bluuebunny/crossref_metadata_2025 huggingface dataset:
Разработка и исследование упаковочной бумаги, модифицированной наночастицами диоксида титана
Authors: Таусарова Б. Р. , Сулейменова М. Ш. , Баймаханов Г. А.
Published: June 2020

Проведены исследования по разработке бумажных упаковочных материалов с антибактериальными свойствами с применением наночастиц диоксида титана. Синтез наночастиц диоксида титана получали гидролизом тетрахлорида титана в щелочной среде, регулируя значение pH водным раствором аммиака при температуре 30–60°С. Изучено влияние условий протекания реакций на синтез наночастиц диоксида титана, рН среды, найдены оптимальные условия синтеза. Определены параметры обработки упаковочных материалов из бумаги водными растворами наночастиц диоксида титана, придающих антимикробные свойства. Методом электронно-сканирующей микроскопии и энергодисперсионного микроанализа показано, что необработанная упаковочная бумага содержит C – 64.69%, O – 35.31%, после модификации раствором наночастиц диоксида титана на поверхности обработанной бумаги образуются частицы диоксида титана в пределах 16.46–21.14%, которые распределены достаточно неравномерно в зависимости от исходной концентрации наночастиц диоксида титана. Модифицированные предлагаемым составом упаковочные материалы показали высокую устойчивость к действию микроорганизмов. Применение разработанной антимикробной пищевой упаковки позволит снизить потери и обеспечить сохранение качества и безопасности пищевых продуктов в процессе транспортировки, хранения и реализации.
Random forest predictive model development with uncertainty analysis capability for the estimation of evapotranspiration in an arid oasis region
Authors: Wu Min , Feng Qi , Wen Xiaohu , Deo Ravinesh C. , Yin Zhenliang , Yang Linshan , Sheng Danrui
Published: June 2020

The study evaluates the potential utility of the random forest (RF) predictive model used to simulate daily reference evapotranspiration (ET0) in two stations located in the arid oasis area of northwestern China. To construct an accurate RF-based predictive model, ET0 is estimated by an appropriate combination of model inputs comprising maximum air temperature (Tmax), minimum air temperature (Tmin), sunshine durations (Sun), wind speed (U2), and relative humidity (Rh). The output of RF models are tested by ET0 calculated using Penman–Monteith FAO 56 (PMF-56) equation. Results showed that the RF model was considered as a better way to predict ET0 for the arid oasis area with limited data. Besides, Rh was the most influential factor on the behavior of ET0, except for air temperature in the proposed arid area. Moreover, the uncertainty analysis with a Monte Carlo method was carried out to verify the reliability of the results, and it was concluded that RF model had a lower uncertainty and can be used successfully in simulating ET0. The proposed study shows RF as a sound modeling approach for the prediction of ET0 in the arid areas where reliable weather data sets are available, but relatively limited.
Does community-wide water chlorination reduce hepatitis E virus infections during an outbreak? A geospatial analysis of data from an outbreak in Am Timan, Chad (2016–2017)
Authors: Lenglet Annick , Ehlkes Lutz , Taylor Dawn , Fesselet Jean-Francois , Nassariman Jean Noel , Ahamat Abdelkhadir , Chen Alexandra , Noh Idriss , Moustapha Abakar , Spina Alexander
Published: June 2020

Hepatitis E Virus (HEV) genotype 1 and 2 infect an estimated 20 million people each year, via the faecal-oral transmission route. An urban outbreak of HEV occurred in Am Timan, Chad, between September 2016 and April 2017. As part of the outbreak response, Médecins Sans Frontières and the Ministry of Health implemented water and hygiene interventions, including the chlorination of town water sources. We aimed to understand whether these water treatment activities had any impact on the number of HEV infections, using geospatial analysis of epidemiological and water treatment monitoring data. By conducting cluster analysis we investigated whether there were areas of particularly high and low infection risk during the outbreak and explored the reasons for this. We observed two high-risk spatial clusters of suspected cases and one high-risk cluster of confirmed cases. Our main finding was that confirmed HEV cases had a higher median number of days of exposure to unsafe water compared to suspected and non-confirmed cases (Kruskal-Wallis Chi Square: 15.5; p < 0.001). Our study confirms the mixed, but shifting, transmission routes during this outbreak. It also highlights the spatial and temporal analytical methods, which can be employed in future outbreaks to improve understanding of HEV transmission.
Multi-objective optimal allocation of water resources based on ‘three red lines’ in Qinzhou, China
Authors: Guan Haopeng , Chen Lihua , Huang Shuping , Yan Cheng , Wang Yan
Published: June 2020

Water shortages and pollution emerge because of anthropogenic demands. Since 2011, ‘China's Most Stringent Water Resources Management’ (CMSWRM) has been comprehensively enacted in the country. This paper presents the characteristics of the ‘three red lines’ (TRL) and a multi-objective optimal allocation model based on the TRL constraint, considering the benefits for society, the economy, and the environment. This model had been applied to the reasonable allocation of water supply and demand in Qinzhou for the planning years of 2020 and 2030. Two water resource allocation scenarios for these years were configured by setting different chemical oxygen demand (COD) concentrations for wastewater discharge in the municipal, secondary, tertiary, and agricultural sectors. The gamultiobj function based on the NSGA-II algorithm was used to solve the model in MATLAB. The results indicate that if COD concentrations in each sector are not reduced, then restrictions on domestic water sources will be necessary, both in 2020 and 2030. The two water resource allocation scenarios in 2020 and 2030 can provide a reference for decision-makers in Qinzhou to implement CMSWRM.
Assessment of medium and small river health based on macroinvertebrates habitat suitability curves: a case study in a tributary of Yangtze River, China
Authors: Su Yifan , Li Weiming , Liu Liu , Li Jinjing , Sun Xuyang , Hu Wei
Published: June 2020

The health of medium and small river ecosystems is threatened by increasing hydropower development and human activities. How to properly diagnose rivers has become a global concern. As a well-accepted theory, the aquatic organism density can be an indicator of river health. A new river health assessment method based on macroinvertebrates habitat suitability curves (M-HSC) was proposed. In this study, the health of Qiaobian River (QBR), a tributary of Yangtze River, China was evaluated by investigating the distribution of macroinvertebrates, chemical and physical parameters during winter 2018 (low flow season) and summer 2019 (high flow season). Based on habitat suitability of dominant macroinvertebrates, the key habitat factors were screened by canonical correspondence analysis (CCA) and Pearson correlation analysis. Suitability curves were determined by Generalized Additive Model (GAM). Ecosystem health comprehensive index method was used to evaluate the health status. The results show most suitable conditions for Corbicula fluminea containing chemical oxygen demand (CODMn) of 1.48 mg L−1, total nitrogen (TN) of 0.27 mg L−1, dissolved oxygen (DO) of 11.17 mg L−1, pH of 8.42, turbidity of 1.76 NTU, and water depth (Dep) of 0.35 m. The health status of QBR is spatially heterogeneous with the apparently better upstream than the downstream. In general, 25, 12.5, 12.5% of the samples were classified as nature, health and sub-health status, respectively and the rest 50% were lower than sub-health. The results are consistent with the environmental quality standards for surface water in China (GB3838-2002), suggesting the applicability of macroinvertebrates habitat suitability for evaluating river health. By minimizing the temporal and spatial limitations of comprehensive evaluation method and indicator species method, this study, for the first time, used macroinvertebrates habitat suitability curves to assess the health of medium and small rivers. The study will provide new insights for future river health assessments.
Efficient degradation of naproxen by persulfate activated with zero-valent iron: performance, kinetic and degradation pathways
Authors: Dong Shuyu , Zhai Xiaoxue , Pi Ruobing , Wei Jinbao , Wang Yunpeng , Sun Xuhui
Published: June 2020

Degradation of naproxen (NAP) by persulfate (PS) activated with zero-valent iron (ZVI) was investigated in our study. The NAP in aqueous solution was degraded effectively by the ZVI/PS system and the degradation exhibited a pseudo-first-order kinetics pattern. Both sulfate radical (SO4•−) and hydroxyl radical (HO•) participate in the NAP degradation. The second-order rate constants for NAP reacting with SO4•− and HO• were (5.64 ± 0.73) × 109 M−1 s−1 and (9.05 ± 0.51) × 109 M−1 s−1, respectively. Influence of key parameters (initial pH, PS dosage, ZVI dosage, and NAP dosage) on NAP degradation were evaluated systematically. Based on the detected intermediates, the pathways of NAP degradation in ZVI/PS system was proposed. It was found that the presence of ammonia accelerated the corrosion of ZVI and thus promoted the release of Fe2+, which induced the increased generation of sulfate radicals from PS and promoted the degradation of NAP. Compared to its counterpart without ammonia, the degradation rates of NAP by ZVI/PS were increased to 3.6–17.5 folds and 1.2–2.2 folds under pH 7 and pH 9, respectively.
Dapsone is not a Pharmacodynamic Lead Compound for its Aryl Derivatives
Authors: Scior Thomas , Abdallah Hassan H. , Salvador-Atonal Kenia , Laufer Stefan
Published: June 2020

Background:

The relatedness between the linear equations of thermodynamics and
QSAR was studied thanks to the recently elucidated crystal structure complexes between sulfonamide
pterin conjugates and dihydropteroate synthase (DHPS) together with a published set of thirty-
six synthetic dapsone derivatives with their reported entropy-driven activity data. Only a few
congeners were slightly better than dapsone.

Objective :

Our study aimed at demonstrating the applicability of thermodynamic QSAR and to
shed light on the mechanistic aspects of sulfone binding to DHPS.

Methods:

To this end ligand docking to DHPS, quantum mechanical properties, 2D- and 3D-QSAR
as well as Principle Component Analysis (PCA) were carried out.

Results:

The short aryl substituents of the docked pterin-sulfa conjugates were outward oriented into
the solvent space without interacting with target residues which explains why binding enthalpy
(ΔH) did not correlate with potency. PCA revealed how chemically informative descriptors are
evenly loaded on the first three PCs (interpreted as ΔG, ΔH and ΔS), while chemically cryptic ones
reflected higher dimensional (complex) loadings.

Conclusions:

It is safe to utter that synthesis efforts to introduce short side chains for aryl derivatization
of the dapsone scaffold have failed in the past. On theoretical grounds we provide computed
evidence why dapsone is not a pharmacodynamic lead for drug profiling because enthalpic terms do
not change significantly at the moment of ligand binding to target.
Job Search Duration and Business Preparation Duration: An Empirical Study of Micro Data in Indonesia with Cox Regression
Authors: Safitri Hendri Cahyo Dwi , Afiatno Bambang Eko
Published: June 2020

Abstract: This study aims to analyze the difference in job search duration and business preparation duration based on education level, training, job experience, marital status, age, and sex. The total unit of analysis used in this study is 51,112 individuals sourced from National Labor Force Survey (Sakernas) conducted in August 2017. This study applies the Survival Analysis with Cox Regression. The survival rate results show that unemployed people who prepare a business will get a job faster than their counterparts who are still looking for a job. Cox regression testing shows that education, training, marital status, and age have significantly affected job search duration in Indonesia. Meanwhile, education, training, and marital status have significantly influenced the period of business preparation in Indonesia.                                      Keywords: unemployment, job search duration, business preparation duration, cox regression, survival analysis Lama Mencari Kerja dan Lama Mempersiapkan Usaha: Studi Empiris Data Mikro di Indonesia Abstrak: Penelitian ini bertujuan untuk menganalisis perbedaan lama mencari kerja dan lama mempersiapkan usaha dilihat dari tingkat pendidikan, pelatihan, pengalaman kerja, status perkawinan, umur, serta jenis kelamin. Total unit analisis yang digunakan sebanyak 51.112 individu yang bersumber dari data Survei Angkatan Kerja Nasional (Sakernas) Agustus 2017. Metode analisis yang digunakan adalah Survival Analysis dengan Cox Regression. Hasil survival rate menunjukkan bahwa pengangguran yang mempersiapkan usaha akan lebih cepat memperoleh pekerjaan dibandingkan dengan pengangguran yang mencari pekerjaan. Pengujian dengan cox regression menunjukkan bahwa pendidikan, pelatihan, status perkawinan, dan umur berpengaruh signifikan terhadap lama mencari pekerjaan di Indonesia. Sedangkan pendidikan, pelatihan, dan status perkawinan berpengaruh signifikan terhadap lama mempersiapkan usaha di Indonesia.                                      Kata kunci: pengangguran, lama mencari kerja, lama mempersiapkan usaha, regresi cox, analisis survival
Analisis perkembangan sertipikat hak atas tanah nelayan dan arahan pemanfaatan ruang wilayah pesisir di Kecamatan Kragan Kabupaten Rembang
Authors: Ilman Mohammad Aulia , Basuki Yudi
Published: June 2020

Penelitian ini bertujuan untuk menganalisis perkembangan sertipikat hak atas tanah nelayan dan arahan pemanfaatan ruang wilayah pesisir di Kecamatan Kragan Kabupaten Rembang. Penelitian ini didasarkan pada kegiatan sertipikasi hak atas tanah nelayan di Kecamatan Kragan selama 5 (Lima) tahun yaitu Tahun 2013 sampai dengan 2018. Metode penelitian digunakan metode penelitian kuantitatif dengan teknik analisis dalam SIG (Sistem Informasi Geografis) yaitu overlay peta. Overlay peta yang dilakukan yaitu antara peta bidang tanah sertipikasi hak atas tanah nelayan dengan peta rencana pola ruang wilayah pesisir. Dari hasil penelitian menunjukkan bahwa perkembangan sertipikat hak atas tanah nelayan mengalami trend kenaikan. Secara keseluruhan, luas bidang tanah sertipikat hak atas tanah nelayan yang berada pada arahan kawasan budidaya adalah seluas 140.689 M2 atau 82,9% sedangkan berada di arahan kawasan lindung adalah seluas 28.919 M2 atau 17,1 %.
SEDIMENTASI DI GUMUK PASIR PARANGTRITIS BERDASARKAN TUTUPAN LAHANNYA
Authors: Putro Sutanto Trijuni , Prasetiyowati Sri Haryanti
Published: June 2020

Gumuk pasirParangtritis merupakan salah satu bentuk lahan asal proses eolian yang berkembang di pesisir dengan keunikan tersendiri dibandingkan bentuklahan serupa di dunia. Gumuk pasir ini telah mengalami tekanan yang sangat tinggi akibat dari aktivitas manusia, sebagai akibatnya, perkembangan dan fungsi dari gumuk pasir ini berkurang. Terdapat hal-hal yang saling berkaitan menyebabkan perubahan penutup lahan yang signifikan di Gumuk Pasir Parangtritis, salah satunya adalah sisi regulasi dan kondisi social budaya ekonomi lokal. Salah satu sisi yang menyumbang perubahan tutupan lahan yang terbesar adalah wisata, tambak udang dan pertanian. Perubahan tutupan lahan paling mencolok adalah perkembangan titik wisata, pertanian, dan tutupan vegetasi yang meluas, sehingga menyebabkan gangguan terhadap perkembangan Gumuk Pasir.Kajian dengan seri data panjang mengenai sedimentasi dan perkembangan Gumuk Pasir belum pernah dilakukan, maka dari itu studi ini dilakukan agar terkumpul data perkembangan Gumuk Pasir seri panjang. Diharapkan data tersebut dapat digunakan untuk penentu regulasi kedepannya. Tujuan lain dari kajian ini adalah menentukan pola spasial sedimentasi pasir saat ini, dengan keterbatasan, hingga saat ini data yang terkumpulmasihsedikit. Sehingga kajian ini baru menjadi pendahuluan dari kajian dengan seri yang panjang. Sedimentasi teraktif terjadi di bagian inti gumuk pasir yang tidak terhalang oleh vegetasi maupun bangunan, dan tepat berada di lorong angin.
Pengukuran Dasar Telaga menggunakan Alat Perum Gema Untuk Menghasilkan Peta Batimetri di Telaga Winong Yogyakarta
Authors: Febriarta Erik , Vienastra Septian , Suyanto Agus , Larasati Ajeng
Published: June 2020

Lake Winong is one lake that is not dried on dry season. This lake is located in the Village Kepek, District Saptosari, Gunung Kidul Regency, Special Region Province Yogyakarta. This study was designed to determine the depth or bottom topography of Lake Winong to produce bathymetry maps. Firstly, a survey was conducted to measure the depth with an echosounder instrument. Principally, an echosounder records the time interval required by the emitted sound wave to propagate to the bottom and return, from which the distance or depth (m) can be computed. Secondly, the depth data were interpolated by initially cross-validating the smallest Root Mean Squared Errors (RMSE) of the Inverse Distance Weighting (IDW), kriging, and natural neighbor methods. Each was run with the power values (weight factors) of 0.5, 1, 2, and 3. The results showed that kriging interpolation with a power value of 3 yielded the smallest RMSE, namely 0.005, and the lake observed was -0.2 to -1.8 m deep, with the deepest location found in the middle of the lake.
NILAI KARAKTER DALAM NOVEL BIOGRAFI HATTA: AKU DATANG KARENA SEJARAH KARYA SERGIUS SUTANTO
Authors: Efendi Anwar
Published: June 2020

Abstrak: Penelitian ini bertujuan mendeskripsikan wujud dan pengekspresian nilai-nilai karakter dalam novel biografi Hatta Aku Datang Karena Sejarah Karya Sergius Sutanto. Pengumpulan data menggunakan teknik studi dokumentasi atau kajian pustaka. Analisis data dilakukan dengan langkah-langkah sebagai berikut. Pertama, membaca untuk menyeleksi dan menandainya kata, frasa, kalimat, paragraf, dan wacana yang mengandung informasi berkaitan dengan nilai-nilai karakter. Kedua, mengidentifikasi dan mengklasifikasikan data berdasarkan butir-butir masalah yang telah dirumuskan, tidak melihat bagian per bagian. Ketiga, menafsirkan kembali secara semiotik seluruh data teridentifikasi dan terklasifikasi untuk menemukan kepaduan, kesatuan, dan hubungan antardata. Hasil penelitian sebagai berikut. Pertama, nilai-nilai karakter utama, yakni (a) kemandirian, (b) semangat kebangsaan, (c) cinta tanah air, (d) cinta damai, (e) gemar membaca, dan (f) kejujuran. Kedua, pengekspresian nilai-nilai karakter disajikan dengan dua pola, yaitu (a) penyampaian langsung dengan cara pendeskripsian karakter, tindakan, dan perilaku tokoh oleh pengarang (pencerita); dan (b) penyampaian tidak langsung dengan cara paparan sikap dan tingkah laku tokoh menghadapi peristiwa dan konflik. Kata kunci: novel biografi, nilai karakter, pola perilaku, realitas kehidupan CHARACTER VALUES IN THE BIOGRAPHICAL NOVEL HATTA: AKU DATANG KARENA SEJARAH BY SERGIUS SUTANTOAbstract: This study aims to describe the form and expression of character values in Hatta: Aku Datang Karena Sejarah, a biograpical novel by Sergius Sutanto. The data collection technique was documentation study or literature review. The data analysis consisted of the following steps: first, reading to select and mark words, phrases, sentences, paragraphs, and discourses that contain information related to character values; second, identifying and classifying data based on the problem points formulated, not seeing part by part; third, semiotically reinterpreting all data identified and classified to find cohesion, unity, and relationships between data. The results of the study are as follows. First, the values of the main character include (a) independence, (b) national spirit, (c) patriotism, (d) love for peace, (e) a fondness for reading, and (f) honesty. Second, the expression of character values is presented in two patterns, namely (a) direct delivery by describing the character, actions, and behavior of the character by the author (narrator); and (b) indirect delivery by way of exposure to attitudes and behaviors of the character in facing events and conflicts. Keywords: biographical novel, character values, behavior patterns, reality of life
Начальная восприимчивость в системах магнитных эллипсоидальных наночастиц
Authors: Акишева А.В. , Пьянзина Е.С.
Published: June 2020

In this work, we use molecular dynamics simulations to investigate the system of magnetic ellipsoidal nanoparticles with two different orientations of the dipole inside each particle. We consider dipoles directed along or perpendicular to the main axis of rotation. Such investigation allows us to determine the influence of the particles' anisotropy on the behavior and properties of the system. The initial susceptibility of the system was investigated and a cluster analysis was made. The obtained results revealed the influence of the orientation of the magnetic moment inside the particles of the same shape on the self-organization of the system, its microscopic and macroscopic properties. For the case of a parallel main orientation axis, the following was found: the initial susceptibility of particles whose shape is close to spherical increases faster and reaches higher values than in the case of ellipsoidal particles. The perpendicular orientation of the magnetic moment does not affect the initial susceptibility as significantly as in the previous case: increase in the magnetic moment leads to increase in the initial susceptibility, while the shape of the particle practically does not affect it.
Структура и магнитные свойства слоевых нанопроволок из 3d-металлов, полученных методом матричного синтеза
Authors: Черкасов Д.А. , Загорский Д.Л. , Хайбуллин Р.И. , Муслимов А.Э. , Долуденко И.М.
Published: June 2020

Arrays of layered nanowires (NWs) with a diameter of 100 nm consisting of alternating layers of Ni/Cu and Co/Cu were obtained by matrix synthesis based on polyethylene terephthalate track etched membranes. The process of galvanic deposition was studied and the regimes of obtaining of layered nanowires with different thicknesses of magnetic (Ni or Co) and non-magnetic (Cu) components of layers were determined. Electron microscopic investigation was performed to verify regimes of obtaining of layered nanowires and to refine the geometric properties of alternating layers. Using vibration magnetometer, the magnetization curves of the obtained arrays of layered NWs was measured at room temperature for two limiting orientations of the scanning magnetic field: parallel and perpendicular to the growth axis of the NW. It is shown that the magnetic anisotropy of the NW array is determined not only by the chemical composition, but also by the thickness and period of alternating magnetic layers in the NW. Numerical calculations of the dependence of the magnetostatic energy and the magnitude of the demagnetizing field in the synthesized layered NWs on the factor of their filling with a magnetic metal are carried out, which are qualitatively consistent with experimental observations.
Мемристоры на основе наноразмерных слоев LiNbO-=SUB=-3-=/SUB=- и композита (Co-=SUB=-40-=/SUB=-Fe-=SUB=-40-=/SUB=-B-=SUB=-20-=/SUB=-)-=SUB=-x-=/SUB=-(LiNbO-=SUB=-3-=/SUB=-)-=SUB=-100-x-=/SUB=-
Authors: Никируй К.Э. , Ильясов А.И. , Емельянов А.В. , Ситников А.В. , Рыльков В.В. , Демин В.А.
Published: June 2020

The memristive properties of layered capacitor structures based on the nanocomposite (Co40Fe40B20)x(LiNbO3)100-x and LiNbO3 with thicknesses of 10 and 40 nm, respectively, have been studied. For the first time, a sharp transition from a single to multi-filament resistive switching mechanism, which occurs when the content of the metal phase in the nanocomposite is increased, is demonstrated and explained on the basis of the previously proposed model.
A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study
Authors: Morgiève Margot , Genty Catherine , Azé Jérôme , Dubois Jonathan , Leboyer Marion , Vaiva Guillaume , Berrouiguet Sofian , Courtet Philippe
Published: June 2020

Background

Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed.

Objective

The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions.

Methods

The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences.

Results

EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports.

Conclusions

These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures.

Trial Registration

ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381
Web-Based Interventions for Dietary Behavior in Adults With Type 2 Diabetes: Systematic Review of Randomized Controlled Trials
Authors: Dening Jedha , Islam Sheikh Mohammed Shariful , George Elena , Maddison Ralph
Published: June 2020

Background

Type 2 diabetes mellitus (T2DM) is among the most prevalent noncommunicable health conditions worldwide, affecting over 500 million people globally. Diet is a key aspect of T2DM management with dietary modification shown to elicit clinically meaningful outcomes such as improved glycemic control, and reductions in weight and cardiovascular disease risk factors. Web-based interventions provide a potentially convenient and accessible method for delivering dietary education, but its effects on dietary behavior in people with T2DM are unknown.

Objective

The objective of this review was to determine the effectiveness of web-based interventions on dietary behavior change and glycemic control in people with T2DM.

Methods

Per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, systematic literature searches were performed using Medline, Embase, The Cochrane Library, and CINAHL to retrieve papers from January 2013 to May 2019. Randomized controlled trials of web-based interventions in adults with T2DM with reported dietary assessment were included. Population and intervention characteristics, dietary guidelines and assessments, and significant clinical outcomes were extracted. Differences between groups and within groups were assessed for dietary behavior and clinical outcomes.

Results

There were 714 records screened, and five studies comprising 1056 adults were included. Studies measured dietary changes by assessing overall diet quality, changes in specific dietary components, or dietary knowledge scores. Significant improvements in dietary behavior were reported in four out of the five studies, representing healthier food choices, improvements in eating habits, reductions in carbohydrates, added sugar, sodium, saturated fat and overall fat intake, and/or increases in dietary knowledge. Three studies found significant mean reductions for hemoglobin A1c ranging from –0.3% to –0.8%, and/or weight ranging from –2.3 kg to –12.7 kg, fasting blood glucose (–1 mmol/L), waist circumference (–1 cm), and triglycerides (–60.1 mg/dL). These studies provided varied dietary recommendations from standard dietary guidelines, national health program guidelines, and a very low carbohydrate ketogenic diet.

Conclusions

This review provided evidence that web-based interventions may be an effective way to support dietary behavior change in people with T2DM, potentially leading to changes in glycemic control and other clinical outcomes. However, the evidence should be viewed as preliminary as there were only five studies included with considerable heterogeneity in terms of the diets recommended, the dietary assessment measures used, the complexity of the interventions, and the modes and methods of delivery.
Meeting Kids Where They Are At–A Substance Use and Sexual Risk Prevention Program via Telemedicine for African American Girls: Usability and Acceptability Study
Authors: Lopez Cristina , Gilmore Amanda K , Moreland Angela , Danielson Carla Kmett , Acierno Ron
Published: June 2020

Background

Rural African American youth lack access to drug and sexual risk–taking prevention programs available in more urban areas. Recent data indicate that rural youth now use substances at higher rates and at younger ages than their urban peers.

Objective

This study aims to evaluate the initial usability and acceptability of a low-cost, technology-based approach to delivering effective, culturally tailored, integrated substance use disorder (SUD) and HIV risk behavior prevention programs to African American female youth to inform the use of this intervention via telemedicine for rural youth.

Methods

Effective SUD prevention strategies and emotion regulation skills were integrated into an existing evidence-based HIV risk reduction program culturally tailored for African American female adolescents—Sisters Informing, Healing, Living, and Empowering (SIHLE)—and delivered to 39 African American female youth via group telehealth. The evaluation of the resulting program, 12-session SIHLEplus, was completed by 27 girls who also completed self-report measures that assessed sexual risk behaviors (eg, number of partners and age of sex initiation), substance use, exposure to traumatic events, and emotion regulation.

Results

The descriptive and qualitative results of the pilot study demonstrate the initial usability and acceptability of delivering evidence-based prevention successfully via telehealth to help address health disparities in this vulnerable population.

Conclusions

Although more research is needed, the findings from this study suggest that SIHLEplus has demonstrated initial usability and acceptability.
The Mobile Health App Trustworthiness Checklist: Usability Assessment
Authors: van Haasteren Afua , Vayena Effy , Powell John
Published: June 2020

Background

The mobile health (mHealth) app trustworthiness (mHAT) checklist was created to identify end users’ opinions on the characteristics of trustworthy mHealth apps and to communicate this information to app developers. To ensure that the checklist is suited for all relevant stakeholders, it is necessary to validate its contents.

Objective

The purpose of this study was to assess the feasibility of the mHAT checklist by modifying its contents according to ratings and suggestions from stakeholders familiar with the process of developing, managing, or curating mHealth apps.

Methods

A 44-item online survey was administered to relevant stakeholders. The survey was largely comprised of the mHAT checklist items, which respondents rated on a 5-point Likert scale, ranging from completely disagree (1) to completely agree (5).

Results

In total, seven professional backgrounds were represented in the survey: administrators (n=6), health professionals (n=7), information technology personnel (n=6), managers (n=2), marketing personnel (n=3), researchers (n=5), and user experience researchers (n=8). Aside from one checklist item—“the app can inform end users about errors in measurements”—the combined positive ratings (ie, completely agree and agree) of the checklist items overwhelmingly exceeded the combined negative ratings (ie, completely disagree and disagree). Meanwhile, two additional items were included in the checklist: (1) business or funding model of the app and (2) details on app uninstallation statistics.

Conclusions

Our results indicate that the mHAT checklist is a valuable resource for a broad range of stakeholders to develop trustworthy mHealth apps. Future studies should examine if the checklist works best for certain mHealth apps or in specific settings.
Engagement With Motivational Interviewing and Cognitive Behavioral Therapy Components of a Web-Based Alcohol Intervention, Elicitation of Change Talk and Sustain Talk, and Impact on Drinking Outcomes: Secondary Data Analysis
Authors: Mujcic Ajla , Linke Stuart , Hamilton Fiona , Phillips Alexandria , Khadjesari Zarnie
Published: June 2020

Background

Down Your Drink (DYD) is a widely used unguided web-based alcohol moderation program for the general public based on cognitive behavioral therapy (CBT) and motivational interviewing (MI); it provides users with many opportunities to enter free-text responses.

Objective

The aim of this study was to assess participants’ use of key CBT and MI components, the presence of change talk and sustain talk within their responses, and whether these data are associated with drinking outcomes after 3 months.

Methods

An exploratory secondary data analysis was conducted on data collected in 2008 from the definitive randomized trial of DYD (N=503). Past week alcohol use at baseline and 3-month follow-up were measured with the TOT-AL. Covariates included baseline alcohol use, age, gender, education level, and word count of the responses. Use of MI and CBT components and presence of change talk and sustain talk were coded by two independent coders (Cohen κ range 0.91-1). Linear model regressions on the subsample of active users (n=410) are presented along with a negative binomial regression.

Results

The most commonly used component was the listing of pros and cons of drinking. The number of listed high-risk situations was associated with lower alcohol use at 3-month follow-up (Badj −2.15, 95% CI −3.92 to −0.38, P=.02). Findings on the effects of the percentage of change talk and the number of listed strategies to deal with high-risk situations were inconsistent.

Conclusions

An unguided web-based alcohol moderation program can elicit change talk and sustain talk. This secondary analysis suggests that the number of listed high-risk situations can predict alcohol use at 3-month follow-up. Other components show inconsistent findings and should be studied further.
Changing the Health Behavior of Patients With Cardiovascular Disease Through an Electronic Health Intervention in Three Different Countries: Cost-Effectiveness Study in the Do Cardiac Health: Advanced New Generation Ecosystem (Do CHANGE) 2 Randomized Controlled Trial
Authors: Piera-Jiménez Jordi , Winters Marjolein , Broers Eva , Valero-Bover Damià , Habibovic Mirela , Widdershoven Jos W M G , Folkvord Frans , Lupiáñez-Villanueva Francisco
Published: June 2020

Background

During the last few decades, preventing the development of cardiovascular disease has become a mainstay for reducing cardiovascular morbidity and mortality. It has been suggested that interventions should focus more on committed approaches of self-care, such as electronic health techniques.

Objective

This study aimed to provide evidence to understand the financial consequences of implementing the “Do Cardiac Health: Advanced New Generation Ecosystem” (Do CHANGE 2) intervention, which was evaluated in a multisite randomized controlled trial to change the health behavior of patients with cardiovascular disease.

Methods

The cost-effectiveness analysis of the Do CHANGE 2 intervention was performed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing tool, based on a Markov model of five health states. The following two types of costs were considered for both study groups: (1) health care costs (ie, costs associated with the time spent by health care professionals on service provision, including consultations, and associated unplanned hospitalizations, etc) and (2) societal costs (ie, costs attributed to the time spent by patients and informal caregivers on care activities).

Results

The Do CHANGE 2 intervention was less costly in Spain (incremental cost was −€2514.90) and more costly in the Netherlands and Taiwan (incremental costs were €1373.59 and €1062.54, respectively). Compared with treatment as usual, the effectiveness of the Do CHANGE 2 program in terms of an increase in quality-adjusted life-year gains was slightly higher in the Netherlands and lower in Spain and Taiwan.

Conclusions

In general, we found that the incremental cost-effectiveness ratio strongly varied depending on the country where the intervention was applied. The Do CHANGE 2 intervention showed a positive cost-effectiveness ratio only when implemented in Spain, indicating that it saved financial costs in relation to the effect of the intervention.

Trial Registration

ClinicalTrials.gov NCT03178305; https://clinicaltrials.gov/ct2/show/NCT03178305
A Graded Exposure, Locomotion-Enabled Virtual Reality App During Walking and Reaching for Individuals With Chronic Low Back Pain: Cohort Gaming Design
Authors: Hennessy Rebecca White , Rumble Deanna , Christian Mike , Brown David A , Trost Zina
Published: June 2020

Background

Chronic low back pain (cLBP) can interfere with daily activities, and individuals with elevated pain-related fear (also known as kinesiophobia or the fear of injury due to movement) can develop worse long-term disability. Graded exposure (GEXP) protocols use successive participation in avoided activities to help individuals overcome fearful movement appraisals and encourage activity. We sought to develop a series of GEXP virtual reality (VR) walking and reaching scenarios to increase the exposure and engagement of people with high kinesiophobia and cLBP.

Objective

This study aims to (1) determine GEXP content validity of the VR application and (2) determine the feasibility of individuals with cLBP performing locomotion-enabled physical activities.

Methods

We recruited 13 individuals with cLBP and high pain-related fear to experience six VR modules, which provide progressive movement exposure over three sessions in a 1 week period. At session 1, participants ranked each module by likelihood to avoid and assigned an expected pain and concern for harming their back rating to each module. Participants provided a rating of perceived exertion (RPE) after experiencing each module. To test feasibility, we administered the system usability scale (SUS) and treatment evaluation inventory (TEI) following the final session. In addition, we measured pain and pain-related fear at baseline and follow-up.

Results

The 12 participants who completed the study period assigned higher avoidance (P=.002), expected pain (P=.002), and expected concern (P=.002) for session 3 modules compared with session 1 modules. RPE significantly increased from session 1 (mean 14.8, SD 2.3) to session 3 (mean 16.8, SD 2.2; P=.009). The VR application showed positive feasibility for individuals with cLBP through acceptable SUS (mean 76.7, SD 13.0) and TEI (mean 32.5, SD 4.9) scores. Neither pain (P=.20) nor pain-related fear (P=.58) changed significantly across sessions.

Conclusions

The GEXP VR modules provided progressive exposure to physical challenges, and participants found the VR application acceptable and usable as a potential treatment option. Furthermore, the lack of significant change for pain and pain-related fear reflects that participants were able to complete the modules safely.
Impact of a Multicomponent Digital Therapeutic Mobile App on Medication Adherence in Patients with Chronic Conditions: Retrospective Analysis
Authors: Wiecek Elyssa , Torres-Robles Andrea , Cutler Rachelle Louise , Benrimoj Shalom Isaac , Garcia-Cardenas Victoria
Published: June 2020

Background

Strategies to improve medication adherence are widespread in the literature; however, their impact is limited in real practice. Few patients persistently engage long-term to improve health outcomes, even when they are aware of the consequences of poor adherence. Despite the potential of mobile phone apps as a tool to manage medication adherence, there is still limited evidence of the impact of these innovative interventions. Real-world evidence can assist in minimizing this evidence gap.

Objective

The objective of this study was to analyze the impact over time of a previously implemented digital therapeutic mobile app on medication adherence rates in adults with any chronic condition.

Methods

A retrospective observational study was performed to assess the adherence rates of patients with any chronic condition using Perx Health, a digital therapeutic that uses multiple components within a mobile health app to improve medication adherence. These components include gamification, dosage reminders, incentives, educational components, and social community components. Adherence was measured through mobile direct observation of therapy (MDOT) over 3-month and 6-month time periods. Implementation adherence, defined as the percentage of doses in which the correct dose of a medication was taken, was assessed across the study periods, in addition to timing adherence or percentage of doses taken at the appropriate time (±1 hour). The Friedman test was used to compare differences in adherence rates over time.

Results

We analyzed 243 and 130 patients who used the app for 3 months and 6 months, respectively. The average age of the 243 patients was 43.8 years (SD 15.5), and 156 (64.2%) were female. The most common medications prescribed were varenicline, rosuvastatin, and cholecalciferol. The median implementation adherence was 96.6% (IQR 82.1%-100%) over 3 months and 96.8% (IQR 87.1%-100%) over 6 months. Nonsignificant differences in adherence rates over time were observed in the 6-month analysis (Fr(2)=4.314, P=.505) and 3-month analysis (Fr(2)=0.635, P=.728). Similarly, the timing adherence analysis revealed stable trends with no significant changes over time.

Conclusions

Retrospective analysis of users of a medication adherence management mobile app revealed a positive trend in maintaining optimal medication adherence over time. Mobile technology utilizing gamification, dosage reminders, incentives, education, and social community interventions appears to be a promising strategy to manage medication adherence in real practice.
Influence of Social Media on Sexualized Drug Use and Chemsex Among Chinese Men Who Have Sex With Men: Observational Prospective Cohort Study
Authors: Wang Zixin , Yang Xue , Mo Phoenix K H , Fang Yuan , Ip Tsun Kwan Mary , Lau Joseph T F
Published: June 2020

Background

Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population.

Objective

This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period.

Methods

Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted.

Results

At Month 6, 6.9% (28/407) and 4.4% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU (β=.04; B=.002, 95% CI 0.001-0.01).

Conclusions

Social media and gay social networking apps may be a major source of influence on MSM’s perceptions and actual behaviors related to SDU.
Seeking Meaningful Innovation: Lessons Learned Developing, Evaluating, and Implementing the Electronic Patient-Reported Outcome Tool
Authors: Steele Gray Carolyn
Published: June 2020

Digital health solutions, in particular information communication technologies, often experience implementation failures leading to slower adoption than expected. This implementation challenge has spurred the development of frameworks to help navigate this uncertain and messy process. These frameworks point to environmental, organizational, individual, and technological factors that can drive or hinder implementation, with some in the field suggesting that perceived value may play a pivotal role. However, the concept of value can have varying meanings and be challenging to operationalize as a means to support implementation. Attending to philosophical and psychological meaningfulness for users and organizations in which technologies are adopted may offer a useful lens, by linking perceived value to individual behavior changes often required as part of implementing digital health technologies. Lessons learned from developing, evaluating, and implementing the electronic Patient-Reported Outcome (ePRO) tool demonstrate how qualitative methods can be used to uncover meaningfulness. By drawing from this example and other similar studies, this viewpoint offers suggestions on how future inquiry could deepen an understanding of meaningful innovation to help drive the implementation of digital health technologies.