bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Childhood Obesity Based on Brazilian Dietary Guidelines Plus Energy Restriction (PAPPAS HUPE Study): Protocol for a Randomized Clinical Trial
Authors: Brandao Joana Maia , Sichieri Rosely , Ribas Simone Augusta , Verly-Jr Eliseu , Pereira Rosangela Alves , Castro Inês Rugani Ribeiro De , Hassan Bruna Kulik , Oliveira Alessandra Silva Dias De , Marques Emanuele Souza , Cunha Diana Barbosa
Published: May 2020

Background

The Food Guide for the Brazilian Population relies on natural or minimally processed foods mainly of plant origin such as beans and rice with low oil, salt, and sugar content and limited consumption of ultraprocessed foods. Reduction of ultraprocessed foods improves diet quality and energy consumption.

Objective

The goal of this study is to evaluate the effectiveness of an intervention for the treatment of obesity in children, with counseling based on the Brazilian Food Guide plus control of total energy intake.

Methods

A parallel, randomized clinical trial will include children aged 7 to 12 years. Randomization will be performed in blocks of 10 individuals using computer-generated random sequence numbers. Both the control and intervention groups will participate in 6 standardized educational activities based on the 10 steps of the Brazilian Food Guide. These activities will be conducted at the University Hospital Toy Library, located in the pediatric outpatient clinic. For the intervention group, in addition to the educational activities, an individualized food plan based on the nutritional recommendations of the Brazilian Society of Pediatrics will be prescribed and discussed with the mothers and fathers. The primary outcome of the study will be variations in body mass index, and secondary outcomes will include analysis of insulin resistance, blood pressure, body fat percentage, and waist and neck circumference.

Results

This project was funded by the National Council for Scientific and Technological Development in December 2017 (grant no 408333/2017-0). Recruitment began in August 2018 and by September 2019, we had enrolled the 101 participants. In addition to the patients referred by the national system of regulation, recruitment was made by medical outpatient referral and external indication. This is an ongoing study. We expect the results to be published in November 2020.

Conclusions

At the end of the project, in case of a positive result, a protocol for the treatment of obesity based on the Brazilian Food Guide will be proposed to the Unified Health System. A successful method to reduce childhood obesity is expected.

Trial Registration

Brazilian Registry of Clinical Trials RBR-3st5sn; http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn

International Registered Report Identifier (IRRID)

DERR1-10.2196/16170
Recommendations for Developing Support Tools With People Suffering From Chronic Obstructive Pulmonary Disease: Co-Design and Pilot Testing of a Mobile Health Prototype
Authors: Davies Alan , Mueller Julia , Hennings Jean , Caress Ann-Louise , Jay Caroline
Published: May 2020

Background

Gaps exist between developers, commissioners, and end users in terms of the perceived desirability of different features and functionalities of mobile apps.

Objective

The objective of this study was to co-design a prototype mobile app for people with chronic obstructive pulmonary disease (COPD). We present lessons learned and recommendations from working on a large project with various stakeholders to develop a mobile app for patients with COPD.

Methods

We adopted a user-centered, participatory approach to app development. Following a series of focus groups and interviews to capture requirements, we developed a prototype app designed to enable daily symptom recording (experience sampling). The prototype was tested in a usability study applying the think aloud protocol with people with COPD. It was then released via the Android app store, and experience sampling data and event data were captured to gather further usability data.

Results

A total of 5 people with COPD participated in the pilot study. Identified themes include familiarity with technology, appropriate levels for feeding back information, and usability issues such as manual dexterity. Moreover, 37 participants used the app over a 4-month period (median age 47 years). The symptoms most correlated to perceived well-being were tiredness (r=0.61; P<.001) and breathlessness (r=0.59; P<.001).

Conclusions

Design implications for COPD apps include the need for clearly labeled features (rather than relying on colors or symbols that require experience using smartphones), providing weather information, and using the same terminology as health care professionals (rather than simply lay terms). Target users, researchers, and developers should be involved at every stage of app development, using an iterative approach to build a prototype app, which should then be tested in controlled settings as well as in the wild (ie, when deployed and used in real-world settings) over longer periods.
A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study
Authors: Sengupta Avijit , Beckie Theresa , Dutta Kaushik , Dey Arup , Chellappan Sriram
Published: May 2020

Background

Coronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care.

Objective

The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants.

Methods

Using a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment.

Results

All 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04).

Conclusions

The mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.
A Blended Physiotherapy Intervention for Persons With Hemophilic Arthropathy: Development Study
Authors: Timmer Merel A , Kloek Corelien J J , de Kleijn Piet , Kuijlaars Isolde A R , Schutgens Roger E G , Veenhof Cindy , Pisters Martijn F
Published: May 2020

Background

Joint bleeds are the hallmark of hemophilia, leading to a painful arthritic condition called as hemophilic arthropathy (HA). Exercise programs are frequently used to improve the physical functioning in persons with HA. As hemophilia is a rare disease, there are not many physiotherapists who are experienced in the field of hemophilia, and regular physiotherapy sessions with an experienced physiotherapist in the field of hemophilia are not feasible for persons with HA. Blended care is an innovative intervention that can support persons with HA at home to perform the advised physical activities and exercises and provide self-management information.

Objective

The aim of this study was to develop a blended physiotherapy intervention for persons with HA.

Methods

The blended physiotherapy intervention, namely, e-Exercise HA was developed by cocreation with physiotherapists, persons with HA, software developers, and researchers. The content of e-Exercise HA was compiled using the first 3 steps of the Center for eHealth Research roadmap model (ie, contextual inquiry, value specification, and design), including people with experience in the development of previous blended physiotherapy interventions, a literature search, and focus groups.

Results

A 12-week blended intervention was developed, integrating face-to-face physiotherapy sessions with a web-based app. The intervention consists of information modules for persons with HA and information modules for physiotherapists, a graded activity program using a self-chosen activity, and personalized video-supported exercises. The information modules consist of text blocks, videos, and reflective questions. The patients can receive pop-ups as reminders and give feedback on the performance of the prescribed activities.

Conclusions

In this study, we developed a blended physiotherapy intervention for persons with HA, which consists of information modules, a graded activity program, and personalized video-supported exercises.
Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study
Authors: Do Vuong Van , Spears Claire Adams , Van Minh Hoang , Huang Jidong , Redmon Pamela Buffington , Xuan Long Nguyen , Eriksen Michael Paul
Published: May 2020

Background

With 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging–based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers.

Objective

This study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers.

Methods

A total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International).

Results

The major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging–based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages.

Conclusions

This study provides important insights to inform the development of a text messaging–based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.
The Ubiquitous Cognitive Assessment Tool for Smartwatches: Design, Implementation, and Evaluation Study
Authors: Hafiz Pegah , Bardram Jakob Eyvind
Published: May 2020

Background

Cognitive functioning plays a significant role in individuals’ mental health, since fluctuations in memory, attention, and executive functions influence their daily task performance. Existing digital cognitive assessment tools cannot be administered in the wild and their test sets are not brief enough to capture frequent fluctuations throughout the day. The ubiquitous availability of mobile and wearable devices may allow their incorporation into a suitable platform for real-world cognitive assessment.

Objective

The aims of this study were threefold: (1) to evaluate a smartwatch-based tool for the assessment of cognitive performance, (2) to investigate the usability of this tool, and (3) to understand participants’ perceptions regarding the application of a smartwatch in cognitive assessment.

Methods

We built the Ubiquitous Cognitive Assessment Tool (UbiCAT) on a smartwatch-based platform. UbiCAT implements three cognitive tests—an Arrow test, a Letter test, and a Color test—adapted from the two-choice reaction-time, N-back, and Stroop tests, respectively. These tests were designed together with domain experts. We evaluated the UbiCAT test measures against standard computer-based tests with 21 healthy adults by applying statistical analyses significant at the 95% level. Usability testing for each UbiCAT app was performed using the Mobile App Rating Scale (MARS) questionnaire. The NASA-TLX (Task Load Index) questionnaire was used to measure cognitive workload during the N-back test. Participants rated perceived discomfort of wearing a smartwatch during the tests using a 7-point Likert scale. Upon finishing the experiment, an interview was conducted with each participant. The interviews were transcribed and semantic analysis was performed to group the findings.

Results

Pearson correlation analysis between the total correct responses obtained from the UbiCAT and the computer-based tests revealed a significant strong correlation (r=.78, P<.001). One-way analysis of variance (ANOVA) showed a significant effect of the N-back difficulty level on the participants' performance measures. The study also demonstrated usability ratings above 4 out of 5 in terms of aesthetics, functionality, and information. Low discomfort (<3 out of 7) was reported by our participants after using the UbiCAT. Seven themes were extracted from the transcripts of the interviews conducted with our participants.

Conclusions

UbiCAT is a smartwatch-based tool that assesses three key cognitive domains. Usability ratings showed that participants were engaged with the UbiCAT tests and did not feel any discomfort. The majority of the participants were interested in using the UbiCAT, although some preferred computer-based tests, which might be due to the widespread use of personal computers. The UbiCAT can be administered in the wild with mentally ill patients to assess their attention, working memory, and executive function.
A Novel Narrative E-Writing Intervention for Parents of Children With Chronic Life-Threatening Illnesses: Protocol for a Pilot, Open-Label Randomized Controlled Trial
Authors: Ho Andy Hau Yan , Dutta Oindrila , Tan-Ho Geraldine , Tan Toh Hsiang Benny , Low Xinyi Casuarine , Ganapathy Sashikumar , Car Josip , Ho Ringo Moon-Ho , Miao Chun Yan
Published: May 2020

Background

A novel evidence-based Narrative e-Writing Intervention (NeW-I) has been developed and tested in Singapore to advance psychosociospiritual support for parents of children with chronic life-threatening illnesses. NeW-I is informed by an international systematic review and a Singapore-based qualitative inquiry on the lived experience of parental bereavement and supported by literature on anticipatory grief interventions for improving the holistic well-being of parent caregivers of seriously ill children.

Objective

This study's aim was to provide an accessible platform, NeW-I—which is a strengths- and meaning-focused and therapist-facilitated mobile app and web-based counseling platform—that aims to enhance quality of life, spiritual well-being, hope, and perceived social support and reduce depressive symptoms, caregiver burden, and risk of complicated grief among parents of children with chronic life-threatening illnesses.

Methods

The NeW-I therapist-facilitated web-based platform comprises a mobile app and a website (both of which have the same content
and functionality). NeW-I has been implemented in Singapore as a pilot open-label randomized controlled trial comprising intervention and control groups. Both primary and secondary outcomes will be self-reported by participants through questionnaires. In collaboration with leading pediatric palliative care providers in Singapore, the trial aims to enroll 36 participants in each group (N=72), so that when allowing for 30% attrition at follow-up, the sample size will be adequate to detect a small effect size of 0.2 in the primary outcome measure, with 90% power and two-sided significance level of at least .05. The potential effectiveness of NeW-I and the accessibility and feasibility of implementing and delivering the intervention will be assessed.

Results

Funding support and institutional review board approval for this study have been secured. Data collection started in January 2019 and is ongoing.

Conclusions

NeW-I aspires to enhance holistic pediatric palliative care services through a structured web-based counseling platform that is sensitive to the unique cultural needs of Asian family caregivers who are uncomfortable with expressing emotion even during times of loss and separation. The findings of this pilot study will inform the development of a full-scale NeW-I protocol and further research to evaluate the efficacy of NeW-I in Singapore and in other Asian communities around the world.

Trial Registration

ClinicalTrials.gov NCT03684382; https://clinicaltrials.gov/ct2/show/NCT03684382

International Registered Report Identifier (IRRID)

DERR1-10.2196/17561
Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery to Facilitate Person-Centered Care: Descriptive Study
Authors: Gustavell Tina , Sundberg Kay , Langius-Eklöf Ann
Published: May 2020

Background

Pancreatic and periampullary cancers are rare but have high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates a health care system responsive to these needs and health care professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support for self-care. The app has been shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer.

Objective

The aim of the study was to describe how patients used the Interaktor app following pancreaticoduodenectomy due to cancer and their experience with doing so.

Methods

A total of 115 patients were invited to use Interaktor for 6 months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped out, and 46 did not meet the inclusion criteria after surgery, leaving 26 patients for inclusion in the analysis. The patients were instructed to report symptoms daily through the app for up to 6 months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts, and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences, and the data were analyzed using thematic analysis.

Results

The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported symptoms. Alerting symptoms were reported by 24 patients, and the most common alert was fever. There were variations in how many times the patients viewed the self-care advice (range 3-181 times). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews, the overarching theme was “Being seen as a person,” with the following 3 sub-themes: “Getting your voice heard,” “Having access to an extended arm of health care,” and “Learning about own health.”

Conclusions

Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in their own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than patients receiving only standard care.
Use of BERT (Bidirectional Encoder Representations from Transformers)-Based Deep Learning Method for Extracting Evidences in Chinese Radiology Reports: Development of a Computer-Aided Liver Cancer Diagnosis Framework (Preprint)
Authors: Liu Honglei , Zhang Zhiqiang , Xu Yan , Wang Ni , Huang Yanqun , Yang Zhenghan , Jiang Rui , Chen Hui
Published: May 2020

BACKGROUND

Liver cancer is a substantial disease burden in China. As one of the primary diagnostic tools for detecting liver cancer, dynamic contrast-enhanced computed tomography provides detailed evidences for diagnosis that are recorded in free-text radiology reports.

OBJECTIVE

The aim of our study was to apply a deep learning model and rule-based natural language processing (NLP) method to identify evidences for liver cancer diagnosis automatically.

METHODS

We proposed a pretrained, fine-tuned BERT (Bidirectional Encoder Representations from Transformers)-based BiLSTM-CRF (Bidirectional Long Short-Term Memory-Conditional Random Field) model to recognize the phrases of APHE (hyperintense enhancement in the arterial phase) and PDPH (hypointense in the portal and delayed phases). To identify more essential diagnostic evidences, we used the traditional rule-based NLP methods for the extraction of radiological features. APHE, PDPH, and other extracted radiological features were used to design a computer-aided liver cancer diagnosis framework by random forest.

RESULTS

The BERT-BiLSTM-CRF predicted the phrases of APHE and PDPH with an F1 score of 98.40% and 90.67%, respectively. The prediction model using combined features had a higher performance (F1 score, 88.55%) than those using APHE and PDPH (84.88%) or other extracted radiological features (83.52%). APHE and PDPH were the top 2 essential features for liver cancer diagnosis.

CONCLUSIONS

This work was a comprehensive NLP study, wherein we identified evidences for the diagnosis of liver cancer from Chinese radiology reports, considering both clinical knowledge and radiology findings. The BERT-based deep learning method for the extraction of diagnostic evidence achieved state-of-the-art performance. The high performance proves the feasibility of the BERT-BiLSTM-CRF model in information extraction from Chinese radiology reports. The findings of our study suggest that the deep learning–based method for automatically identifying evidences for diagnosis can be extended to other types of Chinese clinical texts.
Exploring Novel Funding Strategies for Innovative Medical Research: The HORAO Crowdfunding Campaign (Preprint)
Authors: Schucht Philippe , Roccaro-Waldmeyer Diana M , Murek Michael , Zubak Irena , Goldberg Johannes , Falk Stephanie , Dahlweid Fried-Michael , Raabe Andreas
Published: May 2020

BACKGROUND

The rise of the internet and social media has boosted online crowdfunding as a novel strategy to raise funds for kick-starting projects, but it is rarely used in science.

OBJECTIVE

We report on an online crowdfunding campaign launched in the context of the neuroscience project HORAO. The aim of HORAO was to develop a noninvasive real-time method to visualize neuronal fiber tracts during brain surgery in order to better delineate tumors and to identify crucial cerebral landmarks. The revenue from the crowdfunding campaign was to be used to sponsor a crowdsourcing campaign for the HORAO project.

METHODS

We ran a 7-week reward-based crowdfunding campaign on a national crowdfunding platform, offering optional material and experiential rewards in return for a contribution toward raising our target of Swiss francs (CHF) 50,000 in financial support (roughly equivalent to US $50,000 at the time of the campaign). We used various owned media (websites and social media), as well as earned media (press releases and news articles) to raise awareness about our project.

RESULTS

The production of an explanatory video took 60 hours, and 31 posts were published on social media (Facebook, Instagram, and Twitter). The campaign raised a total of CHF 69,109. Approximately half of all donations came from donors who forwent a reward (CHF 28,786, 48.74%); the other half came from donors who chose experiential and material rewards in similar proportions (CHF 14,958, 25.33% and CHF 15,315.69, 25.93%, respectively). Of those with an identifiable relationship to the crowdfunding team, patients and their relatives contributed the largest sum (CHF 17,820, 30.17%), followed by friends and family (CHF 9288, 15.73%) and work colleagues (CHF 6028, 10.21%), while 43.89% of funds came from donors who were either anonymous or had an unknown relationship to the crowdfunding team. Patients and their relatives made the largest donations, with a median value of CHF 200 (IQR 90).

CONCLUSIONS

Crowdfunding proved to be a successful strategy to fund a neuroscience project and to raise awareness of a specific clinical problem. Focusing on potential donors with a personal interest in the issue, such as patients and their relatives in our project, is likely to increase funding success. Compared with traditional grant applications, new skills are needed to explain medical challenges to the crowd through video messages and social media.
Efficacy of a Novel Intraoperative Engineered Sharps Injury Prevention Device: Pilot Usability and Efficacy Trial (Preprint)
Authors: Jenny Hillary , Reategui Via y Rada Maria , Yesantharao Pooja , Xun Helen , Redett Richard , Sacks Justin Michael , Yang Robin
Published: May 2020

BACKGROUND

The American College of Surgeons reports 88,320 intraoperative needlestick injuries (NSIs) per year, resulting in US $376 to US $2456 in costs per NSI. Engineered sharps injury prevention (ESIP) devices protect against NSIs. To our knowledge, no study has been published to date to demonstrate clinical effectiveness of an intraoperative ESIP device. Operative Armour is a wearable arm cuff that can be donned during surgical closure to allow surgeons to keep a suture pack and sharps protection container on their forearm.

OBJECTIVE

We characterize Operative Armour’s ESIP device effectiveness in a tertiary hospital, hypothesizing that this device will decrease NSI risk by decreasing behaviors associated with NSIs: needle passing and handling.

METHODS

A prospective case-control study was conducted with institutional review board quality improvement designation in which authors observed skin closures of plastic surgery procedures. To ensure accuracy, one surgeon was observed at a time. Control surgeries were purely observational; intervention cases involved surgeon use of the device during skin closure. Outcomes of interest included needle passing, needle handling, lost needles, and loaded waiting needles.

RESULTS

Surgeons were observed in 50 control and 50 intervention cases. Operative Armour eliminated needle passing during skin closure. One NSI occurred in one control case; no NSIs were observed in intervention cases (P=.36). The mean number of loaded and unprotected waiting needles was also significantly decreased in the intervention group from 2.3 to 0.2 (P<.001). Furthermore, a multivariable linear regression established that Operative Armour significantly decreased the number of needle adjustments by hand per stitch observed (F4, 21.68=3.72; P=.01). In fact, needle adjustments by hand decreased overall (1 adjustment per 10 stitches vs 1 adjustment per 5 stitches, P=.004), and adjustments occurred half as frequently with use of Operative Armour in free flap reconstruction (1 adjustment per 10 stitches vs 1 adjustment per 5 stitches, P=.03) and a quarter as frequently in other breast reconstruction cases such as mastopexy (1 adjustment per 20 stitches vs 1 adjustment per 5 stitches, P=.002).

CONCLUSIONS

Operative Armour effectively functions as an ESIP device by decreasing intraoperative needle passing and handling. Although sample size prohibits demonstrating a decrease in NSIs during observed cases, by decreasing behaviors that drive NSI risk, we anticipate an associated decrease in NSIs with use of the device.
An Application of Machine Learning to Etiological Diagnosis of Secondary Hypertension: Retrospective Study Using Electronic Medical Records (Preprint)
Authors: Diao Xiaolin , Huo Yanni , Yan Zhanzheng , Wang Haibin , Yuan Jing , Wang Yuxin , Cai Jun , Zhao Wei
Published: May 2020

BACKGROUND

Secondary hypertension is a kind of hypertension with a definite etiology and may be cured. Patients with suspected secondary hypertension can benefit from timely detection and treatment and, conversely, will have a higher risk of morbidity and mortality than those with primary hypertension.

OBJECTIVE

The aim of this study was to develop and validate machine learning (ML) prediction models of common etiologies in patients with suspected secondary hypertension.

METHODS

The analyzed data set was retrospectively extracted from electronic medical records of patients discharged from Fuwai Hospital between January 1, 2016, and June 30, 2019. A total of 7532 unique patients were included and divided into 2 data sets by time: 6302 patients in 2016-2018 as the training data set for model building and 1230 patients in 2019 as the validation data set for further evaluation. Extreme Gradient Boosting (XGBoost) was adopted to develop 5 models to predict 4 etiologies of secondary hypertension and occurrence of any of them (named as composite outcome), including renovascular hypertension (RVH), primary aldosteronism (PA), thyroid dysfunction, and aortic stenosis. Both univariate logistic analysis and Gini Impurity were used for feature selection. Grid search and 10-fold cross-validation were used to select the optimal hyperparameters for each model.

RESULTS

Validation of the composite outcome prediction model showed good performance with an area under the receiver-operating characteristic curve (AUC) of 0.924 in the validation data set, while the 4 prediction models of RVH, PA, thyroid dysfunction, and aortic stenosis achieved AUC of 0.938, 0.965, 0.959, and 0.946, respectively, in the validation data set. A total of 79 clinical indicators were identified in all and finally used in our prediction models. The result of subgroup analysis on the composite outcome prediction model demonstrated high discrimination with AUCs all higher than 0.890 among all age groups of adults.

CONCLUSIONS

The ML prediction models in this study showed good performance in detecting 4 etiologies of patients with suspected secondary hypertension; thus, they may potentially facilitate clinical diagnosis decision making of secondary hypertension in an intelligent way.
Public Disclosure on Social Media of Identifiable Patient Information by Health Professionals: Content Analysis of Twitter Data (Preprint)
Authors: Ahmed Wasim , Jagsi Reshma , Gutheil Thomas G , Katz Matthew S
Published: May 2020

BACKGROUND

Respecting patient privacy and confidentiality is critical for doctor-patient relationships and public trust in medical professionals. The frequency of potentially identifiable disclosures online during periods of active engagement is unknown.

OBJECTIVE

The objective of this study was to quantify potentially identifiable content shared on social media by physicians and other health care providers using the hashtag #ShareAStoryInOneTweet.

METHODS

We accessed and searched Twitter’s API using Symplur software for tweets that included the hashtag #ShareAStoryInOneTweet. We identified 1206 tweets by doctors, nurses, and other health professionals out of 43,374 tweets shared in May 2018. Tweet content was evaluated in January 2019 to determine the incidence of instances where names or potentially identifiable information about patients were shared; content analysis of tweets in which information about others had been disclosed was performed. The study also evaluated whether participants raised concerns about privacy breaches and estimated the frequency of deleted tweets. The study used dual, blinded coding for a 10% sample to estimate intercoder reliability using Cohen κ statistic for identifying the potential identifiability of tweet content.

RESULTS

Health care professionals (n=656) disclosing information about others included 486 doctors (74.1%) and 98 nurses (14.9%). Health care professionals sharing stories about patient care disclosed the time frame in 95 tweets (95/754, 12.6%) and included patient names in 15 tweets (15/754, 2.0%). It is estimated that friends or families could likely identify the clinical scenario described in 242 of the 754 tweets (32.1%). Among 348 tweets about potentially living patients, it was estimated that 162 (46.6%) were likely identifiable by patients. Intercoder reliability in rating the potential identifiability demonstrated 86.8% agreement, with a Cohen κ of 0.8 suggesting substantial agreement. We also identified 78 out of 754 tweets (6.5%) that had been deleted on the website but were still viewable in the analytics software data set.

CONCLUSIONS

During periods of active sharing online, nurses, physicians, and other health professionals may sometimes share more information than patients or families might expect. More study is needed to determine whether similar events arise frequently and to understand how to best ensure that patients’ rights are adequately respected.
La reconfiguración de los subcentros de empleo en Ciudad Juárez, Chihuahua, 2004-2014
Authors: Chaparro Hernández Isaac , Hernández Hernández Vladimir
Published: May 2020

El objetivo es identificar la estructura urbana de Ciudad Juárez y demostrar la reconfiguración de los subcentros de empleo mediante la implementación de tres indicadores de autocorrelación espacial. El método considera los principios de la dependencia espacial mediante la detección de la autocorrelación global y local. Para ello se hace uso de tres indicadores: I de Moran, G de Getis-Ord y c de Geary. Las variables usadas fueron la densidad bruta de empleo total, en manufactura y terciario de 2004 a 2014 a escala de áreas geoestadísticas básicas. La falta de censos económicos más recientes se considera una limitante, además de que no se encontraron investigaciones previas que hayan utilizado estrictamente la metodología aquí propuesta para comparar y discutir resultados. A través de los indicadores de autocorrelación global fue posible identificar el grado de agrupamiento de las densidades de empleo, mientras que los locales permitieron caracterizar los subcentros de trabajo. Los resultados muestran clústeres de alta densidad que conforman cuatro islas dispersas y dos núcleos de empleo. Además, se comprueba la utilidad de combinar los tres tipos de autocorrelaciones espaciales.
Crébillon hijo, precursor de los libertinajes literarios del siglo XVIII
Authors: Gómez Velázquez José Luis
Published: May 2020

Este artículo analiza la evolución del libertinaje de costumbres en la Francia del siglo XVIII. Para realizar tal tarea es necesario ir más atrás y rastrear la fuente misma de las corrientes libertinas que llevaron a la tradición francesa a crear dicho género narrativo. Así pues, en la primera parte de la investigación se realiza una búsqueda por las fuentes de este género literario y las implicaciones filosóficas del mismo. En un segundo tiempo, se abordan autores propios del siglo XVIII, quienes a ojos de la crítica representan tres momentos importantes de este movimiento literario: Crébillon, Laclos y Sade. Por último, se analiza la producción de Crébillon hijo como fundador de un movimiento estético que es reinterpretado por varios autores.
Implementasi Budaya Sekolah Bernuansa Islami Dalam Pendidikan Karakter Di MIN I Malang
Authors: Chaira Mahda , Tinus Agus
Published: May 2020

Abstract: The purpose of this research is to find out the implementation of Islamic culture in MIN I Malang, the Islamic character developed in MIN I Malang, the obstacles in implementing Islamic culture in MIN I Malang, and to describe the efforts made by school institutions to overcome these obstacles. The research method was conducted by descriptive qualitative. Data is collected using structured interviews by taking the subject of teachers, school principals, and parents of students. The results show that the implementation of Islamic culture in schools begins with the construction of a system that directs the behavior of students with Islamic character through the habituation of Islamic behavior. Then supported by the implementation of the Koran, Kultum, and memorization of the Qur'an in the first fifteen minutes before school hours every day. Duha prayer, Dhuhr prayer, Friday prayer, and princess in school. The obstacle to developing Islamic culture in schools is the habit of parents who are sometimes not in line and the way to overcome them is by creating a Whatsapp group for students' parents.Keywords: Implementation, Islamic Culture, Character EducationAbstrak: Tujuan dari penelitian untuk mengetahui implementasi budaya Islami di MIN I Malang, karakter Islami yang dikembangkan di MIN I Malang, kendala dalam implementasi budaya Islami di MIN I Malang, dan memaparkan upaya yang dilakukan oleh lembaga sekolah untuk mengatasi kendala-kendala tersebut. Metode penelitian dilakukan dengan deskriptif kualitatif. Pengambilan data dilakukan menggunakan wawancara terstruktur dengan mengambil subjek guru, kepala sekolah, dan orang tua siswa. Hasil penelitian menunjukkan bahwa implementasi budaya Islami di sekolah diawali dengan dibangunnya sistem yang mengarahkan perilaku siswa yang berkarakter Islami melalui pembiasaan perilaku Islami. Kemudian ditunjang dengan pelaksanaan mengaji, kultum, dan hafalan Al-Qur’an pada lima belas menit pertama sebelum jam masuk sekolah setiap harinya. Pelaksanaan shalat dhuha, shalat dhuhur, shalat jumat, dan keputrian di sekolah. Kendala dari pembasaan budaya Islami di sekolah adalah pembiasaan orang tua yang kadang tidak sejalan dan cara mengatasinya adalah dengan membuat grup Whatsapp bagi orang tua murid.Kata kunci: Implementasi, Budaya Islami, Pendidikan Karakter
Designing Marketing Strategy Based on Value from Clothing-producing Companies using the AHP and Delphi Methods
Authors: Sari Hasrini , Nurhadi Diningtyas Aulia
Published: May 2020

Organizations design some strategies to win the competition. This paper discusses the design of market strategies to achieve harmony between value-based segmentation and marketing mix.  The strategy's implementation starts with segmentation, targeting, and positioning. The clothing company ("M") was selected as a research object. Identification of market segments using cluster analysis while determine the target market using the AHP and Delphi method. Besides, Bull's eye research was used for product positioning. The results show that "M" customers are classified into two groups, referred Big Spenders and Discount Finders. Big Spender was selected as the primary target market with a focus on size and durability. The marketing strategy focuses on Instagram and Facebook.  As a result, the ads developed prototypes have proven to be better.
Rola i znaczenie wstydu w procesie odstąpienia od przestępczości
Authors: Skuza Aneta
Published: May 2020

W psychologii przyjmuję się, że wstyd jest emocją, która odgrywa istotną rolę w rozwoju społecznym jednostki, rozwoju mechanizmów samokontroli oraz w kształtowaniu obrazu siebie. Jak podkreśla E. Kurtz, doświadczanie wstydu to doświadczenie odsłaniania się nie tylko przed innymi, ale także przed samym sobą. Zatem świadomy wstyd ma właściwości reintegrujące i przywracające więzi. Zwraca na to uwagę w swej teorii przestępczości, wstydu i reintegracji J. Braithwaite, gdzie dowodzi, że najniższa przestępczość jest tam, gdzie wstyd i poczucie winy odgrywają największą rolę. Żeby wstyd mógł zadziałać, potrzebny jest szczególny jego rodzaj: wstyd reintegrujący. Pozwala on zrozumieć zło, ale nie wyklucza ze społeczności i nie przekreśla człowieka – stwarza zatem znacznie lepsze perspektywy i dla wymiaru sprawiedliwości karnej, i dla jakości życia – jednostek oraz całej społeczności. Zatem wstyd może się stać ważnym czynnikiem w procesie odstąpienia od przestępczości.
Rola pedagogiczno-wychowawcza Krajowej Mapy Zagrożeń Bezpieczeństwa – nowa forma dialogu społeczności lokalnej z Policją
Authors: Klonowska Iwona , Stawnicka Jadwiga
Published: May 2020

Podstawową potrzebą człowieka jest poczucie bezpieczeństwa. Współpraca z podmiotami zewnętrznymi ma ogromny wpływ na realizację ustawowych zadań Sił Policyjnych w zakresie zapewnienia bezpieczeństwa i porządku publicznego państwa. Obecnie Policja kładzie większy nacisk na znaczenie społeczeństwa w zapobieganiu i zwalczaniu przestępczości. Przykładem roli społeczeństwa jest interaktywne narzędzie Krajowej Mapy Zagrożenia Bezpieczeństwa, w którym mieszkańcy mogą anonimowo zgłaszać informacje o zagrożeniach pojawiających się w ich sąsiedztwie, zmuszając odpowiednie służby do reagowania jako radykalna zmiana pracy konstabla, przybliżając go obywatelom. Artykuł poświęcony jest pedagogicznej i edukacyjnej roli Krajowej Mapy Zagrożeń dla Bezpieczeństwa Słowa kluczowe: Bezpieczeństwo, Krajowa Mapa Zagrożeń Bezpieczeństwa, przestępczość, zagrożenia, rola pedagogiczna, rola edukacyjna, komunikacja, funkcja wychowawcza i społeczność lokalna.
The probation officer in view of a socialised social rehabilitation system
Authors: Ambrozik Wiesław
Published: May 2020

The article shows a jurisdictional- correctional model of the functioning of the Polish probation system, despite the fact that on its foundation in 1919 and in the current attempts to improve it we emphasize primarily its social rehabilitation and protection functions, the implementation of which should be embedded in the environment of the probationer, while all social forces are used forming this environment. Hence the postulated in this article need for communalization and integration of the actions of probation officers with various components of social participation environments of probationers.
Value chain impact of the increased hilsa shad (Tenualosa ilisha) harvest in Bangladesh
Authors: Khan Md. Akhtaruzzaman , Wahab Md. Abdul , Haque A.B.M. Mahfuzul , Nahiduzzaman M. , Phillips Michael J.
Published: May 2020

Hilsa shad is the largest single fish species, contributing 12% of the total fish production in Bangladesh. Since the rapid decline of its harvest in early 2000, the government of Bangladesh took various initiatives to accelerate the hilsa production and introduced the hilsa fisheries management action plan in 2005. Under WorldFish led enhanced coastal fisheries project, implemented in partnership with the Department of Fisheries, the hilsa fishery reversed and experienced record harvest in 2016. Therefore, this study was undertaken to explore the contributions and benefits of this increased hilsa shad production among value chain actors. The results revealed that increased catches have significant impacts on the volumes of hilsa that were handled by the value chain actors, which depressed market price along the value chain. However, the increased amounts of hilsa harvested compensated for the reduced price and led to increased profits, increased household incomes of the value chain actors, and enhanced fish consumption at the household levels. The increased hilsa catch also had positive and significant impacts on credit repayment. Therefore, the incentive-based co-management system deserves continuation to improve the livelihood of the poor hilsa fishers, to increase the income of the value chain actors and to ensure a sustainable hilsa fishery for Bangladesh.
Can rural e-commerce service centers improve farmers’ subject well-being? A new practice of ‘internet plus rural public services’ from China
Authors: Jin Hui , Li Lili , Qian Xinyi , Zeng Yiwu
Published: May 2020

Whether farmers live happily or not matters a nation’s harmony and stability. Recently, a large number of rural e-commerce service centers (RESC) have been emerged in rural China. RESC provide some convenient services for local residents, such as agent purchase, sales, and payment online. This paper devotes to empirically analyzing the impact of RESC on farmers’ subjective well-being (SWB) with the method of propensity score matching based on the survey data collected from the first pilot city of Alibaba’s RESC project – Tonglu County, Zhejiang Province. It is confirmed that RESC can significantly improve farmers’ SWB, which not only provides an empirical evidence for the further development of RESC, but also reveals that RESC is a beneficial practice for local governments to utilize the internet to improve farmers’ welfare. It also has a positive exemplary significance for ‘internet plus rural public services’.