbroids in the north Ladoga area
Authors:   Institute of Precambrian geology and geochronology, Russian Academy of Sciences, Baltybaev Shauket K. ,   St. Petersburg State University, Ovchinnikova Galina V. ,   Institute of Precambrian geology and geochronology, Russian Academy of Sciences, Kuznetsov Anton B. ,   Institute of Precambrian geology and geochronology, Russian Academy of Sciences,   St. Petersburg State University, Vasilieva Irina M. ,   Institute of Precambrian geology and geochronology, Russian Academy of Sciences, Rizvanova Nailya G. ,   Institute of Precambrian geology and geochronology, Russian Academy of Sciences, Alekseev Ivan A. ,   St. Petersburg State University, Kirillova Polina A. ,   Institute of Precambrian geology and geochronology, Russian Academy of Sciences,   St. Petersburg State University
Published: July 2021

In a study based on Pb isotopes, it has been shown that the formation of gold-sulfide mineralization in the Early Proterozoic gabbros of the Northern Ladoga region is associated with different tectonic phases. This conclusion is based on a comparative study of isotopic data for feldspars and lead sulfides in two Early Proterozoic intrusions; Velimäki and Alattu-Päkylä. The investigated intrusions have similar geological settings at the junction of the Svecofennian accretionary complex and the Karelian craton. Both massifs are characterized by manifestations of noble metal sulfide mineralization associated with zones of local shear deformations. The formation of the studied ore massifs is attributed to the Svecofennian and Caledonian tectonic stages. Feldspars of Velimäki intrusion have parameters and model age of Pb significantly older than U-Pb age of zircon (1.9 Ga), although they correspond to the Svecofennian time of magmatic crystallization of gabbro and clinopyroxenites, while sulfide pyrite-pyrrhotite mineralization is associated with gold in these rocks with the Caledonian stage of fluid-thermal processing of the Early Proterozoic magmatic mineral paracenteses. Feldspars and sulfides of the Alattu-Päkylä intrusion have similar lead isotopic parameters and Pb model age (~ 2 Ga), also somewhat older than the U-Pb age of zircon, but at the same time indicating the formation of rock-forming and ore sulfide associations with gold during the Svecofennian (Early Proterozoic) plutonic and tectonic-thermal events. The source of lead sulfides of the Velimäki massif is characterized by the parameters of the upper crust with high µ2 = 238U / 204Pb, while the µ2 parameter of the minerals of the Alattu-Päkylä massif is slightly lower, which indicates the participation of the mantle-lower crustal reservoir material in the formation of magma.
Avaliação da iluminação natural em edificação de uso coletivo em Cascavel
Authors: Corredato Aryon Pugsley , Siqueira Jair Antonio Cruz , Nascimento Laís Fernanda Juchem do , Cruz Nayara Fernanda Ferraz da Silva , Tokura Luciene Kazue , Villa Bruna de
Published: July 2021

O Brasil é um país com boa incidência de luz solar ao longo do ano, assim edificações que apresentem o máximo aproveitamento da iluminação natural, garantindo maior conforto e eficiência energética são uma das premissas da arquitetura sustentável. Seguindo essa linha de pensamento fica evidente a necessidade de estudos mais profundos referentes ao melhor uso da luz natural e do aproveitamento da ventilação nas edificações. Para que os futuros projetos tenham um maior aproveitamento da iluminação natural deve-se analisar, estudar e compreender as falhas e evidenciar os acertos realizados na concepção das edificações atuais. O presente trabalho teve como objetivo avaliar os níveis de iluminância natural mantida no interior de uma edificação residencial de uso coletivo em Cascavel - PR e compará-los aos valores mínimos estabelecidos pelas normas vigentes. O estudo foi desenvolvido com base em medições do nível de iluminação natural em 3 apartamentos em diferentes andares, cada um com uma orientação diferente, usando a metodologia proposta pela Associação Brasileira de Normas Técnicas. Posteriormente foi realizada uma comparação com os dados obtidos no estudo com os valores mínimos sugeridos pelas normas vigentes. Os apartamentos apresentaram níveis de iluminância natural em conformidade com a norma, em 7 dos 8 cômodos estudados. Apenas o cômodo do BWC 1 não atingiu os níveis mínimos recomendados pelas normas, pelo fato do mesmo não possuir janela que permitiam a entrada de luz natural.
Interrelationships between policies to encourage biofuels, energy efficiency and climate change mitigation: A synergistic analysis focusing on the Brazilian RenovaBio Program
Authors: Simões André Felipe , Kutianski José Romeiro Laércio , Massao Kurita Rodrigo
Published: July 2021

O Brasil, que possui matriz energética tipicamente renovável e como um dos líderes mundiais em produção de biocombustíveis aprovou, em 2017, a implantação de política de fomento aos biocombustíveis correlata à redução das emissões de Gases do Efeito Estufa (GEE), por meio do Programa RenovaBio. O Brasil está inserido em um pequeno grupo de países que possuem matriz energética tipicamente renovável, diferentemente da matriz média mundial que se caracteriza por ser basicamente de origem fóssil. Urge frisar que a despeito da importância crescente que diversos países têm mostrado ao inserir em seus programas econômicos metas de redução das emissões de GEE, os combustíveis de origem fóssil ainda representam um “driver” para maioria dos polos econômicos. Destarte, o objetivo do presente trabalho, de caráter exploratório e com foco em políticas endereçadas ao fomento da oferta e do consumo de biocombustíveis no Brasil e em blocos de países, é analisar, sinergicamente, eventuais discrepâncias tecnológicas, regulatórias e econômicas entre países desenvolvidos e países em desenvolvimento. Concomitantemente, objetiva-se contribuir para a compreensão ampliada sobre o papel da eficiência energética e dos biocombustíveis para o estabelecimento de uma economia de baixo carbono, em nível global. Para tanto, como percursos metodológico, empreendeu-se a uma aprofundada revisão bibliográfica sistêmica com base, centralmente, em periódicos científicos arbitrados e em relatórios de agências públicas e privadas produzidos no Brasil e no exterior atuantes na área de biocombustíveis, eficiência energética e mitigação das mudanças climáticas. Constatou-se que o delineamento e realização de uma economia de baixo carbono que coteje substancial redução da emissão global de GEE ao longo do corrente século XXI e que signifique que a temperatura média da superfície terrestre não ultrapasse os 2 ºC até 2100, tal como preconiza o vigente Acordo de Paris, inexoravelmente, requer medidas de eficiência energética alicerçadas em políticas de fomento à produção e ao consumo de biocombustíveis.

Palavras-chave: Mitigação das mudanças climáticas. Eficiência Energética. Biocombustíveis. Programa Brasileiro Renovabio. Acordo de Paris.
Emissões teóricas de biogás de aterro e seu aproveitamento energético no Brasil: um estudo bibliométrico
Authors: Zavarise Julio Pansiere , Sagrillo Pimassoni Yasmim , Pinotti Laura Marina , Lopes Lemos Ediu Carlos
Published: July 2021

A destinação incorreta dos resíduos sólidos urbanos (RSU) causa a emissão de gases do efeito estufa (GEE), como o metano (CH4). Os aterros sanitários são a principal destinação dos RSU no Brasil e geram o biogás de aterro, o qual pode ser aproveitado para fins energéticos. Para que os aterros possam projetar sistemas de recuperação e uso energético do biogás é necessário estimar o volume de gás que será emitido durante a vida útil do aterro. Para isso, pode-se fazer uso de modelos matemáticos, como o LandGEM e o modelo desenvolvido pelo Painel Intergovernamental sobre Mudanças Climáticas (IPCC, da sigla em inglês). Considerando o crescimento das publicações acerca da valorização energética do biogás de aterro, este estudo teve como objetivo, identificar as tendências e lacunas das pesquisas sobre os estudos das emissões teóricas de CH4 em aterros sanitários brasileiros e seu posterior aproveitamento energético, através de uma análise bibliométrica. Foi observada uma tendência de crescimento no número de publicações no período de 2013 a 2020. A Índia, China e os Estados Unidos são os países que mais publicaram artigos dentro da temática no período de análise. Quanto aos modelos aplicados, observou-se forte preferência pelo modelo LandGEM e por projetos de conversão de biogás em energia elétrica. Destaca-se ainda o crescimento da geração distribuída de eletricidade a partir do biogás de aterro. Como oportunidades de pesquisas tem-se a possibilidade de utilização do modelo IPCC para gerar estimativas teóricas de emissões de GEE nos aterros de RSU brasileiros e o uso do biometano na geração de calor e na substituição da demanda local por gás natural.
A Comprehensive One-Pot Synthesis of Protected Cysteine and Selenocysteine SPPS Derivatives
Authors: Flemer Stevenson
Published: July 2021

A proof-of-principle methodology is presented in which all commercially-available cysteine (Cys) and selenocysteine
(Sec) solid phase peptide synthesis (SPPS) derivatives are synthesized in high yield from easily prepared protected
dichalcogenide precursors. A Zn-mediated biphasic reduction process applied to a series of four bis-Nα-protected
dichalcogenide compounds allows facile conversion to their corresponding thiol and selenol intermediates followed by insitu
S- or Se-alkylation with various electrophiles to directly access twenty one known Cys and Sec SPPS derivatives.
Most of these derivatives were able to be precipitated in crude form out of petroleum ether in sufficient purity for direct
use as peptide building blocks. Subsequent incorporation of these derivatives into peptide models nicely illustrates their
viability and applicability toward SPPS.
Development of a Norovirus P Particle Platform for Eliciting Neutralizing Antibody Responses to the Membrane Proximal External Region of Human Immunodeficiency Virus Type 1 Envelope
Authors: Zang Yang , Bi Jinpeng , Du Dongchuan , Liu Xintao , Zhang Yan , Su Weiheng , Wu Jiaxin , Shan Yaming , Wang Song , Kong Wei , Qiu Aidong , Jiang Chunlai
Published: July 2021

Eliciting efficient broadly neutralizing antibodies (BnAbs) is an important goal that has yet to be achieved for
human immunodeficiency type 1 (HIV-1) vaccine development, although they are rarely produced in virus-infected individuals.
In particular, inducing specific neutralizing antibodies to the gp41 membrane proximal external region (MPER)
has proven a difficult task. In this study, we introduce Norovirus P particles as a new platform to display the MPER epitope
of HIV-1 as a vaccine with the aim of enhancing immune responses. The results showed that HIV-1 chimeric P particles
were capable of inducing MPER-specific antibody responses in immunized guinea pigs, although only weakly neutralizing
activity could be detected. These findings are consistent with other previous studies which have also focused on
the well-studied 2F5 and 4E10 BnAbs. Our findings provide an alternate strategy for design of vaccines against HIV-1.
However, great challenges remain in the effort to develop vaccines that can induce efficient HIV-1 neutralizing antibodies.
Antibacterial Function of the Human Cathelicidin-18 Peptide (LL-37) between Theory and Practice
Authors: Iacob Simona A. , Iacob Diana G.
Published: July 2021

The human cathelicidin-18 is an antimicrobial, immunomodulatory and tissue repair peptide. The LL-37 fragment
of this peptide which is in fact the active domain of the cathelicidin-18 is critical for the human antibacterial defense
and epithelial integrity. It's activity against resistant pathogens, the potential of epithelial healing after microbial injury
and the neutralization of bacterial endotoxin underlie the most important benefits of this peptide. However, there are still a
number of questions that remain to be answered regarding the precise interactions of cathelicidin-18 within the immune
system, the exact tissue concentrations or its possible pro-tumoral activity. In this respect, the therapeutic potential of
cathelicidin-18 in various infections has been proved by in vitro experiments, but additional detailed clinical studies are
still required to ascertain its antimicrobial role in vivo.

We present a short review on the antibacterial activity of human cathelicidin-18 (LL-37) according to in vitro experiments
while discussing its potential use in the clinical practice.
Inflammation-Mediating Proteases: Structure, Function in (Patho) Physiology and Inhibition
Authors: Mancek-Keber Mateja
Published: July 2021

Proteases regulating inflammation are versatile enzymes, usually extracellular matrix degrading enzymes that
are involved in wound healing, angiogenesis, coagulation, development, apoptosis and other physiological processes.
Their dysregulation and increased expression during inflammation can have devastating consequences, promoting etiology
of vascular diseases, inflammatory arthritis, cancer, and allograft rejection. In this review several proteases
(ADAMTS, granzymes, plasmin, and kallikreins) with different mechanisms and substrates are described in addition to
their physiological roles and contribution to inflammation and inflammatory diseases. Inhibition of proteases may therefore
represent an attractive strategy for treatment and herein we describe physiological and engineered inhibitors.
The Genomic DNA Immobilization on Microcrystalline Cellulose and its Application to Separate DNA-Binding Proteins from Kumquat (Fortunella margarita Swingle)
Authors: Yang Hua , Li Huang , Guo Chun , Li Meng-yun , Rao Li-qun , Liu Ting
Published: July 2021

A method of immobilizing genomic DNA on microcrystalline cellulose was described to isolate DNA-binding
proteins. At first, DNA fragments were prepared by sonication and immobilized on cellulose phase. After the
immobilization, DNA duplex formation was done. Using this microcrystalline cellulose affinity chromatography
technique, DNA-binding proteins from kumquat (Fortunella margarita Swingle) leaf samples were isolated and then
analyzed by Liquid Chromatography–Mass Spectrometry (LC-MS/MS). LC-MS/MS analysis showed that twenty-eight
kinds of protein mainly including histones, protein-synthetic proteins and other DNA-binding proteins were identified.
The identification list consists with the results in previous research on DNA-binding proteins isolation. It further suggests
that the technique developed in this study can be applied to the effective isolation of DNA-binding proteins.
The Novel Coronavirus in Pediatric and Geriatric Population- What We Know
Authors: Reche Amit , Nandanwar Anjali , Hedaoo Aniket , Chhbra Kumar G. , Fulzele Punit , Nimbulkar Gargi
Published: July 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)is a virus responsible for the coronavirus infection that is currently causing a severe outbreak of the disease in the world, infecting and killing thousands to lacs of people. The pediatric and geriatric population is no exception to this. Children and older adults have less immunity, which makes them more susceptible to infection than other populations. But still the number of cases of Children where less as compared to adults and those having underlying pulmonary pathology or immunocompromising conditions are more vulnerable to infection. Some studies have shown that this virus causes more death in the older age population as compared to adults or children. Patients having any systemic conditions like diabetes, raised blood pressure, heart diseases, lung diseases and chronic renal diseases were more vulnerable to this infection. In this article, we will outline the epidemiology, symptoms, diagnosis, and treatment modalities of the novel coronavirus-2019(COVID 19) infection in humans, with more focusing on infection in children as well as in older adults.
Ten-Year Mortality Trends and Natural Causes of Death in the Iraqi Kurdistan
Authors: Salih Shahla O. , Moramarco Stefania , Di Giovanni Daniele , Qadir Sivar A. , Alsilefanee Haveen H. , Basa Faiq B. , Gialloreti Leonardo Emberti
Published: July 2021

Background:

Mortality and causes of death are among the most important statistics used in assessing the effectiveness of a country’s health system. Several countries do not have information systems for collecting these data, and they must therefore be estimated from surveys.

Objective:

This study analyzes mortality data retrieved from official government databases in Iraqi Kurdistan to describe ten-year trends in natural causes of death.

Methods:

Data for natural causes of death, reported from 2009 to 2018, were extracted from the databases of the Registration Bureau of Births and Deaths and of the Forensic Medicine of the Province of Sulaymaniyah. A sample of 16,433 causes of death was analyzed.

Results:

Causes of death were coded according to the ICD-10 classification. Overall, cardiovascular diseases were the leading cause of mortality (52.6%), followed by neoplasms (17.7%), infectious and parasitic diseases (8.9%), and genitourinary diseases (6.3%). Neonatal conditions, congenital anomalies, and neurological conditions each accounted for less than 1% each. Numbers of natural deaths by cause and cause-specific mortality rates have been estimated for the entire Region of Iraqi Kurdistan. Comparisons with other sources suggest that there is a substantial amount of underreporting, especially in relation to deaths of infants and under-five children.

Conclusion:

Our findings confirm that the region is facing a burden of non-communicable diseases, coupled with high proportions of infectious diseases. However, the lack of effective vital statistics with combined under-reported data collection highlights the need for implementation of health monitoring systems. Advancements in generating high-quality data are essential in improving health and reducing preventable deaths. The establishment of a novel Health Information System is discussed.
The Beliefs and Practices on Sexual Health and Sexual Transmitted Infection Prevention of Myanmar Migrant Workers in Thailand
Authors: Hounnaklang Nuchanad , Sarnkhaowkhom Chawapon , Bannatham Rattana
Published: July 2021

Background:

Thailand is recognized as one of the countries in Southeast Asia that has attracted a large number of migrant workers from her neighboring counterparts. The issue of sexual transmitted infections among transnational migrant workers has caused grave concerns for Thai government, particularly the authority responsible for healthcare policy and planning.

Objective:

This study aimed to explain the sexual beliefs and practices on sexual health and sexual transmitted infections prevention of Myanmar migrant workers in Thailand.

Methods:

The qualitative research method was applied in this research. The data collection covered observation, field note takings, in-depth interviews, and secondary data derived from literature reviews of various sources. The participants consisted of 22 Myanmar migrant workers who could communicate in Thai and live in Thailand for at least one year. The data was analyzed by using the method of content analysis.

Results:

The findings of this study included two major themes and four subthemes as follows: 1. The meanings of sexual transmitted infections 2. The sexual health and sexual transmitted infections prevention: 2.1) Males and Females: equality to STI’s prevention2.2) Sexual Risk Behaviors: No prostitute services, No sexual risks 2.3) Condom usage: unaffordable and the symbol of promiscuous and untrustworthy and 2.4) Abortion: unavoidable solutions to unwanted pregnancy.

Conclusion:

The findings provided an understanding of sexual beliefs and practices on sexual health and sexually transmitted infections prevention among Myanmar migrant workers that can be applied to the policy making as a foundation data including to inform and propose to the concerned society, healthcare organizations, healthcare providers and nurses, in particular.
Public Health Experts have the Highest Impact on Citizens’ Compliance with COVID-19 Prevention Recommendations
Authors: Tahirbegolli Bernard , Tahirbegolli Iliriana A. , Paice Leonora , Muçaj Sefedin , Hoxha Adnan , Vehid Suphi
Published: July 2021

Introduction:

In this study, we investigated the sources of information that have had the highest impact on Kosovans’ compliance with preventive measures against COVID-19.

Methods:

We recruited 744 participants, aged 18-35, to participate in this cross-sectional survey between 27th April and 5th May 2020, utilising an online questionnaire.

Results:

Our findings show that public health experts had the greatest influence in persuading citizens to obey the recommendations, with 63.2% (470) compliance, followed by family members, with 18% (134), and health workers, with 10.2% (76).

Conclusion:

Our study has shown that public health experts have had the greatest impact on Kosovo citizens, persuading them to follow recommendations designed to prevent the spread of COVID-19.
Development and Validation of Unplanned Extubation Prediction Models Using Intensive Care Unit Data: Retrospective, Comparative, Machine Learning Study
Authors: Hur Sujeong , Min Ji Young , Yoo Junsang , Kim Kyunga , Chung Chi Ryang , Dykes Patricia C , Cha Won Chul
Published: July 2021

Background

Patient safety in the intensive care unit (ICU) is one of the most critical issues, and unplanned extubation (UE) is considered the most adverse event for patient safety. Prevention and early detection of such an event is an essential but difficult component of quality care.

Objective

This study aimed to develop and validate prediction models for UE in ICU patients using machine learning.

Methods

This study was conducted in an academic tertiary hospital in Seoul, Republic of Korea. The hospital had approximately 2000 inpatient beds and 120 ICU beds. As of January 2019, the hospital had approximately 9000 outpatients on a daily basis. The number of annual ICU admissions was approximately 10,000. We conducted a retrospective study between January 1, 2010, and December 31, 2018. A total of 6914 extubation cases were included. We developed a UE prediction model using machine learning algorithms, which included random forest (RF), logistic regression (LR), artificial neural network (ANN), and support vector machine (SVM). For evaluating the model’s performance, we used the area under the receiver operating characteristic curve (AUROC). The sensitivity, specificity, positive predictive value, negative predictive value, and F1 score were also determined for each model. For performance evaluation, we also used a calibration curve, the Brier score, and the integrated calibration index (ICI) to compare different models. The potential clinical usefulness of the best model at the best threshold was assessed through a net benefit approach using a decision curve.

Results

Among the 6914 extubation cases, 248 underwent UE. In the UE group, there were more males than females, higher use of physical restraints, and fewer surgeries. The incidence of UE was higher during the night shift as compared to the planned extubation group. The rate of reintubation within 24 hours and hospital mortality were higher in the UE group. The UE prediction algorithm was developed, and the AUROC for RF was 0.787, for LR was 0.762, for ANN was 0.763, and for SVM was 0.740.

Conclusions

We successfully developed and validated machine learning–based prediction models to predict UE in ICU patients using electronic health record data. The best AUROC was 0.787 and the sensitivity was 0.949, which was obtained using the RF algorithm. The RF model was well-calibrated, and the Brier score and ICI were 0.129 and 0.048, respectively. The proposed prediction model uses widely available variables to limit the additional workload on the clinician. Further, this evaluation suggests that the model holds potential for clinical usefulness.
The Impact of Gamification-Induced Users' Feelings on the Continued Use of mHealth Apps: A Structural Equation Model With the Self-Determination Theory Approach
Authors: Wang Tong , Fan Lingye , Zheng Xu , Wang Wei , Liang Jun , An Kai , Ju Mei , Lei Jianbo
Published: July 2021

Background

Continued use of mHealth apps can achieve better effects in health management. Gamification is an important factor in promoting users’ intention to continue using mHealth apps. Past research has rarely explored the factors underlying the continued use of mobile health (mHealth) apps and gamification’s impact mechanism or path on continued use.

Objective

This study aimed to explore the factors influencing mHealth app users’ intention to continue using mHealth apps and the impact mechanism and path of users’ feelings induced by gamification on continued mHealth app use.

Methods

First, based on the expectation confirmation model of information system continuance, we built a theoretical model for continued use of mHealth apps based on users’ feelings toward gamification. We used self-determination theory to analyze gamification’s impact on user perceptions and set the resulting feelings (competence, autonomy, and relatedness) as constructs in the model. Second, we used the survey method to validate the research model, and we used partial least squares to analyze the data.

Results

A total of 2988 responses were collected from mHealth app users, and 307 responses were included in the structural equation model after passing the acceptance criteria. The intrinsic motivation for using mHealth apps is significantly affected by autonomy (β=.312; P<.001), competence (β=.346; P<.001), and relatedness (β=.165; P=.004) induced by gamification. The intrinsic motivation for using mHealth apps has a significant impact on satisfaction (β=.311, P<.001) and continuance intention (β=.142; P=.045); furthermore, satisfaction impacts continuance intention significantly (β=.415; P<.001). Confirmation has a significant impact on perceived usefulness (β=.859; P<.001) and satisfaction (β=.391; P<.001), and perceived usefulness has a significant impact on satisfaction (β=.269; P<.001) and continuance intention (β=.273; P=.001). The mediating effect analysis showed that in the impact path of the intrinsic motivation for using the mHealth apps on continuance intention, satisfaction plays a partial mediating role (β=.129; P<.001), with a variance accounted for of 0.466.

Conclusions

This study explored the impact path of users’ feelings induced by gamification on the intention of continued mHealth app use. We confirmed that perceived usefulness, confirmation, and satisfaction in the classical continued use theory for nonmedical information systems positively affect continuance intention. We also found that the path and mechanism of users' feelings regarding autonomy, competence, and relatedness generated during interactions with different gamification elements promote the continued use of mHealth apps.
A Tool to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals (CAPOCI): Design and Validation Study
Authors: Lenaerts Gerlinde , Bekkering Geertruida E , Goossens Martine , De Coninck Leen , Delvaux Nicolas , Cordyn Sam , Adriaenssens Jef , Aertgeerts Bert , Vankrunkelsven Patrik
Published: July 2021

Background

User-friendly information at the point of care for health care professionals should be well structured, rapidly accessible, comprehensive, and trustworthy. The reliability of information and the associated methodological process must be clear. There is no standard tool to evaluate the trustworthiness of such point-of-care (POC) information.

Objective

We aim to develop and validate a new tool for assessment of trustworthiness of evidence-based POC resources to enhance the quality of POC resources and facilitate evidence-based practice.

Methods

We designed the Critical Appraisal of Point-of-Care Information (CAPOCI) tool based on the criteria important for assessment of trustworthiness of POC information, reported in a previously published review. A group of health care professionals and methodologists (the authors of this paper) defined criteria for the CAPOCI tool in an iterative process of discussion and pilot testing until consensus was reached. In the next step, all criteria were subject to content validation with a Delphi study. We invited an international panel of 10 experts to rate their agreement with the relevance and wording of the criteria and to give feedback. Consensus was reached when 70% of the experts agreed. When no consensus was reached, we reformulated the criteria based on the experts’ comments for a next round of the Delphi study. This process was repeated until consensus was reached for each criterion. In a last step, the interrater reliability of the CAPOCI tool was calculated with a 2-tailed Kendall tau correlation coefficient to quantify the agreement between 2 users who piloted the CAPOCI tool on 5 POC resources. Two scoring systems were tested: a 3-point ordinal scale and a 7-point Likert scale.

Results

After validation, the CAPOCI tool was designed with 11 criteria that focused on methodological quality and author-related information. The criteria assess authorship, literature search, use of preappraised evidence, critical appraisal of evidence, expert opinions, peer review, timeliness and updating, conflict of interest, and commercial support. Interrater agreement showed substantial agreement between 2 users for scoring with the 3-point ordinal scale (τ=.621, P<.01) and scoring with the 7-point Likert scale (τ=.677, P<.01).

Conclusions

The CAPOCI tool may support validation teams in the assessment of trustworthiness of POC resources. It may also provide guidance for producers of POC resources.
Contact Tracing Apps: Lessons Learned on Privacy, Autonomy, and the Need for Detailed and Thoughtful Implementation
Authors: Hogan Katie , Macedo Briana , Macha Venkata , Barman Arko , Jiang Xiaoqian
Published: July 2021

The global and national response to the COVID-19 pandemic has been inadequate due to a collective lack of preparation and a shortage of available tools for responding to a large-scale pandemic. By applying lessons learned to create better preventative methods and speedier interventions, the harm of a future pandemic may be dramatically reduced. One potential measure is the widespread use of contact tracing apps. While such apps were designed to combat the COVID-19 pandemic, the time scale in which these apps were deployed proved a significant barrier to efficacy. Many companies and governments sprinted to deploy contact tracing apps that were not properly vetted for performance, privacy, or security issues. The hasty development of incomplete contact tracing apps undermined public trust and negatively influenced perceptions of app efficacy. As a result, many of these apps had poor voluntary public uptake, which greatly decreased the apps’ efficacy. Now, with lessons learned from this pandemic, groups can better design and test apps in preparation for the future. In this viewpoint, we outline common strategies employed for contact tracing apps, detail the successes and shortcomings of several prominent apps, and describe lessons learned that may be used to shape effective contact tracing apps for the present and future. Future app designers can keep these lessons in mind to create a version that is suitable for their local culture, especially with regard to local attitudes toward privacy-utility tradeoffs during public health crises.
Feasibility of an Interactive Health Coaching Mobile App to Prevent Malnutrition and Muscle Loss in Esophageal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy: Prospective Pilot Study
Authors: Yang Kyungmi , Oh Dongryul , Noh Jae Myoung , Yoon Han Gyul , Sun Jong-Mu , Kim Hong Kwan , Zo Jae Ill , Shim Young Mog , Ko Hyunyoung , Lee Jungeun , Kim Youngin
Published: July 2021

Background

Excessive muscle loss is an important prognostic factor in esophageal cancer patients undergoing neoadjuvant chemoradiotherapy (NACRT), as reported in our previous research.

Objective

In this pilot study, we prospectively tested the feasibility of a health coaching mobile app for preventing malnutrition and muscle loss in this patient population.

Methods

Between July 2019 and May 2020, we enrolled 38 male patients with esophageal cancer scheduled for NACRT. For 8 weeks from the start of radiotherapy (RT), the patients used Noom, a health coaching mobile app that interactively provided online advice about food intake, exercise, and weight changes. The skeletal muscle index (SMI) measured based on computed tomography and nutrition-related laboratory markers were assessed before and after RT. We evaluated the changes in the SMI, nutrition, and inflammatory factors between the patient group that used the mobile app (mHealth group) and our previous study cohort (usual care group). Additionally, we analyzed the factors associated with walk steps recorded in the app.

Results

Two patients dropped out of the study (no app usage; treatment changed to a definitive aim). The use (or activation) of the app was noted in approximately 70% (25/36) of the patients until the end of the trial. Compared to the 1:2 matched usual care group by propensity scores balanced with their age, primary tumor location, tumor stage, pre-RT BMI, and pre-RT SMI level, 30 operable patients showed less aggravation of the prognostic nutritional index (PNI) (–6.7 vs –9.8; P=.04). However, there was no significant difference in the SMI change or the number of patients with excessive muscle loss (∆SMI/50 days >10%). In patients with excessive muscle loss, the walk steps significantly decreased in the last 4 weeks compared to those in the first 4 weeks. Age affected the absolute number of walk steps (P=.01), whereas pre-RT sarcopenia was related to the recovery of the reduced walk steps (P=.03).

Conclusions

For esophageal cancer patients receiving NACRT, a health care mobile app helped nutritional self-care with less decrease in the PNI, although it did not prevent excessive muscle loss. An individualized care model with proper exercise as well as nutritional support may be required to reduce muscle loss and malnutrition.
Digital Medical Device Companion (MyIUS) for New Users of Intrauterine Systems: App Development Study (Preprint)
Authors: Karakoyun Toeresin , Podhaisky Hans-Peter , Frenz Ann-Kathrin , Schuhmann-Giampieri Gabriele , Ushikusa Thais , Schröder Daniel , Zvolanek Michal , Lopes Da Silva Filho Agnaldo
Published: July 2021

BACKGROUND

Women choosing a levonorgestrel-releasing intrauterine system may experience changes in their menstrual bleeding pattern during the first months following placement.

OBJECTIVE

Although health care professionals (HCPs) can provide counseling, no method of providing individualized information on the expected bleeding pattern or continued support is currently available for women experiencing postplacement bleeding changes. We aim to develop a mobile phone–based medical app (MyIUS) to meet this need and provide a digital companion to women after the placement of the intrauterine system.

METHODS

The MyIUS app is classified as a medical device and uses an artificial intelligence–based bleeding pattern prediction algorithm to estimate a woman’s future bleeding pattern in terms of intensity and regularity. We developed the app with the help of a multidisciplinary team by using a robust and high-quality design process in the context of a constantly evolving regulatory landscape. The development framework consisted of a phased approach including ideation, feasibility and concept finalization, product development, and product deployment or localization stages.

RESULTS

The MyIUS app was considered useful by HCPs and easy to use by women who were consulted during the development process. Following the launch of the sustainable app in selected pilot countries, performance metrics will be gathered to facilitate further technical and feature updates and enhancements. A real-world performance study will also be conducted to allow us to upgrade the app in accordance with the new European Commission Medical Device legislation and to validate the bleeding pattern prediction algorithm in a real-world setting.

CONCLUSIONS

By providing a meaningful estimation of bleeding patterns and allowing an individualized approach to counseling and discussions about contraceptive method choice, the MyIUS app offers a useful tool that may benefit both women and HCPs. Further work is needed to validate the performance of the prediction algorithm and MyIUS app in a real-world setting.
Prediction of the financial risk of Special Treatment of a Listed Pharmaceutical Company in China: A Principal Component Analysis (Preprint)
Authors: Cai Yiming , Hu Xueyan , Guo Yiwei , Yan Ni , Ming Wai-Kit
Published: July 2021

BACKGROUND

The listed pharmaceutical industry of China is growing swiftly by about 10% interest per year. However, risk always keeps pace with improvements. In China, listed companies with significant financial distress or irregularities will be assigned a special treatment (ST) label indicating a risk warning. Recently, eight listed pharmaceutical companies with a ST sign are surviving with but present serious investment risks.

OBJECTIVE

This paper aimed to discover the most significant factors that cause conversion of a listed pharmaceutical company into an ST firm. Tailored approaches for protecting China’s listed pharmaceutical companies from financial risks are being developed in order to help this domain in profit. Besides, we also aimed to offer suggestions for investors for investigating Chinese listed pharmaceuticals with the goal of assisting the investors in making successful investments.

METHODS

After collecting data from online databases, a principal component analysis (PCA) model was applied for descending data dimensions. After selecting the components with highest contribution, a logistic regression (LR) model was conducted for simplifying the outcome and calculating the intercept, component coefficients, standard error (SE), and Z and p-values.

RESULTS

Nine principal components were crucial from the principal component analysis (PCA) model, and two components (components 1 and 5) remaining as the most important factors after the LR model. The estimated intercept was 4.866 (SE 1.096, Z-value 4.442, p < 0.001). The estimated coefficient for components 1 (SE 0.332, Z-value 3.067, p = 0.002) and 5 (SE 0.643, Z-value −2.6, p = 0.009) were 1.017 and −1.672, respectively.

CONCLUSIONS

Investors are supposed to supervise the accounting conditions in three sectors: (1) solvency, profitability, and research and development (R&D) investment; (2) running the firm properly; and/or (3) investing successfully. Firms are supposed to hire professional partitioners as leaders. The major shareholders should not plan any questionable investments for personal income, and they should ensure the firm works under conditions with low liability, high profitability, and R&D costs that match the perfect growth opportunity after the Coronavirus 2019 (COVID-19) pandemic and the strong growth of China’s economy in 2020.
A National Network of Safe Havens: Scottish Perspective (Preprint)
Authors: Gao Chuang , McGilchrist Mark , Mumtaz Shahzad , Hall Christopher , Anderson Lesley Ann , Zurowski John , Gordon Sharon , Lumsden Joanne , Munro Vicky , Wozniak Artur , Sibley Michael , Banks Christopher , Duncan Chris , Linksted Pamela , Hume Alastair , Stables Catherine L , Mayor Charlie , Caldwell Jacqueline , Wilde Katie , Cole Christian , Jefferson Emily
Published: July 2021

UNSTRUCTURED

For over a decade, Scotland has implemented and operationalized a system of Safe Havens, which provides secure analytics platforms for researchers to access linked, deidentified electronic health records (EHRs) while managing the risk of unauthorized reidentification. In this paper, a perspective is provided on the state-of-the-art Scottish Safe Haven network, including its evolution, to define the key activities required to scale the Scottish Safe Haven network’s capability to facilitate research and health care improvement initiatives. A set of processes related to EHR data and their delivery in Scotland have been discussed. An interview with each Safe Haven was conducted to understand their services in detail, as well as their commonalities. The results show how Safe Havens in Scotland have protected privacy while facilitating the reuse of the EHR data. This study provides a common definition of a Safe Haven and promotes a consistent understanding among the Scottish Safe Haven network and the clinical and academic research community. We conclude by identifying areas where efficiencies across the network can be made to meet the needs of population-level studies at scale.