bluuebunny/crossref_metadata_2025 huggingface dataset:
Proton Hopping in Living Systems
Authors: Kier Lemont B.
Published: March 2020

This review focuses on the two-century-old concept of proton hopping. Introduced in
1806 by Grotthuss, it has evolved into an explanation of great diversity in describing many functions
in living systems. It is a process involving water, which expands on the belief that life exists
only in the presence of water. This review describes the mechanism of the process as it carries information
through the water. A focus is initially made on the process of water in the nerve systems.
The nature of the process in these systems is described as the passage of proton hopping in living
systems. In drug-receptor encounters, proton hopping is initiated, carrying specific information
from these specialized encounters. The review continues with an explanation of sleep, arising from
an alteration in proton hopping. A similar phenomenon of the effect of general anesthetic agents is
described, as they interfere with by proton hopping. Finally, memory functions are addressed in the
realm of events carried by proton hopping.
Multivariate Analysis Reveals Different Responses of Antioxidant Defense in Wheat Plants Exposed to Arsenic (As) and Cadmium (Cd)
Authors: Moldes Carlos A. , Cantarelli Miguel A. , Heredia Jorgelina Z. , Camiña José M.
Published: March 2020

Background:

Multivariate analysis is a chemometric tool that has been little explored to
determine physiological status under heavy metal stress. Nevertheless, PCA has an unexplored potential
to determine the plant physiologic status and its modification under stress factors like heavy
metals.

Objectives:

This work aims to assess the physiological and biochemical effects and responses of
wheat plants under the different exposition of As and Cd using multivariate models.

Materials and Methods:

Wheat plants growing in a greenhouse were exposed to 0, 10 and 50 mg kg-1
soil of As and 0, 10 and 33 50 mg kg-1 soil of Cd until growth stage 5. After 56 days, wheat leaves
and roots were collected to determine dry weight, lipid peroxidation and the activity of three enzymes:
catalase, ascorbate peroxidase and guaiacol peroxidase. These measures were considered as
the variables of three performed multivariate models to determine physiological status.

Results:

Through the interpretation of score plot and loading plot in combination, it was possible to
determine that both As and Cd affect chlorophyll content and antioxidant response. However, a chlorophyll
decrease and a lipid peroxidation increase were observed together with an inhibition of antioxidant
response more accentuated in wheat plants exposed to As than those exposed to Cd.

Conclusions:

Multivariate analysis allows us to determine the differences between the physiological
behavior of both stressors, which turn this chemometric tools useful for the characterization of a
physiological response.
Segmented Poly(urea)urethane Nanoparticles: Size Optimization Using Taguchi Experimental Design and Nanoprecipitation Method
Authors: Chan-Chan Lerma Hanaiy , Martínez-Barbosa María Elisa , Vásquez-Alfaro Mónica Mayté , Cauich-Rodríguez Juan Valerio , Cervantes-Uc José Manuel , Lagarda-Diaz Irlanda , Maldonado Amir
Published: March 2020

Background:

Polymeric nanomaterials are important for developing drug delivery systems.
The control of nanoparticle size, polydispersity, and morphology in these systems are important
goals. Therefore, different strategies have been explored depending on the type of materials
used.

Objective:

To prepare biodegradable segmented poly(urea)urethane nanoparticles and to optimize the
nanoparticle size and polydispersity using an experimental design methodology.

Methods:

In this work, a biodegradable segmented poly(urea)urethane (SPUU) was synthesized.
This polymer was used for nanoparticle preparation by the nanoprecipitation technique in the context
of the experimental design methodology Taguchi L9. SPUU and nanoparticles were characterized
using Fourier transformed infrared, proton nuclear magnetic resonance, transmission electron microscopy,
scanning electron microscopy, and dynamic light scattering.

Results:

This methodology produced polymeric nanoparticles with mean sizes in the range of 60 to
220 nm with polydispersity in the range of 0.077 to 0.233. The statistical analysis showed that the
SPUU concentration and the stirring speed were the most influential parameters, while temperature,
at the studied range, did not show a relevant effect.

Conclusion:

The analysis of Taguchi’s experimental design resulted in the optimization of parameters
determining SPUU-NPs’ size. Nanoparticles from 60 nm of effective diameter were obtained at
low polymer concentration and higher stirring speed.
A Novel Method for Microsatellite Instability Detection by Liquid Biopsy Based on Next-generation Sequencing
Authors: Jiang Zheng , Liu Hui , Zhang Siwen , Liu Jia , Wang Weitao , Zang Guoliang , Meng Bo , Lin Huixin , Quan Jichuan , Zou Shuangmei , Yuan Dawei , Wang Xishan , Tian Geng , Lang Jidong
Published: March 2020

Background:

Microsatellite instability (MSI) is a prognostic biomarker used to guide
medication selection in multiple cancers, such as colorectal cancer. Traditional PCR with capillary
electrophoresis and next-generation sequencing using paired tumor tissue and leukocyte samples
are the main approaches for MSI detection due to their high sensitivity and specificity. Currently,
patient tissue samples are obtained through puncture or surgery, which causes injury and risk of
concurrent disease, further illustrating the need for MSI detection by liquid biopsy.

Methods:

We propose an analytic method using paired plasma/leukocyte samples and MSI
detection using next-generation sequencing technology. Based on the theoretical progress of
oncogenesis, we hypothesized that the microsatellite site length in plasma equals the combination
of the distribution of tumor tissue and leukocytes. Thus, we defined a window-judgement method
to identify whether biomarkers were stable.

Results:

Compared to traditional PCR as the standard, we evaluated three methods in 20 samples
(MSI-H:3/MSS:17): peak shifting method using tissue vs. leukocytes, peak shifting method using
plasma vs. leukocytes, and our method using plasma vs. leukocytes. Compared to traditional PCR,
we observed a sensitivity of 100%, 0%, and 100%, and a specificity of 100.00%, 94.12%, and
88.24%, respectively.

Conclusion:

Our method has the advantage of possibly detecting MSI in a liquid biopsy and
provides a novel direction for future studies to increase the specificity of the method.
The Dimensions of Entrepreneurial Orientation and Business Environment
Authors: Mohd Ali Ainunnazlee , Mat Azmi , Saiful Bahry Norliza , Mohd Salleh Muhammad Zaim
Published: March 2020

The fundamental of entrepreneurial orientation (EO) is needed to engage entrepreneur being creative, innovative, risky as well as uncertain activities in the market place and discover new opportunities before their competitors. Due to low risk-taking propensity, Micro, Small Medium Enterprises in Malaysia growing in number each year but they are not into becoming a large corporation due to unwillingness to commit resources to undergo activities and projects which resulted in the uncertainty of the outcomes. Hence, this study discussed the fundamental of entrepreneurial orientation and practices of EO among the new entrant in the business.Keywords: Creative, Innovative, Risky, and EntrepreneurialeISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v5i13.1949
Addressing Recent PISA Rankings: The potential role of preschool physical environment design quality in Malaysia
Authors: Shaari Mariam Felani , Ahmad Sabarinah Sheikh , Ismail Izaham Shah , Zaiki Yazid
Published: March 2020

Recent PISA assessments revealed unsatisfactory cognitive abilities among Malaysian children. Poor cognitive development, stemming from inadequate preschool cognitive school readiness (SR), is an underlying factor. Well-designed preschool physical environments (PPE) could potentially enhance cognitive SR and subsequently improve childhood cognitive development. This study aims to highlight the importance of PPE design quality on children’s cognitive SR in Malaysia. A cohort study involving 336 children at 16 Ministry of Education (MOE) preschools was conducted. PPE design quality demonstrated a significant positive association with cognitive SR. Conclusively, better PPE design is hoped to improve cognitive development by ensuring cognitive SR among Malaysian preschoolers.Keywords: Preschool Physical Environment; Cognitive School Readiness; Piaget’s Theory of Cognitive Development; PISAeISSN: 2398-4287 © 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v5i13.2057
Single-case Experimental Research: Designing emotions by designing spaces - A pilot study
Authors: Zaino Ammar Ayman , Abbas Mohamed Yusoff
Published: March 2020

The belief that the environment shapes human emotions followed by behaviour is not new, as acknowledged by many researchers. Recent studies show that the most significant illness by 2030 is depression, as most of our time spent inside the buildings. Hence, the importance of "re-connecting architecture with emotions" is an essential solution to improve the quality of life. A single-case experimental design (SCED) aimed to investigate the relationship between neural underpinnings of the brain, for a single participant and various environments. Data collected was based on the Electroencephalography tests. Findings showed a significant contrast between different water elements and environmental settings, each with its unique effect on participant emotions as well as the electrical activity of the brain.Keywords: Depression; Neural underpinnings; Water-bodies environment; Quality of Life.eISSN: 2398-4287 © 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v5i13.2103
Исследование защитных свойств комбинированного металлокерамического материала при высокоскоростном ударе
Authors: Ищенко А.Н. , Афанасьева С.А. , Белов Н.Н. , Буркин В.В. , Захаров В.М. , Зыкова А.И. , Саммель А.Ю. , Скосырский А.Б. , Степанов Е.Ю. , Табаченко А.Н. , Чупашев А.В. , Ушакова О.В. , Хабибуллин М.В. , Югов Н.Т.
Published: March 2020

The analysis of ballistics resistance of a combined metal-ceramic material based on high-strength ceramics in conjunction with the intermetallic on high strength metallic substrate layer – (TiB2+NiTi)+Ti in comparison with the steel plates, the titanium alloy BT1-0 plates and the corundum ceramics plates under impact with the steel spherical striker in velocity range about 2500 m/s was carried out. An experimental researches of protective barriers under the high-speed impact were carried out on the high-speed ballistic experimental facility. A mathematical modeling for the porous elastoplastic medium with taking an account various mechanisms of materials disruptions which was modified for mediums with complicated composition was carried out. There is shown, under the considered impact velocity range at breaking through barriers, in spite of low superficial density, a material (TiB2+NiTi)+Ti shows more force impact on the striker and greater penetration resistance then the steel, the titanium and the ceramics.
Композиционный радиопоглощающий материал на основе резистивных квадратов
Authors: Пономаренко В.И. , Лагунов И.М.
Published: March 2020

On the basis of the solution of the diffraction problem, the effective permittivity of the composite material consisting of alternating planar lattices of resistive squares displaced relative to each other and located in the dielectric layer is calculated. It is shown that the dispersion has a relaxation character. It is shown that it is possible to vary the dispersion characteristic over a wide range by varying the parameters of the structure. It is shown that the mutual displacement of lattices significantly changes the dispersion of the dielectric constant of the structure. The ratio of the wavelength to the period of the structure is estimated, at which the homogenization procedure is adequate.
Моделирование формирования сжатого состояния электронного пучка в замкнутой трубе дрейфа при токе пучка, меньшем предельного
Authors: Дубинов А.Е. , Тараканов В.П.
Published: March 2020

Путем PiC-моделирования исследована динамика процесса формирования виртуального катода и сжатого состояния пучка (ССП) в устройстве с допредельным релятивистским пучком электронов при повторном вводе электронного пучка в трубу дрейфа. Были определены физические характеристики ССП: геометрия, концентрация и температура электронов. Ключевые слова: электронный пучок, виртуальный катод, сжатое состояние пучка, PiC-моделирования, трубу дрейфа.
Therapeutic Duplication in Taiwan Hospitals for Patients With High Blood Pressure, Sugar, and Lipids: Evaluation With a Mobile Health Mapping Tool
Authors: Kan Wei-Chih , Kuo Shu-Chun , Chien Tsair-Wei , Lin Jui-Chung John , Yeh Yu-Tsen , Chou Willy , Chou Po-Hsin
Published: March 2020

Background

Cardiovascular disease causes approximately half of all deaths in patients with type 2 diabetes. Duplicative prescriptions of medication in patients with high blood pressure (hypertension), high blood sugar (hyperglycemia), and high blood lipids (hyperlipidemia) have attracted substantial attention regarding the abuse of health care resources and to implement preventive measures for such abuse. Duplicative prescriptions may occur by patients receiving redundant medications for the same condition from two or more sources such as doctors, hospitals, and multiple providers, or as a result of the patient’s wandering among hospitals.

Objective

We evaluated the degree of duplicative prescriptions in Taiwanese hospitals for outpatients with three types of medications (antihypertension, antihyperglycemia, and antihyperlipidemia), and then used an online dashboard based on mobile health (mHealth) on a map to determine whether the situation has improved in the recent 25 fiscal quarters.

Methods

Data on duplicate prescription rates of drugs for the three conditions were downloaded from the website of Taiwan’s National Health Insurance Administration (TNHIA) from the third quarter of 2010 to the third quarter of 2016. Complete data on antihypertension, antihyperglycemia, and antihyperlipidemia prescriptions were obtained from 408, 414, and 359 hospitals, respectively. We used scale quality indicators to assess the attributes of the study data, created a dashboard that can be traced using mHealth, and selected the hospital type with the best performance regarding improvement on duplicate prescriptions for the three types of drugs using the weighted scores on an online dashboard. Kendall coefficient of concordance (W) was used to evaluate whether the performance rankings were unanimous.

Results

The data quality was found to be acceptable and showed good reliability and construct validity. The online dashboard using mHealth on Google Maps allowed for easy and clear interpretation of duplicative prescriptions regarding hospital performance using multidisciplinary functionalities, and showed significant improvement in the reduction of duplicative prescriptions among all types of hospitals. Medical centers and regional hospitals showed better performance with improvement in the three types of duplicative prescriptions compared with the district hospitals. Kendall W was 0.78, indicating that the performance rankings were not unanimous (Chi square2=4.67, P=.10).

Conclusions

This demonstration of a dashboard using mHealth on a map can inspire using the 42 other quality indicators of the TNHIA by hospitals in the future.
A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study
Authors: Lara Juan Sebastian , Braga Mariana Minatel , Zagatto Carlos Gustavo , Wen Chao Lung , Mendes Fausto Medeiros , Murisi Pedroza Uribe , Haddad Ana Estela
Published: March 2020

Background

In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making.

Objective

This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures.

Methods

Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis–associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented.

Results

We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views.

Conclusions

Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts.
Smart, Remote, and Targeted Health Care Facilitation Through Connected Health: Qualitative Study
Authors: Chen Sonia Chien-I , Hu Ridong , McAdam Rodney
Published: March 2020

Background

Societies around the world are aging. Widespread aging creates problems for social services and health care practices. In this light, research on connected health (CH) is becoming essential. CH refers to a variety of technological measures that allow health care to be provided remotely with the aim of increasing efficiency, cost-effectiveness, and satisfaction on the part of health care recipients. CH is reshaping health care’s direction to be more proactive, more preventive, and more precisely targeted and, thus, more effective. CH has been demonstrated to have great value in managing and preventing chronic diseases, which create huge burdens on health care and social services. In short, CH provides promising solutions to diseases and social challenges associated with aging populations. However, there are many barriers that need to be overcome before CH can be successfully and widely implemented.

Objective

The research question of this study is as follows: How can CH facilitate smart, remote, and targeted health care? The objective is to identify how health care can be managed in more comprehensive ways, such as by providing timely, flexible, accessible, and personalized services to preserve continuity and offer high-quality seamless health care.

Methods

A qualitative approach was used based on 60 multistage, semistructured stakeholder interviews.

Results

The results can be divided into two functions of CH: ecosystem and platform. On the one hand, the interviews enabled the authors to develop a stakeholder classification and interaction diagram. These stakeholders interacted sequentially to provide technology-based content to end users. On the other hand, interviewees reflected on how CH serves as a platform to address remote monitoring and patient self-management. In the Discussion section, three innovation strategies are discussed to reflect the manner in which CH promotes smart, timely, and precise health care.

Conclusions

This study indicates that it is essential to continually revise CH business models, given the ongoing and rapid changes in technology across groups of CH stakeholders. We also found that global trends toward smart, timely, and precise health care shape what individuals expect from products and services, providing firms with unique opportunities for growth.
Experiences of African American Breast Cancer Survivors Using Digital Scales and Activity Trackers in a Weight Gain Prevention Intervention: Qualitative Study
Authors: Power Julianne M , Tate Deborah F , Valle Carmina G
Published: March 2020

Background

The use of digital tools to promote daily self-weighing and daily activity tracking may be a promising strategy for weight control among African American breast cancer survivors (AABCS). There have been no studies exploring the acceptability and feasibility of using digital tools for weight control or qualitative studies characterizing perceptions of daily self-weighing and daily activity tracking among AABCS.

Objective

This study aimed to explore the subjective experiences of daily self-weighing and daily activity tracking using digital tools, including wireless scales and activity trackers, in a sample of AABCS participating in two technology-based weight gain prevention interventions over 6 months.

Methods

Semistructured interviews (N=21) were conducted in person or over the phone, were audio recorded, and then transcribed verbatim. Each transcript was read to identify key themes and develop a codebook. Each transcript was coded using Atlas.ti software, and code outputs were used to identify overarching themes and patterns in the data.

Results

On average, participants were 52.6 (SD 8.3) years of age, with obesity at baseline (BMI 33.1 kg/m2, SD 5.9), and weighed on 123.4 (SD 48.0) days out of the 168 days (73.5%) in the study period. Women tended to attribute their weight gain to cancer treatment and framed program benefits in terms of improved quality of life and perceptions of prolonging their survival following treatment. Using the smart scale for daily self-weighing was viewed as the tool by which participants could control their weight and improve their health and well-being posttreatment. The activity tracker increased awareness of physical activity and motivated participants to be more active.

Conclusions

Participants reported positive experiences and benefits from daily self-weighing and daily activity tracking. Findings suggest that daily self-weighing and daily activity tracking using digital tools are well-received, acceptable, and feasible intervention strategies for AABCS in the context of posttreatment weight management.
Assessment of the Efficacy of a Mobile Phone–Delivered Just-in-Time Planning Intervention to Reduce Alcohol Use in Adolescents: Randomized Controlled Crossover Trial
Authors: Haug Severin , Paz Castro Raquel , Scholz Urte , Kowatsch Tobias , Schaub Michael Patrick , Radtke Theda
Published: March 2020

Background

Interventions to reduce alcohol use typically include several elements, such as information on the risks of alcohol consumption, planning for sensible drinking, and training of protective behavioral strategies. However, the effectiveness of these individual intervention elements within comprehensive programs has not been addressed so far, but it could provide valuable insights for the development of future interventions. Just-in-time interventions provided via mobile devices are intended to help people make healthy decisions in the moment and thus could influence health behavior.

Objective

The aim of this study was to test the proximal effects of a mobile phone–delivered, just-in-time planning intervention to reduce alcohol use in adolescents who reported recent binge drinking. The efficacy of this individual intervention element was tested within a comprehensive intervention program to reduce problem drinking in adolescents.

Methods

The study had an AB/BA crossover design, in which participants were randomly allocated to (1) a group receiving the planning intervention (A) in period 1 and assessment only (B) in period 2 or (2) a group receiving assessment only (B) in period 1 and the planning intervention (A) in period 2. The planning intervention included a text message to choose one of two predetermined if-then plans to practice sensible drinking with friends or when going out and a prompt to visualize the chosen plan. There was a washout period of at least 1 week between period 1 and period 2.

Results

Out of 633 program participants who recently binge drank, 136 (21.5%) were receptive in both periods of time and provided data on the proximal outcome, which was the number of alcoholic drinks consumed with friends or when going out. After the planning intervention, the number of alcoholic drinks consumed was approximately one standard drink lower compared with the finding without the intervention (P=.01).

Conclusions

A mobile phone–delivered, just-in-time, if-then planning intervention to practice sensible drinking with friends or when going out is effective in reducing alcohol consumption among adolescents who report recent binge drinking. Based on the relatively low percentage of participants with self-reported receptivity for the planning intervention, measures to increase the population impact of similar planning interventions should be implemented and tested in future trials.

Trial Registration

ISRCTN Registry ISRCTN52150713; http://www.isrctn.com/ISRCTN52150713
Benefits of Massive Open Online Course Participation: Deductive Thematic Analysis
Authors: Blum Elizabeth R , Stenfors Terese , Palmgren Per J
Published: March 2020

Background

Massive open online courses (MOOCs), as originally conceived, promised to provide educational access to anyone with an internet connection. However, the expansiveness of MOOC education has been found to be somewhat limited. Nonetheless, leading universities continue to offer MOOCs, including many in the health sciences, on a number of private platforms. Therefore, research on online education must include thorough understanding of the role of MOOCs. To date, studies on MOOC participants have focused mainly on learners’ assessment of the course. It is known that MOOCs are not reaching the universal audiences that were predicted, and much knowledge has been gained about learners’ perceptions of MOOCs. However, there is little scholarship on what learners themselves gain from participating in MOOCs.

Objective

As MOOC development persists and expands, scholars and developers should be made aware of the role of MOOCs in education by examining what these courses do offer their participants. The objective of this qualitative synthesis of a set of MOOC evaluation studies was to explore outcomes for MOOC learners, that is, how the learners themselves benefit from participating in MOOCs.

Methods

To explore MOOC learners’ outcomes, we conducted a qualitative synthesis in the form of a deductive thematic analysis, aggregating findings from 17 individual studies selected from an existing systematic review of MOOC evaluation methods. We structured our inquiry using the Kirkpatrick model, considering Kirkpatrick levels 2, 3, and 4 as potential themes in our analysis.

Results

Our analysis identified six types of Kirkpatrick outcomes in 17 studies. Five of these outcomes (learning/general knowledge, skills, attitudes, confidence, and commitment) fit into Kirkpatrick Level 2, while Kirkpatrick Level 3 outcomes concerning behavior/application were seen in four studies. Two additional themes were identified outside of the Kirkpatrick framework: culture and identity outcomes and affective/emotional outcomes. Kirkpatrick Level 4 was not represented among the outcomes we examined.

Conclusions

Our findings point to some gains from MOOCs. While we can expect MOOCs to persist, how learners benefit from the experience of participating in MOOCs remains unclear.
Determining the Topic Evolution and Sentiment Polarity for Albinism in a Chinese Online Health Community: Machine Learning and Social Network Analysis
Authors: Bi Qiqing , Shen Lining , Evans Richard , Zhang Zhiguo , Wang Shimin , Dai Wei , Liu Cui
Published: March 2020

Background

There are more than 6000 rare diseases in existence today, with the number of patients with these conditions rapidly increasing. Most research to date has focused on the diagnosis, treatment, and development of orphan drugs, while few studies have examined the topics and emotions expressed by patients living with rare diseases on social media platforms, especially in online health communities (OHCs).

Objective

This study aimed to determine the topic categorizations and sentiment polarity for albinism in a Chinese OHC, Baidu Tieba, using multiple methods. The OHC was deeply mined using topic mining, social network analysis, and sentiment polarity analysis. Through these methods, we determined the current situation of community construction, identifying the ongoing needs and problems experienced by people with albinism in their daily lives.

Methods

We used the albinism community on the Baidu Tieba platform as the data source in this study. Term frequency–inverse document frequency, latent dirichlet allocation models, and naive Bayes were employed to mine the various topic categories. Social network analysis, which was completed using the Gephi tool, was employed to analyze the evolution of the albinism community. Sentiment polarity analysis was performed using a long short-term memory algorithm.

Results

We identified 8 main topics discussed in the community: daily sharing, family, interpersonal communication, social life and security, medical care, occupation and education, beauty, and self-care. Among these topics, daily sharing represented the largest proportion of the discussions. From 2012 to 2019, the average degree and clustering coefficient of the albinism community continued to decline, while the network center transferred from core communities to core users. A total of 68.43% of the corpus was emotional, with 35.88% being positive and 32.55% negative. There were statistically significant differences in the distribution of sentiment polarity between topics (P<.001). Negative emotions were twice as high as positive emotions in the social life and security topic.

Conclusions

The study reveals insights into the emotions expressed by people with albinism in the Chinese OHC, Baidu Tieba, providing health care practitioners with greater appreciation of the current emotional support needed by patients and the patient experience. Current OHCs do not exert enough influence due to limited effective organization and development. Health care sectors should take greater advantage of OHCs to support vulnerable patients with rare diseases to meet their evidence-based needs.
Assessing Hand Hygiene and Low-Level Disinfection of Equipment Compliance in an Acute Care Setting: Mixed Methods Approach (Preprint)
Authors: Akram Hammad , Andrews-Paul Alison , Washburn Rachel
Published: March 2020

BACKGROUND

Hand hygiene and low-level disinfection of equipment behaviors among hospital staff are some of the leading cost-effective methods to reduce hospital-acquired infections (HAI) among patients.

OBJECTIVE

The aim of this study is to examine hand hygiene and low-level disinfection of equipment practices in a central Texas hospital and to explore pertaining gaps, perceptions, and challenges.

METHODS

Data were collected using a multipronged mixed methods approach that included the following: (1) observation of hand hygiene and low-level disinfection practices (12 and 8 units during morning and evening shifts, respectively); (2) observation of usability/placement of hand sanitizer dispensers; (3) semistructured interviews; and (4) a follow-up email survey.

RESULTS

In total, 222 (156 morning shift and 66 evening shift) staff members were observed. Of 526 hand hygiene and 33 low-level disinfection opportunities, compliance was observed 410 (78%) and 17 (51%) times, respectively. Overall, 6 units (50%) had ≥0.80 (favorable) hand hygiene compliance during the morning shift and 2 units (25%) had ≥0.80 hand hygiene compliance during the evening shift. Aggregated low-level disinfection compliance was 0.54 during the morning and 0.33 during the evening. Overall, the odds of noncompliant hand hygiene behavior were 1.4 times higher among staff who worked during night shifts compared to day shifts; however, this relationship was not statistically significant (95% CI 0.86-2.18; P=.18). Noncompliant behavior was most likely among unit B staff during the evening; however, this relationship was not statistically significant (OR 5.3, 95% CI 0.84-32.9; P=.07) All units, except one, had similar hand sanitizer dispenser usability characteristics. In the qualitative part of the study, the following challenges were identified: “shortage of time while seeing patients,” “sometimes the staff forgets,” “concern about drying hands,” “behavior is difficult or requires reminders,” and “there may be issues with resources or access to supplies to perform these behaviors.” Staff also stated that “a process that is considered effective is the Stop the Line program,” and that the “behavior is easy and automatic.”

CONCLUSIONS

Hand hygiene and low-level disinfection compliance is dependent on several personal and nonpersonal factors. Issues such as time constraints, peer pressure, work culture, available resources, and understanding of guidelines could influence staff behavior. The information collected through this study can be used to re-examine similar or related issues at a larger scale.
A Tailored Motivational Messages Library for a Mobile Health Sleep Behavior Change Support System to Promote Continuous Positive Airway Pressure Use Among Patients With Obstructive Sleep Apnea: Development, Content Validation, and Testing (Preprint)
Authors: Alismail Sarah , Olfman Lorne
Published: March 2020

BACKGROUND

Continuous positive airway pressure (CPAP) therapy is the most effective treatment for obstructive sleep apnea (OSA). Despite the reported benefits of CPAP therapy in treating OSA, its effectiveness is reduced by less-than-optimal adherence or use. Up to 50% of patients who accept CPAP therapy fail to adhere to it. As a lack of commitment to CPAP therapy is one of the most significant factors that hinder OSA treatment effectiveness, patient motivation and education are critical to help alleviate the problem of poor CPAP adherence or use.

OBJECTIVE

This study aims to support the development of mobile health interventions or information systems solutions to promote CPAP adherence and use among patients with OSA through development, content validation, and testing of tailored motivational messages.

METHODS

In phase 1, an initial library of 60 messages was developed to promote CPAP use among patients with OSA. In phase 2, draft messages were evaluated for content validation testing for relevance and clarity by research and clinical experts. In phase 3, patients with OSA (N=24) were recruited through a Qualtrics panel to rate the perceived persuasiveness of the messages in terms of threat and efficacy perceptions, as per their computed extended parallel process model (EPPM) response states. The average score of the ratings was calculated for each message. The messages were sorted according to their average (from highest to lowest) to select the best 12 messages for each tailored set based on the potential responses from the EPPM.

RESULTS

In phase 1, 60 messages were developed based on the existing literature and a review of existing materials. In phase 2, the enumerated content validity of the messages was established through the use of the content validity index for items. A total of 57 messages were found to have acceptable content relevance and clarity. In phase 3, patients with OSA perceived the final library of 48 messages to be persuasive.

CONCLUSIONS

After the process of content validation and testing, the final library of messages met the criteria for clarity, relevance, and perceived persuasiveness. This study emphasizes the importance of developing and validating the content of motivational messages, grounded in EPPM theory, across the 4 possible response states in terms of high or low efficacy and threat perceptions.
TOP-Net Prediction Model Using Bidirectional Long Short-term Memory and Medical-Grade Wearable Multisensor System for Tachycardia Onset: Algorithm Development Study (Preprint)
Authors: Liu Xiaoli , Liu Tongbo , Zhang Zhengbo , Kuo Po-Chih , Xu Haoran , Yang Zhicheng , Lan Ke , Li Peiyao , Ouyang Zhenchao , Ng Yeuk Lam , Yan Wei , Li Deyu
Published: March 2020

BACKGROUND

Without timely diagnosis and treatment, tachycardia, also called tachyarrhythmia, can cause serious complications such as heart failure, cardiac arrest, and even death. The predictive performance of conventional clinical diagnostic procedures needs improvement in order to assist physicians in detecting risk early on.

OBJECTIVE

We aimed to develop a deep tachycardia onset prediction (TOP-Net) model based on deep learning (ie, bidirectional long short-term memory) for early tachycardia diagnosis with easily accessible data.

METHODS

TOP-Net leverages 2 easily accessible data sources: vital signs, including heart rate, respiratory rate, and blood oxygen saturation (SpO2) acquired continuously by wearable embedded systems, and electronic health records, containing age, gender, admission type, first care unit, and cardiovascular disease history. The model was trained with a large data set from an intensive care unit and then transferred to a real-world scenario in the general ward. In this study, 3 experiments incorporated merging patients’ personal information, temporal memory, and different feature combinations. Six metrics (area under the receiver operating characteristic curve [AUROC], sensitivity, specificity, accuracy, F1 score, and precision) were used to evaluate predictive performance.

RESULTS

TOP-Net outperformed the baseline models on the large critical care data set (AUROC 0.796, 95% CI 0.768-0.824; sensitivity 0.753, 95% CI 0.663-0.793; specificity 0.720, 95% CI 0.645-0.758; accuracy 0.721; F1 score 0.718; precision 0.686) when predicting tachycardia onset 6 hours in advance. When predicting tachycardia onset 2 hours in advance with data acquired from our hospital using the transferred TOP-Net, the 6 metrics were 0.965, 0.955, 0.881, 0.937, 0.793, and 0.680, respectively. The best performance was achieved using comprehensive vital signs (heart rate, respiratory rate, and SpO2) statistical information.

CONCLUSIONS

TOP-Net is an early tachycardia prediction model that uses 8 types of data from wearable sensors and electronic health records. When validated in clinical scenarios, the model achieved a prediction performance that outperformed baseline models 0 to 6 hours before tachycardia onset in the intensive care unit and 2 hours before tachycardia onset in the general ward. Because of the model’s implementation and use of easily accessible data from wearable sensors, the model can assist physicians with early discovery of patients at risk in general wards and houses.
An Immersive Multi-User Virtual Reality for Emergency Simulation Training: Usability Study (Preprint)
Authors: Lerner Dieter , Mohr Stefan , Schild Jonas , Göring Martin , Luiz Thomas
Published: March 2020

BACKGROUND

Virtual reality (VR) is increasingly used as simulation technology in emergency medicine education and training, in particular for training nontechnical skills. Experimental studies comparing teaching and learning in VR with traditional training media often demonstrate the equivalence or even superiority regarding particular variables of learning or training effectiveness.

OBJECTIVE

In the EPICSAVE (Enhanced Paramedic Vocational Training with Serious Games and Virtual Environments) project, a highly immersive room-scaled multi-user 3-dimensional VR simulation environment was developed. In this feasibility study, we wanted to gain initial insights into the training effectiveness and media use factors influencing learning and training in VR.

METHODS

The virtual emergency scenario was anaphylaxis grade III with shock, swelling of the upper and lower respiratory tract, as well as skin symptoms in a 5-year-old girl (virtual patient) visiting an indoor family amusement park with her grandfather (virtual agent). A cross-sectional, one-group pretest and posttest design was used to evaluate the training effectiveness and quality of the training execution. The sample included 18 active emergency physicians.

RESULTS

The 18 participants rated the VR simulation training positive in terms of training effectiveness and quality of the training execution. A strong, significant correlation (r=.53, P=.01) between experiencing presence and assessing training effectiveness was observed. Perceived limitations in usability and a relatively high extraneous cognitive load reduced this positive effect.

CONCLUSIONS

The training within the virtual simulation environment was rated as an effective educational approach. Specific media use factors appear to modulate training effectiveness (ie, improvement through “experience of presence” or reduction through perceived limitations in usability). These factors should be specific targets in the further development of this VR simulation training.
Más allá de pajaritos y abejitas: sexualidad en el adolescente mexicano
Authors: Cervantes Lara Claudia Alejandra , Álvarez Aguirre Alicia , Moreno Gónzalez María Mercedes
Published: March 2020

La adolescencia es una etapa de transición donde surgen cambios en cada una de las esferas que integran a una persona. Esto, aunado al crecimiento social acelerado, confronta a los adolescentes con nuevos desafíos respecto a su sexualidad. La falta de educación sexual integral desde la infancia y el tema de sexualidad tratado como un tabú permiten que se presenten consecuencias como el embarazo adolescente y enfermedades de transmisión sexual. Por lo tanto, se aborda dicha problemática, así como algunas estrategias que promueven el ejercicio de una sexualidad libre, informada y responsable.
Ambiguity in Writing Story Text of Experience of Grade IV Students of the Champion School Denpasar-Bali
Authors: Anggur Bonefantura
Published: March 2020

This research aims is to describe the lexical ambiguity, gramatical ambiguity and what factors that influence the writing skills of primary IV students of The Champion Denpasar-Bali. The method of this research is a qualitative approach. The data is obtained by the written story text from the student’s experience. The results showed that the type of ambiguity contained is consisted of lexical ambiguity and grammatical ambiguity. Lexical ambiguity is divided into two parts, namely polysemy and homonymy, while grammatical ambiguity is divided into four parts including: grammatical ambiguity caused by grammatical word formation events, grammatical ambiguity in similar phrases, grammatical vocabulary because of sentence context or lack of grammatical context and ambiguity because of the inaccuracy of the grammatical structure. The factors that influence the writing skills of primary IV students of The Champion Denpasar - Bali. First, the use of a foreign language (English) as a daily communication language of students in schools that intervene in Indonesian, which causes the lack of vocabulary that students have so that students find it difficult to write the text of the Indonesian experience stories correctly. Second, family, the assumption that the task of giving lessons to students is only the duty of the teacher to make the family environment rarely train their children to write at home. Third is, intelligence which is related to students' ability to absorb the material taught to them. The fourth is interest related to encouragement, motives, and emotional responses.
Comércio, Serviços e Cidade. Subsídios para Gestão Urbana
Authors: Vargas Heliana Comin
Published: March 2020

O presente artigo pretende contribuir para o entendimento da complexidade do setor terciário, que implica diferentes demandas locacionais, com vistas a fornecer subsídios para alimentar políticas urbanas mais consistentes. Para tanto, discorre-se, inicialmente, sobre a dificuldade de conceituação e classificação das atividades terciárias, buscando explicitar as diferenças entre manufatura, comércio e serviços. Na sequência, são apresentados e discutidos: a composição do terciário; o domínio público ou privado e sua relação com o consumidor (empresas ou indivíduos), bem como sua organização espontânea ou planejada, além de sua alta capacidade de incorporar mudanças. Essas preferências locacionais, nas sociedades capitalistas, que têm como objetivo a viabilidade dos respectivos negócios, apresentam relação direta com a dinâmica urbana (usos e fluxos) e podem, se bem compreendidas, auxiliar na implementação de políticas públicas de dinamização e requalificação urbana.