bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning
Authors: Xu Wan , Sun Nan-Nan , Gao Hai-Nv , Chen Zhi-Yuan , Yang Ya , Ju Bin , Tang Ling-Ling
Published: September 2020

COVID-19 is a newly emerging infectious disease, which is generally susceptible to human beings and has caused huge losses to people's health. Acute respiratory distress syndrome (ARDS) is one of the common clinical manifestations of severe COVID-19 and it is also responsible for the current shortage of ventilators worldwide. This study aims to analyze the clinical characteristics of COVID-19 ARDS patients and establish a diagnostic system based on artificial intelligence (AI) method to predict the probability of ARDS in COVID-19 patients. We collected clinical data of 659 COVID-19 patients from 11 regions in China. The clinical characteristics of the two groups were elaborately compared and both traditional machine learning algorithms and deep learning-based methods were used to build the prediction models. Results indicated the median age of ARDS patients was 56.5 years old, which was significantly older than those with non-ARDS by 7.5 years. Male and patients with BMI>25 were more likely to develop ARDS. The clinical features of ARDS patients included cough (80.3%), polypnea (59.2%), lung consolidation (53.9%), secondary bacterial infection (30.3%), and comorbidities such as hypertension (48.7%). Abnormal biochemical indicators such as lymphocyte count, leukocyte counting, CK, NLR, AST, LDH, and CRP were all strongly related to the aggravation of ARDS. Furthermore, through various AI methods for modeling and prediction effect evaluation based on the above risk factors, decision tree achieved the best AUC, sensitivity, and specificity in identifying the mild patients who were easy to develop ARDS, which undoubtedly helps to optimize the treatment strategy, reduce mortality, and relieve the medical pressure.
A glimpse into the diverse cellular immunity against SARS-CoV-2 
Authors: Chang Lung-Ji , Chang Cheng-Wei , Liu Yuchen , Jiao Cheng , Liu Hongwei , Chen Xiaochuan
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific cellular immune response may prove to be essential for long-term immune protection against the novel coronavirus disease 2019 (COVID-19). To assess COVID-19-specific immunity in the population, we synthesized selected peptide pools of SARS-CoV-2 structural and functional proteins, including Spike (S), Membrane (M), envelope (E), Nucleocapsid (N) and Protease (P) as target antigens. Survey of the T cell precursur frequencies in healthy individuals specific to these viral antigens demonstrated a diverse cellular immunity, including high, medium, low and no responders. This was further confirmed by in vitro induction of anti-SARS-CoV-2 T cell immune responses using dendritic cell (DC)/T cell coculture, which was consistent with the corresponding T cell precursor frequencies in each individual tested. In general, the combination of all five antigenic pools induced the strongest cellular immune response, and individual donors responded differently to different viral antigens. Importantly, a secondary in vitro booster stimulation of the T cells with the DC-peptides induced increased anti-viral immune responses in all individuals even in the no responders, suggesting that booster immunization in a vaccine scheme may elicit a broad protection in immune naïve population. Our analysis illustrates the critical role of cellular immunity in fighting COVID-19 and the importance of analyzing anti-SARS-CoV-2 T cell response in addition to antibody response in the population.
Application of disease model to ascertain risk-mitigation strategies during COVID-19 pandemic in 2020, an example from resource-constrained urban settings in Pakistan
Authors: HASSAN SHOAIB , Salman Mo , Mustafa Tehmina
Published: September 2020

Most COVID-19 affected resource-constrained settings have not ascertained their disease prevalence that pose a risk for global health. In wake of limited diagnostics and research capacity in such settings, this disease forecasting model provides an example to be adapted for evidence-based response efforts. Using officially reported data, this model forecasted COVID-19 prevalence in cosmopolitan cities. Several risk-mitigation strategies were analyzed for effectiveness in controlling disease incidence. Moreover, the reproduction rates to ascertain transmission, herd-immunity threshold, and performance of required laboratory tests were studied. The severe-critical cases were relatively low due to larger young population. Following any risk-mitigation strategy, at end of first wave, a susceptible population remained at risk of recurrent COVID-19 transmission. The herd-immunity threshold was in accordance with global estimates but would need careful monitoring based on adopted risk-mitigation strategy and variation in vaccines’ efficacy. A test-gap between performed vs required laboratory tests led to miss several cases from getting diagnosed. First of its kind, this study estimates sub-national COVID-19 prevalence in dense-urban living in low-middle income settings. Future response policies should consider such evidence to prevent recurrent COVID-19 waves of transmission. Unless sustained herd-immunity is achieved by effective immunization, risk of re-introduction to vulnerable population would remain.
The morbidity and mortality of non-small cell lung cancer in low risk areas of the COVID-19
Authors: Yu Minhao , Cheng Yalin
Published: September 2020

Objective: To analyze the morbidity and mortality of non-small cell lung cancer and evaluate treatment strategies for non-small cell lung cancer patients in low-risk areas of the COVID-19.Materials and methods: We selected patients in the hospital in Sichuan Science City Hospital from September 2019 to February 2020 as research subjects and divided them into experimental and control groups. The evaluation of treatment strategy was based on morbidity and mortality.Results: There were 9010 patients hospitalized. The total morbidity was 0.699%, which was 0.504% in the control group and 0.991% in the experimental group (P=0.024). The total mortality was 0.887 /103, which was 0.840/103 in the control group (4/4764) and 0.942/103 in the experimental group (P=0.998). The patients discontinued therapy or follow-up and cancer progression in the experimental group was significantly higher than that in the control group (P＜0.001, =0.007). Most of the discontinued and progressive cancer patients were elderly and in late stage.Conclusion: The morbidity of NSCLC during the COVID-19 pandemic was significantly high. The mortality in the experimental group was slightly higher than that in the control group, while the difference in cancer progression was significant. It is practicable to perform surgery for early-stage NSCLC patients and undesirable to suspend treatment for late-stage patients in low-risk areas.
SARS-CoV-2 Infection is a frequent cause of pulmonary failure in 2020, but not the only one – a case report
Authors: Metz Carlos , Rixecker Torben , Mang Sebastian , Becker André , Maßmann Alexander , Becker Sören L. , Papan Cihan , Gärtner Barbara , Seiler Frederik , Danziger Guy , Bals Robert , Lepper Philipp M.
Published: September 2020

Background In 2020, a novel coronavirus caused a global pandemic with a clinical picture termed COVID-19 accounting for numerous cases of ARDS. However, there are still other infectious causes of ARDS that should be considered, especially, as the majority of these pathogens are specifically treatable. Case Presentation We present the case of a 36-year-old gentleman who was admitted to the hospital with flu-like symptoms after completing a half-marathon one week before admission. As infection with SARS-CoV2 was suspected based on radiologic imaging, the hypoxemic patient was immediately transferred to the ICU, where he developed ARDS. Empiric antimicrobial chemotherapy was initiated, the patient deteriorated further, therapy was changed and the patient was transferred to a tertiary care ARDS center. As cold agglutinins were present, the hypothesis of an infection with SARS-CoV-2 was then questioned. Bronchoscopic sampling revealed Mycoplasma (M.) pneumoniae. When antimicrobial chemotherapy was adjusted, the patient recovered quickly. Conclusion Usually, M. pneumoniae causes mild disease. When antimicrobial chemotherapy was adjusted, the patient recovered quickly. The case underlines the importance of adhering to established treatment guidelines, scrutinizing treatment modalities and not forgetting other potential causes of severe pneumonia or ARDS.
Bridging the Digital Divide: A National Survey Assessing Public Readiness for Digital Health Strategies Against COVID-19 within the United Kingdom
Authors: Sounderajah Viknesh , Clarke Jonathan , Yalamanchili Seema , Acharya Amish , Markar Sheraz R. , Ashrafian Hutan , Darzi Ara
Published: September 2020

Digital health technologies are a major feature of contemporary public health strategies, particularly in relation to the COVID-19 pandemic. However, digital initiatives risk excluding vulnerable groups, thereby propagating poor health outcomes. We assessed how groups at higher risk from COVID-19 report their relationships with key digital health initiatives in the United Kingdom. We found that those who are female, over 60 and of a lower social group are less confident in using digital information to make health decisions. Those over 40, from lower social groups and of lower educational attainment use digital resources less often in seeking COVID-19 health information. Lastly, those over 60, from lower social groups and of lower educational attainment are less confident in distinguishing reliable digital COVID-19 information. This suggests that a ‘digital first’ model of COVID-19 pandemic management may exacerbate existing digital and health inequalities by reinforcing barriers to health information and public health services.
Lower Rate of COVID-19 in Lupus Patients Receiving Immunosuppressive Drug Regimens
Authors: Damirchi Mohammadrafi , Roshandel Gholamreza , Aghaie Mehrdad , Sedighi Sima , Tavassoli Samaneh , Hassani Mohammadjavad , Abdolahi Nafiseh
Published: September 2020

Introduction Recently, due to the COVID-19 pandemic much concern has been raised about chronic diseases, which could possibly make patients more susceptible, and vulnerable to COVID-19. One of them, is Systemic Lupus Erythematosus(SLE). Objective This study has tried to find the prevalence of COVID-19 in SLE patients in Golestan province of Iran, and to characterize the clinical course of COVID-19 in these patients. This study has also sought to find possible correlation between the incidence of COVID-19, its clinical manifestations and the medication taken by SLE patients. Methods We investigated patients who had been enrolled in our rheumatologic diseases registry system. Patients responded to a questionnaire which contained questions about their primary disease, comorbidities, medications, development of new symptoms, and medical services which they received, pertinent to COVID-19, during the period of COVID-19 outbreak. The data were analyzed using SPSS 16 software. Results This investigation found 25 (7%) COVID-19 positive patients out of the 355 responders. 8 (40%) of them were hospitalized, out of which 2 (8%) required intensive care and later expired. COVID-19 incidence was significantly lower in the immunosuppressed group (2.2% vs 10% P-value 0.005). We didn’t find a significant correlation between hydroxychloroquine consumption, and the incidence of COVID-19 in SLE patients. Fever, fatigue, dyspnea, and dry cough were the most common clinical symptoms.Conclusion Our research has shown that COVID-19 prevalence was lower in immunosuppressed patients. However, broader studies should be conducted to clarify the role of immunosuppression in the development of COVID-19. More research is required.
HOMEOPATIA E SUPLEMENTO ALIMENTAR NO CRESCIMENTO DE FILHOTES DE PERIQUITO AUSTRALIANO (MELOPSITTACUS UNDULATUS)
Authors: Navarro Rodrigo Diana , Martins Jessica , Paz Vanair carlos
Published: September 2020

O experimento foi feito a partir de um Delineamento Inteiramente Casualizado com 3 diferentes tratamentos e 4 repetições, sendo o tratamento 1: suplemento alimentar, tratamento 2: homeopatia e o tratamento 3: controle. Os resultados da análise de peso mostraram que os filhotes que receberam o suplemento alimentar tiveram um maior ganho de peso (33,8g), seguidos dos animais que receberam a homeopatia(33,6g) e por último o grupo controle (30,2g). A média de ganho de peso diário dos filhotes do grupo com suplemento alimentar foi de 1,69 gramas, do grupo com homeopatia foi de 1,68 gramas e o grupo controle 1,51 gramas. Este trabalho teve como objetivo geral analisar e comparar o crescimento de filhotes de Periquitos Australianos (Melopsittacus undulatus) tratados com  homeopatias Calcarea carbonica (12 CH) e Carbo vegetalis (12 CH) e o suplemento alimentar Organew®.
DESENVOLVIMENTO E AVALIAÇÃO FÍSICO-QUÍMICA DE SORVETE DE MANGA ‘TOMMY AKTINS’ A BASE DE LEITE DE CABRA
Authors: Coelho Bruno Emanuel Souza , De Oliveira Erica Antonia Matos , Guimarães Weslem do Nascimento , Santos Ruana de Jesus , Miranda Carlos Victor de Castro , De Sousa Karla dos Santos Melo
Published: September 2020

O presente artigo teve como objetivo desenvolver três formulações de sorvete de leite de cabra saborizados com diferentes teores de polpa de manga ‘Tommy Aktins’ (7, 13 e 19%), e avaliar os atributos físico-químicos da matéria-prima e formulações. As formulações foram avaliadas quanto aos parâmetros físico-químicos de: pH, acidez titulável, sólidos totais, umidade, sólidos solúveis, vitamina C; e cor (L*, C* e ºH). As formulações desenvolvidas classificaram-se como um alimento pouco ácido quanto ao pH, teores de sólidos totais e umidade de acordo com a legislação brasileira vigente. As amostras apresentaram baixo teor de Vitamina C. O aumento do percentual de polpa para saborização promoveu saturação de cores, tornando mais brilhante e atrativo o produto, além de caracterizar como produto de coloração amarelada, lembrando a cor da matéria prima utilizada.
Experiments on two techniques for the removal of barite from detrital zircon
Authors: Martin Aaron J. , Guerrero-Juarez Edna L. , Rocha-Estopier Claudia L.
Published: September 2020

Barite (BaSO4) is a common mineral in sandstone that must be removed during separation of detrital zircon (ZrSiO4). One widespread technique for the removal of barite exploits its lesser tenacity by milling the barite and zircon mixture in a ball mill. Here we test the extent to which such milling affects zircon and thus whether the milling could introduce bias into the detrital zircon sample. We then describe a new chemical technique for the removal of barite from detrital zircon. We find that milling a mixture of barite and zircon both breaks and causes loss of zircon grains, potentially introducing bias into a detrital zircon sample. Boiling barite in a 0.94 molar aqueous solution of sodium carbonate for 4 h converts most grains to barium carbonate. The barium carbonate grains are opaque white and thus visually distinguishable from zircon, allowing separation by hand under a stereoscopic microscope. Alternatively, the barium carbonate grains can be dissolved by boiling in 16 wt% nitric acid for 30 min. In our experiments, boiling zircon in sodium carbonate solution and/or concentrated (65 wt%) nitric acid cleaned the surfaces of and the cracks in the grains but did not visibly change the zircon surfaces in other ways. Boiling only in concentrated nitric acid did not measurably affect the U-Pb and Lu-Hf isotopic systems in zircon interiors, and boiling in a sodium carbonate solution followed by concentrated nitric acid did not detectably alter the Lu-Hf isotopic system. However, boiling in a concentrated sodium carbonate solution followed by concentrated nitric acid did disturb the U-Pb isotopic system in zircon interiors. We recognize this disturbance due to a ~0.5% reduction in 206Pb/238U dates of treated zircon. Our results highlight the importance of proper technique during zircon isolation to minimize the introduction of bias into the sample.
Incorporation of tetrahedral ferric iron into hydrous ringwoodite
Authors: Thomson Andrew R. , Piltz Ross O. , Crichton Wilson A. , Cerantola Valerio , Ezad Isra S. , Dobson David P. , Wood Ian G. , Brodholt John P.
Published: September 2020

Hydrous Fo91 ringwoodite crystals were synthesized at 20 GPa and high-temperature conditions using a multi-anvil press. Recovered crystals were analyzed using electron microprobe analysis, Raman spectroscopy, infrared spectroscopy, synchrotron Mössbauer spectroscopy, single-crystal X-ray diffraction, and single-crystal Laue neutron diffraction, to carefully characterize the chemistry and crystallography of the samples. Analysis of the combined data sets provides evidence for the presence of tetrahedrally coordinated ferric iron and multiple hydrogen incorporation mechanisms within these blue-colored iron-bearing ringwoodite crystals. Tetrahedral ferric iron is coupled with cation disorder of silicon onto the octahedrally coordinated site. Cation disorder in mantle ringwoodite minerals may be promoted in the presence of water, which could have implications for current models of seismic velocities within the transition zone. Additionally, the presence of tetrahedrally coordinated ferric iron may cause the blue color of many ringwoodite and other high-pressure crystals.
Inhibition of Amyloid Fibrillation of HEWL by 4-Methylcoumarin and 4-Methylthiocoumarin Derivatives
Authors: Kumar Shivani , Kumar Manoj , Tyagi Yogesh K. , Kumar Suresh
Published: September 2020

Background:

Several human diseases like Parkinson’s, Alzheimer’s disease, and systemic
amyloidosis are associated with the misfolding and aggregation of protein molecules.

Objective:

The present study demonstrated the comparison of 4-methyl coumarin and 4-methylthiocoumarin
derivative for their anti-amyloidogenic and disaggregation activities. The hen egg-white lysozyme
is used as a model system to study protein aggregation and disaggregation under in vitro conditions.

Methods:

Techniques used in the study were Thioflavin T fluorescence assay, intrinsic fluorescence
assay, circular dichroism, transmission electron microscopy, and molecular dynamics.

Results:

Fifteen compounds were screened for their anti-amyloidogenic and disaggregation potential.
Six compounds significantly inhibited the fibril formation, whereas ten compounds showed disaggregation
property of pre-formed fibrils. Under in vitro conditions, the compound C3 and C7 showed significant
inhibition of fibril formation in a concentration-dependent manner as compared to control. C3
and C7 demonstrated 93% and 76% inhibition of fibril formation, respectively. Furthermore, C3 and
C7 exhibited 83% and 76% disaggregation activity, respectively, of pre-formed HEWL fibrils at their
highest concentration. These anti-amyloidogenic and disaggregation potential of C3 and C7 were validated
by intrinsic fluorescence, CD, molecular dynamics, and TEM study.

Discussion:

4-methylthiocoumarins derivatives have shown better anti-amyloidogenic activity as compared
to 4-methylcoumarin derivatives for both amyloid formation as well as disaggregation of preformed
amyloid fibrils. Structurally, the derivatives of 4-methylthiocoumarins (C3 and C7) contain
thio group on 2nd position that might be responsible for anti-amyloidogenic activity as compared to 4-
methylcoumarin derivatives (C2 and C4).

Conclusion:

C3 and C7 are novel 4-methylthiocoumarin derivatives that can be used as a lead for
alleviation and symptoms associated with protein aggregation disorders.
ASPM Predicts Poor Clinical Outcome and Promotes Tumorigenesis for Diffuse Large B-cell Lymphoma
Authors: Wu Jingjing , He Zhengmei , Zhu Yaning , Jiang Chao , Deng Yuan , Wei Bin
Published: September 2020

Background:

Abnormal spindle-like microcephaly-associated protein (ASPM) has been
implicated in the aggressive behavior of several malignant tumors. However, its potential effects
on diffuse large B-cell lymphoma (DLBCL) still remain unknown.

Methods:

ASPM levels were determined by immunohistochemically in DLBCL tissues from 54 patients
and 15 reactive lymphoid hyperplasia (RLH) tissues as control, and its association with clinical
features and overall survival were evaluated. The effects of ASPM on cell growth, cell apoptosis
and cell cycle of DLBCL cells were assessed. Bioinformatics, quantitative RT-PCR and western
blotting were conducted for mechanic investigation.

Results:

ASPM expression was upregulated in DLBCL tissues compared with RLH tissues. Its
high expression was correlated with inferior clinicopathological characteristics and poor outcomes
of DLBCL patients. Multivariate analysis revealed that high ASPM expression emerged as an independent
factor for poor prognosis. In DLBCL cell lines, silencing of ASPM suppressed cell
growth, induced cell apoptosis and arrested the cell cycle. Mechanically, effects of ASPM knockdown
on DLBCL cells were partially dependent on its block of the Wnt/β-catenin pathway.

Conclusion:

Collectively, our results suggested that ASPM potentially served as a predictive biomarker
of DLCBL tumorigenesis and prognosis, representing a potential therapeutic target for DLCBL.
Urea-SCR System Development in the Mitigation of NOx Emissions from Diesel Engines – A Review Study
Authors: Mehregan Mina
Published: September 2020

Introduction:

Due to energy demand concerns, diesel engines have gained much attraction
recently compared to petrol engines because of their higher thermal efficiencies. However,
they emit a larger amount of NOx emissions into the atmosphere.

Objective:

Nitrogen oxides are known as important ambient air pollutants that are responsible for
health problems, forest damage, and buildings corrosion. Therefore, using emissions control strategies
for diesel engines is required in order to have a cleaner environment. Urea-SCR (selective catalytic
reduction of NOx by urea) after-treatment system is considered as one of the most efficient
techniques available to reduce engine-out NOx emissions sufficiently.

Conclusion:

This review article discusses all the methods suggested to diminish nitrogen oxides
emissions and then presents a comprehensive survey on developing urea-SCR unit -whether from
catalyst development aspect or from injection system modification point of view- in diesel engines
to meet strict emissions regulations.
A New Threat to Mankind: COVID 19 - All You Need to Know
Authors: Patil Mrunali , Patil Tosh
Published: September 2020

The devastating COVID 19 Pandemic, which set an outbreak by the end of 2019, has led the
whole world into an alarming situation. So, considering the need of the time, we decided to put some
light on the important aspects of the pandemic. Here we have discussed the different coronaviruses
which can affect humans and also how this new coronavirus is different than the previously identified
coronaviruses. In general, SARS CoV-2 is elaborated along with origin, virology, and transmission. The
disease (COVID 19) is studied and briefed for its prognosis and symptoms and as to how the detection
of the infection is done. As we know that we have not found any full proof solution for this outbreak but
can fight it to save mankind, the need for new drug development and the current scenario on available
options is discussed along with how the world is combatting the situation to stop its spread. Also, the
common myths among the public about the disease are busted here. The paper is concluded with the current
statistics of the outbreak. The purpose of this paper is to provide the general public with some
know-how of the pandemic.
Elaborating Models of eHealth Governance: Qualitative Systematic Review
Authors: Ekeland Anne Granstrom , Linstad Line Helen
Published: September 2020

Background

Large-scale national eHealth policy programs have gained attention not only for benefits but also for several unintended consequences and failed expectations. Given the complex and mixed accounts of the results, questions have been raised on how large-scale digitalization programs are governed to reach health policy goals of quality improvement and equal access along with necessary digital transformations. In this qualitative systematic review, we investigate the following question: How is governance implemented and considered in the studies included in the qualitative review?

Objective

The aim of this study is to arrive at informed and recognizable conceptualizations and considerations of models of governance connected to eHealth, as presented and discussed in the scientific literature. In turn, we hope our results will help inform the discussion of how to govern such processes to obtain collectively negotiated objectives.

Methods

A qualitative systematic review is a method for integrating or comparing with the findings from qualitative studies. It looks for “themes” or “constructs” that lie in or across individual qualitative studies. This type of review produces a narrative synthesis with thematic analysis and includes interpretive conceptual models. The goal is an interpretation and broadens the understanding of a particular phenomenon. We searched the PubMed database using predefined search terms and selected papers published from 2010 onwards. We specified the criteria for selection and quality assessment.

Results

The search returned 220 papers. We selected 44 abstracts for full-text reading, and 11 papers were included for full-text synthesis. On the basis of the 11 papers, we constructed four governance models to categorize and conceptualize the findings. The models are political governance, normally depicting top-down processes; medical governance, which normally depicts bottom-up processes; the internet and global model, emphasizing international business strategies coupled with the internet; self-governance, which builds upon the development of the internet and Internet of Things, which has paved the way for personal governance and communication of one’s own health data.

Conclusions

Collective negotiations between the nation-state and global policy actors, medical and self-governance actors, and global business and industry actors are essential. Technological affordances represent both positive and negative opportunities concerning the realization of health policy goals, and future studies should scrutinize this dynamic.
Cognitive Training Using Fully Immersive, Enriched Environment Virtual Reality for Patients With Mild Cognitive Impairment and Mild Dementia: Feasibility and Usability Study
Authors: Yun Seo Jung , Kang Min-Gu , Yang Dongseok , Choi Younggeun , Kim Heejae , Oh Byung-Mo , Seo Han Gil
Published: September 2020

Background

Cognitive training using virtual reality (VR) may result in motivational and playful training for patients with mild cognitive impairment and mild dementia. Fully immersive VR sets patients free from external interference and thus encourages patients with cognitive impairment to maintain selective attention. The enriched environment, which refers to a rich and stimulating environment, has a positive effect on cognitive function and mood.

Objective

The aim of this study was to investigate the feasibility and usability of cognitive training using fully immersive VR programs in enriched environments with physiatrists, occupational therapists (OTs), and patients with mild cognitive impairment and mild dementia.

Methods

The VR interface system consisted of a commercialized head-mounted display and a custom-made hand motion tracking module. We developed the virtual harvest and cook programs in enriched environments representing rural scenery. Physiatrists, OTs, and patients with mild cognitive impairment and mild dementia received 30 minutes of VR training to evaluate the feasibility and usability of the test for cognitive training. At the end of the test, the usability and feasibility were assessed by a self-report questionnaire based on a 7-point Likert-type scale. Response time and finger tapping were measured in patients before and after the test.

Results

Participants included 10 physiatrists, 6 OTs, and 11 patients with mild cognitive impairment and mild dementia. The mean scores for overall satisfaction with the program were 5.75 (SD 1.00) for rehabilitation specialists and 5.64 (SD 1.43) for patients. The response time of the dominant hand in patients decreased after the single session of cognitive training using VR, but this was not statistically significant (P=.25). There was no significant change in finger tapping in either the right or left hand (P=.48 and P=.42, respectively). None of the participants reported headaches, dizziness, or any other motion sickness after the test.

Conclusions

A fully immersive VR cognitive training program may be feasible and usable in patients with mild cognitive impairment and mild dementia based on the positive satisfaction and willingness to use the program reported by physiatrists, OTs, and patients. Although not statistically significant, decreased response time without a change in finger tapping rate may reflect a temporary increase in attention after the test. Additional clinical trials are needed to investigate the effect on cognitive function, mood, and physical outcomes.
Disaster eHealth: Scoping Review
Authors: Madanian Samaneh , Norris Tony , Parry Dave
Published: September 2020

Background

Although both disaster management and disaster medicine have been used for decades, their efficiency and effectiveness have been far from perfect. One reason could be the lack of systematic utilization of modern technologies, such as eHealth, in their operations. To address this issue, researchers’ efforts have led to the emergence of the disaster eHealth (DEH) field. DEH’s main objective is to systematically integrate eHealth technologies for health care purposes within the disaster management cycle (DMC).

Objective

This study aims to identify, map, and define the scope of DEH as a new area of research at the intersection of disaster management, emergency medicine, and eHealth.

Methods

An extensive scoping review using published materials was carried out in the areas of disaster management, disaster medicine, and eHealth to identify the scope of DEH. This review procedure was iterative and conducted in multiple scientific databases in 2 rounds, one using controlled indexed terms and the other using similar uncontrolled terms. In both rounds, the publications ranged from 1990 to 2016, and all the appropriate research studies discovered were considered, regardless of their research design, methodology, and quality. Information extracted from both rounds was thematically analyzed to define the DEH scope, and the results were evaluated by the field experts through a Delphi method.

Results

In both rounds of the research, searching for eHealth applications within DMC yielded 404 relevant studies that showed eHealth applications in different disaster types and disaster phases. These applications varied with respect to the eHealth technology types, functions, services, and stakeholders. The results led to the identification of the scope of DEH, including eHealth technologies and their applications, services, and future developments that are applicable to disasters as well as to related stakeholders. Reference to the elements of the DEH scope indicates what, when, and how current eHealth technologies can be used in the DMC.

Conclusions

Comprehensive data gathering from multiple databases offered a grounded method to define the DEH scope. This scope comprises concepts related to DEH and the boundaries that define it. The scope identifies the eHealth technologies relevant to DEH and the functions and services that can be provided by these technologies. In addition, the scope tells us which groups can use the provided services and functions and in which disaster types or phases. DEH approaches could potentially improve the response to health care demands before, during, and after disasters. DEH takes advantage of eHealth technologies to facilitate DMC tasks and activities, enhance their efficiency and effectiveness, and enhance health care delivery and provide more quality health care services to the wider population regardless of their geographical location or even disaster types and phases.
Barriers to Creating Scalable Business Models for Digital Health Innovation in Public Systems: Qualitative Case Study
Authors: Kelley Leah Taylor , Fujioka Jamie , Liang Kyle , Cooper Madeline , Jamieson Trevor , Desveaux Laura
Published: September 2020

Background

Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging.

Objective

This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs.

Methods

This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women’s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation.

Results

A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system’s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs’ business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals.

Conclusions

There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients’ well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.
Ethical Challenges and Opportunities Associated With the Ability to Perform Medical Screening From Interactions With Search Engines: Viewpoint
Authors: Yom-Tov Elad , Cherlow Yuval
Published: September 2020

Recent research has shown the efficacy of screening for serious medical conditions from data collected while people interact with online services. In particular, queries to search engines and the interactions with them were shown to be advantageous for screening a range of conditions including diabetes, several forms of cancer, eating disorders, and depression.
These screening abilities offer unique advantages in that they can serve a broad strata of the society, including people in underserved populations and in countries with poor access to medical services. However, these advantages need to be balanced against the potential harm to privacy, autonomy, and nonmaleficence, which are recognized as the cornerstones of ethical medical care.
Here, we discuss these opportunities and challenges, both when collecting data to develop online screening services and when deploying them. We offer several solutions that balance the advantages of these services with the ethical challenges they pose.
Coping Skills Mobile App to Support the Emotional Well-Being of Young People During the COVID-19 Pandemic: Protocol for a Mixed Methods Study
Authors: Serlachius Anna , Schache Kiralee , Boggiss Anna , Lim David , Wallace-Boyd Kate , Brenton-Peters Jennifer , Buttenshaw Elise , Chadd Stephanie , Cavadino Alana , Cao Nicholas , Morunga Eva , Thabrew Hiran
Published: September 2020

Background

The COVID-19 pandemic is likely to increase anxiety and distress in young people worldwide. It is important to prioritize mental health during crisis events to mitigate the negative and often long-term effects of the crises on young people, families, and society. Mental health and well-being apps represent a scalable approach for improving psychological outcomes in young people and have potential to improve the equity of service access.

Objective

The Whitu: 7 Ways in 7 Days well-being app was recently developed by our group to address the urgent need for innovative approaches to reach young New Zealanders who are struggling to cope with the COVID-19 pandemic. The aim of this study is twofold: to evaluate the acceptability of the prototype app and to examine the effectiveness of the refined app at improving mental and emotional well-being and reducing depression, anxiety, and stress in young people in New Zealand.

Methods

A two-phase mixed methods study will be undertaken to achieve these aims. During the first phase, 20 young people aged 16-30 years (including those of Māori and Pacific ethnicity) will participate in a qualitative study to help refine the prototype app. During the second phase, 90 young people aged 16-30 years will participate in a randomized waitlist-controlled trial (RCT) to evaluate the efficacy of the refined Whitu app at 4 weeks and 3 months after baseline. Outcomes will be evaluated using validated web-based questionnaires at baseline, 4 weeks, and 3 months.

Results

The study received ethics approval in May 2020, and recruitment for the focus groups commenced in June 2020. Recruitment for the RCT is expected to commence in October 2020. Participants for both study phases will be recruited via social media and web-based communities. Data collection for the RCT is expected to be completed by January 2021, and analyses are expected to be completed by March 2021. Linear mixed modelling will be used to determine between-group differences in psychological outcomes.

Conclusions

There is an urgent need to develop culturally appropriate, scalable mental health interventions to address the psychological consequences of the COVID-19 pandemic. In this study, we will develop and test an evidence-based well-being app that, if effective, can be made available to all young people in New Zealand and internationally.

Trial Registration

Australian New Zealand Clinical Trials Registry (ACTRN12620000516987); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379597.

International Registered Report Identifier (IRRID)

PRR1-10.2196/23716
Identifying Key Predictors of Cognitive Dysfunction in Older People Using Supervised Machine Learning Techniques: Observational Study (Preprint)
Authors: Rankin Debbie , Black Michaela , Flanagan Bronac , Hughes Catherine F , Moore Adrian , Hoey Leane , Wallace Jonathan , Gill Chris , Carlin Paul , Molloy Anne M , Cunningham Conal , McNulty Helene
Published: September 2020

BACKGROUND

Machine learning techniques, specifically classification algorithms, may be effective to help understand key health, nutritional, and environmental factors associated with cognitive function in aging populations.

OBJECTIVE

This study aims to use classification techniques to identify the key patient predictors that are considered most important in the classification of poorer cognitive performance, which is an early risk factor for dementia.

METHODS

Data were used from the Trinity-Ulster and Department of Agriculture study, which included detailed information on sociodemographic, clinical, biochemical, nutritional, and lifestyle factors in 5186 older adults recruited from the Republic of Ireland and Northern Ireland, a proportion of whom (987/5186, 19.03%) were followed up 5-7 years later for reassessment. Cognitive function at both time points was assessed using a battery of tests, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), with a score <70 classed as poorer cognitive performance. This study trained 3 classifiers—decision trees, Naïve Bayes, and random forests—to classify the RBANS score and to identify key health, nutritional, and environmental predictors of cognitive performance and cognitive decline over the follow-up period. It assessed their performance, taking note of the variables that were deemed important for the optimized classifiers for their computational diagnostics.

RESULTS

In the classification of a low RBANS score (<70), our models performed well (F1 score range 0.73-0.93), all highlighting the individual’s score from the Timed Up and Go (TUG) test, the age at which the participant stopped education, and whether or not the participant’s family reported memory concerns to be of key importance. The classification models performed well in classifying a greater rate of decline in the RBANS score (F1 score range 0.66-0.85), also indicating the TUG score to be of key importance, followed by blood indicators: plasma homocysteine, vitamin B6 biomarker (plasma pyridoxal-5-phosphate), and glycated hemoglobin.

CONCLUSIONS

The results suggest that it may be possible for a health care professional to make an initial evaluation, with a high level of confidence, of the potential for cognitive dysfunction using only a few short, noninvasive questions, thus providing a quick, efficient, and noninvasive way to help them decide whether or not a patient requires a full cognitive evaluation. This approach has the potential benefits of making time and cost savings for health service providers and avoiding stress created through unnecessary cognitive assessments in low-risk patients.
Shift in work-life balance in Pakistan due to COVID-19 Pandemic: Analysis through the mental health lens (Preprint)
Authors: Abul Hasan Muhammad , Adamson Maheen Mausoof , Khan Hashim Raza , Shahid Hira , Ejaz Osama , Sattar Parisa , Zahid Ammara , Qazi Saad Ahmed
Published: September 2020

BACKGROUND

The outburst of infectious diseases threatens the psychological stability and disrupts work-life balance.

OBJECTIVE

The objective of this study is to investigate shift in work-life balance due to COVID-19 pandemic by examining the mental health status of general population of Pakistan.

METHODS

An online survey was conducted during COVID-19 peak (23-June till 29-June 2020). Out of 2050, 1775 responses from Karachi were included in this study. T-tests and ANOVAs were performed to identify difference among sociodemographic factors. Stepwise linear regression was conducted to determine association of depression, anxiety and stress with each factor of sociodemographic, knowledge and concern, contact, occupational and psychological variables.

RESULTS

In total, 30%, 22.2% and 21.96% of respondents reported severe to extremely severe depression, anxiety and stress on the Depression, anxiety stress scales (DASS). Well educated, unmarried, small scale business holders and changes in income due to COVID-19 reported higher depression. Moreover, respondents who acquired infection, consulted a doctor in fear of being COVID-19 positive, teleworkers and variations in earning reported being more anxious. Female gender, frontline workers, respondents with increased online working hours, clinical consultation doubtful of virus positive and self-acquisition of virus reported higher stress. The attributes of age (under 30 years), more concern regarding virus contraction from others, lower survival chance, new cases, COVID-19 dreams, lockdown, and spending more time on social media, strongly correlated with DASS scores.

CONCLUSIONS

This study confirms that the outbreak of COVID-19 pandemic has adversely impacted work-life balance of general population of Pakistan. Moreover, the aforementioned variables allow health sectors, government authorities and social media to design guidelines necessary for controlling negative post-pandemic effect and future infections outbreaks.

CLINICALTRIAL

NED University of Engineering & Technology
Day-of-the-Week Effect and Investors’ Psychological Mood Testing in a Highly Mispriced Capital Market
Authors: Luxianto Rizky , Arief Usman , Prasetyo Muhammad Budi
Published: September 2020

Research Aims: This research examines investors’ psychological moods which cause day-of-the-week anomalies in highly mispriced stock markets. Design/methodology/approach: We use a sample from the Indonesian capital market as, in the Asian region, this country is considered to have a highly mispriced capital market. We decompose the stock price index in Indonesia into speculative, less speculative, and non-speculative indexes. We employ the mean and variance regressions to control the heteroscedasticity and serial correlation. Novelties: Our novelties are two fold. We postulate a method to decompose stock price indexes in Indonesia (the JKSE, LQ 45, and Kompas 100) into speculative, less speculative, and non-speculative indexes. Secondly, we estimate the mean and variance levels simultaneously to get a robust estimation result of the anomaly. Research Findings: We empirically find that the behavior mood hypothesis is supported only during normal periods, when investors tend to be irrational and use their good mood to trade on speculative stocks on a Wednesday and sell them on Monday. In other periods, rationality and psychological effects play a role with Indonesian investors, when their mood is good they are more active in trading less speculative stocks, to avoid higher risks and earn higher returns from those less speculative and non-speculative stocks.
Indonesian Demand for Online Shopping: Revisited
Authors: Yahya Syarifudin , Sugiyanto, M.A. Ph.D Prof. Catur
Published: September 2020

Introduction/Main Objectives: This study aims to analyze the factors that influence online shopping. Data are aggregated at the national, island, and regional levels. The regions are categorized based on their level of demand for online shopping. Background Problems: The rapid development of information and communications technology contributes to the transformation of the digital economy. By using 281,185 internet users from the National Households Survey (Survei Sosial Ekonomi-Susenas) 2017 data, we found that the percentage of online shopping in Indonesia is 7.59%. Online shopping is concentrated on the island of Java, especially in the Greater Jakarta area (Jakarta, Bogor, Depok, Tangerang, and Bekasi). Novelty: This study analyzes online shopping from the point of view of economic development studies, especially related to the development of information technology and the digital economy. Research Methods: We used a binary logistic regression analysis to assess the effect of demographic, socio-economic, and spatial factors on an individual’s decision to shop online. Finding/Results: The results indicate that individuals who have a greater tendency to shop online are those who have a high income, are women, can access the internet using mobile phones, they are the spouses of the heads of households, are 25 to30 years old, live in urban areas, have graduated from college (especially with a diploma), and work in the tertiary sector. The higher that the share of online shopping is in an area, the more intense the influence of individual characteristics will be on the tendency to shop online, according to the demographic and socio-economic factors, while the spatial factors will fade away. Conclusion: Income, gender, internet access, and the shopper’s position in the household are factors that significantly influence individuals to shop online.