bluuebunny/crossref_metadata_2025 huggingface dataset:
The Ombudsman and the Family
Authors: Tyndall Peter
Published: May 2021

W artykule rozpatrzona jest rola Rzecznika Praw Obywatelskich w sprawach dotyczących rodzin. Autor korzysta z własnego doświadczenia z okresu pełnienia funkcji Rzecznika w dwóch porządkach prawnych common law Zjednoczonego Królestwa Brytyjskiego: obecnie Irlandii, a wcześniej Walii. Artykuł identyfikuje pozycję i działania Rzecznika Praw Obywatelskich tych krajów wśród szerszej społeczności Rzeczników, ze szczególnym uwzględnieniem działań promujących dobrą administrację poprzez zwalczanie niewłaściwych działań administracji. Analizowany jest wpływ działań Rzecznika na różne aspekty interwencji państwa w sprawy życia rodzinnego, na przykład w zakresie pieczy zastępczej, wsparcia dla dzieci z niepełnosprawnościami czy prowadzenia postępowań w przypadku doniesień o przemocy seksualnej wobec dzieci. Artykuł opisuje szerokie spektrum działań Rzecznika – od dochodzeń w sprawach indywidualnych po dochodzenia prowadzone z własnej inicjatywy w zakresie systemowych problemów dotyczących ochrony praw dziecka w Irlandii.
Sytuacja prawna rodziny pacjenta w stanie terminalnym
Authors: Kruczkowski Mateusz
Published: May 2021

Stan terminalny pacjenta wywiera konkretny wpływ na jego rodzinę. Na tą rzeczywistość, której podlega rodzina pacjenta składa się m.in.: lęk, obawa przed samotnością, bezradnością, śmiercią, umieraniem, otrzymaniem potrzebnego sprzętu, awarią sprzętu, bólem i cierpieniem chorego, pogorszeniem statusu ma-terialnego, izolacją społeczną, widokiem i kontaktem z ciałem zmarłego, swoimi emocjami, czy reakcją na śmierć innych członków rodziny. Opieka paliatywna to działanie, które poprawia jakość życia chorych i ich rodzin, stojących wobec problemów związanych z zagrażającą życiu, postępującą chorobą, poprzez zapobieganie i znoszenie cierpienia dzięki wczesnej identyfikacji oraz ocena i leczenie bólu i innych problemów: somatycznych, psychologicznych, socjalnych i duchowych. Stanowi więc ona adekwatną reakcję na stan człowieka będącego w fazie terminalnej oraz jego rodziny. Sytuacja administracyjnoprawna rodziny pacjenta w stanie terminalnym po-zostaje w funkcji sytuacji chorego terminalnie i jest z nią (z tą sytuacją) silnie sprzężona. Oznacza to, że im bardziej będzie poprawiać się sytuacja administracyjnoprawna pacjenta, tym lepsza będzie sytuacja administracyjnoprawna jego rodziny. Co oznacza lepsza? Punkt wyjścia stanowi dla nas prawo do godnego umierania, zakotwiczone w Konstytucji Rzeczypospolitej Polskiej. To właśnie w tymprawie, prawie do umierania w spokoju największym z możliwych i z należną mu ludzką godnością, ukonkretnia się godność człowieka w fazie terminalnej.
A look at the new job-task information in the National Longitudinal Surveys of Youth
Authors: Dey Matthew , Loewenstein Mark A. , Sun Hugette
Published: May 2021

Using data from the National Longitudinal Surveys of Youth 1979 and 1997, this article examines how the skill level and task content of U.S. jobs vary among workers born during the 1957–1964 and 1980–1984 periods. This article presents data on how job attributes vary by sex, race, Hispanic origin, and educational attainment as well as by performance on the Armed Forces Qualifying Test and type of occupation. It also examines the relationship between job attributes and wages.
Efecto de cultivos piscícolas en los sedimentos y la proliferación de comunidades bacterianas nitrificantes en el lago Guamuez, Colombia
Authors: Burbano-Gallardo Elizabeth , Nivia-Duque Guillermo , Imues-Figueroa Marco , Gonzalez-Legarda Edgar , Gómez-Delgado Mario , Pantoja-Díaz Jonny
Published: May 2021

La piscicultura altera los sedimentos y la microbiota en cuerpos de agua debido a los residuos de concentrados, sustancias químicas y desechos provenientes del metabolismo de los animales en producción. El presente estudio determinó el efecto de la producción extensiva, semiintensiva e intensiva de trucha arcoíris (Oncorhynchus mykiss) en los sedimentos y la proliferación de comunidades bacterianas nitrificantes. Se analizó nitrógeno total, fósforo total, carbono orgánico total y materia orgánica, y su relación con la presencia de bacterias nitrificantes (bacterias oxidantes de amonio [BOA] y bacterias oxidantes de nitritos [BON]) en el sedimento del lago Guamuez, ubicado en el departamento de Nariño, Colombia. Los datos recolectados fueron sometidos a un análisis de varianza (ANOVA) y de correlación múltiple, usando el software Statgraphics Centurion XV. Las variables evaluadas presentaron diferencias significativas (p < 0,05) entre los tres sistemas de cultivo y el punto control. Se encontró una correlación alta y positiva entre las bacterias nitrificantes y los compuestos nitrogenados, la materia orgánica y el fósforo medidos en el sedimento. Se concluyó que la presencia de bacterias nitrificantes depende de las cantidades de compuestos nitrogenados y materia orgánica existentes en el sedimento e incrementa a medida que se intensifica el sistema productivo.
Geographical Disparities in HIV Seroprevalence Among Men Who Have Sex with Men and People Who Inject Drugs in Nigeria: Exploratory Spatial Data Analysis
Authors: Onovo Amobi , Kalaiwo Abiye , Katbi Moses , Ogorry Otse , Jaquet Antoine , Keiser Olivia
Published: May 2021

Background

The assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) and people who inject drugs (PWID) can usefully inform targeted HIV prevention and care strategies.

Objective

We aimed to measure HIV seroprevalence and identify hotspots of HIV infection among MSM and PWID in Nigeria.

Methods

We included all MSM and PWID accessing HIV testing services across 7 prioritized states (Lagos, Nasarawa, Akwa Ibom, Cross Rivers, Rivers, Benue, and the Federal Capital Territory) in 3 geographic regions (North Central, South South, and South West) between October 1, 2016, and September 30, 2017. We extracted data from national testing registers, georeferenced all HIV test results aggregated at the local government area level, and calculated HIV seroprevalence. We calculated and compared HIV seroprevalence from our study to the 2014 integrated biological and behavioural surveillance survey and used global spatial autocorrelation and hotspot analysis to highlight patterns of HIV infection and identify areas of significant clustering of HIV cases.

Results

MSM and PWID had HIV seroprevalence rates of 12.14% (3209/26,423) and 11.88% (1126/9474), respectively. Global spatial autocorrelation Moran I statistics revealed a clustered distribution of HIV infection among MSM and PWID with a <5% and <1% likelihood that this clustered pattern could be due to chance, respectively. Significant clusters of HIV infection (Getis-Ord-Gi* statistics) confined to the North Central and South South regions were identified among MSM and PWID. Compared to the 2014 integrated biological and behavioural surveillance survey, our results suggest an increased HIV seroprevalence among PWID and a substantial decrease among MSM.

Conclusions

This study identified geographical areas to prioritize for control of HIV infection among MSM and PWID, thus demonstrating that geographical information system technology is a useful tool to inform public health planning for interventions targeting epidemic control of HIV infection.
Unique Internet Search Strategies of Individuals With Self-Stated Autism: Quantitative Analysis of Search Engine Users’ Investigative Behaviors
Authors: Yechiam Eldad , Yom-Tov Elad
Published: May 2021

Background

Although autism is often characterized in literature by the presence of repetitive behavior, in structured decision tasks, individuals with autism spectrum disorder (ASD) have been found to examine more options in a given time period than controls.

Objective

We aimed to examine whether this investigative tendency emerges in information searches conducted via the internet.

Methods

In total, 1746 search engine users stated that they had ASD in 2019. This group’s naturally occurring responses following 1491 unique general queries and 78 image queries were compared to those of all other users of the search engine. The main dependent measure was scrolled distance, which denoted the extent to which additional results were scanned beyond the initial results presented on-screen. Additionally, we examined the number of clicks on search results as an indicator of the degree of search outcome exploitation and assessed whether there was a trade-off between increased search range and the time invested in viewing initial search results.

Results

After issuing general queries, individuals with self-stated ASD scanned more results than controls. The scrolled distance in the results page of general queries was 45% larger for the group of individuals with ASD (P<.001; d=0.45). The group of individuals with ASD also made the first scroll faster than the controls (P<.001; d=0.51). The differences in scrolled distance were larger for popular queries. No group differences in scrolled distance emerged for image queries, suggesting that visual load impeded the investigative behavior of individuals with ASD. No differences emerged in the number of clicks on search results.

Conclusions

Individuals who self-stated that they had ASD scrutinized more general search results and fewer image search results than the controls. Thus, our results at least partially support the notion that individuals with ASD exhibit investigative behaviors and suggest that textual searches are an important context for expressing such tendencies.
Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled Trial
Authors: Buntrock Claudia , Lehr Dirk , Smit Filip , Horvath Hanne , Berking Matthias , Spiegelhalder Kai , Riper Heleen , Ebert David Daniel
Published: May 2021

Background

The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I’s health-economic effects.

Objective

This study aimed to evaluate the cost-effectiveness and cost–utility of iCBT-I in reducing insomnia among schoolteachers.

Methods

Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping.

Results

Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: β=.30; 95% CI 0.16-0.43; QALYs: β=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of €650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was €11,285. At a willingness-to-pay threshold of €20,000 per QALY gained, the intervention’s probability of being cost-effective was 89%.

Conclusions

Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.

Trial Registration

German Clinical Trial Registry: DRKS00004700; https://tinyurl.com/2nnk57jm

International Registered Report Identifier (IRRID)

RR2-10.1186/1745-6215-14-169
Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review
Authors: Harahap Nabila Clydea , Handayani Putu Wuri , Hidayanto Achmad Nizar
Published: May 2021

Background

Functionalities of personal health record (PHR) are evolving, and continued discussions about PHR functionalities need to be performed to keep it up-to-date. Technological issues such as nonfunctional requirements should also be discussed in the implementation of PHR.

Objective

This study systematically reviewed the main functionalities and issues in implementing the PHR.

Methods

This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search is performed using the online databases Scopus, ScienceDirect, IEEE, MEDLINE, CINAHL, and PubMed for English journal articles and conference proceedings published between 2015 and 2020.

Results

A total of 105 articles were selected in the review. Seven function categories were identified in this review, which is grouped into basic and advanced functions. Health records and administrative records were grouped into basic functions. Medication management, communication, appointment management, education, and self-health monitoring were grouped into advanced functions. The issues found in this study include interoperability, security and privacy, usability, data quality, and personalization.

Conclusions

In addition to PHR basic and advanced functions, other supporting functionalities may also need to be developed based on the issues identified in this study. This paper provides an integrated PHR architectural model that describes the functional requirements and data sources of PHRs.
Recursive Partitioning vs Computerized Adaptive Testing to Reduce the Burden of Health Assessments in Cleft Lip and/or Palate: Comparative Simulation Study
Authors: Harrison Conrad J , Sidey-Gibbons Chris J , Klassen Anne F , Wong Riff Karen W Y , Furniss Dominic , Swan Marc C , Rodrigues Jeremy N
Published: May 2021

Background

Computerized adaptive testing (CAT) has been shown to deliver short, accurate, and personalized versions of the CLEFT-Q patient-reported outcome measure for children and young adults born with a cleft lip and/or palate. Decision trees may integrate clinician-reported data (eg, age, gender, cleft type, and planned treatments) to make these assessments even shorter and more accurate.

Objective

We aimed to create decision tree models incorporating clinician-reported data into adaptive CLEFT-Q assessments and compare their accuracy to traditional CAT models.

Methods

We used relevant clinician-reported data and patient-reported item responses from the CLEFT-Q field test to train and test decision tree models using recursive partitioning. We compared the prediction accuracy of decision trees to CAT assessments of similar length. Participant scores from the full-length questionnaire were used as ground truth. Accuracy was assessed through Pearson’s correlation coefficient of predicted and ground truth scores, mean absolute error, root mean squared error, and a two-tailed Wilcoxon signed-rank test comparing squared error.

Results

Decision trees demonstrated poorer accuracy than CAT comparators and generally made data splits based on item responses rather than clinician-reported data.

Conclusions

When predicting CLEFT-Q scores, individual item responses are generally more informative than clinician-reported data. Decision trees that make binary splits are at risk of underfitting polytomous patient-reported outcome measure data and demonstrated poorer performance than CATs in this study.
Ecological Momentary Assessment and mHealth Interventions Among Men Who Have Sex With Men: Scoping Review
Authors: Clark Viktor , Kim Sunny Jung
Published: May 2021

Background

Ecological momentary assessment (EMA) is a research design that allows for the measurement of nearly instantaneous experiences within the participant’s natural environment. Using EMA can help improve recall bias, ecological validity, and patient engagement while enhancing personalization and the ubiquity of interventions. People that can benefit from the use of EMA are men who have sex with men (MSM). Previous EMA studies have been successful in capturing patterns of depression, anxiety, substance use, and risky sexual behavior. These findings are directly relevant to MSM, who have high rates of each of these psychological and behavioral outcomes. Although there is a driving force behind the growing literature surrounding EMAs among MSM, no synthesizing reviews yet exist.

Objective

The aims of this study were to (1) synthesize the literature across fields on how EMA methods have been used among MSM, (2) better understand the feasibility and acceptability of EMA interventions among MSM, and (3) inform designs for future research studies on best evidence-based practices for EMA interventions.

Methods

Based on 4 library databases, we conducted a scoping review of EMAs used within interventions among MSM. The eligibility criteria included peer-reviewed studies conducted in the United States and the use of EMA methodology in an intervention for MSM. Modeling after the Centers for Disease Control and Prevention’s Compendium of Evidence-Based Interventions as the framework, we applied a typology that used 8 distinct review criteria, for example, sample size, design of the intervention, random assignment, design of the follow-up investigation, rate of retention, and rate of engagement.

Results

Our results (k=15, N=952) indicated a range of sample sizes; the smallest sample size was 12, while the largest sample size was 120. Of the 15 studies, 7 (47%) focused on outcomes related to substance use or outcomes related to psychological experiences. Of the 15 studies, 5 (33%) implemented an EMA intervention across 30 days. Of the 15 studies, 2 studies (13%) used random assignment, and 2 studies (13%) had quasi-experimental designs. Of the 15 studies, 10 studies (67%) reported acceptable retention rates greater than 70%. The outcomes that had event-contingent prompts (ie, prompts after engaging in substance use) were not as effective in engaging participants, with overall engagement rates as low as 37%.

Conclusions

Our systematic scoping review indicates strong evidence that the EMA methodology is both feasible and acceptable at high rates among MSM, especially, when examining psychological and behavioral outcomes such as negative or positive affect, risky sexual behavior, or substance use. Further research on optimal designs of EMA interventions for MSM is warranted.
Australian Children's Exposure to, and Engagement With, Web-Based Marketing of Food and Drink Brands: Cross-sectional Observational Study
Authors: Kelly Bridget , Bosward Rebecca , Freeman Becky
Published: May 2021

Background

Food is one of the most frequently promoted commodities, and promoted foods are overwhelmingly unhealthy. Marketing normalizes unhealthy foods, creates a positive brand image, and encourages overconsumption. Limited research is available to describe the extent of food marketing to children on web-based media, and measuring actual exposure is challenging.

Objective

This study aims to monitor the extent of children’s exposure to web-based media food marketing as an essential step in increasing the accountability of industry and governments to protect children.

Methods

Children aged 13-17 years were recruited from October 2018 to March 2019. Children recorded their mobile device screen for 2 weekdays and 1 weekend day any time they visited relevant web-based platforms. After each day, the participants uploaded the video files to a secure server. Promoted products were defined using the World Health Organization European Region nutrient profile model.

Results

The sample of 95 children uploaded 267.8 hours of video data. Children saw a median of 17.4 food promotions each hour on the internet. Considering the usual time spent on the internet on mobile devices, children would be exposed to a median of 168.4 food promotions on the web on mobile devices per week, 99.5 of which would not be permitted to be marketed based on nutrient profiling criteria. Most promotions (2613/4446, 58.77%) were peer endorsed and derived from third-party sources.

Conclusions

Exposure to brand content that is seemingly endorsed by peers or web-based communities likely heightens the effects of marketing on children. Regulations to protect children from this marketing must extend beyond paid advertising to paid content in posts generated through web-based communities and influencers.
Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled Trial (Preprint)
Authors: Buntrock Claudia , Lehr Dirk , Smit Filip , Horvath Hanne , Berking Matthias , Spiegelhalder Kai , Riper Heleen , Ebert David Daniel
Published: May 2021

BACKGROUND

The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I’s health-economic effects.

OBJECTIVE

This study aimed to evaluate the cost-effectiveness and cost–utility of iCBT-I in reducing insomnia among schoolteachers.

METHODS

Schoolteachers (N=128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a wait list control group, both with unrestricted access to treatment as usual. Health care use, patient and family expenditures, and productivity losses were self-assessed and used for costing from a societal and a public health care perspective. Costs were related to symptom-free status (score <8 on the insomnia severity index) and quality-adjusted life years (QALYs) gained. Sampling error was handled using nonparametric bootstrapping.

RESULTS

Statistically significant differences favoring the intervention group were found for both health outcomes (symptom-free status yes or no: β=.30; 95% CI 0.16-0.43; QALYs: β=.019, 95% CI 0.01-0.03). From a societal perspective, iCBT-I had a 94% probability of dominating the wait list control for both health outcomes. From a public health care perspective, iCBT-I was more effective but also more expensive than the wait list control, resulting in an incremental cost-effectiveness ratio of €650 per symptom-free individual. In terms of QALYs, the incremental cost-effectiveness ratio was €11,285. At a willingness-to-pay threshold of €20,000 per QALY gained, the intervention’s probability of being cost-effective was 89%.

CONCLUSIONS

Our trial indicates that iCBT could be considered as a good value-for-money intervention for insomnia.

CLINICALTRIAL

German Clinical Trial Registry: DRKS00004700; https://tinyurl.com/2nnk57jm

INTERNATIONAL REGISTERED REPORT

RR2-10.1186/1745-6215-14-169
Effectiveness of an Internet-Based Machine-Guided Stress Management Program Based on Cognitive Behavioral Therapy for Improving Depression Among Workers: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Kawakami Norito , Imamura Kotaro , Watanabe Kazuhiro , Sekiya Yuki , Sasaki Natsu , Sato Nana ,   SMART-CBT Project Team
Published: May 2021

BACKGROUND

The effect of an unguided internet-based cognitive behavioral therapy (iCBT) stress management program on depression may be enhanced by applying artificial intelligence (AI) technologies to guide participants adopting the program.

OBJECTIVE

The aim of this study is to describe a research protocol to investigate the effect of a newly developed iCBT stress management program adopting AI technologies on improving depression among healthy workers during the COVID-19 pandemic.

METHODS

This study is a two-arm, parallel, randomized controlled trial. Participants (N=1400) will be recruited, and those who meet the inclusion criteria will be randomly allocated to the intervention or control (treatment as usual) group. A 6-week, six-module, internet-based stress management program, SMART-CBT, has been developed that includes machine-guided exercises to help participants acquire CBT skills, and it applies machine learning and deep learning technologies. The intervention group will participate in the program for 10 weeks. The primary outcome, depression, will be measured using the Beck Depression Inventory II at baseline and 3- and 6-month follow-ups. A mixed model repeated measures analysis will be used to test the intervention effect (group × time interactions) in the total sample (universal prevention) on an intention-to-treat basis.

RESULTS

The study was at the stage of recruitment of participants at the time of submission. The data analysis related to the primary outcome will start in January 2022, and the results might be published in 2022 or 2023.

CONCLUSIONS

This is the first study to investigate the effectiveness of a fully automated machine-guided iCBT program for improving subthreshold depression among workers using a randomized controlled trial design. The study will explore the potential of a machine-guided stress management program that can be disseminated online to a large number of workers with minimal cost in the post–COVID-19 era.

CLINICALTRIAL

UMIN Clinical Trials Registry（UMIN-CTR) UMIN000043897; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050125

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/30305
Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach (Preprint)
Authors: Weber Summer J , Shearer Elyse , Mulvaney Shelagh A , Schmidt Douglas , Thompson Chris , Jones Jessica , Ahmad Haseeb , Coe Martina , Hull Pamela C
Published: May 2021

BACKGROUND

The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants.

OBJECTIVE

This formative study applies user-centered design principles to inform the layout and prioritization of features in mobile apps for low-income families participating in the WIC program.

METHODS

To identify and prioritize desirable app features, caregivers (N=22) of the children enrolled in WIC participated in individual semistructured interviews with a card sorting activity. Interviews were transcribed verbatim and analyzed using constant comparative analysis for themes. App features were ranked and placed into natural groupings by each participant. The sum and average of the rankings were calculated to understand which features were prioritized by the users. Natural groupings of features were labeled according to participant descriptions.

RESULTS

Natural groupings focused on the following categories: clinics/appointments, shopping/stores, education/assessments, location, and recipes/food. Themes from the interviews triangulated the results from the ranking activity. The priority app features were balance checking, an item scanner, and appointment scheduling. Other app features discussed and ranked included appointment reminders, nutrition training and quizzes, shopping lists, clinic and store locators, recipe gallery, produce calculator, and dietary preferences/allergies.

CONCLUSIONS

This study demonstrates how a user-centered design process can aid the development of an app for low-income families participating in WIC to inform the effective design of the app features and user interface.
Clinical features and neuroimaging findings in acute cerebral infarction patients using RAPID Artificial Intelligent (RAPID AI) Software Analysis – a series of 54 cases (Preprint)
Authors: Nguyen Ngoc Huy , Hoang Minh Van , Nguyen An Quang , Tran Luc Quang , Nguyen Thong Van
Published: May 2021

BACKGROUND

Stroke is the second leading cause of death and the leading cause of permanent disability globally. Vietnam is a developing country with a high prevalence of stroke.

OBJECTIVE

This study aimed to present the clinical features and neuroimaging findings in acute cerebral infarction patients using RAPID Artificial Intelligent (RAPID AI) Software Analysis

METHODS

A case series of 54 stroke patients based on data from the electronic medical records who admitted between October 2019 and October 2020, for whom Rapid AI was used to analyze images of stroke.

RESULTS

The results showed that the mean age of patients was 73.39 ± 12.46 years and males comprised 57.4 of the sample. The most common risk factor identified was hypertension (75.9%), followed by atrial fibrillation (24%), diabetes (20%), alcohol (15%), and smoking (9%). The most common clinical signs were hemiparesis in 76% of the patients, followed by dysphasia in 50% and memory loss in 28% of the sample. 7% presented with dizziness and 7% with headache. 6% were unconscious on admission. ASPECTS evaluation showed that 24 (44%) patients had good ASPECTS scores of 8-10, 17 (32%) patients had ASPECTS scores of 5-7, and 13 (24%) patients had ASPECTS scores of 0-4. The number of patients with an infarct core volume <70 mL was 50 (93%), while a mismatch volume of >15 mL was observed in 31 (55%) patients and 22 (41%) patients had a mismatch ratio >1.8. The assessment of CT imaging of thrombi showed 51 cases of anterior cerebral circulation, including 13 (24%) cases diagnosed as ICA, 30 (76%) cases diagnosed as MCA, and 8 (15%) cases diagnosed as SA. There were 10 cases of MCA-M1 (19%), 7 cases of MCA-M2 and MCA-M4 (13%) cases and 6 cases of MCA-M3 (11%), respectively. There were three cases of posterior cerebral circulation, comprising one case of Posterior cerebral artery (PCA) and two cases of Basilar artery (BA) territory infarction.

CONCLUSIONS

A collection of clinical features and neuroradiological assessment based on RAPID Artificial Intelligent (RAPID AI) Software Analysis can be used in identify stroke patients in the hospitals.
The impact of the colon care bundle: An analytics case study using topological data analysis (Preprint)
Authors: Lee Jaehoon
Published: May 2021

BACKGROUND

At Intermountain Healthcare, our surgical specialty department developed a colon bundle to pursue standardized and measurable management of colorectal surgeries, but analysis of its effectiveness to outcomes is challenging due to the complicated nature of procedures and difficulty of measurement.

OBJECTIVE

To analyze effectiveness of the colon bundle to patient outcomes including surgical procedural times and patient length of stay.

METHODS

We used topological data analysis (TDA), which is a data-driven method specialized for heterogeneous and multi-dimensional data and reduce dimensions of data with strength of insensitiveness to particular metric and reduce dimensionability.

RESULTS

We discovered three colon bundle factors related to high length of stay: “Order sets were not used”, “One specific order set was used”, “Laparotomy exploratory in one local hospital with use of one specific order set” and two factors related to high surgical time: “Customized use of order sets”, “One specific surgeon in a local hospital with customized use of one specific order set”.

CONCLUSIONS

The study demonstrated that TDA is a useful tool for clustering and analysis of complicate clinical data with multiple attributes.
A Free Open-Source Bayesian Vancomycin Dosing App for Adults: Design and Evaluation Study (Preprint)
Authors: Oommen Thomas , Thommandram Anirudh , Palanica Adam , Fossat Yan
Published: May 2021

BACKGROUND

It has been suggested that Bayesian dosing apps can assist in the therapeutic drug monitoring of patients receiving vancomycin. Unfortunately, Bayesian dosing tools are often unaffordable to resource-limited hospitals. Our aim was to improve vancomycin dosing in adults. We created a free and open-source dose adjustment app, VancoCalc, which uses Bayesian inference to aid clinicians in dosing and monitoring of vancomycin.

OBJECTIVE

The aim of this paper is to describe the design, development, usability, and evaluation of a free open-source Bayesian vancomycin dosing app, VancoCalc.

METHODS

The app build and model fitting process were described. Previously published pharmacokinetic models were used as priors. The ability of the app to predict vancomycin concentrations was performed using a small data set comprising of 52 patients, aged 18 years and over, who received at least 1 dose of intravenous vancomycin and had at least 2 vancomycin concentrations drawn between July 2018 and January 2021 at Lakeridge Health Corporation Ontario, Canada. With these estimated and actual concentrations, median prediction error (bias), median absolute error (accuracy), and root mean square error (precision) were calculated to evaluate the accuracy of the Bayesian estimated pharmacokinetic parameters.

RESULTS

A total of 52 unique patients’ initial vancomycin concentrations were used to predict subsequent concentration; 104 total vancomycin concentrations were assessed. The median prediction error was –0.600 ug/mL (IQR –3.06, 2.95), the median absolute error was 3.05 ug/mL (IQR 1.44, 4.50), and the root mean square error was 5.34.

CONCLUSIONS

We described a free, open-source Bayesian vancomycin dosing calculator based on revisions of currently available calculators. Based on this small retrospective preliminary sample of patients, the app offers reasonable accuracy and bias, which may be used in everyday practice. By offering this free, open-source app, further prospective validation could be implemented in the near future.
Selective Prediction With Long Short-term Memory Using Unit-Wise Batch Standardization for Time Series Health Data Sets: Algorithm Development and Validation (Preprint)
Authors: Nam Borum , Kim Joo Young , Kim In Young , Cho Baek Hwan
Published: May 2021

BACKGROUND

In any health care system, both the classification of data and the confidence level of such classifications are important. Therefore, a selective prediction model is required to classify time series health data according to confidence levels of prediction.

OBJECTIVE

This study aims to develop a method using long short-term memory (LSTM) models with a reject option for time series health data classification.

METHODS

An existing selective prediction method was adopted to implement an option for rejecting a classification output in LSTM models. However, a conventional selection function approach to LSTM does not achieve acceptable performance during learning stages. To tackle this problem, we proposed a unit-wise batch standardization that attempts to normalize each hidden unit in LSTM to apply the structural characteristics of LSTM models that concern the selection function.

RESULTS

The ability of our method to approximate the target confidence level was compared by coverage violations for 2 time series of health data sets consisting of human activity and arrhythmia. For both data sets, our approach yielded lower average coverage violations (0.98% and 1.79% for each data set) than those of the conventional approach. In addition, the classification performance when using the reject option was compared with that of other normalization methods. Our method demonstrated superior performance for selective risk (12.63% and 17.82% for each data set), false-positive rates (2.09% and 5.8% for each data set), and false-negative rates (10.58% and 17.24% for each data set).

CONCLUSIONS

Our normalization approach can help make selective predictions for time series health data. We expect this technique to enhance the confidence of users in classification systems and improve collaborative efforts between humans and artificial intelligence in the medical field through the use of classification that considers confidence.

CLINICALTRIAL
High exhaustion in geriatric healthcare professionals during the Covid-19 second lockdown (Preprint)
Authors: El Haj Mohamad , ALLAIN PHILIPPE , Anneweiler Cedric , boutoleau Bretonnière Claire , Chapelet Guillaume , Gallouj Karim , Kapogiannis Dimitrios , Roche Jean , Boudoukha Abdel Halim
Published: May 2021

BACKGROUND

In a previous study, we assessed burnout in geriatric healthcare workers during the first lockdown that lasted from March to May 2020 in France, in response to the Covid-19 crisis.

OBJECTIVE

We carried out a follow-up study to assess burnout in the same population during the second lockdown that was implemented at the end of October 2020.

METHODS

We carried out an online study to assess burnout in the geriatric healthcare workers.

RESULTS

We found higher levels of exhaustion, disengagement, and burnout among geriatric healthcare workers during the second than during the first lockdown. We also found high levels of exhaustion but moderate disengagement and burnout during the second lockdown.

CONCLUSIONS

The increased exhaustion, disengagement, and burnout during the second lockdown can be attributed to the increased workload in geriatric facilities throughout this crisis and during the second lockdown due to shortage in staff and increased number of shifts and allocated duties. The high levels of exhaustion reported among geriatric healthcare workers during the second lockdown can reflect their physical fatigue, as well as their feelings of being emotionally overextended and exhausted by their workload.
Early Humoral Responses of Hemodialysis Patients after COVID-19 Vaccination with BNT162b2
Authors: Speer Claudius , Göth Daniel , Benning Louise , Buylaert Mirabel , Schaier Matthias , Grenz Julia , Nusshag Christian , Kälble Florian , Kreysing Martin , Reichel Paula , Töllner Maximilian , Hidmark Asa , Ponath Gerald , Schnitzler Paul , Zeier Martin , Süsal Caner , Morath Christian , Klein Katrin
Published: May 2021

Background and objectives

Patients receiving hemodialysis are at high risk for both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe coronavirus disease 2019. A lifesaving vaccine is available, but sensitivity to vaccines is generally lower in patients on dialysis. Little is yet known about antibody responses after coronavirus disease 2019 (COVID-19) vaccination in this vulnerable group.

Design, setting, participants, and measurements

In this prospective single-center study, we included 22 patients on dialysis and 46 healthy controls from Heidelberg University Hospital between December 2020 and February 2021. We measured anti-S1 IgG with a threshold index for detection greater than one, neutralizing antibodies with a threshold for viral neutralization of ≥30%, and antibodies against different SARS-CoV2 fragments 17–22 days after the first dose and 18–22 days after the second dose of the mRNA vaccine BNT162b2.

Results

After the first vaccine dose, four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls developed positive anti-S1 IgG, with a median anti-S1 IgG index of 0.2 (interquartile range, 0.1–0.7) compared with nine (interquartile range, 4–16), respectively. SARS-CoV2 neutralizing antibodies exceeded the threshold for neutralization in four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls, with a median percent inhibition of 11 (interquartile range, 3–24) compared with 65 (interquartile range, 49–75), respectively. After the second dose, 14 of 17 (82%) patients on dialysis developed neutralizing antibodies exceeding the threshold for viral neutralization and antibodies against the receptor binding S1 domain of the spike protein, compared with 46 of 46 (100%) healthy controls, respectively. The median percent inhibition was 51 (interquartile range, 32–86) compared with 98 (interquartile range, 97–98) in healthy controls.

Conclusions

Patients receiving long-term hemodialysis show a reduced antibody response to the first and second doses of the mRNA vaccine BNT162b2. The majority (82%) develop neutralizing antibodies after the second dose but at lower levels than healthy controls.
Implementation of the
Connect for Health
pediatric weight management program: study protocol and baseline characteristics
Authors: Simione Meg , Farrar-Muir Haley , Mini Fernanda Neri , Perkins Meghan E , Luo Man , Frost Holly , Orav E John , Metlay Joshua , Zai Adrian H , Kistin Caroline J , Sease Kerry , Hambidge Simon J , Taveras Elsie M ,   the Connect for Health Collaborative
Published: May 2021

We are implementing
Connect for Health
, a primary care-based intervention to improve family-centered outcomes for children, ages 2–12 years, in organizations that care for low-income children. We will use the ‘Reach-Effectiveness-Adoption-Implementation-Maintenance’ framework to guide our mixed-methods evaluation to examine the effectiveness of stakeholder-informed strategies in supporting program adoption and child outcomes. We also describe characteristics of children, ages 2–12 years with a BMI ≥85th percentile and obesity-related care practices. During the period prior to implementation, 26,161 children with a BMI ≥85th percentile were seen for a primary care visit and a majority lacked recommended diagnosis codes, referrals and laboratory evaluations. The findings suggest the need to augment current approaches to increase uptake of proven-effective weight management programs.
Clinical trial registration number: NCT04042493
(Clinicaltrials.gov)
, Registered on 2 August 2019;
https://clinicaltrials.gov/ct2/show/NCT04042493
.
Принципы построения оптоэлектронных СВЧ генераторов
Authors: Устинов А.Б. , Таценко И.Ю. , Никитин А.А. , Кондрашов А.В. , Шамрай А.В. , Иванов А.В.
Published: May 2021

Статья знакомит читателей с принципами создания оптоэлектронных СВЧ-генераторов. Не претендуя на полноту охвата, авторы анализируют основные типы генераторов, классифицируя их по принципу действия. Кратко рассмотрены физические процессы, лежащие в основе работы различных типов генераторов. Приведено сравнение характеристик генераторов.
Оптимизация конструкции экспериментального отражательного элемента для амплитудного волоконно-оптического датчика вибрации отражательного типа
Authors: Бурдышева О.В. , Шолгин Е.С. , Максимов А.Ю.
Published: May 2021

Работа посвящена разработке конструкции отражательного элемента для амплитудного волоконно-­оптического датчика вибрации, а также тестированию работоспособности такой конструкции. В работе описана математическая модель поперечных колебаний, помогающая определить частоты резонанса в зависимости от длины свободного волокна. Реализована отражающая поверхность, представляющая собой периодическую структуру ниобата лития и участков, покрытых золотом. Представлена компоновка и конструкция датчика вибрации с возможностью перестройки частоты резонанса, а также продемонстрирована экспериментальная схема. Сигнал, полученный при помощи описанной схемы, поддается обработке преобразования Фурье, рассчитанные частоты совпадают с частотами колебаний источника вибраций. Получена амплитудно-­частотная характеристика, частота резонанса коррелирует с частотами, полученными математической моделью (коэффициент корреляции Пирсона равен 0,977). Результаты реализации настоящей разработки важны для нового междисциплинарного направления – ​агробиофотоники, дают ключ к более тонкому и точному изучению виброчувствительности животных и вибротропизма растений.
ULISSES NO INFERNO DA DIVINA COMÉDIA – UMA COMPARAÇÃO DO HERÓI EM DANTE, HOMERO E VIRGÍLIO
Authors: Ramos Artuso Alysson
Published: May 2021

Ulisses é um personagem constante na literatura ocidental e Dante Alighieri foi um dos autores que o retrabalharam. Na Divina Comédia, Ulisses está na oitava vala do oitavo círculo do Inferno, correspondente aos fraudadores. Na construção do personagem, Dante retoma características de Ulisses da tradição grega e latina, o que é analisado e comparado nesse artigo a partir das elaborações de Homero e Virgílio. Ao fim, estabelece-se uma relação entre Ulisses e os Dantes – autor e personagem da Comédia.
TEXTO DRAMÁTICO: POR UMA TEORIA QUE ESTIMULE A LEITURA
Authors: Grazioli Fabiano Tadeu
Published: May 2021

Este artigo apresenta reflexões teóricas acerca do texto dramático, sua natureza e sua estrutura – diálogos e rubricas. Apresentam-se, primeiramente, apontamentos que em nada colaboram para a leitura do texto dramático impresso. Em seguida, é apresentado o ponto de vista contrário, trazendo-se estudos que permitem pensar a leitura do referido gênero literário e, mais do que isso, podem incentivar tal prática.
O tratamento dado à leitura na fase final do Ensino Fundamental I: entre o real e o ideal
Authors: Azevedo Samara Moço , André Bianka Pires
Published: May 2021

Entendendo a leitura como uma atividade primordial para a formação social do aluno, pesquisou-se como se dão as práticas de leitura em sala de aula e quais as suas influências no processo de ensino e aprendizagem. Este estudo foi realizado em uma escola municipal de CamÂ­pos dos Goytacazes com o objetivo de analisar sobre o tratamento dado à leitura por parte dos professores no 5o ano do ensino fundamental.
Biomarkers for the diagnosis and treatment of rheumatoid arthritis-a systematic review
Authors: abdelhafiz dima , Baker Tara , galscow Alice
Published: May 2021

Background Rheumatoid Arthritis (RA) is an autoimmune disease,
symmetrically affecting the small joints. Biomarkers are tools that can
be used in the diagnosis and monitoring of RA. Aim To systematically
explore the role of the biomarkers: C-reactive protein (CRP), Rheumatoid
factor (RF), Anti-cyclic citrullinated protein (Anti-CCP), 14-3-3η and
the multi-biomarker disease activity (MBDA) score for the diagnosis and
treatment of RA. Methods A systematic review of the English literature
using four different databases was carried out. Results
CRP>7.1 mg/L predicted poor conventional synthetic disease
modifying anti-rheumatic drugs (csDMARDs) outcome in RA. Anti-CCP, CRP
≥0.3 mg/dL and RF predicted bone erosion and cartilage destruction.
Combination of high 14-3-3η with RF and CRP improved the prediction of
rapid erosion progression (REP). Anti-CCP was not associated with
disease activity, but was associated with increased radiographic damage
(r=0.46, p=0.048). RF was not associated with joint damage but
correlated with ultrasound-detected bone erosion. 14-3-3η significantly
correlated with inflammation, bone remodelling and osteoporosis in RA
patients (p<0.05). 14 3 3η positively correlated with RA
duration (p=0.003), disease activity and positive RF (P=0.025) and it
distinguished early from established RA. Early MBDA scores correlated
with later response in disease activity, after 6 and 12 weeks of
treatment (p<0.05). MBDA score was able to differentiate
between small differences in disease activity and predicted remission
over one year period. Conclusion The investigated biomarkers are helpful
tools in clinical practice for diagnosis, monitoring of treatment and
predicting prognosis in RA patients. However, further research is still
required to investigate novel biomarkers for the pre-treatment selection
of potentially responsive patients before starting therapy for a
precision medicine in this area.
Le microalghe e i fotobioreattori: il futuro legato alla cattura della CO2
Authors: Gabriele Pasquale
Published: May 2021

Le emissioni di biossido di carbonio (CO) sono la
problematica principale alla base dei cambiamenti climatici e sono
dannose per la salute dell’uomo. Per ridurre tale concentrazione si è
sperimentato l’utilizzo di microalghe.

Le microalghe sono i microrganismi più importanti negli ecosistemi
acquatici per il bilancio globale del carbonio e sono fondamentali per
la cattura e la bioconversione dell’anidride carbonica
(CO) in energia. Le microalghe vengono coltivate nei
fotobioreattori, sistemi chiusi e aperti che permettono alle microalghe
di crescere e assorbire la CO. Un’ulteriore tipologia
di fotobioreattore molto utilizzato è quella a membrana (MPBR).

Uno sviluppo futuro importante legato ai fotobioreattori e alle
microalghe potrebbe essere quello di unire i due tipi di sistemi, aperti
e chiusi, riuscendo a minimizzare i costi dell’impianto e a permettere
una coltivazione su scala industriale.