bluuebunny/crossref_metadata_2025 huggingface dataset:
To Cheat or not to Cheat? Sex Differences and Academic Performance as Factors of Cheating Behavior
Authors: Hadjar Ibnu
Published: December 2019

Cheating behavior at higher education is a global phenomenon since it is found at any university in any country. This study is to examine whether sex differences and academic performance reflect the different likelihood of doing cheating among students. Using a questionnaire, data were collected from 436 students selected from different semesters and study programs in all faculties at a State Islamic University. Data were analyzed by using logistic regression, both separately and simultaneously. The results of data analysis revealed that male students tend to be more likely to do cheating categories than that of their female counterparts. It also found that academic performance affects negatively the likelihood of students to cheat in three categories of cheating behavior, but not in the other three. There is no stimulant effect of sex and academic performance on the likelihood of all categories of cheating behaviors. In other words, the effect of sex differences is not depended on academic performance and vice versa.
Influences of natural and anthropogenic processes on the groundwater quality in the Dagujia River Basin in Yantai, China
Authors: Zhu Henghua , Zhou Jianwei , Song Tingting , Feng Haibo , Liu Zhizheng , Liu Hongwei , Ren Xiaohua
Published: December 2019

Groundwater plays an important role in water supply and economic development for Yantai city, China. However, the groundwater quality has degraded due to the increase and expansion of agricultural and industrial development. It is urgent to acquire groundwater characteristics and distinguish impacts of natural factors and anthropogenic activities on the groundwater quality. Forty-six groundwater samples collected from different wells showed a great variation of chemical components across the study area. Most wells with higher total dissolved solids, total hardness, K+, Na+, Ca2+, Mg2+, Cl− and SO42− concentrations were located relatively close to the coastal zone. The factor analysis (FA) and hierarchical cluster analysis results displayed that seawater intrusion was the primary mechanism controlling the groundwater quality in the coastal areas. A three-factor model was proposed based on the FA and explained over 85% of the total groundwater quality variation: Factor 1, the seawater intrusion; Factor 2, the water–rock interaction and Factor 3 (NO3−), the human activities. Furthermore, the geographical maps of the factor scores clearly described the spatial distributions of wells affected by natural processes or human activities. The study indicated that both natural processes and human activities are the major factors affecting the chemical compositions of groundwater.
Integrated framework for assessing climate change impact on extreme rainfall and the urban drainage system
Authors: Lu Wei , Qin Xiaosheng
Published: December 2019

Urban areas are becoming increasingly vulnerable to extreme storms and flash floods, which could be more damaging under climate change. This study presented an integrated framework for assessing climate change impact on extreme rainfall and urban drainage systems by incorporating a number of statistical and modelling techniques. Starting from synthetic future climate data generated by the stochastic weather generator, the simple scaling method and the Huff rainfall design were adopted for rainfall disaggregation and rainfall design. After having obtained 3-min level designed rainfall information, the urban hydrological model (i.e., Storm Water Management Model) was used to carry out the runoff analysis. A case study in a tropical city was used to demonstrate the proposed framework. Particularly, the impact of selecting different general circulation models and Huff distributions on future 1-h extreme rainfall and the performance of the urban drainage system were investigated. It was revealed that the proposed framework is flexible and easy to implement in generating temporally high-resolution rainfall data under climate model projections and offers a parsimonious way of assessing urban flood risks considering the uncertainty arising from climate change model projections, downscaling and rainfall design.
Vitex Diterpenoids: Structural Diversity and Pharmacological Activity
Authors: Ban Yanfei , Xia Tianshuang , Jing Rui , Guo Yaoli , Geng Yiya , Ye Qi , Zheng Chengjian
Published: December 2019

Plants of the genus Vitex (Verbenaceae) are mainly distributed throughout tropical and temperate
regions, and many Vitex plants have been traditionally used in folk medicine. Plants of this genus are a rich
source of diterpenoids, which not only displayed versatile structural diversity with potential chemotaxonomical
significance but also exhibited a wide range of biological activities, mainly including in vitro cytotoxic, antiinflammatory,
antimicrobial, hormone level-regulating and antiangiogenic activities. Recently, a series of bioactive
diterpenoids, with interesting carbon skeletons, have been reported and gathered considerable interest. This
article systematically reviewed diterpenoids isolated from the genus Vitex that appeared in the literature up to
December 2018, critically highlighting their structural diversity and pharmacological activities. Up to now, a total
of 154 diterpenoids with diverse structures have been isolated and identified from Vitex plants. The authors also
summarized the reported structure-activity relationships of those well explored Vitex diterpenoids. Finally, the
authors discussed the challenges and potential applications of these diterpenoids in the future.
A Review on the Phytochemistry, Ethnobotanical Uses and Pharmacology of Borago Species
Authors: Ramezani Mahin , Amiri Mohammad S. , Zibaee Elaheh , Boghrati Zahra , Ayati Zahra , Sahebkar Amirhossein , Emami Seyed A.
Published: December 2019

Ethnopharmacological Relevance:

Borago L., (family Boraginaceae) is a small genus of annual or
perennial herbs with branched flowers, which is commonly found in the Mediterranean region. Some species
known as Gavzabȃn in Asian and some African countries are traditionally used instead of Borago.

Aims of the Review:

The purpose of this study was to provide comprehensive scientific information on phytochemistry,
traditional uses and pharmacological activities of Borago species to provide an insight into further
research on the therapeutic potential of these plants. In many studies, it has been shown that different parts of
Borago species, including leaves, flowers, seeds, roots and aerial parts possess numerous ethnobotanical values.

Materials and Methods:

All ethnobotanical, phytochemical, pharmacological, and clinical data were collected
from online journals, magazines and books (all of which were published in English, Arabic, and Persian) from
1968 to 2018. Electronic databases such as Google, Google Scholar, PubMed, Science Direct, Researchgate, and
other online collections were used.

Results:

The phytochemical studies on five species showed a wide range of phytochemicals belonging to different
classes of secondary metabolites. From a pharmacological point of view, different extracts and fractions,
essential oils, and pure compounds isolated from various Borago species have shown diverse activities in in vitro,
in vivo, and clinical studies confirming various traditional uses of Borago genus.

Conclusions:

Considering the reported activities of the Borago genus both in traditional and modern medicine,
further studies on biological aspects and identification of the mechanism of action for drug discovery are highly
required.
Specificity and Continuity of Schizophrenia and Bipolar Disorder: Relation to Biomarkers
Authors: Yamada Yuji , Matsumoto Madoka , Iijima Kazuki , Sumiyoshi Tomiki
Published: December 2019

Schizophrenia and bipolar disorder overlap considerably in terms of symptoms, familial patterns, risk
genes, outcome, and treatment response. This article provides an overview of the specificity and continuity of
schizophrenia and mood disorders on the basis of biomarkers, such as genes, molecules, cells, circuits, physiology
and clinical phenomenology. Overall, the discussions herein provided support for the view that schizophrenia,
schizoaffective disorder and bipolar disorder are in the continuum of severity of impairment, with bipolar disorder
closer to normality and schizophrenia at the most severe end. This approach is based on the concept that examining
biomarkers in several modalities across these diseases from the dimensional perspective would be meaningful.
These considerations are expected to help develop new treatments for unmet needs, such as cognitive dysfunction,
in psychiatric conditions.
The “Gene Cube”: A Novel Approach to Three-dimensional Clustering of Gene Expression Data
Authors: Lambrou George I. , Sdraka Maria , Koutsouris Dimitrios
Published: December 2019

Background:

A very popular technique for isolating significant genes from cancerous tissues is the application of various clustering algorithms on data obtained by DNA microarray experiments.

Aim:

The objective of the present work is to take into consideration the chromosomal identity of every gene before the clustering, by creating a three-dimensional structure of the form Chromosomes×Genes×Samples. Further on, the k-Means algorithm and a triclustering technique called δ- TRIMAX, are applied independently on the structure.

Materials and Methods:

The present algorithm was developed using the Python programming language (v. 3.5.1). For this work, we used two distinct public datasets containing healthy control samples and tissue samples from bladder cancer patients. Background correction was performed by subtracting the median global background from the median local Background from the signal intensity. The quantile normalization method has been applied for sample normalization. Three known algorithms have been applied for testing the “gene cube”, a classical k-means, a transformed 3D k-means and the δ-TRIMAX.

Results:

Our proposed data structure consists of a 3D matrix of the form Chromosomes×Genes×Samples. Clustering analysis of that structure manifested very good results as we were able to identify gene expression patterns among samples, genes and chromosomes. Discussion: to the best of our knowledge, this is the first time that such a structure is reported and it consists of a useful tool towards gene classification from high-throughput gene expression experiments.

Conclusion:

Such approaches could prove useful towards the understanding of disease mechanics and tumors in particular.
The Effectiveness of Tai Chi Exercise in Improving Balance and Preventing Falls Among Older Adults
Authors: Kittichittipanich Boonsri , Kusoom Wichitra
Published: December 2019

Background:

Accidental falls in older adults cause serious health problems, therefore, Tai Chi exercise (TC) is important to help older adults regain body balance and prevent falls.

Objective:

This study aimed to assess: 1) the effect of a 12-week TC intervention on lower extremity strength and body balance in older adults, 2) recent falls within 12 weeks, and 3) participants’ satisfaction toward TC exercise.

Methods:

A quasi-experimental study was conducted, and the participants were older adults, aged 60 and above. One hundred participants were selected by a purposive sampling technique and were divided into 2 groups: the experimental group (n=50) performing the TC exercise, and the control group (n=50) not performing TC. The lower-extremity strength was measured by using a dynamometer, and the body balance was measured by using a timed single leg stance procedure.

Results:

The findings revealed that lower-extremity strength was not significantly different in three time periods: pre-TC, after 6 weeks, and after 12 weeks within the experimental group and also after 12 weeks between the experimental group and control group. The body balance within the experimental group in the three time periods was significantly different (p<.001). Multiple pair comparisons by using the Bonferroni test indicated that phase 3 (a 12-week) was significantly higher than phase 1, and phase 2 (p<.05).

However, the effect of a 12-week TC intervention on the body balance of the experimental group was significantly higher than that of the control group (p<.001). The number of recent falls and near falls within 12 weeks in the control group was 14%, with 10% falls occurring outdoors and 4% occurring indoors, whereas the experimental group did not report any falls and showed satisfaction towards the TC exercise.

Conclusion:

The findings of the study confirm that TC exercise improves body balance and helps reduce the risk of falls in older adults, while the group of older adults who did not undergo TC exercise suffered an increased risk of falls. These results should be applied and implemented among older adults and other groups of populations in different geographic locations and other clinical settings who are at the risk of falls. Also, the study on TC exercise should be extended to 6-12 months so that concrete results from improving lower-limb strength and body balance can be observed.
Coringa
Authors: Tessicini Priscilla
Published: December 2019

Resenha
Selección del modelo de mejor estimación del Valor Razonable en un mercado emergente
Authors: Morales Bañuelos Paula Beatriz
Published: December 2019

El objetivo de este trabajo es encontrar el modelo que brinde la mejor estimación posible del Valor Razonable de las partidas que componen los estados financieros, considerando la ambigüedad en la normatividad sobre el cálculo del mismo. Para ello se compararon tres metodologías: Flujos de Efectivo Descontados, Opciones Reales bajo los procesos Browniano Geométrico (MBG) y Browniano Aritmético (MBA). A pesar de que son muy pocos los estudios que han realizado este tipo de investigación, se ha llegado a la conclusión de que resulta más adecuado modelar un proceso aditivo como un MBA. Por dicha razón, se proyectaron los ingresos y posteriormente el flujo de efectivo anual de 2019 a 2028, posteriormente, se calcularon las Opciones Reales incorporando la flexibilidad de expansión y contracción de forma conjunta. De conformidad con los resultados obtenidos y en concordancia con lo sugerido por diferentes autores, el modelo que brinda la mejor aproximación posible del Valor Razonable es el de Opciones Reales bajo un MBG, con lo cual se recomienda que las empresas mexicanas conozcan y apliquen este modelo, complementando la valuación tradicional de flujos de efectivos descontados con el propósito de presentar información relevante para la toma de decisiones. La limitante más relevante que se presentó en la realización de esta investigación fue la carencia de la información financiera completa de todas las empresas seleccionadas inicialmente para con ello poder contrastar los modelos en comento y poseer una muestra de mayor tamaño.
Expectativas en las tasas de interés y noticias de política monetaria de EEUU.
Authors: San Vicente Gilberto Anzaldo , Benavides Guillermo
Published: December 2019

El evento conocido como Taper Tantrum está relacionado con la alta volatilidad ocurrida en los mercados de capitales de Estados Unidos entre abril y junio de 2013, lo que aparentemente fue consecuencia de un conjunto de anuncios de la FED destinados a incrementar la tasa de interés estando a niveles relativamente bajos desde las crisis financieras de 2008-2009. La presente investigación estima el valor esperado del nivel de las tasas de interés (T-Note de 10 años) de un agente representativo y sus variaciones significativas en torno al Taper Tantrum. Para lograr ese objetivo se estima la densidad neutral-al-riesgo de la tasa de interés extraída de los precios de las opciones, la cual tiene información implícita sobre las expectativas. Los resultados obtenidos indican que la metodología propuesta mide implícitamente las expectativas en el mercado de deuda. La hipótesis del trabajo es que los anuncios de los formuladores de políticas durante el Taper Tantrum tienen un efecto estadísticamente significativo en los mercados de capital.
Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-Sectional Study
Authors: Rogero-Blanco Eloisa , Lopez-Rodriguez Juan A , Sanz-Cuesta Teresa , Aza-Pascual-Salcedo Mercedes , Bujalance-Zafra M Jose , Cura-Gonzalez Isabel ,   MultiPAP Group
Published: December 2019

Background

Multimorbidity is a global health problem that is usually associated with polypharmacy, which increases the risk of potentially inappropriate prescribing (PIP). PIP entails higher hospitalization rates and mortality and increased usage of services provided by the health system. Tools exist to improve prescription practices and decrease PIP, including screening tools and explicit criteria that can be applied in an automated manner.

Objective

This study aimed to describe the prevalence of PIP in primary care consultations among patients aged 65-75 years with multimorbidity and polypharmacy, detected by an electronic clinical decision support system (ECDSS) following the 2015 American Geriatrics Society Beers Criteria, the European Screening Tool of Older Person’s Prescription (STOPP), and the Screening Tool to Alert doctors to Right Treatment (START).

Methods

This was an observational, descriptive, cross-sectional study. The sample included 593 community-dwelling adults aged 65-75 years (henceforth called young seniors), with multimorbidity (≥3 diseases) and polypharmacy (≥5 medications), who had visited their primary care doctor at least once over the last year at 1 of the 38 health care centers participating in the Multimorbidity and Polypharmacy in Primary Care (Multi-PAP) trial. Sociodemographic data, clinical and pharmacological treatment variables, and PIP, as detected by 1 ECDSS, were recorded. A multivariate logistic regression model with robust estimators was built to assess the factors affecting PIP according to the STOPP criteria.

Results

PIP was detected in 57.0% (338/593; 95% CI 53-61) and 72.8% (432/593; 95% CI 69.3-76.4) of the patients according to the STOPP criteria and the Beers Criteria, respectively, whereas 42.8% (254/593; 95% CI 38.9-46.8) of the patients partially met the START criteria. The most frequently detected PIPs were benzodiazepines (BZD) intake for more than 4 weeks (217/593, 36.6%) using the STOPP version 2 and the prolonged use of proton pump inhibitors (269/593, 45.4%) using the 2015 Beers Criteria. Being a woman (odds ratio [OR] 1.43, 95% CI 1.01-2.01; P=.04), taking a greater number of medicines (OR 1.25, 95% CI 1.14-1.37; P<.04), working in the primary sector (OR 1.91, 95% CI 1.25-2.93; P=.003), and being prescribed drugs for the central nervous system (OR 3.75, 95% CI 2.45-5.76; P<.001) were related to a higher frequency of PIP.

Conclusions

There is a high prevalence of PIP in primary care as detected by an ECDSS in community-dwelling young seniors with comorbidity and polypharmacy. The specific PIP criteria defined by this study are consistent with the current literature. This ECDSS can be useful for supervising prescriptions in primary health care consultations.
Capturing At-Home Health and Care Information for Children With Medical Complexity Using Voice Interactive Technologies: Multi-Stakeholder Viewpoint
Authors: Sezgin Emre , Noritz Garey , Elek Alexander , Conkol Kimberly , Rust Steve , Bailey Matthew , Strouse Robert , Chandawarkar Aarti , von Sadovszky Victoria , Lin Simon , Huang Yungui
Published: December 2019

Digital health tools and technologies are transforming health care and making significant impacts on how health and care information are collected, used, and shared to achieve best outcomes. As most of the efforts are still focused on clinical settings, the wealth of health information generated outside of clinical settings is not being fully tapped. This is especially true for children with medical complexity (CMC) and their families, as they frequently spend significant hours providing hands-on medical care within the home setting and coordinating activities among multiple providers and other caregivers. In this paper, a multidisciplinary team of stakeholders discusses the value of health information generated at home, how technology can enhance care coordination, and challenges of technology adoption from a patient-centered perspective. Voice interactive technology has been identified to have the potential to transform care coordination for CMC. This paper shares opinions on the promises, limitations, recommended approaches, and challenges of adopting voice technology in health care, especially for the targeted patient population of CMC.
A Mobile Phone–Based Gait Assessment App for the Elderly: Development and Evaluation
Authors: Zhong Runting , Rau Pei-Luen Patrick
Published: December 2019

Background

Gait disorders are common among older adults. With an increase in the use of technology among older adults, a mobile phone app provides a solution for older adults to self-monitor their gait quality in daily life.

Objective

This study aimed to develop a gait-monitoring mobile phone app (Pocket Gait) and evaluate its acceptability and usability among potential older users.

Methods

The app was developed to allow older adults to track their gait quality, including step frequency, acceleration root mean square (RMS), step regularity, step symmetry, and step variability. We recruited a total of 148 community-dwelling older adults aged 60 years and older from two cities in China: Beijing and Chongqing. They walked in three ways (single task, dual task, and fast walking) using a smartphone with the gait-monitoring app installed and completed an acceptability and usability survey after the walk test. User acceptability was measured by a questionnaire including four quantitative measures: perceived ease of use, perceived usefulness, ease of learning, and intention to use. Usability was measured using the System Usability Scale (SUS). Interviews were conducted with participants to collect open-ended feedback questions.

Results

Task type had a significant effect on all gait parameters, namely, step frequency, RMS, step variability, step regularity, and step symmetry (all P values <.001). Age had a significant effect on step frequency (P=.01), and region had a significant effect on step regularity (P=.04). The acceptability of the gait-monitoring app was positive among older adults. Participants identified the usability of the system with an overall score of 59.7 (SD 10.7) out of 100. Older adults from Beijing scored significantly higher SUS compared with older adults from Chongqing (P<.001). The age of older adults was significantly associated with their SUS score (P=.048). Older adults identified improvements such as a larger font size, inclusion of reference values for gait parameters, and inclusion of heart rate and blood pressure monitoring.

Conclusions

This mobile phone app is a health management tool for older adults to self-manage their gait quality and prevent adverse outcomes. In the future, it will be important to take factors such as age and region into consideration while designing a mobile phone–based gait assessment app. The feedback of the participants would help to design more elderly-friendly products.
A Personalized eHealth Intervention for Lifestyle Changes in Patients With Cardiovascular Disease: Randomized Controlled Trial
Authors: Broers Eva Rosalinde , Kop Willem Johan , Denollet Johan , Widdershoven Jos , Wetzels Mart , Ayoola Idowu , Piera-Jimenez Jordi , Habibovic Mirela
Published: December 2019

Background

Behavior change methods involving new ambulatory technologies may improve lifestyle and cardiovascular disease outcomes.

Objective

This study aimed to provide proof-of-concept analyses of an intervention aiming to increase (1) behavioral flexibility, (2) lifestyle change, and (3) quality of life. The feasibility and patient acceptance of the intervention were also evaluated.

Methods

Patients with cardiovascular disease (N=149; mean age 63.57, SD 8.30 years; 50/149, 33.5% women) were recruited in the Do Cardiac Health Advanced New Generation Ecosystem (Do CHANGE) trial and randomized to the Do CHANGE intervention or care as usual (CAU). The intervention involved a 3-month behavioral program in combination with ecological momentary assessment and intervention technologies.

Results

The intervention was perceived to be feasible and useful. A significant increase in lifestyle scores over time was found for both groups (F2,146.6=9.99; P<.001), which was similar for CAU and the intervention group (F1,149.9=0.09; P=.77). Quality of life improved more in the intervention group (mean 1.11, SD 0.11) than CAU (mean −1.47, SD 0.11) immediately following the intervention (3 months), but this benefit was not sustained at the 6-month follow-up (interaction: P=.02). No significant treatment effects were observed for behavioral flexibility (F1,149.0=0.48; P=.07).

Conclusions

The Do CHANGE 1 intervention was perceived as useful and easy to use. However, no long-term treatment effects were found on the outcome measures. More research is warranted to examine which components of behavioral interventions are effective in producing long-term behavior change.

Trial Registration

ClinicalTrials.gov NCT02946281; https://www.clinicaltrials.gov/ct2/show/NCT02946281
Digital Cognitive Behavioral Therapy for Insomnia for Adolescents With Mental Health Problems: Feasibility Open Trial
Authors: Cliffe Bethany , Croker Abigail , Denne Megan , Smith Jacqueline , Stallard Paul
Published: December 2019

Background

Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated, and the effects of digital cognitive behavioral therapy (CBT) for insomnia (CBTi) on the mental health of adolescents with significant mental health problems are unknown.

Objective

This open study aimed to assess the feasibility of adding supported Web-based CBT for insomnia to the usual care of young people aged 14 to 17 years attending specialist child and adolescent mental health services (CAMHS).

Methods

A total of 39 adolescents with insomnia aged 14 to 17 years attending specialist CAMHS were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence-based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator [SCI], Insomnia Severity Scale, and Web- or app-based sleep diaries), anxiety (Revised Child Anxiety and Depression Scale [RCADS]), and depression (Mood and Feelings Questionnaire [MFQ]) were completed at baseline and post intervention. Postuse interviews assessed satisfaction with digital CBTi.

Results

Average baseline sleep efficiency was very poor (53%), with participants spending an average of 9.6 hours in bed but only 5.1 hours asleep. All participants scored less than 17 on the SCI, with 92% (36/39) participants scoring 15 or greater on the Insomnia Severity Scale, suggesting clinical insomnia. Of the 39 participants, 36 (92%) scored 27 or greater on the MFQ for major depression and 20 (51%) had clinically elevated symptoms of anxiety. The majority of participants (38/49, 78%) were not having any treatment for their insomnia, with the remaining 25% (12/49) receiving medication. Sleepio was acceptable, with 77% (30/39) of the participants activating their account and 54% (21/39) completing the program. Satisfaction was high, with 84% (16/19) of the participants finding Sleepio helpful, 95% (18/19) indicating that they would recommend it to a friend, and 37% (7/19) expressing a definite preference for a digital intervention. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (P=.005) and sleep quality (P=.001) and on measures of sleep (SCI: P=.001 and Insomnia Severity Index: P=.001), low mood (MFQ: P=.03), and anxiety (RCADS: P=.005).

Conclusions

Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and no follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health.

International Registered Report Identifier (IRRID)

RR2-10.2196/11324
Clinical Annotation Research Kit (CLARK): Computable Phenotyping Using Machine Learning
Authors: Pfaff Emily R , Crosskey Miles , Morton Kenneth , Krishnamurthy Ashok
Published: December 2019

Computable phenotypes are algorithms that translate clinical features into code that can be run against electronic health record (EHR) data to define patient cohorts. However, computable phenotypes that only make use of structured EHR data do not capture the full richness of a patient’s medical record. While natural language processing (NLP) methods have shown success in extracting clinical features from text, the use of such tools has generally been limited to research groups with substantial NLP expertise. Our goal was to develop an open-source phenotyping software, Clinical Annotation Research Kit (CLARK), that would enable clinical and translational researchers to use machine learning–based NLP for computable phenotyping without requiring deep informatics expertise. CLARK enables nonexpert users to mine text using machine learning classifiers by specifying features for the software to match in clinical notes. Once the features are defined, the user-friendly CLARK interface allows the user to choose from a variety of standard machine learning algorithms (linear support vector machine, Gaussian Naïve Bayes, decision tree, and random forest), cross-validation methods, and the number of folds (cross-validation splits) to be used in evaluation of the classifier. Example phenotypes where CLARK has been applied include pediatric diabetes (sensitivity=0.91; specificity=0.98), symptomatic uterine fibroids (positive predictive value=0.81; negative predictive value=0.54), nonalcoholic fatty liver disease (sensitivity=0.90; specificity=0.94), and primary ciliary dyskinesia (sensitivity=0.88; specificity=1.0). In each of these use cases, CLARK allowed investigators to incorporate variables into their phenotype algorithm that would not be available as structured data. Moreover, the fact that nonexpert users can get started with machine learning–based NLP with limited informatics involvement is a significant improvement over the status quo. We hope to disseminate CLARK to other organizations that may not have NLP or machine learning specialists available, enabling wider use of these methods.
A Patient-Centered Information System (myED) for Emergency Care Journeys: Design, Development, and Initial Adoption
Authors: Westphal Monika , Yom-Tov Galit Bracha , Parush Avi , Carmeli Nitzan , Shaulov Alina , Shapira Chen , Rafaeli Anat
Published: December 2019

Background

Medical care is highly complex in that it addresses patient-centered health goals that require the coordination of multiple care providers. Emergency department (ED) patients currently lack a sense of predictability about ED procedures. This increases frustration and aggression. Herein, we describe a system for providing real-time information to ED patients regarding the procedures in their ED medical journey.

Objective

This study aimed to develop a system that provides patients with dynamically updated information about the specific procedures and expected waiting times in their personal ED journey, and to report initial evaluations of this system.

Methods

To develop the myED system, we extracted information from hospital databases and translated it using process mining and user interface design into a language that is accessible and comprehensible to patients. We evaluated the system using a mixed methods approach that combined observations, interviews, and online records.

Results

Interviews with patients, accompanying family members, and health care providers (HCPs) confirmed patients’ needs for information about their personal ED journey. The system developed enables patients to access this information on their personal mobile phones through a responsive website. In the third month after deployment, 492 of 1614 (30.48%) patients used myED. Patients’ understanding of their ED journey improved significantly (F8,299=2.519; P=.01), and patients showed positive reactions to the system. We identified future challenges, including achieving quick engagement without delaying medical care. Salient reasons for poor system adoption were patients’ medical state and technological illiteracy. HCPs confirmed the potential of myED and identified means that could improve patient experience and staff cooperation.

Conclusions

Our iterative work with ED patients, HCPs, and a multidisciplinary team of developers yielded a system that provides personal information to patients about their ED journey in a secure, effective, and user-friendly way. MyED communicates this information through mobile technology. This improves health care by addressing patients’ psychological needs for information and understanding, which are often overlooked. We continue to test and refine the system and expect to find positive effects of myED on patients’ ED experience and hospital operations.
Development of a National Caregiver Health Survey for Hematopoietic Stem Cell Transplant: Qualitative Study of Cognitive Interviews and Verbal Probing
Authors: Kedroske Jacob , Koblick Sarah , Chaar Dima , Mazzoli Amanda , O'Brien Maureen , Yahng Lilian , Vue Rebecca , Chappell Grant , Shin Ji Youn , Hanauer David A , Choi Sung Won
Published: December 2019

Background

Roadmap 1.0 is a mobile health app that was previously developed for caregivers of patients who have undergone hematopoietic stem cell transplantation (HSCT). Formative research targeted toward its end users (caregivers) can help inform app design and development, allowing additional components to be incorporated into the app, which can then be tested in a future randomized controlled trial.

Objective

This study aimed to create a methodologically rigorous national survey that would help inform the development of Roadmap 2.0.

Methods

We conducted a prospective, qualitative research study that took place between November 18, 2018, and February 7, 2019, in a blood and marrow transplant unit within a large academic medical institution in the midwestern part of the United States. Cognitive interviews, including think-aloud and verbal probing techniques, were conducted in 10 adult caregivers (≥18 years) of patients who had undergone HSCT.

Results

Most participants were female (9/10, 90%), white (9/10, 90%), married (9/10, 90%), employed at least part time (6/10, 60%), caregivers of adult patients (7/10, 70%), and had some college education (9/10, 90%) and an annual household income of $60,000 or higher (6/10, 60%). All but one interview was audio-recorded, with permission. Overall, participants were engaged in the cognitive interview process of the draft survey, which included 7 topics. The interviews highlighted areas wherein survey items could be further refined, such as offering more response choices (eg, “NA”) or clarifying the type of transplant (eg, autologous or allogeneic) or context of transplant care (eg, pre-HSCT, during HSCT, post-HSCT, inpatient, and outpatient). Apart from these findings, the items in demographics, caregiving experiences, technology, positive activities, and mood were generally interpreted as intended. On the basis of the transcript data and field notes by the interviewer, items within self-efficacy (Caregiver Self-Efficacy Scale) and coping (Brief Coping Orientation to Problems Experienced inventory) questionnaires generated more confusion among interviewer and participants, reflecting difficulties in interpreting the meaning of some survey items.

Conclusions

This study incorporated the four cognitive aspects of survey methodology that describe the question-answering process—(1) comprehension, (2) information retrieval, (3) judgment and decision making, and (4) responding—by using the think-aloud and probing techniques in cognitive interviews. We conclude that this methodologically rigorous process informed revisions and improved our final questionnaire design.

International Registered Report Identifier (IRRID)

RR2-10.2196/resprot.49188
Efficient Reuse of Natural Language Processing Models for Phenotype-Mention Identification in Free-text Electronic Medical Records: A Phenotype Embedding Approach (Preprint)
Authors: Wu Honghan , Hodgson Karen , Dyson Sue , Morley Katherine I , Ibrahim Zina M , Iqbal Ehtesham , Stewart Robert , Dobson Richard JB , Sudlow Cathie
Published: December 2019

BACKGROUND

Much effort has been put into the use of automated approaches, such as natural language processing (NLP), to mine or extract data from free-text medical records in order to construct comprehensive patient profiles for delivering better health care. Reusing NLP models in new settings, however, remains cumbersome, as it requires validation and retraining on new data iteratively to achieve convergent results.

OBJECTIVE

The aim of this work is to minimize the effort involved in reusing NLP models on free-text medical records.

METHODS

We formally define and analyze the model adaptation problem in phenotype-mention identification tasks. We identify “duplicate waste” and “imbalance waste,” which collectively impede efficient model reuse. We propose a phenotype embedding–based approach to minimize these sources of waste without the need for labelled data from new settings.

RESULTS

We conduct experiments on data from a large mental health registry to reuse NLP models in four phenotype-mention identification tasks. The proposed approach can choose the best model for a new task, identifying up to 76% waste (duplicate waste), that is, phenotype mentions without the need for validation and model retraining and with very good performance (93%-97% accuracy). It can also provide guidance for validating and retraining the selected model for novel language patterns in new tasks, saving around 80% waste (imbalance waste), that is, the effort required in “blind” model-adaptation approaches.

CONCLUSIONS

Adapting pretrained NLP models for new tasks can be more efficient and effective if the language pattern landscapes of old settings and new settings can be made explicit and comparable. Our experiments show that the phenotype-mention embedding approach is an effective way to model language patterns for phenotype-mention identification tasks and that its use can guide efficient NLP model reuse.
Perceptions of Patients Regarding Mobile Health Interventions for the Management of Chronic Obstructive Pulmonary Disease: Mixed Methods Study (Preprint)
Authors: Alwashmi Meshari F , Fitzpatrick Beverly , Farrell Jamie , Gamble John-Michael , Davis Erin , Nguyen Hai Van , Farrell Gerard , Hawboldt John
Published: December 2019

BACKGROUND

Using a mobile health (mHealth) intervention consisting of a smartphone and compatible medical device has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes while mitigating health care costs.

OBJECTIVE

This study aims to describe the demographics, use, and access to smartphones of patients with COPD. It also aims to explore and develop an understanding of potential facilitators and barriers that might influence patients using mHealth interventions for COPD management.

METHODS

This was an explanatory, sequential mixed methods study. Patients who attended respirology clinics completed a questionnaire on technology access and use. We conducted semistructured individual interviews with the patients. Interview topics included the following: demographics, mHealth use, perceptions toward challenges of mHealth adoption, factors facilitating mHealth adoption, and preferences regarding features of mHealth interventions for COPD management.

RESULTS

A total of 100 adults completed the survey but 22 participants were excluded because they were not diagnosed with COPD. Of these, 10 patients with COPD participated in the interview. The quantitative component revealed that many patients with COPD owned a mobile phone, but only about one-fourth of the participants (18/77, 23%) owned a smartphone. The likelihood of owning a smartphone was not associated with age, sex, marital status, or geographical location, but patients with high educational status were more likely to own a smartphone. The qualitative component found that patients with COPD, in general, had a positive attitude toward mHealth adoption for COPD management, but several facilitators and barriers were identified. The main facilitators of mHealth adoption are possible health benefits for patients, ease of use, educating patients, and credibility. Alternatively, the barriers to adoption are technical issues, lack of awareness, potential limited uptake from older adults, privacy and confidentiality issues, finances, and lack of interest in mHealth

CONCLUSIONS

It is important to understand the perceptions of patients with COPD regarding the adoption of innovative mHealth interventions for COPD management. This study identifies some potential facilitators and barriers that may inform the successful development and implementation of mHealth interventions for COPD management.
Acceptance and Use of Information Technology: Understanding Information Systems for Indonesia’s Humanitarian Relief Operations
Authors: Dwiputranti Made Irma , Oktora Raden Adriyani , Okdinawati Liane , Fauzan Mohamad Nurkamal
Published: December 2019

Disaster management includes distributing logistical assistance to disaster victims. The implementation of this distribution must occur at the right time, at an appropriate location, on target and be appropriate to the needs of the victims. This research aims to design an information system to improve the performance of disaster relief operations by managing the information while monitoring and evaluating humanitarian relief operations.Consequently, understanding the primary determinants of user acceptance behavior has become a vital aspect in the successful implementation of the information system. The Unified Theory of Acceptance and Use of Technology (UTAUT) model is a tool to investigate and give a better understanding of the factors that affect the potential users’ acceptance and use of an information system. This research used 131 different informants from different groups of potential users to measure performance expectancy, effort expectancy, social influence, and facilitating conditions. The results have shown strong relationships between four aspects of the measurements for the acceptance of all parties involved in humanitarian relief operations.
DO LEADERSHIP STYLES MODERATE THE RELATIONSHIP OF ORGANIZATIONAL COMMITMENT AND BUDGETARY SLACK? AN EXPERIMENTAL APPROACH
Authors: Islami Imas Nurani , Nahartyo Ertambang
Published: December 2019

Introduction: this study aims to provide empirical evidence of the factors that can mitigate and encourage budgetary slack. Specifically, this study examines the effect of affective organizational commitment on budgetary slack with the style of leadership as a moderating variable. Background Problems: budgetary slack is an unethical action that often occurs in companies and little attention is given to companies that experience losses, especially when it is related to the suboptimal allocation of resources. Novelty: Previous studies paid little attention to the direct relationship between affective organizational commitment and budgetary slack. They were limited to investigating the correlation between affective organizational commitment and budgetary slack. This study provides evidence of causality between the two and includes the style of leadership as a moderating factor. Research Methods: This research is conducted through an experimental approach using a 2 x 2 between-subjects design. The participants of this research are 64 from the Master of Management (MM) program at Gadjah Mada University (UGM). Findings: The result of this study indicates that middle managers with high affective organizational commitment create a smaller budgetary slack than the middle managers with low affective organizational commitment. However, the leadership style is not proven to moderate the relationship between affective organizational commitment and budgetary slack. Conclusion: These findings provide theoretical evidence of the self-determination theory that an individual with high affective organizational commitment creates a smaller budgetary slack than an individual with low affective organizational commitment. Therefore, companies need to pay more attention to their employees’ commitment.
ANTIDEPRESSANT-LIKE ACTIVITY OF TRANS-ANETHOLE IN UNSTRESSED MICE AND STRESSED MICE
Authors: DINESH DHINGRA  , SUDHA
Published: December 2019

Objectives: The present study was undertaken to investigate the antidepressant potential of trans-anethole in unstressed and stressed male mice.

Methods: Swiss albino male mice were exposed to chronic unpredictable mild stress for 21 successive days. Simultaneously, trans-anethole (12.5 mg/kg, 25 mg/kg, and 50 mg/kg) and fluoxetine (20 mg/kg) per se were administered for 21 successive days to separate groups of unstressed and stressed mice. The effect of drugs on depressive-like behavior of mice was tested by tail suspension test (TST) and sucrose preference test.

Results: Trans-anethole (25 mg/kg) and fluoxetine significantly decreased the immobility period of unstressed and stressed mice in TST as compared to their respective control. These drugs significantly restored the reduced sucrose preference (%) in stressed mice. Trans-anethole did not show any significant effect on locomotor activity of mice. Antidepressant-like activity of trans-anethole (25 mg/kg) was found to be comparable to fluoxetine. Trans-anethole and fluoxetine significantly inhibited brain monoamine oxidase-A (MAO-A) activity, decreased plasma nitrite, brain malondialdehyde, and increased brain reduced glutathione levels and catalase activity in unstressed and stressed mice. The drugs significantly reversed stress-induced increase in plasma corticosterone levels.

Conclusion: Trans-anethole produced significant antidepressant-like activity in unstressed and stressed mice, possibly through inhibition of brain MAO-A activity and alleviation of oxidative stress. Reversal of stress-induced increase in plasma corticosterone levels might also be responsible for antidepressant-like activity of trans-anethole in stressed mice.
CHEMICAL CONSTITUENTS AND PHARMACOLOGICAL ACTIVITIES OF LANTANA CAMARA – A REVIEW
Authors: ALI ESMAIL AL-SNAFI
Published: December 2019

Objective: The review was designed to investigate the traditional uses, chemical constituents and pharmacological effects of Lantana camara.

Methods: In the current review, databases including Web Science, Pub Med, Scopus and Science Direct, were searched to investigate the chemical constituents and pharmacological effects of Lantana camara.

Results: The plant contained alkaloids, glycosides, steroids, saponins, flavanoids, coumarins, tannins, carbohydrates, hydroxy anthraquinones, anthraquinone glycosides, proteins, phytosteroids, fixed oils, fats, and triterpinoids. Previous pharmacological studies revealed that Lantana camara possessed antimicrobial, antiparasitic, anxiolytic, gastrointestinal, hypoglycemic, cardiovascular, antioxidant, anticancer, antiinflammatory, analgesic, wound healing, antiurolithiatic, hepatoprotective, reproductive, anti–hemorrhoidal, thrombin inhibition and many other effects.

Conclusion: Lantana camara represents a promising medicinal plant with a wide range of pharmacological activities that could be utilized in several medical applications because of its effectiveness and safety.