bluuebunny/crossref_metadata_2025 huggingface dataset:
EXISTENTIAL VISIONS IN SMALL PROSE OF EMIGRANT WRITERS OF THE 1920's
Authors: Zhylenko Iryna
Published: January 2020

The article deals with the existential visions of the period of literary emigration in 1919–1939 according to the stories of the Ukrainian writer Oles Babij and the Russian one -Alexei Tolstoy.
Within the new paradigm – existentialism – the authors showed the person through images of anxiety, despair, and longing. The negative impact of war (in O. Babij's story «Bandit») and emigration (in O. Tolstoy’work «On the Island of Hulk») on the formation of human consciousness is claimed here. Attention is drawn to the psychological aspects, symbolism, and details which are the markers of discomfort and the alienation of the heroes of both stories. The works trace the modes of the existential aesthetics: the boundary situation, the absurdity of existence, the concept of loneliness, etc. It is emphasized that similar existential motives, found out in small prose of the emigrant writers O. Tolstoy and O. Babij, appeared in the works of European writers A. Camus, J. P. Sartre almost twenty years later.
Keywords: emigration, war, existential visions, psychology, despair, boundary situation.
MOTIVES OF «LETTERS FROM THE FARM» BY KULISH IN A STORY BY I. NECHUI-LEVICKY «UNEQUAL PATHS»
Authors: Kalantaievska H. , Sypchenko I.
Published: January 2020

P. Kulish considered the farmer traditions in the context of natural harmonious life and observance of the laws of Scripture as an effective defense against the victorious advance of global urban civilization on the spiritual and moral-ethical space of his contemporary. The writer's attitude to the threats to the Ukrainian society, which went from cultivating consumer tastes, the desire to compete in the pursuit of comfort and fashion, supported in his work I. Nechui-Levitsky, tracing in the story "Unequal paths" the path of rapid decline of two families (rural and countryside), as a result of their capture of the false values of the world of accumulation and vanity.
The proposed article traces the organic connection and creative interpretation of P. Kulish's views expressed in the journalistic series "Letters from the Farm", with the ideological sounding of I. Nechuy-Levitsky's "Unequal Paths", in which the author explored the causes and catastrophic consequences of neglecting genus traditions and
choosing it as priorities for self-centeredness and hedonism. Attention is drawn to the close connection of the influence of irradiated Kiev (or St. Petersburg) on the heroes of the work (Vanatovich, Mikhail Ulasevich) with their internal readiness to become werewolf adapters for the career, state awards or approving reviews in urban private salons. The article analyzes the writer's characteristics and sketches of rural and Kiev
bohemian life on emotional, psychological, household, economic, custom, value, ultural
and educational levels, emphasizes on presented in the work conflict not only the generation of parents and children, but also on conflict - values colonial morality and
entertainment culture, on the one hand, and traditions of the genus and true education, on the other. Also it is showed the figures of new heroes of society, whose life paths are
directed not to the search for pleasure, but to help their people through enlightenment and introduction of modern technologies in agriculture.
Keywords: rural civilization, a world of accumulation and vanity, traditions of the genus, colonial morality.
Cut-style Pollination Can Effectively Overcome Prefertilization Barriers of Distant Hybridization in Loquat
Authors: Yang Qin , Fu Yan
Published: January 2020

Loquat [Eriobotrya japonica (E. japonica)], a small genus of the subtribe Malinae that consists of ≈30 species, is an evergreen rosaceous fruit tree that is native to southeastern China, and some wild species that possess novel, favorable traits have excellent breeding potential. For example, Eriobotrya bengalensis blooms in late spring and ripens in early autumn in Guizhou Province, China, which prevents cold injury in winter by breeding spring-flowering cultivars using the special characters. Therefore, in the present study, the pollination treatments of cut-style pollination were evaluated that may promote successful distant hybridization in Eriobotrya japonica ‘Dawuxing’ × Eriobotrya deflexa and E. japonica ‘Dawuxing’ × E. bengalensis. The results indicated that the impairment of the pollen tube growth in the upper third of the style after pollen germination is an important factor leading to the failure of distant hybridization between the species tested in E. japonica, and that cut-style pollination can effectively overcome prefertilization barriers of the distant hybridization combination. Furthermore, the results of allele-specific polymerase chain reaction (AS-PCR) showed that S-genotypes, in accordance with the S-RNase heredity to separate the rule completely in offspring, should be both parents' S-RNase, and that the random 50 seedlings of Eb-2 and Ed-2 are true hybrids.
The influence of the central warehouse on the functioning of Polish small and medium-sized enterprises operating in group purchasing organizations
Authors: Zimon Grzegorz
Published: January 2020

Growing competition in the market forces primarily small and medium enterprises (SMEs) to implement certain mechanisms that will allow them to build an advantage over the competition. Most often, SMEs try to work together as part of multi-stakeholder organizations and organize themselves into group purchasing organizations (GPOs) with the central warehouse to improve the financial state of enterprises. The article aims to assess and analyze the impact of the central warehouse on the performance of Polish SMEs operating in group purchasing organizations. The research group comprised of 172 trading enterprises operating in Polish group purchasing organizations. The investigated companies were divided into two groups. In the first group, there were companies operating within GPOs, which have a central warehouse. In the second group, there were companies in which central unit does not have a central warehouse. The analysis and research showed that the central warehouse has a positive impact on financial security of small and medium enterprises operating in group purchasing organizations. The use of central warehouse optimizes the most costly current assets component – inventories. This is confirmed by better results of inventory turnover ratios in days, reduced share of inventories in the structure of current assets, and optimization of financial liquidity ratios.
Neural network-based software sensors for the estimation of key components in brewery wastewater anaerobic digester: an experimental validation
Authors: Dewasme L.
Published: January 2020

This work focused on the experimental validation of software sensors with a view to improving on-line anaerobic digester monitoring. Based on cheaply available measurements such as conductivity, temperature, pH, redox potential, total suspended solids concentration and digester inflows and outflows, an intelligent estimator was built to reproduce the evolutions of key components such as volatile fatty acid, carbonate and alkalinity concentrations, as well as biogas composition (methane and carbon dioxide). The proposed solution considers a principal component pre-processing of the data selected as inputs of a radial basis function neural network (RBF-ANN) structure, using a particular sequential learning algorithm. Process dynamics were also taken into account, introducing a moving horizon version of this network (MH-RBF-ANN). Experimental results demonstrated the capacity of the MH-RBF-ANN to correctly predict the key-component evolutions and to improve the estimation accuracy, compared to the classical RBF-ANN.
Synthesis and photocatalytic degradation ability evaluation for rhodamine B of ZnO@SiO2 composite with flower-like structure
Authors: Shen Xiaoyi , Shi Youjiang , Shao Hongmei , Liu Yan , Zhai Yuchun
Published: January 2020

ZnO@SiO2 composite with flower-like structure was successfully prepared with molar ratio of ZnO/SiO2 = 1:1 based on the optimized synthesizing parameters of spherical SiO2 and flower-like ZnO. SiO2 particles were coated on the flower-like ZnO to form a homogeneous film through the multidimensional polycondensation of Si(OH)4. The photocatalytic degradation ability of ZnO@SiO2 composite for rhodamine B (RhB) obtained at different ZnO/SiO2 molar ratio and the comparison to that of flower-like ZnO showed that ZnO@SiO2 composite with ZnO/SiO2 molar ratio of 1:1 displayed a relatively good photocatalytic degradation ability to degrade RhB, but it was weaker than that of flower-like ZnO. Twenty millilitres of RhB solution at a concentration of 15 mg·L−1 could be completely degraded by 300 mg flower-like ZnO powder within 3 h, while the degrading efficiency was only 82.5% by 300 mg ZnO@SiO2 composite. But ZnO@SiO2 composite showed a better photocatalytic activity than flower-like ZnO at a lower pH value of 4.5.
Semi-solid rheology characterization of sludge conditioned with inorganic coagulants
Authors: Feng Guohong , Hu Zhi , Ma He , Bai Tiantian , Guo Yabing , Hao Yiran
Published: January 2020

Rheology measurement, a state-of-the-art technology in a multitude of engineering disciplines, has often been used for computational fluid dynamic simulation of wastewater treatment processes, especially in anaerobic digestion and dewatering. In this work, rheological tests were used to study the semi-solid characteristics of sludge and a good result was obtained. The inorganic coagulants polyaluminum chloride (PAC) and ferric chloride (FC) both increased the floc strength of sludge, leading to higher rheology parameters such as elastic modulus, viscous modulus and specific thixotropy area. Curiously, the shape of all rheological curves exhibited little change with increasing coagulant dosage. The results indicated that various physical and chemical actions among coagulants and sludge flocs relate only to rigid structure, not to the nature of rheology behavior. Frequency sweep tests clearly showed that elastic modulus was a logarithmic function of frequency, suggesting that sludge could not properly be called a soft material due to its inorganic particles. An improved viscoelastic model was successfully developed to predict the experimental data of creep and recovery tests in the linear viscoelastic region. Furthermore, complicated viscoelastic behavior of sludge was also observed, and all the rheology tests could provide the optimum dosage of PAC but not the optimum dosage of FC.
Technical-economic comparison of chemical precipitation and ion exchange processes for the removal of phosphorus from wastewater
Authors: Chiavola Agostina , Bongirolami Simona , Di Francesco Giorgia
Published: January 2020

Chemical precipitation with the addition of ferric chloride is commonly used to remove phosphorus from wastewater. However, since its application also involves several disadvantages, alternative solutions are required. The present paper shows the results of a full-scale experimental work aimed at evaluating the efficiency of the ion exchange process using a polymeric anion exchange resin impregnated with aluminum ions in the removal of phosphorus from wastewater. The study compared the results obtained through this process with chemical precipitation, considering both technical and economic issues. At the same dosage of 6 L/hour and influent concentration (about 6 mg/L), total removal efficiency of 95% and 78% (including also that occurring in the mechanical and biological processes) was achieved by means of the anion exchange process and chemical precipitation, respectively. However, in the latter case, this value was insufficient to ensure consistent compliance with the limit of 2 mg/L Ptot set on the effluent; to achieve this goal, the ferric chloride dosage had to be raised to 12 L/hour, thus increasing the related costs. Furthermore, the anion exchange process generated a lower sludge production. Therefore, the ion exchange process represents a valid alternative to chemical precipitation for P removal from wastewater.
Endoplasmic Reticulum Stress Increases Multidrug-resistance Protein 2 Expression and Mitigates Acute Liver Injury
Authors: Huang Wen-Ge , Wang Jun , Liu Yu-Juan , Wang Hong-Xia , Zhou Si-Zhen , Chen Huan , Yang Fang-Wan , Li Ying , Yi Yu , He Yi-Huai
Published: January 2020

Background:

Multidrug-resistance protein (MRP) 2 is a key membrane
transporter that is expressed on hepatocytes and regulated by nuclear factor kappa B
(NF-κB). Interestingly, endoplasmic reticulum (ER) stress is closely associated with liver
injury and the activation of NF-κB signaling.

Objective:

Here, we investigated the impact of ER stress on MRP2 expression and the
functional involvement of MRP2 in acute liver injury.

Methods:

ER stress, MRP2 expression, and hepatocyte injury were analyzed in a
carbon tetrachloride (CCl4)-induced mouse model of acute liver injury and in a
thapsigargin (TG)-induced model of ER stress.

Results:

CCl4 and TG induced significant ER stress, MRP2 protein expression and NF-
κB activation in mice and LO2 cells (P<0.05). Pretreatment with ER stress inhibitor 4-
phenyl butyric acid (PBA) significantly mitigated CCl4 and TG-induced ER stress and
MRP2 protein expression (P<0.05). Moreover, pretreatment with pyrrolidine
dithiocarbamic acid (PDTC; NF-κB inhibitor) significantly inhibited CCl4-induced NF-κB
activation and reduced MRP2 protein expression (1±0.097 vs. 0.623±0.054; P<0.05).
Furthermore, hepatic downregulation of MRP2 expression significantly increased CCl4-
induced ER stress, apoptosis, and liver injury.

Conclusion:

ER stress enhances intrahepatic MRP2 protein expression by activating
NF-κB. This increase in MRP2 expression mitigates ER stress and acute liver injury.
Current and Future Neuropharmacological Options for the Treatment of Essential Tremor
Authors: Alonso-Navarro Hortensia , García-Martín Elena , Agúndez José A.G. , Jiménez-Jiménez Félix J.
Published: January 2020

Background:

Essential Tremor (ET) is likely the most frequent movement disorder. In this review, we have summarized the current pharmacological options for the treatment of this disorder and discussed several future options derived from drugs tested in experimental models of ET or from neuropathological data.

Methods:

A literature search was performed on the pharmacology of essential tremors using PubMed Database from 1966 to July 31, 2019.

Results:

To date, the beta-blocker propranolol and the antiepileptic drug primidone are the drugs that have shown higher efficacy in the treatment of ET. Other drugs tested in ET patients have shown different degrees of efficacy or have not been useful.

Conclusion:

Injections of botulinum toxin A could be useful in the treatment of some patients with ET refractory to pharmacotherapy. According to recent neurochemical data, drugs acting on the extrasynaptic GABAA receptors, the glutamatergic system or LINGO-1 could be interesting therapeutic options in the future.
Association between Regional Cerebral Blood Flow and Mini-Mental State Examination Score in Patients with Alzheimer’s Disease
Authors: Saito Hitoshi , Kashiwakura Ikuo , Tsushima Megumi , Mariya Yasushi
Published: January 2020

Background:

In patients with Alzheimer’s disease (AD), cerebral blood flow (CBF) is
decreased from the early stages. CBF in AD is currently estimated from Z-scores using statistical
analysis. However, the Z-score is not considered the impaired area ratio.

Methods:

In the present study, a novel indicator, ΣzS, associated with brain surface area and Zscores,
is defined and the association with regional CBF has been estimated using Mini-Mental State
Examination (MMSE) scores, which indicate the severity of cognitive impairment in patients with
AD.

Results:

A negative correlation was detected between ΣzS in the posterior cingulate gyrus and the
subset numbers 1, 2, and 5 of the total MMSE scores. Furthermore, a negative correlation was detected
between the total MMSE score and ΣzS in Brodmann area 30, which is a subdivided area of
the brain.

Conclusion:

These results suggest that ΣzS may be a useful indicator of CBF metabolism, and thus
may improve the current understanding of cognitive function in patients with AD.
Zero Accident Vision: Literature Review and Future Directions in Indian Context
Authors: Narain Jai , Mishra Yogesh , Sain Manoj Kumar , Meena Makkhan Lal , Dangayach Govind Sharan , Posinasetti Naseswara Rao
Published: January 2020

Industrial accidents are grave mishaps that result in injuries and fatalities to people and
damage to property as well as the environment. The impact of the accident is exorbitant and society
has to pay for decades. In most of the developed countries, the wellbeing of people and the environment
is a top priority. The noble mission for every nation should be to reduce the level of the
accident to "Zero" by adopting the Zero Accident Vision (ZAV) to prevent the same. The Zero Accident
Vision is the spirit and commitment to create and ensure a safe workplace and prevent significant
accidents in order to achieve safety excellence. This review paper aims to explore the research
work performed towards ZAV and to study the status of present safety regulatory mechanisms
in detail, safety culture, and awareness in the Indian context. In the first stage of the study, a
systematic review approach was adopted using the Scopus database to explore past research on
ZAV. In the second stage, various policy documents available from government regulatory bodies
including their functions and adequacy of accident prevention, have been studied. The literature revealed
that no significant research has been carried out on ZAV in India. From the study of various
policy documents, it is evident that the country is far behind to achieve the ZAV and it will require
efforts from government, private and non-government organizations to reduce the same. The
planned and phase-wise efforts are needed to reduce the accidents and finally to achieve the ZAV.
The Changes in national safety policy, various acts regulating occupational health and safety need
to be amended suitably to incorporate the core values of ZAV. The mechanism of motivation by
giving suitable grading to the industries adopting ZAV as a vision in their safety policy needs to be
devised and followed.
Continuous Measurement of Reconnaissance Marines in Training With Custom Smartphone App and Watch: Observational Cohort Study
Authors: Saxon Leslie , DiPaula Brooks , Fox Glenn R , Ebert Rebecca , Duhaime Josiah , Nocera Luciano , Tran Luan , Sobhani Mona
Published: January 2020

Background

Specialized training for elite US military units is associated with high attrition due to intense psychological and physical demands. The need to graduate more service members without degrading performance standards necessitates the identification of factors to predict success or failure in targeted training interventions.

Objective

The aim of this study was to continuously quantify the mental and physical status of trainees of an elite military unit to identify novel predictors of success in training.

Methods

A total of 3 consecutive classes of a specialized training course were provided with an Apple iPhone, Watch, and specially designed mobile app. Baseline personality assessments and continuous daily measures of mental status, physical pain, heart rate, activity, sleep, hydration, and nutrition were collected from the app and Watch data.

Results

A total of 115 trainees enrolled and completed the study (100% male; age: mean 22 years, SD 4 years) and 64 (55.7%) successfully graduated. Most training withdrawals (27/115, 23.5%) occurred by day 7 (mean 5.5 days, SD 3.4 days; range 1-22 days). Extraversion, positive affect personality traits, and daily psychological profiles were associated with course completion; key psychological factors could predict withdrawals 1-2 days in advance (P=.009).

Conclusions

Gathering accurate and continuous mental and physical status data during elite military training is possible with early predictors of withdrawal providing an opportunity for intervention.
Exploring the Hierarchical Influence of Cognitive Functions for Alzheimer Disease: The Framingham Heart Study
Authors: Ding Huitong , An Ning , Au Rhoda , Devine Sherral , Auerbach Sanford H , Massaro Joseph , Joshi Prajakta , Liu Xue , Liu Yulin , Mahon Elizabeth , Ang Ting FA , Lin Honghuang
Published: January 2020

Background

Although some neuropsychological (NP) tests are considered more central for the diagnosis of Alzheimer disease (AD), there is a lack of understanding about the interaction between different cognitive tests.

Objective

This study aimed to demonstrate a global view of hierarchical probabilistic dependencies between NP tests and the likelihood of cognitive impairment to assist physicians in recognizing AD precursors.

Methods

Our study included 2091 participants from the Framingham Heart Study. These participants had undergone a variety of NP tests, including Wechsler Memory Scale, Wechsler Adult Intelligence Scale, and Boston Naming Test. Heterogeneous cognitive Bayesian networks were developed to understand the relationship between NP tests and the cognitive status. The performance of probabilistic inference was evaluated by the 10-fold cross validation.

Results

A total of 4512 NP tests were used to build the Bayesian network for the dementia diagnosis. The network demonstrated conditional dependency between different cognitive functions that precede the development of dementia. The prediction model reached an accuracy of 82.24%, with sensitivity of 63.98% and specificity of 92.74%. This probabilistic diagnostic system can also be applied to participants that exhibit more heterogeneous profiles or with missing responses for some NP tests.

Conclusions

We developed a probabilistic dependency network for AD diagnosis from 11 NP tests. Our study revealed important psychological functional segregations and precursor evidence of AD development and heterogeneity.
Effect of a Mobile Phone–Based Glucose-Monitoring and Feedback System for Type 2 Diabetes Management in Multiple Primary Care Clinic Settings: Cluster Randomized Controlled Trial
Authors: Yang Yeoree , Lee Eun Young , Kim Hun-Sung , Lee Seung-Hwan , Yoon Kun-Ho , Cho Jae-Hyoung
Published: January 2020

Background

Recent evidence of the effectiveness of mobile phone–based diabetes management systems is generally based on studies conducted in tertiary hospitals or professional diabetes clinics.

Objective

This study aimed to evaluate the clinical efficacy and applicability of a mobile phone–based glucose-monitoring and feedback system for the management of type 2 diabetes mellitus (T2DM) in multiple primary care clinic settings.

Methods

In this multicenter, cluster-randomized controlled, open trial, 13 primary care clinics in Seoul and other large cities in South Korea were voluntarily recruited. Overall, 150 (9 clinics) and 97 (4 clinics) participants with T2DM were assigned to the intervention and control groups, respectively (2:1 allocation). Every month, participants in both groups attended face-to-face physicians’ consultation for the management of diabetes in the clinic. For the intervention group, participants were required to upload their daily self-monitoring of blood glucose (SMBG) results using the mobile phone app in addition to outpatient care for 3 months. The results were automatically transmitted to the main server. Physicians had to check their patients’ SMBG results through an administrator’s website and send a short feedback message at least once a week. At baseline and 3 months, both groups had anthropometry and blood tests, including hemoglobin A1c (HbA1c), and responded to questionnaires about treatment satisfaction and compliance.

Results

At 3 months, participants in the intervention group showed significantly more improvement in HbA1c (adjusted mean difference to control −0.30%, 95% CI −0.50 to −0.11; P=.003) and fasting plasma glucose (−17.29 mg/dL, 95% CI −29.33 to −5.26; P=.005) than those in the control group. In addition, there was significantly more reduction in blood pressure, and the score regarding treatment satisfaction and motivation for medication adherence increased more in the intervention group than in the control group. In the subgroup analyses, the effect on glycemic control was more significant among younger patients and higher baseline HbA1c levels.

Conclusions

The mobile phone–based glucose-monitoring and feedback system was effective in glycemic control when applied in primary care clinic settings. This system could be utilized effectively with diverse institutions and patients.

Trial Registration

Clinical Research Information Service (CRIS) https://tinyurl.com/tgqawbz
Analysis of Massive Online Medical Consultation Service Data to Understand Physicians’ Economic Return: Data Mining Study
Authors: Jiang Jinglu , Cameron Ann-Frances , Yang Ming
Published: January 2020

Background

Online health care consultation has become increasingly popular and is considered a potential solution to health care resource shortages and inefficient resource distribution. However, many online medical consultation platforms are struggling to attract and retain patients who are willing to pay, and health care providers on the platform have the additional challenge of standing out in a crowd of physicians who can provide comparable services.

Objective

This study used machine learning (ML) approaches to mine massive service data to (1) identify the important features that are associated with patient payment, as opposed to free trial–only appointments; (2) explore the relative importance of these features; and (3) understand how these features interact, linearly or nonlinearly, in relation to payment.

Methods

The dataset is from the largest China-based online medical consultation platform, which covers 1,582,564 consultation records between patient-physician pairs from 2009 to 2018. ML techniques (ie, hyperparameter tuning, model training, and validation) were applied with four classifiers—logistic regression, decision tree (DT), random forest, and gradient boost—to identify the most important features and their relative importance for predicting paid vs free-only appointments.

Results

After applying the ML feature selection procedures, we identified 11 key features on the platform, which are potentially useful to predict payment. For the binary ML classification task (paid vs free services), the 11 features as a whole system achieved very good prediction performance across all four classifiers. DT analysis further identified five distinct subgroups of patients delineated by five top-ranked features: previous offline connection, total dialog, physician response rate, patient privacy concern, and social return. These subgroups interact with the physician differently, resulting in different payment outcomes.

Conclusions

The results show that, compared with features related to physician reputation, service-related features, such as service delivery quality (eg, consultation dialog intensity and physician response rate), patient source (eg, online vs offline returning patients), and patient involvement (eg, provide social returns and reveal previous treatment), appear to contribute more to the patient’s payment decision. Promoting multiple timely responses in patient-provider interactions is essential to encourage payment.
Patient-Reported Outcome Measures of Utilizing Person-Generated Health Data in the Case of Simulated Stroke Rehabilitation: Development Method
Authors: Dimaguila Gerardo Luis , Gray Kathleen , Merolli Mark
Published: January 2020

Background

Person-generated health data (PGHD) are health data that people generate, record, and analyze for themselves. Although the health benefits of PGHD use have been reported, there is no systematic way for patients to measure and report the health effects they experience from using their PGHD. Patient-reported outcome measures (PROMs) allow patients to systematically self-report their outcomes of a health care service. They generate first-hand evidence of the impact of health care services and are able to reflect the real-world diversity of actual patients and management approaches. Therefore, this paper argues that a PROM of utilizing PGHD, or PROM-PGHD, is necessary to help build evidence-based practice in clinical work with PGHD.

Objective

This paper aims to describe a method for developing PROMs for people who are using PGHD in conjunction with their clinical care—PROM-PGHD, and the method is illustrated through a case study.

Methods

The five-step qualitative item review (QIR) method was augmented to guide the development of a PROM-PGHD. However, using QIR as a guide to develop a PROM-PGHD requires additional socio-technical consideration of the PGHD and the health technologies from which they are produced. Therefore, the QIR method is augmented for developing a PROM-PGHD, resulting in the PROM-PGHD development method.

Results

A worked example was used to illustrate how the PROM-PGHD development method may be used systematically to develop PROMs applicable across a range of PGHD technology types used in relation to various health conditions.

Conclusions

This paper describes and illustrates a method for developing a PROM-PGHD, which may be applied to many different cases of health conditions and technology categories. When applied to other cases of health conditions and technology categories, the method could have broad relevance for evidence-based practice in clinical work with PGHD.
Locating Medical and Recreational Cannabis Outlets for Research Purposes: Online Methods and Observational Study
Authors: Pedersen Eric R , Firth Caislin , Parker Jennifer , Shih Regina A , Davenport Steven , Rodriguez Anthony , Dunbar Michael S , Kraus Lisa , Tucker Joan S , D'Amico Elizabeth J
Published: January 2020

Background

An increasing number of states have laws for the legal sale of recreational and medical cannabis out of brick-and-mortar storefront locations. Given the proliferation of cannabis outlets and their potential for impact on local economies, neighborhood structures, and individual patterns of cannabis use, it is essential to create practical and thorough methods to capture the location of such outlets for research purposes. However, methods used by researchers vary greatly between studies and often do not include important information about the retailer’s license status and storefront signage.

Objective

The aim of this study was to find methods for locating and observing cannabis outlets in Los Angeles County after the period when recreational cannabis retailers were granted licenses and allowed to be open for business.

Methods

The procedures included searches of online cannabis outlet databases, followed by methods to verify each outlet’s name, address, license information, and open status. These procedures, conducted solely online, resulted in a database of 531 outlets. To further verify each outlet’s information and collect signage data, we conducted direct observations of the 531 identified outlets.

Results

We found that 80.9% (430/531) of these outlets were open for business, of which 37.6% (162/430) were licensed to sell cannabis. Unlicensed outlets were less likely to have signage indicating the store sold cannabis, such as a green cross, which was the most prevalent form of observed signage. Co-use of cannabis and tobacco/nicotine has been found to be a substantial health concern, and we observed that 40.6% (175/430) of cannabis outlets had a tobacco/nicotine outlet within sight of the cannabis outlet. Most (350/430, 81.4%) cannabis outlets were located within the City of Los Angeles, and these outlets were more likely to be licensed than outlets outside the city.

Conclusions

The findings of this study suggest that online searches and observational methods are both necessary to best capture accurate and detailed information about cannabis outlets. The methods described here can be applied to other metropolitan areas to more accurately capture the availability of cannabis in an area.
Accurate Measurement of Handwash Quality Using Sensor Armbands: Instrument Validation Study
Authors: Wang Chaofan , Sarsenbayeva Zhanna , Chen Xiuge , Dingler Tilman , Goncalves Jorge , Kostakos Vassilis
Published: January 2020

Background

Hand hygiene is a crucial and cost-effective method to prevent health care–associated infections, and in 2009, the World Health Organization (WHO) issued guidelines to encourage and standardize hand hygiene procedures. However, a common challenge in health care settings is low adherence, leading to low handwashing quality. Recent advances in machine learning and wearable sensing have made it possible to accurately measure handwashing quality for the purposes of training, feedback, or accreditation.

Objective

We measured the accuracy of a sensor armband (Myo armband) in detecting the steps and duration of the WHO procedures for handwashing and handrubbing.

Methods

We recruited 20 participants (10 females; mean age 26.5 years, SD 3.3). In a semistructured environment, we collected armband data (acceleration, gyroscope, orientation, and surface electromyography data) and video data from each participant during 15 handrub and 15 handwash sessions. We evaluated the detection accuracy for different armband placements, sensor configurations, user-dependent vs user-independent models, and the use of bootstrapping.

Results

Using a single armband, the accuracy was 96% (SD 0.01) for the user-dependent model and 82% (SD 0.08) for the user-independent model. This increased when using two armbands to 97% (SD 0.01) and 91% (SD 0.04), respectively. Performance increased when the armband was placed on the forearm (user dependent: 97%, SD 0.01; and user independent: 91%, SD 0.04) and decreased when placed on the arm (user dependent: 96%, SD 0.01; and user independent: 80%, SD 0.06). In terms of bootstrapping, user-dependent models can achieve more than 80% accuracy after six training sessions and 90% with 16 sessions. Finally, we found that the combination of accelerometer and gyroscope minimizes power consumption and cost while maximizing performance.

Conclusions

A sensor armband can be used to measure hand hygiene quality relatively accurately, in terms of both handwashing and handrubbing. The performance is acceptable using a single armband worn in the upper arm but can substantially improve by placing the armband on the forearm or by using two armbands.
Internet Use, eHealth Literacy, and Dietary Supplement Use Among Young Adults in Pakistan: Cross-Sectional Study
Authors: Tariq Amina , Khan Shanchita R , Basharat Amna
Published: January 2020

Background

Increased access to the internet has facilitated widespread availability of health information. Thus, electronic health (eHealth) literacy—the ability to seek, find, understand, and appraise health information from electronic resources and apply that knowledge in making a health-related decision—is a crucial skill. Despite the increasing use of the internet as a source of health information in developing countries, only a few studies have examined the eHealth literacy of young adults, who frequently use the internet to access health information in these developing countries.

Objective

The aim of this study was to assess the patterns of internet use and eHealth literacy levels among university students pursuing a non–health-related degree in Pakistan. We also examined the association of the eHealth literacy levels of these young adults with their physical activity levels and dietary supplement intake.

Methods

Students from 2 leading engineering universities in Pakistan were invited to participate in a cross-sectional anonymous web-based survey in order to collect data on their internet use, eHealth literacy, and dietary supplement intake. Of the 900 eligible university students who were invited to participate, 505 (56.1%) students who completed the questionnaire were included in the analysis. The findings were converted to median values and frequency analyses were performed. The associations between the variables were determined using the chi-square test; P≤.05 was considered significant.

Results

In this study, the median eHealth literacy scale (eHEALS) score was 29, which did not vary across gender. The most common type of health-related information that was searched by the participants was that related to maintaining a healthy lifestyle (305/505, 60.4%). Participants with high eHEALS scores were those who used the internet frequently for finding people with similar health issues (P<.001). The use of specific social media platforms was not associated with the perceived eHealth literacy levels. Neither the frequency of physical activity nor the dietary supplement use was associated with the eHealth literacy of the participants.

Conclusions

University students in non–health-related disciplines in Pakistan expressed high confidence in their skills to find health-related information on the internet, as indicated by the aggregate eHEALS scores. However, the findings of our study show that the perceived eHealth literacy was not associated with health behaviors such as physical activity and dietary supplement intake. Further research is necessary to investigate the extent to which eHealth literacy can be considered as a panacea for solving public health challenges in developing countries.
Spatiotemporal Analysis of Men Who Have Sex With Men in Mainland China: Social App Capture-Recapture Method (Preprint)
Authors: Hu Maogui , Xu Chengdong , Wang Jinfeng
Published: January 2020

BACKGROUND

In China, the cases of newly diagnosed HIV/AIDS in men who have sex with men (MSM) have increased more than tenfold since 2006. However, the MSM population size, geographical distribution, and migration patterns are largely unknown.

OBJECTIVE

Our aim is to estimate the number, spatial distribution, and migration of MSM populations in mainland China using big data from social networking.

METHODS

We collected 85 days of data on online users of a social networking MSM app in mainland China. Daily online MSM users and their migration across the country were investigated during a holiday period and a nonholiday period. Using the capture-mark-recapture model, we designed an experiment consisting of two independent samples to estimate the total provincial MSM population.

RESULTS

The estimate of MSM in mainland China was 8,288,536 (95% CI 8,274,931-8,302,141), accounting for 1.732% (95% CI 1.729%-1.734%) of adult men aged 18 to 64 years. The average daily number of MSM social networking online across mainland China was 1,198,682 during the nonholiday period. The five provinces (including municipalities) with the highest average number of daily online MSM numbers were Guangdong (n=141,712), Jiangsu (n=90,710), Zhejiang (n=72,212), Shandong (n=68,065), and Beijing (n=66,057). The proportion of daily online MSM among adult men in different cities varied from 0.04% to 0.96%, with a mean of 0.20% (SD 0.14%). Three migrating centers—Guangdong, Beijing, and the Yangtze River Delta (Shanghai-Zhejiang-Jiangsu)—accounted for 57.23% of MSM migrants in the county.

CONCLUSIONS

The percentage of MSM among adult men in mainland China is at the middle level compared with other Asia and Pacific countries. However, the number of MSM is very large, and the distribution is uneven. Both MSM distribution and migration are highly affected by socioeconomic status.
Evaluation of Patterns of Presentation, Practice, and Outcomes of Upper Tract Urothelial Cancer: Protocol for an Observational, International, Multicenter, Cohort Study by the Clinical Research Office of the Endourology Society (Preprint)
Authors: Baard Joyce , Celebi Merve , de la Rosette Jean , Alcaraz Antonio , Shariat Shahrokh , Cormio Luigi , Cavadas Vítor , Laguna M Pilar
Published: January 2020

BACKGROUND

Available guidelines on the management of upper tract urothelial carcinoma (UTUC) are restricted due to the lack of strong evidence–based recommendations. Adequate, well-powered randomized trials are missing due to the rarity of the disease. To overcome this problem, we need alternative study designs to provide generalizable data.

OBJECTIVE

The primary aim of this registry is to provide a real-world overview on patterns of presentation and management of UTUC. Secondary objectives include comparison of outcomes of different treatments and tumor stages and evaluation of compliance with the current European Association of Urology recommendations for UTUC.

METHODS

For this observational, international, multicenter, cohort study, clinical data of consecutive patients suspected of having UTUC, irrespective of type of management, will be prospectively collected up to 5 years after inclusion. Data on the patterns of presentation, diagnostics, and treatment as well as short-, mid-, and long-term oncological and functional outcomes will be analyzed. Possible associations between variables, basal characteristics, and outcomes will be tested by multivariable analyses. The methodology will address potential sources of bias and confounders.

RESULTS

The registry was initiated in November 2014 after obtaining institutional review board approval. Data collection started in December 2014. At the time of submission of this manuscript, 2451 patients from 125 centers from 37 countries were included. Inclusion of patients will be closed 5 years after initiation of the registry. Quality checks will be performed centrally with continuous communication and feedback with the centers to ensure accuracy. The first results are expected in the first trimester of 2020.

CONCLUSIONS

This large observational prospective cohort will generate landmark “real-world” data and hypotheses for further studies. We expect these data to optimize the management of UTUC, provide insights on harms and benefits of treatment, and serve as quality control.

CLINICALTRIAL

ClinicalTrials.gov NCT02281188; https://clinicaltrials.gov/ct2/show/NCT02281188.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/15363
Deep Learning Frameworks for Rapid Gram Stain Image Data Interpretation: Protocol for a Retrospective Data Analysis (Preprint)
Authors: Kim Hee , Ganslandt Thomas , Miethke Thomas , Neumaier Michael , Kittel Maximilian
Published: January 2020

BACKGROUND

In recent years, remarkable progress has been made in deep learning technology and successful use cases have been introduced in the medical domain. However, not many studies have considered high-performance computing to fully appreciate the capability of deep learning technology.

OBJECTIVE

This paper aims to design a solution to accelerate an automated Gram stain image interpretation by means of a deep learning framework without additional hardware resources.

METHODS

We will apply and evaluate 3 methodologies, namely fine-tuning, an integer arithmetic–only framework, and hyperparameter tuning.

RESULTS

The choice of pretrained models and the ideal setting for layer tuning and hyperparameter tuning will be determined. These results will provide an empirical yet reproducible guideline for those who consider a rapid deep learning solution for Gram stain image interpretation. The results are planned to be announced in the first quarter of 2021.

CONCLUSIONS

Making a balanced decision between modeling performance and computational performance is the key for a successful deep learning solution. Otherwise, highly accurate but slow deep learning solutions can add value to routine care.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/16843
Perceptions and Experiences of Internet-Based Testing for Sexually Transmitted Infections: Systematic Review and Synthesis of Qualitative Research (Preprint)
Authors: Spence Tommer , Kander Inès , Walsh Julia , Griffiths Frances , Ross Jonathan
Published: January 2020

BACKGROUND

Internet-based testing for sexually transmitted infections (STIs) allows asymptomatic individuals to order a self-sampling kit online and receive their results electronically, reducing the need to attend a clinic unless for treatment. This approach has become increasingly common; however, there is evidence that barriers exist to accessing it, particularly among some high-risk populations. We review the qualitative evidence on this topic, as qualitative research is well-placed to identify the complex influences that relate to accessing testing.

OBJECTIVE

This paper aims to explore perceptions and experiences of internet-based testing for STIs among users and potential users.

METHODS

Searches were run through 5 electronic databases (CINAHL, EMBASE, MEDLINE, PsycINFO, and Web of Science) to identify peer-reviewed studies published between 2005 and 2018. Search terms were drawn from 4 categories: STIs, testing or screening, digital health, and qualitative methods. Included studies were conducted in high-income countries and explored patient perceptions or experiences of internet-based testing, and data underwent thematic synthesis.

RESULTS

A total of 11 studies from the 1735 studies identified in the initial search were included in the review. The synthesis identified that internet-based testing is viewed widely as being acceptable and is preferred over clinic testing by many individuals due to perceived convenience and anonymity. However, a number of studies identified concerns relating to test accuracy and lack of communication with practitioners, particularly when receiving results. There was a lack of consensus on preferred media for results delivery, although convenience and confidentiality were again strong influencing factors. The majority of included studies were limited by the fact that they researched hypothetical services.

CONCLUSIONS

Internet-based testing providers may benefit from emphasizing this testing’s comparative convenience and privacy compared with face-to-face testing in order to improve uptake, as well as alleviating concerns about the self-sampling process. There is a clear need for further research exploring in depth the perceptions and experiences of people who have accessed internet-based testing and for research on internet-based testing that explicitly gathers the views of populations that are at high risk of STIs.

CLINICALTRIAL

PROSPERO CRD42019146938; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=146938