bluuebunny/crossref_metadata_2025 huggingface dataset:
Perde-Çerçeve Sistemlerde Rijitlik ve Kayma Merkezi
Authors: BOZDOĞAN Kanaat Burak , AYDIN Süleyman
Published: June 2020

Binalarda burulma olması durumunda yapıya ilave deprem kuvvetleri etkimekte ve iç kuvvetler ve yer değiştirmeler artmaktadır. Bu nedenle düşey taşıyıcı sistemlerin planda mümkün olduğunca burulma etkisini azaltıcı şekilde yerleştirilmesi önemlidir. Burulma etkilerini en aza indirmek için rijitlik merkezi ile ağırlık merkezinin mümkün olduğunca yakın olması gerekmektedir. Her ne kadar mevcut deprem yönetmeliklerinin birçoğunda analiz aşamasında rijitlik merkezinin belirlenmesine ihtiyaç duyulmasa da özellikle burulma etkilerinin azaltılması açısından rijitlik merkezinin yerinin bilinmesi önemlidir. Uygulamada rijitlik merkezi ve kayma merkezi kavramları zaman zaman karıştırılmakta ve yanlış olarak bulunabilmektedir. Perde-çerçeve sistemlerde perde ve çerçevede hâkim davranışın farklı olması nedeniyle, perde ve çerçevelerin boyutlarının yapı yüksekliği boyunca sabit olması durumunda bile rijitlik merkezi kattan kata değişmektedir. Rijitlik merkezi bu tür yapılarda bazı katlarda plan dışına bile çıkabilmektedir. Bu çalışmada öncelikle rijitlik merkezi ve kayma merkezi kavramları kısaca açıklanmıştır. Daha sonra rijitlik merkezi ve kayma merkezinin bulunması için bir yaklaşım önerilmiştir. Sunulan yaklaşım literatürden alınan iki örnek üzerinde uygulanarak elde edilen sonuçlar literatür ve ETABS yazılımı ile karşılaştırılmış ve sunulan yöntemin uygunluğu gösterilmiştir.
Termal Uzaktan Algılama Görüntüleri İle Yüzey Sıcaklıklarının Belirlenmesi: Kocaeli Örneği
Authors: AKYÜREK Özer
Published: June 2020

Kentleşme ile paralel olarak yoğun yerleşim alanlarında sıcaklık, kent çevresinde bulunan kırsal alanlardan daha yüksek olarak gözlenir. Kentsel alanların etrafında bulunan doğal alanlardan daha sıcak olmasına sebep olan bu sıcaklık olayı kentsel ısı adası olarak tanımlanmaktadır. Uzaktan algılama platformlarında termal bandların kullanılması ile birlikte yer yüzey sıcaklıklarının (YYS) belirlenmesi ve ilgili parametrelerin konumsal dağılımları eski yöntemlere göre daha iyi bir biçimde temsil edilmeye başlanmıştır. Uydular sayesinde algılanan görüntülerden elde edilen bu verilerin, düşük maliyetli olması ve geniş alanları kapsamasından dolayı çok çeşitli uygulamalarda veri kaynağı olarak kullanılmalarına imkân sağlamıştır. Bu çalışmada, 2015 – 2019 yılları arasında her yılın Temmuz ayına ait toplam 5 adet Landsat 8 uydu görüntüsünün termal bandı kullanılarak, Kocaeli il sınırları içerisindeki YYS haritaları oluşturulmuştur. Oluşturulan haritalara göre 5 yıllık dönem içerisinde, ilin batı –sanayileşmenin yüksek olduğu– ve güney –jeotermal aktivitenin yüksek olduğu– bölgelerinin YYS değerlerinin yüksek olduğu belirlenmiştir. Ayrıca İzmit ve Kartepe ilçelerindeki çeşitli sanayi tesislerinin de YYS değerlerinin yüksek olduğu tespit edilmiştir. Hava kalitesi istasyonlarından alınan rüzgâr hızı ve yönü bilgileri ile rüzgâr haritaları oluşturulmuş ve YYS’yi azaltıcı bir etki göstermediği tespit edilmiştir. Son olarak, uydu görüntüleri üzerinden Düzeltilmiş Toprak Bitki İndeksi (SAVI) ve Normalleştirilmiş Fark Yerleşim Alanı İndeksi (NDBI) görüntüleri oluşturularak YYS ile aralarında bulunan istatistiksel ilişki incelenmiştir. Bu inceleme sonucunda SAVI ile ters, NDBI ile doğrusal bir ilişkinin olduğu belirlenmiştir.
Nevşehir İlinde Hava Kalitesinin ve Meteorolojik Faktörlerin Hava Kirliliği Üzerine Etkilerinin İncelenmesi
Authors: OĞUZ Kahraman
Published: June 2020

Kentsel hava kirliliğinin artması çevreyi ve insan sağlığını etkileyen önemli problemlere neden olmaktadır. Kentsel hava kirliliğinin en önemli kaynaklarından biri karayolu taşımacılığı sektörüdür. Ayrıca, yerel, ticari ve endüstriyel faaliyetler ile uzun mesafeli taşınımlar kentsel hava kirliliğine önemli katkıda bulunmaktadır. Hava kirliliğinin çevreyi etkilediği gibi, hava kirliliği üzerinde etkili olan faktörler de bulunmaktadır. Bunların başında meteorolojik faktörler gelmektedir. Bu çalışmada, Nevşehir bölgesindeki hava kirliliğinin ve limiti aşan kirli gün sayısının değerlendirilmesi ile birlikte meteorolojik faktörlerin hava kirliliğine olan etkilerinin detaylıca incelenmesi amaçlanmıştır. Bu amaçla, Çevre ve Şehircilik Bakanlığı Hava Kalite İzleme İstasyon verilerinden Nevşehir iline ait 2010-2019 yılları arası PM10, SO2, hava sıcaklığı, basınç, rüzgâr hızı ve bağıl nem verileri elde edilmiştir. Bu verilerin Mann-Kendall ve Şen testi yardımı ile trend ve eğimleri hesaplanmıştır. PM10 ve SO2 parametrelerinin yıllık, mevsimlik, aylık ve saatlik değişimleri ile sınır aşan günlerin analizi yapılmıştır. Bunun yanında, ölçülen en yüksek 6 adet PM10 değerlerinin kaynağının analizinin yapılması amacıyla HYSPLIT modeli çıktıları elde edilmiştir. Sonrasında, meteorolojik koşulların Nevşehir bölgesinde hava kirliliğine etkisinin analizi kapsamında, PM10 ve SO2 kirleticilerinin hava sıcaklığı, basınç, rüzgâr hızı ve bağıl nem parametreleri ile ilişkisi incelenmiştir.
Phonological Processes in A 18-Months Bilingual Toddler
Authors: Setiyono Agung , Indrayani Lia Maulia , Soemantri Ypsi Soeria
Published: June 2020

The toddler’s first words were unintelligible speech by adult. This study was conducted to investigate the language development undergone by a 18-months bilingual toddler. The study of language development had two perspectives in terms of clinical and linguistic perspective. This study was a linguistic perspective to find out the language development processes especially in phonological processes undergone by a 18-months bilingual toddler. This study employed descriptive case study as the method with observation and video recording as the data collection. The participant of this study was a 18-months Javanesse-Indonesian toddler. The data were collected for 30 days. The data were categorized and analyzed based on Ingram's theory (1976). The result revealed that there were three categories of phonological processes undergone by 18-months Javanesse-Indonesian toddler such as substitution, assimilatory, and syllable structure processes. The syllable structure processes with initial consonant deletion is the most dominant types of phonological processes. The results are expected to enrich the study of language development especially in a 18-months Javanesse-Indonesian toddler in which the information will benefit for the practicing clinicians.
Informal Settlements Sustainable Development: Comfort Level Enhancements through the Micro-Scale Intervention, Metamorphic Shutters, and Its Effect on the Built Environment of Cairo
Authors: Yasser Farres
Published: June 2020

The sustainable development of the built environment through informal settlements may introduce itself through micro-scale architectural interventions. This research’s aim is to inspect whether the Metamorphic Shutters intervention can have a positive effect on the built environment through improving thermal comfort levels. The consideration of the residents’ socio-economic dimensions was foundational to try and improve their overall quality of life using this simple intervention. The Literature suggests that the key problem with these interventions which have been designed before is the lack of economic and practical efficiency for informal settlement users due to them using expensive and inaccessible materials whilst using complicated construction methods. This makes it difficult for the interventions to be realized and repeated in informal settlements. Moreover, they concentrate solely on the lighting level enhancements rather than the effect of that on thermal comfort levels.The Metamorphic shutters (MS) are rotatable horizontal louvers installed in window draft casements. The intervention's 2 main objective was to quantitatively test the possible thermal comfort and lighting level outcomes of the MS by controlling the amount of direct light which enters the room. The second objective was to qualitatively understand the end user’s subjective perception of the intervention’s practicality, lighting and thermal comfort outcomes. Finally, the final objective was to test the MS after particular modifications were made based on the end users’ request to increase the amount of daylight entering the rooms. Both an experimental and mixed method approach-with both quantitative and subtle and subsidiary qualitative data-were used to carry out the research. The qualitative data was gathered by interviewing a sample of informal residents before and after the intervention’s construction and installation whilst the Quantitative data was gathered by monitoring the Metamorphic Shutters’ performance.It is important to mention that the conclusions found that the Metamorphic Shutters had high and mediocre levels of thermal comfort level improvements which varied for both summer and winter due to the amount of direct sun light which the experiment room received. These are not solely a result of the residents’ control over the shutters but also-to a large extent-an effect of the building orientation and of the neighboring buildings’ heights which obscure sunlight during certain time periods of the day and during different periods of the year.
Oxidovanadium(IV) Complex Disrupts Mitochondrial Membrane Potential and Induces Apoptosis in Pancreatic Cancer Cells
Authors: Kowalski Szymon , Tesmar Aleksandra , Sikorski Artur , Inkielewicz-Stępniak Iwona
Published: June 2020

Background:

At the present time, there is a growing interest in metal-based anticancer agents. Metal
complexes exhibit many valuable clinical properties, however, due to toxicity, only a few clinically useful complexes
have been discovered. It has been demonstrated that synthetic vanadium complexes exhibit many biological
activities, including anti-cancer properties, however, cellular and molecular mechanisms still are not
fully understood.

Objective:

This investigation examined the potential effects of three newly synthesized oxidovanadium(IV)
complexes with 2-amino-3-hydroxypyridine against pancreatic cancer cells.

Methods:

We measured cytotoxicity by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide,
antiproliferative activity by bromodeoxyuridine assay and necrosis as well as late apoptosis by lactate dehydrogenase
assay. Reactive oxygen species generation, apoptosis and mitochondrial membrane potential were determined
by a flow cytometry technique. Cell morphology was evaluated by using a transmission electron microscope.

Results:

The results showed that oxidovanadium(IV) complexes were cytotoxic on pancreatic cancer cells
(PANC-1 and MIA PaCa2) over the concentration range of 12.5-200μM, following 48h incubation. Additionally,
the cellular mechanism of cytotoxic activity of [2-NH2-3-OH(py)H]4[V2O2(pmida)2]·6H2O (V3) complex
was dependent on ROS generation, induction apoptosis with simultaneous disruption of mitochondrial membrane
potential.

Conclusion:

We have proven that oxidovanadium (IV) complexes show therapeutic potential in pancreatic
cancer therapy. The results of our research will help to understand the cellular mechanisms of the cytotoxic
activity of the vanadium complexes and will allow a more effective design structure of new vanadium-based
compounds in the future.
Tradición, Sentido y Formación en el Desarrollo de las Albañilas en Latinoamérica
Authors: Montes-Ponce Wendy Margarita , López-Altamirano Otniel Josafat
Published: June 2020

La participación de las Albañilas en la construcción se ha incrementado en los últimos años. La formación en el oficio representa desventajas que tienen origen, tanto en lo biológico como en el género. El presente artículo tiene la finalidad de exponer las condiciones bajo las cuales se desarrollan las Albañilas en Latinoamérica, demostrando que el reconocimiento laboral ha experimentado ensambles políticos, empresariales y sociales, hasta lograr su formalización de aprendizaje académico, potenciando sus saberes, habilidades y economía familiar. Los avances han rendido frutos positivos. Sin embargo, se requieren políticas públicas permanentes que fortalezcan los programas académicos, implicando los ambientes urbanos y rurales.
Hematological Impacts of the Traffic Emissions in Sulaymaniyah Governorate
Authors: Bapir Dunya Hars , Hama Salih Ahmed
Published: June 2020

Abstract

The current study was achieved to evaluate the essential hematologic impacts of traffic emission. Ninety-six cases were studied included both exposures and controls. The focal point was on Raparin District in Sulaimani Governorates. A questioner form was depended for collecting information about each case. Fresh venous blood (5ml) were collected aseptically from both exposures and controls. Hematologic Autoanalyzer (Coulter) was used for hematologic investigations. It appeared that the mean leukocyte counts were higher among exposures in comparison to controls; the period of exposure and smoking were significantly effective on total white cells. Lymphocyte counts were significantly declined among exposures. It appeared that the distance from the emission gas sources, smoking, and period of exposure was significantly effective on the total lymphocyte counts (p<0.05). No valuable effects of traffic emission were noticed on granulocytes in general (p>0.05), although the neutrophil counts were significantly higher among exposure. It was concluded that traffic emission has no significant effects on Red cell profiles, including red cell numbers, Hb, HCT, RDW, MCH in general (p>0.05). The current study revealed that there were no noticeable effects of traffic emission, generally on the total platelet counts between exposures and controls. It has concluded that the distance from the emission sources was significantly effective on platelet counts among exposures themselves (p<0.05).
Understanding the Attitudes of Clinicians and Patients Toward a Self-Management eHealth Tool for Atrial Fibrillation: Qualitative Study
Authors: Cher Boon Piang , Kembhavi Gayatri , Toh Kai Yee , Audimulam Jananie , Chia Wei-Yan Aloysius , Vrijhoef Hubertus JM , Lim Yee Wei , Lim Toon Wei
Published: June 2020

Background

Atrial fibrillation (AF) is the most common heart rhythm disorder and poses a growing disease burden worldwide because of an aging population. A multidisciplinary approach with an emphasis on patient education and self-management has been demonstrated to improve outcomes for AF through the engagement of patients in their own care. Although electronic tools (e-tools) such as apps have been proposed to provide patient education and facilitate self-management, there have been few studies to guide the development of these tools for patients with AF.

Objective

This study aims to explore the perceptions of patients and health care providers (HCPs) and their attitudes toward the use of e-tools for the self-management of AF. It also seeks to elicit the factors that contribute to these attitudes.

Methods

Semistructured qualitative interviews with HCPs and patients were conducted to understand the interpretations and expectations of an e-tool that would be used for the self-management of AF. Interview data were analyzed using an exploratory thematic analysis approach to uncover emergent themes and infer ideas of preferred features in a device. A modified technology acceptance model was developed as a framework to help interpret these findings. Data from the HCPs and patients were compared and contrasted.

Results

Both patients and HCPs thought that an e-tool would be useful in the self-management of AF. Although both groups favored educational content and monitoring of blood pressure, patients expressed more passivity toward self-care and an ambivalence toward the use of technology to monitor their medical condition. This appears to be related to factors such as a patient’s age, social support, and their attitudes toward technology. Instead, they favored using the app to contact their HCPs.

Conclusions

This study provides insights into significant differences in the attitudes of patients and HCPs toward the use of e-tools for self-care against their priorities. Understanding patients’ motivations and their needs are key to ensuring higher acceptance of such tools.
Racial and Ethnic Disparities in Patient Experiences in the United States: 4-Year Content Analysis of Twitter
Authors: Hswen Yulin , Hawkins Jared B , Sewalk Kara , Tuli Gaurav , Williams David R , Viswanath K , Subramanian S V , Brownstein John S
Published: June 2020

Background

Racial and ethnic minority groups often face worse patient experiences compared with the general population, which is directly related to poorer health outcomes within these minority populations. Evaluation of patient experience among racial and ethnic minority groups has been difficult due to lack of representation in traditional health care surveys.

Objective

This study aims to assess the feasibility of Twitter for identifying racial and ethnic disparities in patient experience across the United States from 2013 to 2016.

Methods

In total, 851,973 patient experience tweets with geographic location information from the United States were collected from 2013 to 2016. Patient experience tweets included discussions related to care received in a hospital, urgent care, or any other health institution. Ordinary least squares multiple regression was used to model patient experience sentiment and racial and ethnic groups over the 2013 to 2016 period and in relation to the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014.

Results

Racial and ethnic distribution of users on Twitter was highly correlated with population estimates from the United States Census Bureau’s 5-year survey from 2016 (r2=0.99; P<.001). From 2013 to 2016, the average patient experience sentiment was highest for White patients, followed by Asian/Pacific Islander, Hispanic/Latino, and American Indian/Alaska Native patients. A reduction in negative patient experience sentiment on Twitter for all racial and ethnic groups was seen from 2013 to 2016. Twitter users who identified as Hispanic/Latino showed the greatest improvement in patient experience, with a 1.5 times greater increase (P<.001) than Twitter users who identified as White. Twitter users who identified as Black had the highest increase in patient experience postimplementation of the ACA (2014-2016) compared with preimplementation of the ACA (2013), and this change was 2.2 times (P<.001) greater than Twitter users who identified as White.

Conclusions

The ACA mandated the implementation of the measurement of patient experience of care delivery. Considering that quality assessment of care is required, Twitter may offer the ability to monitor patient experiences across diverse racial and ethnic groups and inform the evaluation of health policies like the ACA.
Awareness of and Attitudes Toward User Involvement in Research on Aging and Health: Protocol for a Quantitative Large-Scale Panel Study
Authors: Kylén Maya , Schmidt Steven M , Jonsson Oskar , Slaug Björn , Iwarsson Susanne
Published: June 2020

Background

User involvement is a requirement of most research funders. There is a growing body of literature exploring the benefits and challenges of user involvement in research, but such studies are scarce in the field of aging and health. Moreover, the majority of such research is qualitative, which limits the generalizability of results. The UserAge panel study will be instrumental in expanding knowledge that will benefit the quality and impact of user involvement in future research.

Objective

The aim of this study is to determine the awareness and understanding of and attitudes toward user involvement in research among different categories of knowledge users and researchers over time.

Methods

A panel study will be implemented with 3 different categories of knowledge users (people aged 60 years and older, informal carers, and professionals in health care and architecture) and researchers in aging and health. A professional survey company will collect data from all samples in parallel. Potential participants will be asked to complete the survey via telephone or online, or participants can request a paper survey to be sent to them in the post. A draft set of questions on attitudes and behavioral patterns related to research utilization and user involvement in research was compiled based on existing literature and input from the research team. Using a participatory approach, we engaged a user forum, where 8 older people and 3 researchers jointly refined the survey for time/length to complete, terminology, readability, and context. Data collected via the internet or telephone will be automatically processed, and data collected on paper forms will be entered in machine-readable forms. The survey company will store all data and deliver the quality-controlled database to the university for further storage. Analyses of frequencies and measures of central tendency will be used for descriptive purposes. To compare groups, state-of-the art statistical analyses will be used.

Results

Data collection for the first study wave started in September 2019 and will be completed in spring 2020. Data will be ready for analysis following cleaning and quality control, which started during summer 2020 and will be completed autumn 2020. We anticipate the data collection for the second study wave to start in September 2021.

Conclusions

This is the first quantitative large-scale panel study focusing on trends in attitudes toward, awareness of, and knowledge about user involvement in research on aging and health in Sweden. The results will generate new and important knowledge to advance the understanding of user needs and preferences as well as the relevance of user involvement in research on aging and health.

International Registered Report Identifier (IRRID)

DERR1-10.2196/17759
Perceptions and Opinions of Patients About Mental Health Chatbots: Scoping Review
Authors: Abd-Alrazaq Alaa A , Alajlani Mohannad , Ali Nashva , Denecke Kerstin , Bewick Bridgette M , Househ Mowafa
Published: June 2020

Background

Chatbots have been used in the last decade to improve access to mental health care services. Perceptions and opinions of patients influence the adoption of chatbots for health care. Many studies have been conducted to assess the perceptions and opinions of patients about mental health chatbots. To the best of our knowledge, there has been no review of the evidence surrounding perceptions and opinions of patients about mental health chatbots.

Objective

This study aims to conduct a scoping review of the perceptions and opinions of patients about chatbots for mental health.

Methods

The scoping review was carried out in line with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching 8 electronic databases (eg, MEDLINE and Embase) in addition to conducting backward and forward reference list checking of the included studies and relevant reviews. In total, 2 reviewers independently selected studies and extracted data from the included studies. Data were synthesized using thematic analysis.

Results

Of 1072 citations retrieved, 37 unique studies were included in the review. The thematic analysis generated 10 themes from the findings of the studies: usefulness, ease of use, responsiveness, understandability, acceptability, attractiveness, trustworthiness, enjoyability, content, and comparisons.

Conclusions

The results demonstrated overall positive perceptions and opinions of patients about chatbots for mental health. Important issues to be addressed in the future are the linguistic capabilities of the chatbots: they have to be able to deal adequately with unexpected user input, provide high-quality responses, and have to show high variability in responses. To be useful for clinical practice, we have to find ways to harmonize chatbot content with individual treatment recommendations, that is, a personalization of chatbot conversations is required.
Assessment of the Robustness of Convolutional Neural Networks in Labeling Noise by Using Chest X-Ray Images From Multiple Centers
Authors: Jang Ryoungwoo , Kim Namkug , Jang Miso , Lee Kyung Hwa , Lee Sang Min , Lee Kyung Hee , Noh Han Na , Seo Joon Beom
Published: June 2020

Background

Computer-aided diagnosis on chest x-ray images using deep learning is a widely studied modality in medicine. Many studies are based on public datasets, such as the National Institutes of Health (NIH) dataset and the Stanford CheXpert dataset. However, these datasets are preprocessed by classical natural language processing, which may cause a certain extent of label errors.

Objective

This study aimed to investigate the robustness of deep convolutional neural networks (CNNs) for binary classification of posteroanterior chest x-ray through random incorrect labeling.

Methods

We trained and validated the CNN architecture with different noise levels of labels in 3 datasets, namely, Asan Medical Center-Seoul National University Bundang Hospital (AMC-SNUBH), NIH, and CheXpert, and tested the models with each test set. Diseases of each chest x-ray in our dataset were confirmed by a thoracic radiologist using computed tomography (CT). Receiver operating characteristic (ROC) and area under the curve (AUC) were evaluated in each test. Randomly chosen chest x-rays of public datasets were evaluated by 3 physicians and 1 thoracic radiologist.

Results

In comparison with the public datasets of NIH and CheXpert, where AUCs did not significantly drop to 16%, the AUC of the AMC-SNUBH dataset significantly decreased from 2% label noise. Evaluation of the public datasets by 3 physicians and 1 thoracic radiologist showed an accuracy of 65%-80%.

Conclusions

The deep learning–based computer-aided diagnosis model is sensitive to label noise, and computer-aided diagnosis with inaccurate labels is not credible. Furthermore, open datasets such as NIH and CheXpert need to be distilled before being used for deep learning–based computer-aided diagnosis.
Artificial Intelligence for Caregivers of Persons With Alzheimer’s Disease and Related Dementias: Systematic Literature Review
Authors: Xie Bo , Tao Cui , Li Juan , Hilsabeck Robin C , Aguirre Alyssa
Published: June 2020

Background

Artificial intelligence (AI) has great potential for improving the care of persons with Alzheimer’s disease and related dementias (ADRD) and the quality of life of their family caregivers. To date, however, systematic review of the literature on the impact of AI on ADRD management has been lacking.

Objective

This paper aims to (1) identify and examine literature on AI that provides information to facilitate ADRD management by caregivers of individuals diagnosed with ADRD and (2) identify gaps in the literature that suggest future directions for research.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for conducting systematic literature reviews, during August and September 2019, we performed 3 rounds of selection. First, we searched predetermined keywords in PubMed, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, PsycINFO, IEEE Xplore Digital Library, and the ACM Digital Library. This step generated 113 nonduplicate results. Next, we screened the titles and abstracts of the 113 papers according to inclusion and exclusion criteria, after which 52 papers were excluded and 61 remained. Finally, we screened the full text of the remaining papers to ensure that they met the inclusion or exclusion criteria; 31 papers were excluded, leaving a final sample of 30 papers for analysis.

Results

Of the 30 papers, 20 reported studies that focused on using AI to assist in activities of daily living. A limited number of specific daily activities were targeted. The studies’ aims suggested three major purposes: (1) to test the feasibility, usability, or perceptions of prototype AI technology; (2) to generate preliminary data on the technology’s performance (primarily accuracy in detecting target events, such as falls); and (3) to understand user needs and preferences for the design and functionality of to-be-developed technology. The majority of the studies were qualitative, with interviews, focus groups, and observation being their most common methods. Cross-sectional surveys were also common, but with small convenience samples. Sample sizes ranged from 6 to 106, with the vast majority on the low end. The majority of the studies were descriptive, exploratory, and lacking theoretical guidance. Many studies reported positive outcomes in favor of their AI technology’s feasibility and satisfaction; some studies reported mixed results on these measures. Performance of the technology varied widely across tasks.

Conclusions

These findings call for more systematic designs and evaluations of the feasibility and efficacy of AI-based interventions for caregivers of people with ADRD. These gaps in the research would be best addressed through interdisciplinary collaboration, incorporating complementary expertise from the health sciences and computer science/engineering–related fields.
Patients’ Convergence of Mass and Interpersonal Communication on an Online Forum: Hybrid Methods Analysis
Authors: Sanders Remco , Araujo Theo B , Vliegenthart Rens , van Eenbergen Mies C , van Weert Julia C M , Linn Annemiek J
Published: June 2020

Background

Patients are increasingly taking an active role in their health. In doing so, they combine both mass and interpersonal media to gratify their cognitive and affective needs (ie, convergence). Owing to methodological challenges when studying convergence, a detailed view of how patients are using different types of media for needs fulfillment is lacking.

Objective

The aim of this study was to obtain insight into the frequency of reported convergence, how convergence affects what posters write online, motives for posting, and the needs posters are trying to fulfill.

Methods

Using a hybrid method of content analysis and supervised machine learning, this study used naturally available data to fill this research gap. We analyzed opening posts (N=1708) of an online forum targeting cancer patients and their relatives (Kanker.nl).

Results

Nearly one-third of the forum opening posts contained signs of convergence in mass or interpersonal media. Posts containing mass media references disclosed less personal information and were more geared toward community enhancement and sharing experiences compared to posts without convergence. Furthermore, compared to posts without signs of convergence, posts that included interpersonal media references disclosed more personal information, and posters were more likely to ask for the experiences of fellow users to fulfill their needs. Within posts containing signs of convergence, posts including interpersonal media references reported fewer shortages of information, disclosed more information about the disease, and were more active in seeking other posters’ experiences compared to posts containing mass media references.

Conclusions

The current study highlights the intertwining of media platforms for patients. The insights of this study can be used to adapt the health care system toward a new type of health information–seeking behavior in which one medium is not trusted to fulfill all needs. Instead, providers should incorporate the intertwinement of sources by providing patients with reliable websites and forums through which they can fulfill their needs.
Evaluation of the Sexual Health Behaviors of Black Male Adolescents and Young Adults Through Social Media Platforms: Web-Based Survey Study
Authors: Burns Jade , Johnstone Keith , Chavanduka Tanaka , Jamison Cornelius , Pena Valery , Stephenson Rob , Darbes Lynae
Published: June 2020

Background

Social media platforms such as Facebook, Instagram, and Twitter, which have millions of users who interact and communicate every day, have been effective in promoting sexual health interventions and in disseminating reproductive health education. They have also been shown to be useful in health promotion and have been used to track several key metrics (eg, comments, posts) among users of all demographics. However, there is a lack of research on the impact and reach of these social media platforms as a community-based tool for disseminating sexual health information and for increasing engagement among Black adolescents and young adults, which is a targeted high-risk population.

Objective

The purpose of this study was to determine the social media platforms and banner advertisements that affected engagement among Black male adolescents and young adults in participating in web-based health surveys.

Methods

A web-based survey was conducted from March 2019 to July 2019 to assess sexual health and health behaviors in a convenience sample of Black male adolescents and young adults in the age range of 18-24 years (N=170). Social media metrics from Facebook, Instagram, and Twitter were monitored. This cross-sectional survey comprised several categories, including basic personal information, drug-related risk behaviors, health care, sexual reproductive health questions, attitudes, norms, and perceived control, mental health, violence-related risk behaviors, and social media preferences.

Results

Social media advertisements on the Black Male Opinion survey reached approximately 146,412 individuals. Our primary finding of the web-based survey engagement was that referral (eg, group chat, indirect social media sharing) led to as the greatest proportion of recruitment, with Twitter and YouTube as the preferred sites to receive sexual health information.

Conclusions

Recognizing the variety of technologies being used among Black male young adults and adolescents can help the community, researchers, and health care providers understand the web-based engagement of this high-risk population. This information may also promote culturally sensitive, customized marketing on sexual health information for this population.
Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19: Cross-Sectional Analysis
Authors: Lonergan Peter E , Washington III Samuel L , Branagan Linda , Gleason Nathaniel , Pruthi Raj S , Carroll Peter R , Odisho Anobel Y
Published: June 2020

Background

The emergence of the coronavirus disease (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video-based telehealth consultations as a means to continue ambulatory care.

Objective

The aim of this study is to analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare patient demographics and appointment data from January 1, 2020, and in the 11 weeks after the transition to video visits.

Methods

Patient demographics and appointment data (dates, visit types, and departments) were extracted from the electronic health record reporting database. Video visits were performed using a HIPAA (Health Insurance Portability and Accountability Act)-compliant video conferencing platform with a pre-existing workflow.

Results

In 17 departments and divisions at the UCSF Cancer Center, 2284 video visits were performed in the 11 weeks before COVID-19 changes were implemented (mean 208, SD 75 per week) and 12,946 video visits were performed in the 11-week post–COVID-19 period (mean 1177, SD 120 per week). The proportion of video visits increased from 7%-18% to 54%-72%, between the pre– and post–COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor.

Conclusions

In a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing.
Application and Preliminary Outcomes of Remote Diagnosis and Treatment During the COVID-19 Outbreak: Retrospective Cohort Study
Authors: Liu Luwen , Gu Jianqin , Shao Fengmin , Liang Xinliang , Yue Lixia , Cheng Qiaomei , Zhang Lianzhong
Published: June 2020

Background

The coronavirus disease (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in the self-quarantine of countless people due to possible infection. This situation makes telemedicine necessary as it can overcome geographical barriers, increase the number of people served, and provide online clinical support for patients. However, the outcomes of telemedicine have not yet been evaluated.

Objective

The aim of our study is to describe the epidemiological features and clinical symptoms of patients receiving remote diagnosis and treatment at the online outpatient clinic of our hospital, as well as to analyze the outcomes and advantages of telemedicine, during the COVID-19 pandemic.

Methods

Data from patients receiving remote diagnosis and treatment via consultation services for COVID-19 concerns at the online outpatient clinic of Henan Provincial People's Hospital from January 24 to February 17, 2020, were collected. A retrospective analysis was performed on epidemiological features, clinical symptoms, and preliminary outcomes.

Results

Online inquiry, consultation, and suggestions were provided for patient concerns related to COVID-19. Our hospital also offered offline noncontact drug delivery services following online ordering and payment. A total of 4589 patients receiving remote diagnosis and treatment were recruited. The daily number of online outpatient visits initially increased and then decreased, reaching its peak on January 28 when the daily number of online outpatient visits totaled 612. Of 4589 patients, 1940 (42.3%) were males and 2649 (57.7%) were females (age range: 78 days to 85 years). Most patients were aged 20-39 years (n=3714, 80.9%) and came from Henan Province (n=3898, 84.9%). The number of patients from other provinces was 691 (15.1%). During the online consultations, patients discussed the following symptoms: fever (n=2383), cough (n=1740), nasal obstruction (n=794), fatigue (n=503), and diarrhea (n=276). A total of 873 orders of noncontact drug delivery following online payment was completed. The daily number of such orders gradually stabilized after the initial, steady increase. For offline drug delivery orders, the median (IQR) was 36 (58). An online satisfaction survey was filled out postconsultation by patients; of the 985 responses received, 98.1% (n=966) of respondents were satisfied with the service they received.

Conclusions

Remote diagnosis and treatment offered via online outpatient consultations effectively reduced the burden on hospitals, prevented overcrowding, reduced the risk of cross-infection, and relieved patients' anxiety during the COVID-19 outbreak. This plays an essential role in pandemic management.
Implementing mHealth Interventions in a Resource-Constrained Setting: Case Study From Uganda
Authors: Meyer Amanda J , Armstrong-Hough Mari , Babirye Diana , Mark David , Turimumahoro Patricia , Ayakaka Irene , Haberer Jessica E , Katamba Achilles , Davis J Lucian
Published: June 2020

Background

Mobile health (mHealth) interventions are becoming more common in low-income countries. Existing research often overlooks implementation challenges associated with the design and technology requirements of mHealth interventions.

Objective

We aimed to characterize the challenges that we encountered in the implementation of a complex mHealth intervention in Uganda.

Methods

We customized a commercial mobile survey app to facilitate a two-arm household-randomized, controlled trial of home-based tuberculosis (TB) contact investigation. We incorporated digital fingerprinting for patient identification in both study arms and automated SMS messages in the intervention arm only. A local research team systematically documented challenges to implementation in biweekly site visit reports, project management reports, and minutes from biweekly conference calls. We then classified these challenges using the Consolidated Framework for Implementation Research (CFIR).

Results

We identified challenges in three principal CFIR domains: (1) intervention characteristics, (2) inner setting, and (3) characteristics of implementers. The adaptability of the app to the local setting was limited by software and hardware requirements. The complexity and logistics of implementing the intervention further hindered its adaptability. Study staff reported that community health workers (CHWs) were enthusiastic regarding the use of technology to enhance TB contact investigation during training and the initial phase of implementation. After experiencing technological failures, their trust in the technology declined along with their use of it. Finally, complex data structures impeded the development and execution of a data management plan that would allow for articulation of goals and provide timely feedback to study staff, CHWs, and participants.

Conclusions

mHealth technologies have the potential to make delivery of public health interventions more direct and efficient, but we found that a lack of adaptability, excessive complexity, loss of trust among end users, and a lack of effective feedback systems can undermine implementation, especially in low-resource settings where digital services have not yet proliferated. Implementers should anticipate and strive to avoid these barriers by investing in and adapting to local human and material resources, prioritizing feedback from end users, and optimizing data management and quality assurance procedures.

Trial Registration

Pan-African Clinical Trials Registration PACTR201509000877140; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=877
COVID-19 Pneumonia Diagnosis Using a Simple 2D Deep Learning Framework With a Single Chest CT Image: Model Development and Validation
Authors: Ko Hoon , Chung Heewon , Kang Wu Seong , Kim Kyung Won , Shin Youngbin , Kang Seung Ji , Lee Jae Hoon , Kim Young Jun , Kim Nan Yeol , Jung Hyunseok , Lee Jinseok
Published: June 2020

Background

Coronavirus disease (COVID-19) has spread explosively worldwide since the beginning of 2020. According to a multinational consensus statement from the Fleischner Society, computed tomography (CT) is a relevant screening tool due to its higher sensitivity for detecting early pneumonic changes. However, physicians are extremely occupied fighting COVID-19 in this era of worldwide crisis. Thus, it is crucial to accelerate the development of an artificial intelligence (AI) diagnostic tool to support physicians.

Objective

We aimed to rapidly develop an AI technique to diagnose COVID-19 pneumonia in CT images and differentiate it from non–COVID-19 pneumonia and nonpneumonia diseases.

Methods

A simple 2D deep learning framework, named the fast-track COVID-19 classification network (FCONet), was developed to diagnose COVID-19 pneumonia based on a single chest CT image. FCONet was developed by transfer learning using one of four state-of-the-art pretrained deep learning models (VGG16, ResNet-50, Inception-v3, or Xception) as a backbone. For training and testing of FCONet, we collected 3993 chest CT images of patients with COVID-19 pneumonia, other pneumonia, and nonpneumonia diseases from Wonkwang University Hospital, Chonnam National University Hospital, and the Italian Society of Medical and Interventional Radiology public database. These CT images were split into a training set and a testing set at a ratio of 8:2. For the testing data set, the diagnostic performance of the four pretrained FCONet models to diagnose COVID-19 pneumonia was compared. In addition, we tested the FCONet models on an external testing data set extracted from embedded low-quality chest CT images of COVID-19 pneumonia in recently published papers.

Results

Among the four pretrained models of FCONet, ResNet-50 showed excellent diagnostic performance (sensitivity 99.58%, specificity 100.00%, and accuracy 99.87%) and outperformed the other three pretrained models in the testing data set. In the additional external testing data set using low-quality CT images, the detection accuracy of the ResNet-50 model was the highest (96.97%), followed by Xception, Inception-v3, and VGG16 (90.71%, 89.38%, and 87.12%, respectively).

Conclusions

FCONet, a simple 2D deep learning framework based on a single chest CT image, provides excellent diagnostic performance in detecting COVID-19 pneumonia. Based on our testing data set, the FCONet model based on ResNet-50 appears to be the best model, as it outperformed other FCONet models based on VGG16, Xception, and Inception-v3.
Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey
Authors: Peine Arne , Paffenholz Pia , Martin Lukas , Dohmen Sandra , Marx Gernot , Loosen Sven H
Published: June 2020

Background

In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user’s acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear.

Objective

The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels.

Methods

A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language.

Results

A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant’s age negatively correlated with the perception of telemedicine’s significance (ρ=–0.23; P<.001).

Conclusions

Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.