bluuebunny/crossref_metadata_2025 huggingface dataset:
Nematodes and the effect of seasonality in grassland habitats of South Africa
Authors: Girgan Chantelle , du Preez Gerhard , Marais Mariette , Swart Antoinette , Fourie Hendrika
Published: December 2020

Nematodes in South Africa have mainly been studied for their diversity and agricultural importance. However, the ecological status of nematodes and the effect of seasonal variation in local grasslands remain unknown. For this reason, a nematode study was conducted in the Telperion Nature Reserve and represented the first ecological study in a natural grassland area in South Africa. In total, 104 soil samples were collected during four consecutive seasons from 2015 until 2016 in three habitats, viz. (i) open grassland, (ii) shrubland with rocky outcrops, and (iii) riparian zone. From these the nematode community structure and soil ecosystem status were studied. In total, 93 genera from 50 families were recorded with herbivores and bacterivores being the most abundant trophic groups in all three habitats. Linear mixed models revealed that season had an overwhelmingly dominant impact on the condition, food web status, and functioning of the soil ecosystems with pairwise comparisons indicating that significantly higher values were recorded during winter. Interestingly, this seasonal shift can largely be attributed to fluctuations in the populations of only a few nematode groups (namely Aporcelaimellus, Dorylaimidae, Iotonchus, and Mononchus) with high colonizer-persister values. Although the reason for the higher abundance of specific nematode groups recorded during the winter is not explicitly clear, it is possibly linked to reduced competition from other soil fauna. This study clearly shows that further investigations are required to better understand the dynamics of grassland ecosystems.
ESTIMATION OF WORKLOAD OF ANMS AND CALCULATING THE REQUIRED NUMBER OF ANMS IN IMPLEMENTING MOTHER CHILD TRACKING SYSTEM IN NORTHERN INDIA: WISN METHODOLOGY
Authors:   Tutor, National Institute of Nursing Education, PGIMER, Chandigarh., a Monika , Kaur Sukhpal ,   Lecturer, National Institute of Nursing Education, PGIMER, Chandigarh., Singh Amarjeet ,   Professor and Head, School of Public Health, PGIMER, Chandigarh.
Published: December 2020

Mother child tracking system(MCTS) is an information system for tracking maternal and child health beneficiaries in Indias public health system, and improving service delivery planning and outcomes. Auxiliary nurse midwife(ANM) has broad spectrum of responsibilities to play in under National health mission. In the present study the workload of ANM was estimated using standard methodology WISN(Workload indicators of staffing needs) given by WHO. Quantitative research approach with time-motion research design was chosen for the study. Workload was estimated in 21 civil dispensaries of Chandigarh, India. The workload was found to be high in 9 dispensaries. It was very high in 4 dispensaries where ANMs spent their total annual working time in doing activities under MCTS and they are left with no time for doing activities under other national health programs.
A házibeteg-ellátás kulcsfontosságú szerepe az idős korú betegek gyógyászati szakellátásában
Authors: Plachy Judit , Füge Ágnes , Kiss-Tóth Emőke , Rucska Andrea
Published: December 2020

BEVEZETÉS, CÉLKITŰZÉS: Az otthoni szakápolás a beteg otthonában vagy tartózkodási helyén, szakorvosi javaslatra és a háziorvos elrendelésére szakképzet ápoló személyzet által végzet tevékenység. CÉL: Megvizsgálni, hogy a 60 éves életkort betöltöttek közül kik veszik igénybe a szolgáltatást és milyen betegséggel kapnak javaslatot a házibeteg-ápolásra, valamint a páciensek milyen társbetegségekkel rendelkeznek. Megvizsgálni, hogy mely szolgáltatást veszik igénybe a páciensek – ápolás, fizioterápia, logopédia, hospice –, ezt milyen eredménnyel, valamint mennyire elégedettek az ellátással. EREDMÉNYEK: Vizsgálatunkat 2020. július 1. – október 30. között végeztük Egerben a Medicina Komplex Házibeteg Szolgálat Kf. 60 év fölött önkéntes betegei körében (n=49; M=70év±10SD). A kérdőív alapján az alapbetegégek közül első helyen szerepel a perézis (34,6%), a magas vérnyomás volt a legjellemzőbb kísérőbetegség (75,5%). Az érintetek háziorvosuktól értesültek az otthonápolás lehetőségéről (21fő), és leginkább az ápolást és a gyógytornát vették igénybe (16-16 fő). KÖVETKEZTETÉS: Az otthonápolás hatékonynak bizonyult, mely meleg családi környezetben valósult meg, szakszerűen, a beteg mihamarabbi rehabilitációja érdekében.
Implementation of state financial monitoring based on risk-oriented indicators in the activities of financial institutions
Authors: Andriichenko Zhanna
Published: December 2020

The article examines the systems of risks of various types of financial institutions and focuses on the absence of the risk of legalization among them. This risk is considered separately within the framework of a special system of relations in the field of combating money laundering, financing of terrorism and financing the proliferation of weapons of mass destruction. The evolution of criteria for assessing the risk of a financial institution to be involved in legalization is analyzed, risk-oriented indicators of the activities of financial institutions used to assess their risk profile are generalized. It is established that one of the regulators in the financial services market, the National Securities and Stock Market Commission, uses outdated, formal, and ineffective criteria for assessing the risks of a financial institution to be involved in money laundering. However, the other regulator, the NBU, has already carried out the process of adapting state financial monitoring to the requirements of FATF and AMLD4 and developed risk-oriented indicators of financial institutions’ activities, used to assess their risk profile. Strengthening the control by the subjects of state financial monitoring over the risk profile of a financial institution and its overall financial monitoring system will help to increase the efficiency of state financial monitoring. It is proposed to unify risk-oriented features and introduce identical financial monitoring mechanisms for all participants in the financial services markets, considering the specifics of their activities, as well as including the risk of legalization in the risk system of a financial institution in order to improve the efficiency of the financial monitoring system.
The impact of state regulation in a sphere of education on sustainable development of national economy
Authors: Vorontsova Anna , Shvindina Hanna , Mayboroda Tetyana , Mishenina Halyna , Heiets Iryna
Published: December 2020

Education is a core element of the Sustainable Development Concept. It is not only because of the declaration of SDG 4 within the 2030 Agenda but also its embeddedness in other goals, targets, and indicators. Thus, the study aims to generalize approaches to define the relationship between the efficiency of the strategy of sustainable development of the national economy and state regulation of education. The research is accomplished for 14 Central and Eastern European countries (2006–2016) using the combination of principal components method and parametric method of stochastic frontier analysis in the software package STATA 11 and FRONTIER 4.1. As a result, the empirical proofs of the strong and adequate link between the efficiency of the sustainable development strategy of the national economy and state regulation of education are identified. The technical efficiency indexes were also calculated that allowed forming three clusters for Central and Eastern European countries distributed by the level of state regulation of education and efficiency of sustainable development strategy implementation. It helps to distinguish the main measures to reform the state regulation of education in Ukraine considering the experience of Slovenia, Poland, the Czech Republic, countries that proved to be the leaders in a sphere of sustainable development strategy implementation. The recommendations for further improvements in educational policies were defined. For instance, effective and sustainable state regulation of education should focus on decentralizing education, developing private-public partnerships, stimulating adult education development, etc.
Acknowledgment and fundingThis research was funded by the grant from the Ministry of Education and Science of Ukraine “Reforming the lifelong learning system in Ukraine for the prevention of the labor emigration: a coopetition model of institutional partnership” (No. 0120U102001).
Barriers to the Application of the Nursing Process in the Regional Hospital Bamenda-Cameroon
Authors: Yuh Loh Stanley
Published: December 2020

The nursing process remains one of the unique pillars that confer nursing autonomy as a profession. However, implementation of the nursing process in the Regional Hospital Bamenda remains a challenge. This study set to assess barriers to the application of the nursing process at the Regional Hospital Bamenda-Cameroon. The specific objectives were to determine the demographic factors of nurses; identify the institutional factors and to find out the socio-cultural factors that hinder the implementation of the nursing process. A cross sectional study was carried out using a convenient sample of 65 nursing staff. Data were collected using self-administered questionnaires with Pearson reliability coefficient of 0.87. The data were analysed using SPSS. The study revealed that 68% of the participants did not know the steps of the nursing process. Advancing age and longevity of nurses; rejection and lack of support of nursing process, non- recognition of those who make an effort, inadequate monitoring; inadequate resources; and nursing peers, family, religion and culture hindered implementation of the nursing process. The nursing process was viewed by all participants as time-consuming and others, 92% as tedious. Implementation of the nursing process was found to be negatively affected by demographic institutional and sociocultural factors. Within the perspectives of this study, the nursing care plan needs to be vulgarized as a professional tool in the hospital, client satisfaction with nursing services evaluated and an observational study carried out using patients’ records to improve on the objectivity of this study.
Histone Deacetylase Inhibitors and Papillary Thyroid Cancer
Authors: Spartalis Eleftherios , Kotrotsios Konstantinos , Chrysikos Dimosthenis , Spartalis Michael , Paschou Stavroula A. , Schizas Dimitrios , Tsamakis Konstantinos , Dimitroulis Dimitrios , Troupis Theodore , Nikiteas Nikolaos
Published: December 2020

Background/Aim:

Papillary Thyroid Cancer (PTC) is the most common type of endocrine malignancy.
Although PTC has an excellent prognosis, the recurrent or metastatic disease could affect patients' survival.
Recent studies show that Histone Deacetylase Inhibitors (HDACIs) might be promising anticancer agents
against PTC. The aim of this review is to evaluate the role of HDACIs as an additional modality in PTC treatment
and to depict the latest trends of current research on this field.

Materials and Methods:

This literature review was performed using the MEDLINE database. The search strategy
included terms: “thyroid cancer”, “papillary”, “HDAC”, “histone”, and “deacetylase”.

Results:

Agents, such as Suberoyl Anilide Hydroxamic Acid, Trichostatin A, Valproic Acid, Sodium butyrate,
Panobinostat, Belinostat, Romidepsin, CUDC907 and N-Hydroxy-7-(2-naphthylthio)-Hepanomide have shown
promising anti-cancer effects on PTC cell lines but fail to trigger a major response in clinical trials.

Conclusion:

HDACIs have no significant effect as monotherapy against PTC, but further research needs to be
conducted in order to investigate their potential effect when used as an additional modality.
Mechanisms Underlying the Biological Effects of Molecular Hydrogen
Authors: Radyuk Svetlana N.
Published: December 2020

Aberrant redox-sensitive reactions and accumulation of oxidative damage can impair body functions
and contribute to the development of various pathologies and aging. Although antioxidant substances have long
been recognized as a measure of alleviating oxidative stress and restoring redox balance, the arsenal of effective
means of preventing the development of various disorders, is still limited. There is an emerging field that utilizes
molecular hydrogen (H2) as a scavenger of free radicals and reactive oxygen species (ROS). Among the remarkable
characteristics of H2 is its ability to counteract the harmful effects of hydroxyl radical and peroxynitrite
without affecting the activity of functionally important ROS, such as hydrogen peroxide and nitric oxide.
The beneficial effects of H2 have been documented in numerous clinical studies and studies on animal models
and cell cultures. However, the established scavenging activity of H2 can only partially explain its beneficial
effects because the effects are achieved at very low concentrations of H2. Given the rate of H2 diffusion, such
low concentrations may not be sufficient to scavenge continuously generated ROS. H2 can also act as a signaling
molecule and induce defense responses. However, the exact targets and mechanism(s) by which H2 exerts
these effects are unknown. Here, we analyzed both positive and negative effects of the endogenous H2, identified
the redox-sensitive components of the pathways affected by molecular hydrogen, and also discussed the
potential role of molecular hydrogen in regulating cellular redox.
Prognostic Hub Genes in the Immune Microenvironment of Lung Adenocarcinoma by Estimation
Authors: Liu Shanshan , Tian Wenjuan , Li Burong
Published: December 2020

Background:

The mortality of lung adenocarcinoma (LUAD) is high. Recent studies
have found that the degree of immune infiltration and stromal cells in the tumour microenvironment
or tumours makes a significant contribution to prognosis.

Methods:

During the study, we screened differentially expressed genes (DEGs) of the TCGA
database for prognostic genes in the LUAD immune microenvironment. Furthermore, immune
and stromal cells were quantified using the ESTIMATE algorithm. To study the effects of
immune and stromal cell-associated genes on the prognosis of LUAD, LUAD patients were
divided into high and low groups according to their immune/stromal scores. The obtained
scores were found to be related to the phenotype and survival rate of LUAD patients. By selecting
DEGs with high expression in immune and stromal cells, we performed functional enrichment
analysis and found that most genes are associated with pathways of cancer, stimulus
response and MAPK signaling. The functions and enriched pathways of LUAD prognostic
genes were shown by a protein-protein interaction (PPI) network. Nonetheless, an external database
was used to validate the prognostic genes from the TCGA.

Results:

Prognostic genes were listed according to their expression position and protein function.

Conclusion:

We provided a new targets for immunotherapy of LUAD, which further provides basic knowledge for future clinical research.
Changes in Market Share of Biologic and Targeted Synthetic Disease-Modifying Anti-Rheumatic Drugs for Treatment of Rheumatoid Arthritis: Results from the Ontario Best-Practice Research Initiative Database
Authors: Hepworth Elliot , Movahedi Mohammad , Rampakakis Emmanouil , Mirza Reza , Lau Arthur , Cesta Angela , Pope Janet , Sampalis John S. , Bombardier Claire
Published: December 2020

Objective:

For patients with Rheumatoid Arthritis (RA) who do not achieve adequate
clinical response with combined conventional synthetic disease-modifying anti-rheumatic drugs (cs-
DMARDs), initiation of advanced therapies such as biologic DMARDs (bDMARDs) or targeted
synthetic DMARDs (tsDMARDs) is recommended. Tumour necrosis factor inhibitors (TNFi) are
the oldest and most commonly used subgroup of advanced therapies. In the last decade, new non-TNFi
advanced therapy options have become available. We described the relative use of TNFi vs.
non-TNFi in Ontario-based practices from 2008-2017.

Methods:

Adult patients with RA enrolled in the Ontario Best Practices Research Initiative (OBRI)
database who started bDMARDs or tsDMARDs anytime during or within 30 days prior to enrollment
were included. The proportion of patients treated with TNFi vs. non-TNFi agents between
2008 and 2017 was described for all patients and those initiating their first bDMARD/tsDMARD.
All TNFi therapies were included. Non-TNFi included Abatacept, Rituximab, Tocilizumab, and Tofacitinib.

Results:

A total of 1,057 patients were included, of whom 72.0% were bDMARD/tsDMARD
naïve. In 2008, the relative non-TNFi use was 5.4% in all patients while it was 0% in bDMARD/ts-
DMARD-naïve patients. In 2017, the proportion of patients using non-TNFi increased to 33.8%
among all patients and 33.3% in bDMARD/tsDMARD-naïve patients.

Conclusion:

This descriptive analysis of data from the OBRI cohort reveals that TNFi are still
used in the majority of cases; however, there has been an increase in the use of non-TNFi therapies
both overall and as first-line advanced therapy. This trend towards non-TNFi therapies as first-line
advanced therapy may be partially explained by the shift in guideline recommendations from TNFi
as first-line to any of the advanced therapeutics.
Plankton Community Structure as Bioindicator Trophic Status of Jatigede Reservoir Waters
Authors: Rosadi Rosadi , Musa Muhammad , Djoko Lelono Tri
Published: December 2020

Jatigede Reservoir in Sumedang Regency is a land mass planning designed as a multi-function reservoir. The main water source for this reservoir is from Cimanuk River, which flows through Garut Regency, and has many industrial activities around the river flow. This research was conducted to assess the trophic status of water pollution in Jatigede Reservoir by utilizing plankton as a bioindicator agent. Samples were collected from 9 observation stations from November 2018 until January 2019. The results showed that 26 species of phytoplankton from 7 divisions including Dinophyta, Cyanophyta, Chlorophyta, Chrysophyta, Euglenophyta, Bacillariophyta, and Charophyta was found in Jatigede Reservoir at about 461 ind/m3. Zooplankton abundance of 6 species from 2 divisions of Rotifera and Copepoda at 2 ind/m3. The average phytoplankton diversity index was 0.93 and zooplankton diversity index was 0.23. The average phytoplankton evenness index was 0.44 and zooplankton evenness index was 0.24. The average dominance of phytoplankton was 0.58 and dominance of zooplankton was 0.25. Based on the plankton community structure, the trophic status of Jatigede Reservoir was classified to moderate polluted (eutroph) to heavily pollutants (hypereutroph). The dominant species was Perinidium sp from Dinophyta division.
Direct Optimization of an Automotive Sheet Metal Part Using ANSYS
Authors: Khalid Usman , Mustafa Othman Mohammad Ahmed , Naeem Muhammad Ali , Alkhateeb Mohammad Yousef Mohammad , Awad Basil Marwan Abed Eljaber
Published: December 2020

Optimization of automotive parts nowadays is mainly used to design lightweight and cost-effective vehicle parts in order to improve the cost and efficiency. In this research, a sheet metal part was taken into consideration and optimized using direct optimization module in ANSYS to evaluate the process. An initial Finite Element Analysis (FEA) was done on the sheet metal part by adding forces and constraints in order to initiate direct optimization. The purpose of the optimization is to minimize the mass of the sheet metal part and maintaining a certain Factor of Safety (FOS) by automatically modifying the sheet thickness and the dimension of the side holes. As a result, the best candidate point with 23% mass reduction was found which complied with FOS value was selected for optimal geometry.
Szakképzés 4.0 és a mérnöktanár-képzés
Authors: Imre Kocsis
Published: December 2020

A mérnöktanár-képzés a regionális iparfejlesztés összetett folyamatának egyik apró, de fontos eleme. A korszerű ipari termelés új szerepköröket (munkaköröket) és új kompetenciákat igényel. Ezekre figyelni kell a műszaki képzés minden szintjén, ha felelősen gondolkodunk, és meg akarjuk alapozni a végzett műszaki szakemberek sikeres karrierjét. A mérnöktanár-képzésből kerülnek ki a középfokú szakképzés új tanárgenerációi, az ő szemléletük határozza meg a szakképzés mindennapjait a következő évtizedekben. A képző intézményeknek érzékenyeknek kell lenniük az aktuális és a jövőbeli elvárásokra, a képzési programjuk és az oktatási módszereik megújításával támogatniuk kell a szakképzési rendszer törekvéseit az iparfejlesztés humán erőforrásának biztosításában.
Additív gyártástechnológiával előállított hőálló PLA anyag szilárdsági vizsgálata
Authors: Ficzere Péter , Lukács Norbert László
Published: December 2020

Az utóbbi években egyre több helyen alkalmazzák az additív gyártástechnológiákat az egyedi, valamint a kisszériás gyártásban. Ilyen esetekben az alkatrésznek valós körülmények közt is működőképesnek kell maradnia. Ez azt jelenti, hogy teherviselőnek is kell lennie. Sok esetben szilárdsági szempontból már megfelelnek az anyagok. Ugyanakkor sok esetben (gépalkatrészek, kültéri felhasználás) a modelleknek nagyobb hőmérsékleten is megbízhatóan kell működniük. Erre kínál lehetőséget a legelterjedtebb additív gyártástechnológia esetében (FDM) egy új, hőtűrő anyag a HT PLA. Sok esetben a hűtés alkalmazása elengedhetetlen a gyártás során, különösen a nagy túllógásokkal tűzdelt alkatrészek esetében, ahol szükséges az anyag mielőbbi megszilárdulása a megfelelő felületminőség eléréséhez. Cikkünkben a gyártás során alkalmazott hűtésnek a mechanikai szilárdságra gyakorolt hatását vizsgáltuk.
Possible ways of IP Commercialisation in the European Higher Education Ecosystem
Authors: Dr.Peredy Zoltán , Laki Balázs
Published: December 2020

Strong links between universities, and companies can play crucial role in promoting taking into practice of ideas that drive the knowledge society, and in raising competitiveness and living standards. In academic terms of IP management, all activities aimed at sharing knowledge generated in research institutions as a knowledge transfer including scientific publishing, conference presentations, collaborative research with external partners, and contract-based clustering activities, such as licensing and spin-offs. In a narrower sense, the IP management means technology transfer is aimed at placing a given technology on the market, and includes any process by which the recovery partner becomes able to produce new products or services. IP with traditional university mission, values, and activities primarily focusing an active university role in entrepreneurship and contracts with private sector for IP commercialization. This paper gives a comprehensive overview about IP management in universities of the European Higher Education System including the following aspects: partnerships (licensing, industry collaborators); IP invention (disclosures, patenting); proof of concept research bridging the gap between lab discoveries and market application (highly innovative R&D to solve practical problems and commercialization research aiming patented technologies towards business exploitations) and commercialization (start-up incubators and strengthening the entrepreneurial attitudes and competencies). The methodology based on secondary research analysing EU, OECD, on-line literature sources and relevant, up-to date statistical data as well. The conclusions and recommendations based on this „desk research” work reflects the authors.
EXTRACTION, ISOLATION AND PURIFICATION OF VARIOUS COMPONENTS OF CASSIA UNIFLORA AND IT’S IN VITRO STUDIES
Authors: V Sowmya , Ahmed Syed Arbaz , Sameer Syed , P. Polireddy , K. Rajeshwari Dutt
Published: December 2020

Cassia species are one among the plants to possess great therapeutical value due to their wide rage of pharmacological activities. Hence, in our present study, we have isolated the extract of Cassia uniflora and isolated some important constituents using various solvents among which methanolic extract was optimal. The isolated compounds were also characterized by mass and IR spectroscopy. The extract was further checked for anti-oxidant as well as anti-diabetic activity. From the results obtained, the leaves and fruit extract were found to have good alpha-glucosidase as well as 5-lipoxygenase inhibition.
Wearables in the SARS-CoV-2 Pandemic: What Are They Good for?
Authors: Bent Brinnae , Dunn Jessilyn P
Published: December 2020

Recently, companies such as Apple Inc, Fitbit Inc, and Garmin Ltd have released new wearable blood oxygenation measurement technologies. Although the release of these technologies has great potential for generating health-related information, it is important to acknowledge the repercussions of consumer-targeted biometric monitoring technologies (BioMeTs), which in practice, are often used for medical decision making. BioMeTs are bodily connected digital medicine products that process data captured by mobile sensors that use algorithms to generate measures of behavioral and physiological function. These BioMeTs span both general wellness products and medical devices, and consumer-targeted BioMeTs intended for general wellness purposes are not required to undergo a standardized and transparent evaluation process for ensuring their quality and accuracy. The combination of product functionality, marketing, and the circumstances of the global SARS-CoV-2 pandemic have inevitably led to the use of consumer-targeted BioMeTs for reporting health-related measurements to drive medical decision making. In this viewpoint, we urge consumer-targeted BioMeT manufacturers to go beyond the bare minimum requirements described in US Food and Drug Administration guidance when releasing information on wellness BioMeTs. We also explore new methods and incentive systems that may result in a clearer public understanding of the performance and intended use of consumer-targeted BioMeTs.
Addressing Public Health Emergencies via Facebook Surveys: Advantages, Challenges, and Practical Considerations (Preprint)
Authors: Grow André , Perrotta Daniela , Del Fava Emanuele , Cimentada Jorge , Rampazzo Francesco , Gil-Clavel Sofia , Zagheni Emilio
Published: December 2020

UNSTRUCTURED

Surveys of the general population can provide crucial information for designing effective nonpharmaceutical interventions to tackle public health emergencies, such as the COVID-19 pandemic. Yet, conducting such surveys can be difficult, especially when timely data collection is required. In this viewpoint paper, we discuss our experiences with using targeted Facebook advertising campaigns to address these difficulties in relation to the COVID-19 pandemic. We describe central advantages, challenges, and practical considerations. This includes a discussion of potential sources of bias and how they can be addressed.
Correction: Digital Health Coaching Programs Among Older Employees in Transition to Retirement: Systematic Literature Review (Preprint)
Authors: Stara Vera , Santini Sara , Kropf Johannes , D'Amen Barbara
Published: December 2020

UNSTRUCTURED

The rapid increase of the aging population is pushing many national governments to reshape retirement legislation in order to extend older adults’ working life. Once retired, older adults can be invaluable resources for the community as family carers, as volunteers, or by returning to work. Healthy aging is one of the main conditions for being able to work longer and being active after retirement. The latter, indeed, represents a very sensitive life transition, which can entail psychological and social difficulties. Interventions for promoting older workers’ health and well-being and supporting the transition to retirement are on the top of the policy agenda of most European countries. Recently, computer-based and digital health interventions have been seen as promising means to reach this purpose. This systematic literature review aimed to explore studies on digital health coaching programs for older workers that followed a user-centered design approach and evaluated their effectiveness in providing older adults with guidance for adopting a healthy lifestyle and being active in the community. The search identified 1931 papers, and 2 relevant articles were selected by applying specific eligibility criteria. To our knowledge, only few digital health coaching programs have targeted the population of older workers to date; there is an insufficient number of studies on the efficacy of such programs. The results show the difficulties of assessing the efficacy of digital coaching itself and with respect to older employees. The 2 studies suggest that digital health programs for workplaces can improve various aspects of older employees’ well-being; however, they considered health mainly from a physical perspective and neglected contextual, social, psychological, and cultural factors that can influence older workers’ health and general well-being. Future digital health coaching programs should adopt the healthy aging paradigm as a multidimensional lens for interpreting the impact of eHealth technology on aging and retirement. The literature around this issue remains at an embryonic state, and this gap needs to be filled by further investigations that apply a user-centered approach for designing the technology, test innovative research methodologies, and adopt new technical solutions for high-quality interaction design. Further digital health coaching programs aimed at supporting healthy and active living for older workers and retirees are necessary. The user-centered design approach is recommended in order to fully address the users’ health needs and the technological requirements throughout development. Moreover, the healthy aging perspective allows inclusion of physical, social, and psychological factors influencing the transition from work to retirement, as well as the experiences and interactions of individuals with the technology. J Med Internet Res 2020;22(9):e17809
Machine Learning Approach to Predict the Probability of Recurrence of Renal Cell Carcinoma After Surgery: Prediction Model Development Study (Preprint)
Authors: Kim HyungMin , Lee Sun Jung , Park So Jin , Choi In Young , Hong Sung-Hoo
Published: December 2020

BACKGROUND

Renal cell carcinoma (RCC) has a high recurrence rate of 20% to 30% after nephrectomy for clinically localized disease, and more than 40% of patients eventually die of the disease, making regular monitoring and constant management of utmost importance.

OBJECTIVE

The objective of this study was to develop an algorithm that predicts the probability of recurrence of RCC within 5 and 10 years of surgery.

METHODS

Data from 6849 Korean patients with RCC were collected from eight tertiary care hospitals listed in the KOrean Renal Cell Carcinoma (KORCC) web-based database. To predict RCC recurrence, analytical data from 2814 patients were extracted from the database. Eight machine learning algorithms were used to predict the probability of RCC recurrence, and the results were compared.

RESULTS

Within 5 years of surgery, the highest area under the receiver operating characteristic curve (AUROC) was obtained from the naïve Bayes (NB) model, with a value of 0.836. Within 10 years of surgery, the highest AUROC was obtained from the NB model, with a value of 0.784.

CONCLUSIONS

An algorithm was developed that predicts the probability of RCC recurrence within 5 and 10 years using the KORCC database, a large-scale RCC cohort in Korea. It is expected that the developed algorithm will help clinicians manage prognosis and establish customized treatment strategies for patients with RCC after surgery.
Exploring Breaks in Sedentary Behavior of Older Adults Immediately After Receiving Personalized Haptic Feedback: Intervention Study (Preprint)
Authors: Compernolle Sofie , Van Dyck Delfien , Cardon Greet , Brondeel Ruben
Published: December 2020

BACKGROUND

“Push” components of mobile health interventions may be promising to create conscious awareness of habitual sedentary behavior; however, the effect of these components on the near-time, proximal outcome, being breaks in sedentary behavior immediately after receiving a push notification, is still unknown, especially in older adults.

OBJECTIVE

The aims of this study are to examine if older adults break their sedentary behavior immediately after receiving personalized haptic feedback on prolonged sedentary behavior and if the percentage of breaks differs depending on the time of the day when the feedback is provided.

METHODS

A total of 26 Flemish older adults (mean age 64.4 years, SD 3.8) wore a triaxial accelerometer (Activator, PAL Technologies Ltd) for 3 weeks. The accelerometer generated personalized haptic feedback by means of vibrations each time a participant sat for 30 uninterrupted minutes. Accelerometer data on sedentary behavior were used to estimate the proximal outcome, which was sedentary behavior breaks immediately (within 1, 3, and 5 minutes) after receiving personalized haptic feedback. Generalized estimating equations were used to investigate whether or not participants broke up their sedentary behavior immediately after receiving haptic feedback. A time-related variable was added to the model to investigate if the sedentary behavior breaks differed depending on the time of day.

RESULTS

A total of 2628 vibrations were provided to the participants during the 3-week intervention period. Of these 2628 vibrations, 379 (14.4%), 570 (21.7%), and 798 (30.4%) resulted in a sedentary behavior break within 1, 3 and 5 minutes, respectively. Although the 1-minute interval did not reveal significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided, the 3- and 5-minute intervals did show significant differences in the percentage of breaks depending on the time at which the haptic feedback was provided. Concretely, the percentage of sedentary behavior breaks was significantly higher if personalized haptic feedback was provided between noon and 3 PM compared to if the feedback was provided between 6 and 9 AM (odds ratio 1.58, 95% CI 1.01-2.47, within 3 minutes; odds ratio 1.78, 95% CI 1.11-2.84, within 5 minutes).

CONCLUSIONS

The majority of haptic vibrations, especially those in the morning, did not result in a break in the sedentary behavior of older adults. As such, simply bringing habitual sedentary behavior into conscious awareness seems to be insufficient to target sedentary behavior. More research is needed to optimize push components in interventions aimed at the reduction of the sedentary behavior of older adults.

CLINICALTRIAL

ClinicalTrials.gov NCT04003324; https://clinicaltrials.gov/ct2/show/NCT04003324
Impact of Individual, Organizational, and Technological Factors on the Implementation of an Online Portal to Support a Clinical Pathway Addressing Psycho-Oncology Care: Mixed Methods Study (Preprint)
Authors: Masya Lindy , Shepherd Heather L , Butow Phyllis , Geerligs Liesbeth , Allison Karen C , Dolan Colette , Prest Gabrielle ,   The ADAPT Program Group, Shaw Joanne
Published: December 2020

BACKGROUND

Clinical pathways (CPs) can improve patient outcomes but can be complex to implement. Technologies, such as clinical decision support (CDS) tools, can facilitate their use, but require end-user testing in clinical settings.

OBJECTIVE

This study applied the Technology Acceptance Model to evaluate the individual, organizational, and technological contexts impacting application of a portal to facilitate a CP for anxiety and depression (the ADAPT Portal) in a metropolitan cancer service. The ADAPT Portal triggers patient screening on patient reported outcomes, alerts staff to high scores, recommends evidence-based management, and triggers review and rescreening at set intervals.

METHODS

Quantitative and qualitative data on portal activity, data accuracy, and health service staff perspectives were collected. Quantitative data were analyzed descriptively, and thematic analysis was applied to qualitative data.

RESULTS

Overall, 15 (100% of those invited) health service staff agreed to be interviewed. During the pilot, 73 users (36 health service staff members and 37 patients) were registered on the ADAPT Portal. Of the 37 patients registered, 16 (43%) completed screening at least once, with seven screening positive and triaged appropriately. In total, 34 support requests were lodged, resulting in 17 portal enhancements (technical issues). Health service staff considered the ADAPT Portal easy to use and useful; however, some deemed it unnecessary or burdensome (individual issues), particularly in a busy cancer service (organizational issues).

CONCLUSIONS

User testing of a CDS to facilitate screening and assessment of anxiety and depression in cancer patients highlighted some technological issues in implementing the ADAPT CDS, resulting in 17 enhancements. Our results highlight the importance of obtaining health service staff feedback when piloting specialized CDS tools and addressing contextual factors when implementing them.
Optimization of Patient Flow in Urgent Care Centers Using a Digital Tool for Recording Patient Symptoms and History: Simulation Study (Preprint)
Authors: Montazeri Maryam , Multmeier Jan , Novorol Claire , Upadhyay Shubhanan , Wicks Paul , Gilbert Stephen
Published: December 2020

BACKGROUND

Crowding can negatively affect patient and staff experience, and consequently the performance of health care facilities. Crowding can potentially be eased through streamlining and the reduction of duplication in patient history-taking through the use of a digital symptom-taking app.

OBJECTIVE

We simulated the introduction of a digital symptom-taking app on patient flow. We hypothesized that waiting times and crowding in an urgent care center (UCC) could be reduced, and that this would be more efficient than simply adding more staff.

METHODS

A discrete-event approach was used to simulate patient flow in a UCC during a 4-hour time frame. The baseline scenario was a small UCC with 2 triage nurses, 2 doctors, 1 treatment/examination nurse, and 1 discharge administrator in service. We simulated 33 scenarios with different staff numbers or different potential time savings through the app. We explored average queue length, waiting time, idle time, and staff utilization for each scenario.

RESULTS

Discrete-event simulation showed that even a few minutes saved through patient app-based self-history recording during triage could result in significantly increased efficiency. A modest estimated time saving per patient of 2.5 minutes decreased the average patient wait time for triage by 26.17%, whereas a time saving of 5 minutes led to a 54.88% reduction in patient wait times. Alternatively, adding an additional triage nurse was less efficient, as the additional staff were only required at the busiest times.

CONCLUSIONS

Small time savings in the history-taking process have potential to result in substantial reductions in total patient waiting time for triage nurses, with likely effects of reduced patient anxiety, staff anxiety, and improved patient care. Patient self-history recording could be carried out at home or in the waiting room via a check-in kiosk or a portable tablet computer. This formative simulation study has potential to impact service provision and approaches to digitalization at scale.
Estimation of COVID-19 Period Prevalence and the Undiagnosed Population in Canadian Provinces: Model-Based Analysis (Preprint)
Authors: Hamadeh Abdullah , Feng Zeny , Niergarth Jessmyn , Wong William WL
Published: December 2020

BACKGROUND

The development of a successful COVID-19 control strategy requires a thorough understanding of the trends in geographic and demographic distributions of disease burden. In terms of the estimation of the population prevalence, this includes the crucial process of unravelling the number of patients who remain undiagnosed.

OBJECTIVE

This study estimates the period prevalence of COVID-19 between March 1, 2020, and November 30, 2020, and the proportion of the infected population that remained undiagnosed in the Canadian provinces of Quebec, Ontario, Alberta, and British Columbia.

METHODS

A model-based mathematical framework based on a disease progression and transmission model was developed to estimate the historical prevalence of COVID-19 using provincial-level statistics reporting seroprevalence, diagnoses, and deaths resulting from COVID-19. The framework was applied to three different age cohorts (< 30; 30-69; and ≥70 years) in each of the provinces studied.

RESULTS

The estimates of COVID-19 period prevalence between March 1, 2020, and November 30, 2020, were 4.73% (95% CI 4.42%-4.99%) for Quebec, 2.88% (95% CI 2.75%-3.02%) for Ontario, 3.27% (95% CI 2.72%-3.70%) for Alberta, and 2.95% (95% CI 2.77%-3.15%) for British Columbia. Among the cohorts considered in this study, the estimated total number of infections ranged from 2-fold the number of diagnoses (among Quebecers, aged ≥70 years: 26,476/53,549, 49.44%) to 6-fold the number of diagnoses (among British Columbians aged ≥70 years: 3108/18,147, 17.12%).

CONCLUSIONS

Our estimates indicate that a high proportion of the population infected between March 1 and November 30, 2020, remained undiagnosed. Knowledge of COVID-19 period prevalence and the undiagnosed population can provide vital evidence that policy makers can consider when planning COVID-19 control interventions and vaccination programs.
Predicting Therapy Outcome in a Digital Mental Health Intervention for Depression and Anxiety: A Machine Learning Approach (Preprint)
Authors: Hornstein Silvan , Forman-Hoffman Valerie , Nazander Albert , Ranta Kristian , Hilbert Kevin
Published: December 2020

BACKGROUND

Predicting the outcomes of individual participants for treatment interventions appears central for making mental healthcare more tailored and effective. Machine Learning (ML) has been proven to be able to make such predictions with notable accuracy. However, little work has been done to investigate the performance of such ML-based predictions within digital mental health (DMH) interventions. Using such data from real world settings could provide more realistic estimates of predictive performance in practice.

OBJECTIVE

This study evaluates the performance of ML in predicting treatment response in a DMH intervention designed for treating depression and anxiety.

METHODS

Several algorithms were trained based on the data of 970 participants to predict significant reduction in depression and anxiety symptoms, by using clinical and sociodemographic variables. As a Random Forest Classifier (RF) performed best over cross-validation, it was used to predict the outcomes of 279 new participants.

RESULTS

The RF achieved an accuracy of 0.71 for the test set (base-rate: 0.67, AUC: 0.60, P = .001, balanced accuracy: 0.60). Additionally, predicted non-responders showed less average reduction of their PHQ-9 (-2.7, P = .004) and GAD-7 values (-3.7, P < .001) compared to responders. Besides pre-treatment PHQ and GAD-7 values, the self-reported motivation, type of referral into the program (self versus healthcare provider) as well as Work Productivity and Activity Impairment Questionnaire (WPAI) items contributed most to the predictions.

CONCLUSIONS

The RF achieved an accuracy of 0.71 for the test set (base-rate: 0.67, AUC: 0.60, P = .001, balanced accuracy: 0.60). Additionally, predicted non-responders showed less average reduction of their PHQ-9 (-2.7, P = .004) and GAD-7 values (-3.7, P < .001) compared to responders. Besides pre-treatment PHQ and GAD-7 values, the self-reported motivation, type of referral into the program (self versus healthcare provider) as well as Work Productivity and Activity Impairment Questionnaire (WPAI) items contributed most to the predictions.

CLINICALTRIAL
A longitudinal evaluation of web analytics for HeadsUpGuys: A men’s depression e-mental health resource (Preprint)
Authors: Ogrodniczuck John , Beharry Joshua , Oliffe John
Published: December 2020

BACKGROUND

There has been rapid growth in the area of eHealth as a means to delivering tailored health interventions for men. Yet, there have been few attempts at developing eHealth programs specifically oriented to men with depression, and by extension little is known about the uptake and usage patterns of potential end-users.

OBJECTIVE

The objective of the present study was to conduct a longitudinal evaluation of web analytics for HeadsUpGuys.org, an eHealth resource for men with depression. The study focused on user engagement, traffic sources, and goal conversion (i.e., specific interactivity targets).

METHODS

Google Analytics, Search Console, and Tag Manager were used to monitor user activity over the course of the website’s first five years (June 15, 2015 – June 15, 2020). These tools were used to harvest data regarding the number of visits, visit duration, bounce rates, most visited pages; traffic filters, country sources, city sources; and goal conversion relating to three specific outcomes [Self Check (depression screen) completion, Stress Test (stress checklist and rating) completion, session of at least 3 minutes].

RESULTS

Through its first five years of operation, HeadsUpGuys had a total of 1,665,356 unique users, amounting to 1,948,481 sessions and 3,328,258 pageviews. One in seven visits (14.53%) was from a returning user. Organic traffic accounted for the highest proportion (53.44%) of all the website sessions. Four of the top 10 Google search queries that brought users to the website related to suicidality. Three countries (United States, United Kingdom, Canada) accounted for almost three-quarters (71.10%) of the site’s traffic. Nearly three-quarters (73.35%) of sessions occurred on a mobile device. The goal conversion rate for the Self Check was 60.27%. The average time on page was 2 minutes 53 seconds, with a bounce rate of 65.92%, and an exit rate of 57.20%. The goal conversion rate for the Stress Test was 52.89%. The average time on page was 4 minutes 8 seconds, with a bounce rate of 72.40% and an exit rate of 48.88%. The conversion rate for the final goal was 11.53%, indicating that approximately one in ten visitors to the site had a session of at least 3 minutes.

CONCLUSIONS

The volume of traffic and the conversion rates affirm the acceptability and usability of HeadsUpGuys. The study illustrates the potential of eHealth resources to support men’s mental health and provides some guidance to advancing the men’s eHealth field.
Opportunity, Challenge, or Both? Managing Adolescent Socioemotional and Mental Health During Web-Based Learning (Preprint)
Authors: Evans Yolanda , Hutchinson Jeffrey , Ameenuddin Nusheen
Published: December 2020

UNSTRUCTURED

The transition to web-based learning during the COVID-19 pandemic has highlighted the need to consider the benefits of and the risks associated with web-based technology for education, media use, and access to resources. Prior to the pandemic, children and adolescents had in-person access to peers; social relationships; educators; health care providers; and, in some cases, mental health resources and medical care in schools and community settings. Due to the introduction of universal masking and physical distancing guidelines to prevent the spread of COVID-19 in early 2020, methods for accessing these resources have shifted dramatically, as people now rely on web-based platforms to access such resources. This viewpoint will explore equity in access to technology for web-based learning, mental health (with a focus on students of color), and the challenge of cultivating meaningful relationships on web-based platforms. Challenges and possible solutions will be offered.