bluuebunny/crossref_metadata_2025 huggingface dataset:
Russian Disabled Veterans in Poland in the 1920s – 1930s: Community, Personalities and Daily Life
Authors:   Kazan State University of Architecture and Civil Engineering, Nikonova S. I.
Published: November 2021

The article examines the dramatic history of the survival of Russian disabled veteran emigrants in Poland in the 1920s–1930s. The main aim is to highlight issues of the financial situation of disabled veterans, their legal status and self-organization, and the humanitarian activity of the Union of Russian Disabled Veteran Emigrants in Poland. The paper reflects the adjustment difficulties of disabled veterans in Poland, aspects of the mixed attitude of the Polish authorities to Russian emigrants, and the internal problems of the emigrant community. Continuous support and assistance to disabled people and their families, and care for disadvantaged fellow countrymen are he focus. The article shows the efforts of the Board of the Union of Russian Disabled Veteran Emigrants in Poland, not only to support disabled people financially, but also to encourage the emigrant community’s morale and to oppose the marginalization of disabled veterans. The paper states the fundamental reasons for moral problems associated with the physical well-being of disabled people, the lack of prospect awareness, the loss of hope for a status change and receiving Polish citizenship, and the loss of connections with Russia. The article presents features of everyday life of the Russian disabled veteran emigrants; it observes the policy of the Union’s Board in relation both to Polish authorities and to members of the Union. In the 1920s and 1930s the Union of Russian Disabled Veteran Emigrants remained the only uniting center for disadvantaged Russian people, and its leaders honestly fulfilled their duties. The author used materials from the documents of the Russian archives (State Archive of the Russian Federation, Russian State War and Historical Archive), and newly available documents of the Lithuanian Central State Archive (LCVA).
A Comparative Study of the Talking Tree Motif in Persian Versions of Qazvini’s Wonders of Creation (Ajā’ib al-makhlūqāt wa gharā’ib al-mawjūdāt)
Authors:   Shahed University, Heidari Fatemeh , Hosseini Seyed Reza ,   Shahed University
Published: November 2021

A tree is one of the most beautiful creations in the world. The development of mythical concepts and the prevalence of some beliefs about it have led to certain connotations and the emergence of specific beliefs in human thought. Among trees, there is the talking tree (Waqwaq), which has a long history and has been mentioned in various books, including reliable geographic sources such as Qazvini’s the Wonders of Creation. The article examines the pictorial motif of talking tree in the Persian version of Qazvini’s Wonders of Creation and considers the similarities and differences of its presentation in Persian versions as well as the origin of its aesthetic principles. The results of the research show that all versions have human heads or a statue on the tree. Among them, the Wonders of Creation 1816 AD has a female motif and depicts a female statue on the tree. The head motif in the Wonders of Creation of 1550–1560 AD is male and illustrates masculine statues on the tree. The head motif in the Wonders of Creation 1566 AD, the Wonders of Creation of the 16 century AD, the Wonders of Creation 1651 AD and the Wonders of Creation 1695 AD and the two heads in the Wonders of Creation 1822 AD was male and only depict human heads on the tree, not the full body. In some versions, in addition to human heads, animal heads are also portrayed on the tree. What is interesting is the presence of the head of legendary animals and birds such as Dragon and Simurgh.
The political crisis of power in modern Venezuela: Reasons, dynamics, prospects of resolution
Authors:   Kazan (Volga region) Federal University, Bolshakov Andrei G. , Mansurov Timur Z. ,   Kazan (Volga region) Federal University
Published: November 2021

The article examines the features and contradictions of resolving the political crisis in Venezuela. The authors analyze the activities of the direct parties to the conflict (the ruling regime led by current President Nicolas Maduro and the political opposition supported by the country’s Parliament) to resolve it and get the country out of the impasse. The work emphasizes the importance of socio-economic reasons that led to the emergence of the political crisis and the emergence of political forces, on the one hand, defending the ideas of socialist development, and, on the other, the values of the liberal — democratic structure of the state. The authors focus on the mechanisms and ways of resolving the political crisis implemented by Latin American countries, non-regional states and international organizations. However, their activities, as the study shows, are not effective enough since the national interests of states have a superior influence over the needs of stabilizing the political situation in the country and resolving the crisis. The authors examine the contradictions that prevent the beginning of a constructive dialogue between the parties of the conflict, supported by various segments of the population. The effectiveness of various international platforms and negotiation formats aimed at finding and developing solutions to the current crisis, compromises, and areas of joint activity is analyzed. As a result of the research, the authors come to the conclusion that at present it is necessary to cooperate more closely with both the ruling political elite and the opposition, despite the polar views of their representatives, as well as to expand the number of states in order to form a more objective negotiation process and achieve mutually acceptable solutions.
Global values of the global world
Authors:   St. Petersburg Academy of Postgraduate Pedagogical Education, Sergeichik Elena M.
Published: November 2021

The article is devoted to the problem of global values, whose existence is problematized in the face of increased regionalization as a vector of world development. Regionalization is not “the end of globalization”, but its stage, which is “the revolution of plurality” (M. Naim) — distribution regularities of the network society on the whole world. The global world is not a homo geneous world of mankind based on the same values, rather the global world is a combination of diverse social communities striving for autonomy and self-determination. Building on the concepts of M. McLuhan, A. Toffler, D. Bell and N. Luhman, the article analyzes the information society in which the main element is communication as a source of social innovations. Digital technologies contribute to the development of human abilities and personal qualities without which social progress is impossible. If the vision of humanity in the development of the network society, where relations between the countries, regions, social communities and people are built on the basis of the values of life, liberty, creativity, justice, law, etc., then these values should be recognized as global. Particular attention is paid to the analysis of the reaction of various social communities on regionalization, which finds its expression in the deepening of social inequality, increasing conflict of generations and other phenomena that contribute to disseminating conservative ideas and moods. Based on the works of J. Derrida, N. Luhman and D. Kean, it is shown that global values are not the achievements of exclusively European culture but are to varying degrees implemented and developed in all cultures. Against the background of the crisis of multiculturalism, the integration of cultures should be based on intercultural communication, for which the process of coordinating positions is important. The purpose of intercultural communication is not only the exchange of cultural values, but the demonstration of the benefits of life in those communities that are guided by global values.
Ethical concepts in Russian religious-didactic literature of the 17th century
Authors:   St. Petersburg State University, Chumakova Tatiana V.
Published: November 2021

The article offers an analysis of ethical concepts in Russian religious-didactic literature of the 17th century. The main sources are alphabets published in Moscow. There were two alphabets printed by Vasily Burtsov, and an alphabet by Karion Istomin, as well as “Azbuka s oratsiey” (Alphabet with Didactics), and the manuscript “Alfavititsy didaskala” (Small Alphabet of a Teacher). These alphabets can be considered as religious-didactic literature because in addition to grammar, these manuals included the narration “On the Letters” by Chernorizets Hrabar (Hrabar, the Black Robe Wearer), extensive religious-anthropological reasoning, prayers, the Credo, Decalogue (in the Alphabet by Karion Istomin only), the Beatitudes, and other texts which were presented in Catholic catechisms of that time, as well as in the “Profession of Faith” by Peter Mogila (he used the Catholic catechism in his “Profession”). The influence of Reformation ideas is obvious, too. Several works by Karion Istomin, the alphabet primarily, were written and illustrated under the influence of “Orbis sensualium pictus” by John Amos Comenius, the last bishop of the Unity of Brethen (Bohemian or Moravian Church). The content of these manuals (including visual content) allows us to conclude that their mass publication was induced by the disciplinary revolution that began after the end of the Smuta (the Time of Troubles) in Russia, which is associated with the House of the Romanovs coming to power. The creation of a new tsardom was impossible without new people whose education was based on religious ideas and regulations. Ethical concepts in these books were almost inseparable from religious regulations, which is explained by the doctrinal aims of primary education in Russia of the 17th century.
Faecal contamination pathways of shallow groundwater in low-income urban areas: implications for water resource planning and management
Authors: Nayebare Jacintha Gumoteyo , Owor Michael M. , Kulabako Robinah , Taylor Richard Graham
Published: November 2021

Shallow groundwater is vulnerable to faecal contamination, especially in low-income urban areas where use of on-site sanitation facilities is high. This paper explores statistical relationships between potential factors influencing contaminant pathways (i.e., variables) and observed faecal contamination of shallow groundwater, represented by nitrate concentrations and counts of Escherichia coli (i.e., response function) in a small, growing town in Uganda over dry and wet seasons in 2018 and 2019. A statistically significant (p = 0.004) multiple linear regression model from dry-season E. coli counts in 2018 identifies medium sanitary risk levels and modes of construction as significant pathways (p = 0.01). Water source depth (<20 m) and proximity (>10 m) to a pit latrine were also significant (p<0.05) in both hydrogeological formations. No significant linear regression models were established for NO3 during both seasons due to low pH and rapid infiltration velocities; inconsistent sample timing during the wet season impaired the significance of the statistical models of E. coli counts. We show that modes of construction of water sources and pit latrines play key roles in determining the quality of the shallow groundwater in urban environments. Greater emphasis is therefore required to improve the functionality and sustainability of on-site water sources and pit latrines.
Occurrence and removal of poly/perfluoroalkyl substances (PFAS) in municipal and industrial wastewater treatment plants
Authors: Barisci Sibel , Suri Rominder
Published: November 2021

The presence of poly- and perfluoroalkyl substances (PFAS) has caused serious problems for drinking water supplies especially at intake locations close to PFAS manufacturing facilities, wastewater treatment plants (WWTPs), and sites where PFAS-containing firefighting foam was regularly used. Although monitoring is increasing, knowledge on PFAS occurrences particularly in municipal and industrial effluents is still relatively low. Even though the production of C8-based PFAS has been phased out, they are still being detected at many WWTPs. Emerging PFAS such as GenX and F-53B are also beginning to be reported in aquatic environments. This paper presents a broad review and discussion on the occurrence of PFAS in municipal and industrial wastewater which appear to be their main sources. Carbon adsorption and ion exchange are currently used treatment technologies for PFAS removal. However, these methods have been reported to be ineffective for the removal of short-chain PFAS. Several pioneering treatment technologies, such as electrooxidation, ultrasound, and plasma have been reported for PFAS degradation. Nevertheless, in-depth research should be performed for the applicability of emerging technologies for real-world applications. This paper examines different technologies and helps to understand the research needs to improve the development of treatment processes for PFAS in wastewater streams.
Peroxiredoxin-6: A Guardian of Lung Pathophysiologies
Authors: Kumari Anju , Chowhan Rimpy Kaur , Kakchingtabam Pushpa , Shahnaj Sharifun , Rahaman Hamidur , Ansari Mohd Saquib , Singh Laishram Rajendrakumar
Published: November 2021

:

The moonlighting protein, Prdx-6, exhibits peroxidase activity, phospholipase activity,
and lysophosphatidylcholine acyltransferase (LPCAT) activity. Although it is ubiquitous in expression,
its level is prominently high in the lung. Prdx-6 has been known to be an important enzyme
for the maintenance of normal lung physiologies including, anti-oxidant defense, lung surfactant
homeostasis, and cell signaling. Studies further unveiled that the altered activity (peroxidase or ai-
PLA2) of this enzyme is linked with various lung pathologies or diseases. In the present article, we
attempted to address the various pathophysiologies or disease conditions (like lung ischemia, hyperoxia,
lung cancer, emphysema, and acute lung injury) wherein Prdx-6 is involved. The study implicates
that Prdx-6 could be used as a common drug target for multiple lung diseases. Important future
insights have also been incorporated.
Programmed Cell Death in Plants: Insights into Developmental and
Stress-Induced Cell Death
Authors: Ebeed Heba T. , El-helely Ahmed A.
Published: November 2021

:

Programmed cell death (PCD) is a fundamental genetically controlled process in most organisms. PCD is responsible for the selective elimination of damaged or unwanted cells and organs to maintain cellular homeostasis during the organ’s development under normal conditions as well as during defense or adaptation to stressful conditions. PCD pathways have been extensively studied in animals. In plants, studies focusing on understanding the pathways of PCD have advanced significantly. However, the knowledge about the molecular basis of PCD is still very limited. Some PCD pathways that have been discovered in animals are not present in plants or found with a similar form. PCD in plants is developmentally controlled (by endogenous factors) to function in organ development and differentiations as well as environmentally induced (by exogenous stimuli) to help the plant in surviving under stress conditions. Here, we present a review of the role of PCD in plant development and explore different examples of stress-induced PCD as well as highlight the main differences between the plant and animal PCD.
Hydroxysafflor Yellow a Promotes Angiogenesis in Rat Brain Microvascular Endothelial Cells Injured by Oxygen-glucose Deprivation/reoxygenation(OGD/R) through SIRT1-HIF-1α-VEGFA Signaling Pathway
Authors: Ruan Juxuan , Wang Lei , Dai Jiheng , Li Jing , Wang Ning , Seto Saiwang
Published: November 2021

Objective:

Angiogenesis led by brain microvascular endothelial cells (BMECs) contributes
to the remission of brain injury after brain ischemia reperfusion. In this study, we investigated
the effects of hydroxysafflor yellow A(HSYA) on angiogenesis of BMECs injured by
OGD/R via SIRT1-HIF-1α-VEGFA signaling pathway.

Methods:

The OGD/R model of BMECs was established in vitro by OGD for 2h and reoxygenation
for 24h. At first, the concentrations of vascular endothelial growth factor (VEGF), Angiopoietin
(ang) and platelet-derived growth factor (PDGF) in supernatant were detected by ELISA, and
the proteins expression of VEGFA, Ang-2 and PDGFB in BMECs were tested by western blot; the
proliferation, adhesion, migration (scratch healing and transwell) and tube formation experiment of
BMECs; the expression of CD31 and CD34 were tested by immunofluorescence staining. The levels
of sirtuin1(SIRT1), hypoxia-inducible factor-1α (HIF-1α), VEGFA mRNA and protein were
tested.

Results:

HSYA up-regulated the levels of VEGF, Ang and PDGF in the supernatant of BMECs under
OGD/R, and the protein expression of VEGFA, Ang-2 and PDGFB was increased; HSYA
could significantly alleviate the decrease of cell proliferation, adhesion, migration and tube formation
ability of BMECs during OGD/R; HSYA enhanced the fluorescence intensity of CD31 and
CD34 of BMECs during OGD/R; HSYA remarkably up-regulated the expression of SIRT1,
HIF-1α, VEGFA mRNA and protein after OGD/R, and these increase decreased after SIRT1 was
inhibited.

Conclusion:

SIRT1-HIF-1α-VEGFA signaling pathway is involved in HSYA improves angiogenesis
of BMECs injured by OGD/R.
Resveratrol and Colorectal Cancer: A Molecular Approach to Clinical Researches
Authors: Vernousfaderani Eisa Kaveh , Akhtari Negin , Rezaei Sara , Rezaee Yasaman , Shiranirad Saba , Mashhadi Melika , Hashemi Ali , Khankandi Hamed Parsa , Behzad Sahar
Published: November 2021

Phytochemicals are the most valuable and comprehensive structures, which may have a
broad range of protective benefits, from reducing inflammation and speeding healing to preventing
infection and fighting cancer. Resveratrol (RSV) is a natural phenolic compound from the oligomeric
stilbenoids group, which is usually found in daily human diet, such as grape, peanut, berries and
grains. It exhibits anti-inflammatory, neuroprotective, antioxidant, and cancer prevention and treatment
effects. RSV is thought to have an impressive outcome in colorectal cancer (CRC) treatment
through the vital molecules and cancer signaling pathways, including SIRT1, P53, P21, AMPK, ROS,
BMP7, COX-2, NO, caspases, Wnt, TNFs, NF-κB, EMT, and pentose phosphate pathway. Therefore,
this paper reviews the current researches on the pharmacological effects and pharmacokinetics of
resveratrol and its drug delivery system, as well as clinical studies involving CRC.
Structural, Morphological, and Magnetic Characterization of Iron Oxide Nanoparticles Synthesized at Different Reaction Times via Thermal
Decomposition Method
Authors: Dogan Nurcan , Ozel Fatmahan , Koten Hasan
Published: November 2021

Background:

Superparamagnetic Iron Oxide Nanoparticles (SPIONs) were synthesized
by the thermal decomposition method.

Methods:

In this work, the properties of the nanoparticles synthesized at different reaction times
were investigated. Fourier Transformed Infrared Spectroscopy (FTIR) and thermal analysis were
carried out to characterize oleate adsorbed on the surface of nanoparticles.

Results:

The oleate-coated surfaces were obtained for all samples, and the amount of oleate on
the surfaces of the particles changed with the change in reaction time. The size, size distribution,
and shape of SPIONs were determined by X-ray Diffraction (XRD), transmission electron microscopy
(SEM), and Dynamic Light Scattering (DLS). It was seen that changing the reaction
time affected the shape of the nanoparticles, but almost the same sized nanoparticles were obtained
with the increase of reaction time. The sample's crystallite size of 12.5-14.2 nm achieved
with XRD is in good agreement with the mean size of 15-16.4 that was obtained by TEM results.
Maximum magnetic saturation of the sample was achieved at 3 h reaction time.

Conclusion:

The magnetic properties of iron oxide nanoparticles were characterized by Electron-
Spin Resonance (ESR) and Physical Properties Measurement System (PPMS). All samples
showed superparamagnetic behaviors at room temperature.
Iron, Cobalt and Nickel-catalyzed Hydrosilylative Reduction of Functional
Groups
Authors: Avinash Kiran , Rohit K.R. , Anilkumar Gopinathan
Published: November 2021

Hydrosilylation is an important transformation in organic synthesis. It has displayed
widespread applications in homogenous catalysis and in the commercial production of organosilanes
and organosilicon compounds. Though metals like Ru, Rh etc., were used widely for
achieving hydrosilylation, the increasing environmental concerns and the search for less expensive
alternatives resulted in the investigation of transition metals. Metals like Ni, Co etc., exhibit potential
cost benefits, in addition to their low CO2 footprint and lower toxicity. Thus, transition metal
catalysis has emerged as a promising strategy for hydrosilylation. This comprehensive review discusses
the catalytic hydrosilylation of various functional groups with non-noble transition metals
such as iron, cobalt and nickel in the last decade. Here, the topic is categorized based on the substrate
functional groups such as aldehydes, ketones, alkenes, etc.
russification legacy of historical monuments of Uzbekistan
Authors: Yusupov Otabek Yakubovich
Published: November 2021

This article illustrates the naming convention of historical monuments by the Russian Empire and the Soviet Union in Uzbekistan. The Russification is a form of cultural assimilation during which the non-Russian communities whether voluntary or involuntary gave up their culture or statehood or language in favor of the Russian culture. Undeniably, the Russification in the naming convention of Uzbekistan’s historical monuments still bears its legacy. For instance, the names of archaeological finding on the territories of Selengur—Kulbulak and Teshiktash—pronounced in the Russian phonetics rather than Uzbek. Rather, Kulbulak is ought to be spelled Qulbuloq; and, Teshiktash—Teshiktosh.
Establishment of a non-invasive detecting test for pancreatic cancer using urine
Authors: Ito Tomoaki
Published: November 2021

Pancreatic cancer has a high mortality rate and so early detection is important. However, many patients remain asymptomatic until the disease has reached an advanced stage. Therefore, researchers on a global scale are searching for ways to facilitate early detection of the disease.
Associate Professor Tomoaki Ito, Juntendo University, School of Medicine, Juntendo University Shizuoka Hospital, Japan, is one such researcher. He is a gastrointestinal surgeon who is working to uncover non-invasive ways of detecting pancreatic cancer early. He and his team's non-invasive
detecting test involves a urine test and detecting methylated DNA in pancreatic cancer patients. This involves quantitative methylation-specific PCR, which enables the researchers to measure, compare and analyse the methylation DNA of multiple genes and is helpful in reducing the traditional
costs associated with methylation research. Ito and the team have clarified that pancreatic tissue has higher methylation of some genes than normal tissue. Through their work, Ito and the team hope to develop a new, completely non-invasive diagnostic method that will help improve the rate
of early cancer detection in pancreatic cancer patients. In addition, it may be possible to extend the methods developed by the researchers for use in the early detection of other cancers.
Endothelial regeneration in repair from vascular injury and stem cell biology
Authors: Inoue Teruo , Simon Daniel , Murohara Toyoaki , Dezawa Mari , Inoue Ken-ichi , Sakuma Masashi , Toyoda Shigeru
Published: November 2021

Professor Teruo Inoue and his collaborators are exploring repair from vascular and myocardial injury in the context of stem cell biology in work that is set to make waves in regenerative medicine. This research involves endothelial progenitor cells (EPCs) for vascular repair, adipose-derived
regenerative cells (ADRCs) for angiogenesis and multilineage differentiating stress enduring cell (Muse) cells for myocardial repair. Inoue and his collaborators are also investigating the 'wound repair priming' phenomenon with a view to overcoming the challenge of the inconsistent capacities
of angiogenesis due to individual differences in cell quality. The researchers found that the ADRCs (also called adipose-derived stromal fractions: SVFs) obtained from subcutaneous fat after manipulation caused by surgical injury as well as ischaemia showed higher angiogenetic ability. The
researchers plan to pharmacologically reproduce wound repair priming in order to facilitate more consistent cell therapy using ADRCs. The team is also exploring other promising functional analysis methods for stem cells, including comprehensive gene analysis using single cell RNA sequence
(scRNA seq), which the researchers plan to apply to Muse cells. In addition to Muse cell research targeting myocardial repair, the team will also conduct Muse cell vascular research as they believe that Muse cell treatment holds great promise for the repair of injured-vessel sites. Ultimately,
Inoue and his collaborators hope their work will significantly impact medical research and clinical medicine.
Health data sharing and use explored
Authors: Annette Lucy
Published: November 2021

Three expert roundtables took place as part of DigitalHealthEurope (DHE), with discussions surrounding health data sharing and use. In the first roundtable, the implementation of GDPR was explored and the experts delved into possible remaining challenges associated with understanding
the way in which health related data may be used. Legal issues and the importance of data protection and citizen protection were discussed, as was the need for more human resources regarding data protection, which could be rectified by the provision of education in this area. The introduction
of a new EU body responsible for data legislative needs was an idea that was put forward. Next, the law as an enabler of data use was discussed, along with the protection of citizens and data. It was highlighted that in order for the full potential of digital health to be realised, data literacy
and skills are paramount. The experts also discussed how data can be used to protect citizens, without compromising a right to privacy, as well as the importance of generating the right data to ensure that it can be used to protect citizens' health and wellness. A further topic of discussion
was how the development of a range of skills among data stakeholders would lead to the better use of data and that this would have a positive impact on health and wellness.
Diagnostic Performance of an App-Based Symptom Checker in Mental Disorders: Comparative Study in Psychotherapy Outpatients
Authors: Hennemann Severin , Kuhn Sebastian , Witthöft Michael , Jungmann Stefanie M
Published: November 2021

Background

Digital technologies have become a common starting point for health-related information-seeking. Web- or app-based symptom checkers aim to provide rapid and accurate condition suggestions and triage advice but have not yet been investigated for mental disorders in routine health care settings.

Objective

This study aims to test the diagnostic performance of a widely available symptom checker in the context of formal diagnosis of mental disorders when compared with therapists’ diagnoses based on structured clinical interviews.

Methods

Adult patients from an outpatient psychotherapy clinic used the app-based symptom checker Ada–check your health (ADA; Ada Health GmbH) at intake. Accuracy was assessed as the agreement of the first and 1 of the first 5 condition suggestions of ADA with at least one of the interview-based therapist diagnoses. In addition, sensitivity, specificity, and interrater reliabilities (Gwet first-order agreement coefficient [AC1]) were calculated for the 3 most prevalent disorder categories. Self-reported usability (assessed using the System Usability Scale) and acceptance of ADA (assessed using an adapted feedback questionnaire) were evaluated.

Results

A total of 49 patients (30/49, 61% women; mean age 33.41, SD 12.79 years) were included in this study. Across all patients, the interview-based diagnoses matched ADA’s first condition suggestion in 51% (25/49; 95% CI 37.5-64.4) of cases and 1 of the first 5 condition suggestions in 69% (34/49; 95% CI 55.4-80.6) of cases. Within the main disorder categories, the accuracy of ADA’s first condition suggestion was 0.82 for somatoform and associated disorders, 0.65 for affective disorders, and 0.53 for anxiety disorders. Interrater reliabilities ranged from low (AC1=0.15 for anxiety disorders) to good (AC1=0.76 for somatoform and associated disorders). The usability of ADA was rated as high in the System Usability Scale (mean 81.51, SD 11.82, score range 0-100). Approximately 71% (35/49) of participants would have preferred a face-to-face over an app-based diagnostic.

Conclusions

Overall, our findings suggest that a widely available symptom checker used in the formal diagnosis of mental disorders could provide clinicians with a list of condition suggestions with moderate-to-good accuracy. However, diagnostic performance was heterogeneous between disorder categories and included low interrater reliability. Although symptom checkers have some potential to complement the diagnostic process as a screening tool, the diagnostic performance should be tested in larger samples and in comparison with further diagnostic instruments.
Hospital Homebound Students and K-12 Online Schooling: A Cross-Sectional Analysis (Preprint)
Authors: Black Erik , Ferdig Richard E. , Fleetwood April , Thompson Lindsay A.
Published: November 2021

BACKGROUND

The United States public educational system encourages inclusion, integrating learners with different needs in the same classroom students, including those with chronic disability and illness. However, a small but significant number of students with chronic illnesses or disabilities may not be healthy enough to attend school in a traditional environment. Hospital homebound programs serve these children by providing educational instruction for those living with short-term and chronic disabilities in non-school settings. These programs are publicly supported, differing significantly from homeschooling where, traditionally, a child’s parent or guardian assumes responsibility for the delivery of educational services. The limited research exploring hospital homebound programs describes them as challenged, characterized by instructors who may lack the qualifications to teach critical core subject matters and teach with limited instructional time. As online learning continues to become more mainstream in the United States, it is important to explore the impact that the medium could have on students with differing needs. The flexibility afforded by online education may provide opportunities for learners with disability that necessitates absence from traditional learning environments.

OBJECTIVE

This study sought to describe how a subset of learners with disability, those with a hospital-homebound designation, perform in K-12 online classes, particularly as compared to non-hospital homebound counterparts.

METHODS

A cross-sectional analysis was performed of all Florida Virtual School course enrollments from August 1, 2012, to July 31, 2018. Researchers analyzed 2,534-course enrollments associated with students who, at the time of their course enrollment, had hospital-homebound designation, and a comparison group of 5,470,591 enrollments from students without hospital-homebound status.

RESULTS

Hospital-homebound designed student academic performance was equivalent to their non-hospital homebound counterparts (P = .05 - .28). But, hospital-homebound course enrollments were 26% more likely to result in a withdrawal prior to grade generation (P < .01).

CONCLUSIONS

Hospital-homebound students represent a population under-served by many education systems, including online education. The results of this study provided evidence that when they can remain enrolled, hospital-homebound learners experience equivalent academic outcomes in online learning environments. These findings suggest that healthcare professionals should be made aware of the potentially equivalent outcomes for their patients, and virtual schools should seek to identify and create supports for these students.
A Telehealth Diabetes Intervention for Rural Populations: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Litchman Michelle L , Kwan Bethany M , Zittleman Linda , Simonetti Juliana , Iacob Eli , Curcija Kristen , Neuberger Julie , Latendress Gwen , Oser Tamara K
Published: November 2021

BACKGROUND

Diabetes self-management education and support (DSMES) is a crucial component of diabetes care associated with improved clinical, psychosocial, and behavioral outcomes. The American Association of Diabetes Care and Education Specialists, the American Diabetes Association, and the American Academy of Family Physicians all recommend DSMES yet accessing linguistically and culturally appropriate DSMES is challenging in rural areas. The Diabetes One-Day (D1D) program is an established DSMES group intervention that has not been adapted or evaluated in rural communities.

OBJECTIVE

The specific aims of this paper are (1) to adapt the existing D1D program for use in rural communities, called rural D1D (R-D1D); and (2) to conduct a patient-level randomized controlled trial to examine the effects of R-D1D and standard patient education, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework.

METHODS

This is a protocol for a pilot type II hybrid implementation-effectiveness trial of a culturally adapted virtual DSMES program for rural populations, R-D1D. We will use Boot Camp Translation, a process grounded in the principles of community-based participatory research, to adapt an existing DSMES program for rural populations, in both English and Spanish. Participants at 2 rural primary care clinics (4 cohorts of N=16 plus care partners, 2 in English and 2 in Spanish) will be randomized to the intervention or standard education control. The evaluation is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Patient-level effectiveness outcomes (hemoglobin A1c, diabetes distress, and diabetes self-care behaviors) will be assessed using patient-reported outcomes measures and a home A1c test kit. Practice-level and patient-level acceptability and feasibility will be assessed using surveys and interviews.

RESULTS

This study is supported by the National Institute of Nursing. The study procedures were approved, and the adaptation processes have been completed. Recruitment and enrollment started in July 2021.

CONCLUSIONS

To our knowledge, this will be the first study to evaluate both effectiveness and implementation outcomes for virtually delivered DSMES, culturally adapted for rural populations. This research has implications for delivery to other rural locations where access to specialty diabetes care is limited.

CLINICALTRIAL

ClinicalTrials.gov NCT04600622; https://clinicaltrials.gov/ct2/show/NCT04600622

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/34255
Direct-to-consumer Telemedicine Platforms in China: A National Market Survey and Quality Evaluation (Preprint)
Authors: Xue Hao , D’Souza Karishma , Fang Yian , Si Yafei , LIao Huipeng , Wang Aiqin , Yip Winnie , Xu Dong , Gong Wenjie , Cheng Weibin , Tian Junzhang , Tang Weiming , Sylvia Sean
Published: November 2021

BACKGROUND

Direct to Consumer (DTC) telemedicine platforms are digital platforms that enable patients to match with and initiate online consultations. This growing area of digital health has the potential to expand access to quality outpatient care by extending patient choice of providers and providers’ ability to interact with new patients online.

OBJECTIVE

This study aims to to evaluate the status of DTC telemedicine and the quality of care provided through these platforms in China, the country where DTC telemedicine has expanded most rapidly.

METHODS

In this cross-sectional study, we first conducted a systematic search of all DTC telemedicine platforms in China providing on-demand consultations through video or SMS/MMS and manually scraped information from each platform. We then evaluated the quality of care provided using unannounced virtual visits by standardized patients (SPs) presenting seven different disease cases. We evaluate the performance of online providers relative to national standards of care and to traditional on-site providers in rural areas. Multiple regressions were used to assess associations between quality and platform characteristics.

RESULTS

The systematic search identified 36 independent platforms providing synchronous or asynchronous consultations via videoconferencing or SMS/MMS text. Platforms varied widely in design, access methods, services, and pricing. The quality of care provided through online-only platforms was superior to platforms that were extensions of physical hospitals in terms of diagnosis and case management. SPs were significantly more likely to be correctly managed through videoconference compared to SMS/MMS consultations, though costs were significantly higher. Both videoconference and SMS/MMS consultations were likely to refer patients unnecessarily. Platform features and the price of consultations were significantly associated with measures of quality.

CONCLUSIONS

There was substantial variation in the design of DTC telemedicine platforms in China as well as the quality of care provided. Incentives inherent in the design of these platforms may influence care quality and patient costs. The expansion of DTC telemedicine may improve access to high quality care, but could increase unnecessary care and reduce equity in access without thoughtful regulation. Research is needed to inform policies governing DTC telemedicine platforms, particularly in middle-income countries such as China.
Building a Precision Medicine Delivery Platform for Clinics: The University of California, San Francisco, BRIDGE Experience (Preprint)
Authors: Bove Riley , Schleimer Erica , Sukhanov Paul , Gilson Michael , Law Sindy M , Barnecut Andrew , Miller Bruce L , Hauser Stephen L , Sanders Stephan J , Rankin Katherine P
Published: November 2021

UNSTRUCTURED

Despite an ever-expanding number of analytics with the potential to impact clinical care, the field currently lacks point-of-care technological tools that allow clinicians to efficiently select disease-relevant data about their patients, algorithmically derive clinical indices (eg, risk scores), and view these data in straightforward graphical formats to inform real-time clinical decisions. Thus far, solutions to this problem have relied on either bottom-up approaches that are limited to a single clinic or generic top-down approaches that do not address clinical users’ specific setting-relevant or disease-relevant needs. As a road map for developing similar platforms, we describe our experience with building a custom but institution-wide platform that enables economies of time, cost, and expertise. The BRIDGE platform was designed to be modular and scalable and was customized to data types relevant to given clinical contexts within a major university medical center. The development process occurred by using a series of human-centered design phases with extensive, consistent stakeholder input. This institution-wide approach yielded a unified, carefully regulated, cross-specialty clinical research platform that can be launched during a patient’s electronic health record encounter. The platform pulls clinical data from the electronic health record (Epic; Epic Systems) as well as other clinical and research sources in real time; analyzes the combined data to derive clinical indices; and displays them in simple, clinician-designed visual formats specific to each disorder and clinic. By integrating an application into the clinical workflow and allowing clinicians to access data sources that would otherwise be cumbersome to assemble, view, and manipulate, institution-wide platforms represent an alternative approach to achieving the vision of true personalized medicine.
Acceptability of mixed reality technology as a delivery mechanism for psychological intervention in adolescents with asthma: a qualitative study using the Theoretical Framework of Acceptability. (Preprint)
Authors: Sharrad Kelsey , Martini Caitlin , Kopsaftis Zoe , Tai Andrew , Spurrier Nicola , Smith Ross , Esterman Adrian , Gwilt Ian , Sandford Debra , Carson-Chahhoud Kristin
Published: November 2021

BACKGROUND

Interactive, mixed-reality technologies such as augmented reality (AR), virtual reality (VR) and holographic technology may provide a novel, low-cost solution to fast-track the translation of evidence into practice; and may help overcome barriers to both mental health and asthma management service uptake.

OBJECTIVE

The aim of this study was to investigate if mixed reality technology is an acceptable mechanism for the delivery of a component of CBT for the management of symptoms of elevated psychological distress among young people with asthma.

METHODS

To explore the perceived acceptability of these technologies, mixed reality tools were evaluated via qualitative, one-on-one interviews with young people with asthma and symptoms of psychological distress, parents/caregivers of young people with asthma and symptoms of psychological distress, and relevant health professionals. The Theoretical Framework of Acceptability (TFA) was used for deductive coding of recorded interview transcripts.

RESULTS

Three young people with asthma and symptoms of psychological distress (2 female, mean age (years) = 14, SD= 1.73), four parents/caregivers of individuals with asthma (1 female, mean age (years) = 55, SD= 14.58) and six health professionals (4 females, mean age = 40.8, SD= 4.32) consented to participate. Four constructs – experienced affective attitude, experienced effectiveness, self-efficacy and intervention coherence – were coded in all participant transcripts. The most frequently coded constructs were experienced affective attitude and intervention coherence; both reported a total of 96 times, while the least frequently coded construct was anticipated opportunity cost; reported a total of 5 times. Participants were mostly positive about the mixed reality resources. However, some concerns were raised regarding ethicality, particularly in relation to privacy, accessibility, and messaging. Participants noted the need for technology to be used in conjunction with face-to-face engagement with health professionals, and that some patients would respond to this type of delivery mechanism better than others.

CONCLUSIONS

These results suggest that mixed reality technology for the purposes of delivery of psychological intervention may be an acceptable addition to current healthcare practices for young people with asthma and symptoms of psychological distress.

CLINICALTRIAL

The study was prospectively registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620001109998.
Technology Acceptance of Home-Based Cardiac Telerehabilitation Programs in Patients With Coronary Heart Disease: Systematic Scoping Review (Preprint)
Authors: Ramachandran Hadassah Joann , Jiang Ying , Teo Jun Yi Claire , Yeo Tee Joo , Wang Wenru
Published: November 2021

BACKGROUND

An understanding of the technology acceptance of home-based cardiac telerehabilitation programs is paramount if they are to be designed and delivered to target the needs and preferences of patients with coronary heart disease; however, the current state of technology acceptance of home-based cardiac telerehabilitation has not been systematically evaluated in the literature.

OBJECTIVE

We aimed to provide a comprehensive summary of home-based cardiac telerehabilitation technology acceptance in terms of (1) the timing and approaches used and (2) patients’ perspectives on its usability, utility, acceptability, acceptance, and external variables.

METHODS

We searched PubMed, CENTRAL, Embase, CINAHL, PsycINFO, and Scopus (inception to July 2021) for English-language papers that reported empirical evidence on the technology acceptance of early-phase home-based cardiac telerehabilitation in patients with coronary heart disease. Content analysis was undertaken.

RESULTS

The search identified 1798 studies, of which 18 studies, with 14 unique home-based cardiac telerehabilitation programs, met eligibility criteria. Technology acceptance (of the home-based cardiac telerehabilitation programs) was mostly evaluated at intra- and posttrial stages using questionnaires (n=10) and usage data (n=11). The least used approach was evaluation through qualitative interviews (n=3). Usability, utility, acceptability, and acceptance were generally favored. External variables that influenced home-based cardiac telerehabilitation usage included component quality, system quality, facilitating conditions, and intrinsic factors.

CONCLUSIONS

Home-based cardiac telerehabilitation usability, utility, acceptability, and acceptance were high; yet, a number of external variables influenced acceptance. Findings and recommendations from this review can provide guidance for developing and evaluating patient-centered home-based cardiac telerehabilitation programs to stakeholders and clinicians.
Evaluating Voice Assistants' Responses to COVID-19 Vaccination in Portuguese: Quality Assessment (Preprint)
Authors: Seródio Figueiredo Carlos Maurício , de Melo Tiago , Goes Raphaela
Published: November 2021

BACKGROUND

Voice assistants (VAs) are devices that respond to human voices and can be commanded to do a variety of tasks. Nowadays, VAs are being used to obtain health information, which has become a critical point of analysis for researchers in terms of question understanding and quality of response. Particularly, the COVID-19 pandemic has and still is severely affecting people worldwide, which demands studies on how VAs can be used as a tool to provide useful information.

OBJECTIVE

This work aimed to perform a quality analysis of different VAs’ responses regarding the actual and important subject of COVID-19 vaccines. We focused on this important subject since vaccines are now available and society has urged for the population to be rapidly immunized.

METHODS

The proposed study was based on questions that were collected from the ofﬁcial World Health Organization website. These questions were submitted to the 5 dominant VAs (Alexa, Bixby, Cortana, Google Assistant, and Siri), and responses were evaluated according to a rubric based on the literature. We focused this study on the Portuguese language as an additional contribution, since previous works are mainly focused on the English language, and we believe that VAs cannot be optimized to foreign languages.

RESULTS

Results showed that Google Assistant has a better overall performance, and only this VA and Samsung Bixby achieved high scores on question understanding in the Portuguese language. Regarding the obtained answers, the study also showed the best Google Assistant overall performance.

CONCLUSIONS

Under the urgent context of COVID-19 vaccination, this work can help to understand how VAs must be improved to be more useful to the society and how careful people must be when considering VAs as a source of health information. VAs have been demonstrated to perform well regarding comprehension and user-friendliness. However, this work has found that they must be better integrated to their information sources to be useful as health information tools.