bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the effect of wind-operated power plants on the total inertia of an electric power system
Authors: Razzhivin I. A. , Ruban N. Yu. , Rudnik V. E. , Gusev A. S.
Published: May 2021

This paper is aimed at determining the effect of a variable number of Type 4 wind turbines in the total generation of the corresponding electric power system on the parameters of an asynchronous regime of such a system. Processes occurring in an electric power system were simulated using an all-mode real-time simulation complex of electric power systems constituting a multi-processor software and hardware system. A model of an electric power system was developed, which, in addition to conventional power sources, included a wind-operated power plant combining a variable number of Type 4 wind turbines. The automatic control system of the simulated wind-operated power plant comprised a control loop (in terms of active power and voltage) equipped with an additional regulator of virtual inertia. An analysis of changes in the parameters of the asynchronous regime using a virtual inertia algorithm showed that the time of its advancement along the protected line was reduced maximally by 0.1 s. However, the time of the first cycle of asynchronous motion between two generators in the post-emergency regime increased by 2 times. Thus, for a wind-operated plant with a capacity of 100 MW, the time of asynchronous motion was 0.36 sec and 0.74 sec without using and when using a virtual inertia algorithm, respectively. It was experimentally confirmed that an increase in the power of a wind-operated power plant leads to a decrease in both the time of advancement of the asynchronous regime and the time, during which conventional generators transit from the synchronous regime. The latter was evidenced by the effect of Type 4 wind turbines on the value of total inertia, which ranged from 8.746 to 5.478 s. A study of the virtual inertia algorithm confirmed its impact on the electromechanical transient processes in power systems. The most favourable effect was noted at a virtual inertia value of 2 s and a wind-operated power plant capacity of 100 MW.
Respiratory tactics during cardiopulmonary bypass in cardiac surgery
Authors: Kirillov A. Yu. , Yavorovskiy A. G. , Vyzhigina M. A. , Komarov R. N. , Nogtev P. V. , Bagdasarov P. S. , Khalikova E. Yu. , Yavorovskaya D. A. , No I. I.
Published: May 2021

An important place in the structure of the causes of postoperative respiratory failure in cardiac surgery is occupied by atelectasis of the lung tissue, which is formed during cardiopulmonary bypass (CPB). The incidence of this complication makes 54–92%.

The objective: to evaluate the effectiveness of various respiratory support techniques during CPB.

Subjects and methods. 60 patients were randomly included in the study. CPAP Group (positive airway pressure +5 cm H2O) and VC Group (lung ventilation during CPB with parameters: tidal volume 3 ml/kg, respiratory rate 6/min, positive end-expiratory pressure +5 cm H2O).

Results. The oxygenation index in VC Group was higher than in CPAP Group at the stages after the end of CPB (289.6 ± 100.0 in VC Group and 223.1 ± 152.0 in CPAP Group), at the end of surgery (in VC Group 318,7 ± 73.8 and in CPAP Group 275.2 ± 90.0) The frequency of intraoperative (VC 16% and CPAP 43%) and postoperative recruiting lung maneuvers (VC 7% and CPAP 26%) in VC Group was lower versus CPAP Group. The incidence of atelectasis in VC Group (10%) decreased compared to CPAP (36.6%).

Conclusion: Low-volume ventilation during cardiopulmonary bypass has a more favorable effect on the oxygenating function compared to respiratory support in the CPAP mode.
Comparative evaluation of visceral and renal protection methods during thoracoabdominal aortic repair (Experience of Russian Surgery Research Center named after B.V. Petrovsky)
Authors: Chepurnyak E. Yu. , Belov Yu. V. , Charchyan E. R. , Eremenko A. A. , Lokshin L. S. , Аkselrod B. A. , Dymova O. V. , Zinoviev K. A. , Panov A. V.
Published: May 2021

The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs.

Subjects: 81 patients who underwent TAA repair were enrolled in retrospective analysis: LAFB was used in 29 patients (Group 1), CPB and SP ‒ in 52 patients (Group 2).

Results. In Group 2, there were lower intraoperative blood loss volume (1,500 ml vs 4,200 ml, p < 0.001), significantly lower levels of direct bilirubin, blood creatinine, blood alpha-amylase in postoperative period, significantly shorter duration of hospital stay, ICU stay and duration of mechanical ventilation. Also in this group, there were lower incidence of multiple organ dysfunction (11.5% vs 37.9%, p = 0.005), stroke (0 vs 10.3%, p = 0.043), lower need for requirement (3.8% vs 20.7%, p = 0.022) and mortality (3.8% vs 27.6%, p = 0.003).

Conclusion: During TAA repair, CPB in conjunction with selective visceral and renal perfusion is more beneficial for organ protection as compared with LAFB.
Evaluation of the validity of the nSOFA score in newborns with sepsis
Authors: Mironov P. I. , Lekmanov A. U.
Published: May 2021

The objective of the study is to evaluate the discriminative ability of nSOFA in newborns with sepsis.

Subjects: The study was designed as retrospective, observational, and one-center. End points included assessment of the severity as per nSOFA and pSOFA; 28-day survival. 121 patients were enrolled in the study. Microsoft Excel (Graphpad Software, San Diego, California, USA) and MedCalc (v 7.1.0.0; MedCalc Software, Belgium) were used for the analysis.

Results. A study of the discriminative power of the scores showed that both assessment systems had a good model quality. However, nSOFA had a statistically more significant (p < 0.05) area under the ROC curve (0.981± 0.014).

Conclusion. The high value of the discriminative ability of the nSOFA scale indicates the feasibility of its use in patients with sepsis in neonatal intensive care units
THE JAVA CALENDAR AND ITS RELEVANCE WITH THE ISLAMIC CALENDAR
Authors: Farichah Faiz
Published: May 2021

Calendar or calendar system is an important reference for mankind from ancient times to the present. Judging from the reference system, there are three types of calendars, namely solar-based, lunar-based and both-based calendars. Meanwhile, in terms of its complexity, the calendar is divided into two, namely the astronomical and arithmetic calendars. The Javanese calendar after the changes made by the great sultan, was inspired by the hijri calendar. Both are based on the lunar calendar. The aim of this study is to introduce the calendar system, the Javanese calendar and its relevance to the hijriah calendar, and the Javanese Aboge calendar. This research is descriptive. The source in this research study is literature review. From this research it was found that the hijri calendar is an astronomical calendar that requires observation and has a high degree of accuracy with respect to the visibility of the new moon, while the Javanese calendar is an arithmetic calendar system, so it requires corrections in a certain period to be the same or nearly the same as the hijri calendar. However, the Aboge calendar does not change curves or cycles, so that the Aboge Javanese calendar has a difference of days with the Javanese calendar currently in use, namely the calendar with the asapon calendar, and it could be the same or the difference of up to two days with the Hijri calendar. Yet the calendar is used by the Javanese not only for worship, but also for petungan in determining traditional ceremonies and personal interests.
Essential Oils in Experimental Models of Neuropsychiatric Disorders: A Systematic Review
Authors: Fernandes Luciana Cristina B. , Costa Ianara Mendonça , Freire Marco Aurelio M. , Lima Francisca Overlânia V. , Neta Francisca Idalina , de Souza Lucena Eudes Euler , Alves Rodrigo Dias , Cavalcanti Jose Rodolfo Lopes P. , Pinheiro Francisco Irochima , de Azevedo Eduardo Pereira , Freitas Carlos Iberê A. , Guzen Fausto Pierdoná
Published: May 2021

Background:

Neural cells undergo functional or sensory loss due to neurological disorders.
In addition to environmental or genetic factors, oxidative stress is a major contributor to neurodegeneration.
In this context, there has been a growing interest in investigating the effects of EOs (EOs) in recent
years, especially in the treatment of neuropathologies. The chemical and biological effects of EOs have
led to important treatment tools for the management of various neurological disorders.

Objective:

In the present study we performed a systematic review that sought to comprehend the neuroprotective
effects of different EOs.

Method:

This work is a systematic review where an electronic search was performed on PubMed, ScienceDirect,
Cochrane Library and SciELO (Scientific Electronic Library Online) databases, covering
the last 10 years, using “Essential oil” and “Neuroprotective effect” as reference terms.

Results:

A total of 9 articles were identified, in which the efficacy of EOs was described in experimental
models of anxiety, dementia, oxidative stress, cerebral ischemia, Alzheimer’s disease, and oxidative
toxicity.

Conclusion:

EOs from different species of medicinal plants have shown positive responses in neurological
disorders such as anxiety, dementia, oxidative stress, cerebral ischemia, and oxidative toxicity.
Thus, EOs emerges with the potential to be used as alternative agents in the treatment of neurological
disorders.
Uncoupling Protein 2 as a Pathogenic Determinant and Therapeutic
Target in Cardiovascular and Metabolic Diseases
Authors: Stanzione Rosita , Forte Maurizio , Cotugno Maria , Bianchi Franca , Marchitti Simona , Busceti Carla Letizia , Fornai Francesco , Rubattu Speranza
Published: May 2021

:

Uncoupling protein 2 (UCP2) is a mitochondrial protein that acts as an anion carrier. It is
involved in the regulation of several processes, including mitochondrial membrane potential, generation
of reactive oxygen species within the inner mitochondrial membrane and calcium homeostasis.
UCP2 expression can be regulated at different levels: genetic (gene variants), transcriptional [by
peroxisome proliferator-activated receptors (PPARs) and microRNAs], and post-translational. Experimental
evidence indicates that activation of UCP2 expression through the AMPK/PPAR-α axis
exerts a protective effect toward renal damage and stroke occurrence in an animal model of ischemic
stroke (IS) associated with hypertension. UCP2 plays a key role in heart diseases (myocardial
infarction and cardiac hypertrophy) and metabolic disorders (obesity and diabetes). In humans,
UCP2 genetic variants (-866G/A and Ala55Val) associate with an increased risk of type 2 diabetes
mellitus and IS development. Over the last few years, many agents that modulate UCP2 expression
have been identified. Some of them are natural compounds of plant origin, such as Brassica
oleracea, curcumin, berberine and resveratrol. Other molecules, currently used in clinical practice,
include anti-diabetic (gliptin) and chemotherapeutic (doxorubicin and taxol) drugs. This evidence
highlights the relevant role of UCP2 for the treatment of a wide range of diseases, which affect the
national health systems of Western countries. We will review current knowledge on the physiological
and pathological implications of UCP2 with particular regard to cardiovascular and metabolic
disorders and will focus on the available therapeutic approaches affecting UCP2 level for the treatment
of human diseases.
Brucellosis Serostatus Among Pregnant Women with Spontaneous Abortion
and Stillbirth
Authors: Alavi Ezatollah Rafiei , Alavi Niloofar Rafiei , Alavi Romina Rafiei , Farokhi Ermia
Published: May 2021

Background:

Brucellosis in pregnancy is associated with severe outcomes ranging from
abortion to neonatal development problems.

Objective:

The aim of this study is to evaluate the seroprevalence of brucellosis antibodies among
pregnant women presented with spontaneous abortion and stillbirth.

Methods:

In this cross-sectional study, 80 cases (stillbirth or spontaneous abortion) and 80 healthy
pregnant women were serologically examined for brucellosis antibodies using Coombs, Wright and
2-mercaptoethanol (2ME) brucella agglutination tests. The questionnaire consisting of the following
data was prepared for all the participants: gestational age, age, history of abortion, parity,
source of dairy consumption, contact with livestock, urban or rural living setup, serological outcomes
and education levels.

Results:

The two groups were not significantly different in terms of the brucellosis test. Patients in
the case group with and without infection were not significant in terms of contact with livestock,
place of residence, dairy consumption, and history of abortion. However, education level was significantly
different in the two, seropositive and seronegative, groups.

Conclusion:

Our study did not find a significant number of seropositive brucellosis cases associated
with stillbirth and spontaneous abortion. Further studies with greater samples are therefore recommended.
COVID-19 ve Pankreas
Authors: Gümüştekin Reyhan , Ergani Anna Carina , Gümüş Meltem , Emiroğlu Halil Haldun
Published: May 2021

Coronavirüs Hastalığı-2019 (COVID-19) pandemisi, Aralık 2019’da bilinmeyen kökenli bir pnömoni salgını ile başladı. SARS-CoV-2 enfeksiyonunda öksürük, nefes darlığı ve ateş gibi klasik pnömoni semptomlarının yanı sıra; ishal, bulantı, kusma ve karın ağrısı gibi mide-bağırsak semptomları da mevcut olabilir. Bununla birlikte, son çalışmalar, pankreas dahil diğer organ tutulumlarını bildiren COVİD-19 hastalarının sayısının arttığını göstermiştir. Virüslerin çocuklarda pankreatit nedeni olduğu bilinmesine rağmen, SARS-CoV-2 virüsüyle ilişkili akut pankreatit tanımlanmaya yeni başlanmış olup bu konudaki güncel veriler sınırlı ve prevalansı ve patogenezi hakkında çok az şey bilinmektedir. Bu derlemede SARS-CoV-2 enfeksiyonu sırasında pankreas tutulumu konusundaki en son literatür bilgileri incelenecektir.
Uncommon presentation of an atrial myxoma in an adolescent patient
Authors: Akkuzu Emine , Sincar Şahin , Tokgöz Semiha , Kalkan Gökhan
Published: May 2021

Cardiac myxomas are rare benign tumors in childhood. They most commonly occur in left atrium. Irregular surface of atrial myxomas is associated with a high risk of embolic events. The majority of cardiac myxoma patients are diagnosed with cardiac symptoms. In the literature, there are a limited number of case reports on neurological symptoms in childhood which are diagnosed with cardiac myxoma after a detailed examination. We present a 16-year-old female patient with left atrial myxoma who presented with neurologic symptoms like diplopia and ataxia mimicking demyelinating neurological diseases.
Evaluation of the Relationship between Cesarean Section and Childhood Allergic Disorders
Authors: Fidancı İzzet , Ötegen Eribenur , Keçik Halise , Yılmaz Rumeysa Betül , Yağlı Zehra Nur , Aksoy Hilal , Ayhan Başer Duygu , Cankurtaran Mustafa
Published: May 2021

Aim: The aim of this study is to investigate and examine the possibility that cesarean section, which is becoming increasingly common today, may cause risky conditions such as allergies not only for the mother but also for the baby in the future.
Material and Method: The questionnaire was applied to the mothers who applied to the Family Medicine outpatient clinic between July and November 2020, who accepted to participate in the study and received written consent.
Results: Of the 90 participants included in the study, 45 (50%) had cesarean section and 45 (50%) had a normal birth. No variation was found according to the type of delivery in those whose children were diagnosed with allergies. Likewise, there was no statistical relationship between the presence of allergies and the variables we looked at. Among the other variables examined, there was only a significant difference in smoking during pregnancy according to the mode of delivery (p = 0.041).
Conclusion: Although it is prohibited off-label cesarean delivery, which can be left to the patient due to commercial concerns, is a delivery method to be chosen by a doctor only in the presence of an indication. Cesarean section may have complications for the mother and the baby, and the recommended method is to deliver the baby with normal delivery through the vaginal canal. Pregnant women should be informed that normal birth is the healthiest delivery method with correct information.
Çocuk Acil Servise Düşmeye Bağlı Travma Nedeniyle Getirilen Olgular
Authors: Fidancı İlknur , Derinöz Okşan , Tokgöz Aslıhan
Published: May 2021

Amaç: Çocuk acil ünitemize düşme nedeniyle başvuran travma olgularının kaza mekanizmasını ve kaza ilişkili ortaya çıkan sakatlıklarını değerlendirmeyi amaçladık.
Materyal-Metod: Çalışma 01.06.2009 – 01.02.2010 tarihleri arasında Gazi Üniversitesi Tıp Fakültesi Çocuk Acil Servis’ in de prospektif olarak düşmeye bağlı travma nedeniyle başvuran hastaların tanı, tedavi ve takipleri değerlendirilerek yapılmıştır.
Bulgular: Çalışmaya, 126 (%60)’sı erkek 210 olgu dahil edildi. Yaş ortalaması 44,5±45,01 (minumum:1 ay; maksimum:17 yıl) aydı. Yüz elli yedi hasta (%75), beş yaşın altında idi. 149 (%73,4)’unun ev içinde düştüğü, ev içinde düşen olguların 91 (%44,2)’inin 90 cm altı; 16 (%7,6)’sının 90 cm üzeri yükseklikten düştüğü görüldü. En çok zedelenen vücut bölgesi değerlendirildiğinde, 142 (%72,4) olgunun baş-boyun bölgesinden yaralandığı görüldü. Bu olgularında 76 (%38,8)’sın da yumuşak doku travması, 36 (%18,4)’sında laserasyon-kesi mevcuttu. 141 (%67,1) olguya direkt grafi, 53 (%25.2) hastaya kraniyal bilgisayarlı tomografi (BT) çekildiği görüldü. Yetmiş beş hasta (%40.1) mevcut klinik durumu nedeniyle acil gözlem ünitesine izleme alınmıştı. Bu olguların 54 (%72)’ü kafa travması olan olgulardı. Olguların 30 (%16)’una baş ve yüz bölgesindeki kesi-laserayon nedeniyle sütür atılmıştı. Değerlendirilen tüm hastalar herhangi bir mortalite ve morbidite olmadan muayene, tedavi ve/veya gözlem ardından taburcu edildi.
Sonuç: Düşme ilişkili travmalar sıklıkla ev içinde meydana gelmektedir. Ve en sık baş boyun bölgesi yaralanmaları görülmektedir. Özellikle okul öncesi dönmede yaşam ve oyun alanları evler olan çocukların sağlıklı şartlarda büyüyebilmesi ve düşme ilişkili travmalar nedeniyle acil servis başvurularının önlenmesinde ailelere çok iş düşmektedir. Güvenli ev ortamının nasıl oluşturulacağı ve alınacak önlemler hekimler tarafından ailelere anlatılmalıdır.
Türkiye’de Anne/Baba-Bebek Bağlanmasını Belirlemeye Yönelik Kullanılan Ölçekleri İnceleme
Authors: Çataloluk Ayşe , Kahraman Ayşenur , Alparslan Özgür
Published: May 2021

Amaç: Bu araştırmada Türkiye’de anne- bebek ve baba-bebek bağlanmasıyla ilgili kullanılan ölçeklerin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Araştırma retrospektif ve tanımlayıcı olarak tasarlanmıştır. Araştırma evrenini 2000-2020 yılları arasında yayınlanan, anne/baba ve bebek bağlanmasını ölçmek için Türk kültürüne uyarlanan veya geliştirilen ölçek çalışmaları oluşturmaktadır. Araştırmanın örneklemini ise ULAKBİM-TR, Google Akademik ve Yükseköğretim Kurulu Ulusal Tez Merkezi Veri Tabanından ulaşılan ölçekler oluşturmuştur (n=15). Ulaşılan 15 ölçekten 4 tanesinin farklı araştırmacılarca farklı zamanlarda kültürümüze tekrar uyarlandığı belirlenmiş ve bu nedenle 11 ölçek üzerinden değerlendirme yapılmıştır. Araştırma verilerinin değerlendirmesi içerik analizi yöntemiyle yapılmıştır. Verilerin frekans ve yüzde dağılımları istatistik programı ile yapılmıştır.Bulgular: Ölçeklerin %63,7’si doğum öncesi, %36,3’ü doğum sonrası dönemde kullanılmakta olup, %81,8’i uyarlanmış, %18,2’si geliştirilmiştir. Sonuç: İncelenen tüm ölçeklerin anne/baba-bebek bağlanmasını ölçmede ve bu alanda çalışan sağlık profesyonellerinin bağlanmayla ilgili sorunları erken belirlemede kullanılabileceği söylenebilir.
PUTUSAN KPPU SEBAGAI DASAR DALAM GUGATAN KELOMPOK (CLASS ACTION) ATAS PENGEMBALIAN KERUGIAN KONSUMEN AKIBAT PELANGGARAN PERSAINGAN USAHA TIDAK SEHAT
Authors:   Fakultas Hukum Universitas Brawijaya
Published: May 2021

Abstract This study aims analyze the KPPU's decision as the basis for class action in court in demanding compensation for violations of unfair business competition, and the juridical obstacles in examining group claims based on the KPPU's decision. This is normative legal research using statutory and case approach. The results shows that the KPPU's decision can be used as the basis for a class action lawsuit in court in the context of demanding compensation for consumer losses caused by violations of business competition as long as the KPPU's deliberations and decisions include preliminary evidence of public (consumer) loss and meet the general requirements for a class action lawsuit. The juridical obstacles really depend on the level of understanding of the judges and also the documents and / or case files from the KPPU as evidence of consideration of consumer losses.
Effects of Positive Psychology-Based Program for the Depressed Pregnant Women
Authors: Shin Hyeon Hee , Shin Yeong Hee
Published: May 2021

Purpose: This study examined the effects of a positive psychology-based program for depressed pregnant women.Methods: Of the 221 pregnant women who were screened, 24 were recruited from 4 local women’s clinic in Daegu city, South Korea. Subjects were at 6–29 weeks of gestation and scored 9–13 points on the Korean version of the Edinburgh Postnatal Depression Scale. Subjects were assigned to experimental (n= 12) and control (n=12) groups. The program consisted of ten 120-minute sessions conducted twice a week. Data were collected during the period between December 21, 2017 and April 12, 2018 and analyzed using IBM SPSS/WIN (ver. 21.0). Homogeneity of the experimental and control groups was evaluated by chi-square test and t-test. Hypotheses were tested by repeated measure analysis of variance.Results: The results revealed that in terms of stress coping styles, the active coping style (group*time= 15.23, p<0.001) increased, while the passive coping style decreased (group*time=15.27, p<0.001). Perceived spouse support (group*time=19.45, p<0.001), self-esteem (group*time=17.39, p<0.001), perinatal depression (group*time=78.77, p<0.001), and flourish (group*time=57.56, p<0.001) have significantly improved in the experimental group compared with the control group.Conclusion: These findings indicate that positive psychology-based program can be useful for pregnant women already suffering from depression to prevent perinatal depression.
Impact of Body Mass Index on Eating Disorders in Adolescents with Type 1 Diabetes: Focusing on Mediating Effect of Body Dissatisfaction, Self-esteem, and Depression
Authors: Park Hye-Ryeon , Ju Hyeon Ok
Published: May 2021

Purpose: The purpose of this study was to verify the mediating effects of body dissatisfaction, selfesteem, and depression on the association between the body mass index (BMI) and eating disorders in adolescents with type 1 diabetes.Methods: Secondary data were analyzed in this study. The original analysis was conducted using data from 136 adolescents aged 13–18 years with type 1 diabetes. The results of testing for mediating effects were analyzed using a serial-multiple mediation model (model 6) using the PROCESS macro in SPSS ver. 3.3.Results: The direct effect of the BMI on eating disorders was not statistically significant (effect=0.22; 95 % confidence interval [CI], -0.20 to 0.64), but the indirect effects were statistically significant (effect=0.28; 95% CI, 0.05–0.63). In detail, the indirect effect of BMI on eating disorders mediated by body dissatisfaction was statistically significant (effect=0.28; 95% CI, 0.10–0.61); by body dissatisfaction and depression was statistically significant (effect=0.06; 95% CI, 0.01–0.15); and by body dissatisfaction, self-esteem, and depression was statistically significant (effect=0.05; 95% CI, 0.01–0.11).Conclusion: Individual interventions according to BMI are required to prevent the development of eating disorders in adolescents with type 1 diabetes. Adolescents with type 1 diabetes require intervention programs that may positively change their attitudes toward themselves, increasing self-esteem and lowering depression.
The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands
Authors: Huygens Martine W J , Voogdt-Pruis Helene R , Wouters Myrah , Meurs Maaike M , van Lettow Britt , Kleijweg Conchita , Friele Roland D
Published: May 2021

Background

Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.

Objective

This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals.

Methods

Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring.

Results

Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%).

Conclusions

The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.
The Roles of Social Comparison Orientation and Regulatory Focus in College Students’ Responses to Fitspiration Posts on Social Media: Cross-sectional Study
Authors: Pasko Kristen , Arigo Danielle
Published: May 2021

Background

Information shared via social media influences college students’ self-perceptions and behavior, particularly, “fitspiration” posts (ie, images of healthy food, people exercising, or fitness quotations). There are mixed findings regarding the mental health implications of fitspiration and its potential to motivate healthy behavior. Individual differences such as social comparison orientation and regulatory focus could aid in determining for whom fitspiration may be helpful versus harmful, though these characteristics have received limited attention in terms of students’ fitspiration perceptions.

Objective

This cross-sectional study examined associations between students’ fitspiration use (ie, intentional versus unintentional exposure while using social media), response tendencies (ie, feelings about the self and motivation to be physically active), social comparison orientation, and regulatory focus.

Methods

College students (N=344; 239/344, 69.5% women) completed an electronic survey in which they self-reported demographic information, the frequency of their social media use, exposure to fitspiration posts, typical feelings in response to fitspiration posts, and typical motivation for physical activity after viewing fitspiration posts. They also completed validated self-report measures of social comparison orientation and regulatory focus.

Results

College students reported frequent exposure to fitspiration posts on social media and that they experienced negative feelings in response to these posts more often than positive feelings. Average motivation for physical activity was rated as feeling motivated “some of the time.” However, students who reported more negative feelings after viewing fitspiration also reported greater motivation to be physically active after exposure. Associations between the frequency of intentional fitspiration use and motivation for physical activity after viewing fitspiration posts were moderated by social comparison orientation (b=−0.01, P=.03) but not by regulatory focus (b=−0.002, P=.67).

Conclusions

Negative feelings about the self may be motivating for students with weak social comparison orientation, as fitspiration may highlight a discrepancy between one’s real and ideal self that does not prompt dejection or disengagement. However, negative feelings for prevention-focused students might not be as motivating because there are no salient negative models to avoid. Further research into these associations is warranted and could inform future efforts to promote student health and well-being during college.
Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study
Authors: Wu Xue , Nazari Nabi , Griffiths Mark D
Published: May 2021

Background

Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19.

Objective

This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria.

Methods

Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling.

Results

A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: β=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: β=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (β=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (β=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=–2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=–3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=–3.69, P<.001, Cohen d=0.29).

Conclusions

The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.
US Physicians’ Perspective on the Sudden Shift to Telehealth: Survey Study
Authors: Walia Bhavneet , Shridhar Anshu , Arasu Pratap , Singh Gursimar Kaur
Published: May 2021

Background

Given the sudden shift to telemedicine during the early COVID-19 pandemic, we conducted a survey of practicing physicians’ experience with telehealth during the prepandemic and early pandemic periods. Our survey estimates that most patient visits in the United States during the early COVID-19 pandemic period were conducted via telehealth. Given this magnitude and the potential benefits and challenges of telehealth for the US health care system, in this paper, we obtain, summarize, and analyze telehealth views and experiences of US-based practicing-physicians.

Objective

The aim of this study was to examine the extent of shift toward telehealth training and care provision during the early pandemic from the US-based practicing physicians’ perspective. We also sought to determine the short- and long-term implications of this shift on the quality, access, and mode of US health care delivery.

Methods

We conducted a purposive, snowball-sampled survey of US practicing-physicians. A total of 148 physician completed the survey. Data were collected from July 17, 2020, through September 4, 2020.

Results

Sample training intensity scaled 21-fold during the early pandemic period, and patient-care visits conducted via telehealth increased, on average, from 13.1% directly before the pandemic to 59.7% during the early pandemic period. Surveyed physician respondents reported that telehealth patient visits and face-to-face patient visits are comparable in quality. The difference was not statistically significant based on a nonparametric sign test (P=.11). Moreover, physicians feel that telehealth care should continue to play a larger role (44.9% of total visits) in postpandemic health care in the United States. Our survey findings suggest a high market concentration in telehealth software, which is a market structural characteristic that may have implications on the cost and access of telehealth. The results varied markedly by physician employer type.

Conclusions

During the shift toward telehealth, there has been a considerable discovery among physicians regarding US telehealth physicians. Physicians are now better prepared to undertake telehealth care from a training perspective. They are favorable toward a permanently expanded telehealth role, with potential for enhanced health care access, and the realization of enhanced access may depend on market structural characteristics of telehealth software platforms.
Monitoring Health Care Workers at Risk for COVID-19 Using Wearable Sensors and Smartphone Technology: Protocol for an Observational mHealth Study
Authors: Clingan Caroline A , Dittakavi Manasa , Rozwadowski Michelle , Gilley Kristen N , Cislo Christine R , Barabas Jenny , Sandford Erin , Olesnavich Mary , Flora Christopher , Tyler Jonathan , Mayer Caleb , Stoneman Emily , Braun Thomas , Forger Daniel B , Tewari Muneesh , Choi Sung Won
Published: May 2021

Background

Health care workers (HCWs) have been working on the front lines of the COVID-19 pandemic with high risks of viral exposure, infection, and transmission. Standard COVID-19 testing is insufficient to protect HCWs from these risks and prevent the spread of disease. Continuous monitoring of physiological data with wearable sensors, self-monitoring of symptoms, and asymptomatic COVID-19 testing may aid in the early detection of COVID-19 in HCWs and may help reduce further transmission among HCWs, patients, and families.

Objective

By using wearable sensors, smartphone-based symptom logging, and biospecimens, this project aims to assist HCWs in self-monitoring COVID-19.

Methods

We conducted a prospective, longitudinal study of HCWs at a single institution. The study duration was 1 year, wherein participants were instructed on the continuous use of two wearable sensors (Fitbit Charge 3 smartwatch and TempTraq temperature patches) for up to 30 days. Participants consented to provide biospecimens (ie, nasal swabs, saliva swabs, and blood) for up to 1 year from study entry. Using a smartphone app called Roadmap 2.0, participants entered a daily mood score, submitted daily COVID-19 symptoms, and completed demographic and health-related quality of life surveys at study entry and 30 days later. Semistructured qualitative interviews were also conducted at the end of the 30-day period, following completion of daily mood and symptoms reporting as well as continuous wearable sensor use.

Results

A total of 226 HCWs were enrolled between April 28 and December 7, 2020. The last participant completed the 30-day study procedures on January 16, 2021. Data collection will continue through January 2023, and data analyses are ongoing.

Conclusions

Using wearable sensors, smartphone-based symptom logging and survey completion, and biospecimen collections, this study will potentially provide data on the prevalence of COVID-19 infection among HCWs at a single institution. The study will also assess the feasibility of leveraging wearable sensors and self-monitoring of symptoms in an HCW population.

Trial Registration

ClinicalTrials.gov NCT04756869; https://clinicaltrials.gov/ct2/show/NCT04756869

International Registered Report Identifier (IRRID)

DERR1-10.2196/29562
The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)
Authors: Huygens Martine W J , Voogdt-Pruis Helene R , Wouters Myrah , Meurs Maaike M , van Lettow Britt , Kleijweg Conchita , Friele Roland D
Published: May 2021

BACKGROUND

Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.

OBJECTIVE

This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals.

METHODS

Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring.

RESULTS

Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%).

CONCLUSIONS

The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.
Publication Trends and Their Relationship With Academic Success Among Dermatology Residents: Cross-sectional Analysis (Preprint)
Authors: Anderson J Michael , Wenger David , Johnson Austin L , Walters Corbin , Adewumi Mopileola Tomi , Esmond Lindy , Waddell Jourdan , Vassar Matt
Published: May 2021

BACKGROUND

Involvement in scholarly activities is considered to be one of the foundational pillars of medical education.

OBJECTIVE

This study aims to investigate publication rates before, during, and after residency to determine whether research productivity throughout medical training correlates with future academic success and research involvement.

METHODS

We successfully identified a list of 296 graduates from 25 US dermatology residency programs from the years 2013-2015. The publication history for each graduate was compiled using Scopus, PubMed, and Google Scholar. The Pearson correlation test and linear regression were used to assess the relationship between research productivity and continued academic success after residency graduation.

RESULTS

Before residency, graduates published a mean of 1.9 (SD 3.5) total publications and a mean of 0.88 (SD 1.5) first-author publications. During residency, graduates published a mean of 2.7 (SD 3.6) total publications and a mean of 1.39 (SD 2.0) first-author publications. Graduates who pursued a fellowship had more total publications (t294=−4.0; P<.001), more first-author publications (t294=−3.9; P<.001), and a higher h-index (t294=−3.8; P=.002). Graduates who chose to pursue careers in academic medicine had more mean total publications (t294=−7.5; P<.001), more first-author publications (t294=−5.9; P<.001), and a higher mean h-index (t294=−6.9; P<.001). Graduates with one or more first-author publications before residency were 1.3 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.3, 95% CI 1.1-1.5). Graduates who pursued a fellowship were also 1.9 times more likely to pursue a career in academic medicine (adjusted odds ratio 1.9, 95% CI 1.2-3.2).

CONCLUSIONS

Our results suggest that research productivity before and during residency training are potential markers for continued academic success and research involvement after completing dermatology residency training.
Assessing the Legal Aspects of Information Security Requirements for Health Care in 3 Countries: Scoping Review and Framework Development (Preprint)
Authors: Yeng Prosper Kandabongee , Fauzi Muhammad Ali , Sun Luyi , Yang Bian
Published: May 2021

BACKGROUND

The loss of human lives from cyberattacks in health care is no longer a probabilistic quantification but a reality that has begun. In addition, the threat scope is also expanding to involve a threat of national security, among others, resulting in surging data breaches within the health care sector. For that matter, there have been provisions of various legislation, regulations, and information security governance tools such as policies, standards, and directives toward enhancing health care information security–conscious care behavior among users. Meanwhile, in a research scenario, there are no comprehensive required security practices to serve as a yardstick in assessing security practices in health care. Moreover, an analysis of the holistic view of the requirements that need more concentration of management, end users, or both has not been comprehensively developed. Thus, there is a possibility that security practice research will leave out vital requirements.

OBJECTIVE

The objective of this study was to systematically identify, assess, and analyze the state-of-the-art information security requirements in health care. These requirements can be used to develop a framework to serve as a yardstick for measuring the future real security practices of health care staff.

METHODS

A scoping review was, as a result, adopted to identify, assess, and analyze the information security requirement sources within health care in Norway, Indonesia, and Ghana.

RESULTS

Of 188 security and privacy requirement sources that were initially identified, 130 (69.1%) were fully read by the authors. Subsequently, of these 188 requirement documents, 82 (43.6%) fully met the inclusion criteria and were accessed and analyzed. In total, 253 security and privacy requirements were identified in this work. The findings were then used to develop a framework to serve as a benchmark for modeling and analyzing health care security practices.

CONCLUSIONS

On the basis of these findings, a framework for modeling, analyzing, and developing effective security countermeasures, including incentivization measures, was developed. Following this framework, research results of health care security practices would be more reliable and effective than relying on incomprehensive security requirements.
Telemedicine as a therapeutic option in sports medicine: Results of a nationwide cross-sectional study among physicians and patients (Preprint)
Authors: Hertling Stefan
Published: May 2021

BACKGROUND

Background: The global incidence of treating people in the field of sports medicine is increasing. The COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed or converted to a virtual format. Telemedicine in sports medicine could support physicians.

OBJECTIVE

The study analyses the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany.

METHODS

This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. Regression analyses were performed to show correlations.

RESULTS

We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Physicians as well as patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine, although would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine is considered to be helpful for follow-up monitoring and prevention by both groups.

CONCLUSIONS

Telemedicine in Sports medicine finds limited use but high acceptance among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in tele-sportsmed is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.