bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of noise effect on bearing vibration signal based on statistical parameters
Authors: Jahagirdar Ankush , Mohanty Satish , Gupta Karunesh Kumar
Published: December 2018

The signals emanating from the bearings are complex and contribute to various distributions. The effect of the distribution and mathematical operations are responsible for the change in the statistical moments. This paper investigates the effect of noise on statistical moments of the bearing vibration signals. Initially, the distribution function for Healthy, inner race defect (IRD), outer race defect (ORD), and ball defect (BD) are tested using Kolmogorov Smirnov test (K-S test). The resulting distributions obtained from the K-S test are normal and Laplacian distributed patterns and convey the faulty state of the bearings. The change in noise levels and their influence on the statistical moments are verified. It is observed, the kurtosis for IRD and ORD decreases with increase in noise, whereas, the trend increases for healthy and BD faults.
Comparison of natural frequencies of isotropic plate using DSM with Wittrick-Williams algorithm
Authors: Chauhan Manish , Ranjan Vinayak , Singh Baij Nath
Published: December 2018

In this paper, comparison of natural undamped frequencies of isotropic plates are investigated by using the dynamics stiffness element for isotropic plates. The DS Matrix for isotropic has been formulated by the application of classical plate theory. The generalized DS matrix has to solve by using Wittrick-Williams algorithm. Results of different aspect ratio have been validated from the existing literature.
Analysis of free vibration of nano plate resting on Winkler foundation
Authors: Singh Piyush Pratap , Azam Mohammad Sikandar , Ranjan Vinayak
Published: December 2018

Present paper deals with the vibration analysis of nano plate supported by Winkler foundation using Eringen’s elasticity theory with Classical Plate theory. Rayleigh-Ritz method has been employed in this study for finding frequencies of plate subjected to different edge conditions. The obtained results are first tested for convergence and then validated with the published literature. Further study is carried out to analyse the effect of various parameters on natural nondimensional frequencies of nano plate resting on Winkler foundation. The study reveals that the non-local effect has significant effect on vibration behaviour of nano plate resting on elastic foundation. Observations shows that on increasing the Winkler foundation modulus and aspect ratio the nondimensional frequency parameters increases.
A HOSPITALIZAÇÃO DO ADOLESCENTE NA ÓTICA DOS PROFISSIONAIS DE ENFERMAGEM
Authors: Reis Nathália Da Silva Pimentel , Dos Santos Maria Fabiane Galdino , De Almeida Inez Silva , Gomes Helena Ferraz , Leite Dayana Carvalho , Peres Ellen Márcia
Published: December 2018

Objetivo: Compreender a ótica dos profissionais de enfermagem sobre a hospitalização de adolescentes. Metodologia: Pesquisa qualitativa, descritiva, utilizando entrevista com perguntas semi-estruturadas, realizada em uma enfermaria especializada em saúde do adolescente no Rio de Janeiro, no período de fevereiro a abril de 2016, com 15 profissionais de enfermagem. Resultados: A partir da análise de conteúdo de Bardin, definiram-se três categorias: a inexperiência no cuidado de enfermagem ao adolescente como um desafio, especificidades da adolescência, e sentimentos gerados pela hospitalização do adolescente no profissional de enfermagem. Conclusão: Conclui-se que os profissionais de enfermagem se colocaram inexperientes em cuidar desse público e declararam que o cuidado a essa população é um desafio para a equipe.Descritores: Adolescente, Enfermagem, Hospitalização.THE ADOLESCENT’S HOSPITALIZATION IN THE OPTICS OF NURSING PROFESSIONALSObjective: Analyze the contents of nursing notes in patients’ records in an intensive care unit (ICU) of a public tertiary hospital in Fortaleza, CE. It is a descriptive study with quantitative approach that analyzed 151 medical records of patients admitted to an ICU, from September 2014 to February 2015, whose 48 hour and discharge notes were evaluated. Data revealed notes with poor content, which did not express the patients’ situation, nor the nursing care provided. Data concerning date, time, and patient identification were adequate. However, the COREN number and the professional’s signature raised concern given the high percentage of non-compliance regarding ethical and legal aspects. Nursing notes did not reflect the severity of patients, nor the dynamics in the ICUDescriptors: Adolescent, Nursing, HospitalizationADOLESCENTE EN PERSPECTIVA DE LOS PROFESIONALES DE ENFERMERÍAComprender la óptico del profesional de enfermería de hospitalización de los adolescentes. Metodología: cualitativos, investigación descriptiva, utilizando entrevistas con preguntas semi-estructuradas en una sala especializada para la salud de los adolescentes en Río de Janeiro, en el período de febrero a abril 2016 con 15 profesionales de enfermería. Resultados: A partir del análisis de contenido de Bardin, definido tres categorías: la falta de experiencia en la atención de enfermería a la adolescente como un desafío, características de los adolescentes y los sentimientos generados por la hospitalización de los adolescentes en profesionales de enfermería. Conclusión: Se concluye que los profesionales de enfermería se colocaron inexpertos en cuidar de ese público y declararon que el cuidado a esa población es un desafío para el equipo.Descriptores: Adolescente, Enfermería, Hospitalización
Target Molecules and Delivery Vehicles for Anti-HIV Drugs In vitro and In vivo
Authors: Bolhassani Azam
Published: December 2018

Acquired Immune Deficiency Syndrome (AIDS) is the most serious stage of Human Immunodeficiency
Virus (HIV) infection. The combinatorial Anti-Retroviral Therapy (cART) is widely used in suppressing
HIV-1 infection and enhancing life span of infected patients to a significant level. However, delivery of therapeutic
molecules is still a major challenge in vivo. The studies showed that the anti-HIV drugs delivered via nanocarriers
could be selectively accumulated in infected cells accompanied by low side effects. On the other hand,
HIV-1 infection kinetics is different in macrophages and T-cells suggesting various effects of antiretroviral drugs
against HIV-1 in these target cells. Current anti-HIV therapeutic studies have focused on developing drug delivery
systems targeted specifically to HIV-infected host cells. Indeed, the drug targeting can significantly lead to
reduce in drug toxicity, drug dose, and increase in treatment efficacy through localizing its pharmacological activity
to the site of interest. This review describes development of novel drug targeting systems used in suppressing
the transmission and treatment of HIV infections.
Impact of PEGylated Nanoparticles on Tumor Targeted Drug Delivery
Authors: Mozar Fitya Syarifa , Chowdhury Ezharul Hoque
Published: December 2018

PEG-functionalized nanoparticles as carriers of chemotherapeutics agents have been explored with
notable successes in preclinical and clinical stages of cancer treatment, with some already approved by FDA,
namely PEGylated liposomes and polymers. Half-life extension of therapeutic agents through PEGylation process
improves their pharmacokinetic (PK) profiles, thereby reducing their dosing frequency. Protein corona composition
of PEGylated nanoparticles (NPs) confers a tremendous influence on their surface characteristics which
directly impact tumor accumulation and clearance properties of the drugs. By controlling the size and complexity
of PEG molecules, as well as by attaching targeting moieties, the surface characteristics of NPs can be manipulated
to improve their tumor uptake without sacrificing the circulation time. This review focuses on design and
applications of PEGylated NPs for tumor targeted drug delivery in animal models and clinical setting.
Synthesis and Biological Studies of New Multifunctional Curcumin Platforms for Anticancer Drug Delivery
Authors: Bazylevich Andrii , Tuchinsky Helena , Zigman-Hoffman Eti , Weissman Ran , Shpilberg Ofer , Hershkovitz-Rokah Oshrat , Patsenker Leonid , Gellerman Gary
Published: December 2018

Background:

Scientists have extensively investigated curcumin, yielding many publications
on treatments of cancer. Numerous derivatives of curcumin were synthesized, evaluated for
their anti-oxidant and free-radical scavenging, SAR, ADME properties and tested in anticancer applications.

Objective:

We decided to exploit curcumin as a bioactive core platform for carrying anticancer
drugs, which likely possesses a carboxyl moiety for potential linkage to the carrier for drug delivery.

Methods:

The goal of this work is to develop biolabile multifunctional curcumin platforms towards
anticancer drug delivery, including determination of drug release profiling in hydrolytic
media, in vitro cytotoxicity, antioxidant properties and blockage of relevant cell survival pathways.

Results:

We report on a facile synthesis of the bioactive multifunctional curcumin-based platforms
linked to a variety of anticancer drugs like amonafide and chlorambucil, and release of the drugs in
a hydrolytic environment. The leading curcumin-based platform has presented antioxidant activity
similar to curcumin, but with much more potent cytotoxicity in vitro in agreement with the augmented
blockage of the NF-kB cell survival pathway.

Conclusion:

The approach presented here may prove beneficial for bioactive curcumin-based delivery
applications where multiple drug delivery is required in a consecutive and controlled mode.
Efficacy of Novel Schiff base Derivatives as Antifungal Compounds in Combination with Approved Drugs Against Candida Albicans
Authors: Malik Manzoor Ahmad , Lone Shabir Ahmad , Gull Parveez , Dar Ovas Ahmad , Wani Mohmmad Younus , Ahmad Aijaz , Hashmi Athar Adil
Published: December 2018

Background:

The increasing incidence of fungal infections, especially caused by Candida albicans, and their increasing drug resistance has drastically increased in recent years. Therefore, not only new drugs but also alternative treatment strategies are promptly required.

Methods:

We previously reported on the synergistic interaction of some azole and non-azole compounds with fluconazole for combination antifungal therapy. In this study, we synthesized some non-azole Schiff-base derivatives and evaluated their antifungal activity profile alone and in combination with the most commonly used antifungal drugs- fluconazole (FLC) and amphotericin B (AmB) against four drug susceptible, three FLC resistant and three AmB resistant clinically isolated Candida albicans strains. To further analyze the mechanism of antifungal action of these compounds, we quantified total sterol contents in FLC-susceptible and resistant C. albicans isolates.

Results:

A pyrimidine ring-containing derivative SB5 showed the most potent antifungal activity against all the tested strains. After combining these compounds with FLC and AmB, 76% combinations were either synergistic or additive while as the rest of the combinations were indifferent. Interestingly, none of the combinations was antagonistic, either with FLC or AmB. Results interpreted from fractional inhibitory concentration index (FICI) and isobolograms revealed 4-10-fold reduction in MIC values for synergistic combinations. These compounds also inhibit ergosterol biosynthesis in a concentration-dependent manner, supported by the results from docking studies.

Conclusion:

The results of the studies conducted advocate the potential of these compounds as new antifungal drugs. However, further studies are required to understand the other mechanisms and in vivo efficacy and toxicity of these compounds.
MMP7 Induces T-DM1 Resistance and Leads to the Poor Prognosis of Gastric Adenocarcinoma via a DKK1-Dependent Manner
Authors: Li Hua , Xu Xin , Liu Yang , Li Shunle , Zhang Di , Meng Xiaofen , Lu Le , Li Yiming
Published: December 2018

Background:

Gastric adenocarcinoma is one of the most common and lethal cancer types and is known as
the second leading cause of cancer-related death of Asian adults, early diagnosis based on either pathology or molecular
biology could be one of the most efficient ways to improve the outcomes of gastric adenocarcinoma patients.

Methods:

Quantitative Real-Time PCR and Western-blot were used in detection of mRNA and protein expression.
Lentivirus infection was used to overexpression or knock down target gene. Alarma blue assay was used to monitor
cells proliferation. Flow cytometry analysis was performed to test protein expression and apoptosis level. Immunohistochemistry
was used to identify protein expression in tissue. Statistical differences between two groups are evaluated
by two-tailed t-tests. The comparison among multiple groups is performed by one-way Analysis of Variance
(ANOVA) followed by Dunnett’s posttest. The statistical significance of the Kaplan-Meier survival plot is determined
by log-rank analysis.

Results:

MMP7 as one of the most up-regulated genes in T-DM1 resistant NCI-N87 gastric adenocarcinoma cells
compared to matched naïve cell lines. T-DM1 resistant NCI-N87 cell lines by exposed to T-DM1 in vitro. Exogenous
overexpression of MMP7 promotes T-DM1 resistance and tumor growth in NCI-N87 cell lines while MMP7 knockdown
enhanced sensitivity to T-DM1 in T-DM1 resistant NCI-N87 cell lines established previously. MMP7 was
enriched in high WHO grade GC samples and implies poor outcomes for these patients. DKK1 as one of the most
correlated genes to MMP7 in gastric adenocarcinoma and knock-down of DKK1 or inhibition of Wnt/β-catenin
pathway led to a decreased expression of MMP7 and resistance to T-DM1.

Conclusion:

DKK1 and Wnt/β-catenin-dependent activation of MMP7 induces T-DM1 resistance and leads to the
poor prognosis of gastric adenocarcinoma, which might be a novel potential therapeutical target for T-DM1 resistant
gastric adenocarcinoma.
The Intertwined Relationship Between Job Crafting, Work-Related Positive Emotions, and Work Engagement. Evidence from a Positive Psychology Intervention Study
Authors: Costantini Arianna , Sartori Riccardo
Published: December 2018

Purpose:

The present study examines the impact of a positive psychology intervention on job crafting, positive emotions and work engagement.

Design:

A sample of 43 employees working in a public organisation received a three day-long resource-based intervention grounded on meaningfulness and practical exercises.

Findings:

Results showed that the intervention had a positive effect on job crafting, positive job-related affective well-being and work engagement. Moreover, findings from a mediation model show that the intervention was effective in sustaining work engagement resulting from experienced positive emotions, which in turn resulted from job crafting behaviours.

Originality/Value:

To the best of our knowledge, this study is the first to investigate the intertwined relationships between job crafting behaviours, positive emotions in the workplace, and work engagement. Moreover, our findings provide evidence of the effectiveness of the proposed positive psychology intervention to support work engagement resulting from proactive adjustment to the work environment and the positive emotions deriving from it.
Common Variants of the Plant microRNA-168a Exhibit Differing Silencing Efficacy for Human Low-Density Lipoprotein Receptor Adaptor Protein 1 (LDLRAP1)
Authors: Lang Claudia , Karunairetnam Sakuntala , Lo Kim R. , Kralicek Andrew V. , Crowhurst Ross N. , Gleave Andrew Peter , MacDiarmid Robin M. , Ingram John Ronald
Published: December 2018

Background:

The discovery that a plant microRNA (miRNAs) from rice (Oryza sativa
miR168a) can modify post-transcriptional expression of the mammalian. Low-Density Lipoprotein
Receptor Adaptor Protein 1 (LDLRAP1) gene highlights the potential for cross-kingdom miRNAmRNA
interactions.

Objective:

To investigate whether common variants of the conserved miR168a family have the capability
for similar cross-kingdom regulatory functions, we selected sequences from three dietary plant
sources: rice (Oryza sativa), tomato (Solanum lycopersicum), apple (Malus domestica) and compared
their ability to regulate human LDLRAP1 expression.

Methods:

Target prediction software intaRNA and RNAhybrid were used to analyze and calculate
the energy and alignment score between the miR168a variants and human LDLRAP1 mRNA. An in
vitro cell-based Dual-Luciferase® Reporter Assay (pmirGLO, Promega), was then used to validate
the miRNA-mRNA interaction experimentally.

Results:

Computational analyses revealed that a single nucleotide difference at position 14 (from the
5’ end of the miRNA) creates a G:U wobble in the miRNA-mRNA duplex formed by tomato and apple
miR168a variants. This G:U wobble had only a small effect on the free energy score (-33.8–34.7
kcal/mol). However, despite reasonable hybridization energy scores (<-20 kcal/mol) for all miR168a
variants, only the rice miR168a variant lacking a G:U wobble significantly reduced LDLRAP1 transcript
expression by 25.8 + 7.3% (p<0.05), as measured by relative luciferase activity.

Conclusion:

In summary, single nucleotide differences at key positions can have a marked influence
on regulatory function despite similar predicted energy scores and miRNA-mRNA duplex structures.
Pengaruh budaya organisasi, penghargaan dan kepercayaan terhadap motivasi berprestasi pegawai Dinas Pendidikan Pemuda dan Olahraga Kabupaten Rokan Hulu
Authors: Hardianto Hardianto
Published: December 2018

Tujuan penelitian ini untuk menganalisis besarnya pengaruh budaya organisasi, penghargaan dan kepercayaan terhadap motivasi berprestasi pegawai dinas pendidikan pemuda dan olahraga Kabupaten Rokan Hulu. Survei dilakukan terhadap 75 orang pegawai yang dijadikan sampel penelitian dengan teknik simple random sampling. Pengolahan data dilakukan dengan analisis jalur. Hasil penelitian menunjukkan bahwa: (1) budaya organisasi berpengaruh langsung positif terhadap motivasi berprestasi, (2) penghargaan berpengaruh langsung positif terhadap motivasi berprestasi, (3) kepercayaan berpengaruh langsung positif terhadap motivasi berprestasi, (4) budaya organisasi berpengaruh langsung positif terhadap kepercayaan, (5) penghargaan berpengaruh langsung positif terhadap kepercayaan. Berdasarkan hasil penelitian dapat disimpulkan bahwa untuk meningkatkan motivasi berprestasi pegawai dapat dilakukan dengan meningkatkan budaya organisasi, penghargaan dan kepercayaan. Sementara untuk meningkatkan kepercayaan pegawai dapat dilakukan dengan meningkatkan budaya organisasi dan penghargaan.Kata Kunci: budaya organisasi, penghargaan, kepercayaan, motivasi berprestasi THE EFFECT OF ORGANIZATION CULTURE, REWARD, AND TRUST ON ACHIEVEMENT MOTIVATION OF YOUTH AND SPORTS EDUCATION DEPARTMENT OF ROKAN HULU DISTRICTAbstractThe purpose of this study was to analyze the magnitude of the effect of organizational culture, appreciation and trust toward the employees’ achievement motivation of Education, Youth and Sports education Ministery of Rokan Hulu Regency. The survey was conducted on 75 employees. Sample was taken by simple Random Sampling Technique. Data analysis was done by path analysis. The results showed that: 1) Organizational culture has a direct positive effect toward achievement motivation, (2) The reward has a direct positive effect toward achievement motivation, (3) Trust has a direct positive effect toward achievement motivation, (4) Organizational culture has a direct positive effect toward the trust, (5) Reward has a positive direct effect toward the trust. Based on the research results could be concluded that to improve employees’ achievement motivation could be done by improving organizational culture, appreciation, and trust. Meanwhile, to increase the confidence of employees could be done by improving the organizational culture and appreciation.Keywords: organizational culture, reward, trust, achievement motivation
Influence of learning media based on adobe flash professional to psychomotor domain learning outcomes on plc courses viewed from level of creative thinking student
Authors: Muslim Supari , Gitama Nahindi Putra , Suprianto Bambang , Rahmadyanti Erina , Kusumawati Nita
Published: December 2018

This study uses adobe flash professional based learning media for experimental class while in control class using CourseLab media. Learning media based on adobe flash professional designed in the form of applications for smartphones and computers or notebooks. This study aims to determine the interaction and differences in learning result for students who have low and high creative thinking level who learn by using adobe flash professional media than students who use the media CourseLab. This research was conducted in department D3 mechatronic class of 2015 at State University of Trunojoyo Madura (UTM) on PLC course and using factorial design 2 x 2, with  total of students in the experimental class as much as 44 people and total of students in the control class as many as 26 people. Data Processing Technique for hypothesis testing, used two-independent-samples test technique. If the prerequisite test of normality and homogeneity is not met, we will use the mann-whitney u test technique. Research finds: (1) for students who have a low level of creative thinking, who learn by using adobe flash professional learning media, psychomotor domain learning outcomes is significantly higher than students who learn by using instructional media CourseLab; (2) for students who have a high level of creative thinking, who learn by using adobe flash professional learning media, psychomotor domain learning outcomes is significantly higher than students who learn by using instructional media CourseLab; and (3) there is a significant interaction between the level of students' creative thinking and learning media, to psychomotor domain learning outcomes. Research suggests: (1) research subjects used at least more than 150 students, to obtain better data (normal distributed data); and (2) the preparation of tools and materials must be in accordance with the needs to be used, so that the quality of learning is increasing.
Hypertension: The future of Ghana (protocols) (Preprint)
Authors: Amponsem-Boateng Cecilia , Zhang Weidong , Oppong Bonney Timothy , Opolot Godfery , Zhao QingLin
Published: December 2018

BACKGROUND

Many studies on HPT (hypertension) in Ghana are focused mainly on the adult population. There is no in-depth study conducted on the youth of Ghana to ascertain what the future holds for the nation with regards to HPT.

OBJECTIVE

The aim of this protocol is to assess the current prevalence of HPT and pre HPT of the youth of Ghana, estimate the future prevalence and propose possible interventions.

METHODS

: A community-based, cross-sectional study will be conducted in selected SHS (Senior High Schools) in the Ashanti region of Ghana to assess the prevalence of HPT and pre HPT within the youth of Ghana.

RESULTS

Phase A data collection in progress

CONCLUSIONS

Discussion: Early detection efforts such as screening at risks population are embraced in the prevention of HPT as this study seeks to do, and to convey clarity of HPT and pre HPT. Though focusing on Ghanaian youth, study findings could also be used as a reference for Africa and the world at large.
Profiling Clinical Research Activity at an Academic Medical Center by Using Institutional Databases: Content Analysis (Preprint)
Authors: Langford Aisha , Sherman Scott , Thornton Rachel , Nightingale Kira , Kwon Simona , Chavis-Keeling Deborah , Link Nathan , Cronstein Bruce , Hochman Judith , Trachtman Howard
Published: December 2018

BACKGROUND

It is important to monitor the scope of clinical research of all types, to involve participants of all ages and subgroups in studies that are appropriate to their condition, and to ensure equal access and broad validity of the findings.

OBJECTIVE

We conducted a review of clinical research performed at New York University with the following objectives: (1) to determine the utility of institutional administrative data to characterize clinical research activity; (2) to assess the inclusion of special populations; and (3) to determine if the type, initiation, and completion of the study differed by age.

METHODS

Data for all studies that were institutional review board–approved between January 1, 2014, and November 2, 2016, were obtained from the research navigator system, which was launched in November 2013. One module provided details about the study protocol, and another module provided the characteristics of individual participants. Research studies were classified as observational or interventional. Descriptive statistics were used to assess the characteristics of clinical studies across the lifespan, by type, and over time.

RESULTS

A total of 22%-24% of studies included children (minimum age <18 years) and 4%-5% focused exclusively on pediatrics. Similarly, 64%-72% of studies included older patients (maximum age >65 years) but only 5%-12% focused exclusively on geriatrics. Approximately 85% of the studies included both male and female participants. Of the remaining studies, those open only to girls or women were approximately 3 times as common as those confined to boys or men. A total of 56%-58% of projects focused on nonvulnerable patients. Among the special populations studied, children (12%-15%) were the most common. Noninterventional trial types included research on human data sets (24%), observational research (22%), survey research (16%), and biospecimen research (8%). The percentage of projects designed to test an intervention in a vulnerable population increased from 17% in 2014 to 21% in 2015.

CONCLUSIONS

Pediatric participants were the special population that was most often studied based on the number of registered projects that included children and adolescents. However, they were much less likely to be successfully enrolled in research studies compared with adults older than 65 years. Only 20% of the studies were interventional, and 20%-35% of participants in this category were from vulnerable populations. More studies are exclusively devoted to women’s health issues compared with men’s health issues.
Use of smartphone application WhatsApp® as an e-learning method for residents teaching: a multicenter, controlled, randomized trial (Preprint)
Authors: Clavier Thomas , Ramen Julie , Dureuil Bertrand , Veber Benoit , Hanouz Jean-Luc , Dupont Hervé , Lebuffe Gilles , Besnier Emmanuel , Compère Vincent
Published: December 2018

BACKGROUND

The WhatsApp® (WA) smartphone application is the most widely used instant messaging application in the world. Recent studies report the use of WA for educational purposes but there is no prospective study comparing WA's pedagogical effectiveness to any other teaching modality. The goal of this study was to evaluate this cross-platform messaging as a pedagogic tool for the teaching of residents.

OBJECTIVE

The main objective of this study was to evaluate the impact of WA on clinical reasoning.

METHODS

Prospective, randomized, multicenter study conducted among first and second year anesthesiology residents (online recruitment) from four university hospitals in France. Residents were randomized in two groups of online teaching (WA and control). The WA group benefited from daily delivery on the WA application of teaching documents and a weekly clinical case supervised by a senior physician. In the control group, residents had access to the same documents via a traditional computer e-learning platform. Medical reasoning was self-assessed online by script concordance test (SCT; primary parameter) and medical knowledge by multiple choice questions (MCQ). The residents completed an online satisfaction questionnaire.

RESULTS

In this study, 62 residents were randomized (32 in WA group, 30 in control group), 22 residents in each group answered the online final evaluation. We found a difference between WA and control groups for SCT (60 ± 9 % vs. 68 ± 11 %, respectively; P = .006) but no difference for MCQ (18 ± 4 /30 vs. 16 ± 4 /30, respectively; P = .22). Concerning satisfaction, there was a better global satisfaction rate in the WA group compared to control (9 ± 1 /10 vs. 8 ± 2 /10; P = .049).

CONCLUSIONS

In this study, the use of WA compared to traditional e-learning for resident teaching was associated with worse clinical reasoning despite better global appreciation. The use of WA probably contributes to the dispersion of attention linked to the use of the smartphone. The impact of smartphones on clinical reasoning should be further studied.
Assessing the Content Validity of a New Patient-Reported Measure of Barriers to Antiretroviral Therapy Adherence for Electronic Administration in Routine HIV Care: Proposal for a Web-Based Delphi Study (Preprint)
Authors: Engler Kim , Ahmed Sara , Lessard David , Vicente Serge , Lebouché Bertrand
Published: December 2018

BACKGROUND

Adherence to lifesaving antiretroviral therapy (ART) for HIV infection remains a challenge for many patients. Routine screening for barriers to ART adherence could help make HIV care more patient-centered and prevent virologic rebound or failure. Our team is currently developing a new HIV-specific patient-reported outcome measure (PROM) of these barriers for use in Canada and France along with a digital app for its electronic administration. In our previous work, we developed the PROM’s multidimensional conceptual framework and generated 100 English items, which have been translated to French.

OBJECTIVE

This study aims to use a Web-based Delphi to help validate and select the content of this new HIV-specific PROM, based on the perspective of anglophone and francophone patients and providers in Canada and France. Here, we present the proposal for this Delphi.

METHODS

This modified Delphi will involve a diverse panel of patients (n=32) and providers (n=52) recruited especially from the 9 sites of the PROM development study (site locations in Canada: Montreal, Toronto, Vancouver; in France: Paris, Nantes, Clermont-Ferrand, Saint-Martin, Cayenne). Overall, 2 rounds of Web-based questionnaires will be conducted. The threshold for consensus is set at 60% and will determine which items are carried forward to the second round. Per item, 3 aspects will be rated: importance as a barrier to ART adherence, relevance for HIV care, and clarity. In both rounds, space will be available for free text comments. Overall comprehensiveness will be assessed in the second round.

RESULTS

This study has undergone a methodological review by experts in patient-oriented research. It has received approval from a research ethics board of the McGill University Health Centre. It is financially supported, in part, by the Canadian Institutes of Health Research’s Strategy for Patient-Oriented Research-Quebec Support Unit (M006). As of May 21, 2019, 15 people living with HIV and 25 providers completed the first round of the Delphi (24 from Canada and 16 from France).

CONCLUSIONS

To our knowledge, this is the first Delphi to seek consensus on the most relevant and clinically actionable barriers to ART adherence, collecting opinions on an extensive list of barriers. Drawing on a relatively large and diverse panel of HIV patients and providers, it essentially engages key stakeholders in decision making about the PROM’s final content, helping to ensure its utility and adoption.

INTERNATIONAL REGISTERED REPOR

PRR1-10.2196/12836
Using the Unified Theory of Acceptance and Use of Technology (UTAUT) to Investigate the Intention to Use Physical Activity Apps among University Students in Guangzhou, China (Preprint)
Authors: Liu Di , Maimaitijiang Remina , Gu Jing , Zhong Shuyi , Zhou Mengping , Wu Ziyue , Luo Ao , Lu Cong , Hao Yuantao
Published: December 2018

BACKGROUND

Many university students are lacking adequate physical exercise and failing to develop physical activity behaviors in China. Physical activity apps’ use is an effective to improve this situation.

OBJECTIVE

The aim of this study is to use UTAUT to investigate the intention to use physical activity apps among university students in Guangzhou, China.

METHODS

A cross-sectional study was conducted among 1704 university students from different cluster in Guangzhou, China. The UTAUT model was used to measure the determinants of intention to use physical activity apps.

RESULTS

Of the participants, 41.8% intended to use physical activity apps. All three UTAUT-related scales (Performance Expectancy, Effort Expectancy, and Social Influence) are all positively associated with the intention to use physical apps after adjusting for background variables (ORa = 1.10 ~ 1.31, p < .001). PE scale had stronger associations with the intention to use physical activity Apps among those whose BMI were beyond normal range (BMI ≥ 24) compared to those whose BMI were within normal range ( p < .001).

CONCLUSIONS

Interventions regarding UTAUT-related scales could be taken into consideration when developing interventions to improve university students’ physical activity.
Clinical Profiles and Survival Outcomes of Patients With Well-Differentiated Neuroendocrine Tumors at a Health Network in New South Wales, Australia: Retrospective Study (Preprint)
Authors: Reeders Jocelyn , Ashoka Menon Vivek , Mani Anita , George Mathew
Published: December 2018

BACKGROUND

Neuroendocrine tumors (NETs) are a heterogeneous group of malignancies with varying and often indolent clinicobiological characteristics according to their primary location. NETs can affect any organ and hence present with nonspecific symptoms that can lead to a delay in diagnosis. The incidence of NETs is increasing in Australia; data regarding characteristics of NETs were collected from the cancer registry of Hunter New England, Australia.

OBJECTIVE

This study aimed to explore the clinical profiles and treatment and survival outcomes of patients with well-differentiated NETs in an Australian population.

METHODS

We reviewed the data of all adult patients who received the diagnosis of NET between 2008 and 2013. The clinicopathological, treatment, and follow-up data were extracted from the local Cancer Clinical Registry. We also recorded the level of remoteness for each patient by matching the patient’s residential postcode to the corresponding Australian Bureau of Statistics 2011 remoteness area category. Univariate analysis was used to find the factors associated with NET-related mortality. Survival analysis was computed.

RESULTS

Data from 96 patients were included in the study (men: 37/96, 38.5%, and women: 59/96, 61.5%). The median age at diagnosis was approximately 63 years. A higher proportion of patients lived in remote/rural areas (50/96, 52.1%) compared with those living in city/metropolitan regions (46/96, 47.9%). The most common primary tumor site was the gastroenteropancreatic tract, followed by the lung. The factors significantly associated with NET-related mortality were age, primary tumor site, surgical resection status, tumor grade, and clinical stage of the patient. At 5 years, the overall survival rate was found to be 62%, and the disease-free survival rate was 56.5%.

CONCLUSIONS

Older age, advanced unresectable tumors, evidence of metastasis, and higher-grade tumors were associated with poorer outcomes. Lung tumors had a higher risk of NET-related mortality compared with other sites.
Functional Magnetic Resonance Imaging Biomarkers Predicting Cognitive Progression in Parkinson Disease: Protocol for a Prospective Longitudinal Cohort Study (Preprint)
Authors: Hanna-Pladdy Brenda , Gullapalli Rao , Chen Hegang
Published: December 2018

BACKGROUND

Cardinal features of Parkinson disease (PD) are motor symptoms, but nonmotor features such as mild cognitive impairment (MCI) are common early in the disease process. MCI can progress and convert to dementia in advanced stages, creating significant disability and reduced quality of life. The primary pathological substrate for cognitive decline in PD is unclear, and there are no reliable biomarkers predicting the risk of conversion to dementia. A subgroup of PD patients with visual hallucinations may display more rapid conversion to dementia, suggesting that regional markers of visuoperceptual dysfunction may be sensitive to pathologic density in posterior cortical regions.

OBJECTIVE

The purpose of this project is to characterize PD-MCI and evaluate the utility of genetic and neuroimaging biomarkers in predicting cognitive outcomes with a prospective longitudinal study. We will evaluate whether accelerated cognitive progression may be reflected in biomarkers of early posterior cortical changes reflective of α-synuclein deposition.

METHODS

We will evaluate a cohort of early-stage PD patients with the following methods to predict cognitive progression: (1) serial neuropsychological evaluations including detailed visuoperceptual functioning across 4 years; (2) genetic analysis of SNCA (α-synuclein), MAPT (microtubule-associated tau), and APOE (apolipoprotein E); (3) an event-related functional magnetic resonance imaging paradigm of object recognition memory; and (4) anatomical and regional brain activation changes (resting-state functional magnetic resonance imaging) across 4 years.

RESULTS

The project received funding from the National Institutes of Health in August 2017, and data collection began in February 2018. Enrollment is ongoing, and subjects will be evaluated annually for 4 years extended across a 5-year project including data analysis and image processing.

CONCLUSIONS

Cognitive, genetic, and structural and functional magnetic resonance imaging will characterize neural network changes predictive of cognitive progression in PD across 4 years. Identification of biomarkers with sensitivity for early prediction and estimation of risk for conversion to dementia in PD will pave the way for effective intervention with neuroprotective therapies during the critical stage when treatment can have the greatest impact.

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12870
Physicians’ Perceptions of Chatbots in Health Care: Cross-Sectional Web-Based Survey (Preprint)
Authors: Palanica Adam , Flaschner Peter , Thommandram Anirudh , Li Michael , Fossat Yan
Published: December 2018

BACKGROUND

Many potential benefits for the uses of chatbots within the context of health care have been theorized, such as improved patient education and treatment compliance. However, little is known about the perspectives of practicing medical physicians on the use of chatbots in health care, even though these individuals are the traditional benchmark of proper patient care.

OBJECTIVE

This study aimed to investigate the perceptions of physicians regarding the use of health care chatbots, including their benefits, challenges, and risks to patients.

METHODS

A total of 100 practicing physicians across the United States completed a Web-based, self-report survey to examine their opinions of chatbot technology in health care. Descriptive statistics and frequencies were used to examine the characteristics of participants.

RESULTS

A wide variety of positive and negative perspectives were reported on the use of health care chatbots, including the importance to patients for managing their own health and the benefits on physical, psychological, and behavioral health outcomes. More consistent agreement occurred with regard to administrative benefits associated with chatbots; many physicians believed that chatbots would be most beneficial for scheduling doctor appointments (78%, 78/100), locating health clinics (76%, 76/100), or providing medication information (71%, 71/100). Conversely, many physicians believed that chatbots cannot effectively care for all of the patients’ needs (76%, 76/100), cannot display human emotion (72%, 72/100), and cannot provide detailed diagnosis and treatment because of not knowing all of the personal factors associated with the patient (71%, 71/100). Many physicians also stated that health care chatbots could be a risk to patients if they self-diagnose too often (714%, 74/100) and do not accurately understand the diagnoses (74%, 74/100).

CONCLUSIONS

Physicians believed in both costs and benefits associated with chatbots, depending on the logistics and specific roles of the technology. Chatbots may have a beneficial role to play in health care to support, motivate, and coach patients as well as for streamlining organizational tasks; in essence, chatbots could become a surrogate for nonmedical caregivers. However, concerns remain on the inability of chatbots to comprehend the emotional state of humans as well as in areas where expert medical knowledge and intelligence is required.
Traumatic Retropharyngeal Abscess of Insidious Onset -a case report and literature review (Preprint)
Authors: Aremu Shuaib Kayode
Published: December 2018

UNSTRUCTURED

Retropharyngeal abscess is an abscess of the deep spaces in the neck which if not treated urgently can be life-threatening as a result of airway compromise. It is important to detect and treat very early. It may arise in pediatrics from direct neck trauma which is not very common and fishbone impaction. Direct anterior neck trauma resulting in insidious retropharyngeal abscess has not been widely reported.
Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)
Authors: Dunleavy Gerard , Nikolaou Charoula Konstantia , Nifakos Sokratis , Atun Rifat , Law Gloria Chun Yi , Tudor Car Lorainne
Published: December 2018

BACKGROUND

There is a pressing need to implement efficient and cost-effective training to address the worldwide shortage of health professionals. Mobile digital education (mLearning) has been mooted as a potential solution to increase the delivery of health professions education as it offers the opportunity for wide access at low cost and flexibility with the portability of mobile devices. To better inform policy making, we need to determine the effectiveness of mLearning.

OBJECTIVE

The primary objective of this review was to evaluate the effectiveness of mLearning interventions for delivering health professions education in terms of learners’ knowledge, skills, attitudes, and satisfaction.

METHODS

We performed a systematic review of the effectiveness of mLearning in health professions education using standard Cochrane methodology. We searched 7 major bibliographic databases from January 1990 to August 2017 and included randomized controlled trials (RCTs) or cluster RCTs.

RESULTS

A total of 29 studies, including 3175 learners, met the inclusion criteria. A total of 25 studies were RCTs and 4 were cluster RCTs. Interventions comprised tablet or smartphone apps, personal digital assistants, basic mobile phones, iPods, and Moving Picture Experts Group-1 audio layer 3 player devices to deliver learning content. A total of 20 studies assessed knowledge (n=2469) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning over traditional learning for knowledge (standardized mean difference [SMD]=0.43, 95% CI 0.05-0.80, N=11 studies, low-quality evidence). There was no difference between blended learning and traditional learning for knowledge (SMD=0.20, 95% CI –0.47 to 0.86, N=6 studies, low-quality evidence). A total of 14 studies assessed skills (n=1097) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning (SMD=1.12, 95% CI 0.56-1.69, N=5 studies, moderate quality evidence) and blended learning (SMD=1.06, 95% CI 0.09-2.03, N=7 studies, low-quality evidence) over traditional learning for skills. A total of 5 and 4 studies assessed attitudes (n=440) and satisfaction (n=327), respectively, with inconclusive findings reported for each outcome. The risk of bias was judged as high in 16 studies.

CONCLUSIONS

The evidence base suggests that mLearning is as effective as traditional learning or possibly more so. Although acknowledging the heterogeneity among the studies, this synthesis provides encouraging early evidence to strengthen efforts aimed at expanding health professions education using mobile devices in order to help tackle the global shortage of health professionals.
Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study (Preprint)
Authors: Mortada Hatan Hisham , Alqahtani Yara Aayed , Seraj Hadeel Zakaria , Albishi Wahbi Khalid , Aljaaly Hattan A
Published: December 2018

BACKGROUND

Although plastic surgery has been gaining a lot of popularity recently, there seems to be limited perception and a poor understanding of this field by both medical professionals, including medical students, and the general public. This might alter referral patterns as well as medical students’ choice to pursue a career in plastic surgery.

OBJECTIVE

The purpose of this study was to assess knowledge and perception of plastic surgery among medical students and to explore the influencing factors underlying particular beliefs.

METHODS

Data for this cross-sectional study were collected between August 22 and December 22, 2017. The questionnaire was formulated on the basis of our own study objectives and from available questionnaires with similar objectives. It was composed of 14 questions divided into three main parts: demographics, the specialty of plastic surgery, and media involvement and its effect on plastic surgery. The study was conducted via an online questionnaire among medical students in all years at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were considered significant at P<.05. All analyses were performed using SPSS, version 20.

RESULTS

A total of 886 medical students participated in this study. We achieved a response rate of 56.79%. The mean age of the participants was 21.2 years. The mean awareness score was 9.7 (SD 4.2) for female students and 8.3 (SD 4.2) for male students (P<.001). The condition most commonly known to be treated by a plastic surgeon was burns (70.3% of responses).

CONCLUSIONS

Medical students do not have adequate awareness of plastic surgery, and early exposure to this specialty may enhance their awareness.