bluuebunny/crossref_metadata_2025 huggingface dataset:
The COVID-19 pandemic and its effect on Otolaryngology trainees: A comprehensive nationwide cross-sectional study.
Authors: Sharhan Salma S. Al , Bar Mohammed H. Al , AlSaied Abdulmalik S. , ALEnazi Abdulaziz S. , Aljubran Hussain J. , AlKhaldi Saud K. , Alghamdi Amal A.
Published: September 2020

Background: As a consequence of the COVID-19 global pandemic, otolaryngology residents are at high risk due to the nature of the specialty and long work hours. Moreover, COVID-19 could have a severe impact on residents from different frontline specialties, particularly otolaryngology. To the best of our knowledge, this is the first nationwide survey providing insights into the impact of COVID-19 on otolaryngology residents.Methods: A cross-sectional questionnaire-based study was conducted among all otolaryngology training centers of Saudi Arabia to investigate the extent of the impact of COVID-19 on otolaryngology residents and the learning process.Results: A total of 152 residents were contacted to participate in the study, and 101 participants were included after successfully completing the questionnaire. The mean age of the participants was 28.12 years (S.D. = 1.89, max = 36, min = 25). There has been a significant impact on outpatient clinics, elective operations, consultations, and working hours. Also, we evaluated the impact on academic training activities, the frequency of training activities per week, and the psychological impact of the COVID-19 pandemic on otolaryngology residents as well.Conclusion: COVID-19 has had a serious impact on residents both physically and mentally; otolaryngology residents have been hit especially hard by this emergency pandemic period. Trainees suffered from excessive worries regarding clinical training, specifically academic concerns for different training levels. Further studies need to be done here in Saudi Arabia to evaluate this impact in greater detail and to protect the residents.
L’absence annoncée du défendeur à l’audience de conciliation : une tare pour le demandeur ?
Authors: Clément Eric
Published: September 2020

Le Tribunal fédéral considère, dans l’arrêt 4A_416/2019, que le demandeur, dans le cadre d’une procédure de conciliation, est astreint à participer à l’audience de conciliation, même si le défendeur a annoncé préalablement qu’il ne s’y présentera pas. Il ne peut pas requérir, de l’autorité, une dispense de comparution personnelle et la délivrance d’une autorisation de procéder en réaction à l’annonce du défendeur. L’autorisation de procéder ne peut être délivrée que lors de l’audience de conciliation.
Measuring and Testing Mutual Dependence of Multivariate Functional Data
Authors: Krzyśko Mirosław , Smaga Łukasz
Published: September 2020

This paper considers new measures of mutual dependence between multiple multivariate random processes representing multidimensional functional data. In the case of two processes, the extension of functional distance correlation is used by selecting appropriate weight function in the weighted distance between characteristic functions of joint and marginal distributions. For multiple random processes, two measures are sums of squared measures for pairwise dependence. The dependence measures are zero if and only if the random processes are mutually independent. This property is used to construct permutation tests for mutual independence of random processes. The finite sample properties of these tests are investigated in simulation studies. The use of the tests and the results of simulation studies are illustrated with an example based on real data.
Statistical Properties and Estimation of Power-Transmuted Inverse Rayleigh Distribution
Authors: Hassan Amal S. , Assar Salwa M. , Abdelghaffar Ahmed M.
Published: September 2020

A three-parameter continuous distribution is constructed, using a power transformation related to the transmuted inverse Rayleigh (TIR) distribution. A comprehensive account of the statistical properties is provided, including the following: the quantile function, moments, incomplete moments, mean residual life function and Rényi entropy. Three classical procedures for estimating population parameters are analysed. A simulation study is provided to compare the performance of different estimates. Finally, a real data application is used to illustrate the usefulness of the recommended distribution in modelling real data.
Poisson Weighted Ishita Distribution: Model for Analysis of Over-Dispersed Medical Count Data
Authors: Para Bilal Ahmad , Jan Tariq Rashid
Published: September 2020

A new over-dispersed discrete probability model is introduced, by compounding the Poisson distribution with the weighted Ishita distribution. The statistical properties of the newly introduced distribution have been derived and discussed. Parameter estimation has been done with the application of the maximum likelihood method of estimation, followed by the Monte Carlo simulation procedure to examine the suitability of the ML estimators. In order to verify the applicability of the proposed distribution, a real-life set of data from the medical field has been analysed for modeling a count dataset representing epileptic seizure counts.
Through a Random Route to the Goal: Theoretical Background and Application of the Method in Tourism Surveying in Poland
Authors: Wójcik Sebastian
Published: September 2020

Classic survey methods are ineffective when surveying a small or rare population. Several methods have been developed to address this issue, but often without providing a full mathematical justification. In this paper we propose estimators of parameters relating to Random Route Sampling and explore their basic properties. A formula for the Horvitz-Thompson estimator weights is presented. Finally, a case of a tourism-related survey conducted in Poland is discussed.
Vibration characteristics of Timoshenko stepped beam under moving load considering inertial effect
Authors: Wang Shoule , Sun Dan , Li Hongliang
Published: September 2020

The vibration of gun barrels would result in the change of impact point, which would further reduce the firing accuracy of weapons. In the past, the calculation model based on the Euler beam theory could not satisfy the accuracy requirements. Based on the Timoshenko beam theory, the vibration equation of the stepped beam is established by invoking continuum transfer matrix method. The forced vibration of the stepped beam under the inertial moving load is solved. The model has better precision than the Euler beam model. The endpoint of the cantilever beam is analyzed. It is shown that the endpoint response increases with the increasing mass and acceleration of moving load, so does the inertial coefficient. With the increase of moving load speed, the endpoint response decreases, and the inertia coefficient increases. Among the three parameters, the mass of moving load is the main factor affecting the inertia coefficient. Furthermore, both free and forced vibrations of other stepped beam shaped structures with arbitrary segments and boundary conditions can be explored by using the proposed method.
EROSÕES LINEARES NO SEMIÁRIDO PERNAMBUCANO: AVALIAÇÃO DE UMA PARCELA EROSIVA EM MICROESCALA NA DEPRESSÃO SÃO FRANCISCANA
Authors: Xavier Joaquim Pedro de Santana , Coutinho Edilson Amaral Tavares , Tavares Kaio César de Oliveira , Silva Danielle Gomes da , Listo Fabrizio de Luiz Rosito
Published: September 2020

Estudos sobre processos erosivos em ambientes semiáridos ainda são bastantes escassos na literatura geomorfológica, principalmente, aqueles relacionados a erosão linear. O objetivo desse trabalho foi selecionar uma parcela representativa do conjunto ambiental do município de Belém do São Francisco, semiárido pernambucano, para detalhar, o papel desempenhado pelos elementos do contexto natural sobre a deflagração de processos erosivos. Para isso, foi realizado um mapeamento em microescala em uma parcela de 30mx60m, por meio da análise de diferentes fatores condicionantes em uma ficha de campo descritiva. Os resultados apontaram que a interação sistêmica dos fatores condicionantes promove erosões com geometrias mais largas e alongadas com menor profundidade, comparando-se com processos erosivos comuns em áreas úmidas. Também foi verificado que a erosão linear, nestes ambientes, muitas vezes ocorre quando a erosão laminar já degradou o solo de maneira acentuada, proporcionando uma micro-topografia que favorece o escoamento de erosões lineares bem desenvolvidas.
Cardiovascular Risk and Quality of Life in Autosomal Dominant Polycystic Kidney Disease Patients on Therapy With Tolvaptan: A Pilot Study
Authors: Lai Silvia , Mangiulli Marco , Perrotta Adolfo M. , Gigante Antonietta , Napoleoni Ludovica , Cipolloni Elena , Mitterhofer Anna P. , Gasperini Maria L. , Muscaritoli Maurizio , Cianci Rosario , Giovannetti Antonello , Falco Fabiana , Mastroluca Daniela , Mazzaferro Sandro
Published: September 2020

Introduction:

Cardiovascular (CV) complications are the most frequent cause of morbidity
and mortality in autosomal dominant polycystic kidney disease (ADPKD) patients. In 2017, the
Italian Medicines Agency authorised tolvaptan, a vasopressin V2 receptor antagonist, for the treatment
of ADPKD, based on the Tolvaptan Phase 3 Efficacy and Safety Study in ADPKD (TEMPO
3: 4), TEMPO 4: 4 and Replicating Evidence of Preserved Renal Function: An Investigation of Tolvaptan
Safety and Efficacy (REPRISE) studies.

Aim of the Study:

The aim of the study was to assess the impact of tolvaptan on CV risk and quality
of life, evaluated by nutritional, inflammatory, metabolic, instrumental parameters and psychocognitive
tests on ADPKD patients.

Methods and Materials:

We evaluated 36 patients with ADPKD; 10 patients (7 males, mean age
42.5±7.0 years) treated with tolvaptan and 26 controls (11 males, mean age 36.7±9.1 years). They
underwent, at T0, monthly, and at T1 (1 year) clinical, laboratory and instrumental evaluation, in
addition to psychocognitive tests.

Results:

In ADPKD patients treated with tolvaptan, we found at T1, a decrease in carotid intima--
media thickness (p=0.048), epicardial adipose tissue thickness (p=0.002), C-reactive protein
(p=0.026), sympathovagal balance during night (p=0.045) and increased flow-mediated dilation
(p=0.023) with a reduction in depression (Hamilton and Beck tests, p=0.008 and p=0.002, respectively)
compared with controls.

Conclusions:

These preliminary results suggest that treatment with tolvaptan could improve early
atherosclerosis and endothelial dysfunction markers and improve mood in ADPKD patients (probably
by acting on endothelial cell and adipocyte V2 receptors).
Anti-Cancer Activity of Curcumin on Multiple Myeloma
Authors: Mirzaei Hamed , Bagheri Hossein , Ghasemi Faezeh , Khoi Jaber M. , Pourhanifeh Mohammad H. , Heyden Yvan V. , Mortezapour Erfan , Nikdasti Ali , Jeandet Philippe , Khan Haroon , Sahebkar Amirhossein
Published: September 2020

Multiple Myeloma (MM) is the third most common and deadly hematological malignancy, which is characterized by a progressive monoclonal proliferation within the bone marrow. MM is cytogenetically heterogeneous with numerous genetic and epigenetic alterations, which lead to a wide spectrum of signaling pathways and cell cycle checkpoint aberrations. MM symptoms can be attributed to CRAB features (hyperCalcemia, Renal failure, Anemia, and Bone lesion), which profoundly affect both the Health-Related Quality of Life (HRQoL) and the life expectancy of patients. Despite all enhancement and improvement in therapeutic strategies, MM is almost incurable, and patients suffering from this disease eventually relapse. Curcumin is an active and non-toxic phenolic compound, isolated from the rhizome of Curcuma longa L. It has been widely studied and has a confirmed broad range of therapeutic properties, especially anti-cancer activity, and others, including anti-proliferation, anti-angiogenesis, antioxidant and anti-mutation activities. Curcumin induces apoptosis in cancerous cells and prevents Multidrug Resistance (MDR). Growing evidence concerning the therapeutic properties of curcumin caused a pharmacological impact on MM. It is confirmed that curcumin interferes with various signaling pathways and cell cycle checkpoints, and with oncogenes. In this paper, we summarized the anti- MM effects of curcumin.
Efficiently Computing Geodesic Loop for Interactive Segmentation of a 3D Mesh
Authors: Meng Yun , Zhu Shaojun , Liu Bangquan , Sun Dechao , Liu Li , Yang Weihua
Published: September 2020

Introduction:

Shape segmentation is a fundamental problem of computer graphics and geometric modeling.
Although the existence segmentation algorithms of shapes have been widely studied in mathematics community, little
progress has been made on how to compute them on polygonal surfaces interactively using geodesic loops.

Method:

We compute the geodesic distance fields with improved Fast March Method (FMM) proposed by Xin and Wang.
We propose a new algorithm to compute geodesic loops over a triangulate surface and a new interactive shape
segmentation manner on triangulate surface.

Result:

The average computation time on 50K vertices model is less than 0.08s.

Discussion:

In the future, we will use an accurate geodesic algorithm and parallel computing techniques to improve our
algorithm to obtain better smooth geodesic loop.

Conclusion:

A large number of experimental results show that the algorithm proposed in this paper can effectively
achieve high precision geodesic loop paths, and our method can also be used to interactive shape segmentation in real
time.
A Multi-Layer LSTM-Time-Density-Softmax (LDS) Approach for Protein Structure Prediction Using Deep Learning
Authors: Tejeshwar Gururaj , Mat Siddesh G.
Published: September 2020

Introduction:

The primary structure of the protein is a polypeptide chain made up of a
sequence of amino acids. What happens due to interaction between the atoms of the backbone is
that it forms within a polypeptide folded structure, which is very much within the secondary
structure. These alignments can be made more accurate by the inclusion of secondary structure
information.

Objective:

It is difficult to identify the sequence information embedded in the secondary structure of
the protein. However, Deep learning methods can be used for solving the identification of the
sequence information in the protein structures.

Methods:

The scope of the proposed work is to increase the accuracy of identifying the sequence
information in the primary structure and the tertiary structure, thereby increasing the accuracy of the
predicted Protein Secondary Structure (PSS). In this proposed work, homology is eliminated by a
Recurrent Neural Network (RNN) based network that consists of three layers, namely bi-directional
Long Short Term Memory (LSTM), time distributed layer and Softmax layer.

Results:

The proposed LDS model achieves an accuracy of approximately 86% for the prediction of
the three-state secondary structure of the protein.

Conclusion:

The gap between the number of protein primary structures and secondary structures is
huge and increasing. Machine learning is trying to reduce this gap. In most of the other pre attempts
in predicting the secondary structure of proteins, the data is divided according to the homology of the
proteins. This limits the efficiency of the predicting model and the inputs given to such models.
Hence, in our model, homology has not been considered while collecting the data for training or
testing out model. This has led to our model to not be affected by the homology of the protein fed to
it and hence remove that restriction, so any protein can be fed to it.
Understanding the Role of HDL during COVID-19 Infection
Authors: Garg Iti , Srivastava Swati , Kumar Bhuvnesh
Published: September 2020

Background:

Recently emerged COVID-19 pandemic has caused a large number of deaths
with lacs of confirmed cases worldwide posturing a grim situation and severe threat to public health.
There is an imperative necessity of analyzing emerging clinical and laboratory data of COVID-19 patients,
which may contribute to elucidate the pathogenic mechanism and development of effective prevention
and treatment countermeasures.

Methods:

Under this article, the emerging role of High-Density Lipoprotein (HDL) was analyzed by
collecting recently published articles related to this field having clinical data of COVID-19 patients.

Results:

Based on the recently published reports of laboratory-confirmed COVID-19 infected hospitalized
patients it was consistently observed that levels of HDL were low at the time of admission to hospital
and remained relatively low during the disease course i.e., treatment, recovery, and discharge stage. It
was also reported critically that levels of HDL in the patients, those did not survive, decreased continuously
until death.

Conclusion:

These clinical reports of patients have risen the concern about probable infection and
worsen the clinical outcome of a healthy person having a compromised level of HDL for COVID-19
infection. Eventually, these findings stated that there is a strong association of low HDL levels with a
higher risk of COVID-19 infection and further severity of the illness. Proper attention is needed to understand
the significance of altered quantity and quality of HDL in COVID-19 patients compared to
healthy controls, so that appropriate therapies could be given at the right time to combat severity and
mortality due to this infection.
From the Editor - October 2009
Authors: Stark Ernie
Published: September 2020

A letter from the editor.
Ethics of Potential New Retail Employees: Relationships Between Ethical Perceptions and Grades of Future Retail Personnel
Authors: Burns David J.
Published: September 2020

Retailers use a number of screening mechanisms to determine the suitability of potential new employees. Rarely, however, does the selection process address the ethics of potential employees. This study explores this issue by determining whether retailers can obtain an assessment of potential employees’ ethical perceptions by using information that they are already gathering, namely students’ grades. Although the findings do not suggest that grades can be used to differentiate students in all areas of ethical activity, they do suggest that grades may be used to differentiate between ethical evaluations in some areas, particularly situations that are particularly disturbing to practitioners.
FOREX Performance And Bank Profitability: An Evaluation of PNB FOREX Branch
Authors: Yadav Shubhanker
Published: September 2020

Banks form an essential backbone of the economy. In this era of globalization foreign trade form a significant functional priority of the bank. India faces stiff competition in the global market and to continue in the race it needs to strengthen its banking system. Punjab National Bank (PNB) is one of the leading banks which have flown its branches to various small parts of the country. As so it is an essential bank of India, and therefore there is an utmost need to have an insight into the foreign exchange of PNB. This study reveals various loopholes in the foreign exchange policy of PNB Varanasi like 98.5% percent of foreign exchange business from one party only, the dissatisfaction of customers, merging of foreign Exchange and general banking, lack of yearly financial reports and many more. Based on the finding positive recommendation has been suggested to improve the foreign exchange status of PNB which if followed can enhance the functionality of its foreign exchange, and it can stand as an essential backbone in the Indian economy.
Температурные и концентрационные зависимости соотношения Ландау-Плачека в водных растворах γ-пиколина
Authors: Сабиров Л.М. , Исмаилов Ф.Р. , Кадиров Ш.А. , Каршибаев Ш.Э.
Published: September 2020

In aqueous solutions of -picoline we investigated intensity relations in components of the fine structure spectrum of molecular light scattering – Landau-Placzek ratio – in dependence on temperature and concentration. Complex dependence of the fine structure spectrum intensity distribution was observed on temperature and concentration, which is due to structural processes in aqueous solutions.
Геометрическая оптика во вращающемся диэлектрике
Authors: Миловский Н.Д. , Климин А.О.
Published: September 2020

Rotating solid-state homogeneous isotropic dielectric without dispersion in the accompanying rotation of the reference frame turns out to be an inhomogeneous anisotropic medium due to the influence of two competing physical mechanisms: the inhomogeneity of free space caused by rotation and entrainment of light by the moving medium. In a rotating dielectric in the geometric optics approximation the eikonal equation and the corresponding system of ordinary differential equations in characteristic form are obtained. The solutions of the equations with the calculated parameters determined using of the first integrals of the system are pairs "opposite “R-ray trajectories and f - phase trajectories fronts. A formula for the intensity of a light pulse propagating along an arbitrary R-trajectories was obtained. "Oncoming “trajectories of both types do not have common points and are shifted to opposite sides of a straight line between end points. Their structural parameters (minimum distance to the axis of rotation, the length of the arc, the region of determination by the azimuthal coordinate, the optical length, etc.) change under the influence of both physical mechanisms, depending on the speed of rotation. Closed optical paths in the RRF for the relay network and for the two-mirror Fabry-Perot resonator in generating laser can be created using two types of mirrors that are adaptable to the frequency of rotation which normals to the reflecting surfaces must have certain different angles with the ray vectors and wavefronts of radiation arriving at the reflector. The Sagnac effect is a consequence inhomogeneity (deformation) of free space along the azimuthal coordinate, and its value is the result of the competing influence of both physical mechanisms.
Изучение воздействия УФ излучения на смолы и асфальтеновые фракции сырой нефти методом ИК спектроскопии
Authors: Идрисов Т.С. , Курбанов М.А. , Кулиева У.А.
Published: September 2020

In this work, the dependences of the intensity of the IR spectra of resins and asphaltenes on the time of irradiation during their photolysis under the action of radiation from a mercury lamp are studied. It was found that an increase in the irradiation time leads to a decrease in the intensity of absorption bands corresponding to normal paraffin. The observed pattern is explained on the basis of the transfer of excitation energy from PAH molecules to alkane molecules. Based on the values ​​of the extinction coefficient and the relative concentration of PAHs in crude oil, the fractions of absorption of UV light energy by molecules of individual PAH components were calculated.
Performance, Cost-Effectiveness, and Representativeness of Facebook Recruitment to Suicide Prevention Research: Online Survey Study
Authors: Lee Sylvia , Torok Michelle , Shand Fiona , Chen Nicola , McGillivray Lauren , Burnett Alexander , Larsen Mark Erik , Mok Katherine
Published: September 2020

Background

Researchers are increasingly using social media advertisements to recruit participants because of their many advantages over traditional methods. Although there is growing evidence for the effectiveness and cost-effectiveness of social media recruitment in the health sciences, no studies have yet examined this in the context of suicide prevention, which remains to be a highly stigmatized and sensitive topic.

Objective

This study aims to recruit a general community sample to complete a survey on suicide literacy, stigma, and risk via Facebook advertisements. Specifically, we aim to establish the performance of the advertisements, cost-effectiveness, sample representativeness, and the impact of gender-specific advertising on recruiting men into the study.

Methods

From June 2017 to March 2019, we released Facebook advertisements targeted at adults 18 years or older, residing in the New South Wales (NSW) trial or control regions, and involved in the LifeSpan suicide prevention trial. Cost-effectiveness was examined descriptively using metrics provided by Facebook. Chi-square analyses were conducted to determine demographic differences between our sample and the general NSW population as well as the impact of gender-specific advertisements on gender engagement.

Results

The 14 Facebook advertisement campaigns reached a total of 675,199 people, yielding 25,993 link clicks and resulting in 9603 individuals initiating the survey (7487 completions) at an overall cost of Aus $2.81 (US $2.01) per participant. There was an overrepresentation of younger (P=.003), female (P=.003), highly educated (P<.001) participants and mental health conditions (P<.001) compared with the total NSW population. The use of male-specific advertisements resulted in a significantly higher proportion of men completing the survey relative to gender-neutral advertisements (38.2% vs 24.6%; P<.001).

Conclusions

This study demonstrates the potential of Facebook to be an effective, low-cost strategy for recruiting a large sample of general community participants for suicide prevention research. Strategies to improve sample representativeness warrant further investigation in future research.
Chronological Age Assessment in Young Individuals Using Bone Age Assessment Staging and Nonradiological Aspects: Machine Learning Multifactorial Approach
Authors: Dallora Ana Luiza , Kvist Ola , Berglund Johan Sanmartin , Ruiz Sandra Diaz , Boldt Martin , Flodmark Carl-Erik , Anderberg Peter
Published: September 2020

Background

Bone age assessment (BAA) is used in numerous pediatric clinical settings as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical as the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods have drawbacks such as exposure of minors to radiation, they do not consider factors that might affect the bone age, and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals, it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA.

Objective

This study aims to investigate CA estimation through BAA in young individuals aged 14-21 years with machine learning methods, addressing the drawbacks of research using magnetic resonance imaging (MRI), assessment of multiple regions of interest, and other factors that may affect the bone age.

Methods

MRI examinations of the radius, distal tibia, proximal tibia, distal femur, and calcaneus were performed on 465 men and 473 women (aged 14-21 years). Measures of weight and height were taken from the subjects, and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, and type of residence during upbringing). Two pediatric radiologists independently assessed the MRI images to evaluate their stage of bone development (blinded to age, gender, and each other). All the gathered information was used in training machine learning models for CA estimation and minor versus adult classification (threshold of 18 years). Different machine learning methods were investigated.

Results

The minor versus adult classification produced accuracies of 0.90 and 0.84 for male and female subjects, respectively, with high recalls for the classification of minors. The CA estimation for the 8 age groups (aged 14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter, a lower error occurred only for the ages of 14 and 15 years.

Conclusions

This study investigates CA estimation through BAA using machine learning methods in 2 ways: minor versus adult classification and CA estimation in 8 age groups (aged 14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results; however, for the second case, the BAA was not precise enough for the classification.
Efficacy of an Online Physical Activity Intervention Coordinated With Routine Clinical Care: Protocol for a Pilot Randomized Controlled Trial
Authors: Rockette-Wagner Bonny , Fischer Gary S , Kriska Andrea M , Conroy Molly B , Dunstan David , Roumpz Caroline , McTigue Kathleen M
Published: September 2020

Background

Most adults are not achieving recommended levels of physical activity (150 minutes/week, moderate-to-vigorous intensity). Inadequate activity levels are associated with numerous poor health outcomes, and clinical recommendations endorse physical activity in the front-line treatment of obesity, diabetes, dyslipidemia, and hypertension. A framework for physical activity prescription and referral has been developed, but has not been widely implemented. This may be due, in part, to the lack of feasible and effective physical activity intervention programs designed to coordinate with clinical care delivery.

Objective

This manuscript describes the protocol for a pilot randomized controlled trial (RCT) that tests the efficacy of a 13-week online intervention for increasing physical activity in adult primary care patients (aged 21-70 years) reporting inadequate activity levels. The feasibility of implementing specific components of a physical activity clinical referral program, including screening for low activity levels and reporting patient program success to referring physicians, will also be examined. Analyses will include participant perspectives on maintaining physical activity.

Methods

This pilot study includes a 3-month wait-listed control RCT (1:1 ratio within age strata 21-54 and 55-70 years). After the RCT primary end point at 3 months, wait-listed participants are offered the full intervention and all participants are followed to 6 months after starting the intervention program. Primary RCT outcomes include differences across randomized groups in average step count, moderate-to-vigorous physical activity, and sedentary behavior (minutes/day) derived from accelerometers. Maintenance of physical activity changes will be examined for all participants at 6 months after the intervention start.

Results

Recruitment took place between October 2018 and May 2019 (79 participants were randomized). Data collection was completed in February 2020. Primary data analyses are ongoing.

Conclusions

The results of this study will inform the development of a clinical referral program for physical activity improvement that combines an online intervention with clinical screening for low activity levels, support for postintervention behavior maintenance, and feedback to the referring physician.

Trial Registration

ClinicalTrials.gov NCT03695016; https://clinicaltrials.gov/ct2/show/NCT03695016.

International Registered Report Identifier (IRRID)

DERR1-10.2196/18891
Telemedicine in the United States: An Introduction for Students and Residents
Authors: Hyder Maryam A , Razzak Junaid
Published: September 2020

Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing evidence proving its potential for enhanced quality of care for patients, reduction in hospital readmissions, and increase in savings for both patients and providers. The COVID-19 pandemic has resulted in a significant increase in the reliance on telemedicine and telehealth for provision of health care services. Developments in telemedicine should be structured as complements to current health care procedures, not with the goal of completely digitizing the entire health care system, but rather to use the power of technology to enhance areas that may not be working at their full potential. At the same time, it is also clear that further research is needed on the effectiveness of telemedicine in terms of both financial and patient benefits. We discuss the current and rapidly increasing knowledge about the use of telemedicine in the United States, and identify the gaps in knowledge and opportunities for further research. Beginning with telemedicine’s origins in the United States to its widespread use during the COVID-19 pandemic, we highlight recent developments in legislation, accessibility, and acceptance of telemedicine.
Responses to Concerning Posts on Social Media and Their Implications for Suicide Prevention Training for Military Veterans: Qualitative Study
Authors: Teo Alan R , Strange Wynn , Bui Ricky , Dobscha Steven K , Ono Sarah S
Published: September 2020

Background

A “concerning post” is a display of a user’s emotional crisis on a social media platform. A better understanding of concerning posts is relevant to suicide prevention, but little is known about social media users’ attitudes and responses to concerning posts. Military veterans in the United States are disproportionately affected by suicide, often use social media, and may have exposure to individuals with elevated suicide risk via concerning posts.

Objective

The objective of the study was (1) to obtain insight into whether and how US military veterans respond to members of their social network on social media (ie, “friends”) who are experiencing substantial emotional distress, and (2) to identify potential interventions that could assist in users’ response to concerning posts.

Methods

We recruited veterans through Facebook and conducted semistructured interviews with 30 participants between June and December 2017. We used a summary template for rapid analysis of each interview, followed by double-coding using a codebook based on topic domains from the interview guide. Members of the research team met regularly to discuss emerging patterns in the data, generate themes, and select representative quotes for inclusion in the manuscript.

Results

Veterans were reluctant to disclose emotional and health issues on Facebook, but they were open to reaching out to others’ concerning posts. There was a complex calculus underlying whether and how veterans responded to a concerning post, which involved considering (1) physical proximity to the person posting, (2) relationship closeness, (3) existing responses to the post, and (4) ability to maintain contact with the person. Veterans desired additional training, backed by community-based veteran organizations, in how to respond to concerning posts from peers.

Conclusions

There is a need to incorporate features that will help veterans effectively respond to concerning posts from peers into suicide prevention training and to expand access for veterans to such training.
Online Public Attention During the Early Days of the COVID-19 Pandemic: Infoveillance Study Based on Baidu Index
Authors: Gong Xue , Han Yangyang , Hou Mengchi , Guo Rui
Published: September 2020

Background

The COVID-19 pandemic has become a global public health event, attracting worldwide attention. As a tool to monitor public awareness, internet search engines have been widely used in public health emergencies.

Objective

This study aims to use online search data (Baidu Index) to monitor the public’s attention and verify internet search engines’ function in public attention monitoring of public health emergencies.

Methods

We collected the Baidu Index and the case monitoring data from January 20, 2020, to April 20, 2020. We combined the Baidu Index of keywords related to COVID-19 to describe the public attention’s temporal trend and spatial distribution, and conducted the time lag cross-correlation analysis.

Results

The Baidu Index temporal trend indicated that the changes of the Baidu Index had a clear correspondence with the development time node of the pandemic. The Baidu Index spatial distribution showed that in the regions of central and eastern China, with denser populations, larger internet user bases, and higher economic development levels, the public was more concerned about COVID-19. In addition, the Baidu Index was significantly correlated with six case indicators of new confirmed cases, new death cases, new cured discharge cases, cumulative confirmed cases, cumulative death cases, and cumulative cured discharge cases. Moreover, the Baidu Index was 0-4 days earlier than new confirmed and new death cases, and about 20 days earlier than new cured and discharged cases while 3-5 days later than the change of cumulative cases.

Conclusions

The national public’s demand for epidemic information is urgent regardless of whether it is located in the hardest hit area. The public was more sensitive to the daily new case data that represents the progress of the epidemic, but the public’s attention to the epidemic situation in other areas may lag behind. We could set the Baidu Index as the sentinel and the database in the online infoveillance system for infectious disease and public health emergencies. According to the monitoring data, the government needs to prevent and control the possible outbreak in advance and communicate the risks to the public so as to ensure the physical and psychological health of the public in the epidemic.
Evaluation of an Occupational Exercise Training Program for Firefighters: Mixed Methods Pilot Study (Preprint)
Authors: Leary Miriam , Thomas James , Hayes Ryan , Sherlock Lori
Published: September 2020

BACKGROUND

Occupational exercise training programs can improve overall health and fitness in firefighters, but evidence beyond clinical and performance outcomes is needed before fire departments invest in and successfully adopt health promotion programs.

OBJECTIVE

This mixed methods pilot study sought to pair clinical and performance outcomes with participants’ qualitative feedback (eg, participants’ enjoyment, lifestyle behavior changes, and team structure) with the goal of informing recommendations for future programs.

METHODS

Professional firefighters participated in a 14-week occupational exercise training program with assessments conducted pre- and posttraining. Clinical outcomes included weight, BMI, body fat percentage, resting heart rate, systolic blood pressure, and diastolic blood pressure. Performance outcomes included the sharpened Romberg balance test, 1-repetition maximum leg press and bench press, graded exercise test (estimated VO2max), knee range of motion, shoulder flexibility, and hamstring flexibility. Self-administered surveys (Short Form-36, International Physical Activity Questionnaire, Barriers Self-Efficacy Scale, and Barriers to Being Active Quiz) were completed. In 3 private focus groups of 3 to 4 participants, firefighters' experiences in the training program and their health behaviors were explored.

RESULTS

Male firefighters (n=14; age: mean 36.4, SD 2.6 years) completed 20 training sessions. There were no significant changes to weight (P=.20), BMI (P=.15), body fat percentage (P=.16), systolic blood pressure (P=.12), estimated VO2max (P=.34), balance (P=.24), knee range of motion (left: P=.35; right: P=.31), or hamstring flexibility (P=.14). There was a significant decrease in diastolic blood pressure (P=.04) and significant increases in shoulder flexibility (P<.001) and leg press 1-repetition maximum volume (P=.04). Participants reported improvements in overall health, endurance, flexibility, and mood as well as improvements to team environment and health behaviors around the station; however, there was a decline in overcoming barriers to physical activity.

CONCLUSIONS

A 14-week program of exercise training in firefighters elicited improvements in clinical, performance, and self-reported physical activity outcomes. This occupational exercise training program for firefighters increased time spent exercising, improved team building, and led to physical and mental health benefits. Results from this pilot study set a broad, informed, and meaningful foundation for future efforts to increase firefighter participation in occupational fitness programs.
Cancer Clinicians’ Views Regarding an App That Helps Patients With Cancer Meet Their Information Needs: Qualitative Interview Study (Preprint)
Authors: Richards Rebecca , Kinnersley Paul , Brain Kate , Wood Fiona
Published: September 2020

BACKGROUND

Many patients with cancer have unmet information needs during the course of the illness. Smart devices, such as smartphones and tablet computers, provide an opportunity to deliver information to patients remotely. We aim to develop an app intervention to help patients with cancer meet their illness-related information needs in noninpatient settings. In addition to the in-depth exploration of the issues faced by the target users of a potential intervention, it is important to gain an understanding of the context in which the intervention will be used and the potential influences on its adoption. As such, understanding the views of clinicians is key to the successful implementation of this type of app in practice. Additionally, clinicians have an awareness of their patients’ needs and can provide further insight into the type of app and features that might be most beneficial.

OBJECTIVE

This study aims to explore cancer clinicians’ views on this type of intervention and whether they would support the use of an app in cancer care. Specifically, the perceived acceptability of an app used in consultations, useful app features, the potential benefits and disadvantages of an app, and barriers to app use were explored.

METHODS

A total of 20 qualitative, semistructured interviews were conducted with 22 clinicians from urological, colorectal, breast, or gynecological cancer clinics across 2 hospitals in South Wales. The interviews were audio recorded, transcribed, and analyzed using thematic analysis.

RESULTS

Clinicians felt that it would be acceptable for patients to use such an app in noninpatient settings, including during consultations. The benefits of this type of app were anticipated to be a more informed patient, an increased sense of control for patients, better doctor-patient communication, and a more efficient and effective consultation. In contrast, an increase in clinicians’ workload and poorer communication in consultations, which depended on the included app features, were identified as potential disadvantages. The anticipated barriers to app use included patients’ age and prior experience with smart technology, their access to smart devices, the confidentiality of information, and an avoidant coping approach to their condition.

CONCLUSIONS

This study suggests that clinicians should support their patients in using an app to help them meet their information needs both at home and during consultations. This study highlights some of the potential barriers for this type of intervention in practice, which could be minimized during the intervention design process.

CLINICALTRIAL
Security of medical devices (Preprint)
Authors: Nejadsahebi Milad
Published: September 2020

UNSTRUCTURED

Cybersecurity of medical devices is a decisive factor in people's lives. In fact, if criminals could get an access to these devices, they can do anything with the patient or their property. In this article, we will discuss some types of criminal activities related to hacking medical devices or getting an access to the central computer of the hospital. Moreover, I mentioned that why should some countries care about these devices' security and which countries now have laws in this field. Also, we will talk about governments' responsibilities and what people should know about the importance of cybersecurity of medical devices and what should they do.
A survey on cloud computing privacy and security compliances in health domain (Preprint)
Authors: Zandesh Zahra
Published: September 2020

BACKGROUND

The complicated nature of cloud computing encompassing internet-based technologies and service models for delivering IT applications, processing capability, storage, and memory space and some notable features motivate organizations to migrate their core businesses to the cloud. Consequently, healthcare organizations are much interested to migrate to this new paradigm despite challenges about security, privacy and compliances issues.

OBJECTIVE

The present study was conducted to investigate all related cloud compliances in health domain in order to find gaps in this context.

METHODS

All works on cloud compliance issues were surveyed after 2013 in health domain in PubMed, Scopus, Web of Science, and IEEE Digital Library databases.

RESULTS

Totally, 36 compliances had been found in this domain used in different countries for a variety of purposes. Initially, all founded compliances were divided into three parts as well as five standards, twenty-eight legislations and three policies and guidelines each of which is presented here by in detail.

CONCLUSIONS

Then, some main headlines like compliance management, data management, data governance, information security services, medical ethics, and patients' rights were recommended in terms of any compliance or frameworks and their corresponding patterns which should be involved in this domain.
Using Information Technology to Assess Patient Risk Factors in Primary Care Clinics: Pragmatic Evaluation (Preprint)
Authors: Kosowan Leanne , Katz Alan , Halas Gayle , LaBine Lisa , Singer Alexander
Published: September 2020

BACKGROUND

Tobacco use, physical inactivity, and poor diet are associated with morbidity and premature death. Health promotion and primary prevention counseling, advice, and support by a primary care provider lead to behavior change attempts among patients. However, although physicians consider preventative health important, there is often a larger focus on symptom presentation, acute care, and medication review.

OBJECTIVE

This study evaluated the feasibility, adoption, and integration of the tablet-based Risk Factor Identification Tool (RFIT) that uses algorithmic information technology to support obtainment of patient risk factor information in primary care clinics.

METHODS

This is a pragmatic developmental evaluation. Each clinic developed a site-specific implementation plan adapted to their workflow. The RFIT was implemented in 2 primary care clinics located in Manitoba. Perceptions of 10 clinic staff and 8 primary care clinicians informed this evaluation.

RESULTS

Clinicians reported a smooth and fast transfer of RFIT responses to an electronic medical record encounter note. The RFIT was used by 207 patients, with a completion rate of 86%. Clinic staff reported that approximately 3%-5% of patients declined the use of the RFIT or required assistance to use the tablet. Among the 207 patients that used the RFIT, 22 (12.1%) smoked, 39 (21.2%) felt their diet could be improved, 20 (12.0%) reported high alcohol consumption, 103 (56.9%) reported less than 150 minutes of physical activity a week, and 6 (8.2%) patients lived in poverty. Clinicians suggested that although a wide variety of patients were able to use the tablet-based RFIT, implemented surveys should be tailored to patient subgroups.

CONCLUSIONS

Clinicians and clinic staff positively reviewed the use of information technology in primary care. Algorithmic information technology can collect, organize, and synthesize individual health information to inform and tailor primary care counseling to the patients’ context and readiness to change. The RFIT is a user-friendly tool that provides an effective method for obtaining risk factor information from patients. It is particularly useful for subsets of patients lacking continuity in the care they receive. When implemented within a context that can support practical interventions to address identified risk factors, the RFIT can inform brief interventions within primary care.