bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating Sources of Inaccuracy in Wearable Optical Heart Rate Sensors (Preprint)
Authors: Bent Brinnae , Goldstein Benjamin , Kibbe Warren , Dunn Jessilyn
Published: May 2020

UNSTRUCTURED

As wearable technologies are being increasingly used for clinical research and healthcare, it is critical to understand their accuracy and determine how measurement errors may affect research conclusions and impact healthcare decision-making. Accuracy of wearable technologies has been a hotly debated topic in both the research and popular science literature. Currently, wearable technology companies are responsible for assessing and reporting the accuracy of their products, but little information about the evaluation methods is made publicly available. Heart rate measurements from wearables are derived from photoplethysmography (PPG), an optical method for measuring changes in blood volume under the skin. Potential inaccuracies in PPG stem from three major areas, including: 1) diverse skin types, 2) motion artifacts, and 3) signal crossover. To date, no study has systematically explored the accuracy of wearables across the full range of skin tones. Here, we explored heart rate and PPG data from consumer- and research-grade wearables under multiple circumstances to test whether and to what extent these inaccuracies exist. We saw no statistically significant difference in accuracy across skin tones, but we saw significant differences between devices, and between activity types, notably, that absolute error during activity was, on average, 30% higher than during rest. Our conclusions indicate that different wearables are all reasonably accurate at resting and prolonged elevated heartrate, but that differences exist between devices in responding to changes in activity. This has implications for researchers, clinicians and consumers in drawing study conclusions, combining study results, and making health-related decisions using these devices.
Infodemiological study on COVID-19 epidemic and COVID-19 infodemic (Preprint)
Authors: Hu Zhiwen , Yang Zhongliang , Li Qi , Zhang An , Huang Yongfeng
Published: May 2020

UNSTRUCTURED

Less aligned emphasis has been given to the COVID-19 infodemic coordinating with the COVID-19 outbreak. Global profusion of tangled monikers and hashtags has found their ways in daily communication and contributed to backlash against Chinese. Official naming efforts against infodemic should be meet with a fair share of identification. Based on brief critical reviews on previous multifarious naming practices, we punctuate heuristic introspection in scientific conventions and sociocultural paradigms. Infodemiological analysis promises to articulate that people around the globe are divided in their favor stigmatized monikers in the public and scientific communities because of perceptual bias. There is no positive correlation between the degree of infection in their territories and collective perceptual bias against COVID-19. The official portfolio “COVID-19” and “SARS-CoV-2” has not become de facto standard usages, but full-fledged official names are excepted to duly contribute to the resilience of negative perceptual bias and collective behavioral propensities amid public panic. As an integral component of preparedness, appropriate nomenclatures should be duly assigned to the newly identified coronavirus and caused respiratory tract disease in humans amid global public health crisis.
Measuring Earwax Cortisol Concentration Using a Non-Stressful Method (Preprint)
Authors: Herane-Vives Andrés
Published: May 2020

BACKGROUND

“Short-term” samples are not the most appropriate for reflecting Chronic Cortisol Concentration (CCC). Although hair is used for reflecting the systemic cortisol level over “long-term”, its use appears clinically problematic. Local stress and non-stress related factors may release a circumscribed cortisol secretion that is accumulated in hair. Non-stressful earwax extraction methods may provide a more accurate specimen to measure CCC.

OBJECTIVE

Correlate cortisol levels using hair, serum and earwax samples

METHODS

Earwax from both ears of 37 controls were extracted using a clinical procedure commonly associated with local pain. One month later, earwax from the left ear side was extracted using the same procedure, and earwax from the right ear side was comfortably extracted, using an earwax self-sampling device. Participants also provided one centimetre of hair that represented the retrospective month of cortisol output, and one serum sample that reflected the effect of systemic stressors on cortisol levels. Earwax (ECC), Hair (HCC) and Serum (SCC) Cortisol Concentration were correlated and compared. Confounders´ effect on cortisol levels were studied.

RESULTS

Serum showed the largest and hair the lowest cortisol concentration (p<0.01). Left-ECC was larger than Right-ECC (p=0.03). Right-ECC was the only sample unaffected by confounders (all p>0.05). Right-ECC and HCC showed the only significant association (r=0.39; p=0.03).

CONCLUSIONS

The self-sampling device did not represent a local stressor for the ceruminous glands. It provided the cortisol level with the least likely to be affected by confounding factors over the previous month. ECC using the novel device may constitute another accurate, but more suitable and affordable specimen for measuring CCC.
Cardiovascular disease in the literature: A selection of recent original research
papers (Preprint)
Authors: Hage Fadi
Published: May 2020

UNSTRUCTURED

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), has been declared a pandemic with devastating effects on the
entire world. Madjid et al. from the University of Texas Health Science, Houston, Texas review
current information on the virus and COVID-19 and its effects on the cardiovascular system.
Coronaviruses, classified in 4 groups, were first identified in humans in the 1960s with 4 types
(all from the α and β classes) are endemic in humans usually causing mild and self-limiting
upper respiratory infections accounting for 15-30% of common colds. Both SARS (caused by
SARS-CoV) and Middle East respiratory syndrome (MERS, caused by MERS-CoV) caused
outbreaks (in 2002 and 2012, respectively) that had higher fatality rates but were much less
widespread than COVID-19. SARS-CoV-2 is genetically more similar to SARS-CoV (82%) than
MERS-CoV (50%). The virus has a mean incubation period of 5.2 days (95%CI, 4.1-7.0 days),
with the 95th percentile of the distribution at 12.5 days according to one study and up to 14 days
according to another. The World Health Organization reported a global mortality rate of 3.4%
but importantly, this rate varies by location, intensity of transmission, variations of care,
presence of comorbidities (including cardiovascular disease), advanced age, and likely other
factors. The primary symptoms of COVID-19 are fever, cough, and shortness of breath. Acute
cardiac injury determined by elevated high-sensitivity troponin levels is commonly observed in
severe cases and is strongly associated with mortality, complications such as acute respiratory
distress syndrome, arrhythmia, renal injury, and coagulopathy. There has been reported cases of
viral infiltration of the myocardium causing myocarditis. Myocardial injury can also be caused
by ischemia. It is important to note that COVID-19 in addition to inducing new cardiac
pathologies (such as myocarditis) may also exacerbate pre-existing cardiovascular disease.
Finally, some of the investigational therapies for COVID-19 may have cardiovascular effects.
Current treatment, until investigational therapies have been shown to be effective, is supportive
care and treatment of complications. The article offers a wonderful review of current knowledge
on COVID-19 as well as a review of SARS and MERS which provide further insights on the
effects of coronaviruses on the cardiovascular system.
Respiration-averaged CT versus standard CT attenuation maps for
correction of 18F-NaF uptake on hybrid PET/CT (Preprint)
Authors: Slomka Piotr
Published: May 2020

UNSTRUCTURED

Purpose
To evaluate the impact of a respiratory averaged computed tomography attenuation
correction (RACTAC) instead of a standard single-phase computed tomography (CT)
attenuation correction (CTAC) map on the quantitative measures of coronary 18F-NaF
uptake in PET/CT.
Methods
This study comprised 23 patients who underwent 18F-NaF coronary PET in a hybrid
PET/CT system, employing 18F-NaF (250MBq). All patients had two CT scans, a standard
single-phase CTAC obtained during free-breathing, and a 4D cine-CT scan. From the
Cine-CT acquisition, RACTAC maps were obtained by averaging all images acquired
over 5 seconds. Two PET reconstruction protocols, one employing CTAC and another
employing RACTAC for attenuation correction were considered in this study. Following
reconstruction, the quantitative impact of employing RACTAC was assessed using
maximum target-to-background (TBRMAX) and coronary microcalcification activity (CMA).
Statistical differences were analyzed using reproducibility coefficients and Bland-Altman
plots.
Results
In 23 patients, we evaluated 34 coronary lesions using PET reconstructions utilizing
CTAC and RACTAC. There was good agreement between CTAC and RACTAC PET
reconstructions for TBRMAX (median [Interquartile range, IQR]: CTAC = 1.65[1.23-2.38],
RACTAC = 1.63[1.23-2.33], p=0.55), with coefficient of reproducibility of 0.18. The CMA
agreement was similar (median [IQR]: CTAC = 0.10 [0-1.0], RACTAC= 0.15[0-1.03],
p=0.55 with coefficient of reproducibility of 0.17
Conclusion
Employing RACTAC maps does not affect the quantification of the coronary 18F-NaF
uptake on PET/CT.
The peculiar transmissibility of Covid-19 points towards a potential Achilles Heel. (Preprint)
Authors: Magiorkinis Gkikas
Published: May 2020

UNSTRUCTURED

The outbreak of Covid-19 in Wuhan in late 2019-early 2020 initiated massive public health responses based on quarantines and contact tracing. Given the many uncertainties of Covid-19’s epidemiology, can we guestimate how likely are such measures to prevent the spread of the epidemic?
Exposure to Morning Sunlight/Ultraviolet B (UV-B) Radiations (290–320nm) Decreases the Risk of COVID-19: India (Preprint)
Authors: Khan Sharuk , Siddiqui Falak , Jain Shirish
Published: May 2020

UNSTRUCTURED

The novel coronavirus 2019-nCoV/SARS-CoV-2 that has caused the outbreak of the coronavirus disease, COVID-19, has created an alarming situation around the world, including India. Vitamin D is a hormone precursor that plays an important role in adaptive immunity, cellular differentiation, maturation, and proliferation of immune cells. The optimum level of vitamin D could be a potential lead to fight against SARS-CoV-2 infection. In the Indian subcontinent, Vitamin D deficiency prevails in wide-ranging proportions, with a prevalence of 70%–100%. Vitamin D produced in the skin by sunlight/ultraviolet B (UV-B) radiation (290–320nm) may last in the blood twice compared with supplementary vitamin D, wherein consuming vitamin D through supplementary source may lead to toxicity. Balancing vitamin D levels between normal ranges will be effective and cheap to control and/or to prevent respiratory tract infections (RTIs). Although, if we talk about India, it is challenging to provide vitamin D through the supplementary source to every individual, and also it will not be affordable for people of below poverty line (BPL). Therefore, the optimum level of vitamin D could be a potential lead to fight against SARS-CoV-2 infection, which could be achieved by proper exposure to sunlight (preferably in the morning) for 10-20 min daily.
COVID-19: Escape routes from the Symplegades of hygienic crisis and economic meltdown (Preprint)
Authors: Raptis Vasilios
Published: May 2020

UNSTRUCTURED

A source of difficulties in the fight against the COVID-19 pandemic, is an incubation period in the order of several days combined with a reproduction rate above two, resulting in fast growth that goes undetected and forces authorities to adopt measures heavily disruptive to the economy and societal life at large. Recent findings regarding the detection of SARS-CoVid-2 in sewage waste water, point to the possibility of setting up early warning systems accompanied by geographically focused preventive policies, to minimise hygienic threat without resorting to nationwide lockdowns. Simple network modelling suggests that such systems would be equally relevant in the mitigation phase; this is when sources of massive transmission (superspreaders, strong population inhomogeneities) can have a detrimental effect and literally turn gain into loss.
Web- and Artificial Intelligence–Based Image Recognition For Sperm Motility Analysis: Verification Study (Preprint)
Authors: Tsai Vincent FS , Zhuang Bin , Pong Yuan-Hung , Hsieh Ju-Ton , Chang Hong-Chiang
Published: May 2020

BACKGROUND

Human sperm quality fluctuates over time. Therefore, it is crucial for couples preparing for natural pregnancy to monitor sperm motility.

OBJECTIVE

This study verified the performance of an artificial intelligence–based image recognition and cloud computing sperm motility testing system (Bemaner, Createcare) composed of microscope and microfluidic modules and designed to adapt to different types of smartphones.

METHODS

Sperm videos were captured and uploaded to the cloud with an app. Analysis of sperm motility was performed by an artificial intelligence–based image recognition algorithm then results were displayed. According to the number of motile sperm in the vision field, 47 (deidentified) videos of sperm were scored using 6 grades (0-5) by a male-fertility expert with 10 years of experience. Pearson product-moment correlation was calculated between the grades and the results (concentration of total sperm, concentration of motile sperm, and motility percentage) computed by the system.

RESULTS

Good correlation was demonstrated between the grades and results computed by the system for concentration of total sperm (r=0.65, P<.001), concentration of motile sperm (r=0.84, P<.001), and motility percentage (r=0.90, P<.001).

CONCLUSIONS

This smartphone-based sperm motility test (Bemaner) accurately measures motility-related parameters and could potentially be applied toward the following fields: male infertility detection, sperm quality test during preparation for pregnancy, and infertility treatment monitoring. With frequent at-home testing, more data can be collected to help make clinical decisions and to conduct epidemiological research.
Rapid Implementation and Innovative Applications of a Virtual Intensive Care Unit During the COVID-19 Pandemic: Case Study (Preprint)
Authors: Dhala Atiya , Sasangohar Farzan , Kash Bita , Ahmadi Nima , Masud Faisal
Published: May 2020

BACKGROUND

The COVID-19 pandemic has necessitated a rapid increase of space in highly infectious disease intensive care units (ICUs). At Houston Methodist Hospital (HMH), a virtual intensive care unit (vICU) was used amid the COVID-19 outbreak.

OBJECTIVE

The aim of this paper was to detail the novel adaptations and rapid expansion of the vICU that were applied to achieve patient-centric solutions while protecting staff and patients’ families during the pandemic.

METHODS

The planned vICU implementation was redirected to meet the emerging needs of conversion of COVID-19 ICUs, including alterations to staged rollout timing, virtual and in-person staffing, and scope of application. With the majority of the hospital critical care physician workforce redirected to rapidly expanded COVID-19 ICUs, the non–COVID-19 ICUs were managed by cardiovascular surgeons, cardiologists, neurosurgeons, and acute care surgeons. HMH expanded the vICU program to fill the newly depleted critical care expertise in the non–COVID-19 units to provide urgent, emergent, and code blue support to all ICUs.

RESULTS

Virtual family visitation via the Consultant Bridge application, palliative care delivery, and specialist consultation for patients with COVID-19 exemplify the successful adaptation of the vICU implementation. Patients with COVID-19, who were isolated and separated from their families to prevent the spread of infection, were able to virtually see and hear their loved ones, which bolstered the mental and emotional status of those patients. Many families expressed gratitude for the ability to see and speak with their loved ones. The vICU also protected medical staff and specialists assigned to COVID-19 units, reducing exposure and conserving personal protective equipment.

CONCLUSIONS

Telecritical care has been established as an advantageous mechanism for the delivery of critical care expertise during the expedited rollout of the vICU at Houston Methodist Hospital. Overall responses from patients, families, and physicians are in favor of continued vICU care; however, further research is required to examine the impact of innovative applications of telecritical care in the treatment of critically ill patients.
Informatics management of tumor specimens in the era of Big Data: Challenges and solutions (Preprint)
Authors: Zhang Peifen , Zheng XiaoHui , Li XiZhao , Sun Lin , Jia WeiHua
Published: May 2020

UNSTRUCTURED

Biomedical data bears the potential to facilitate personalize diagnosis and precision treatment in the era of Big Data. Based on this, high-quality annotation of human specimens has become the primary mission of bio-bankers, especially for tumor bio-banks with large amounts of “omics” and clinical data. However, the lack of agreed-upon standardizations and the gap among heterogeneous databases make information application and communication a major challenge. International efforts are undergoing to develop national projects on informatics management. The aim of this paper is to provide references in data annotation and process to standardize and take full advantage of biomedical information. First, information categories that are vital for specimen applications, including sample attributes, external clinical and experimental data, are systematically listed to provide references for subsequent data mining. Second, commonly-used approaches in data collection, recording, extraction, transformation, integration and storage were summarized in support of data processes. In particular, a practical workflow of information annotation in daily bio-banking was drawn to help handling each step of the informatics management procedure. This review highlights the importance of informatics management of tumor specimens, presents the process of data standardization, and provides practical instructions for bio-bankers in specimen annotation and data management.
Evaluation of the Perceived Persuasiveness Questionnaire: User-Centered Card-Sort Study (Preprint)
Authors: Beerlage-de Jong Nienke , Kip Hanneke , Kelders Saskia Marion
Published: May 2020

BACKGROUND

eHealth technologies aim to change users’ health-related behavior. Persuasive design and system features can make an eHealth technology more motivating, engaging, or supportive to its users. The Persuasive Systems Design (PSD) model incorporates software features that have the possibility to increase the persuasiveness of technologies. However, the effects of specific PSD software features on the effectiveness of an intervention are still largely unknown. The Perceived Persuasiveness Questionnaire (PPQ) was developed to gain insight into the working mechanisms of persuasive technologies. Although the PPQ seems to be a suitable method for measuring subjective persuasiveness, it needs to be further evaluated to determine how suitable it is for measuring perceived persuasiveness among the public.

OBJECTIVE

This study aims to evaluate the face and construct validity of the PPQ, identify points of improvement, and provide suggestions for further development of the PPQ.

METHODS

A web-based closed-ended card-sort study was performed wherein participants grouped existing PPQ items under existing PPQ constructs. Participants were invited via a Massive Open Online Course on eHealth. A total of 398 people (average age 44.15 years, SD 15.17; 251/398, 63.1% women) completed the card sort. Face validity was evaluated by determining the item-level agreement of the original PPQ constructs. Construct validity was evaluated by determining the construct in which each item was placed most often, regardless of the original placement and how often 2 items were (regardless of the constructs) paired together and what interitem correlations were according to a cluster analysis.

RESULTS

Four PPQ constructs obtained relatively high face validity scores: perceived social support, use continuance, perceived credibility, and perceived effort. Item-level agreement on the other constructs was relatively low. Item-level agreement for almost all constructs, except perceived effort and perceived effectiveness, would increase if items would be grouped differently. Finally, a cluster analysis of the PPQ indicated that the strengths of the newly identified 9 clusters varied strongly. Unchanged strong clusters were only found for perceived credibility support, perceived social support, and use continuance. The placement of the other items was much more spread out over the other constructs, suggesting an overlap between them.

CONCLUSIONS

The findings of this study provide a solid starting point toward a redesigned PPQ that is a true asset to the field of persuasiveness research. To achieve this, we advocate that the redesigned PPQ should adhere more closely to what persuasiveness is according to the PSD model and to the mental models of potential end users of technology. The revised PPQ should, for example, enquire if the user thinks anything is done to provide task support but not how this is done exactly.
A serious game for listening-in-noise training in adults with cochlear implant: a randomized controlled trial. (Preprint)
Authors: Reynard Pierre , Attina Virginie , Barilly Claire , Joly Charles-Alexandre , Veuillet Evelyne , Thai-Van Hung
Published: May 2020

BACKGROUND

Adults with cochlear implants (CI) find listening-in-noise challenging even after prolonged experience. Personalized auditory training (AT) programs can be proposed to improve specific auditory skills in adults with CI.

OBJECTIVE

The objective was to evaluate the efficacy of a 5-week serious game-based intensive AT-in-noise-program in CI recipients on SNR for speech-in-noise. The secondary objective was to evaluate the benefits of this program over time by reassessing the trained group 5 weeks after the end of the AT.

METHODS

Thirty adults with post-lingual deafness and at least nine months of experience with CI were randomized to participate in a 5-week specific serious game-based intensive AT program (n=15) or a control group (n=15). The serious game-based training consisted of specific tasks that targeted auditory skills. All participants were tested at enrolment and at 5 weeks using the sentence recognition-in-noise Fr-Matrix test to determine the SNR at a speech reception threshold (SRT) of 70%. In addition, participants in the trained group were retested 5 weeks after the end of the training program.

RESULTS

Thirteen patients completed the training program and were tested pre- and post-training. The intensive 5-week auditory training-in-noise program was associated with an improvement of SNRs with SRT fixed at 70%, the gain induced after training was 4 dB SNR (15.5 dB and 11.5 dB before and after, respectively, p< 0.001). No significant changes in speech reception in noise scores after five weeks were observed in the non-trained group.

CONCLUSIONS

Listening-in-noise training, using an adapted serious game-based strategy, may improve auditory perception performance under adverse environmental conditions for adults with CI, and could thus contribute to the enhancement of their quality of life and maximize the benefits of their implants.

CLINICALTRIAL

Local ethic committee: CPP Sud-Est IV 14/034 ID RCB 2014-A00345-42

ClinicalTrials: NCT02323256
A Telemonitoring and Hybrid Virtual Coaching Solution “CAir” for Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Gross Christoph , Kohlbrenner Dario , Clarenbach Christian F , Ivankay Adam , Brunschwiler Thomas , Nordmann Yves , v Wangenheim Florian
Published: May 2020

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is one of the most common disorders in the world. COPD is characterized by airflow obstruction, which is not fully reversible. Patients usually experience breathing-related symptoms with periods of acute worsening and a substantial decrease in the health-related quality-of-life. Active and comprehensive disease management can slow down the progressive course of the disease and improve patients’ disabilities. Technological progress and digitalization of medicine have the potential to make elaborate interventions easily accessible and applicable to a broad spectrum of patients with COPD without increasing the costs of the intervention.

OBJECTIVE

This study aims to develop a comprehensive telemonitoring and hybrid virtual coaching solution and to investigate its effects on the health-related quality of life of patients with COPD.

METHODS

A monocentric, assessor-blind, two-arm (intervention/control) randomized controlled trial will be performed. Participants randomized to the control group will receive usual care and a CAir Desk (custom-built home disease-monitoring device to telemonitor disease-relevant parameters) for 12 weeks, without feedback or scores of the telemonitoring efforts and virtual coaching. Participants randomized to the intervention group will receive a CAir Desk and a hybrid digital coaching intervention for 12 weeks. As a primary outcome, we will measure the delta in the health-related quality of life, which we will assess with the St. George Respiratory Questionnaire, from baseline to week 12 (the end of the intervention).

RESULTS

The development of the CAir Desk and virtual coach has been completed. Recruitment to the trial started in September 2020. We expect to start data collection by December 2020 and expect it to last for approximately 18 months, as we follow a multiwave approach. We expect to complete data collection by mid-2022 and plan the dissemination of the results subsequently.

CONCLUSIONS

To our knowledge, this is the first study investigating a combination of telemonitoring and hybrid virtual coaching in patients with COPD. We will investigate the effectiveness, efficacy, and usability of the proposed intervention and provide evidence to further develop app-based and chatbot-based disease monitoring and interventions in COPD.

CLINICALTRIAL

ClinicalTrials.gov identifier: NCT04373070; https://clinicaltrials.gov/ct2/show/NCT04373070

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/20412
Exploring How Older Adults Use a Smart Speaker–Based Voice Assistant in Their First Interactions: Qualitative Study (Preprint)
Authors: Kim Sunyoung
Published: May 2020

BACKGROUND

Smart speaker–based voice assistants promise support for the aging population, with the advantages of hands-free and eyes-free interaction modalities to handle requests. However, little is known about how older adults perceive the benefits of this type of device.

OBJECTIVE

This study investigates how older adults experience and respond to a voice assistant when they first interact with it. Because first impressions act as strong predictors of the overall attitude and acceptability of new technologies, it is important to understand the user experiences of first exposure.

METHODS

We conducted semistructured interviews with 18 people 74 years and older who had never used a smart speaker before, investigating the patterns of use, usability issues, and perspectives that older adults have when using a voice assistant for the first time.

RESULTS

The overall first response to a voice assistant was positive, thanks to the simplicity of a speech-based interaction. In particular, a positive and polite response to complete the interaction with a voice assistant was prevalent, such as expressing gratitude or giving feedback about the quality of answers. Two predominant topics of commands made in the first interaction include asking health care–related questions and streaming music. However, most of the follow-up reactions were unfavorable because of the difficulty in constructing a structured sentence for a command; misperceptions about how a voice assistant operates; and concerns about privacy, security, and financial burdens. Overall, a speech-based interaction was perceived to be beneficial owing to its efficiency and convenience, but no other benefits were perceived.

CONCLUSIONS

On the basis of the findings, we discuss design implications that can positively influence older adults' first experiences with a voice assistant, including helping better understand how a voice assistant works, incorporating mistakes and common interaction patterns into its design, and providing features tailored to the needs of older adults.
Assessing the Performance of Clinical Natural Language Processing Systems: Development of an Evaluation Methodology (Preprint)
Authors: Canales Lea , Menke Sebastian , Marchesseau Stephanie , D’Agostino Ariel , del Rio-Bermudez Carlos , Taberna Miren , Tello Jorge
Published: May 2020

BACKGROUND

Clinical natural language processing (cNLP) systems are of crucial importance due to their increasing capability in extracting clinically important information from free text contained in electronic health records (EHRs). The conversion of a nonstructured representation of a patient’s clinical history into a structured format enables medical doctors to generate clinical knowledge at a level that was not possible before. Finally, the interpretation of the insights gained provided by cNLP systems has a great potential in driving decisions about clinical practice. However, carrying out robust evaluations of those cNLP systems is a complex task that is hindered by a lack of standard guidance on how to systematically approach them.

OBJECTIVE

Our objective was to offer natural language processing (NLP) experts a methodology for the evaluation of cNLP systems to assist them in carrying out this task. By following the proposed phases, the robustness and representativeness of the performance metrics of their own cNLP systems can be assured.

METHODS

The proposed evaluation methodology comprised five phases: (1) the definition of the target population, (2) the statistical document collection, (3) the design of the annotation guidelines and annotation project, (4) the external annotations, and (5) the cNLP system performance evaluation. We presented the application of all phases to evaluate the performance of a cNLP system called “EHRead Technology” (developed by Savana, an international medical company), applied in a study on patients with asthma. As part of the evaluation methodology, we introduced the Sample Size Calculator for Evaluations (SLiCE), a software tool that calculates the number of documents needed to achieve a statistically useful and resourceful gold standard.

RESULTS

The application of the proposed evaluation methodology on a real use-case study of patients with asthma revealed the benefit of the different phases for cNLP system evaluations. By using SLiCE to adjust the number of documents needed, a meaningful and resourceful gold standard was created. In the presented use-case, using as little as 519 EHRs, it was possible to evaluate the performance of the cNLP system and obtain performance metrics for the primary variable within the expected CIs.

CONCLUSIONS

We showed that our evaluation methodology can offer guidance to NLP experts on how to approach the evaluation of their cNLP systems. By following the five phases, NLP experts can assure the robustness of their evaluation and avoid unnecessary investment of human and financial resources. Besides the theoretical guidance, we offer SLiCE as an easy-to-use, open-source Python library.

CLINICALTRIAL
Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health (Preprint)
Authors: Schleider Jessica Lee , Dobias Mallory , Sung Jenna , Mumper Emma , Mullarkey Michael C
Published: May 2020

BACKGROUND

Many youths with mental health needs are unable to access care. Single-session interventions (SSIs) have helped reduce youth psychopathology across multiple trials, promising to broaden access to effective, low-intensity supports. Online, self-guided SSIs may be uniquely scalable, particularly if they are freely available for as-needed use. However, the acceptability of online SSI and their efficacy have remained unexamined outside of controlled trials, and their practical utility is poorly understood.

OBJECTIVE

We evaluated the perceived acceptability and proximal effects of Project YES (Youth Empowerment & Support), an open-access platform offering three online SSIs for youth internalizing distress.

METHODS

After selecting one of three SSIs to complete, participants (ages 11-17 years) reported pre- and post-SSI levels of clinically relevant outcomes that SSIs may target (eg, hopelessness, self-hate) and perceived SSI acceptability. User-pattern variables, demographics, and depressive symptoms were collected to characterize youths engaging with YES.

RESULTS

From September 2019 through March 2020, 694 youths accessed YES, 539 began, and 187 completed a 30-minute, self-guided SSI. SSI completers reported clinically elevated depressive symptoms, on average, and were diverse on several dimensions (53.75% non-white; 78.10% female; 43.23% sexual minorities). Regardless of SSI selection, completers reported pre- to post-program reductions in hopelessness (dav=0.53; dz=0.71), self-hate (dav=0.32; dz=0.61), perceived control (dav=0.60; dz=0.72) and agency (dav=0.39; dz=0.50). Youths rated all SSIs as acceptable (eg, enjoyable, likely to help peers).

CONCLUSIONS

Results support the perceived acceptability and utility of open-access, free-of-charge SSIs for youth experiencing internalizing distress.

CLINICALTRIAL

Open Science Framework; osf.io/e52p3
Verbal Issues and Its Effect in Controlling the Scientific Mentality and Fundamentalist Controversy
Authors: Shehata Hussein Mohamed Ahmed
Published: May 2020

The main research themes are: 1) The first requirement: definition of the verbal issue and its problems and diversity: a) Definition of the Verbal Case and its Importance; b) Problems of Reconciliation and Explanation between Philosophers and Speakers; c) the diversity of the verbal case. 2) The second demand: control the scientific mindset and fundamentalist controversy: a) the issue of knowledge and Almsdq; b) the ten categories; c) the issue of science between demonstration and justification. 3) Conclusion and recommendations. 4) Sources and references.
Introducing the Black Male Life Success Theory
Authors: Smith, EdD Dr. Aaron D. , Aggarwal, MEd, BS Jyoti
Published: May 2020

For decades, literature has described success for Black males as an unattainable phenomenon due to the nearly insurmountable hardships they face. Although this narrative has changed within the last 15 years, there are insignificant amounts of research on Black male life success. This study sought to identify and discover how 14 Black males in Central Virginia achieved life success. This study defined life success for Black males utilizing the psychological construct of well-being. This grounded theory study identified a framework for Black male life success which included a definition for life success as well as common attributes and circumstances or Black males on their journey towards life success.
State Management of Social Security in Vietnam
Authors: Tri Nguyen Minh , Vu Van Khac
Published: May 2020

In recent years, Vietnam has made remarkable progress in ensuring social security, which is clearly shown through the development and good implementation of insurance policies, contributing to reducing difficulties and stabilizing people life and social welfare and people’s lives continue to be improved. However, in the context of international integration and Industrial revolution 4.0, state management of social security faces many challenges. This article clarifies the requirements of international integration and Industry revolution 4.0 for state management of social security.
PREVALENCE OF CHILDHOOD SKIN DISORDERS ATTENDING AT OUTPATIENT PEDIATRIC HOSPITAL
Authors: THUMMANAPALLY NANDINI , LAWDYAVATH KAVITHA , GURUVA CHARANDAS , ENUMULA DEEPTHI , PVK SASTRY , ANCHURI SHYAM SUNDER
Published: May 2020

Objective: The objective of the study was to study the prevalence of various skin diseases in pediatric population.

Methods: A prospective observational study was conducted at private children’s outpatient clinic in Warangal from March to August 2018 with the prior approval from the Institutional Ethical Committee BIPS/IEC/2018/P8. A total of 200 patients with various skin diseases of age group <17 years were included in the study.

Results: Out of 200 pediatric skin disorders, male children 138 (69%) outnumbered female children 62 (31%). The mean age of the study population was found to be 5.85±4.11 years. About 64% of the patients are from rural area and 36% are from urban. The percentage of skin disorders is allergic infections (26%), bacterial infections (23%), viral infections (11%), fungal infections (7.5%), parasitic infections (6%), autoimmune disorders (4%), and skin adnexa (2.5%).

Conclusion: Our study concludes that the prevalence of allergic and bacterial skin infections was found to be common among male children from rural area
FORMULATION AND IN VITRO EVALUATION OF EZETIMIBE RAPIDMELTS
Authors: RANI T NEELIMA , MUZIB Y INDIRA
Published: May 2020

Objective: The main objective of the present research was formulation and evaluation of ezetimibe rapidmelts.

Methods: As ezetimibe comes under Class II drug, solubility of the drug should be increased before formulation. For that solid dispersions were prepared with β-CD and PVP K-30 using coevaporation and kneading method. Among those solid dispersions prepared with β-CD (1:1.5) using coevaporation method has given better drug entrapment values compared to other solid dispersions. Those solid dispersions were formulated as rapidmelts using direct compression. In direct compression method, rapidmelts were prepared using superdisintegrants such as crospovidone, croscarmellose sodium, and starch 1500. Those are evaluated for both pre-compression and post-compression parameters. Rapidmelts of ezetimibe were prepared using sublimation method with subliming agents camphor, urea, and ammonium bicarbonate. The concentrations of subliming agents were found to be 2.5, 5.0, and 7.5%.

Results: Rapidmelts prepared using direct compression and sublimation methods were evaluated for weight variation, hardness, friability, % drug content, and disintegration time. The best formulation was subjected to stability testing for 6 months at 25°C/60% RH and 40°C/75% RH. All the prepared formulations compiled with the pharmacopeial limits. In all the formulations, results suggest that E12 formulation has given the best results.

Conclusion: From the result, it was concluded that rapidmelts prepared using sublimation method which has given better result than direct compression method. That final formulation was further evaluated for in vivo studies using rabbits.
ANTITUMOR AND GASTROPROTECTIVE SCREENING OF SOME NOVEL ORGANIC DERIVATIVES OF BISMUTH
Authors: MANI TRIPATHI DIPTI , KANT RAVI , SRIVASTAVA KRISHNA
Published: May 2020

Objectives: The objectives of present manuscript are to synthesize some new organic derivatives of bismuth having general formula (RBiL2; wherein R = C6F5; L = Substituted aromatic carboxylic acid), and characterized with the help of M.P., elemental, I.R., and NMR spectral analysis to ascertain the structure of novel compounds. These compounds were also characterized for their in vitro antitumor activity against human breast (MCF-7) and mammary cancer (EVSA-7) cell line along with gastroprotective (anti-ulcer) activity in rats using standard methods.

Methods: All the newly organobismuth having general formula (RBiL2) were synthesised by earliar reported methods especially using redistribution and complexation reactions. The in-vitro antitumor and gastroprotective studies were performed by using standard protocols and methods.

Results: It was found that the compounds were crystalline solids, air stable, and soluble in common organic solvent, have sharp melting points, and possess trigonal/pyramidal structure, exhibit higher activity than the standard ranitidine when the tests were carried out with aspirin induced and moderate activity was seen when the tests were done with ethanol induced along with potential antitumor activity against MCF-7 and EVSA-7 cell lines.

Conclusion: The newly synthesized organobismuth complexes were characterized to ascertain their structure by sophisticated instrumental and spectral analysis resulted as trigonal/pyramidal structure. The compounds were also screened 1st time for gastroprotective and antitumor activity in vitro. The observations clearly indicate that organobismuth carboxylates as reported here show potential gastroprotective and antitumor activity in vitro.
COMPARISION OF ANTIOXIDANT ACTIVITY OF ACTINIDIA DELICIOSA AND PSIDIUM GUAJAVA USING FERRIC REDUCING ANTIOXIDANT POWER ASSAY METHOD
Authors: JEBA R CAROLINE , D INDHUJA
Published: May 2020

Objectives: Antioxidant activity was studied in naturally dried seed extract and hot air oven dried extract of Actinidia deliciosa and Psidium guajava using ferric reducing antioxidant power (FRAP) assay method.

Methods: The dried powdered seed of A. deliciosa and P. guajava 10 g was dissolved in 100 ml of ethanol in four different conical flasks S1 (for naturaly dried seeds of A. deliciosa), S2 (for hot air oven-dried seeds of A. deliciosa), S3 (for naturally dried seeds of P. guajava), and S4 (for hot air oven-dried seeds of P. guajava). The extract was carried out in shaker at 120 rpm for 72 h at room temperature by mild shaking. The extract was taken out and centrifuged at 4000 rpm for 10 min, the supernatant was taken out. The supernatant was placed in a water bath at 95°C for the solvent to evaporate and stored at room temperature.

Results: According to the FRAP results, P. guajava which was naturally dried and extracted has shown the highest antioxidant activity (sample 3) then followed by the samples S4, S1, and S2. The least activity is observed in the sample (S2).

Conclusion: By comparing the antioxidant activity between the A. deliciosa and P. guajava with the help of FRAP assay results, P. guajava has the highest amount of vitamin C (responsible for antioxidant activity) when compared to that of the A. deliciosa.
METHOD VALIDATION OF CAPECITABINE IN API AND PHARMACEUTICAL DOSAGE FROM BY UV SPECTROPHOTOMETRIC METHOD
Authors: KAR AYAN KUMAR , KAR BANHISHIKHA , MAHANTI BEDUIN , KUMAR CHANDAN
Published: May 2020

Objective: The simple, rapid spectrophotometric method was developed for the determination of capecitabine, an anticancer drug, in pharmaceutical formulations. Among the approaches, most commonly used targeted mechanism is pH-dependent delivery system which is based on pH gradient of the gastrointestinal tract (GIT) that increases progressively from the stomach.

Methods: The focus of the present study is to similarize the capecitabine drug in bulk form with the marketed tablet (Capegard 500) on the simple, accurate, and precise manner by UV spectrophotometer.

Results: Beer’s law was obeyed over a concentration range of 5–30 μg/mL in HCl at pH 1.2 and in phosphate buffer at pH 6.8 and 7.4. The linear regression equations of pure drug were found to be y = 0.0135x+0.2014, y = 0.0147x+0.2153, and y = 0. 0245x+0.1507 in HCl, phosphate buffer at 6.8 and 7.4, respectively, whereas the linear regression equations of marketed tablet were found to be y = 0.0158x+0.1964, y = 0.0192x+0.2261, and y = 0.015x+0.2032, respectively, and the three methods were validated as per the International Council for Harmonisation guideline (ICH).

Conclusion: The regression values of every equation were found to be above 0.990 which indicated that all the equations were maintaining linearity.
MEMANTINE, AS A P-GLYCOPROTEIN EXPRESSION MODULATOR, ENHANCES LEVETIRACETAM THERAPEUTIC RESPONSE IN EPILEPTIC PATIENTS
Authors: HARBY SAHAR AHMED , NASSRA RASHA A , F MEKKY JAIDAA , M ALI SAMIA , A ISMAIL CHERINE
Published: May 2020

Objective: The principal aim of the present study was to assess the importance of multidrug transporter; P-glycoprotein (P-gp) as a potential therapeutic target in patients with epilepsy. Can P-gp transporter expression modulation by memantine add to the standard antiepileptic drugs (AEDs) response?

Methods: A cohort of 56 epilepsy patients was included in a 4 monthly visits prospective study. Patients were on levetiracetam (LEV) 1000 mg/ day alone or combined with other AEDs. They were randomly assigned into two groups; LEV only group including LEV-treated patients and LEV + memantine group including patients on LEV with add-on oral memantine 10 mg/day until the end of the study. During monthly follow-up visits, therapeutic responses were evaluated for each patient by recording the monthly seizures frequency. Blood samples were drawn from every patient twice (on the first and last visits) for assessment of P-gp mRNA expression level.

Results: Fifty patients completed the study. At the end of 4th month, LEV only group showed a non-significant decrease in P-gp expression and seizure frequency compared to the 1st month, whereas, in LEV + memantine group, P-gp expression was significantly reduced and associated with significant seizure control.

Conclusion: Memantine by hindering P-gp overexpression was apt to enhance LEV efficacy and exhibit a better seizure control.
CORRELATION BETWEEN BODY MASS INDEX AND MICROALBUMINURIA IN ESSENTIAL HYPERTENSIVE ADULTS
Authors: DEVI IRENGBAM SUSUPRIYA , RAI GLADYS , PUNIA V. P. S , NANDKEOLIAR MANOJ KUMAR
Published: May 2020

Objective: This study aimed to find the correlation between body mass index (BMI) and microalbuminuria (MA) in essential hypertensive adults.

Methods: This study included 35 essential hypertensive patients in the 18–65 years of age group, who satisfied the inclusion criteria. Arterial blood pressure was measured by a sphygmomanometer and the first voided early morning urine sample was collected for the estimation of microalbumin.

Results: The mean age of the population studied was 49±11.08 in essential hypertensive patients and 46.89±11.10 in the control group. The mean value of BMI in the hypertensive group was found to be 27.59±5.45. In the present study, the mean value of microalbumin in essential hypertensive patients was 20.95±16.96. A significant positive correlation between BMI and MA was observed in the study with p<0.001.

Conclusion: Our study shows a positive correlation between BMI and MA. Therefore, this study will help in the early detection of renal injury and prevents its progression to renal failure by lifestyle and diet modifications.