bluuebunny/crossref_metadata_2025 huggingface dataset:
Development a set of scales to assess job satisfaction among physicians in Peru: validity and reliability assessment
Authors: Villarreal-Zegarra David , Torres-Puente Roberto , Castillo-Blanco Ronald , Cabieses Baltica , Bellido-Boza Luciana , Mezones-Holguín Edward
Published: March 2021

Background: To assess the evidences of validity and reliability of a set of scales on different areas of job satisfaction (general professional activity, health services management, and working conditions) in Peruvian physicians based on data from the National Survey of Satisfaction of Users in Health (ENSUSALUD). Method: We carried out a psychometric study based on secondary data analysis. Participants were selected from a two-stage probabilistic national representative sampling stratified by political region. Validity was assessed by exploratory and confirmatory factor analysis and measurement invariance analysis. Reliability was assessed by internal consistency coefficients (alpha and omega). The set of scales was composed of items related to three different areas of job satisfaction: 1) satisfaction with general professional activity, 2) satisfaction with the health services management, and 3) satisfaction with the working conditions of the health center. Results: We included 2,137 participants in the analysis. General professional activity scale with 6 items (CFI=0.946; RMSEA=0.071; SRMR=0.035) and the health services management scale with 8 items (CFI=0.972; RMSEA=0.081; SRMR=0.028) showed good measurement properties for the one-dimensional model. The scale of working conditions presented adequate measurement properties with a two-dimensional model (CFI=0.914; RMSEA=0.080; SRMR=0.055): individual conditions (8 items) and infrastructural conditions (3 items). The invariance analysis presented that comparisons can be made between sex, age, civil status, medical specialty, working in other institutions, work-related illness, chronic disease, and time working in health care center. All scales had adequate internal consistency (ω and α between 0.70 and 0.90). Conclusions: The set of scales solid factorial structure and measurement invariance, which makes it possible for group comparison. They also achieved stability in their scores as they showed adequate internal consistency coefficients. Based on our findings, these instruments are suitable for measuring job satisfaction among outpatient physicians throughout Peru, as our data is representative at the country level.
Relato de caso de paciente com tetraplegia incompleta e seu processo de reabilitação
Authors: Santos Raulcilaine Érica dos , Barbosa Gustavo Faleiro , Spaziani Amanda Oliva , Santos Flávio Henrique Nuevo Benez dos , Frota Raissa Silva , Parreira Luciana Lara Vicente , Brito Bianca Pereira de , Balech Victor Nagib Queiroz , Larrosa Fabielli Mioto , Garcia André Victor Vian , Colognesi Lara Maria Souza Marcondes , Silva Maurício Caramel da , Oliveira Rullya Marson de Melo , Silva Victor Borges da , Barbosa Talita Costa , Santos Hayani Yuri Ferreira Outi
Published: March 2021

Introdução: A tetraplegia é definida como uma paralisia que atinge simultaneamente os quatro membros. Já a lesão medular pode acometer multifatorialmente o paciente, o qual necessita de um conjunto de ações que vai desde o atendimento primário até a reabilitação. O objetivo deste trabalho é relatar um caso de lesão medular por efeito chicote com tetraplegia incompleta e o seu processo de reabilitação. Relato de caso: realizado por meio de coleta de dados por prontuário médico e levantamento de dados; sexo masculino, 23 anos. A tetraplegia incompleta entre C3 e C4 ocorreu devido a acidente em outubro de 2016 em uma lesão em chicote sem perda da consciência. Foi realizada uma artrodese para estabilização, quatro dias após, teve alta hospitalar. Iniciou a reabilitação e até dezembro de 2016 recuperou os movimentos grossos manipulativos das mãos, ainda sem sensibilidade. Em janeiro de 2017 começou a utilizar órtese de posicionamento de dedos e punho, realizou exercício para coordenação motora fina, aumento da amplitude de movimento e força. Em maio apresentava dominância manual direita, função manual preservada com dificuldade nas preensões, força muscular diminuída, alterações de sensibilidade, bom controle cervical e foram realizadas atividades com o objetivo de ortostatismo. Atualmente, o paciente encontra-se melhorando a habilidade já adquirida de ortostatismo. Conclusão: Como a lesão medular traz consigo muitas repercussões na vida do paciente espera-se que o cuidado seja integral, tendo como resultado a manutenção da sua saúde física e mental, proporcionando o desenvolvimento da autonomia para exercer plenamente suas atividades da vida diária.
QMetrology from QCosmology: Study with entangled two qubit open quantum system in De Sitter space
Authors: Choudhury Sayantan , Chowdhury Satyaki , Gupta Nitin , Swain Abinash
Published: March 2021

In this paper, our prime objective is to apply the techniques of parameter estimation theory and the concept of Quantum Metrology in the form of Fisher Information to investigate the role of certain physical quantities in the open quantum dynamics of a two entangled qubit system under the Markovian approximation. There exist various physical parameters which characterize such system, but can not be treated as any quantum mechanical observable. It becomes imperative to do a detailed parameter estimation analysis to determine the physically consistent parameter space of such quantities. We apply both Classical Fisher Information (CFI) and Quantum Fisher Information (QFI) to correctly estimate these parameters, which play significant role to describe the out-of-equilibrium and the long range quantum entanglement phenomena of open quantum system. Quantum Metrology, compared to classical parameter estimation theory, plays a two-fold superior role, improving the precision and accuracy of parameter estimation. Additionally, in this paper we present a new avenue in terms of Quantum Metrology, which beats the classical parameter estimation. We also present an interesting result of revival of out-of-equilibrium feature at the late time scales, arising due to the long range quantum entanglement at early time scale and provide a physical interpretation for the same in terms of Bell's Inequality Violation in early time scale giving rise to non-locality.
Human resource management practices and total quality management in insurance companies: Evidence from Jordan
Authors: Khdour Naser , Samed Al-Adwan Ahmad , Alsoud Anas , Ahmed Al-Douri Jamal
Published: March 2021

This study aims to extend the argument about the association between HRM and Total Quality Management (TQM) in insurance companies in Jordan. It is argued that the consideration of TQM can be supported in terms of configuration as an effect of Human Resource Management (HRM) in the presence or absence of other HRM practices. Data for this study were collected from 24 insurance companies listed on the Amman Stock Exchange and 342 employees. PLS-SEM was used to analyze the data collected through path analysis. Structural equation modeling was used to examine a causal relationship between the variables. The overall effect of HRM on TQM was explored to improve quality orientation and people criteria in insurance companies. The findings have indicated a significant and positive effect of teamwork, staffing, performance appraisals, and compensation on TQM. However, training and development have a negative, but significant impact on TQM. In addition, TQM significantly and positively affects the HRM of an organization. Performance was also positively and significantly affected by HRM. TQM is an important factor of HRM in insurance companies.
AcknowledgmentThe authors are very thankful to all the associated personnel in any reference that contributed to the purpose of this study.
Melodrama, Ascetic Modality, and Communist Self-fashioning: Mukhamukham and the Communist Hero in Malayalam Cinema
Authors:   0000-0002-9989-6251, Afzal P. Muhammed
Published: March 2021

This paper treats the Malayalam film Mukhamukham and the debates it engendered in the Kerala public sphere about the history and legacy of communism as an archive of passions and disavowals that have shaped the political subjectivities in contemporary Kerala and explores how the film offers a critique of the Left popular in Kerala. Through a critique of the ascetic modality of the communist hero, Mukhamukham offers a critique of the representative strategies through which the communist hero was produced in the early Left political melodramas in Malayalam, which have been a significant part of the Left’s constitutive role in the construction of the domain of the popular in Kerala. The attempt in this paper is to read the film as one that, while marked by liberal prejudices, offers a critique of the Left popular and certain prevailing notions on the Left in Kerala. The paper explores how the film represents the figure of the revolutionary; and the shift from the melodramatic conventions of the construction of the revolutionary figure that Gopalakrishnan attempts in the film.
Gender Subversion in Iris Murdoch’s The Unicorn
Authors:   English Department, Islamic Azad University, Branch of Abadan, Iran., Nejad Soheila Farhani
Published: March 2021

This study examines the various representations of female identity in Murdoch’s The Unicorn. The analysis of the novel revolves around the character of Hannah who is the center of everyone’s obsessive gaze. She is described both as an angel and a monster, a victim and a victimizer. Her victimization is aggravated by her passive submission to the will of her victimizers. This simultaneous presence of contradictory features in one character problematizes the notion of perceiving female identity in terms of binaries. As a typical Gothic heroine, Hannah is trapped within cultural assumptions about women. She passively and yet subversively plays the roles projected on her by the contradictory desires of other characters. It will be argued that the obsessive pursuit of perfection in a female figure as well as the disruption of the boundaries of victim and victimizer in this novel serve to problematize the cultural tendency to understand individuals in terms of stereotypes. Therefore, this study aims to illustrate how Murdoch has used an enigmatic female character to challenge the readers’ disposition to perceive characters in terms of gender stereotypes.
Laughing out Loud: The Popular Politics of Schadenfreude in Joker
Authors:   Lecturer, Department of English and Humanities, University of Liberal Arts Bangladesh., Shoilee Nishat Atiya
Published: March 2021

This research attempts to identify and analyze the relatively less explored aspects of schadenfreude as a primary currency in an American attention economy as depicted in the 2019 movie, Joker. It discusses how the protagonist’s comedic ambition to become a live performer falls short of its aim, as he feels inclined to embrace the negativity bias in his city and its questionable amusement impulses. Maintaining the appealing and appalling forces of liking and disliking; the deservingness of others’ good and bad fortunes; desirability for self-evaluation; rivalry and intergroup factors- the paper pursues schadenfreude as the masses’ new opiate. It analyzes the American renaissance of self-effacement and public humiliation in light of its mass media environment that had been abandoning meaningful stories for ticklish delights since the mid-nineties. Both primary and secondary data are used to reinforce an end result which takes the current glocal reality to be the distinct creation of a bizarre comedic moment that both defies and weaponizes a mediafication of its consumers’ emotional health.
Modernity and Alienation in Fahd Al-Atiq’s Life on Hold
Authors:   Department of English Language and Literature, Faculty of science and Art-Al-Mandaq, Al-Baha University, Kingdom of Saudi Arabia,, Alwuraafi Ebrahim Mohammed
Published: March 2021

The second half of the twentieth century Saudi Arabia witnessed an extraordinary economic boom that resulted from the oil production. The new wealth changed people’s life and instead of the old and impoverished life, there started a new one of unimaginable riches and wealth. This sudden metamorphosis has had negative psychological impacts such as alienation and estrangement on Saudis who, unexpectedly, found themselves in an entirely new world. Fahd Al-Atiq’s novel Life on Hold depicts this economic transformation and its impact on the life of Saudi people. The aim of this paper is to analyze Al-Atiq’s usage of alienation as a consequence of modernity and consumerism in Saudi Arabia. The paper examines Al-Atiq’s disappointment with modernity as a culture of alienation in its celebration of appearance and superficiality which necessitates the need to look beyond the surface.
“Prompter’s Whisper”: History, Travel and Narrative in Post-Colonial Indian English Travel Writing
Authors:   JNU, Yadav Komal
Published: March 2021

The theory revolution and the counter-traditional wave in humanities in the 1980s have garnered attention towards new localism by positing alternatives to the great tradition. In this, Travel writing has proved adaptable and responsive to post-colonial and Globalization studies, thereby shaking off its ‘middlebrow’ status. Keeping in mind the relevance of travel writing in Global politics, the paper aims to engage with In an Antique Land: History in the Guise of a Traveller’s Tale (1992) by Amitav Ghosh to delineate the question of History, Travel and Narrative in Indian English Travel Writing. The paper contends that Ghosh uses the Hybrid non-fiction space of the travelogue to write a counter-narrative to the Eurocentric discourse of Travel writing. It seeks to foreground that the reverse Grand tour of Amitav Ghosh problematizes the western hegemonic hold on the field of Ethnography and History. The paper is divided into two parts- the first part will establish In an Antique Land as Resistive subaltern history, followed by the second part, which focuses on Ghosh’s privileging of third world ethnography to write an alternative narrative.
The System of Intergovernmental Relations: are there any Incentives for Economic Development
Authors: Lykova L. N.
Published: March 2021

In the last decade, the system of inter-budgetary relations has undergone some changes, which  were  mainly  of  a  partial  nature.  The  result  is  an  established  model  with  a significant  and  non-decreasing  number  of  subsidized  regions,  a  high  level  of  income concentration, and subfederal budgets that differ significantly in the degree of income base diversification. At the same time, if half of the regions have an insufficient level of economic development to finance the necessary expenditures (relative to GRP), then for the other half this level is quite sufficient within the GRP potential, but the current tax system and the procedure for distributing tax revenues do not allow this, which requires replacing tax revenues with federal transfers. This model does not generate intention in supporting economic growth and economic activity in the regions and deprives them of incentives for development. The way out of this situation may be to take into account the formed macro-trends (changes in the place of the hydrocarbon economy, the place in the value chains, etc.) in the formation of an explicitly asymmetric model of intergovernmental relations, which may allow us to use the intention in economic development at the level of the subjects of the Russian Federation.
Zarządzanie środowiskiem przyrodniczym w perspektywie public governance
Authors: Korporowicz-Żmichowska Violetta
Published: March 2021

Zarządzenie środowiskiem przyrodniczym to działalność społeczeństwa, organizacji i pojedynczych osób. Jego celem jest ograniczanie niekorzystnych przemian w ekosystemach. Zarządzanie to jest procesem podejmowania i wprowadzania w życie decyzji dotyczących stanu środowiska. Jest ponadto praktyczną aktywnością mającą na celu utrzymanie i poprawę stanu środowiska przyrodniczego, które ulega degradacji w wyniku gospodarczej i bytowej działalności człowieka. Zarządzanie środowiskiem musi być spójne z polityką ekologiczną państwa, która jest celową oraz świadomą aktywnością władz państwowych. Zadaniem tej polityki jest zapewnienie bezpieczeństwa ekologicznego wszystkim obywatelom. Polityka ekologiczna polega na odgórnych decyzjach, planach, które są tworzone, aby osiągnąć poprawę dobra wspólnego, jakim jest środowisko. Poprawa ta dotyczy środowiska i jego jakości, które jest nie tylko dobrem prywatnym, lecz także dobrem publicznym, gdyż ma szczególnie ważne znaczenie dla funkcjonowania danego społeczeństwa. Część z problemów z zakresu ochrony środowiska może być rozwikłanych przez wdrażanie nowych rozwiązań organizacyjnych traktowanych jako proces społeczny. Mowa tu o idei public governance, która jest oddolnym podejściem do zarządzania w sferze publicznej, w tym również zarządzania środowiskiem. Public governance, czyli „partycypacyjne zarządzanie publiczne”, to taki typ zarządzania, który cechuje się: zaangażowaniem interesariuszy, transparentnością decyzji, równością i brakiem wykluczenia poszczególnych członków czy grup społeczeństwa z możliwości decydowania o kształcie usług publicznych. Przykładem tu mogą być budżety obywatelskie, umożliwiające społecznościom lokalnym współdecydowanie o tym, jak będą realizowane inwestycje opłacane z części środków z budżetu samorządowego. Celem artykułu jest przedstawienie public governance ‒ jednej z koncepcji zarządzania w sektorze publicznym ‒ oraz próba odpowiedzi, czy koncepcja public governance może być wykorzystana w zarządzaniu środowiskiem przyrodniczym.
Analysis of Sedimentation for The Optimization of Lempake Dam Operations for Flood Control for The City of Samarinda, Province of East Kalimantan
Authors: Erryanto Sandi , Andawayanti Ussy , Suhartanto Ery
Published: March 2021

The Lempake Dam currently functions as a dam that provides raw water for irrigation and clean water, besides its indirect functioning as the only flood control dam in the Karangmumus sub-watershed. Current conditions indicate that the Lempake Reservoir has experienced decreased capacity from year to year. At the normal water level, the reservoir capacity of Lempake Reservoir in 2013 was 0.76 million m3 and in 2018 was 0.39 million m3. Therefore, efforts are needed to control reservoir sedimentation and reservoir operations to allow the Lempake Dam to continue to function as a flood control reservoir. This study was carried out by analyzing the volume of sedimentation in the reservoir using the ArcGIS program and analyzing the flood hydrograph at the site by flood routing at the Pasar Segiri River, optimizing reservoir operations, and mapping flood inundation using the RAS Mapping program (HEC-RAS). The results showed that the storage volume in 2020 is predicted to be 0.241 million m3 with an annual sediment rate of 0.074 million m3. From the flood routing analysis and optimization of reservoir operations, the cross-sectional capacity of the river in Pasar Segiri (safe limit elevation +3.30 m) is insufficient for a flood discharge of a return period of more than 2 years (more than 222.14 m3/sec) for Scenario 1, and of more than 5 years (more than 320.48 m3/sec) for Scenario 2
Development and Implementation of a Multidisciplinary Electronic Discharge Readiness Tool: User-Centered Design Approach
Authors: Keniston Angela , McBeth Lauren , Pell Sr Jonathan , Bowden Kasey , Ball Stephen , Stoebner Kristin , Scherzberg Elaina , Moore Susan L , Nordhagen Jamie , Anthony Amanda , Burden Marisha
Published: March 2021

Background

Typical solutions for improving discharge planning often rely on one-way communication mechanisms, static data entry into the electronic health record (EHR), or in-person meetings. Lack of timely and effective communication can adversely affect patients and their care teams.

Objective

Applying robust user-centered design strategies, we aimed to design an innovative EHR-based discharge readiness communication tool (the Discharge Today tool) to enable care teams to communicate any barriers to discharge, the status of patient discharge readiness, and patient discharge needs in real time across hospital settings.

Methods

We employed multiple user-centered design strategies, including exploration of the current state for documenting discharge readiness and directing discharge planning, iterative low-fidelity prototypes, multidisciplinary stakeholder meetings, a brainwriting premortem exercise, and preproduction user testing. We iteratively collected feedback from users via meetings and surveys.

Results

We conducted 28 meetings with 20 different stakeholder groups. From these stakeholder meetings, we developed 14 low-fidelity prototypes prior to deploying the Discharge Today tool for our pilot study. During the pilot study, stakeholders requested 46 modifications, of which 25 (54%) were successfully executed. We found that most providers who responded to the survey reported that the tool either saved time or did not change the amount of time required to complete their discharge workflow (21/24, 88%). Responses to open-ended questions offered both positive feedback and opportunities for improvement in the domains of efficiency, integration into workflow, avoidance of redundancies, expedited communication, and patient-centeredness.

Conclusions

Survey data suggest that this electronic discharge readiness tool has been successfully adopted by providers and clinical staff. Frequent stakeholder engagement and iterative user-centered design were critical to the successful implementation of this tool.
Notes from the Field: The Combined Effects of Tocilizumab and Remdesivir in a Patient with Severe COVID-19 and Cytokine Release Syndrome
Authors: Ali Sabahat , Khalid Sundas , Afridi Maham , Akhtar Samar , Khader Yousef S , Akhtar Hashaam
Published: March 2021

SARS-CoV-2 is known to cause severe bilateral pneumonia and acute respiratory distress syndrome or COVID-19 in patients, which can be debilitating and even fatal. With no drugs or vaccines available yet, a wide range of treatment regimens used are being repurposed. The need of the hour is to analyze various currently available regimens and devise a treatment plan that is most effective for COVID-19. Here we describe the case of a 68-year-old man with hypertension and diabetes, exhibiting symptoms of cough and shortness of breath, who presented at the emergency department of our hospital. Chest computed tomography revealed bilateral ground glass opacities that were indicative of COVID-19, and a computed tomography score of 24 was indicative of severe pulmonary pneumonia. He tested positive for COVID-19. His treatment regimen included the use of convalescent plasma, oxygen therapy, steroids, high-dose antibiotics, broad-spectrum antiviral remdesivir, and anti–interleukin-6 monoclonal antibody (Tocilizumab) at various stages of the disease. Oxygen supplementation was required at the time of admission. The patient initially developed a cytokine release storm, and oxygen supplementation was initiated to manage his condition. Supportive care and multiple treatment regimens were used to successfully recover the patient’s health. With a rapid increase in number of confirmed cases worldwide, COVID-19 has become a major challenge to our health care system. With no available vaccines currently, the establishment of a combination of therapeutic drugs that effectively reduce disease progression is of utmost importance.
Nonalcoholic Fatty Liver Disease in Children and Adolescents Taking Atypical Antipsychotic Medications: Protocol for a Systematic Review and Meta-analysis (Preprint)
Authors: Hatem Reem , Nawaz Faisal A , Al-Sharif Ghadah A , Almoosa Mohammad , Kattan Wid , Tzivinikos Christos , Amirali E Lila , Albanna Ammar
Published: March 2021

BACKGROUND

Atypical antipsychotics (AAP) are commonly prescribed to children and adolescents and are associated with important adverse effects including weight gain and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is not only the most common pediatric liver disease but is also associated with serious complications including liver cirrhosis.

OBJECTIVE

Given that NAFLD and AAP are associated with metabolic syndrome, we aim to comprehensively examine the association between AAP and NAFLD in children and adolescents.

METHODS

We will conduct a systematic review of studies exploring NAFLD in subjects younger than 18 years on AAP published in English between 1950 and 2020 following the PRISMA (Preferred Reporting items for Systematic Reviews and Meta-Analysis) guidelines.

RESULTS

A PRISMA flowchart will be used present the study results after comprehensively reviewing studies on NAFLD in children and adolescents taking AAP. The first and second systematic searches will be conducted during December 2021. The results are expected to be published in June 2022.

CONCLUSIONS

This research project will serve as a foundation for future studies and assist in devising interventions and reforming clinical guidelines for using AAP to ensure improved patient safety.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/20168
Designing a Cancer Prevention Collaborative Goal Setting Mobile App for Non-Hispanic Black Primary Care Patients: An Iterative, Qualitative Patient-led Process (Preprint)
Authors: Resnick Daniel , Kearney Matthew D , Smith Jazmine M , Bautista Allison , Jones Liz , Schapira Marilyn M , Aysola Jaya
Published: March 2021

BACKGROUND

There remains a need to engage at-risk primary care populations in cancer prevention behaviors, yet primary care physicians often lack the time or resources to discuss these behaviors with their patients.

OBJECTIVE

The objective of the study was to evaluate the content, usability, and acceptability of a mobile app that leverages insights from goal-setting and social networks literature to facilitate cancer prevention goal setting, tracking, and sharing between Non-Hispanic Black primary care patients and their social ties.

METHODS

We recruited eligible Non-Hispanic Black primary care patients (age 18 or older) from two practice sites in West Philadelphia, using non-probabilistic purposive sampling. We conducted semi-structured interviews with 5 to 7 participants over three weeks to solicit feedback on paper mock-ups of the app, iteratively adapting these mock-ups after each set of interviews. Thereafter, and informed by initial feedback, we created an electronic beta-version of the app and sought acceptability and usability feedback from a different set of participants. Then we conducted content analysis of all user responses to search for unifying themes on acceptability and usability of both the initial mock-ups and beta-version of the app. We further assessed app usability using questions derived from the System Usability Scale (SUS).

RESULTS

Thirty-three Non-Hispanic Black primary care patients participated in the study. The mean age was 49 (SD ± 13) and 26 out of 33 (79%) participants identified as female. Semi-structured interviews revealed three primary generalizable insights from our target population: 1) the framing of each goal and its relevance to cancer impacted the likelihood the goal would be chosen; 2) participants thought that sharing health goals with others facilitates health behaviors; and 3) most participants found it motivating to see other users’ goal progress, while still collaborating with these users on their health goals. An overarching insight that permeated across each theme was the participants’ desire to customize and personalize the app. Usability testing revealed that 100% (33/33) of participants found the app easy to use and 76% (25/33) of participants reported they would like to use this app frequently.

CONCLUSIONS

Cancer prevention in the modern era must include options that are accessible to all, but this does not mean that all options must be universal. This study’s iterative process led to the development of a cancer prevention mobile app that Non-Hispanic Black primary care patients deemed usable and acceptable and yielded noteworthy insights about what intended end-users value in setting and accomplishing health goals.

CLINICALTRIAL
COVID-19 Contact Tracing: A Review on mHealth Application and HIPPA (Preprint)
Authors: Migiro Lorna , Shahriar Hossain , Sneha Sweta
Published: March 2021

BACKGROUND

Contact tracing has been implemented as a necessary tool to slow the spread outbreaks over the years. During the COVID-19 pandemic, the introduction of digital applications has allowed a lot of flexibility regarding transmission by driving more people to testing and quarantine.

OBJECTIVE

This study discusses contact tracing application usage in COVID-19, compare and analyze them based on HIPPA privacy rule. We also discuss challenges facing these new applications and recommend best practices.

METHODS

The research sampled top ten applications currently in use. Using Android devices, we downloaded and interacted with apps that had over 100,000 downloads on google play store the way a normal user would. we reviewed their privacy policies and compared them against HIPPAs’ privacy rule and generated a checklist.

RESULTS

The study interacted and analyzed 10 contact tracing applications, particular attention was paid to how the apps’ privacy policies and Google Play Store app privacy policy descriptions disclosed information.

CONCLUSIONS

Contact tracing applications have proved to be a fundamental pillar during this pandemic. Aligning this apps with the HIPPA privacy rule is one of the major challenges they face. Privacy concerns, user adoption and perception obstacles have also been associated with this apps.

CLINICALTRIAL

Not applicable.
Patient-Facing Mobile Apps to Support Physiotherapy Care: Protocol for a Systematic Review of Apps Within App Stores (Preprint)
Authors: Merolli Mark , Francis Jill J , Vallance Patrick , Bennell Kim L , Malliaras Peter , Hinman Rana S
Published: March 2021

BACKGROUND

Care delivered by physiotherapists aims to facilitate engagement in positive health behaviors by patients (eg, adherence to exercise). However, research suggests that behavioral interventions are frequently omitted from care. Hence, better understanding of strategies that can be used by physiotherapists to support patients to engage in positive behaviors is important and likely to optimize outcomes. Digital health interventions delivered via mobile apps are garnering attention for their ability to support behavior change. They have potential to incorporate numerous behavior change techniques (BCTs) to support goals of physiotherapy care, including but not limited to self-monitoring, goal setting, and prompts/alerts. Despite their potential to support physiotherapy care, much is still unknown about what apps are available to consumers, the BCTs they use, their quality, and their potential to change behaviors.

OBJECTIVE

The primary aim of this study is to systematically review the mobile apps available in app stores that are intended for use by patients to support physiotherapy care, including the BCTs within these apps. The secondary aims are to evaluate the quality and behavior change potential of these apps.

METHODS

A systematic review of mobile apps in app stores will be undertaken. This will be guided by recommendations for systematic reviews in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement but adapted to suit our app store search, consistent with similar systematic reviews of apps published in the Journal of Medical Internet Research. Apple Store and Google Play will be searched with a two-step search strategy, using terms relevant to physiotherapy, physiotherapists, and common physiotherapy care. Key eligibility criteria will include apps that are intended for use by patients and are self-contained or stand-alone without the need of additional wearable devices or other add-ons. Included apps will be coded for BCTs and rated for quality using the Mobile Application Rating Scale (MARS) and for potential to change behavior using the App Behavior Change Scale (ABACUS).

RESULTS

App store search and screening are expected to be completed in 2021. Data extraction and quality appraisal are expected to commence by November 2021. The study results are expected to be published in a subsequent paper in 2022.

CONCLUSIONS

Knowledge gained from this review will support clinical practice and inform research by providing a greater understanding of the quality of currently available mobile apps and their potential to support patient behavior change goals of physiotherapy care.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/29047
Antecedents of Medical Crowdfunding Information Sharing Behaviors on Social Media: an empirical study (Preprint)
Authors: Yang Xuejie , Ding Bin , Wang Xiaoyu , Gu Dongxiao , Liang Changyong , Guo Jingjing , Li Xingguo , Zhang Gongrang
Published: March 2021

BACKGROUND

The extensive use of social media enables crowdfunding information to spread to a wider extent. Therefore, understanding people’s psychological motivation to help others becomes a critical issue.

OBJECTIVE

We focus on the sharing behaviors of medical crowdfunding initiations on social media and aims to investigate the psychological motivational factors contribute to people’s sharing behaviors.

METHODS

Based on the theory of interpersonal behavior, a model was developed to examine the factors that influence people’s intention and actual sharing behaviors of medical crowdfunding on social media. The model was tested empirically using lagged data from 363 Chinese participants.

RESULTS

The results show that altruism (β = 0.11, p < .05), warm glow (β = 0.45, p < .001), relationship orientation (β = 0.12, p < .05), and perceived information credibility (β = 0.21, p < .001) are antecedents of intention to share of medical crowdfunding information. Inter-dependency between altruism and warm glow such that altruism is positively related to warm glow (β = 0.59, p < .001). Intention to share information (β = 0.59, p < .001), habit (β = 0.29, p < .001), and facilitating conditions (β = 0.15, p < .01) positively impact actual sharing behaviors of medical crowdfunding information. Our results also reveal no moderating effects of facilitating conditions (β = 0.08, p > .05) and habits (β = -0.03, p > .05) in the relationship between crowdfunding information sharing intention and actual sharing behavior.

CONCLUSIONS

This study develops a theoretical model that explains people's intention to share crowdfunding information. Findings have theoretical values for researchers as well as practical values for medical crowdfunding initiator and the platform designer.
Utility of the ROX Index in Predicting Intubation for Patients With COVID-19–Related Hypoxemic Respiratory Failure Receiving High-Flow Nasal Therapy: Retrospective Cohort Study (Preprint)
Authors: Patel Maulin , Chowdhury Junad , Mills Nicole , Marron Robert , Gangemi Andrew , Dorey-Stein Zachariah , Yousef Ibraheem , Zheng Matthew , Tragesser Lauren , Giurintano Julie , Gupta Rohit , Rali Parth , D'Alonzo Gilbert , Zhao Huaqing , Patlakh Nicole , Marchetti Nathaniel , Criner Gerard , Gordon Matthew
Published: March 2021

BACKGROUND

The use of high-flow nasal therapy (HFNT) to treat COVID-19 pneumonia has been greatly debated around the world due to concerns about increased health care worker transmission and delays in invasive mechanical ventilation (IMV). Herein, we analyzed the utility of the noninvasive ROX (ratio of oxygen saturation) index to predict the need for and timing of IMV.

OBJECTIVE

This study aimed to assess whether the ROX index can be a useful score to predict intubation and IMV in patients receiving HFNT as treatment for COVID-19–related hypoxemic respiratory failure.

METHODS

This is a retrospective cohort analysis of 129 consecutive patients with COVID-19 admitted to Temple University Hospital in Philadelphia, PA, from March 10, 2020, to May 17, 2020. This is a single-center study conducted in designated COVID-19 units (intensive care unit and other wards) at Temple University Hospital. Patients with moderate and severe hypoxemic respiratory failure treated with HFNT were included in the study. HFNT patients were divided into two groups: HFNT only and intubation (ie, patients who progressed from HFNT to IMV). The primary outcome was the value of the ROX index in predicting the need for IMV. Secondary outcomes were mortality, rate of intubation, length of stay, and rate of nosocomial infections in a cohort treated initially with HFNT.

RESULTS

Of the 837 patients with COVID-19, 129 met the inclusion criteria. The mean age was 60.8 (SD 13.6) years, mean BMI was 32.6 (SD 8) kg/m², 58 (45%) were female, 72 (55.8%) were African American, 40 (31%) were Hispanic, and 48 (37.2%) were nonsmokers. The mean time to intubation was 2.5 (SD 3.3) days. An ROX index value of less than 5 at HFNT initiation was suggestive of progression to IMV (odds ratio [OR] 2.137, P=.052). Any further decrease in ROX index value after HFNT initiation was predictive of intubation (OR 14.67, P<.001). Mortality was 11.2% (n=10) in the HFNT-only group versus 47.5% (n=19) in the intubation group (P<.001). Mortality and need for pulmonary vasodilators were higher in the intubation group.

CONCLUSIONS

The ROX index helps decide which patients need IMV and may limit eventual morbidity and mortality associated with the progression to IMV.
Discovery and Topic Evolution Analysis of CRISPR/Cas9 Gene Editing Technology in Biomedical Field:Internet-based Survey (Preprint)
Authors: Zhang Lixin , Tang Mingkun , Xiu Xiaolei , Wu Jinming , Wu Sizhu , Qian Qing
Published: March 2021

BACKGROUND

In 2020, the discoverers of CRISPR/Cas9 technology, Jennifer A. Doudna and Emmanuelle Charpentier, were awarded the Nobel Prize in Chemistry. This technology has revolutionized the field of biomedical science since its birth and contributed to the treatment of a variety of complex diseases. Scholars have carried out many studies on the development trend of CRISPR technology, bibliometrics, visualization and other aspects. However, there are few studies on the hot spot analysis and topic changes in the biomedical field, which is not conducive to scholars' thinking.

OBJECTIVE

This study aimed to:(1) mining and analyzing the research hotspots of CRISPR/Cas9 system in each stage; (2) sorting out and visualizing the evolution direction of the hot research topics of CRISPR/Cas9 gene editing technology in the past decade; (3) exploring the hidden research hotspots of CRISPR/Cas9 gene editing technology, so as to provide reference for further research

METHODS

In this study, research papers related to CRISPR/Cas9 gene editing technology in biomedical field published on the Web of Science core datasets from 2010 to 2020 were used; literature research method, analysis method and expert consultation method and other methods were comprehensively utilized; CiteSpace software and VOS viewer software were selected as visualization tools to analyze hot topics and topic evolution in research.

RESULTS

The generated co-occurrence map and cluster map were analyzed by keyword analysis strategy to determine the hot topics in each development stage. The topic evolution types and evolution paths are studied based on the categories and keywords of hot topics in each stage and the characteristics of their advancement along the time axis, and the topic evolution diagram and evolution path diagram were presented respectively.

CONCLUSIONS

Based on the above research results, firstly, in recent years, scholars have attached great importance to the research on this technology in the field of biomedical science, and the research topics have been deepened and enriched. Secondly, the development of CRISPR/Cas9 system shows different hot research directions in different periods, which is in line with the development of The Times. Finally, the theme evolution of CRISPR/Cas9 in the field of biomedicine generally shows a trend from single to multiple, and from theory to practice. Hidden research hotspots focus on the detection and treatment of infectious diseases, aging mitigation, drug resistance and other common diseases.
Developing a USSD-based mobile phone app to provide adolescents with sexual reproductive health information: A human-centered design approach (Preprint)
Authors: Macharia Paul , Pérez-Navarro Antoni , Inwani Irene , Nduati Ruth , Carrion Carme
Published: March 2021

BACKGROUND

Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information in resource-limited settings can often be due to cultural and societal attitudes to adolescent sexual reproductive health. Innovative approaches, including mobile phone technologies, are needed to address the need for adolescent reproductive health information.

OBJECTIVE

To design and develop a mobile app prototype to provide confidential adolescent reproductive health information on demand and evaluate its usability and user experience.

METHODS

A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. Field usability testing enabled the adolescents to provide feedback on the functionality, usability, and usefulness of the app.

RESULTS

During the usability test, 62 (54.9%) of the adolescents that were followed-up had used the app at least once, 30 (48.4%) of these were male participants and 32 (51.6%) female. The app was described as ‘very interesting’ to use by 44 (70.9%) participants, 20 male and 24 female. The content was deemed to be either ‘perfectly’ or ‘well targeted’ on sexual reproductive health by 60 (96.7%) adolescents, and the app was rated ‘best app’ by 45 (72.6%) adolescents, 27 female and 18 male, with a p-value = 0.011.

CONCLUSIONS

A mobile phone app is a feasible and acceptable way to deliver adolescent sexual reproductive health information in resource-limited settings. The USSD mobile phone technology could deliver confidential information on demand.
Chronic Patients’ eHealth Literacy Skills and Related Factors: The Example of Turkey (Preprint)
Authors: Yuce Alp Eren , Albayrak Ahmet
Published: March 2021

BACKGROUND

Previous studies on the eHealth suggested that chronic patients use the internet to obtain health information and to manage their health conditions. It has been revealed, particularly during the pandemic, that the internet has a significant potential to become a crucial health information source for chronic patients. However, there are both fluctuant and constant factors that influence the various eHealth literacy skills of chronic patients. It is critical to discover the current parameters influencing eHealth literacy skills in countries such as Turkey, which is in the process of adapting technology use, while eHealth literacy is gaining attention globally.

OBJECTIVE

This study aims to reveal the eHealth literacy skills of chronic patients and to investigate the relations and patterns between eHealth literacy skills and various factors such as demographics, search strategies and health information sources, and to explain their effects on eHealth literacy in Turkey in Izmir.

METHODS

The study, based on a quantitative research, including the administration of a questionnaire. A total of 604 chronic patients who applied to the five popular identified hospitals in Izmir, Turkey, responded to the questionnaire. The questionnaire, which includes information on demographics, social media platforms, internet usage frequency, eHealth literacy scale, search strategies scale, and health information sources scale, was conducted with the participants. CHAID analysis method was implemented to analyze the results and determine the relations between dependent and independent variables.

RESULTS

The type of the social media platform used by participants was an influencing factor on eHealth literacy scores. Finding health information across multiple platforms, such as Facebook, Twitter, and Pinterest, was found to be a positive predictor of eHealth literacy. (25.3%, 153 patients). Additionally, a positive correlation has been found between the use of the internet as a source of health information and eHealth literacy scores while using the strategy of “following the links that appear on websites” is positively correlated with eHealth literacy scores.

CONCLUSIONS

The study's findings indicate that using the internet and various social media platforms to obtain health information has a positive effect on eHealth literacy skills. Patients with greater interaction with the internet and its substructures, as well as a greater interest in utilizing the technological features of digital environments, were found to be more qualified eHealth literates. However, given the pollution of health information on the Internet, the information channel through which health information is obtained is also a critical issue in terms of health literacy. Online health knowledge should be scientifically promoted by medical institutions or governmental organizations in order to be widely and effectively disseminated, particularly in countries such as Turkey.
Cyber-Addiction among University Students: Insights and Implications from a Web-based Cross-Sectional Study (Preprint)
Authors: Guelmami Noomen , Chen Wen , Chalghaf Nasr , Azaiez Fairouz , Bragazzi Nicola Luigi
Published: March 2021

BACKGROUND

Cyber-addiction has become a particularly serious problem among students around the world. However, few researches have investigated cyber-addiction and its impact on Tunisian university students.

OBJECTIVE

Our study aimed to assess the presence and severity of internet addiction among Tunisian university students.

METHODS

. We sampled 540 students from Sfax, Tunisia (191 males, 35.4% and 349 females, 64.6%) aged from 18 to 30 years, with a mean age of 21.72 ± 1.93 years. They were administered the French version of the "Internet Addiction Test” (IAT), initially developed by Young and validated in French language by Khazaal and colleagues. This questionnaire consists of 20 items scoring on a Likert scale from 1 to 5 (never, rarely, occasionally, often, and always).

RESULTS

Mean IAT score resulted 65.02 ± 19.71 (median 68). Exploratory and confirmatory factor analyses enabled to discover a 1-factor structure. Overall reliability proved excellent, as shown by the Cronbach’s alpha (0.93) and by the test-retest correlation (0.73). Almost half of the students (42.8%) were found to be cyber-addicted, with females being much more affected than males (respectively 30.9% versus 11.9%). Together with gender, age was found to be another determinant of cyber-addiction, with students aged less than 20 years exhibiting a higher risk than students aged 20 years and older. Furthermore, there was a relation between the academic studies chosen and the cyber-addiction score, with students pursuing studies in the field of physical education and sports having a higher risk of cyber-addiction.

CONCLUSIONS

In conclusion, the IAT proved to be a reliable instrument that can be administered to Tunisian students. Moreover, our results showed that cyber-addiction has become a widespread phenomenon also among Tunisian university students.