bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Water Debit and Number of Blades on the Power Generated of Prototype Turbines Propeller as Renewable Electricity
Authors: Biantoro Agung Wahyudi , Iskendar Iskendar , Subekti Subekti , Bin Muhd Noor Nik Hisyamudin
Published: June 2021

This research is a prototype design of a Pico hydropower plant. The Pico hydro laboratory scale is planned to be installed at the water outlet at the steam gas power plant (PLTGU) in Cilegon, whose water discharge has not been utilized. Pico hydro will produce green energy, which in turn can partially replace fossil energy needs. The purpose of this study was to determine the effect of water discharge and the number of blades on the power generated by Pico hydro. The method used in this research is an experimental method carried out in the laboratory, by designing and making Pico hydro prototypes, with several variations in the number of blades. The results of the manual calculation analysis show that the mass flow rate, circumferential speed, and the highest rotational speed are found in blade 6. Furthermore, the design process uses the CFD method, which produces the best energy when using 6 or 7 blades.  The stronger the water discharge, the higher the Rpm, and the stronger the electric current and the resulting voltage. The water discharge of 0.04 m3/s produces 215 Rpm, a current of 0.30 ampere, and a voltage of 2.00 volts. While the airflow rate of 0.08 m3/s produces 695 Rpm, a current of 0.70 ampere,s and a voltage of 4.30 volts. Statistical analysis also shows that the higher the Rpm value of the 6 blade turbine, the higher the power and current it produces.
Development of Accuracy Evaluation Method for Open Loop Educational CNC Milling Machine
Authors: Winarno Agustinus , Lasiyah Sus , Tulung Prayoga Benidiktus , Aris Hendaryanto Ignatius , Sukidjo Fransiskus Xaverius
Published: June 2021

The open-loop educational computer numerical control (CNC) milling machine requires accuracy verification in order to ensure its accuracy and functionality. In this paper, the new verification method is proposed based on the length measurement using the fringe counting of He-Ne laser interferometry. The ideal translation length is defined by the number of electric pulses generated by the micro-stepping driver, while the actual length is measured using He-Ne laser interferometry. In the experimental process, the data of the fringe pattern of the He-Ne laser and the number of electric pulses which drive the stepper motors were simultaneously acquired using an oscilloscope. Hence, the data has been analyzed to obtain the ideal and actual lengths by using an in-house program developed in Python. By comparing the actual translation and ideal length, the accuracy of the educational CNC milling machine has been evaluated to be 50 µm for the length up to 200 mm.
Kinerja Thermoelectric pada Kotak Pendingin Berdasarkan Rangkaian Thermoelectric dan Putaran Fan Wind Tunnel
Authors: Munawir Munawir , Sasongko Mega Nur , Hamidi Nurkholis
Published: June 2021

A thermoelectric cooler (TEC ) is a component of an electric solid-state cooler that works as a heat pump in the cooling process. Utilizing the peltier effect that is when an electric current is flowed heat absorption occurs on both sides of the thermoelectric and the release of heat on the other side. The use of thermoelectric as a coolant in cool box systems has been widely studied. The purpose of this study was to determine the performance of the cooler using thermoelectric based on the circuit and air velocity in the wind tunnel. The studied performance includes temperature difference, heat absorption, and coefficient of performance. The method used in this study is a real experimental method, with research variables namely series and parallel thermoelectric series and wind tunnel air velocity. Data were taken in the form of cool room temperature cold side temperature, hot side temperature, heatsink temperature, and ambient temperature. Thermoelectric connectivity electrically uses series and parallel circuits and is thermally arranged in series. The results showed that the thermoelectric circuit and wind tunnel air velocity affect the performance of the thermoelectric. Thermoelectric with series circuit produces the highest COP absorption compared to the parallel circuit. The highest performance thermoelectric series is obtained at an airspeed of 9.8 m/s. in these conditions the temperature difference (AT) produced reaches 19oC. the heat absorption (qc) reaches 34.26 watts and the COP reaches 0.89
Efek Zeolit untuk Produksi Tar dan Char pada Pirolisis Rotary Kiln
Authors: Wijayanti Widya
Published: June 2021

This study aims to investigate the effect of zeolite as a catalyst to enlarge biomass decomposition in the pyrolysis process. It absorbs a high water content in the biomass, besides it makes the easier breaking of biomass molecules to maximize the biomass decomposition into the expected pyrolysis products; tar and char. In addition, to decompose the biomass molecules, the zeolite also stimulates the rate of heat transfer due to its ability to hold and release the heat. If the previous research pyrolysis was conducted in a fixed bed reactor, in this study, it will be carried out rotary kiln as a pyrolysis furnace. If the fixed bed reactor the heat transfer was dominated by conduction, the heat transfer in the rotary kiln is more controlled by the convection and radiation transfer due to stirring and turning of biomass by the kiln. In the study, the biomass used was mahogany with an initial weight of 150 grams. The rotary kiln rotated at 10 rpm and the heating rate during the pyrolysis process was around 0.1483°C/s. The pyrolysis temperatures used were varied as 250°C, 350°C, 450°C. Meanwhile, the percentage of zeolites used from 0% to 60% with a mesh size of 80. The results showed that zeolites were able to increase tar production and maximize the reduction of char as an effect of the Bronsted-Lowry and Lewis reaction in the process of catalytic cracking. The maximum production of tar and char production was also supported by the process of convection and radiation from the rotary kiln wall increasing the rate of heat transfer to decompose the biomass.

 
On the permissible speeds of empty freight cars mounted on 18-100 model bogies
Authors: Brzhezovskiy A. M. , Krasnobaev O. A. , Spirov A. V. , Il’in I. E.
Published: June 2021

Problem of ensuring motion safety of empty freight cars is most acute in relation to cars on bogies of model 18-100, which is mainly due to operational wear of wheelsets, side frames and bolsters, as well as spring suspension elements. A potential threat to traffic safety arises when a train, composed of mostly empty and lightly loaded cars, moves along track sections that have deviations in the geometry of rail track of III and higher degrees or combinations and sequences of deviations of II degree. The article presents the main results of complex studies: mathematical modeling of the dynamic interaction of the track and empty freight cars of various types of bogie wear based on the Universal Mechanism software and field tests of cars on measuring sections of tangent, easement and circular curves with a radius of 350, 650, 800, 1000 and 2050 m on the section Belorechenskaya — Maykop of the North Caucasian railway. Dynamic qualities and motion stability of empty freight cars of various types are investigated depending on the parameters of the technical condition of the running gears and the deviations of the geometry of the rail track of II and III degrees of various types and combinations when moving in tangent and curved track sections. Authors provide tables and graphs of the dependences of indicators of dynamic qualities and motion stability of universal empty freight cars of various types on the motion speed in tangent sections of the track and circular curves of various radii and easement curves containing artificial deviations of the geometry of the rail track, most negatively affecting traffic safety. Recommendations are given for correcting the regulatory documents of the Russian Railways, which regulate the permissible speed of motion of empty freight cars, depending on the technical condition of the running gear.
Evaluation of Quality of Life and Self-Care Among Individuals with Heart Failure
Authors: Güneş Demet , Atalıkoğlu Başkan Sebahat , Kasımoğlu Necla
Published: June 2021

The objective of the research was to evaluate quality of life and self-care agency among individuals with heart failure.
Materials and Methods. The study sample consisted of 61 patients who were diagnosed with heart failure that occurred at least six months before we started our research, had no communication problems, were over 18 years old and were selected by random sampling method. The data were collected by the researcher using a face-to-face interview technique, a descriptive information form, the Short Form-36 Quality of Life Scale, and the Self-Care Agency Scale. In the analysis of the data, numbers, percentiles, means, the Kruskal-Wallis test, the Mann-Whitney U test, and the Pearson correlation coefficient were used.
Results. The patients’ average self-care agency score was 71.75 ± 33.66. The patients received the highest score on the subscale of bodily pain (46.76 ± 31.02) and the lowest score on the subscale of role limitations due to physical health problems (19.26 ± 32.40). The patients’ age and disease duration were found to affect their self-care. Some quality-of-life subscales were affected by the educational, occupational and socioeconomic status, age, disease duration.
Conclusions. Patients’ quality of life was found to be low, and the level of self-care agency was found to be moderate. Patients’ quality of life can be improved by increasing the frequency of self-care trainings given to patients.
Teoremi nemogućnosti u ekonomici zdravstva
Authors: Mance Davor
Published: June 2021

Kolektivno odlučivanje podložno je nemogućnosti agregiranja preferencija pojedinaca u društvenu funkciju blagostanja, nemogućnosti agregiranja ordinalnih preferencija u društvenu funkciju odlučivanja te nemogućnosti agregiranja preferencija prema međusobno neusporedivim kriterijima. Ovi problemi, za koje postoje formalni teoremi dokaza, mogu imati značajne posljedice za društvo na primjeru odlučivanja u javnom zdravstvu. Metodološka nemogućnost agregiranja preferencija dodatno je uvećana etičkim problemima, što se može vidjeti iz trenutnih primjera alokacije oskudnih cjepiva. Međutim, bez nekog oblika društvenog agregiranja preferencija ili nekog oblika odlučivanja, javni sektor, pa tako i javno zdravstvo ne može obavljati svoju djelatnost. U radu se ukazuje na neke od problema koji se javljaju zbog trenutnog načina alokacije.
Diabetes type 1 and pregnancy outcome at University Hospital Center Split – a retrospective study
Authors: Praprotnik Doris , Meštrović Zoran , Vulić Marko , Radman Maja , Roje Damir
Published: June 2021

Aim: To evaluate the prevalence, assessment, and perinatal outcome of pregnancies complicated with diabetes mellitus type 1 (DM type 1) at a tertiary perinatal center in the town of Split, Dalmatia County. Materials and methods: The investigation was designed as a retrospective cohort study. All pregnant women with DM type 1 that were supervised and gave birth at Clinical Department of Obstetrics and Gynecology, Split University Hospital Center during a 7-year period (2009-2015), including those diagnosed in 2015 and having delivered in 2016, were included in the study group. Data were collected by the census method from legal protocol books. Control group included DM type 1-free pregnancies entered in the same protocol books just following a particular study woman, if meeting all inclusion and exclusion criteria. Results: There were 70 DM type 1 pregnancies, accounting for 0.2% of all deliveries. DM type 1 group newborns were statistically heavier (3650±605 vs. 3428±591g; p=0.031), more frequent large for gestational age (24.3% vs. 5.7%; p=0.002) and macrosomic (24.3% vs. 10%; p=0.033). Compared to control group, DM type 1 women had a significantly higher delivery rate in the 37th to 39th week of gestation (84.3% vs. 58.6%; p=0.001) and higher cesarean section rate (61.4% vs. 32.9%; p=0.001). Conclusion: DM type 1 significantly influences perinatal outcome. It requires multidisciplinary approach and complete supervision should be provided at specialized centers. Respecting the fetal origin of adult diseases theory, inappropriate protocol(s) and/or individual decision(s) can have many health consequences throughout newborns life, which highlights DM type 1 pregnancies to a public health level issue.
Эффекты амплитудно-зависимого внутреннего трения в низкочастотном стержневом резонаторе из отожженной поликристаллической меди
Authors: Назаров В.Е. , Колпаков А.Б.
Published: June 2021

Experimental and theoretical studies of the effects of amplitude-dependent internal friction in a low-frequency rod resonator made of annealed polycrystalline copper are carried out. The results of measurements of nonlinear losses and the shift of resonant frequencies at the first three longitudinal modes of the resonator in the kilohertz frequency range from 2 to 11 kHz are presented. The analytical description of the observed effects is carried out in the framework of the rheological model and the equation of state of a microhomogeneous medium with saturation of hysteresis losses and relaxation of its visco-elastic defects. From the comparison of experimental and analytical results, the values of the effective parameters of the hysteresis nonlinearity of the annealed copper sample and their dependence on the frequency are determined.
Динамика капель, подброшенных над испаряющейся поверхностью воды
Authors: Габышев Д.Н. , Медведев Д.Н. , Мисиюк К.В.
Published: June 2021

The data of a ballistic experiment are analyzed, in which an intense capillary wave injects up microdroplets formed and levitated above a heated region of water due to an ascending convective steam-air flow. The drag force resisting the movement of a droplet is estimated. Using various theoretical approaches, the flow parameters (velocity at different heights, the rate of change of velocity) are estimated. The maximum size of droplets that can levitate freely has been determined. The impossibility of the stationary droplet levitation in a linearly inhomogeneous flow is shown.
Влияние облучения низкоэнергетическими ионами гелия на спектральный коэффициент отражения монокристаллических молибденовых зеркал
Authors: Рогов А.В. , Капустин Ю.В. , Мартыненко Ю.В.
Published: June 2021

The results of a comparative study of the effect of irradiation with helium ions on the optical properties of single-crystal molybdenum mirrors with crystallographic orientations <110> and <111> are presented. The irradiation regime corresponds to the conditions in plasma cleaning systems of the entrance mirrors from contamination in optical diagnostics of ITER while helium is using as a working gas. As a result of such irradiation, a change in specular reflection and diffuse scattering of the mirror occurs, which is practically independent of the initial structure of the surface layer of the mirror and the duration of the irradiation process. Authors explain the observed changes in the optical characteristics of the mirror by the formation of nanosized bubbles in the surface skin layer. Rayleigh scattering of incident radiation on these bubles decreases the intensity of specular reflection and increases diffuse scattering. A model of the formation and growth of nanosized bubbles and their effect on optical properties is proposed. The obtained results should be taken into account when analyzing experimental data in optical diagnostics of ITER after removing contaminants using helium, when choosing a working gas for mirror cleaning, and also for the formation of a nanoporous structure in a thin surface layer of metals.
Объемно-температурная зависимость электро- и теплофизических свойств alpha-железа при высоких давлениях и температурах
Authors: Молодец А.М. , Голышев А.А.
Published: June 2021

Modification of the semiempirical description of the volume-temperature dependence of the electrical conductivity and thermal conductivity of alpha-iron (iron having a body-centered cubic lattice structure) is presented. The interpolation of the volume-temperature dependences of the resistivity and thermal conductivity of alpha-iron along high-temperature isobars and high-pressure isotherms in the pressure range from -5 GPa to +5 GPa and temperatures of 400-800 K is considered for the conditions of normal and emergency operation of iron alloys. The interpolation of the electro-and thermophysical properties of alpha-iron is performed on the basis of the developed equation of state of alpha-iron at high pressures and temperatures. the effect of compression and tensile pressure on the thermal conductivity of alpha-iron is estimated.
Экспериментальное и теоретическое исследование схождения тороидальной ударной волны
Authors: Барышников А.С. , Басаргин И.В. , Безверхний Н.О. , Монахов Н.А. , Попов П.А.
Published: June 2021

Экспериментально и теоретически исследуется схождение тороидальной ударной волны, образующейся в кольцевом электрическом разряднике. Для расчетов схождения внутренней волны использовано уравнение "геометрической динамики" Честера-Чизнелла-Уизема, полученное для распространения ударной волны с учетом физико-химических превращений в газе. Проведено сравнение экспериментальных и расчетных результатов. Отмечено увеличение инкремента нарастания возмущений на фронте для химически реагирующих газов. Ключевые слова: сходящаяся ударная волна, кольцевой электрический разрядник, химические процессы, метод Честера-Чизнелла-Уизема.
Сравнение энергетической эффективности воспламенения топливной смеси искровым и стримерным разрядами
Authors: Булат П.В. , Волков К.Н. , Грачев Л.П. , Есаков И.И. , Лавров П.Б. , Продан Н.В. , Чернышов П.С.
Published: June 2021

An increase in fuel efficiency and efficiency of combustion processes in power plants is discussed based on the data of physical and computational experiments. Two systems for ignition of a fuel mixture are considered, one of which uses a multi-point pulsed spark discharge, and the other uses a multipoint streamer discharge. A comparative assessment of the energy efficiency of each approach to the ignition of the air/fuel mixture is carried out, and conclusions are drawn about their effectiveness and prospects for use.
Physical Activity Together for People With Multiple Sclerosis and Their Care Partners: Protocol for a Feasibility Randomized Controlled Trial of a Dyadic Intervention
Authors: Fakolade Afolasade , Cameron Julie , McKenna Odessa , Finlayson Marcia L , Freedman Mark S , Latimer-Cheung Amy E , Pilutti Lara A
Published: June 2021

Background

Physical activity (PA) is beneficial for all people; however, people affected by multiple sclerosis (MS) find regular PA challenging. These people may include individuals with advanced disabilities and their care partners.

Objective

The objective of this study is to determine the feasibility of a dyadic PA intervention for people with advanced MS and their care partners.

Methods

This study is a randomized controlled feasibility trial of a 12-week intervention, with 1:1 allocation into an immediate intervention condition or delayed control condition. A target of 20 people with MS–care partner dyads will be included. The outcomes will be indicators of process, resources, management, and scientific feasibility. Participant satisfaction with the intervention components will be evaluated using a satisfaction survey. The subjective experience of participation in the study will be explored using semistructured interviews.

Results

The project is funded by the Consortium of Multiple Sclerosis Centers. This protocol was approved by the Ottawa Hospital Research Ethics Board (20190329-01H) and the University of Ottawa Research Ethics Board (H-09-19-4886). The study protocol was registered with ClinicalTrials.gov in February 2020. The findings of this feasibility trial will be disseminated through presentations at community events to engage the MS population in the interpretation of our results and in the next steps. The results will also be published in peer-reviewed journals and presented to the scientific community at national and international MS conferences.

Conclusions

The data collected from this feasibility trial will be used to refine the intervention and materials in preparation for a pilot randomized controlled trial.

Trial Registration

ClinicalTrials.gov NCT04267185; https://clinicaltrials.gov/ct2/show/NCT04267185.

International Registered Report Identifier (IRRID)

PRR1-10.2196/18410
Gamifying Sexual Education for Adolescents in a Low-Tech Setting: Quasi-Experimental Design Study
Authors: Haruna Hussein , Okoye Kingsley , Zainuddin Zamzami , Hu Xiao , Chu Samuel , Hosseini Samira
Published: June 2021

Background

Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education.

Objective

The aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting.

Methods

A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods.

Results

The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches.

Conclusions

Digital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.
Evaluating Simplified Web Interfaces of Risk Models for Clinical Use: Pilot Survey Study
Authors: Beaubien Louis , Conrad Colin , Music Janet , Toze Sandra
Published: June 2021

Background

In this pilot study, we investigated sociotechnical factors that affect intention to use a simplified web model to support clinical decision making.

Objective

We investigated factors that are known to affect technology adoption using the unified theory of acceptance and use of technology (UTAUT2) model. The goal was to pilot and test a tool to better support complex clinical assessments.

Methods

Based on the results of a previously published work, we developed a web-based mobile user interface, WebModel, to allow users to work with regression equations and their predictions to evaluate the impact of various characteristics or treatments on key outcomes (eg, survival time) for chronic obstructive pulmonary disease. The WebModel provides a way to combat information overload and more easily compare treatment options. It limits the number of web forms presented to a user to between 1 and 20, rather than the dozens of detailed calculations typically required. The WebModel uses responsive design and can be used on multiple devices. To test the WebModel, we designed a questionnaire to probe the efficacy of the WebModel and assess the usability and usefulness of the system. The study was live for one month, and participants had access to it over that time. The questionnaire was administered online, and data from 674 clinical users who had access to the WebModel were captured. SPSS and R were used for statistical analysis.

Results

The regression model developed from UTAUT2 constructs was a fit. Specifically, five of the seven factors were significant positive coefficients in the regression: performance expectancy (β=.2730; t=7.994; P<.001), effort expectancy (β=.1473; t=3.870; P=.001), facilitating conditions (β=.1644; t=3.849; P<.001), hedonic motivation (β=.2321; t=3.991; P<.001), and habit (β=.2943; t=12.732). Social influence was not a significant factor, while price value had a significant negative influence on intention to use the WebModel.

Conclusions

Our results indicate that multiple influences impact positive response to the system, many of which relate to the efficiency of the interface to provide clear information. Although we found that the price value was a negative factor, it is possible this was due to the removal of health workers from purchasing decisions. Given that this was a pilot test, and that the system was not used in a clinical setting, we could not examine factors related to actual workflow, patient safety, or social influence. This study shows that the concept of a simplified WebModel could be effective and efficient in reducing information overload in complex clinical decision making. We recommend further study to test this in a clinical setting and gather qualitative data from users regarding the value of the tool in practice.
A Biofeedback App for Migraine: Development and Usability Study
Authors: Ingvaldsen Sigrid Hegna , Tronvik Erling , Brenner Eiliv , Winnberg Ingunn , Olsen Alexander , Gravdahl Gøril Bruvik , Stubberud Anker
Published: June 2021

Background

Biofeedback is effective in treating migraines. It is believed to have a beneficial effect on autonomous nervous system activity and render individuals resilient to stressors that may trigger a migraine. However, widespread use of biofeedback is hampered by the need for a trained therapist and specialized equipment. Emerging digital health technology, including smartphones and wearables (mHealth), enables new ways of administering biofeedback. Currently, mHealth interventions for migraine appear feasible, but development processes and usability testing remain insufficient.

Objective

The objective of this study was to evaluate and improve the feasibility and usability of an mHealth biofeedback treatment app for adults with migraine.

Methods

In a prospective development and usability study, 18 adults with migraine completed a 4-week testing period of self-administered therapist-independent biofeedback treatment consisting of a smartphone app connected to wearable sensors (Cerebri, Nordic Brain Tech AS). The app included biofeedback training, instructions for self-delivery, and a headache diary. Two wearable sensors were used to measure surface electromyographic voltage at the trapezius muscle and peripheral skin temperature and heart rate at the right second fingertip. Participants were instructed to complete a daily headache diary entry and biofeedback session of 10 minutes duration. The testing period was preceded by a preusability expectation interview and succeeded by a postusability experience interview. In addition, an evaluation questionnaire was completed at weeks 2 and 4. Adherence was calculated as the proportion of 10-minute sessions completed within the first 28 days of treatment. Usability and feasibility were analyzed and summarized quantitatively and qualitatively.

Results

A total of 391 biofeedback sessions were completed with a median of 25 (IQR 17-28) per participant. The mean adherence rate was 0.76 (SD 0.26). The evaluation questionnaire revealed that functionality and design had the highest scores, whereas engagement and biofeedback were lower. Qualitative preexpectation analysis revealed that participants expected to become better familiar with physical signals and gain more understanding of their migraine attacks and noted that the app should be simple and understandable. Postusability analysis indicated that participants had an overall positive user experience with some suggestions for improvement regarding the design of the wearables and app content. The intervention was safe and tolerable. One case of prespecified adverse events was recorded in which a patient developed a skin rash from the sticky surface electromyography electrodes.

Conclusions

The app underwent a rigorous development process that indicated an overall positive user experience, good usability, and high adherence rate. This study highlights the value of usability testing in the development of mHealth apps.
Evaluating the Acceptability, Feasibility, and Outcomes of Two Methods Involving Patients With Disability in Developing Clinical Guidelines: Crossover Pilot Study
Authors: Lamontagne Marie-Eve , Gagnon Marie-Pierre , Perreault Kadija , Gauthier Véronique
Published: June 2021

Background

Engaging patients and the public in clinical practice guideline (CPG) development is believed to contribute significantly to guideline quality, but the advantages of the various co-design strategies have not been empirically compared, making it difficult to choose one strategy over another.

Objective

This pilot study aims to document the acceptability, feasibility, and outcomes of 2 methods of involving patients in outlining CPG.

Methods

A single-blind crossover pragmatic study was performed with patients with traumatic brain injury. The patients experimented with 2 alternative methods of producing clinical practice recommendations (ie, a discussion group and a wiki). The participants rated the acceptability of the 2 methods, and feasibility was assessed using indicators, such as the number of participants who completed the 2 methods and the number of support interventions required. Experts, blinded to the method, independently rated the participants' outcome recommendations for clarity, accuracy, appropriateness, and usefulness.

Results

We recruited 20 participants, and 16 completed the study. The acceptability of the 2 methods showed little variation, with qualitative comments expressing a slight preference for the social nature of focus groups. Thus, both methods of involving patients in CPG development appeared feasible, and the experts’ opinions of the adapted recommendations were both positive, although the recommendations produced through focus groups were deemed more relevant to support clinical practice.

Conclusions

Our results confirm the acceptability and feasibility of focus groups and wikis to allow patients with traumatic brain injury to participate in clinical practice guideline production. This study contributes to the scientific literature by suggesting that the 2 methods were acceptable, feasible, and produced positive outcomes.

Trial Registration

ClinicalTrials.gov NCT02023138; https://clinicaltrials.gov/ct2/show/NCT02023138
Understanding Physicians’ Preferences for Telemedicine During the COVID-19 Pandemic: Cross-sectional Study
Authors: Nies Sarah , Patel Shae , Shafer Melissa , Longman Laura , Sharif Iman , Pina Paulo
Published: June 2021

Background

In contrast to the current broad dissemination of telemedicine across medical specialties, previous research focused on the effectiveness of telemedicine in special populations and for behavioral health encounters, demonstrating that both physician and patient factors impact the efficacious use of telemedicine.

Objective

We aim to evaluate physician perceptions of the appropriateness of telemedicine for patients attending the primary care practices of a federally qualified health center in New York City.

Methods

We used an anonymous cross-sectional survey including closed- and open-ended questions. We used chi-square to test whether providers from certain specialties were more likely to state they would use telemedicine in the future. We used t tests to compare age between those who would versus would not use telemedicine. We then used logistic regression to test whether age and specialty were both correlated with the desire to use telemedicine in the future. We used thematic content analysis to describe the reasons providers felt they would not want to use telemedicine in the future and to describe the situations for which they felt telemedicine would be appropriate.

Results

Of 272 health care providers who were sent the electronic survey, 157 (58%) responded within the 2-week survey time frame. The mean age of providers was 45 (range 28-75) years. Overall, 80% (126/157) stated they would use telemedicine in the future. Compared to the family medicine, internal medicine, behavioral health, dental, and obstetrics and gynecology specialties, providers from pediatrics, med-peds, subspecialties, and surgery (protelemedicine specialties) were more likely to believe telemedicine would be useful post pandemic (61/67 [91%] vs 65/90 [72%]; P<.001). Providers who reported they would use telemedicine in the future were younger (mean age 44, range 42-46 years vs mean age 50, range 46-55 years; P=.048). In the regression analysis, both protelemedicine specialties and age were significantly associated with odds of reporting they would use telemedicine in the future (prospecialties: odds ratio 5.2, 95% CI 1.7-16.2; younger age: odds ratio 1.05, 95% CI 1.01-1.08). Providers who did not want to use telemedicine in the future cited concerns about inadequate patient care, lack of physical patient interaction, technology issues, and lack of necessity. Providers who felt telemedicine would be useful cited the following situations: follow-up visits, medication refills, urgent care, patient convenience, and specific conditions such as behavioral health, dermatology visits, and chronic care management.

Conclusions

The majority of health providers in this resource-limited setting in a federally qualified health center believed that telemedicine would be useful for providing care after the pandemic is over.
Supportive Accountability and Mobile App Use in a Tobacco Control Intervention Targeting Low-Income Minority Mothers Who Smoke: Observational Study
Authors: Lepore Stephen J , Collins Bradley N , Killam Howard W , Barry Barbara
Published: June 2021

Background

Smartphone mobile apps are frequently used in standalone or multimodal smoking cessation interventions. However, factors that impede or improve app usage are poorly understood.

Objective

This study used the supportive accountability model to investigate factors that influence app usage in the context of a trial designed to reduce maternal smoking in low-income and predominantly minority communities.

Methods

We conducted a secondary analysis of data (N=181) from a randomized controlled trial that included a smoking cessation app (QuitPal-m). Supportive accountability was measured by the number of times a participant was advised by their cessation counselor to use QuitPal-m. Participants reported app use helpfulness and barriers. Investigators tracked reported phone and technical problems that impeded app use.

Results

Most participants rated the app as very helpful (103/155, 66.5%), but daily use declined rapidly over time. App use was positively related to the level of perceived app helpfulness (P=.02) and education (P=.002) and inversely related to perceived barriers (P=.003), phone technical problems (P<.001), and cigarettes smoked per day at the end of treatment (P<.001). Participants used the app a greater proportion of the days following app advice than those preceding app advice (0.45 versus 0.34; P<.001). The positive relation between counselor app advice and app usage 24 hours after receiving advice was stronger among smokers with no plan to quit than in those planning to quit (P=.03), independent of education and phone or app problems.

Conclusions

Findings show the utility of supportive accountability for increasing smoking cessation app use in a predominantly low-income, minority population, particularly if quit motivation is low. Results also highlight the importance of addressing personal and phone/technical barriers in addition to adding supportive accountability.

Trial Registration

ClinicalTrials.gov NCT02602288; https://clinicaltrials.gov/ct2/show/NCT02602288
Creation of a Student-Run Medical Education Podcast: Tutorial
Authors: Milligan Kevin John , Daulton Robert Scott , St Clair Zachary Taylor , Epperson Madison Veronica , Holloway Rachel Mackenzie , Schlaudecker Jeffrey David
Published: June 2021

Background

Podcasting has become a popular medium for medical education content. Educators and trainees of all levels are turning to podcasts for high-quality, asynchronous content. Although numerous medical education podcasts have emerged in recent years, few student-run podcasts exist. Student-run podcasts are a novel approach to supporting medical students. Near-peer mentoring has been shown to promote medical students’ personal and professional identity formation. Student-run podcasts offer a new medium for delivering near-peer advice to medical students in an enduring and accessible manner.

Objective

This paper describes the creation of the UnsCripted Medicine Podcast—a student-run medical education podcast produced at the University of Cincinnati College of Medicine.

Methods

The planning and preparatory phases spanned 6 months. Defining a target audience and establishing a podcast mission were key first steps. Efforts were directed toward securing funding; obtaining necessary equipment; and navigating the technical considerations of recording, editing, and publishing a podcast. In order to ensure that high professionalism standards were met, key partnerships were created with faculty from the College of Medicine.

Results

The UnsCripted Medicine Podcast published 53 episodes in its first 2 years. The number of episodes released per month ranges from 0 to 5, with a mean of 2.0 episodes. The podcast has a Twitter account with 217 followers. The number of listeners who subscribed to the podcast via Apple Podcasts grew to 86 in the first year and then to 218 in the second year. The show has an average rating of 4.8 (out of 5) on Apple Podcasts, which is based on 24 ratings. The podcast has hosted 70 unique guests, including medical students, resident physicians, attending physicians, nurses, physicians’ family members, graduate medical education leadership, and educators.

Conclusions

Medical student–run podcasts are a novel approach to supporting medical students and fostering professional identity formation. Podcasts are widely available and convenient for listeners. Additionally, podcast creators can publish content with lower barriers of entry compared to those of other forms of published content. Medical schools should consider supporting student podcast initiatives to allow for near-peer mentoring, augment the community, facilitate professional identity formation, and prepare the rising physician workforce for the technological frontier of medical education and practice.
The GIMEMA-ALLIANCE Digital Health Platform for Patients With Hematologic Malignancies in the COVID-19 Pandemic and Postpandemic Era: Protocol for a Multicenter, Prospective, Observational Study (Preprint)
Authors: Efficace Fabio , Breccia Massimo , Fazi Paola , Cottone Francesco , Holzner Bernhard , Vignetti Marco
Published: June 2021

BACKGROUND

The COVID-19 pandemic has raised unprecedented challenges in the management of patients with cancer and has increased the demands for digital health tools that, for example, could facilitate remote monitoring of patients. Based on this, the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) has recently developed a digital health tool dedicated to patients with hematologic malignancies: the GIMEMA-ALLIANCE platform.

OBJECTIVE

The main objectives of this web-based platform are to generate relevant data to better understand quality of life, symptoms, and medication adherence during the COVID-19 pandemic and postpandemic era; to develop a prospective real-life registry on outcomes of patients with hematologic cancer, with or without a diagnosis of COVID-19; and to facilitate patient-centered care in routine practice.

METHODS

The platform consists of physician- and patient-secure portals and enables electronic patient-reported outcome (ePRO) assessments with real-time graphical presentation to physicians of individual patient symptoms and quality-of-life outcomes. Automated alerts are sent to treating hematologists based on the following predetermined criteria: presence of clinically important problems and symptoms, problems with adherence to therapy, and risk of COVID-19 diagnosis. The platform also allows physicians to set up video consultations. Clinical information regarding disease and treatment as well as clinical and survival outcomes are also prospectively collected.

RESULTS

Recruitment of participants started in December 2020. As of April 2021, a total of 116 patients have been enrolled in this study. Use of this platform may help to improve patient-physician communication and help hematologists in the early recognition of clinically important problems and symptoms of their patients. More than 20 community and university-based hospitals have currently agreed to participate. In addition to patient-reported outcome data, the prospective collection of disease- and treatment-related information, as well as data on possible COVID-19 diagnosis and COVID-19 vaccination, will allow the development of a large database to also identify subgroups of patients at risk of poor outcomes.

CONCLUSIONS

Data generated via this platform will help to answer clinically relevant questions for patients with hematologic malignancies during the COVID-19 pandemic and postpandemic era. The use of the GIMEMA-ALLIANCE platform in routine practice may also contribute to enhancing patient-centered care.

CLINICALTRIAL

ClinicalTrials.gov NCT04581187; https://clinicaltrials.gov/ct2/show/NCT04581187

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/25271
Physicians’ Perspectives of Telemedicine During the COVID-19 Pandemic in China: Qualitative Survey Study (Preprint)
Authors: Liu Jialin , Liu Siru , Zheng Tao , Bi Yongdong
Published: June 2021

BACKGROUND

Generalized restriction of movement due to the COVID-19 pandemic, together with unprecedented pressure on the health system, has disrupted routine care for non–COVID-19 patients. Telemedicine should be vigorously promoted to reduce the risk of infections and to offer medical assistance to restricted patients.

OBJECTIVE

The purpose of this study was to understand physicians’ attitudes toward and perspectives of telemedicine during and after the COVID-19 pandemic, in order to provide support for better implementation of telemedicine.

METHODS

We surveyed all physicians (N=148), from October 17 to 25, 2020, who attended the clinical informatics PhD program at West China Medical School, Sichuan University, China. The physicians came from 57 hospitals in 16 provinces (ie, municipalities) across China, 54 of which are 3A-level hospitals, two are 3B-level hospitals, and one is a 2A-level hospital.

RESULTS

Among 148 physicians, a survey response rate of 87.2% (129/148) was attained. The average age of the respondents was 35.6 (SD 3.9) years (range 23-48 years) and 67 out of 129 respondents (51.9%) were female. The respondents come from 37 clinical specialties in 55 hospitals located in 14 provinces (ie, municipalities) across Eastern, Central, and Western China. A total of 94.6% (122/129) of respondents’ hospitals had adopted a telemedicine system; however, 34.1% (44/129) of the physicians had never used a telemedicine system and only 9.3% (12/129) used one frequently (≥1 time/week). A total of 91.5% (118/129) and 88.4% (114/129) of physicians were willing to use telemedicine during and after the COVID-19 pandemic, respectively. Physicians considered the inability to examine patients in person to be the biggest concern (101/129, 78.3%) and the biggest barrier (76/129, 58.9%) to implementing telemedicine.

CONCLUSIONS

Telemedicine is not yet universally available for all health care needs and has not been used frequently by physicians in this study. However, the willingness of physicians to use telemedicine was high. Telemedicine still has many problems to overcome.
Mindfulness-Based Stress Reduction (MBSR) increases mental wellbeing and emotion regulation during the first wave of the COVID-19 pandemic: a synchronous online intervention study. (Preprint)
Authors: Sanilevici Maya , Reuveni Omer , Lev-Ari Shahar , Golland Yulia , Levit-Binnun Nava
Published: June 2021

UNSTRUCTURED

The COVID-19 pandemic imposed extreme living conditions of social distancing and stay-at-home orders, which not only triggered negative mental health problems, but also created challenges in seeking mental health support. Consequently, many support services and programs were forced to rapidly shift into online platforms. Mindfulness-based programs have been found to enhance wellbeing and mental health, by reducing stress and anxiety and improving emotion regulation. Preliminary evidence suggests that online, synchronous mindfulness-based programs may produce beneficial effects similar to face-to-face programs. However, the effectiveness of such online mindfulness programs to support mental health in extremely stressful times such as a global pandemic requires more study.
To test the effect of an online 8-week mindfulness-based program (Mindfulness-Based Stress Reduction, MBSR) on anxiety and stress levels, and on emotion regulation and tolerance of uncertainty abilities during the first wave of the COVID-19 pandemic.
Individuals/Participants (N=92) who expressed interest in discounted online-MBSR programs were recruited to the study. Division into experimental and control groups was based on actual enrollment to the courses. Those who decided to enroll to one of the programs were assigned to the experimental condition and those who decided not to enroll served as controls. Participants were assessed pre-intervention (T1), post-intervention (T2) and one-month post-intervention (T3) for levels of mindfulness, perceived stress, anxiety, emotion regulation and intolerance of uncertainty. The study was conducted in April 2020, at the peak of the first wave of COVID-19 in Israel and ended in July at the beginning of the second wave.
The findings indicate that relative to the control group, MBSR improved mindfulness abilities (p=.004), decreased anxiety (p=.021) and stress (p<.001) and increased emotion regulation (p<.001). These effects persisted even a month after the end of the program, although governmental public-health restrictions due to COVID-19 were worsened at that time. Ability to tolerate uncertainty, a central characteristic of the pandemic, was not significantly affected by the program. The interventions effect on mental health improvement was partially mediated by the improvement in emotion regulation (β = 0.24, CI = [0.054, 0.373])
Overall, our findings provide positive evidence for the feasibility of an online-MBSR program to support mental health of individuals from the general population through the mediation of emotion regulation, in challenging times such as a global pandemic.