bluuebunny/crossref_metadata_2025 huggingface dataset:
Content Analysis of Mothers’ Questions Related to Parenting Young Children in Internet Parenting Community
Authors: Yu Jung Ok , June Kyung Ja , Park Sun Hwa , Woo Min Soo
Published: November 2020

Purpose: This study aimed to investigate mothers’ questions related to parenting young children in the internet community.Methods: One representative in the internet community was selected and parenting questions were collected over 2 weeks in October 2019. A total of 15,016 questions were analyzed by frequency and proportion after categorizing of 10 themes; health and daily care, connecting and communicating, play and learning, development and growth, poos and wees, sleep, feeding, solid foods, safety, behavior.Results: The most frequently asked questions per age ranged from 1 to 3 months (32.2%). The most frequently asked questions by theme per age were about feeding newborn up to 6 months, solid foods from 7 to 12 months, health and daily care from 13 to 24 months, and play and learning from 25 to 71 months. Conclusion: As these results reflect mother’s need for information and support, it is suggested that more specific and targeted online/offline support per age should be developed.
Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial
Authors: Wu Qiong , Huang Yiwen , Liao Zijun , van Velthoven Michelle Helena , Wang Wei , Zhang Yanfeng
Published: November 2020

Background

The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors.

Objective

This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices.

Methods

This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum.

Results

At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1% vs 63.3%; odds ratio [OR] 2.75, 95% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0%; control: 96/152, 63.2%) and 4-5 months postpartum(intervention: 50/108, 46.3%; control: 46/109, 42.2%).

Conclusions

This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs.

Trial Registration

Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325

International Registered Report Identifier (IRRID)

RR2-10.1186/s12889-019-7676-2
Smart Data Collection for the Assessment of Treatment Effects in Irritable Bowel Syndrome: Observational Study (Preprint)
Authors: Weerts Zsa Zsa R M , Heinen Koert G E , Masclee Ad A M , Quanjel Amber B A , Winkens Bjorn , Vork Lisa , Rinkens Paula E L M , Jonkers Daisy M A E , Keszthelyi Daniel
Published: November 2020

BACKGROUND

End-of-day symptom diaries are recommended by drug regulatory authorities to assess treatment response in patients with irritable bowel syndrome. We developed a smartphone app to measure treatment response.

OBJECTIVE

Because the employment of an app to measure treatment response in irritable bowel syndrome is relatively new, we aimed to explore patients’ adherence to diary use and characteristics associated with adherence.

METHODS

A smartphone app was developed to serve as a symptom diary. Patients with irritable bowel syndrome (based on Rome IV criteria) were instructed to fill out end-of-day diary questionnaires during an 8-week treatment. Additional online questionnaires assessed demographics, irritable bowel syndrome symptom severity, and psychosocial comorbidities. Adherence rate to the diary was defined as the percentage of days completed out of total days. Adherence to the additional web-based questionnaires was also assessed.

RESULTS

Overall, 189 patients were included (age: mean 34.0 years, SD 13.3 years; female: 147/189, 77.8%; male: 42/189, 22.2%). The mean adherence rate was 87.9% (SD 9.4%). However, adherence to the diary decreased over time (P<.001). No significant association was found between adherence and gender (P=.84), age (P=.22), or education level (lower education level: P=.58, middle education level: P=.46, versus high education level), while higher anxiety scores were associated with lower adherence (P=.03). Adherence to the online questionnaires was also high (>99%). Missing data due to technical issues were limited.

CONCLUSIONS

The use of a smartphone app as a symptom diary to assess treatment response resulted in high patient adherence. The data-collection framework described led to standardized data collection with excellent completeness and can be used for future randomized controlled trials. Due to the slight decrease in adherence to diary use throughout the study, this method might be less suitable for longer trials.
Co-design of a Smartphone App for People Living With Dementia by Applying Agile, Iterative Co-design Principles: Development and Usability Study (Preprint)
Authors: Fox Sarah , Brown Laura J E , Antrobus Steven , Brough David , Drake Richard J , Jury Francine , Leroi Iracema , Parry-Jones Adrian R , Machin Matthew
Published: November 2020

BACKGROUND

The benefits of involving those with lived experience in the design and development of health technology are well recognized, and the reporting of co-design best practices has increased over the past decade. However, it is important to recognize that the methods and protocols behind patient and public involvement and co-design vary depending on the patient population accessed. This is especially important when considering individuals living with cognitive impairments, such as dementia, who are likely to have needs and experiences unique to their cognitive capabilities. We worked alongside individuals living with dementia and their care partners to co-design a mobile health app. This app aimed to address a gap in our knowledge of how cognition fluctuates over short, microlongitudinal timescales. The app requires users to interact with built-in memory tests multiple times per day, meaning that co-designing a platform that is easy to use, accessible, and appealing is particularly important. Here, we discuss our use of Agile methodology to enable those living with dementia and their care partners to be actively involved in the co-design of a mobile health app.

OBJECTIVE

The aim of this study is to explore the benefits of co-design in the development of smartphone apps. Here, we share our co-design methodology and reflections on how this benefited the completed product.

METHODS

Our app was developed using Agile methodology, which allowed for patient and care partner input to be incorporated iteratively throughout the design and development process. Our co-design approach comprised 3 core elements, aligned with the values of patient co-design and adapted to meaningfully involve those living with cognitive impairments: end-user representation at research and software development meetings via a patient proxy; equal decision-making power for all stakeholders based on their expertise; and continuous user consultation, user-testing, and feedback.

RESULTS

This co-design approach resulted in multiple patient and care partner–led software alterations, which, without consultation, would not have been anticipated by the research team. This included 13 software design alterations, renaming of the product, and removal of a cognitive test deemed to be too challenging for the target demographic.

CONCLUSIONS

We found patient and care partner input to be critical throughout the development process for early identification of design and usability issues and for identifying solutions not previously considered by our research team. As issues addressed in early co-design workshops did not reoccur subsequently, we believe this process made our product more user-friendly and acceptable, and we will formally test this assumption through future pilot-testing.
Establishing and Facilitating Large-Scale Manuscript Collaborations via Social Media: Novel Method and Tools for Replication (Preprint)
Authors: Acquaviva Kimberly D
Published: November 2020

BACKGROUND

Authorship teams in the health professions are typically composed of scholars who are acquainted with one another before a manuscript is written. Even if a scholar has identified a diverse group of collaborators outside their usual network, writing an article with a large number of co-authors poses significant logistical challenges.

OBJECTIVE

This paper describes a novel method for establishing and facilitating large-scale manuscript collaborations via social media.

METHODS

On September 11, 2020, I used the social media platform Twitter to invite people to collaborate on an article I had drafted. Anyone who wanted to collaborate was welcome, regardless of discipline, specialty, title, country of residence, or degree completion. During the 25 days that followed, I used Google Docs, Google Sheets, and Google Forms to manage all aspects of the collaboration.

RESULTS

The collaboration resulted in the completion of 2 manuscripts in a 25-day period. The International Council of Medical Journal Editors authorship criteria were met by 40 collaborators for the first article (“Documenting Social Media Engagement as Scholarship: A New Model for Assessing Academic Accomplishment for the Health Professions”) and 35 collaborators for the second article (“The Benefits of Using Social Media as a Health Professional in Academia”). The authorship teams for both articles were notably diverse, with 17%-18% (7/40 and 6/35, respectively) of authors identifying as a person of color and/or underrepresented minority, 37%-38% (15/40 and 13/35, respectively) identifying as LGBTQ+ (lesbian, gay, bisexual, transgender, gender non-conforming, queer and/or questioning), 73%-74% (29/40 and 26/35, respectively) using she/her pronouns, and 20%-23% (9/40 and 7/35, respectively) identifying as a person with a disability.

CONCLUSIONS

Scholars in the health professions can use this paper in conjunction with the tools provided to replicate this process in carrying out their own large-scale manuscript collaborations.
Reliability and validity analysis of color word test based on the smartphone program Stroop (Preprint)
Authors: Qiuju Bai , Hai Zhang Yan , Bo Pan , Jing Zhao , Dan Li , Miao Ren , Yi Chi Li
Published: November 2020

BACKGROUND

The Stroop colorword test was developed by the American psychologist John Riddly Stroop as a result of his famous color naming experiment at 1935. Generally, reading a word and telling the color of a font are two distinct cognitive processes. It is widely used in the clinical evaluation of cognitive and executive functions [2, 3], mainly including automatic processing and controlled processing, psychosis, or the cognitive interference caused by neurophysiological irregularities, the cognitive structure of selective attention, and so forth. In the traditional Stroop scale test, the participants read the colors of Chinese characters one by one from the paper cards. Many complicating factors may bias the results of the test one way or another [ 4 ]. Among these complicating factors, the skill level of testers is prominent, affecting the test–retest reliability of the scale, which is not conducive to the clinical application of the Stroop effect.

OBJECTIVE

This study aimed to evaluate the reliability and validity of the colorword test based on the smartphone program Stroop (C-Stroop).

METHODS

A total of 30 participants were selected from outpatients of the Department of Neurology of the 986th Hospital of the Air Force from December 2019 to March 2020. These participants were randomly divided into groups and subjected to either traditional Stroop colorword test (administered by a professional or nonprofessional examiner) or C-Stroop colorword test. The response time and the number of responses after completing the tasks were compared between different groups. Conclusions were drawn about the relative reliability and effectiveness of different testing methods.

RESULTS

(1) The KMO value of the test time was 0.860, and the KMO value of the correct number was 0.768. The analysis of the correspondence relationship between the test time and the correct number of items and factors in the scale homogeneity test showed that the correlation coefficients were both greater than 0.8 and 0.7. (2) The Cronbach’s alpha coefficient of the reliability analysis test and the correct number was 0.981 and 0.886, respectively. (3) The correlation coefficient and the P value of the time and the correct number were statistically significant.

CONCLUSIONS

The C-Stroop colorword test was easy to administer, and exhibited high sensitivity, good reliability, and excellent repetitiveness. It can be used to evaluate the executive function of participants in place of the traditional Stroop colorword test.
Understanding the Relationship Between Official and Social Information About Infectious Disease: Experimental Analysis (Preprint)
Authors: Assaf Elias , Bond Robert M , Cranmer Skyler J , Kaizar Eloise E , Ratliff Santoro Lauren , Shikano Susumu , Sivakoff David J
Published: November 2020

BACKGROUND

Communicating official public health information about infectious diseases is complicated by the fact that individuals receive much of their information from their social contacts, either via interpersonal interaction or social media, which can be prone to bias and misconception.

OBJECTIVE

This study aims to evaluate the effect of public health campaigns and the effect of socially communicated health information on learning about diseases simultaneously. Although extant literature addresses the effect of one source of information (official or social) or the other, it has not addressed the simultaneous interaction of official information (OI) and social information (SI) in an experimental setting.

METHODS

We used a series of experiments that exposed participants to both OI and structured SI about the symptoms and spread of hepatitis C over a series of 10 rounds of computer-based interactions. Participants were randomly assigned to receive a high, low, or control intensity of OI and to receive accurate or inaccurate SI about the disease.

RESULTS

A total of 195 participants consented to participate in the study. Of these respondents, 186 had complete responses across all ten experimental rounds, which corresponds to a 4.6% (9/195) nonresponse rate. The OI high intensity treatment increases learning over the control condition for all symptom and contagion questions when individuals have lower levels of baseline knowledge (all P values ≤.04). The accurate SI condition increased learning across experimental rounds over the inaccurate condition (all P values ≤.01). We find limited evidence of an interaction between official and SI about infectious diseases.

CONCLUSIONS

This project demonstrates that exposure to official public health information increases individuals’ knowledge of the spread and symptoms of a disease. Socially shared information also facilitates the learning of accurate and inaccurate information, though to a lesser extent than exposure to OI. Although the effect of OI persists, preliminary results suggest that it can be degraded by persistent contradictory SI over time.
A Machine Learning Application for Raising WASH Awareness in the Times of COVID-19 Pandemic (Preprint)
Authors: Pandey Rohan , Gautam Vaibhav , Pal Ridam , Bandhey Harsh , Dhingra Lovedeep Singh , Sharma Himanshu , Jain Chirag , Bhagat Kanav , Arushi Arushi , Patel Lajjaben , Agarwal Mudit , Agrawal Samprati , Jalan Rishabh , Garg Ayush , Wadhwa Akshat , Misra Vihaan , Agrawal Yashwin , Rana Bhavika , Kumaraguru Ponnurangam , Sethi Tavpritesh
Published: November 2020

BACKGROUND

The COVID-19 pandemic has uncovered the potential of digital misinformation in shaping the health of nations. The deluge of unverified information that spreads faster than the epidemic itself is an unprecedented phenomenon that has put millions of lives in danger. Mitigating this ‘Infodemic’ requires strong health messaging systems that are engaging, vernacular, scalable, effective and continuously learn the new patterns of misinformation.

OBJECTIVE

We created WashKaro, a multi-pronged intervention for mitigating misinformation through conversational AI, machine translation and natural language processing. WashKaro provides the right information matched against WHO guidelines through AI, and delivers it in the right format in local languages.

METHODS

We theorize (i) an NLP based AI engine that could continuously incorporate user feedback to improve relevance of information, (ii) bite sized audio in the local language to improve penetrance in a country with skewed gender literacy ratios, and (iii) conversational but interactive AI engagement with users towards an increased health awareness in the community.

RESULTS

A total of 5026 people who downloaded the app during the study window, among those 1545 were active users. Our study shows that 3.4 times more females engaged with the App in Hindi as compared to males, the relevance of AI-filtered news content doubled within 45 days of continuous machine learning, and the prudence of integrated AI chatbot “Satya” increased thus proving the usefulness of an mHealth platform to mitigate health misinformation.

CONCLUSIONS

We conclude that a multi-pronged machine learning application delivering vernacular bite-sized audios and conversational AI is an effective approach to mitigate health misinformation.

CLINICALTRIAL

Not Applicable
Factors Associated With Perceived Trust of False Abortion Websites: Cross-sectional Online Survey (Preprint)
Authors: Chaiken Sarina Rebecca , Han Lisa , Darney Blair G , Han Leo
Published: November 2020

BACKGROUND

Most patients use the internet to search for health information. While there is a vast repository of searchable information online, much of the content is unregulated and therefore potentially incorrect, conflicting, or confusing. Abortion information online is particularly prone to being inaccurate as antichoice websites publish purposefully misleading information in formats that appear as neutral resources. To understand how antichoice websites appear neutral, we need to understand the specific website features of antichoice websites that impart an impression of trustworthiness.

OBJECTIVE

We sought to identify the characteristics of false or misleading abortion websites that make these websites appear trustworthy to the public.

METHODS

We conducted a cross-sectional study using Amazon’s Mechanical Turk platform. We used validated questionnaires to ask participants to rate 11 antichoice websites and one neutral website identified by experts, focusing on website content, creators, and design. We collected sociodemographic data and participant views on abortion. We used a composite measure of “mean overall trust” as our primary outcome. Using correlation matrices, we determined which website characteristics were most associated with mean overall trust. Finally, we used linear regression to identify participant characteristics associated with overall trust.

RESULTS

Our analytic sample included 498 participants aged from 22 to 70 years, and 50.1% (247/493) identified as female. Across 11 antichoice websites, creator confidence (“I believe that the creators of this website are honest and trustworthy”) had the highest correlation coefficient (strongest relationship) with mean overall trust (coefficient=0.70). Professional appearance (coefficient=0.59), look and feel (coefficient=0.59), perception that the information is created by experts (coefficient=0.59), association with a trustworthy organization (coefficient=0.58), valued features and functionalities (coefficient=0.54), and interactive capabilities (coefficient=0.52) all demonstrated strong relationships with mean overall trust. At the individual level, prochoice leaning was associated with higher overall trust of the neutral website (B=−0.43, 95% CI −0.87 to 0.01) and lower mean overall trust of the antichoice websites (B=0.52, 95% CI 0.05 to 0.99).

CONCLUSIONS

The mean overall trust of antichoice websites is most associated with design characteristics and perceived trustworthiness of website creators. Those who believe that access to abortion should be limited are more likely to have higher mean overall trust for antichoice websites.
Differences in the Gut Microbiome of Women With and Without Hypoactive Sexual Desire Disorder: Case Control Study (Preprint)
Authors: Li Guanjian , Li Weiran , Song Bing , Wang Chao , Shen Qunshan , Li Bo , Tang Dongdong , Xu Chuan , Geng Hao , Gao Yang , Wang Guanxiong , Wu Huan , Zhang Zhiguo , Xu Xiaofeng , Zhou Ping , Wei Zhaolian , He Xiaojin , Cao Yunxia
Published: November 2020

BACKGROUND

The gut microbiome is receiving considerable attention as a potentially modifiable risk factor and therapeutic target for numerous mental and neurological diseases.

OBJECTIVE

This study aimed to explore and assess the difference in the composition of gut microbes and fecal metabolites between women with hypoactive sexual desire disorder (HSDD) and healthy controls.

METHODS

We employed an online recruitment method to enroll “hard-to-reach” HSDD populations. After a stringent diagnostic and exclusion process based on DSM-IV criteria, fecal samples collected from 24 women with HSDD and 22 age-matched, healthy controls underwent microbiome analysis using 16S ribosomal RNA gene sequencing and metabolome analysis using untargeted liquid chromatography–mass spectrometry.

RESULTS

We found a decreased abundance of Ruminococcaceae and increased abundance of Bifidobacterium and Lactobacillus among women with HSDD. Fecal samples from women with HSDD showed significantly altered metabolic signatures compared with healthy controls. The abundance of Bifidobacterium, Lactobacillus, and several fecal metabolites correlated negatively with the sexual desire score, while the number of Ruminococcaceae correlated positively with the sexual desire score in all subjects.

CONCLUSIONS

Our analysis of fecal samples from women with HSDD and healthy controls identified significantly different gut microbes and metabolic signatures. These preliminary findings could be useful for developing strategies to adjust the level of human sexual desire by modifying gut microbiota.

CLINICALTRIAL

Chinese Clinical Trial Registry ChiCTR1800020321; http://www.chictr.org.cn/showproj.aspx?proj=34267
Reliable Deep Learning–Based Detection of Misplaced Chest Electrodes During Electrocardiogram Recording: Algorithm Development and Validation (Preprint)
Authors: Rjoob Khaled , Bond Raymond , Finlay Dewar , McGilligan Victoria , J Leslie Stephen , Rababah Ali , Iftikhar Aleeha , Guldenring Daniel , Knoery Charles , McShane Anne , Peace Aaron
Published: November 2020

BACKGROUND

A 12-lead electrocardiogram (ECG) is the most commonly used method to diagnose patients with cardiovascular diseases. However, there are a number of possible misinterpretations of the ECG that can be caused by several different factors, such as the misplacement of chest electrodes.

OBJECTIVE

The aim of this study is to build advanced algorithms to detect precordial (chest) electrode misplacement.

METHODS

In this study, we used traditional machine learning (ML) and deep learning (DL) to autodetect the misplacement of electrodes V1 and V2 using features from the resultant ECG. The algorithms were trained using data extracted from high-resolution body surface potential maps of patients who were diagnosed with myocardial infarction, diagnosed with left ventricular hypertrophy, or a normal ECG.

RESULTS

DL achieved the highest accuracy in this study for detecting V1 and V2 electrode misplacement, with an accuracy of 93.0% (95% CI 91.46-94.53) for misplacement in the second intercostal space. The performance of DL in the second intercostal space was benchmarked with physicians (n=11 and age 47.3 years, SD 15.5) who were experienced in reading ECGs (mean number of ECGs read in the past year 436.54, SD 397.9). Physicians were poor at recognizing chest electrode misplacement on the ECG and achieved a mean accuracy of 60% (95% CI 56.09-63.90), which was significantly poorer than that of DL (P<.001).

CONCLUSIONS

DL provides the best performance for detecting chest electrode misplacement when compared with the ability of experienced physicians. DL and ML could be used to help flag ECGs that have been incorrectly recorded and flag that the data may be flawed, which could reduce the number of erroneous diagnoses.

CLINICALTRIAL
The Value of Web-Based Patient Education Materials on Transarterial Chemoembolization: Systematic Review (Preprint)
Authors: Sideris Georgios Antonios , Vyllioti Aikaterini-Themis , Dima Danai , Chill Michael , Njuguna Njogu
Published: November 2020

BACKGROUND

Thousands of web searches are performed related to transarterial chemoembolization (TACE), given its palliative role in the treatment of liver cancer.

OBJECTIVE

This study aims to assess the reliability, quality, completeness, readability, understandability, and actionability of websites that provide information on TACE for patients.

METHODS

The five most popular keywords pertaining to TACE were searched on Google, Yahoo, and Bing. General website characteristics and the presence of Health On the Net Foundation code certification were documented. Website assessment was performed using the following scores: DISCERN, Journal of the American Medical Association, Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Patient Education Materials Assessment Tool. A novel TACE content score was generated to evaluate website completeness.

RESULTS

The search yielded 3750 websites. In total, 81 website entities belonging to 78 website domains met the inclusion criteria. A medical disclaimer was not provided on 28% (22/78) of website domains. Health On the Net code certification was present on 12% (9/78) of website domains. Authorship was absent on 88% (71/81) of websites, and sources were absent on 83% (67/81) of websites. The date of publication or of the last update was not listed on 58% (47/81) of websites. The median DISCERN score was 47.0 (IQR 40.5-54.0). The median TACE content score was 35 (IQR 27-43). The median readability grade level was in the 11th grade. Overall, 61% (49/81) and 16% (13/81) of websites were deemed understandable and actionable, respectively. Not-for-profit websites fared significantly better on the Journal of the American Medical Association, DISCERN, and TACE content scores.

CONCLUSIONS

The content referring to TACE that is currently available on the web is unreliable, incomplete, difficult to read, understandable but not actionable, and characterized by low overall quality. Websites need to revise their content to optimally educate consumers and support shared decision-making.

CLINICALTRIAL

PROSPERO International Prospective Register of Systematic Reviews CRD42020202747; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020202747
Development of a digital assistant to support teleconsultations between remote doctors and frontline health workers in India: A User-centered Design Approach (Preprint)
Authors: Verma Neha , Lehmann Harold , Alam Amal Afroz , Yazdi Youseph , Acharya Soumyadipta
Published: November 2020

BACKGROUND

Many low and middle-income countries (LMICs) have adopted telemedicine programs that connect frontline health workers (FHWs) such as nurses, midwives, or community health workers in rural and remote areas with doctors in urban areas to deliver care to patients. By leveraging technology to reduce temporal, financial, and geographic barriers, these health worker-to-doctor telemedicine programs have the potential to increase quality, to expand the specialties available to patients, and to reduce the time and cost required to deliver care.

OBJECTIVE

We aimed to identify, validate, prioritize unmet needs in this healthcare space of health worker-to-doctor telemedicine programs, and develop and refine a solution that addresses those needs.

METHODS

We collected information regarding user needs through ethnographic research, direct observation, and semi-structured interviews with 37 stakeholders (5 doctors, 1 public health program manager, 12 community health workers, and 19 patients) at two telemedicine clinics in rural West Bengal, India. We used the Spiral-Innovative Iteration model to design and develop a prototype solution to meet these needs.

RESULTS

We identified 74 unmet needs through our immersion in health worker-to-doctor telemedicine programs. We identified a critical unmet need that achieving optimal teleconsultations in LMICs often requires shifting tasks such as history taking and physical examination, from high-skilled remote doctors to the frontline health worker (FHW). To solve this need, we developed a prototype digital assistant that would allow frontline health workers to assume some of the tasks carried out by remote clinicians. The user needs of multiple stakeholder groups (patients, FHWs, doctors, and health organizations) were incorporated into the design and features of the task-shifting tool. The final prototype was shared with the health workers, doctors and public health program managers who expressed that the tool would be useful and valuable.

CONCLUSIONS

The final prototype developed was released as an open source digital public good and may improve the quality and efficiency of care delivery in health worker-to-doctor telemedicine programs.

CLINICALTRIAL
Assesing the usage of Youtube as a health information source about mitral valve prolapse. (Preprint)
Authors: Aslan Onur , Yildirim Sinan
Published: November 2020

BACKGROUND

Youtube is the largest media sharing site with more than a billion active users monthly. Youtube videos are using for many subjects and health information is popular one of these subjects.

OBJECTIVE

In this study, we aim to examine and analyse a common mitral valve disease such as mitral valve prolapse videos on Youtube, which can be used on researching health problem, can contribute how and in what extend to inform patients and healthcare professionals.

METHODS

All cookies on the computer were cleared and the term "mitral valve prolapse" was entered in YouTube's search bar on 26/04/2020 (YouTube, www.youtube.com YouTube LLC, San Bruno, CA, USA). Search was made by selecting sorting criteria "number of views", type "general", loading date "any time" and time "all" among filter options. İrrelevant (n:68), two or more repeated videos (n:3), non-English (n:1) were excluded from study. 40 videos were watched by two independent observers. The number of views, duration, who uploaded, like and dislike numbers of the videos were recorded in the form that prepared beforehand. GQS (table 1), JAMA (table 2), Discern (table 3) and VPI scores were calculated. The averages of the values recorded by the two observers were recorded on the form.

RESULTS

Of the 40 videos included in the study, 23 (57.5%) were informative and 17 (42.5%) were educational. 21 (52.5%) of these videos were targeted to patients and 19 (47.5%) to health professionals. 26 (65%) videos were created by healthcare professionals (figure 1).
When the features of the 40 videos included in the study were examined, one video has the JAMA score of 4 and five video has the GQS score of 5. The average scores of all videos on the quality scales are given in table 4. The VPI average of the videos included in the study was found to be 0.91 ± 0.11.

CONCLUSIONS

Although it was not statistically significant, the number of views and likes of the informative videos were higher than educational videos, but the average of the GQS, JAMA, DISCERN, and VPI scores of the educational videos were higher in our study. Although the number of views and likes of the videos for patients were higher, this difference was not statistically significant. The VPI average was statistically significantly higher in the videos targeting to patients than the videos targeting to health professionals.
Ecological Momentary Assessment of Physical Activity and Wellness Behaviors in College Students Throughout a School Year: Longitudinal Naturalistic Study (Preprint)
Authors: Bai Yang , Copeland William E , Burns Ryan , Nardone Hilary , Devadanam Vinay , Rettew Jeffrey , Hudziak James
Published: November 2020

BACKGROUND

The Wellness Environment app study is a longitudinal study focused on promoting health in college students.

OBJECTIVE

The two aims of this study were (1) to assess physical activity (PA) variation across the days of the week and throughout the academic year and (2) to explore the correlates that were associated with PA, concurrently and longitudinally.

METHODS

The participants were asked to report their wellness and risk behaviors on a 14-item daily survey through a smartphone app. Each student was provided an Apple Watch to track their real time PA. Data were collected from 805 college students from Sept 2017 to early May 2018. PA patterns across the days of the week and throughout the academic year were summarized. Concurrent associations of daily steps with wellness or risk behavior were tested in the general linear mixed-effects model. The longitudinal, reciprocal association between daily steps and health or risk behaviors were tested with cross-lagged analysis.

RESULTS

Female college students were significantly more active than male ones. The students were significantly more active during the weekday than weekend. Temporal patterns also revealed that the students were less active during Thanksgiving, winter, and spring breaks. Strong concurrent positive correlations were found between higher PA and self-reported happy mood, 8+ hours of sleep, ≥1 fruit and vegetable consumption, ≥4 bottles of water intake, and ≤2 hours of screen time (P<.001). Similar longitudinal associations found that the previous day’s wellness behaviors independently predicted the following day’s higher PA except for mood. Conversely, the higher previous-day PA levels were associated with better mood, more fruit and vegetable consumption, and playing less music, but with higher liquor consumption the next day.

CONCLUSIONS

This study provides a comprehensive surveillance of longitudinal PA patterns and their independent association with a variety of wellness and risk behaviors in college students.
Embodied Conversational Agents for Patients With Dementia: Thematic Literature Analysis (Preprint)
Authors: Rampioni Margherita , Stara Vera , Felici Elisa , Rossi Lorena , Paolini Susy
Published: November 2020

BACKGROUND

As the world’s population rapidly ages, the number of older adults with cognitive impairment will also increase. Several studies have identified numerous complex needs of people with dementia, which assistive technologies still fail to support. Recent trends have led to an increasing focus on the use of embodied conversational agents (ECAs) as virtual entities able to interact with a person through natural and familiar verbal and nonverbal communication. The use of ECAs could improve the accessibility and acceptance of assistive technologies matching those high-level needs that are not well covered to date.

OBJECTIVE

The aim of this thematic literature analysis was to map current studies in the field of designing ECAs for patients with dementia in order to identify the existing research trend and possible gaps that need to be covered in the near future. The review questions in this study were as follows: (1) what research frameworks are used to study the interaction between patients with dementia and ECAs? (2) what are the findings? and (3) what are the barriers reported in these studies?

METHODS

Separate literature searches were conducted in PubMed, Web of Science, Scopus, and Embase databases by using specific umbrella phrases to target the population (patients with dementia) and the technology-based intervention (embodied conversational agent). Studies that met the inclusion criteria were appraised through the Mixed Methods Appraisal Tool and then discussed in a thematic analysis.

RESULTS

The search process identified 115 records from the databases and study references. After duplicates (n=45) were removed, 70 papers remained for the initial screening. A total of 7 studies were finally included in the qualitative synthesis. A thematic analysis of the reviewed studies identified major themes and subthemes: the research frameworks used to gather users’ perspectives on ECAs (theme 1), the insights shared by the 7 studies as well as the value of user involvement in the development phases and the challenge of matching the system functionalities with the users’ needs (theme 2), and the main methodological and technical problems faced by each study team (theme 3).

CONCLUSIONS

Our thematic literature analysis shows that the field of ECAs is novel and poorly discussed in the scientific community and that more sophisticated study designs and proofs of efficacy of the approach are required. Therefore, by analyzing the main topic of the narrative review, this study underscores the challenge of synchronizing and harmonizing knowledge, efforts, and challenges in the dementia care field and its person-centered paradigm through the user-centered design approach. Enabling strict collaboration between interdisciplinary research networks, medical scientists, technology developers, patients, and their formal and informal caregivers is still a great challenge in the field of technologies for older adults.
Information and scientific impact of Advanced Therapies in the age of mass media: an Altmetrics-based analysis of Tissue Engineering. (Preprint)
Authors: Santisteban Espejo Antonio , Martín Piedra Miguel Ángel , Morán Sánchez Julia , Moral Muñoz José Antonio , Pacheco Serrano Ana Isabel , Cobo Martín Manuel Jesús
Published: November 2020

BACKGROUND

Tissue engineering (TE) constitutes a multidisciplinary field aiming to construct artificial tissues to regenerate end-staged organs. Its development has taken placed since the last decade of the 20th century, entailing a clinical revolution. In this sense, TE research groups have worked and shared relevant information in the mass media era. Thus, it would be interesting to study the online dimension of TE research and to compare it with traditional measures of scientific impact.

OBJECTIVE

To evaluate TE online dimension from 2012 to 2018 by using metadata obtained from the Web of Science (WoS) and Altmetrics and to develop a prediction equation for the impact of TE documents from Almetrics scores.

METHODS

We have analyzed 23,719 TE documents through descriptive and statistical methods. First, TE temporal evolution was exposed for WoS and fifteen online platforms (News, Blogs, Policy, Twitter, Patents, Peer review, Weibo, Facebook, Wikipedia, Google, Reddit, F1000, Q&A, Video and Mendeley readers). The 10 most-cited TE original articles were ranked according to WoS citations and the Altmetric Attention Score. Second, in order to better comprehend TE online framework, a correlation and factorial analysis were performed based on the suitable results previously obtained for the Bartlett Sphericity and Kaiser-Meyer-Olkin tests. Finally, the liner regression model was applied to elucidate the relation between academy and online media and to construct a prediction equation for TE from Altmetrics data.

RESULTS

TE dynamic shows an upward trend in WoS citations, Twitter, Mendeley Readers and Altmetric Scores. However, WoS and Altmetrics rankings for the most cited documents clearly differs. When compared, the best correlation results were obtained for Mendeley readers and WoS (ρ=0.71). In addition, the factorial analysis identified six factors that could explain the previously observed differences between TE academy, and the online platforms evaluated. At this point, the mathematical model constructed is able to predict and explain more than the 40% of TE WoS citations from Altmetrics scores.

CONCLUSIONS

The scientific information related to the construction of bioartificial tissues increasingly reaches society through different online media. Because of the focus of TE research importantly differs when the academic institutions and online platforms are compared, it could be stated that basic and clinical research groups, academic institutions and health politicians should take it into account in a coordinated effort oriented to the design and implementation of adequate strategies for information diffusion and population health education.
Informing the Development of a Standardized Clinical Definition of Neonatal Abstinence Syndrome: Protocol for a Modified-Delphi Expert Panel (Preprint)
Authors: Khodyakov Dmitry , Jilani Shahla M , Dellva Stephanie , Faherty Laura J
Published: November 2020

BACKGROUND

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome that most commonly results from prenatal opioid exposure. Every 15 minutes, an infant is born in the United States with signs of NAS. The field lacks a standardized clinical definition of NAS, complicating discussions on programmatic and policy development to support opioid-exposed mothers and infants.

OBJECTIVE

The goal of this paper is to describe a protocol for a systematic expert panel process to inform the development of a clinical definition of NAS.

METHODS

We will conduct two three-round online modified-Delphi panels using the ExpertLens system and will follow the recommendations for Conducting and REporting of DElphi Studies (CREDES). One panel will focus on developing key components of a clinical definition of NAS, and the second panel will focus on neonatal opioid withdrawal syndrome (NOWS), which is a term that has come into use to differentiate opioid-exposed infants from infants exposed to other substances in utero. However, there is lack of agreement on the precise clinical definition of NOWS and how it is distinct from or overlaps with NAS. Each panel will complete two rating rounds and a discussion round using a similar protocol. We will analyze all rating data descriptively and determine the presence of agreement within and between the two panels. We will also perform thematic analysis of the qualitative comments to contextualize the panel findings.

RESULTS

The panels were convened between October 29 and December 17, 2020. Their results were disseminated and discussed at a national conference on NAS that took place on March 17-18, 2021.

CONCLUSIONS

A standardized clinical definition of NAS will help to better characterize NAS incidence and to design effective clinical, public health, and policy interventions to support opioid-exposed mother-infant dyads.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/25387
Does Language Type Affect Perceptions of Disability Images? An Experimental Study
Authors: Kamenetsky Stuart B. , Sadowski Adam S.
Published: November 2020

The present experimental study examined the impact of language type on perception of disability images with text captions. 204 disability naïve undergraduate students viewed disability images containing one of six disability language captions: disability-first, defiant self-naming, impairment, negative, person-first, and apologetic naming. Participants completed measures of identification, emotion, willingness to help, willingness to include, and perceptions of capabilities and rights. Person-first and apologetic naming did not result in more positive perceptions of disability. Rather, defiant self-naming evoked the most positive emotions and identification, and greater perceived capabilities and willingness to include whereas negative language evoked the most negative perceptions of images. Results suggest that the elimination of negative language and the use of empowering defiant self-naming by people with disabilities, rather than a focus on using person-first and apologetic naming, may be more effective in reducing negative disability stereotypes.
An experimental test of green management information system effects on carrier selection: weigh station and tollbooth bypass technology adoption
Authors: Thomas Rodney W , Robinson Jessica L , Darby Jessica L , Cox Scott , Williams Donnie F
Published: November 2020

In a highly competitive price-driven industry, carriers are continuously searching for opportunities to differentiate their offerings, minimize operational costs, and appeal to shippers. At the same time, environmental sustainability has evolved from being trendy jargon into a requirement for competitive supply chain management. It is at the intersection of these two modern topics that the current study identifies a new carrier selection attribute based on a specialized type of green management information system. We apply social exchange theory to hypothesize carrier price and green technology adoption effects on shipper purchase intent. The hypothesized direct and interaction effects are tested by way of a vignette-based experiment, with a sample of full-time working professionals. The supported hypotheses collectively suggest that the adoption of weigh station and tollbooth bypass technology, as a type of environmentally sustainable information system, positively affects transportation carrier selection and attenuates the negative effect of a carrier’s price on shippers’ purchase intentions. These research findings offer unique theoretical, practical, and policy implications surrounding the trucking carrier selection decision.
The tumultuous world of global maritime transportation: a cautionary tale for supply chain managers
Authors: Gourdin Kent N , Ozment John
Published: November 2020

The past five years have seen unprecedented changes transform the way goods are moved around the world. The expanded Panama Canal now permits larger vessels as well as simultaneous transits in each direction. Coincidently, steamship lines began purchasing a new generation of bigger ships, forcing ports in the United States to make very large investments in new infrastructure. When examined within the context of other environmental events impacting global trade, the total effect has been to put the maritime industry into a state of flux. This paper will examine these and other important issues before offering conclusions intended to help managers develop successful supply chain strategies in today’s uncertain post-Panamax world.
BAR ANALOGUES FOR MODELLING OF BUILDING STRUCTURES
Authors: Barabash Maria , Tomashebskyi Andrii
Published: November 2020

his paper discusses the use of bar analogues for calculation of internal forces in the cross-sections of building structures, which are modelled by a set of finiteelements. It also introduces the concepts of bar analogues, explains their basic theoretical premises and provides the results of the calculations of verification problems