bluuebunny/crossref_metadata_2025 huggingface dataset:
PELATIHAN PEMBUATAN MEDIA PEMBELAJARAN INOVATIF 2D KOMIK DALAM MENGHADAPI TUNTUTAN PEMBELAJARAN KETERAMPILAN ABAD 21 DI MTS AHMAD YANI JABUNG KABUPATEN MALANG
Authors: Utomo Ardika Riski Pranoto , Azizah Zhazha Lutfi , Hidajati Hidajati , Untari Sri
Published: January 2024

Tujuan kegiatan ini memberikan pelatihan pembuatan media pembelajaran inovatif 2D komik untuk menghadapi tuntutan pembelajaran keterampilan abad 21. Jumlah peserta pelatihan ada 20 orang guru, mewakili setiap bidang mata pelajaran. Metode kegiatan PKM yaitu: (1) Sosialisasi pelatihan media pembelajaran inovatif 2D komik, (2) Persiapan perangkat teknologi, (3) Pelatihan media pembelajaran inovatif 2D komik, (4) Monitoring dan Evaluasi pelatihan. Hasil kegiatan pelatihan ini, para guru di MTs Ahmad Yani Jabung yang pada awalnya hanya menggunakan media pembelajaran buku dalam mengajar sudah mampu membuat media pembelajaran 2D komik sebagai media pembelajaran yang inovatif bagi peserta pelatihan. Media pembelajaran 2D komik ini nantinya diimplementasikan oleh guru pada kegiatan pembelajaran di semester Ganjil Tahun Pelajaran 2023/2024.Kata kunci: media, pembelajaran, komik
IMPLEMENTASI KEBIJAKAN PEMERINTAH KABUPATEN JEPARA DALAM PEMULIHAN USAHA MIKRO, KECIL DAN MENENGAH PADA MASA PANDEMI COVID-19 TAHUN 2020
Authors: Rindhoillah Fahmi Putra , Ni'am Harun
Published: January 2024

Pandemi Covid-19 tahun 2020 menciptakan kondisi dimana Usaha Mikro Kecil dan Menengah (UMKM) di Kabupaten Jepara yang mengalami dampak yang serius. Ada dua kebijakan yang dijalankan oleh Pemerintah Kabupaten Jepara melalui Dinas Koperasi, Usaha Kecil Menengah, Tenaga Kerja dan Transmigrasi Kabupaten Jepara, yaitu penyaluran Bantuan bagi Pelaku Usaha Mikro (BPUM) dan melaksanakan beberapa pelatihan. Tujuan penelitian ini ialah untuk mengetahui implementasi kebijakan Pemerintah Kabupaten Jepara dalam memulihkan UMKM pada saat pandemi Covid-19 tahun 2020. Jenis penelitian ini adalah penelitian kualitatif. Pengambilan data menggunakan metode dokumentasi dan wawancara. Penelitian ini menggunakan teori implementasi kebijakan George C. Edward III yang memiliki empat indikator yaitu komunikasi, sumber daya, disposisi dan struktur birokrasi. Dari Analisa dengan teori tersebut dapat disimpulkan bahwa implementasi yang dijalankan sudah dilakukan secara transparan tapi kurang merata yang dipengaruhi oleh faktor pendukung dan faktor penghambat. Kata Kunci: Implementasi Kebijakan, UMKM, Covid-19, Jepara
PENERAPAN PEMASARAN DIGITAL PADA UMKM KEMPLANG DI DESA PEMULIHAN ULU
Authors: Helmi Sulaiman , Anggela Nova , Trisninawati Trisninawati
Published: January 2024

Minimnya penerapan strategi pemasaran digital di platform Marketplace Facebook, yang menjadi tantangan bagi UMKM, terutama UMKM Kemplang, dalam memperluas jangkauan pasar. Tujuannya adalah meningkatkan pemahaman dan penerapan strategi pemasaran digital bagi UMKM Kemplang Desa Pemulutan Ulu melalui kegiatan penyuluhan, pelatihan, dan bantuan langsung dalam membuat akun Marketplace Facebook serta strategi pemasaran online. Metode penelitian meliputi observasi awal untuk menilai pemahaman masyarakat, penyuluhan untuk meningkatkan kesadaran dan keterampilan pelaku usaha, serta pelatihan praktis dalam pemanfaatan Marketplace Facebook. Hasilnya mencakup langkah-langkah konkret, mulai dari pembuatan logo, desain label kemasan yang lebih menarik, hingga pelatihan langsung tentang pemanfaatan Marketplace Facebook. Diharapkan, hasil ini mampu meningkatkan penjualan produk UMKM Kemplang, memperluas pasar secara online, dan mengedukasi konsumen terhadap produk lokal tersebut
DESTINATION IMAGE DAN PLACE ATTACHMENT SEBAGAI ANTESEDEN DESTINATION LOYALTY WISATAWAN PANTAI PANGANDARAN JAWA BARAT
Authors: Hardiansyah Hardiansyah , Ernawadi Yadi
Published: January 2024

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh destination image terhadap destination loyalty yang dimediasi oleh place attachment wisatawan Pantai Pangandaran Kabupaten Pangandaran. Sebanyak 120 responden yang berpengalaman mengunjungi Pantai Pangandaran berpartisipasi dalam penelitian ini. Metode cross-sectional atau one shot digunakan untuk mendapatkan data. Instrumen penelitian ini dinyatakan lolos uji validitas dan reliabilitas. Teknik analisis data yang digunakan adalah structural equation modelling (SEM) dengan menggunakan tool SmartPLS versi 3.0. Dari tujuh hipotesis penelitian yang diusulkan, semua hipotesis didukung oleh data empiris. Hasil peneltian ini menunjukan bahwa destination image berpengaruh positif terhadap destination loyalty yang dimediasi oleh place attachment. Penambahan variabel place attachment sebagai anteseden dari destination loyalty merupakan pengembangan dari model kenseptual pada penelitian sebelumnya.
THE INFLUENCE OF SERVICE QUALITY, ENTRANCE TICKET PRICE, AND FACILITIES ON VISITOR SATISFACTION AT TIRTA CITAPEN SWIMMING POOL TOURISM, PURWADADI, SUBANG DISTRICT
Authors: Basri Anindita Imam , Rosita Tita
Published: January 2024

Based on the phenomena that occur, the increasing number of tours in Subang Regency, West Java, therefore there is a need for a strategy to survive, namely visitor satisfaction. This study aims to determine the effect of service quality, entrance ticket prices and facilities on tourist visitor satisfaction at the Tirta Citapen Swimming Pool, Purwadadi, Subang Regency. The population in this study is all visitors who have visited the Tirta Citapen Swimming Pool tour. The sample in this study were 80 respondents. Data analysis used in this study is multiple linear regression. The results of this study indicate that service quality, entrance ticket prices, and facilities have a positive and significant effect on visitor satisfaction. The influence of quality, service, price of admission, and facilities has an effect of 66.8 % . Shows that the three hypotheses are accepted, and together they have an influence on visitor satisfaction.
THE EFFECT OF WORKLOAD, WORK ENVIRONMENT AND MOTIVATION ON EMPLOYEE PERFORMANCE AT PT KEJAR JEMBER
Authors: Sugiarto Riski , Hidayah Tamriatin , Sauqi Ahmad
Published: January 2024

This study aims to determine and analyze the effect of workload, physical work environment, and motivation partially or simultaneously on the performance of PT Kejar Jember employees. The respondents of this research were 38 employees of PT Kejar Jember which were determined by a census technique. The data analysis method used is multiple linear regression analysis. The results showed that the workload affected the performance of the employees of PT Kejar Jember. The workload which consists of working conditions, use of time and targets to be achieved is perceived as high by employees so employees must be able to manage the workload to produce a good performance. The physical work environment affects the performance of PT Kejar Jember employees. The work environment which consists of lighting/lighting, documentation, space, room coloring, air temperature, noise, and work safety is perceived by employees as good so that employees can produce a good performance by company expectations. Motivation affects the performance of PT Kejar Jember employees. Motivation consisting of encouragement to achieve goals, morale, initiative, and a sense of responsibility is perceived well by employees so that employees can strive to achieve work results by company targets.
RANCANG BANGUN SISTEM INFORMASI PENJUALAN GAS LPG 3 KG DI PT. NAFA ENERGI INDONESIA BOTOLINGGO, BONDOWOSO
Authors: Fitriana Dewi Alfien , Ghozali R.M , Budiono Karim
Published: January 2024

Sales of 3 kg LPG gas at the LPG gas base PT. Nafa Energi Indonesia, sub agent of PT. Pertamina Patra Niaga which sells subsidized gas from the government. Today, information systems are essential for everything, including business. Information systems are designed and implemented to meet the internal and external needs of an organization or company. The sales information system will be built using the MySQL DBMS. The reasons for the authors to conduct research at PT. Nafa Energi Indonesia in the Administrative Staff section, because the authors found several weaknesses, namely the LPG gas base PT. Nafa Energi Indonesia uses media that is still manual. Methods of data collection through observation, interviews, documentation and literature studies. The design method starts with making context diagrams, DFD, flowcharts, and ERD with the help of supporting applications, namely XAMPP, PHP, MySQL, and databases. The resulting output is an online information system for reporting company sales transactions at PT. NAFA ENERGY INDONESIA.
ANALISIS DAYA TARIK WISATA, HARGA, PROMOSI, FASILITAS WISATA, DAN KUALITAS PELAYANAN TERHADAP MINAT BERKUNJUNG KEMBALI WISATAWAN OBJEK WISATA JEMBER MINI ZOO
Authors: Miastita Alit , Hidayah Tamriatin , Maspufah Hayatul
Published: January 2024

This study aims to determine and analyze the effect of tourist attraction, promotion, price, tourist facilities, and service quality on tourists' intention to return to the Jember Mini Zoo tourist attraction. The research method used is quantitative method with descriptive research type. The samples taken in this study were 60 respondents. The sampling technique used was purposive sampling and the data analysis technique used was multiple linear regression analysis, with the help of the SPSS 25 analysis tool. Data collection method using a questionnaire. The results of this study indicate that tourist attraction and service quality have a positive and significant effect on tourists' intention to return to the Jember Mini Zoo tourist attraction, while promotions, prices and service facilities have a positive but not significant effect on tourists' intention to return to tourist attractions. Jember Mini Zoo and simultaneously (simultaneously) have a positive and significant effect on tourists' interest in revisiting the Jember Mini Zoo tourist attraction.
STRATEGI PEMASARAN BISNIS KULINER NASI KULIT PAS KANTONG DI KOTA JEMBER MENGGUNAKAN INFLUENCER MELALUI MEDIA SOSIAL INSTRAGRAM
Authors: Leonardo Wiyanto Nico , Amin Saiful , Sauqi Ahmad
Published: January 2024

This research was conducted to analyze, know, describe and also examine marketing strategies using influencer services from Nasi Kulit Pas Kantong. This research uses a qualitative narrative study approach where after we analyze the existing data, we retell the facts in the field narratively. The results of this study show that using marketing strategies through influencer services through Instagram has proven to increase sales volume and reach a wider range of consumers from the Nasi Kulit Pas Kantong Culinary Business. In addition, there are also supporting and inhibiting factors for Nasi Kulit Pas Kantong Culinary Business in marketing products using influencers through Instagram social media. Based on this research, researchers provide solutions to the owner of the Nasi Kulit Pas Kantong culinary business to overcome inhibiting factors in using marketing strategies through influencers via social media Instagram.
STRATEGI KEPALA SEKOLAH DALAM MENINGKATKAN MUTU SUMBER DAYA MANUSIA DI PASCA PANDEMI COVID-19 SMK ISLAM BUSTANUL ULUM PAKUSARI
Authors: Putri Yuliana Setia , Sulaksono Hary , Salim Helmi Agus
Published: January 2024

This research the Principal's Strategy in Improving the Quality of Human Resources in the Post-Covid 19 Pandemic at Bustanul Ulum Pakusari Islamic Vocational School, the objectives of this study are 1) to find out the principal's strategy during the Covid 19 pandemic at IBU Vocational School. 2) to find out the principal's strategy in improving human resource management during a pandemic at IBU Vocational School. 3) to find out the inhibiting factors and supporting factors for school principals in improving human resources during the covid pandemic at SMK IBU. The method used is descriptive method in the form of spoken or written words from the observed people or actors, with a qualitative approach. Data collection techniques used are interview techniques, observation and documentation. The subjects in this study consisted of school principals and teachers. The results of this study suggest that the principal's strategy in improving the quality of human resources has been well implemented. Because the principal cannot be separated from providing motivation and coaching to teachers. This can be seen in terms of teacher performance and tasks carried out from time to time. The inhibiting factors and supporting factors for improving the quality of human resources at the Islamic Vocational School of Bustanul Ulum are infrastructure facilities that are getting better than before, while the inhibiting factors (weaknesses and challenges) of school principals in improving the quality of human resources in post-covid 19 are students who are under the auspices of the pesantren because most of the students of the Bustanul Ulum Islamic Vocational School are santri which are not allowed to use or bring cell phones into the pesantren because it is regulated in the pesantren regulations.
PENGARUH E-SERVICE QUALITY, HARGA, KEPERCAYAAN DAN KUALITAS INFORMASI TERHADAP KEPUTUSAN PEMBELIAN TIKET KERETA API MELALUI APLIKASI KAI ACCESS DI KABUPATEN JEMBER
Authors: Wulandari Vivin Santika , Dimyati Muhaimin , Maspufah Hayatul
Published: January 2024

This study aims to examine the effect of E-Service Quality, Price, Trust and Information Quality on the Decision to Purchase Train Tickets Through the KAI Access Application in Jember Regency. Research data obtained from distributing questionnaires with purposive sampling technique. This type of quantitative research. The samples used were ITS Mandala students, University of Jember, and Jember State Polytechnic of 111 respondents. The results of the study show that E-Service Quality partially influences the decision to purchase train tickets through KAI Access. Prices partially affect the decision to purchase train tickets through KAI Access. Trust partially influences the decision to purchase train tickets through KAI Access. The quality of information partially influences the decision to purchase train tickets through KAI Access. While the results of the calculation of simultaneous test statistics, it was concluded that E-Service Quality, Price, Trust and Information Quality simultaneously had a positive and significant effect on Purchase Decision. and the coefficient of determination (60.8%). This means (E-Service Quality, Price, Trust and Quality of Information) is able to explain the variation of the Purchase Decision of 60.8%. The remaining 39.2% is explained by other variables outside the research.
PENGARUH BRANDING, PROMOSI DAN EDUKASI TERHADAP KEPUTUSAN BERWISATA DI IJEN GEOPARK KABUPATEN BONDOWOSO TERHADAP PERAN STAKEHOLDER SEBAGAI VARIABEL INTERVENING
Authors: Arifin Zainal , Sulaksono Hary , Hidayah Tamriatin , Hasan Zainul
Published: January 2024

This research examines the influence of branding, promotion and education on tourism decisions in the Ijen Geopark, Bondowoso Regency through the role of stakeholders as intervening variables. The respondents used in this research were 113 tourists who had visited Ijen Geopark in the Bondowoso area using descriptive quantitative research methods with a path analysis approach. Research reveals that promotion and education have a direct influence on travel decisions, as does the role of stakeholders. Branding and promotion influence travel decisions through the role of stakeholders, while the influence of education has an influence on travel decisions through the role of stakeholders. This finding has important implications in the development of Ijen Geopark, that in tourism development, the role of stakeholders has a very important role.
PENGARUH CORPORATE SOCIAL RESPONSIBILITY, PROFITABILITAS, STRUKTUR KEPEMILKAN, DAN KINERJA LINGKUNGAN TERHADAP NILAI PERUSAHAAN
Authors: Khomariyah Khomariyah , Astuti Diana Dwi , Rachmawati Lia
Published: January 2024

Penelitian ini bertujuan untuk menganalisis pengaruh corporate social responsibility, profitabilitas, struktur kepemilikan, dan kinerja lingkungan terhadap nilai perusahaan. Populasi dalam penelitian ini adalah perusahaan sektor basic materials yang terdaftar di Bursa Efek Indonesia tahun 2018-2022. Teknik pengambilan sampel yang digunakan dalam penelitian ini yaitu purposive sampling dan diperoleh sebanyak 49 perusahaan. Metode analisis data yang digunakan yaitu Analisis Regresi Linear Berganda. Hasil penelitian menunjukkan Profitabilitas yang diproksikan dengan Retrun On Assets, Struktur kepemilikan yang diproksikan dengan dengan kepemilikan manajerial secara parsial berpengaruh terhadap nilai perusahaan, sedangkan corporate social responsibility yang diproksikan dengan CSRIJ, struktur kepemilikan yang diproksikan dengan kepemilikan institusional, kinerja lingkungan yang diproksikan dengan PROPER secara parsial tidak berpengaruh terhadap nilai perusahaan. Namun secara simultan menunjukkan bahwa corporate social responsibility, profitabilitas, struktur kepemilikan, dan kinerja lingkungan berpengaruh terhadap nilai perusahaan.
Bringing Communities Together: Mapping the Investigation-Study-Assay-Model (ISA) to Fast Healthcare Interoperability Resources (FHIR)
Authors: Klopfenstein Sophie A.I. , Sass Julian , Vorisek Carina N. , Jorczik Felix , Schmidt Carsten Oliver , Löbe Matthias , Golebiewski Martin , Abaza Haitham , Thun Sylvia
Published: January 2024

Adhering to FAIR principles (findability, accessibility, interoperability, reusability) ensures sustainability and reliable exchange of data and metadata. Research communities need common infrastructures and information models to collect, store, manage and work with data and metadata. The German initiative NFDI4Health created a metadata schema and an infrastructure integrating existing platforms based on different information models and standards. To ensure system compatibility and enhance data integration possibilities, we mapped the Investigation-Study-Assay (ISA) model to Fast Healthcare Interoperability Resources (FHIR). We present the mapping in FHIR logical models, a resulting FHIR resources’ network and challenges that we encountered. Challenges mainly related to ISA’s genericness, and to different structures and datatypes used in ISA and FHIR. Mapping ISA to FHIR is feasible but requires further analyses of example data and adaptations to better specify target FHIR elements, and enable possible automatized conversions from ISA to FHIR.
Structured Queries to AQL: Querying OpenEHR Data Leveraging a FHIR-Based Infrastructure for Federated Feasibility Queries
Authors: Rosenau Lorenz , Ingenerf Josef
Published: January 2024

In digital healthcare, data heterogeneity is a reoccurring issue caused by proprietary source systems. It is often overcome by utilizing ETL processes resulting in data warehouses, which ensure common data models for interoperability. Unfortunately, the achieved interoperability is usually limited to an institutional level. The broad solution space to achieve interoperability with different health data standards is part of the problem, resulting in different standards used at various institutions. For cross-institutional use cases like federated feasibility queries, the issue of heterogeneity is reintroduced. This work showcases how the existing German infrastructure for federated feasibility queries based on Hl7 FHIR can be extended to support openEHR without further data transformation. By utilizing an intermediate query format that can be transferred to FHIR Search, CQL, and AQL.
A High-Fidelity Combined ATC-Rxnorm Drug Hierarchy for Large-Scale Observational Research
Authors: Ostropolets Anna , Talapova Polina , De Wilde Marcel , Abedtash Hamed , Rijnbeek Peter , Reich Christian G.
Published: January 2024

Observational research utilizes patient information from many disparate databases worldwide. To be able to systematically analyze data and compare the results of such research studies, information about exposure to drugs or classes of drugs needs to be harmonized across these data. The NLM’s RxNorm drug terminology and WHO’s ATC classification serve these needs but are currently not satisfactorily combined into a common system. Creating such system is hampered by a number of challenges, resulting from different approaches to representing attributes of drugs and ontological rules. Here, we present a combined ATC-RxNorm drug hierarchy, allowing to use ATC classes for retrieval of drug information in large scale observational data. We present the heuristic for maintaining this resource and evaluate it in a real world database containing drug and drug classification information.
An ICD for the Digital World: What Does the ICD-11 Research Show?
Authors: Fenton Susan H. , Stanfill Mary H. , Giannangelo Kathy
Published: January 2024

The 11th revision of the International Classification of Diseases (ICD) is now available for use. A literature search was conducted to review and summarize the research conducted to date. In addition to the ease of integration into electronic health records using standard digital tools such as uniform resource identifiers and application programming interfaces, ICD-11 and the World Health Organization provided linearization for mortality and morbidity, ICD-11-MMS, promise improved backward compatibility to ICD-10; increased availability in multiple languages; greater detail for clinical use, including traditional Chinese medicine; and enhanced maintenance for continued relevance. The studies reviewed here support the superior content and utility of ICD-11-MMS. Meaningful planning for implementation has begun, including the provision of a framework. It is time for the world to adopt a digitally prepared ICD.
Integrating a Categorial Structure for Clinical Practice into EHRs
Authors: Hovenga Evelyn J.S.
Published: January 2024

A continuing global desire to be using clinical systems within a digital health ecosystem, able to facilitate data flows and information exchange as required to support person-centred, predictive, preventative, participatory and precision (5p) health and medical care can best be supported through the use of the standard categorial structure able to represent not only the clinical nursing practice domain but also other clinical disciplines by the generic labelling of some high-level categories. It is hypothesised that adoption of this generic clinical categorial structure within any electronic health/medical record within a well connected digital health ecosystem, supported by a cloud based openEHR platform, will enable the 5p support to be realized. This presentation provides the results of the latest update of this technical standard based on the 20+ year nursing practice categorial structure development process adopted to achieve this aim and a summary about linking this categorial structure to standard terminologies and to standard EHR/EMR system architectures.
Setting the Scene to Link SNOMED CT to Realism-Based Ontologies
Authors: Pengput Anuwat , Ceusters Werner
Published: January 2024

In a proof of concept study, we assessed the feasibility of designing a first-order logic (FOL) framework capable of translating SNOMED CT’s terminological view on patient data as referencing concepts, into the realism-based view of the Basic Formal Ontology and the Ontology for General Medical Science according to which patient data represent instances of types. Because within the subject domain of this study, SNOMED CT’s terminological coverage was excellent, and its EL++ axioms can be automatically translated into FOL as well as the antecedent part of bridging axioms between SNOMED CT and realism-based ontologies, we conclude that this is an area of R&D that deserves further attention and that may lead to new ways of federating terminologies with ontologies.
Improving Waiting Time for Chemotherapy with Ahead-of-Time Drug Preparation
Authors: Descalzo Juan Marcos , Frutos Eliana Ludmila , Castro Javier , Lombardo Victoria Regia , Gimenez Cintia , Otero Paula , Luna Daniel , Otero Carlos
Published: January 2024

Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.
Development and Usage Patterns of a Home-Grown Drug Information Tool
Authors: Torrens Pierina , Verdinelli Julian , Rubin Luciana , Binder Fernando , Diaz Soledad , Gambarte Laura , Avila Pilar , Luna Daniel
Published: January 2024

Drug information tools help avoid medication errors, a common cause of avoidable harm in health care systems. We sought to describe the design, development process and architecture of an electronic drug information tool, as well as its overall use by health professionals. We developed a tool that can be accessed by all health professionals in a tertiary level university hospital. The functionalities of eDrugs are organized into two main parts: Drug Summary sheet, and Prescription Simulator. Most users accessed eDrugs to use the Drug summary sheet. Clinical information and antimicrobial drugs were the most accessed drug information and drug group. The analysis of log data provides insights into the information priorities of health professionals.
Feasibility of Utilizing Electronic Dental Record Data and Periodontitis Case Definition to Automate Diagnosis
Authors: Patel Jay , Shin Daniel , Willis Lisa , Zai Ahad , Thyvalikakath Thankam
Published: January 2024

Periodontitis is an irreversible disease leading to tooth loss, and 42% U.S. population suffers from periodontitis. Hence, diagnosing, monitoring, and determining its prevalence is critical to develop preventive strategies. However, a nationwide epidemiological study estimating the prevalence reported a concern about the discontinuation of such studies due to cost and ethical reasons. Therefore, this study determined the feasibility of utilizing electronic dental record (EDR) data and periodontitis case definition to automate periodontitis diagnosis. We utilized EDR data from the Indiana University School of Dentistry of 28,908 unique patients. We developed and tested a computer algorithm to diagnose periodontitis using the case definition. We found 44%, 22%, and 1% of patients with moderate, severe, and mild periodontitis, respectively. The algorithm worked with 100% sensitivity, specificity, and accuracy because of the excellent quality of the EDR data. We concluded the feasibility of providing automated periodontitis diagnosis from EDR data to conduct epidemiological studies across the US.
Digital Twins for More Precise and Personalized Treatment
Authors: Wickramasinghe Nilmini , Ulapane Nalika , Sloane Elliot B. , Gehlot Vijay
Published: January 2024

The use of Digital Twins (DTs) or the digital replicas of physical entities has provided benefits to several industry sectors, most notably manufacturing. To date, the application of DTs in the healthcare sector has been minimal, however. But, as pressure increases for more precise and personalized treatments, it behooves us to investigate the potential for DTs in the healthcare context. As a proof-of-concept demonstration prior to working with real patients, we attempt in this paper, to explore the potential for creating and using DTs. We do this in a synthetic environment at this stage, making use of data that is all computer-generated. DTs of synthetic present patients are created making use of data of synthetic past patients. In the real world, the clinical objective for creating such DTs of real patients would be to enable enhanced real-time clinical decision support to enable more precise and personalized care. The objective of the numerical experiment reported in this paper, is to envisage the possibilities and challenges of such an approach. We attempt to better understand the strengths and weaknesses of applying DTs in the healthcare context to support more precise and personalized treatments.
What-You-See-Is-What-You-Get Computer-Interpretable Guidelines: The Case of NoviGuide Neonatal
Authors: Danziger Elon , Muhindo Mary , Bress Joshua
Published: January 2024

Complex clinical decision support (CDS) that goes beyond representing simple clinical flowcharts to supporting the totality of a care encounter may help improve care quality and consistency. However, integrating a large volume of clinical guidelines applicable to a care encounter poses unique design and safety considerations. We present the visual and technical methods employed in developing NoviGuide, a platform for complex CDS. Assuring safe functioning required transparency of all outputs, which we achieved using a JSON formalism for capturing logic. Unlike raw computer code, logic-as-data can be presented clearly in context to non-informatician reviewers. Two different styles for visualizing CDS logic, random-access and narrative, support different review contexts. We assess the fitness of these solutions for encoding hundreds of neonatal-care guidelines into integrated multi-topic CDS.
Patient-Specific Mobile Phone-Generated Reminders and Quality of Hypertension Care in Western Kenya
Authors: Kirui Nicholas , Kamano Jemimah , Savai Simon , Misoi Lawrence , Rono Steven , Were Martin C.
Published: January 2024

To evaluate the impact of clinician-targeted mHealth-generated care suggestions on compliance with hypertension care guidelines in a resource-limited setting. This study was conducted in 10 rural health clinics in Western Kenya that offered hypertension care through nurses and clinical officers. Sites were grouped into intervention and control groups. Intervention group clinicians had patient-specific care suggestions triggered and displayed on a mobile application, mUzima, for their action. Care suggestions were also triggered in the mHealth application for control arm clinicians but were not displayed. Differences in compliance with hypertension care guidelines were evaluated. The study involved 378 patients with hypertension who had care suggestions generated during visits (217 in intervention group and 161 in control group). There was a higher proportion of adherence to hypertension care guidelines in the intervention group compared to the control group (91.1% vs. 85.7%, p=0.014). The random effects model showed significant variability in compliance rates among study clinicians (variance of 0.44, 95% CI: 0.12 -1.62). When displayed care suggestions were rejected by intervention providers, the most common reason given was ‘Previously ordered’ (58.8%). Clinicians felt that care suggestions improved awareness of hypertension care guidelines. The successful scaled implementation of mUzima with patient specific care suggestions led to higher adherence to hypertension care guidelines and improved quality of hypertension care. Tailormade m-Health applications in resource constrained settings for hypertension care and other chronic non-communicable diseases has the potential to lead to better adherence to care guidelines and quality of care.
Temporal Phenotyping for End-Stage Renal Disease Using Longitudinal Electronic Health Records
Authors: Chi Shengqiang , Wang Feng , Li Xueyao , Xu Minghong , Li Jingsong
Published: January 2024

End Stage Renal Disease (ESRD) is a highly heterogeneous disease with significant differences in prevalence, mortality, complications, and treatment modalities across age, sex, race, and ethnicity. An improved knowledge of disease characteristics results from the use of a data-driven phenotypic classification strategy to identify patients of different subtypes and expose the clinical traits of different subtypes. This study used topic models and process mining techniques to perform subtyping of ESRD patients on hemodialysis based on real-world longitudinal electronic health record data. The mined subtypes are interpretable and clinically significant, and they can reflect differences in the progression of the disease state and clinical outcomes.
Adapting an Environmental Scan for ‘Insights Reporting’: Learnings from an Online Brain Cancer Peer Support Platform
Authors: Burns Kara , Huckvale Kit , Borda Ann , Gilbert Cecily , Ferdous Hasan , Kalla Mahima , Chapman Wendy , Capurro Daniel
Published: January 2024

When developing a digital health solution, product owners, healthcare professionals, researchers, IT teams, and consumers require timely, accurate contextual information to inform solution development. Insights Reporting can rapidly draw together information from literature, end users and existing technology to inform the development process. This was the case when creating an online brain cancer peer support platform where solution development was conducted in parallel with contextual information synthesis. This paper discusses the novel adaptation of an environmental scan methodology using codesign and multiple layers of qualitative rigor, to create Insights Reporting. This seven-step process can be completed in two months and results in salient points of knowledge that can rapidly inform the design of a solution, creating a shared understanding of a digital health phenomenon. Project members noted that Insights Reporting surfaces previously inaccessible knowledge, catalyzes decision-making and allows all stakeholders to influence the report agenda, affirming principles of digital health equity.
Unscheduled Emergency Department Revisits Within 48 Hours of Discharge
Authors: Ratti María Florencia Grande , Martingano Ignacio , Otero Paula Daniela , Otero Carlos Martin , Farina Juan María , Rubin Luciana , Luna Daniel , Esteban Jorge Ariel , Pedretti Ana Soledad , Rodríguez María de la Paz , Cid Micaela Sanchez Del , Martínez Bernardo Julio
Published: January 2024

This study aimed to analyze early revisits (within 48 hours of discharge) in an Emergency Department. Among the 178,295 visits, 11,686 were revisits, resulting in a rate of 6.55% (95%CI 6.43-6.67). A total of 1,410 revisits required hospitalization, and 252 were due to preventable errors (17.87%). These errors were mainly related to an inadequate therapeutic plan at discharge (47.22%), an incomplete diagnostic process (29.37%), and misdiagnoses (13.10%). These findings represent a technology-enabled clinical audit tool. Electronic Healthcare Records have the potential to: provide quality metrics of hospital performance, help to keep revisit rates updated (assessment through a real-time dashboard), and improve clinical management (by transparency initiatives about errors, and a supportive learning environment regarding lessons learned).
Learning from Non-Routine Events and Teamwork in Intensive Care Units: Challenges and Opportunities
Authors: Gong Yang , Chen You
Published: January 2024

Patients admitted to intensive care units (ICUs) have profound and complex illnesses, often fraught with uncertainties in diagnoses, treatments, and care decisions. Clinicians often deviate from best practices to handle ICUs’ myriad complexities and uncertainties. Non-routine events (NREs), defined as any aspect of care perceived by clinicians as deviations from optimal care, are latent and frequent safety threats that, if left unchecked, can be precursors to adverse events. Proper identification and analysis of NREs that represent latent safety threats have been proposed as a feasible and more effective approach for performance improvement than traditional root cause analysis for patient safety events. However, NRE studies to date have yet to show the holistic picture of NREs in the contexts of teamwork and time-dependent tasks that are frequently associated with NREs. NREs, an upstream interventional area to understand root causes, team performance, and human-computer interaction, still needs to be expanded. This article presents concepts of NREs, and the use of real-world data (RWD) and informatics methodology to investigate NREs in contexts and discusses the opportunities and challenges to enhance NREs research in teamwork and time-dependent tasks.
The Health Innovation Series: Translating Research Evidence into Practice
Authors: Raban Magdalena Z. , Merchant Alison , Clay Chrissy , Fitzpatrick Erin , Westbrook Johanna I.
Published: January 2024

Electronic medication systems (EMS) improve medication safety in hospitals; however require modifications to optimize their performance. Drawing on a five-year program of research, we developed the Health Innovation Series to disseminate recommendations arising from our research to a wide audience. Each issue contains EMS optimization tips that can be actioned by EMS managers and system vendors, as well as user tips for health professionals including nurses, doctors and pharmacists. Five issues were released by 30 Nov 2022, via two email campaigns, with further issues planned. The five issues had 2,035 downloads by March 2023. The most recent email campaign open and click rates indicate very good audience engagement.
Development of Integrated Data Quality Management System for Observational Medical Outcomes Partnership Common Data Model
Authors: Oh Seol Whan , Ko Soo Jeong , Im Yun Seon , Jung Surin , Choi Bo Yeon , Kim Jae Yoon , Park Sunghyeon , Choi Wona , Choi In Young
Published: January 2024

The amount of research on the gathering and handling of healthcare data keeps growing. To support multi-center research, numerous institutions have sought to create a common data model (CDM). However, data quality issues continue to be a major obstacle in the development of CDM. To address these limitations, a data quality assessment system was created based on the representative data model OMOP CDM v5.3.1. Additionally, 2,433 advanced evaluation rules were created and incorporated into the system by mapping the rules of existing OMOP CDM quality assessment systems. The data quality of six hospitals was verified using the developed system and an overall error rate of 0.197% was confirmed. Finally, we proposed a plan for high-quality data generation and the evaluation of multi-center CDM quality.
The Viability and Acceptability of a Virtual Wound Care Command Centre in Australia
Authors: Barakat-Johnson Michelle , Kita Badia , Jones Aaron , Burger Mitchell , Airey David , Stephenson John , Leong Thomas , Pinkova Jana , Frank Georgina , Ko Natalie , Kirk Andrea , Frotjold Astrid , White Kate , Coyer Fiona
Published: January 2024

The objective of this study was to assess the viability and acceptability of an innovative Virtual Wound Care Command Centre where patients in the community, and their treating clinicians, have access to an expert wound specialist service that comprises a digital wound application (app) for wound analysis, decision-making, remote consultation, and monitoring. Fifty-one patients with chronic (42.6%) wounds were healed, with a median time to healing of 66 (95% CI: 56-88) days. All patients reported high satisfaction with their wound care, 86.4% of patients recommended the Virtual Wound Care Command Centre with 84.1% of patients reporting the app as easy to use. The data revealed that the Virtual Wound Care Command Centre was a viable and acceptable patient-centred expert wound consultation service for chronic wound patients in the community.
A Human-Centered Approach to Measuring the Impact of Evidence-Based Online Resources
Authors: Pinero De Plaza Maria Alejandra , Archibald Mandy , Lawless Michael , Ambagtsheer Rachel , McMillan Penelope , Mudd Alexandra , Freeling Michelle , Kitson Alison
Published: January 2024

Evidence-based online resources aim to combat vulnerabilities associated with health misinformation, evidence misalignment, and science illiteracy. Yet, it is a challenge to measure and demonstrate their impacts beyond looking at proxies for success (e.g., numbers of followers and likes). Addressing this gap, we introduce an emerging evaluation and verify its functionality in delivering optimal impact and sustainability measures for an evidence-based video resource on frailty.
LIV Well when Life Is Limited: Technology to Support Independence at Home
Authors: Kholghi Mahnoosh , Silvera David , Wong Glen , Walker Janine , Wilson Jennifer , Bradford DanaKai
Published: January 2024

There has been significant growth in technologies and services creating ‘care at home’ ecosystems for people with life-limiting conditions such as dementia. Dementia is one of the leading causes of disability and loss of independence that causes a heavy burden for families and caregivers. There is a clear need to support independent living of people living with dementia and their caregivers. Health technologies can help to foster supported living and social connection. The LIV app, developed by Miroma Project Factory and piloted in collaboration with CSIRO, was designed to achieve these aims. Here we describe the development and functionality of the app and present the preliminary findings from the pilot trial.
Introducing a Comprehensive Score of Systemic Anticancer Treatment Relevance
Authors: Zack Travis , Warner Jeremy L.
Published: January 2024

Treatment patterns in systemic anticancer therapy (SACT) are extremely varied and complex. While professional society guidelines exist that suggest recommended treatment strategies, these guidelines are produced through an extremely laborious and sometimes opaque manual process, making it impossible for such guidelines to cover all relevant treatment scenarios. To complement these manually curated guidelines, we leveraged a database of 5818 clinical trials and 7012 supporting references from 1943–present to calculate a quantifiable “relevance score”. In a pilot evaluation, this score was strongly associated with professional society guideline recommendations, while also providing relevance information on thousands of additional therapies. We show that this score also accurately illustrates trends in SACT adoption over time. We foresee that this score, which comprehensively evaluates the relevance of SACT overall and by cancer subtype, will have utility for clinical practitioners as well as researchers in real-world data.
The Impact of Social and Broadcast Media on Public Health Initiatives: Study of the COVID-19 Infodemics
Authors: Upadhyay Umashankar , Dhar Eshita , Bomrah Sherali , Huang Yarou , Uddin Mohy , Kabir Muhammad Ashad , Syed-Abdul Shabbir
Published: January 2024

The COVID-19 outbreak, declared a pandemic in March 2020, lacked specific treatments until vaccine development. Medication misinformation via media caused panic, self-prescription, and drug resistance. False propaganda led to shortages. This study analyzes Google Trends for hydroxychloroquine (HCQ), azithromycin, and BCG vaccine searches across six countries. US, Brazil, and India showed interest in HCQ, while Taiwan, Japan, and South Korea focused on BCG vaccine. This article aims to raise awareness of adverse drug reactions, cautioning against self-prescription, political assumptions, and social media during future emergencies.
Primary Healthcare Professionals’ Improvement Suggestions for the Patient Accessible Health Record
Authors: Muli Irene , Scandurra Isabella , Hägglund Maria
Published: January 2024

Patients’ online record access is a worldwide phenomenon, where Sweden is one of the pioneers in actual countrywide implementation. Healthcare professionals (HCPs) have previously raised usability issues with e-health systems and proposed several solutions, yet no studies have explored PAEHRs from this perspective. The aim of this study was to describe primary HCPs’ suggestions on how the Swedish online record could be improved. They (n=14) were asked what they would like to improve with the system to increase usability and usefulness for patients or for themselves. Suggestions covered expanding what patients could view, simplification of the service for both the patients and themselves, adding feedback functions, and limiting access to only signed records.
A New Role for Chatbots: Automation of a Sleep-Dependent Memory Task
Authors: Ireland David , Lam Aaron , Bradford DanaKai , Naismith Sharon
Published: January 2024

Sleep is known to contribute to memory consolidation. Sleep-dependent memory is not often studied in patients with mild cognitive impairment (MCI), however, due to the need to attend sleep laboratories which are typically expensive, time-consuming and lacking in trained task administrators. We developed a conversation agent able to deliver a sleep-dependent memory task at home. Utility of the chatbot was confirmed through in-house testing and focus groups. The chatbot promises consistent task delivery and improved access for people with MCI.
Effect of Step Count Measurement on Glycemic Control: Secondary Analysis of a Randomized Controlled Trial
Authors: Saito Ryo , Sze Wei Thing , Waki Kayo , Enomoto Syunpei , Yamauchi Toshimasa , Nangaku Masaomi , Ohe Kazuhiko
Published: January 2024

Although walking has proven efficacy for glycemic control, patients struggle to meet daily step goals. This secondary analysis investigated the effect of step count measurement rate on glycemic control. Patients with type 2 diabetes from eight hospitals in Japan participated in a 12-month randomized controlled trial. The intervention group received DialBetesPlus, a self-management support system that allowed patients to monitor step count using a pedometer. We divided the intervention group into two groups based on whether daily step count measurement rate (the percentage of days with pedometer use) increased or decreased during the last three months of the intervention (month 10-12), relative to the first three months of the intervention (month 1-3). Patients with a reduced measurement rate experienced a worsening in glycemic control, with between-group difference of 0.516% in the amount of change in HbA1c (p=0.012). We conclude that step count measurement may lead to a better glycemic profile.
Detection of Adverse Event Signals with Severity Grade Classification from Cancer Patient Narrative
Authors: Nishioka Satoshi , Asano Masaki , Yada Shuntaro , Aramaki Eiji , Yajima Hiroshi , Kizaki Hayato , Hori Satoko
Published: January 2024

Adverse event (AE) management is crucial to improve anti-cancer treatment outcomes, but it is reported that some AE signals can be missed in clinical visits. Thus, monitoring AE signals seamlessly, including events outside hospitals, would be helpful for early intervention. Here we investigated how to detect AE signals from texts written by cancer patients themselves by developing deep-learning (DL) models to classify posts mentioning AEs according to severity grade, in order to focus on those that might need immediate treatment interventions. Using patient blogs written in Japanese by cancer patients as a data source, we built DL models based on three approaches, BERT, ELECTRA, and T5. Among these models, T5 showed the best F1 scores for both Grade ≥ 1 and ≥ 2 article classification tasks (0.85 and 0.53, respectively). This model might benefit patients by enabling earlier AE signal detection, thereby improving quality of life.