bluuebunny/crossref_metadata_2025 huggingface dataset:
Lip spreading, not lip rounding
Authors:   St. Petersburg State University, Andronov Aleksey V.
Published: March 2021

The article is devoted to the issue of detecting classificatory features of phonemes. Unlike phonetic characteristics of phoneme realisations, which are explored instrumentally, phonological features should be discovered by means of functional analysis. Due to their role as exponents of meaningful units, phonemes are grouped according to their morphophonological behaviour. Here, detecting phonological features is illustrated by the analysis of the vocalic systems of Russian, Latvian and Finnish. The ‘lip rounding’ feature traditionally used in descriptions of these languages has no functional grounds and should be considered as an incorrect substitution of an articulatory characteristic for a phonological feature. However, apart from ‘height’ and ‘backness’, another feature should be postulated. For this feature the articulatory-based term ‘lip spreading’ is proposed. In Russian, the spread vowels /e/, /i/, /ɨ/ are distinguished due to their sensibility (primarily in morphophonological alternations) to the correlative feature of softness-hardness of the preceding consonant. Non-spread vowels /a/, /o/, /u/ are indifferent to the softness-hardness of the preceding consonant. Thus, /a/ is grouped not with /e/, /i/, /ɨ/ (as non-rounded in traditional models), but with /o/ and /u/ (no separate group of these two “rounded” phonemes, /o/ and /u/, exists). In Latvian, the spread phonemes /i/, /e/, /i:/, /e:/, /i͡e/ determine the choice of the closed vowels /e/ and /ē/ (instead of open /æ/ and /æ:/) in the preceding syllable. It is worthwhile to differentiate front vowels (according to lip spreading), not the back ones (according to lip rounding). In Finnish, the distinguishing of spread /i/ and /e/ is based on their relation with the fundamental peculiarity of the exponent of a word form, vowel harmony. These phonemes themselves do not participate in harmony alternation and they determine front vocalism of affixes only when other, non-spread phonemes are lacking.
Hygienic safety characteristics of bottled water, used for potable water supply
Authors:   St. Petersburg State University, Kopytenkova Olga ,   North-West Public Health Research Center, Ganichev Pavel ,   North-West Public Health Research Center, Zaritskaya Ekaterina ,   North-West Public Health Research Center
Published: March 2021

On the basis of the results of performed analysis of literature references concerning influence of phthalates on population health indicators it was found out that their influence at prenatal period may lead to asthma development in children, as well as to allergy, obesity; they also provide anti-androgens effect, leading to growth inhibition and delay in sexual maturation, and to variance of systolic pressure. In case of men phthalates are associated with decreasing of testosterone level and sperms quality, that indicates at their possible role in male sterility. In case of women phthalates are associated with increase of the risk of the second type of diabetes appearance, as well as leiomyoma, endometriosis and breast carcinoma. Laboratory studies performed in accordance with Customs union’s technical regulation ТР ТС 005/2011 enabled to detect phthalates in the packages of bottled water, able to migrate into the bottled water. The results justify the necessity to monitor phthalates in bottled water.
Assessment of the quality of medical care provided to patients in a psychiatric hospital
Authors:   Federal Research Institute for Health Organization and Informatics of Ministry of Public Health of Russian Federation, Shikina Irina , Davidov David ,   Federal Research Institute for Health Organization and Informatics of Ministry of Public Health of Russian Federation
Published: March 2021

Monitoring and evaluation of the quality of medical care provided to patients is essential in any medical specialty, but especially in relation to specialized care in mental health hospitals. The aim of our work is to assess the quality of specialized medical care provided to patients in the psychiatric hospital. We have examined 270 medical records and internal quality control cards of patients hospitalized from 2015 to 2019 in the Psychiatric Clinical Hospital No. 4 of the Moscow Healthcare Department (hereinafter referred to as “PCH No. 4” of MHD). The quality control of the provided medical care was carried out twice with the assessment of each studied section in the range from 0 to 1 point. Thus, it was possible to calculate the overall medical care quality coefficient with a description of the defects found in the provision of medical services. After the first control, quality coefficient appeared to be 0.86 (0.79; 0.91), and after the second one 0.95 (0.92; 0.96). During the second control, which was conducted in 2019, the medical care quality was significantly higher (p = 0.011) compared to the results of 2015–2018. The total share of detected defects in the medical-diagnostic process in a psychiatric hospital was 40.7 % (and was captured in 110 out of 270 cases). The results of our study demonstrate the necessity of medical care internal quality monitoring in a psychiatric hospital, since it contributes not only to the improvement of overall quality of medical treatment, but also to timely detection and reduction of the number of defects in the medical-diagnostic process.
Optimization of the work of a nutritionist physician using tools of lean technologies in a simulated clinic
Authors:   St. Petersburg State Pediatric Medical University, Lisovskii Oleg , Gostimskii Alexandr ,   St. Petersburg State Pediatric Medical University, Lisitsa Ivan ,   St. Petersburg State Pediatric Medical University, Zavyalova Anna ,   St. Petersburg State Pediatric Medical University, Karpatsky Igor ,   St. Petersburg State Pediatric Medical University
Published: March 2021

The article presents the possibilities of implementing the priority project “New model of medical organization providing primary health care” aimed at increasing the accessibility and satisfaction of patients with the quality of medical care. An example of an outpatient dietary consultation shows the resources for detecting medical losses and ways of optimizing the activities of medical personnel using the tools of lean technologies. The article reflects the experience of the Training Centre for lean technologies in health care of the Saint Petersburg State pediatric medical university, created in 2018 with the aim of training medical workers of different specialties to use tools of economical production in conditions of simulated clinic. The conduct of business games and “The Factories of Processes” makes it possible to reconstruct the work of the individual office or the entire polyclinic. The possibility of standardization of medical processes, use of check-lists in the work and organization of each cabinet, introduction of the system “5S” and identification of medical losses with subsequent optimization of the initial reception is presented. In this work “The Process Factory” “The optimization of the appointment of a doctor-specialist” is presented, allowing to make a detailed analysis of the duration and structure of the reception, to perform the mapping of medical processes and to use visual management, considering the efficiency, Safety and quality of the doctor’s work. The acquired skills in simulated conditions help to implement this methodology and effectively use the tools of lean technologies in practice.
Application of cellular and artificial membranes in nanomedicine
Authors:   First Pavlov State Medical University of St. Peterburg, Galkin Mikhail
Published: March 2021

The use of nanoparticles in treatment and diagnostics of a number of disorders is becoming more and more popular. Further investigations are needed for improving the specificity of nanoparticle action, precisely targeted drug delivery, decreasing opsonization of nanoparticles by macrophages. Numerous ways of nanoparticle surface modification have been successfully tested for increasing their therapeutic potential and reducing possible side effects. Nanoparticle encapsulation using plasma membranes of red blood cells as well as other cell types has been recently introduced. This field of translational medicine substantially expands opportunities for nanoparticle application in clinical diagnostics and therapy of cancer, cardiovascular diseases, in vaccine development etc. This review focuses on ways, advantages and disadvantages of using cellular membranes in nanomedicine. Application of artificial lipid membranes in nanoparticles encapsulation is proposed.
Spiral Dynamics, System Cycles and New Organizational Models: Pearlescent Enterprises
Authors:   Department of System Analysis in Economics, Central Economics and Mathematics Institute of the RAS, Kleiner George ,   Department of Institutional Economy Financial University under the Government of the Russian Federation
Published: March 2021

According to C. Graves, D. Beck, and C. Cowan’s Spiral Dynamics theory, the development of a socio-economic system, including an individual, organization, society, occurs discretely by moving from one level to another under the influence of change in the dominant value system. The authors of the Spiral Dynamics theory point to 8 levels, marked with a uniform color — from beige to turquoise. In this article, based on the analysis of trends in enterprises’ organizational models, the list of known organizational forms is supplemented by a new model — “pearlescent organization”. This form of an organization aims to strengthen employees’ emotional attachment due to an increase in the enterprise’s internal diversity, adaptability, and flexibility of the structure. The model of synthesis of the theory of linear change of value systems and cyclical change of four phases of the enterprise’s state is also developed in the article. Each of these stages is characterized by the dominance of the object, project, process, or environmental subsystems of the enterprise. The conditions for the transition from one stage of enterprise development to another, particularly the transformation of the turquoise stage into the pearlescent one, are shown based on this model.
Uncertainty assessment of kernel based approaches on scour depth modeling in downstream of ski-jump bucket spillways
Authors: Ghasemlounia Redvan , Saghebian Seyed Mahdi
Published: March 2021

From the hydraulic structures designer's point of view, the scour depth accurate estimation in downstream of spillways is so important. In this study, the scour depth was assessed downstream of ski-jump bucket spillways using two kernel based approaches namely Support Vector Machine (SVM) and Kernel Extreme Learning Machine (KELM). In the model developing process, two states were tested and the impacts of dimensional and non-dimensional parameters on model efficiency were assessed. The best applied model dependability was investigated via Monte Carlo uncertainty analysis. In addition, the model accuracy was compared with some available semi-theoretical formulas. It was observed that the applied models were more successful than available formulas. The sensitivity analysis results showed that q (unit discharge of spillway) variable in the state 1 and q2/[gYt3] (g is gravity acceleration and Yt is tail water depth) variable in the state 2 were the most significant parameters in the modeling process. Comparison among applied methods and one other intelligence approach showed that KELM was more successful in predicting process. The obtained results from uncertainty analysis indicated that the KELM model had an allowable degree of uncertainty in the scour depth modeling.
Superintending Scenedesmus and Chlorella sp. with lead and cobalt tolerance governed via stress biomarkers
Authors: Kashyap Mrinal , Anand Vishal , Ghosh Atreyee , Kiran Bala
Published: March 2021

In this study, Scenedesmus sp. and Chlorella sp. were exposed to 100, 150, 200 mg/L of lead and 10, 50, 100 mg/L of cobalt for 10 days. The chlorophyll content at Pb (200 mg/L) was found to be 2.35 ± 0.15 μg/mL in Scenedesmus sp. and 2.58 ± 0.02 μg/mL in Chlorella sp. on the 10th day. Scenedesmus sp. and Chlorella sp. exposed to Co (100 mg/L) showed a decline in chlorophyll content (0.83 ± 0.09 μg/mL and 0.74 ± 0.08 μg/mL) respectively. Furthermore, Scenedesmus sp. and Chlorella sp. exposed to 100 mg/L of lead showed the highest lipid peroxidation measured using malonaldehyde (MDA) (10.60 μmol/g and 6.24 μmol/g), superoxide dismutase (SOD) (49.04 U/mL and 49.32 U/mL) and catalase (CAT) (237.74 nmol/min/mL and 373.48 nmol/min/mL) activity, respectively. Scenedesmus sp. and Chlorella sp. exposed to 200 mg/L of lead showed elevated MDA (4.89 μmol/g and 5.14 μmol/g), SOD (32.05 U/mL and 37.80 U/mL) and CAT (121.78 nmol/min/mL and 160.46 nmol/min/mL) activity, respectively. Scenedesmus sp. and Chlorella sp. showed a high tolerance for 100 mg/L of lead and 10 mg/L of cobalt. As the concentration of lead and cobalt was increased, cell growth declined and elevated levels of stress biomarkers were observed. This study helps to understand plant tolerance levels and presents their candidature for treating wastewater with high lead and cobalt content.
Application of immobilized mycelium-based pellets for the removal of organochlorine compounds: a review
Authors: Pereira J. C. V. , Serbent M. P. , Skoronski E.
Published: March 2021

Organochlorines have diverse structures and applications and are included in the list of persistent organic pollutants (POPs) due to their toxicity and environmental persistence. The reduced capacity of conventional wastewater treatment plants to remove these compounds encourages the development of cost-effective and efficient remediation approaches. Fungal biotechnology can contribute to the development of these technologies through their enzymatic machinery but faces several drawbacks related to the use of dispersed mycelium. In this sense, investigations concerning the degradation of organochlorines using immobilized fungi demonstrated an increase in contaminant removal efficiency compared with degradation by free cells. Despite this interest, the mechanisms of immobilized fungi have not been comprehensively reviewed. In this paper, recent advances of laboratory and field studies in organochlorine compounds removal by fungi are reviewed, focusing on the role of immobilization techniques. Firstly, the mechanisms of organochlorines bioconversion by fungi and the factors affecting enzyme activity are elucidated and discussed in detail. Then, the main targeted compounds, fungi, technics, and materials used for immobilization are discussed, as well as their advantages and limitations. Furthermore, critical points for future studies of fungi immobilization for organochlorine removal are proposed.
Phosphorus recovery and recycling from model animal wastewaters using materials prepared from rice straw and corn cobs
Authors: Ding Yifan , Sabatini David A. , Butler Elizabeth C.
Published: March 2021

Anthropogenic loss of phosphorus to surface waters not only causes environmental problems but depletes valuable phosphorus reserves. In this study, magnesium amended biochars and magnesium silicate, synthesized from corn cobs and rice straw, respectively, were evaluated for phosphorus uptake including the effects of pH and alkalinity. The overall goal was to close the phosphorus loop by recovering phosphorus from animal waste and reusing it as fertilizer. After phosphorus uptake, spent materials were tested for phosphorus release using modified soil tests representing different soil pH and alkalinity conditions. In experiments using model animal wastewaters containing both ammonia and bicarbonate alkalinity, dissolved phosphorus was removed by struvite (MgNH4PO4·6H2O) formation, whereas in deionized water, dissolved phosphorus was removed by adsorption. Alkalinity in the model animal wastewaters competed with phosphate for dissolved or solid-associated magnesium, thereby reducing phosphorus uptake. Spent materials released significant phosphorus in waters with bicarbonate alkalinity. This work shows that abundant agricultural wastes can be used to synthesize solids for phosphorus uptake, with the spent materials having potential application as fertilizers.
Flaws in the Android Permission Protocol with Limited Verification
Authors:   Moscow State Institute of International Relations (University), Erokhin Viktor
Published: March 2021

Purpose of the article: analysis of the resolution protocol implemented in the Android operating system as the most popular for smartphones and other electronic gadgets; consider a formal model of the Android permission protocol and describe the automatic security analysis of this model; identify potential flaws in the permitting protocol. Research method: A formal model of the Android permission protocol based on C++ using the Java NDK based on first-order relational logic is considered, with an analysis engine that performs limited model validation. Result. Created a formal model of Android permission protocol using C ++ using Java NDK. The model identified flaws in the Android permission protocol, and thus exposed Android security vulnerabilities. The developed Android protocol permission model consists of three parts: an Android device architecture query; Android permission scheme request; system operations. Fixed flaws in Android OS related to custom permissions vulnerability. An experiment is presented to demonstrate the feasibility and prevalence of custom permissions vulnerability in existing Android applications. Examination of real Android applications supports our finding that flaws in the Android permission protocol can have serious security implications for electronic gadget applications, and in some cases allows an attacker to completely bypass permission checks. A study of one of the vulnerabilities showed that it is widespread among many existing Android applications. Most developers do not perform any additional validation to ensure that inbound APIs come from trusted applications or vendors, assuming they may not be aware of a custom permissions vulnerability despite its potential for security breaches. The result will be useful for software developers for operating systems with permissions - Android, iOS and Fire OS.
Security Assessment Methodology Based on the Semantic Model of Metrics and Data
Authors:   St. Petersburg Federal Research Center of the Russian Academy of Sciences, Doynikova Elena , Fedorchenko Andrey ,   St. Petersburg Federal Research Center of the Russian Academy of Sciences, Kotenko Igor ,   St. Petersburg Federal Research Center of the Russian Academy of Sciences, Novikova Evgenia ,   St. Petersburg Federal Research Center of the Russian Academy of Sciences
Published: March 2021

The purpose of the article: development of semantic model of metrics and data and technique for security assessment based on of this model to get objective scores of information system security. Research method: theoretical and system analysis of open security data sources and security metrics, semantic analysis and classification of security data, development of the security assessment technique based on the semantic model and methods of logical inference, functional testing of the developed technique. The result obtained: an approach based on the semantic model of metrics and data is proposed. The model is an ontology generated considering relations among the data sources, information system objects and data about them, primary metrics of information system objects and integral metrics and goals of assessment. The technique for metrics calculation and assessment of unspecified information systems security level in real-time using the proposed model is developed. The case study demonstrating applicability of the developed technique and ontology to answer security assessment questions is provided. The area of use of the proposed approach are security assessment components of information security monitoring and management systems aimed at increasing their efficiency.
Multi-Level Policy Model Access Control Security Operating Systems of the Windows Family
Authors:   The Academy of the Federal Guard Service of the Russian Federation, Kozachok Vasilii , Kozachok Alexander ,   The Academy of the Federal Guard Service of the Russian Federation, Kochetkov Evgenii ,   The Academy of the Federal Guard Service of the Russian Federation
Published: March 2021

The purpose of research – development of a more advanced Windows NT family access control mechanism to protect against information leakage from memory by hidden channels. The method of research – analysis of Windows NT family models of mandatory access control and integrity control, modeling of access control security policy for specified security properties, automatic verification of models. The Lamport Temporal Logic of Actions (TLA +) used to describe the model and its specification is used. TLA+ allows automatic verification of the model with the specified security properties. The result of research – revealed the main limitations of the existing mandatory integrity control of operating systems of the Windows NT family. A set of structures of a multilevel model has been developed, reflecting the attributes that are significant for modeling the process of access of subjects to objects. The key mechanisms of access control in the operating system are modeled: management of users, groups, subjects, objects, roles, rights, discretionary and mandatory access control, mandatory integrity control - multilevel control of subjects’ access to objects. The model defines a mechanism for controlling the creation of subjects based on executable files to organize an isolated software environment. The values of the attributes of the model variables for the initialization stage are determined. The invariants of variables correctness in the process of verification and subjects to objects safe access are developed. The model was specified using the TLA + modeling language and verified.
The Role of Spiritual Health Experience with Intensity and Duration of Labor
Pain While Childbearing and Postpartum
Authors: Dehestani Hanieh , Tayebi Naeimeh , Moshfeghy Zeinab , Akbarzadeh Marzieh
Published: March 2021

Background:

The birth of a child is one of the most important events in a mother's life. The use of religious beliefs and spirituality is often considered as a constructive coping strategy in improving the psychological health of individuals.

Objective:

The present study aimed to examine the role of spiritual health experience with intensity and duration of labor pain during childbearing and postpartum.

Materials and Methods:

In a cross-sectional study, a total of 200 pregnant women who were 37-42 weeks pregnant and referred to Shiraz
Medical Hospital for delivery were selected by nonprobability convenience sampling method. Personal and Midwifery Information Questionnaire and Ellison-Paloutzian Spiritual Health Questionnaire were used for data collection. These questionnaires were completed by interviews. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) software. Descriptive test was used for data description and Chi-square test was used for data analysis. The significance level in all testes was set at < 0.05.

Results:

There is a significant negative relationship between the variable of spiritual health and duration of the admission stage until the full opening of the cervix in primipara and multipara. But there is no significant relationship between the variables of complete opening of the cervix to fetal delivery and fetal delivery to placental delivery and maternal spiritual health.

Conclusion:

This study increases our knowledge about spiritual health strategies to prevent labor pains and promote mental health in pregnant women. Midwives should be sensitive to the spiritual health of pregnant women and integrate this element into maternal care.
Preparation and Characterization of Liposomes Double-loaded with Amphotericin B and Amphotericin B/hydroxypropyl-beta-cyclodextrin Inclusion Complex
Authors: Tran Thi H. Yen , Vu Thi T. Giang , Pham Thi M.H.
Published: March 2021

Background:

Amphotericin B (AMB) is water-insoluble polyene, which has a broad
spectrum of antifungal activity. The hydrophobic drug only exits in the phospholipid bilayer, leading
to a low-drug liposomal loading capacity.

Objectives:

This study is designed to prepare water-soluble inclusion complex (IC) between AMB
and cyclodextrin (CD) to formulate liposomal vesicles, double-loaded with drug molecules in the
phospholipid bilayer and AMB/CD IC in the aqueous core.

Methods:

Water-soluble AMB/CD IC was prepared by pH adjustment of the aqueous media and
consequently characterized by scanning electron microscopy (SEM) and differential scanning
calorimetry (DSC). Liposomes double-loaded with AMB were formulated by the thin-film hydration
method and accordingly evaluated for vesicle size, polydispersity index, entrapment efficiency,
zeta potential, and in vitro drug leakage.

Results:

Hydroxypropyl β cyclodextrin (HP-β-CD) better solubilized AMB than both α-CD and β-
CD e.g., the concentration of water-soluble AMB/HP-β-CD IC could reach 465 μg/mL. Both DSC
and SEM data illustrated that the drug no longer existed in its crystalline form, in AMB/HP-β-CD
IC. Liposomes double-loaded with hydrophilic AMB/HP-β-CD IC and hydrophobic AMB had a diameter
of 270 nm, polydispersity index less than 0.27, and zeta potential ca.-42.8 mV. Moreover, liposomes
double-loaded with AMB enhanced drug-liposomal loading capacity by 25%, less leaked
drug in phosphate buffer pH 7.4 at 37°C in comparison to liposomes loaded with only hydrophobic
AMB.

Conclusion:

Liposomes double-loaded with AMB and AMB/HP-β-CD IC increased drug-encapsulation
ability and in vitro stability, suggesting potential drug delivery systems.
Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study
Authors: Zhang Cevin , Baalsrud Hauge Jannicke , Härenstam Karin Pukk , Meijer Sebastiaan
Published: March 2021

Background

Using serious games for learning in operations management is well established. However, especially for logistics skills in health care operations, there is little work on the design of game mechanics for learning engagement and the achievement of the desired learning goals.

Objective

This contribution presents a serious game design representing patient flow characteristics, systemic resource configurations, and the roles of the players based on a real Swedish emergency ward. The game was tested in a set of game-based learning practices in the modalities of a physical board game and an online multiplayer serious game that implemented the same game structure.

Methods

First, survey scores were collected using the Game Experience Questionnaire Core and Social Presence Modules to evaluate the experience and acceptance of the proposed design to gamify real processes in emergency care. Second, lag sequential analysis was applied to analyze the impact of the game mechanics on learning behavior transitions. Lastly, regression analysis was used to understand whether learning engagement attributes could potentially serve as significant predicting variables for logistical performance in a simulated learning environment.

Results

A total of 36 students from courses in engineering and management at KTH Royal Institute of Technology participated in both game-based learning practices during the autumn and spring semesters of 2019 and 2020. For the Core Module, significant differences were found for the scores for negative affect and tension compared with the rest of the module. For the Social Presence Module, significant differences were found in the scores for the psychological involvement – negative feelings dimension compared with the rest of the module. During the process of content generation, the participant had access to circulating management resources and could edit profiles. The standard regression analysis output yielded a ΔR2 of 0.796 (F14,31=2725.49, P<.001) for the board version and 0.702 (F24,31=2635.31, P<.001) for the multiplayer online version after the learning engagement attributes.

Conclusions

The high scores of positive affect and immersion compared to the low scores of negative feelings demonstrated the motivating and cognitive involvement impact of the game. The proposed game mechanics have visible effects on significant correlation parameters between the majority of scoring features and changes in learning engagement attributes. Therefore, we conclude that for enhancing learning in logistical aspects of health care, serious games that are steered by well-designed scoring mechanisms can be used.
Comparison of Public Responses to Containment Measures During the Initial Outbreak and Resurgence of COVID-19 in China: Infodemiology Study
Authors: Zhou Xinyu , Song Yi , Jiang Hao , Wang Qian , Qu Zhiqiang , Zhou Xiaoyu , Jit Mark , Hou Zhiyuan , Lin Leesa
Published: March 2021

Background

COVID-19 cases resurged worldwide in the second half of 2020. Not much is known about the changes in public responses to containment measures from the initial outbreak to resurgence. Monitoring public responses is crucial to inform policy measures to prepare for COVID-19 resurgence.

Objective

This study aimed to assess and compare public responses to containment measures during the initial outbreak and resurgence of COVID-19 in China.

Methods

We curated all COVID-19–related posts from Sina Weibo (China’s version of Twitter) during the initial outbreak and resurgence of COVID-19 in Beijing, China. With a Python script, we constructed subsets of Weibo posts focusing on 3 containment measures: lockdown, the test-trace-isolate strategy, and suspension of gatherings. The Baidu open-source sentiment analysis model and latent Dirichlet allocation topic modeling, a widely used machine learning algorithm, were used to assess public engagement, sentiments, and frequently discussed topics on each containment measure.

Results

A total of 8,985,221 Weibo posts were curated. In China, the containment measures evolved from a complete lockdown for the general population during the initial outbreak to a more targeted response strategy for high-risk populations during COVID-19 resurgence. Between the initial outbreak and resurgence, the average daily proportion of Weibo posts with negative sentiments decreased from 57% to 47% for the lockdown, 56% to 51% for the test-trace-isolate strategy, and 55% to 48% for the suspension of gatherings. Among the top 3 frequently discussed topics on lockdown measures, discussions on containment measures accounted for approximately 32% in both periods, but those on the second-most frequently discussed topic shifted from the expression of negative emotions (11%) to its impacts on daily life or work (26%). The public expressed a high level of panic (21%) during the initial outbreak but almost no panic (1%) during resurgence. The more targeted test-trace-isolate measure received the most support (60%) among all 3 containment measures in the initial outbreak, and its support rate approached 90% during resurgence.

Conclusions

Compared to the initial outbreak, the public expressed less engagement and less negative sentiments on containment measures and were more supportive toward containment measures during resurgence. Targeted test-trace-isolate strategies were more acceptable to the public. Our results indicate that when COVID-19 resurges, more targeted test-trace-isolate strategies for high-risk populations should be promoted to balance pandemic control and its impact on daily life and the economy.
Distributed Ledger Infrastructure to Verify Adverse Event Reporting (DeLIVER): Proposal for a Proof-of-Concept Study (Preprint)
Authors: Milne-Ives Madison , Lam Ching , Rehman Najib , Sharif Raja , Meinert Edward
Published: March 2021

BACKGROUND

Adverse drug event reporting is critical for ensuring patient safety; however, numbers of reports have been declining. There is a need for a more user-friendly reporting system and for a means of verifying reports that have been filed.

OBJECTIVE

This project has 2 main objectives: (1) to identify the perceived benefits and barriers in the current reporting of adverse events by patients and health care providers and (2) to develop a distributed ledger infrastructure and user interface to collect and collate adverse event reports to create a comprehensive and interoperable database.

METHODS

A review of the literature will be conducted to identify the strengths and limitations of the current UK adverse event reporting system (the Yellow Card System). If insufficient information is found in this review, a survey will be created to collect data from system users. The results of these investigations will be incorporated into the development of a mobile and web app for adverse event reporting. A digital infrastructure will be built using distributed ledger technology to provide a means of linking reports with existing pharmaceutical tracking systems.

RESULTS

The key outputs of this project will be the development of a digital infrastructure, including a backend distributed ledger system and an app-based user interface.

CONCLUSIONS

This infrastructure is expected to improve the accuracy and efficiency of adverse event reporting systems by enabling the monitoring of specific medicines or medical devices over their life course while protecting patients’ personal health data.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/28616
A Shared Decision-making Tool for Drug Interactions Between Warfarin and Nonsteroidal Anti-inflammatory Drugs: Design and Usability Study (Preprint)
Authors: Reese Thomas J , Del Fiol Guilherme , Morgan Keaton , Hurwitz Jason T , Kawamoto Kensaku , Gomez-Lumbreras Ainhoa , Brown Mary L , Thiess Henrik , Vazquez Sara R , Nelson Scott D , Boyce Richard , Malone Daniel
Published: March 2021

BACKGROUND

Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and nonsteroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a substantial role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician centric.

OBJECTIVE

This study aims to design and study the usability of DDInteract, a tool to support shared decision-making (SDM) between a patient and provider for the DDI between warfarin and nonsteroidal anti-inflammatory drugs.

METHODS

We used an SDM framework and user-centered design methods to guide the design and usability of DDInteract—an SDM electronic health record app to prevent harm from clinically significant DDIs. The design involved iterative prototypes, qualitative feedback from stakeholders, and a heuristic evaluation. The usability evaluation included patients and clinicians. Patients participated in a simulated SDM discussion using clinical vignettes. Clinicians were asked to complete eight tasks using DDInteract and to assess the tool using a survey adapted from the System Usability Scale.

RESULTS

The designed DDInteract prototype includes the following features: a patient-specific risk profile, dynamic risk icon array, patient education section, and treatment decision tree. A total of 4 patients and 11 clinicians participated in the usability study. After an SDM session where patients and clinicians review the tool concurrently, patients generally favored pain treatments with less risk of gastrointestinal bleeding. Clinicians successfully completed the tasks with a mean of 144 (SD 74) seconds and rated the usability of DDInteract as 4.32 (SD 0.52) of 5.

CONCLUSIONS

This study expands the use of SDM to DDIs. The next steps are to determine if DDInteract can improve shared decision-making quality and to implement it across health systems using interoperable technology.
Evidence for Continuing Professional Development and Recency of Practice Standards for Regulated Health Professionals in Australia: Protocol for a Systematic Review (Preprint)
Authors: Main Penelope , Anderson Sarah
Published: March 2021

BACKGROUND

Continuing professional development (CPD) and recency of practice (ROP) standards are components of health practitioner regulation in Australia. The CPD and ROP standards are currently under review, and an evidence base to assist the development of consistent standards is required. Preliminary searching was unable to find a recent systematic review of the literature to provide an evidence base to underpin the standards review.

OBJECTIVE

This paper presents the protocol for a systematic review that aims to develop a current evidence base that will support the National Boards to develop more consistent, evidence-based, effective standards that are clear and easy to understand and operationalize.

METHODS

Research questions were developed to support the planned review of CPD and ROP registration standards. Major databases and relevant journals were searched for articles published in English between 2015 and 2021, using key search terms based on previous unpublished reviews of the CPD and ROP registration standards. The quality of the articles retrieved will be assessed using an instrument suitable for use in the development of public policy. The findings will be published in a peer-reviewed journal.

RESULTS

In September 2021, our search strategy identified 18,002 studies for the CPD-related research questions after removal of duplicates. Of these, 509 records were screened based on their title, and 66 full-text articles were assessed for eligibility based on their abstract, of which 31 met the inclusion criteria. A further 291 articles were identified as relevant to the ROP research questions. Of these, 87 records were screened based on their title, and 46 full-text articles were assessed for eligibility based on their abstract, of which 8 studies met our inclusion criteria.

CONCLUSIONS

This protocol outlines the scope and methodology that will be used to conduct a systematic review of evidence for CPD and ROP and inform a review of the standards for regulated health professionals in Australia. Previous research has shown that while CPD improves practitioner knowledge, the link to public safety is unclear. While there has been a greater focus on maintenance of certification and other quality assurance activities over the past 10 years, there remains great variability in CPD requirements across both professions and jurisdictions. ROP was found to be a poorly researched area with most research concentrating on medical practitioners, nurses, and midwives and no clear consensus about the optimal time period after which retraining or an assessment of competence should be introduced. As the CPD and ROP standards are currently under review, it is timely that a review of current evidence be undertaken.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/28625
Characteristics of Citizens and Their Use of Teleconsultations in Primary Care in the Catalan Public Health System Before and During the COVID-19 Pandemic: Retrospective Descriptive Cross-sectional Study (Preprint)
Authors: Solans Oscar , Vidal-Alaball Josep , Roig Cabo Pasqual , Mora Núria , Coma Ermengol , Bonet Simó Josep Maria , Hermosilla Pérez Eduardo , Saigí-Rubió Francesc , Olmos Domínguez Carmen , Piera-Jiménez Jordi , Abizanda González Mercè , López Seguí Francesc
Published: March 2021

BACKGROUND

eConsulta—that is, asynchronous, two-way teleconsultation in primary care—is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the onset of the COVID-19 pandemic. It is vital to know the characteristics of its users in order to be able to meet their needs and understand the coverage of this service in a context where there is reduced accessibility to the health system.

OBJECTIVE

This study aims to analyze the profile of the citizens who use the eConsulta tool and the reasons for their use, as well as to gain an understanding of the elements that characterize their decision to use it while distinguishing between those who used it before and those who have used it since the onset of the COVID-19 pandemic.

METHODS

A descriptive, observational study based on administrative data was performed. This study differentiates between the COVID-19 pandemic era and the period preceding it, considering the day the state of emergency was declared in Spain (ie, March 12, 2020) as the cut-off point. It also differentiates between eConsulta users who send messages and those who only receive them.

RESULTS

During the pandemic, the number of unique users of this teleconsultation service had almost tripled, with up to 33.10 visits per 1000 inhabitants per month reported in the first three months. For the two user profiles analyzed, most users since the start of the COVID-19 outbreak were predominantly female, systematically younger, more actively employed, and with less complex pathologies. Furthermore, eConsulta users received more messages proactively from the health professionals. There was also a relative decrease in the number of conversations initiated by higher-income urban users and an increase in conversations initiated by users in rural areas.

CONCLUSIONS

The COVID-19 pandemic has helped to generalize the use of telemedicine as a tool to compensate, to some extent, for the decline in face-to-face visits, especially among younger citizens in Catalonia. Telemedicine has made it possible to maintain contact between citizens and the health care system in the context of maximum complexity.
Correction: Effects of COVID-19 Emergency Alert Text Messages on Practicing Preventive Behaviors: Cross-sectional Web-Based Survey in South Korea (Preprint)
Authors: Lee Minjung , You Myoungsoon
Published: March 2021

UNSTRUCTURED

Sending emergency messages via mobile phone text messaging can be a promising communication tool to rapidly disseminate information and promote preventive behavior among the public during epidemic outbreaks. The battle to overcome COVID-19 is not yet over; thus, it is essential that the public practices preventive measures to prevent the spread of COVID-19. This study aimed to investigate the effectiveness of reading and obtaining information via emergency alert SMS text messages and their effects on the individual's practice of preventive behaviors during the early stages of the COVID-19 outbreak in South Korea. A cross-sectional web-based survey comprising 990 participants was conducted over 3 days (March 25-27, 2020). A multivariable logistic regression analysis revealed the sociodemographic factors that might influence the behavior of reading emergency alert text messages. A hierarchical linear regression model estimated the associations between reading emergency alert text messages for each precautionary behavior practiced against COVID-19. Additionally, the indirect effects of reading the text messages on each precautionary behavior via psychological factors (ie, perceived risk and response efficacy) were calculated. All data were weighted according to the 2019 Korea census data. Overall, 49.2% (487/990) of the participants reported that they always read emergency alert text messages and visited the linked website to obtain more information. Factors such as female sex (odds ratio [OR] 1.68, 95% CI 1.28-2.21) and older age (30-39 years: OR 2.02, 95% CI 1.25-3.28; 40-49 years: OR 2.84, 95% CI 1.80-4.47; 50-59 years: OR 3.19, 95% CI 2.01-5.06; 60 years and above: OR 3.12, 95% CI 2.00-4.86 versus 18-29 years) were identified to be associated with a higher frequency of reading the text messages. Participants who always read the text messages practiced wearing facial masks (β=.074, P=.01) more frequently than those who did not. In terms of social distancing, participants who reported they always read the text messages avoided crowded places (β=.078, P=.01) and canceled or postponed social gatherings (β=.103, P<.001) more frequently than those who did not read the text messages. Furthermore, reading text messages directly and indirectly affected practicing precautionary behaviors, as the mediation effect of response efficacy between reading text messages and practicing preventive behaviors was significant. Our findings suggest that emergency alert text messages sent to individuals' mobile phones are timely and effective strategies for encouraging preventive behavior in public. Sending emergency alert text messages to provide the public with accurate and reliable information could be positively considered by the health authorities, which might reduce the negative impact of infodemics.
Pool Testing as a Strategy for Prevention of SARS-CoV-2 Outbreaks in Schools: Protocol for a Feasibility Study (Preprint)
Authors: Sweeney-Reed Catherine M , Wolff Doreen , Niggel Jakob , Kabesch Michael , Apfelbacher Christian
Published: March 2021

BACKGROUND

School closures are a widely implemented strategy for limiting infection spread in the current COVID-19 pandemic. The negative impact of school closures on children and young people is increasingly apparent, however.

OBJECTIVE

We aim to evaluate the feasibility of an infection monitoring program in schools to enable targeted quarantining to replace school closures. The program is currently being implemented in two model schools in Magdeburg, Germany, within the framework of the Study of Coronavirus Outbreak Prevention in Magdeburg Schools (Studie zur Ausbruchsvermeidung von Corona an Magdeburger Schulen [STACAMA]).

METHODS

Five pupils per class are pseudorandomly selected twice a week and asked to provide a gargle sample over a 16-week evaluation period. RNA is extracted from each sample individually in a laboratory and pooled according to school class for real-time reverse transcription polymerase chain reaction (rRT-PCR) analysis. Immediate individual sample testing will be carried out in the case of a positive pool test. Individual RNA extraction prior to pooling and application of rRT-PCR result in high test sensitivity. Testing will be performed in strict adherence to data protection standards. All participating pupils will receive a 16-digit study code, which they will be able to use to access their test

RESULTS

When the study commenced on December 2, 2020, 520 (52%) pupils and their families or guardians had consented to study participation. The study was suspended after four test rounds due to renewed school closures resulting from rising regional infection incidence. Testing resumed when schools reopened on March 8, 2021, at which time consent to participation was provided for 54% of pupils. We will quantitatively and qualitatively evaluate the logistics and acceptability of the program.

CONCLUSIONS

The findings from this study should inform the design of infection surveillance programs in schools based on gargle samples and a PCR-based pool testing procedure, enabling the identification of aspects that may require adaptation before large-scale implementation. Our focus on each step of the logistics and on the experiences of families should enable a robust assessment of the feasibility of such an approach.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/28673