bluuebunny/crossref_metadata_2025 huggingface dataset:
El desempeño docente y la práctica inclusiva en el nivel superior
Authors: Valcazar Montenegro Guimel Christopher
Published: July 2020

La presente investigación tuvo como objetivo determinar la relación que existe entre el desempeño docente y la práctica inclusiva desde la percepción de los estudiantes de Mecánica Automotriz del Cetpro Benjamín Galecio Matos de Lima. Es un estudio de naturaleza aplicada, no experimental, de enfoque cuantitativo. La muestra seleccionada fue de 230 estudiantes de la institución, elegidos probabilísticamente. Se elaboraron dos encuestas con la intención de compilar información referida a las variables de estudio, una de 18 ítems para el desempeño docente y otra de 21 ítems para la práctica inclusiva. Se realizó el contraste de la hipótesis por medio del rho Spearman = ,793 (p-valor = ,000 < 0,01) y se recabó suficiente información estadística para probar la hipótesis de investigación. El estudio concluye probando la existencia de la relación considerable y significativa entre el desempeño docente y la práctica inclusiva desde la percepción de los estudiantes de Mecánica Automotriz del Cetpro Benjamín Galecio Matos de Lima. Es decir, si hay un buen desempeño docente, este se verá reflejado con el aumento de una buena práctica inclusiva.
El método AIV para efectivizar la comprensión lectora de textos poéticos
Authors: Farje Cuchillo José Armando
Published: July 2020

El estudio tuvo por finalidad determinar si la aplicación del método AIV (análisis, interpretación y valoración) efectiviza la comprensión lectora de textos poéticos en estudiantes de la Universidad Privada del Norte. La investigación fue de tipo aplicado, explicativo, cuasi experimental transversal, hipotético deductivo y cuantitativo.

La muestra fue de 45 estudiantes para el grupo experimental (GE) y 46 para el grupo control (GC). En ambos se enseñaron los mismos contenidos, pero el método se aplicó al GE, mientras el GC trabajó con la metodología habitual.

El resultado indico que los promedios alcanzados por el GE fueron más altos en relación con el GC. En consecuencia, se rechazó la hipótesis nula. Se concluyo que existen diferencias significativas en la comprensión lectora de textos poéticos del GE antes y después de aplicar el método AIV.
Canine colostrum exosomes: Characterization and influence on the canine mesenchymal stem cell secretory profile and fibroblast anti-oxidative capacity.
Authors: Villatoro Antonio J , Martín-Astorga María del Carmen , Alcoholado Cristina , Becerra José
Published: July 2020

Background: Canine colostrum milk (CCM) is a specific secretion of the mammary gland that is fundamental for the survival of the newborn. CCM has many described components (immunoglobulins, proteins or fat), but its small vesicles, named exosomes, are largely unknown.Results: A characterization of CCM exosomes was performed. Exosomes were abundant in CCM and appeared with the characteristic cup-shaped morphology and well-defined round vesicles. The size distribution of exosomes was between 37 and 140 nm, and western blot analysis showed positive expression of specific exosomal markers. Proteomic analysis revealed a total of 826 proteins in exosome cargo. We also found that exosomes modified the proliferation and secretory profiles in canine mesenchymal stem cells derived from bone marrow (cBM-MSCs) and adipose tissue (cAd-MSCs). Additionally, CCM exosomes demonstrated a potent antioxidant effect on canine fibroblasts in culture.Conclusions: Our findings highlight, for the first time, the abundant presence of exosomes in CCM and their ability to interact with mesenchymal stem cells (MSCs). The addition of exosomes to two types of MSCs in culture resulted in specific secretory profiles with functions related to angiogenesis, migration and chemotaxis of immune cells. In particular, the cAd-MSCs secretory profile showed higher potential in adipose tissue development and neurogenesis, while cBM-MSC production was associated with immunity, cell mobilization and haematopoiesis. Finally, exosomes also presented antioxidant capacity on fibroblasts against reactive oxygen species activity within the cell, demonstrating their fundamental role in the development and maturation of dogs in the early stages of their life.
Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: A before-and-after study.
Authors: John James , Tannous W Kathy , Jones Amanda
Published: July 2020

Background: Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate the outcomes of a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on the activation levels of patients with one or more chronic diseases in general practices across Northern Sydney, Australia.Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program which was delivered across six general practices in Northern Sydney, Australia. The WellNet intervention includes team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. The level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine the adjusted mean differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Additionally, the backward stepwise multivariable regression models were employed to identify significant predictors of activation at follow-up.Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores by increase of 6.5 (95% CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. The multivariable regression models showed that older age (B = -0.14; 95% CI -0.28, -0.01) and private insurance (uninsured patients) (B = -3.41; 95% CI -6.50, -0.32) were significantly associated with lower PAM scores at 12 months whereas higher baseline PAM score (B = 0.48; 95% CI 0.37, 0.59) was significantly associated with higher follow-up PAM score.Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.
Salt tolerance involved candidate genes in rice: an integrative meta-analysis approach
Authors: Mansuri Raheleh Mirdar , Shobbar Zahra-Sadat , Jelodar Nadali Babaeian , Ghaffari Mohammadreza , Mohammadi Seyed Mahdi , Daryani Parisa
Published: July 2020

Background: Salinity, as one of the main abiotic stresses, critically threatens growth and fertility of main food crops including rice in the world. To get insight into the molecular mechanisms by which tolerant genotypes responds to the salinity stress, we propose an integrative meta-analysis approach to find the key genes involved in salinity tolerance. Herein, a genome-wide meta-analysis, using microarray and RNA-seq data was conducted which resulted in the identification of differentially expressed genes (DEGs) under salinity stress at tolerant rice genotypes. DEGs were then confirmed by meta-QTL analysis and literature review. Results: A total of 3449 DEGs were detected in 46 meta-QTL positions, among which 1286, 86, 1729 and 348 DEGs were observed in root, shoot, seedling, and leaves tissues, respectively. Moreover, functional annotation of DEGs located in the meta-QTLs suggested some involved biological processes (e.g., ion transport, regulation of transcription, cell wall organization and modification as well as response to stress) and molecular function terms (e.g., transporter activity, transcription factor activity and oxidoreductase activity). Remarkably, 23 potential candidate genes were detected in Saltol and hotspot-regions overlying original QTLs for both yield components and ion homeostasis traits; among which, there were many unreported salinity-responsive genes. Some promising candidate genes were detected such as pectinesterase, peroxidase, transcription regulator, high-affinity potassium transporter, cell wall organization, protein serine/threonine phosphatase, and CBS domain cotaining protein. Conclusions: The obtained results indicated that, the salt tolerant genotypes use qualified mechanisms particularly in sensing and signalling of the salt stress, regulation of transcription, ionic homeostasis, and Reactive Oxygen Species (ROS) scavenging in response to the salt stress.
Evaluation of image quality at the detector’s edge of dedicated breast positron emission tomography
Authors: Satoh Yoko , Motosugi Utaroh , Imai Masamichi , Omiya Yoshie , Onishi Hiroshi
Published: July 2020

Background: We assessed image quality of dedicated breast positron emission tomography (dbPET) at the detector's edge by phantom and clinical studies.Methods: A breast phantom with four spheres (16, 10, 7.5, and 5 mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and % background variability (%N5mm), % contrast (%QH,5mm), and contrast-to-noise ratio (QH,5mm/N5mm) for the 5 mm sphere; and coefficient of variation of the background (CVbackground) were calculated. Subsequently, clinical cases were analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/computed tomography (CT).Results: Closer to the detector’s edge, the %N5mm and CVbackground increased and %QH,5mm and QH,5mm/N5mm decreased in the phantom study. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.1±6.2 vs. 6.5±3.4, p=0.0001) and non-peripheral (13.1±7.1 vs. 7.7±7.4, p=0.0004) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups (12.1±6.2 vs. 13.1±7.1, p=0.6367).Conclusion: The phantom study revealed poorer image quality closer to the detector edge at a depth of 1/8 of the axial field of view (FOV) than at other more central parts. In clinical studies, however, lesion detectability of dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are within the FOV, even in young women with small breasts.
TaClpS1, Negatively Regulates Wheat Resistance Against Puccinia striiformis f. sp. tritici
Authors: Yang Qian , Islam Md Ashraful , Cai Kunyan , Tian Shuxin , Liu Yan , Kang Zhensheng , Guo Jun
Published: July 2020

Background: The degradation of intracellular proteins plays an essential role in plant responses to stressful environments. ClpS1 and E3 ubiquitin ligase function as adaptors for selecting target substrates in caseinolytic peptidase (Clp) proteases pathways and the 26S proteasome system, respectively. Currently, the role of E3 ubiquitin ligase in the plant immune response to pathogens is well defined. However, the role of ClpS1 in the plant immune response to pathogens remains unknown. Results: Here, we identified and characterized wheat (Triticum aestivum) ClpS1 (TaClpS1). TaClpS1 encoded 161 amino acids, contained a conserved ClpS domain and a chloroplast transit peptide (1-32 aa). TaClpS1 was found to be specifically localized in the chloroplast when expressed transiently in wheat protoplasts. The transcript level of TaClpS1 in wheat was significantly induced during infection by Puccinia striiformis f. sp. tritici (Pst). Knock-down of TaClpS1 via virus-induced gene silencing (VIGS) resulted in an increase in resistance against Pst, accompanied by an increase in the hypersensitive response (HR), accumulation of reactive oxygen species (ROS) and expression of TaPR1 and TaPR2, and a reduction in the growth of Pst. Furthermore, heterologous expression of TaClpS1 in Nicotiana benthamiana enhanced the infection by Phytophthora parasitica. Conclusions: These results suggest that TaClpS1 negatively regulates the resistance of wheat to Pst.
­­­­­The kappa opioid receptor agonist U50,488H did not affect brain-stimulation reward while it elicited conditioned place aversion in mice
Authors: Huang Peng , Gentile Taylor , Muschamp John , Liu-Chen Lee-Yuan
Published: July 2020

Objective: Selective kappa opioid receptor (KOR) agonists were shown to produce a dose-dependent depression of brain-stimulation reward (BSR) in the rat intracranial self-stimulation (ICSS) tests. However, limited studies using mice produced less conclusive results. Here the effects of U50,488H were re-examined on BSR in mice with a larger cohort of animals. Results: Forty C57BL/6J male mice were implanted with the electrodes in medial forebrain bundle. About a week after surgery, mice were subject to ICSS training. Only eighteen passed the two-phase procedures, at which point they readily spun the wheels to obtain reinforcing effect of BSR, and were used for the ICSS tests. Compared with saline (s.c.), U50,488H (2 mg/kg, s.c.) did not have effects on the BSR thresholds within 1 h post-treatment, while it decreased the maximum wheel-spinning rates in a time-dependent manner. In contrast, cocaine (5 mg/kg, s.c.) decreased the BSR thresholds time-dependently without affecting the maximum wheel-spinning rates in the same cohort of mice, demonstrating the validity of our mouse ICSS models. For comparison, U50,488H (2 mg/kg, s.c.) induced significant conditioned place aversion (CPA) in a different cohort of mice without surgeries. Thus, ICSS may not be an appropriate test for KOR agonist-induced aversion in mice.
Experimental investigation on the nanoindentation viscoelastic constitutive model of quartz and kaolinite in mudstone
Authors: Sun Changlun , Li Guichen , Elgharib Gomah Mohamed , Xu Jiahui , Rong Haoyu
Published: July 2020

The creep behaviors in deep underground engineering structures, especially in soft rocks, have a remarkable impact on the long-term stability of the excavations, which finally leads to the high risk and failure of it. Accordingly, it is essential to recognize the time-dependent deformation through the investigation of this phenomenon. In this study, the creep behaviors of soft rocks have been widely examined to help understand the underlying mechanism of the extended time-dependent deformation. Due to the limited results about the time-dependent properties of the constituents of the rock that reveal their heterogeneity, the targeting nanoindentation technique (TNIT), was adopted to investigate the viscoelastic characteristics of kaolinite and quartz in a two-constituent mudstone sample. The TNIT consists of identifications of mineralogical ingredients in mudstone with nanoindentation experiments on each identified constituent. After conducting experiments, the unloading stages of the typical indentation curves were analyzed to calculate the hardness and elastic modulus of both elements in mudstone. Additionally, the 180 s load-holding stages with the peak load of 50 mN were transformed into the typical creep strain-time curves for fitting analysis by using the Kelvin model, the standard viscoelastic model, and the extended viscoelastic model. Fitting results show that the standard viscoelastic model not only can perfectly express the nanoindentation creep behaviors of both kaolinite and quartz but also can produce suitable constants used to measure their creep parameters. Furthermore, the creep parameters of kaolinite are much smaller than that of quartz, which causes the considerable time-dependent deformation of the soft mudstone. Eventually, the standard viscoelastic model was also verified on the quartz in a sandstone sample.
Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery
Authors: Kryzauskas Marius , Bausys Augustinas , Degutyte Austeja Elzbieta , Abeciunas Vilius , Poskus Eligijus , Bausys Rimantas , Dulskas Audrius , Strupas Kestutis , Poskus Tomas
Published: July 2020

Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR=10.54, p=0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR=2.40, p=0.004), CCI score >5 (OR=1.72, p=0.025) and T3/T4 stage tumors (OR=2.25, p=0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p=0.009 and p=0.001) and rectal (p=0.003 and p=0.014) surgery.Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.
Quality change mechanism and drinking safety of repeatedly-boiled water and prolonged-boil water: a comparative study
Authors: Zhai Yuanzheng , Yang Jingwen , Zhu Yaguang , Du Qingqing , Yuan Wenzhen , Lu Hong
Published: July 2020

Quality, safety and potability of repeatedly-boiled water (RBW) and prolonged-boil water (PBW) lead to concern and even misgivings in the public from time to time, especially in China, and other societies have a habit of drinking boiled water, with improvements of living standards and owing to increasing concerns for human health. This phenomenon is mainly attributed to the fact that the conclusions drawn from existing scientific experiments could not respond well to the concerns. In order to make up for this deficiency, tap water was selected to carry out RBW and PBW experiments independently. The quality changes of RBW and PBW show very similar trends that are not as great as might be imagined, and both are impacted by the tap water quality and the physiochemical effects. The dominating physiochemical effects are the water evaporation and the resulting concentration of unreactive components (most dissolved components), which can be easily explained by the existing evaporation-concentration theory. The results show that tap water will be still safe and potable after being frequently boiled or after having undergone prolonged boiling, as long as it satisfies the sanitary standards of drinking water prior to heating. Therefore, there is no need to worry about drinking RBW or PBW in daily life.
QUESTION PATTERNS AND CONVERSATION IMPLICATURE ON TRADITIONAL MARKET IN LAMPUNG-INDONESIA
Authors: Prastio Bambang , Nurzafira Istiqomah , Ghazali A. Syukur , Pratiwi Yuni
Published: July 2020

The purpose of this study was to describe the patterns and functions of questions expressed in conversational implicature found in market transactions. A descriptive qualitative method was used in this research. And conversation analysis was applied to determine question patterns, while conversational implicature was to examine question functions. The research data was collected in the form of recorded and transcripted conversations along with the corresponding situations or contexts. The data of this research was primarily obtained from both sellers and buyers in Way Halim Market, Lampung, Indonesia, and it was gathered by listening and taking notes. This study showed that there were six types of question patterns found in such transactions that contained conversational implicature, namely (1) yes/no question for asking, (2) tag question for rejecting and ordering (3) declarative question for ordering, (4) alternative question for asking, (5) wh-question for asking and sugesting, and (6) rhetorical question for rejecting. The results also indicated that the sellers used persuasive implied questions more often than the buyers. These questions functioned to persuade buyers politely to make purchase.Keywords: question patterns, implicature, market transactionsPOLA PERTANYAAN DAN IMPLIKATUR PERCAKAPANDI PASAR TRADISIONAL LAMPUNG-INDONESIAAbstrakTujuan penelitian ini untuk mendeskripsikan pola dan fungsi tuturan pertanyaan yang disampaikan dalam implikatur percakapan ketika melakukan transaksi jual beli. Pendekatan penelitian ini adalah kualitatif deskriptif. Adapun jenis penelitian dalam menganalisis data menggunakan analisis percakapan untuk menentukan pola pertanyaan dan implikatur percakapan untuk menentukan fungsi tuturan pertanyaan. Data penelitian berupa tuturan percakapan hasil rekaman yang telah ditranskrip serta situasi atau konteks percakapan yang melatarbelakangi peristiwa tersebut. Sumber data penelitian ini diperoleh dari para pedagang dan pembeli di Pasar Way Halim, Provinsi Lampung, Indonesia. Pengumpulan data menggunakan metode simak dan metode catat. Hasil penelitian ini ditemukan enam bentuk pola pertanyaan dalam transaksi jual beli yang mengandung implikatur percakapan, yaitu (1) yes/no question fungsi meminta, (2) tag question fungsi menolak dan menyuruh (3) declarative question fungsi menyuruh, (4) alternative question fungsi meminta, (5) wh-question fungsi meminta dan menyarankan, dan (6) rhetorical question fungsi menolak. Dari data yang ditemukan, penjual lebih sering menggunakan tuturan pertanyaan bersifat persuasif dengan makna yang disampaikan secara tidak langsung kepada pembeli. Fungsi penggunaan tuturan persuasif tersebut yakni penjual terlihat memiliki kesantunan sehingga mempengaruhi pembeli dengan harapan akan terjadi transaksi jual beli.Kata kunci: pola pertanyaan, implikatur, transaksi jual-beli
Perceptions of Digital Technology Experiences and Development Among Family Caregivers and Technology Researchers: Qualitative Study (Preprint)
Authors: Xiong Chen , D'Souza Andrea , El-Khechen-Richandi Graziella , Mihailidis Alex , Cameron Jill I , Astell Arlene , Nalder Emily , Colantonio Angela
Published: July 2020

BACKGROUND

Caregiving is highly stressful and is associated with poor mental and physical health. Various technologies, including mobile and eHealth apps, have been developed to address caregiver needs. However, there is still a paucity of research examining the technology perceptions of informal caregivers, especially from the perspectives of sex, gender, and diversity.

OBJECTIVE

To address the research gap and inform the development of future caregiving technologies, this study aims to examine how family caregivers perceive using technology to assist with their caregiving routines; identify the sex, gender, and diversity factors that shape these perceptions; and understand how these perceptions and needs are reflected within the current technology development process.

METHODS

Semistructured interviews were conducted with 16 informal caregivers of individuals with a range of chronic medical conditions and 8 technology researchers involved in caregiving technology projects.

RESULTS

Three main themes with subthemes were developed. The first main theme is that caregivers see a need for technology in their lives, and it comprises the following 3 subthemes: caregiving is a challenging endeavor, technology is multifaceted, and caregiver preferences facilitate technology use. The second main theme is that relationships play a vital role in mediating technology uptake, and it comprises the following 2 subthemes: the caregiver-care recipient dynamic shapes technology perceptions and caregivers rely on external sources for technology information. Finally, the third main theme is that barriers are present in the use and adoption of technology, and it comprises the following 2 subthemes: technology may not be compatible with personal values and abilities and technology that is not tailored toward caregivers lacks adoption.

CONCLUSIONS

The findings highlight the multifaceted role that technology can play in aiding caregiving while drawing attention to the perceived drawbacks of these technologies among caregivers. The inclusion of technology researchers in this study provides a more holistic understanding of technologies in caregiving from their initial development to their eventual uptake by caregivers.
Development of a Mobile Health App (TOGETHERCare) to Reduce Cancer Care Partner Burden: Product Design Study (Preprint)
Authors: Oakley-Girvan Ingrid , Davis Sharon Watkins , Kurian Allison , Rosas Lisa G , Daniels Jena , Palesh Oxana Gronskaya , Mesia Rachel J , Kamal Arif H , Longmire Michelle , Divi Vasu
Published: July 2020

BACKGROUND

Approximately 6.1 million adults in the United States serve as care partners for cancer survivors. Studies have demonstrated that engaging cancer survivors and their care partners through technology-enabled structured symptom collection has several benefits. Given the high utilization of mobile technologies, even among underserved populations and in low resource areas, mobile apps may provide a meaningful access point for all stakeholders for symptom management.

OBJECTIVE

We aimed to develop a mobile app incorporating user preferences to enable cancer survivors’ care partners to monitor the survivors’ health and to provide care partner resources.

METHODS

An iterative information gathering process was conducted that included (1) discussions with 138 stakeholders to identify challenges and gaps in survivor home care; (2) semistructured interviews with clinicians (n=3), cancer survivors (n=3), and care partners (n=3) to identify specific needs; and (3) a 28-day feasibility field test with seven care partners.

RESULTS

Health professionals noted the importance of identifying early symptoms of adverse events. Survivors requested modules on medication, diet, self-care, reminders, and a version in Spanish. Care partners preferred to focus primarily on the patient’s health and not their own. The app was developed incorporating quality-of-life surveys and symptom reporting, as well as resources on home survivor care. Early user testing demonstrated ease of use and app feasibility.

CONCLUSIONS

TOGETHERCare, a novel mobile app, was developed with user input to track the care partner’s health and report on survivor symptoms during home care. The following two clinical benefits emerged: (1) reduced anxiety among care partners who use the app and (2) the potential for identifying survivor symptoms noted by the care partner, which might prevent adverse events.

CLINICALTRIAL

ClinicalTrials.gov NCT04018677; https://clinicaltrials.gov/ct2/show/NCT04018677
Estimating the Incidence of Conjunctivitis by Comparing the Frequency of Google Search Terms With Clinical Data: Retrospective Study (Preprint)
Authors: Kammrath Betancor Paola , Tizek Linda , Zink Alexander , Reinhard Thomas , Böhringer Daniel
Published: July 2020

BACKGROUND

Infectious conjunctivitis is contagious and may lead to an outbreak. Prevention systems can help to avoid an outbreak.

OBJECTIVE

We aimed to evaluate if Google search data on conjunctivitis and associated terms can be used to estimate the incidence and if the data can provide an estimation for outbreaks.

METHODS

We obtained Google search data over 4 years for the German term for conjunctivitis (“Bindehautentzündung”) and 714 associated terms in 12 selected German cities and Germany as a whole using the Google AdWords Keyword Planner. The search volume from Freiburg was correlated with clinical data from the Freiburg emergency practice (Eye Center University of Freiburg).

RESULTS

The search volume for the German term for conjunctivitis in Germany as a whole and in the 12 German cities showed a highly uniform seasonal pattern. Cross-correlation between the temporal search frequencies in Germany as a whole and the 12 selected cities was high without any lag. Cross-correlation of the search volume in Freiburg with the frequency of conjunctivitis (International Statistical Classification of Diseases and Related Health Problems [ICD] code group “H10.-”) from the centralized ophthalmologic emergency practice in Freiburg revealed a considerable temporal association, with the emergency practice lagging behind the frequency. Additionally, Pearson correlation between the count of patients per month and the count of searches per month in Freiburg was statistically significant (P=.04).

CONCLUSIONS

We observed a close correlation between the Google search volume for the signs and symptoms of conjunctivitis and the frequency of patients with a congruent diagnosis in the Freiburg region. Regional deviations from the nationwide average search volume may therefore indicate a regional outbreak of infectious conjunctivitis.
Neural Network–Based Retinal Nerve Fiber Layer Profile Compensation for Glaucoma Diagnosis in Myopia: Model Development and Validation (Preprint)
Authors: Li Lei , Zhu Haogang , Zhang Zhenyu , Zhao Liang , Xu Liang , Jonas Rahul A , Garway-Heath David F , Jonas Jost B , Wang Ya Xing
Published: July 2020

BACKGROUND

Due to the axial elongation–associated changes in the optic nerve and retina in high myopia, traditional methods like optic disc evaluation and visual field are not able to correctly differentiate glaucomatous lesions. It has been clinically challenging to detect glaucoma in highly myopic eyes.

OBJECTIVE

This study aimed to develop a neural network to adjust for the dependence of the peripapillary retinal nerve fiber layer (RNFL) thickness (RNFLT) profile on age, gender, and ocular biometric parameters and to evaluate the network’s performance for glaucoma diagnosis, especially in high myopia.

METHODS

RNFLT with 768 points on the circumferential 3.4-mm scan was measured using spectral-domain optical coherence tomography. A fully connected network and a radial basis function network were trained for vertical (scaling) and horizontal (shift) transformation of the RNFLT profile with adjustment for age, axial length (AL), disc-fovea angle, and distance in a test group of 2223 nonglaucomatous eyes. The performance of RNFLT compensation was evaluated in an independent group of 254 glaucoma patients and 254 nonglaucomatous participants.

RESULTS

By applying the RNFL compensation algorithm, the area under the receiver operating characteristic curve for detecting glaucoma increased from 0.70 to 0.84, from 0.75 to 0.89, from 0.77 to 0.89, and from 0.78 to 0.87 for eyes in the highest 10% percentile subgroup of the AL distribution (mean 26.0, SD 0.9 mm), highest 20% percentile subgroup of the AL distribution (mean 25.3, SD 1.0 mm), highest 30% percentile subgroup of the AL distribution (mean 24.9, SD 1.0 mm), and any AL (mean 23.5, SD 1.2 mm), respectively, in comparison with unadjusted RNFLT. The difference between uncompensated and compensated RNFLT values increased with longer axial length, with enlargement of 19.8%, 18.9%, 16.2%, and 11.3% in the highest 10% percentile subgroup, highest 20% percentile subgroup, highest 30% percentile subgroup, and all eyes, respectively.

CONCLUSIONS

In a population-based study sample, an algorithm-based adjustment for age, gender, and ocular biometric parameters improved the diagnostic precision of the RNFLT profile for glaucoma detection particularly in myopic and highly myopic eyes.
An Optimized Multi-teacher Knowledge Distillation Method: Application to Early Diagnosis of Otitis Media (Preprint)
Authors: Liu Hongwei , Luo Shuai , Guo Shuaibing
Published: July 2020

BACKGROUND

Otitis media (OM) is a common ear disease, which can induce hearing loss and even life-threatening. However, due to poor classification performance, insufficient data, and high computational costs, OM cannot be diagnosed accurately.

OBJECTIVE

An optimized multi-teacher knowledge distillation method is proposed to realize the early diagnosis of otitis media with insufficient data at a lower computational cost.

METHODS

Based on ensemble learning and conventional knowledge distillation method, an optimized multi-teacher knowledge distillation method is proposed. The framework of the method consists of a teacher network and a student network. The teacher network is responsible for learning from raw data and exporting prior knowledge, and the student network is responsible for the diagnosis task. The teacher network is composed of three components: VGG, ResNet, and Inception. Each component could be regarded as a teacher to learn knowledge. The student network consists of three identical lightweight CNNs (convolutional neural networks). Each CNN could be viewed as a student to obtain the knowledge from teachers and execute the diagnosis task. First, three teachers learn from raw data separately to obtain prior knowledge. Then, the student is trained based on the learned knowledge from a teacher. This is a knowledge transfer process that could compress the teacher network and reduce the computational costs. Next, to improve the diagnosis accuracy, the predicted results of three well-trained students are fused based on two contrastive methods: the voting-based knowledge fusion method and the average-based knowledge fusion method. Finally, the well-trained model forms and could be used for the diagnosis task. The validity of the proposed method is verified on a tympanic membrane data set.

RESULTS

The well-trained model achieves a good performance in the early diagnosis of OM at a lower computational cost. The training diagnosis accuracy of the average-based model reaches 99.02%, and the testing diagnosis accuracy reaches 97.38%, which exceeds that of any teacher. Compared with using the teacher network for the diagnosis task directly, the training time of the proposed well-trained model reduces by 64.37%, which greatly shortens the calculation time. Three deep and large teachers are compressed into a lightweight well-trained model, which greatly reduces the computational costs.

CONCLUSIONS

The optimized multi-teacher knowledge distillation method is suitable for the early diagnosis of OM with insufficient data. In addition, the method realizes model compression and reduces the computational costs.
Identification of Behavior Change Techniques From Successful Web-Based Interventions Targeting Alcohol Consumption, Binge Eating, and Gambling: Systematic Review (Preprint)
Authors: Humphreys Gabrielle , Evans Rebecca , Makin Harriet , Cooke Richard , Jones Andrew
Published: July 2020

BACKGROUND

Web-based interventions are thought to overcome barriers to treatment, such as accessibility and geographical location, which can undermine the effectiveness of traditional face-to-face interventions. Owing to these features, researchers are increasingly testing the efficacy of web-based interventions as ways to reduce alcohol misuse, binge eating, and gambling. However, many web-based interventions have poorly defined mechanisms of action; therefore, it is often uncertain how they propose to bring about behavior change.

OBJECTIVE

This systematic review aims to identify effective behavior change techniques (BCTs) present in web-based interventions aimed at reducing alcohol consumption, binge eating, or gambling.

METHODS

This systematic review covered research conducted in the last 20 years. Inclusion criteria for interventions were web-based administration; targeting alcohol use, binge eating, and/or gambling; and reporting on baseline and postintervention measures of behavior. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. We coded intervention effectiveness, study quality, and BCTs present in the interventions.

RESULTS

Following removal of 4152 ineligible articles, 45 were included in the review: 32 (71%) targeted alcohol misuse, 6 (13%) targeted binge eating, and 7 (16%) targeted gambling. In total, 5 frequency counts were performed to identify the most commonly used BCTs: all studies, effective interventions, high-quality studies at 2 thresholds, and both high quality and effective studies. The results obtained from this were integrated to identify 7 BCTs. These 7 BCTs were problem solving, feedback on behavior, self-monitoring of behavior, self-monitoring of outcomes, instruction on how to perform a behavior, information about social and health consequences, and social comparison. A total of 4 BCTs were found in all frequency counts: feedback on behavior, self-monitoring of behavior, instruction on how to perform a behavior, and social comparison. Self-monitoring of outcomes of behavior was found in 3 of the 5 frequency counts, problem solving was found in 2 frequency counts, and information about social and health consequences was found in 1 frequency count.

CONCLUSIONS

This systematic review identified 7 of the most frequently used BCTs used in web-based interventions focused on alcohol misuse, binge eating, and gambling. These results can inform the development of evidence-based eHealth interventions that have the potential to lead to effective, positive behavior changes in all 3 areas.
Global Collaborative Social Network (Share4Rare) to Promote Citizen Science in Rare Disease Research: Platform Development Study (Preprint)
Authors: Radu Roxana , Hernández-Ortega Sara , Borrega Oriol , Palmeri Avril , Athanasiou Dimitrios , Brooke Nicholas , Chapí Inma , Le Corvec Anaïs , Guglieri Michela , Perera-Lluna Alexandre , Garrido-Aguirre Jon , Ryll Bettina , Nafria Escalera Begonya
Published: July 2020

BACKGROUND

Rare disease communities are spread around the globe and segmented by their condition. Little research has been performed on the majority of rare diseases. Most patients who are affected by a rare disease have no research on their condition because of a lack of knowledge due to absence of common groups in the research community.

OBJECTIVE

We aimed to develop a safe and secure community of rare disease patients, without geographic or language barriers, to promote research.

METHODS

Cocreation design methodology was applied to build Share4Rare, with consultation and input through workshops from a variety of stakeholders (patients, caregivers, clinicians, and researchers).

RESULTS

The workshops allowed us to develop a layered version of the platform based on educating patients and caregivers with publicly accessible information, a secure community for the patients and caregivers, and a research section with the purpose of collecting patient information for analysis, which was the core and final value of the platform.

CONCLUSIONS

Rare disease research requires global collaboration in which patients and caregivers have key roles. Collective intelligence methods implemented in digital platforms reduce geographic and language boundaries and involve patients in a unique and universal project. Their contributions are essential to increase the amount of scientific knowledge that experts have on rare diseases. Share4Rare has been designed as a global platform to facilitate the donation of clinical information to foster research that matters to patients with rare conditions. The codesign methods with patients have been essential to create a patient-centric design.
Efficacy of a Transdiagnostic Self-Help Internet Intervention for Reducing Depression, Anxiety, and Suicidal Ideation in Adults: Randomized Controlled Trial (Preprint)
Authors: Batterham Philip J , Calear Alison L , Farrer Louise , Gulliver Amelia , Kurz Ella
Published: July 2020

BACKGROUND

Low-intensity self-guided mental health interventions that are delivered on the web may meet the needs and preferences of adults with mild to moderate symptoms. However, few clinical trials have examined the effectiveness of self-guided transdiagnostic interventions within a naturalistic setting.

OBJECTIVE

This randomized controlled trial (RCT) tests the effectiveness of the video-based transdiagnostic intervention FitMindKit in reducing depression symptoms (primary outcome), anxiety symptoms, disability, and suicidal ideation, relative to an attention-matched control condition called HealthWatch.

METHODS

The RCT was conducted with adults living in the Australian Capital Territory, Australia. Participants (n=1986) were recruited through the web using social media advertisements, screened for psychological distress, and then randomized to receive one of two 4-week programs: FitMindKit (12-module psychotherapy intervention) or HealthWatch (12-module program providing general health information). Participants were assessed at baseline and at 4 weeks postbaseline. To maintain the ecological validity of the trial, participants completed brief assessments and interventions without direct researcher contact or incentives.

RESULTS

Mixed model repeated-measures analyses of variance demonstrated that FitMindKit significantly improved depression symptoms (F1,701.7=3.97; P=.047), along with panic symptoms (F1,706.5=5.59; P=.02) and social anxiety symptoms (F1,680.0=12.37; P<.001), relative to the attention control condition. There were no significant effects on other outcomes.

CONCLUSIONS

Self-guided transdiagnostic interventions can be beneficial when delivered directly to end users through the internet. Despite low adherence and small effect sizes, the availability of such interventions is likely to fill a critical gap in the accessibility of mental health services for the community.

CLINICALTRIAL

Australian New Zealand Clinical Trials Registry ACTRN12618001688279; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376113.

INTERNATIONAL REGISTERED REPORT

RR2-10.1016/j.conctc.2019.100341
Using Information Technology to Assess Patient Risk Factors in Primary Care Clinics: A Pragmatic Evaluation (Preprint)
Authors: Kosowan Leanne , Katz Alan , Halas Gayle , LaBine Lisa , Singer Alexander
Published: July 2020

BACKGROUND

Tobacco use, physical inactivity and poor diet are associated with morbidity and premature death. Health promotion and primary prevention counseling, advice and support by a primary care provider leads to behaviour change attempts among patients. However, although physicians consider preventative health important the focus on presentation, acute care and medication review often overshadows primary prevention counseling.

OBJECTIVE

This study evaluates feasibility, adoption and integration of the tablet-based Risk Factor Identification Tool (RFIT) that uses algorithmic information technology to support obtainment of patient risk factor information in primary care clinics.

METHODS

This is a pragmatic developmental evaluation. Each clinic developed a site-specific implementation plan adapted to their workflow. RFIT was implemented in two primary care clinics located in Manitoba. Perceptions of 10 clinic staff and 8 primary care clinicians informed this evaluation.

RESULTS

Clinicians reported a smooth and fast transfer of RFIT responses to an EMR encounter note. There were 207 patients that used the RFIT with a completion rate of 86%. Clinic staff reported that very few patients declined the use of RFIT or required assistance to use the tablet. Among the patients that used RFIT 12.1% smoked, 21.2% felt their diet could be improved, 9.3% reported high alcohol consumption, 56.4% reported less than 150 minutes of PA a week, and 8.2% lived in poverty. Clinicians suggested that although a wide variety of patients were able to use the tablet-based RFIT, implemented surveys should be tailored to patient subgroups.

CONCLUSIONS

Clinicians and clinic staff positively reviewed the use of information technology in primary care. RFIT is a user-friendly tool that provides an effective method for obtaining risk factor information from patients. It is particularly useful for subsets of patients lacking continuity in the care they receive. When implemented within a context that can support practical interventions to address identified risk factors, RFIT can inform brief interventions within primary care.
EFFECTS OF POLYASPARTIC ACID ON REMINERALIZATION OF INTRAFIBRILLAR DENTIN AND SIZE OF HYDROXYAPATITE CRYSTALS
Authors: AHDI WAVIYATUL , DJAUHARIE NILAKESUMA , MEIDYAWATI RATNA , MUSLIM IKHWAN
Published: July 2020

Objective: The objective of this study was to analyze the intrafibrillar remineralization process and the size of hydroxyapatite crystals formed.Methods: The samples were divided into four groups. The control group was immersed in a demineralization solution, whereas the remaining threetreatment groups were immersed in a remineralization solution containing polyaspartic acid for 3, 7, or 14 days. The effect of polyaspartic acid onintrafibrillar remineralization during the polymer-induced liquid-precursor (PILP) process was evaluated using transmission electron microscopy,and the size of hydroxyapatite crystals was examined through X-ray diffraction.Results: Significant differences were detected in the intrafibrillar remineralization between the treatment groups (subjected to remineralization for3, 7, and 14 days) and the demineralized dentin control group. However, no significant differences were detected in the size of hydroxyapatite crystalsbetween the control and the treatment groups.Conclusion: Our data suggest that polyaspartic acid enables intrafibrillar remineralization during the PILP process.
CONCENTRATION DEPENDENT EFFECTS OF CARBOXYMETHYL CHITOSAN ON DENTIN REMINERALIZATION WITH AMORPHOUS CALCIUM PHOSPHATE
Authors: SETIATI HASTI DWI , SUPRASTIWI ENDANG , PUTRI ARTININGSIH DEWA AYU NYOMAN , BUDI UTAMI LUH PUTU TRISNA
Published: July 2020

Objective: Carboxymethyl chitosan (CMC) is a non-collagenous protein analog which has a similar role as dentin matrix protein 1. CMC stabilizes amorphous calcium phosphate (ACP); hence forming nanocomplexes of CMC-ACP. The purpose of this study was to evaluate the effect of CMC concentration in CMC-ACP on dentin remineralization.Methods: Cavities were formed on the occlusal surfaces of freshly extracted premolar teeth. All samples were demineralized and immersed in phosphate-buffered saline and stored in a shaking incubator at 37°C. The teeth were randomly divided into five groups. Group 1 was control group (no treatment), whereas Groups 2, 3, 4, and 5 were treated with CMC-ACP containing 1%, 2.5%, 5%, and 10% CMC. The remineralized layer on the dentin surface was evaluated using scanning electron microscopy and energy-dispersive X-ray analysis.Results: The highest dentin remineralization capacity was achieved in Group 5 (10% CMC), whereas diminishing effects were observed in Group 4 (5% CMC), Group 3 (2.5% CMC), and Group 2 (1% CMC). Although no significant differences in calcium levels were observed between 2.5%, 5%, and 10% CMC groups, phosphate levels differed significantly in all treatment groups.Conclusion: Optimal dentin remineralization was achieved by the application of CMC–ACP containing 2.5% CMC.