bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights on Using Social Media in Dental Education: A Cross-Sectional Study in Saudi Arabia
Authors: Rajeh Mona T. , Aboalshamat Khalid T. , Nassar Afnan A. , Sembawa Shahinaz N. , Al Hebshi Seba A. , Badri Mohammad K.
Published: January 2021

Objective:

The purpose of this study is to investigate the insight of utilizing social media as an educational tool among dental faculty members in Saudi Arabia.

Methods:

A descriptive cross-sectional survey was distributed to 380 randomly selected faculty members from three governmental universities in the Western region of Saudi Arabia. The participants completed a validated questionnaire to assess the intent of using social media and their opinion about the benefits and drawbacks of adopting social media as an educational tool. Descriptive statistics and chi-square test were used to analyse the results.

Results:

Out of 380 faculty members who were invited to participate, 271 responded (71% response rate). Results reveal that WhatsApp, followed by YouTube, Facebook, and Twitter were the mostly used social media platforms. Around 31% of the participants reported using social media for ten hours or more. The main reason reported by the participants for using social media was searching for information (82.17%), followed by professional networking (78.29%) and learning (75.97%). The majority of the participants agreed that social media have advantages like it helps students to communicate and share ideas with instructors, update students with new resources, and improve students’ skills. Social media also has several disadvantages; the respondents believe that it can increase their addictive potential, create more demand for internet access, and raise concerns on direct contact with students.

Conclusion:

As an educational tool, social media can enrich the teaching experience by using the appropriate strategies. The findings may be useful for educators to adopt social media platforms in dental education.
The Effect of Topical Anesthetic Gel versus Relaxation Exercise in Controlling the Pain of Anterior Maxillary Injection
Authors: Omidpanah Neda , Shahrzad Nematollahi , Safari Roya
Published: January 2021

Background and Aim:

Adequate intraoral anesthesia is a major prerequisite for many dental procedures. Bubble breath exercise, distraction, and play therapy technique may be used as relaxation exercises to decrease pain. This study aimed to compare the efficacy of bubble breath exercise versus topical anesthetic gel in controlling the pain of anterior maxillary infiltration.

Methods:

This crossover clinical trial was performed on 50 children aged 10-12 years. Subjects received a total of 100 maxillary injections (two per person) in the buccal mucosal area of canine teeth of both sides at intervals of 2 to 3 days. On one side, the injection was performed after applying 20% benzocaine gel. On the other side, a similar injection was performed after the bubble breath exercise. The injection solution was 1/4 of 1.8 mL cartridge of 2% lidocaine containing 1:200,000 epinephrine using a 30-gauge needle. The pain was measured immediately after anesthesia injection using a Visual Analogue Scale (VAS). Data analysis was carried out using SPSS Version 18.0 (IBM Inc., Chicago, IL, USA). Wilcoxon signed-rank tests were used to compare with the 10-mm visual analog scale (VAS) scores obtained from all participants. The level of significance was considered at 5% (p <0.05). The correlation between gender and pain score (VAS) for the two methods was analyzed using the Mann-Whitney U test.

Results:

The results showed no statistically significant difference between injection pain after topical anesthetic gel application and injection pain after bubble breath exercise (p value=0.30). Also, no statistically significant difference was found between injection pain after gel application and injection pain after bubble breath exercise in boys (p value=0.59) or girls (p value=0.32). There were statistically significant differences between boys and girls in terms of injection pain after gel application (p value=0.001) and also injection pain after e bubble breath exercise (pvalue=0.004).

Conclusion:

There is no significant difference between perceived injection pain after bubble breath exercise and after applying the topical anesthetic gel. Furthermore, future studies should explore the role of age, dental fear, and anxiety, previous painful experiences, the pain thresholds.
Intervention versus Observation in Mild Idiopathic Scoliosis in Skeletally Immature Patients
Authors: Yan NG Shu , NG Ying Ling , Cheng Ka Ping , Chan Wing Yan , Ho Tsz Ki
Published: January 2021

Introduction:

Observation is the treatment of choice for idiopathic scoliosis with Cobb angles between 15 degrees - 20 degrees in growing children. This passive approach does not address the anxiety of the patient and the stress of the parents. In this paper, we attempt to identify skeletally immature patients with mild scoliosis curvatures that are more at risk of progression and propose possible intervention for this group of subjects.

Methods:

The literature was searched in Pubmed, and additional references were searched manually in the literature.

Results:

Many studies have shown that low serum 25[OH]D level, bone mineral density (BMD), and body mass index (BMI) are related to the curve severity or progression of the curve.

We suggest that skeletally immature patients (< Risser 2) with mild curves be divided into two groups, viz. Group O (observation) with a lower risk of progression, and Group I (intervention) with a higher risk of curvature progression. We propose early intervention for the latter group.

It is suggested that pre-menarcheal, skeletally immature patients with mild idiopathic scoliosis, and low vitamin D, BMD, and BMI should be treated. Also, asymmetric foot biomechanics should be addressed, although nutrition and foot orthoses are regarded to have no role in the management of idiopathic scoliosis. The outcome of early intervention may be utterly different from late treatment when the curvature becomes more structural, and the patient more skeletally mature.

Conclusion:

Research is required to prove if the intervention is clinically indicated.
Descriptive Study of Nursing Students' Learning Styles. Case Study of the Professional Bachelor's Degree Cycle in Nursing of the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco
Authors: Lamiri Abderrahmane , Qaisar Rabia , Khoaja Driss , Abidi Omar , Bouzoubaa Hind , Khyati Abderrahim
Published: January 2021

Background:

Learning difficulties experienced by learners are among the most recurring problems in education and, without doubt, the most worrying. Thus, at the beginning of each year, we at the Higher Institute of Nursing Professions and Health Techniques of Casablanca, Morocco (ISPITSC) note the diversity of intrinsic characteristics in our students in the initial training of the Professional Bachelor's (PB) degree cycle in initial nursing training. We believe these characteristics are related to the varied difficulties of adaptation and learning encountered in the first year. However, a lack of knowledge of the learning styles adopted by our students prevents the teaching staff from detecting the difficulties encountered by the learners in assimilating new knowledge during the 3 years of their training course. The identification of these learning styles and subsequent readjustments in training would help improve the quality of training and guarantee an effective mobilisation of knowledge during various care activities, while allowing the acquisition of necessary skills in the context of quality care that meets the needs of patients.

Objective:

The objective of this study is to identify the learning styles of nursing students in the BP nursing cycle at ISPITS Casablanca in Morocco and to classify their origin and nature according to the typology described by Honey and Mumford.

Methods:

Our research used a diagnostic and screening instrument for learning styles developed by Honey and Mumford, the “Learning Style Questionnaire” (LSQ), an abbreviated French version of which (LSQ-Fa) has been translated by Fortin et al. A sample of 49 students received the data collection instrument.

Results:

The study obtained a response rate of 87.75% (43 students). The results are similar to the research that shows that reflector style is the preferred learning style of learners in PB nursing education. However, the study also identified an important category of students who have dual learning styles.

Conclusion:

Given the gap between learners' teaching style and learning style and its consequences for the assimilation of the knowledge provided, nursing educators should adapt their educational strategies to the particularities of their students in order to reduce learning difficulties and promote the effective mobilisation of knowledge in various complex learning situations.
The Connection between Health Promotion, Prevention, and Psychosocial Health: An Innovative Action Model
Authors: Helfer Tannys , Faeh David , Luijckx Eefje , Frey Sibylle , Berg Annemarie , Peter Karin Anne
Published: January 2021

The promotion of psychosocial health among individuals, groups, and society is becoming an increasingly important task and research topic in the field of public health. Psychosocial health is a complex interaction between the psyche of an individual and the social environment in which that individual lives. Promoting psychosocial health is often challenging and complex for health care professionals. Therefore, an important question of public health significance is: how can we address and improve the psychosocial health of individuals, groups, as well as society in general?

An interdisciplinary team of specialists at the Department of Health Professions at the Bern University of Applied Sciences, Switzerland, focused on the connection between health promotion, prevention, and psychosocial health. This team newly defined these topics in relation to how they could be synergistically combined to promote psychosocial health. Additionally, they presented an action model to graphically depict their connection.

The proposed action model is based upon already well-established concepts, models, frameworks in health promotion, and prevention practice. In a further step, they have depicted them in a way that clearly integrates and combines their core concepts for their practical application in promoting psychosocial health. As these topics are overlapping, their clear illustration is important in promoting their systematic and planned usage.

This new and innovative approach encourages the systematic usage of health promotion and prevention for the promotion of psychosocial health. The next step would be the implementation and evaluation of this action model, especially the measurement of the outcome (psychosocial health). The integrative and intentional use of health promotion and prevention is an innovative approach for the promotion of psychosocial health in public health practice.
Strengthening Capacity through Expansion of Community Participation in Mangrove Ecotourism Management in Pamurbaya
Authors: Rahaju Tjitjik , Suryono Agus , Mardiyono Mardiyono , Rochmah Siti
Published: January 2021

The movement of the public sector in development has become important in relation to the governance agenda (Pomerantz in Bevir,2011;164) . Development failures in many developing countries are due to the presence of insignificant community participation in poverty alleviation (Grindle,2004;526). Surabaya is an example of a city that is trying to continue to empower its people through various activities under Dinas Pertanian dan Ketahanan Pangan.The potential of coastal areas that are rich in mangroves in Surabaya along the East Coast of Surabaya (Pamurbaya) is the choice to empower the community with mangrove ecotourism designn. Theoretically the phenomenon of empowerment in the view of researchers is interesting to study. Considering even though there have been many empowerment programs implemented in Pamurbaya. The existing program has not been able to fully complete community capacity development. Active community participation was also still limited and the achievement of prosperity that needs to be improved.
Financial Performance of Village-Owned Enterprises (VOEs): Case in Blitar Regency, East Java, Indonesia
Authors: Sari Yuni Purwita , Putra Fadilah , Sujarwoto Sujarwoto
Published: January 2021

Villages have many assets and potentials. Through Village-Owned Enterprises (VOEs), business entities owned by villages, the village assets, and potentials could be managed well for the greatest welfare of the village community. As public enterprises, VOEs are expected to play an important role in the mobilization of resources and they can do so if they are financially viable. Therefore, financial performance is a vital element for Village-Owned Enterprises (VOEs) sustainability. Using a multi-method design, this research aims to examine the growth of financial performance of VOEs in Blitar Regency from 2015 to 2019 and to explore factors that affect the financial performance of VOEs in Blitar Regency from 2015 to 2019. The results discovered that, in general, the financial performance of VOEs in Blitar Regency did not show any significant growth. Out of 85 observed VOEs, 74 of them did not go up from their previous level. However, there are VOEs whose financial performance is increase and decrease, which are five and six VOEs respectively. In addition, human resources, support from the Village Government, and VOE's ability to see business opportunities that exist in accordance with community needs and the potential of the village become the factors that affect the financial performance of Village-Owned Enterprises (VOEs). These factors should be considerations for policymaker and other stakeholders in setting appropriate programs or activities intended to enhance the development of VOEs, which will eventually, contributes to the village development.
Governmental policy capacity and policy work in a small place: Reflections on perceptions of civil servants in Prince Edward Island, Canada from a practitioner in the field
Authors: Cameron Bobby Thomas Robert
Published: January 2021

The body of public administration literature is missing contributions from practitioners in the field. Emic or insider-led studies of public administration can act as powerful mechanisms to generate new knowledge. This article studies the relationship between place, perceptions and policy work by drawing on the author’s own public administration experience and interviews with civil servants. The results show that societal factors such as political culture and reduced anonymity associated with small place create challenges when developing public policy. However, expedited public engagement and problem identification were perceived by civil servants to be enhanced by a small context. This means that small place can be both limiting and beneficial for high levels of policy capacity. Overall, this article finds that geospatial factors such as smallness impact perceptions of policy work and capacity. Furthermore, this article finds that insider-led studies of public administration can indeed make important and unique contributions to the body of literature and are therefore deserving of more serious methodological consideration.
Transformasi Makna dan Fungsi Ruang di RPTRA Kalijodo dalam Pergulatan Citra Kota Jakarta
Authors:   Universitas Pembangunan Jaya, Permanasari Eka , Lientino Thomas ,   Universitas Pembangunan Jaya
Published: January 2021

Kalijodo has a long history in terms of gambling, prostitution, human trafficking and other illicit activities. Although it is a green belt area, the location had always being filled with semipermanent buildings. The area was changed its meaning in 2016 when the late Governor of Ahok with the help of the police and army, eradicated these housing and transformed this place as the community center (RPTRA-Ruang Publik Terpadu Ramah Anak). Together with Yori Antar, Basuki changed Kalijodo into a new center for Jakarta with its mural and skatepark. Former illicit users have been pushed out from the site. Some built a temporary shelter under the highway bridge while others went to their villages. After the fall of Basuki due to the blasphemy crime, the image of RPTRA Kalijodo was contested. Within a day, the area was filled with illegal parking and prostitution returned in different forms taking place under the highway bridge. Layers of meaning and use of Kalijodo transforms rapidly and in results changes the image of the city. Through observation, interviews and archival research, this paper analyses the contestation of the city image by investigating the relationship between the top-down approach and the everyday life uses of space.
Faktor Penentu Preferensi Tipe Hunian di Kalangan Mahasiswa
Authors:   SAPPK ITB, Reski Imega , Tampubolon Angela Christysonia ,   SAPPK ITB
Published: January 2021

The universities development in Indonesia has implications on the increasing number of students. The tendency of the students majority who are transmigrants in the relevant college areas has further implications on the increasing need of shelter. Different backgrounds made different needs. Thus, there are several types of dwellings with their own characteristics. This study divides the dwellings into seven types, namely parents’ house, relatives’ house, bought house, apartment, unit rented house, rented house and dormitory. This study attempts to examine dwelling type preference factors. This study also attempts to find the key factors that became the main preference differentiators, and also comparing the respondent's importance level to each key factor on each dwelling type. The data were collected through a two-stage questionnaire. The results of the pilot phase questionnaire were analyzed qualitatively and became the framework of second phase questionnaire. The exploratory research data were then analyzed quantitatively using factor analysis and ANOVA. The results showed that there were 14 dwelling type preference factors with four preference key factors which differed significantly on the importance level valuation of each dwelling type, namely independency, social interaction, freedom, and privacy. The key factors’ importance level diagram on each dwelling types is served.
Kehadiran Subkultur Klub Motor di Ruang Publik Kota Bandung
Authors:   Fakultas Teknik, Universitas Andi Djemma Palopo, Nurhijrah Nurhijrah
Published: January 2021

The presence of subcultures in urban society is as a result of the heterogeneity of culture. One of subculture that presence in Bandung city is a motorcycle club which can be found in almost every corner of the Bandung city, especially in public spaces. This study was conducted to identify the phenomenon of the process of motorcycle club subculture occupy space in public open space under flyover in Bandung city. Data was collected by observation and interview members of the subculture as a subject of the research. The result showed that the main motive for using public open space under flyover is the desire for self-existence that cannot be accommodated in public space that already exists. Utilization of the space under flyover by the motorcycle club gives new meaning to the space that originally did not have a function in urban spatial. However they also do legitimacy of power over space by said that “the space is theirs”. Therefore architects and planners should consider subculture as a part of the society that have the same right to access public open space and do their activities in Bandung City.
Karakteristik Seting Fisik Ruang Interaksi Warga di Kampung Bantaran Sungai Winongo Yogyakarta
Authors:   Program Studi Arsitektur, Fakultas Teknik, Universitas Atma Jaya Yogyakarta, Pramudito Sidhi
Published: January 2021

Kampung is one type of living space in a city with distinctive characteristics. Yogyakarta is one of the cities in Indonesia which still has a village as part of its inhabitant' living space, one of them is a riverbank kampung. The existence of a riverbank creates a unique physical setting in the kampung, which indirectly affects the creation of inhabitant interaction space. The uniqueness and limitations of the space become interesting to be observed further as a basis for understanding local wisdom in planning future village spaces. This study uses an exploratory method, which was carried out by field observations to collect data with case studies in Kampung Gampingan on Winongo riverbank. This study aimed to determine the variations in the physical settings of space used by residents to interact in the riverbank kampung. The results of this study found several characteristics of physical settings of kampung that affect citizens in conducting interactions, as the combination of the enclosure and spatial elements for a variety of community activities. These results are expected to be used as a reference in conducting the arrangement of Kampung Gampingan as one of the slums in the city of Yogyakarta in the future that is accommodating to the characteristics of the setting of interaction spaces of its citizens.
Keterkaitan Desain Ruang Publik Dengan Perilaku Pengunjung Mall Di Yogyakarta Kasus : Ambarrukmo Plaza Dan Galeria Mal
Authors:   Program Studi Arsitektur, Fakultas Teknik, Universitas Atmajaya Yogyakarta, Sekarlangit Nimas
Published: January 2021

The lifestyle of urban people who prefer shopping in shopping centers rather than traditional markets makes the construction of shopping centers in big cities even bigger. The difference in mall level and the shape of public space offered by the mall are related to visitor behavior. Visitor activities can vary depending on the way they describe the public spaces offered in the mall. This study uses two malls located on Yogyakarta's Adisucipto Road, namely Galeria Mall and Ambarrukmo Plaza. The selection is due to its location on the main road of Yogyakarta. This research aims to study the relationship between the public spaces design and the behavior of visitors at the mall. The method used is descriptive qualitative by recording all activities and designs of public spaces in the mall and analyzing their interrelationships. The results show that Ambarrukmo Plaza and Galeria Mall use a sociopetal space with regulatory spaces that tend to unite individuals to create social interaction. This service is a psychological effect on visitors so that they do not feel alienated in the mall.
Preferensi Masyarakat terhadap Ruang Kota sebagai Tempat Relaksasi
Authors:   SAPPK ITB, Cahyaningtyas Mutia Ayu , Kusuma Hanson Endra ,   SAPPK ITB
Published: January 2021

People who live in urban areas tend to have a higher stress level than those who live in rural areas. Level of stress can be prevented and diminished through the establishment of urban relaxation spaces within the city. Urban city planning needs to consider citizens’ preferences as potential users to obtain the maximum result. This study aims to determine the characteristics of preferred urban relaxation spaces within the city. The research was conducted through a grounded theory approach and exploratory qualitative method. Data collection was carried out based on the open-ended online survey questionnaire with a non-random sampling technique. Data was then analyzed by content analysis in three stages: open coding, axial coding, and selective coding. The finding shows that there are six aspects of preferred urban relaxation spaces: the sense of nature, facilities, tranquility, ambience, accessibility, and quality of space. Research is expected to explore new potentials in urban planning in accordance with the characteristics of its citizens.
Upgrading Slum Area, Development and Hidden Inequality (Case Study: Kampung Warna-Warni and Kampung Tridi)
Authors:   Program Studi Ilmu Politik, Pusat Kajian Perubahan Lingkungan, Universitas Brawijaya Malang, Alfian Faqih , Akbar Taufik ,   Program Studi Ilmu Politik, Pusat Pengkajian Kebijakan Sosial, Universitas Brawijaya Malang
Published: January 2021

The existence of injustice and inequality in access to the development results of the city. Slum areas have become one of the problems that exist in urban life. This automatically occurs as a result of a normal process called urbanization and development. Where many residents end up occupying non-residential areas due to their limited access. Seeing from the perspective of the access theory, how people live in the area is a form of their right to be able to utilize natural resources. One of these uses is used as a place to live. This study used a qualitative descriptive method, by taking several samples as a source of interviews. The arrangement of the slum area is now moving to another dimension, which is no longer forced evictions, but how to organize and change the residential area to be habitable. There are several indicators used in seeing a residential area that is said to be unfit for habitation. Upgrading slum areas have been able to change areas that were previously unfit to be better and able to meet indicators of the feasibility of residential areas in general. This step is also how the community continues to strive to gain access to the area. Kampung Jodipan and Kampung Tridi have changed their appearance, and have improved the quality of their living environment, with tidier, cleaner, and more affordable access to public services. Apart from the results of this research, there are still some problems, one of which is the uncertainty of land rights, so that they will not know the future of the area they live in now. The guarantee of land ownership is important to fight for equal rights to state services, state recognition, and the right to live in the area.
Mudanças microtopográficas na superfície do solo em cultivo de tabaco na Região Sudeste do Paraná – Brasil
Authors: Antoneli Valdemir , Bednarz João Anésio , Menon Leonardo
Published: January 2021

O cultivo do tabaco se tornou uma das principais atividades agrícolas das pequenas propriedades na região sudeste do estado do Paraná - Brasil. Na maior parte dessas propriedades o cultivo é realizado com pouca mecanização, favorecendo assim o desenvolvimento do plantio convencional. Esta forma de cultivo é caracterizada pela exposição e revolvimento periódico do solo. O revolvimento da superfície do solo durante o cultivo cria condições adversas na superfície do solo, modificando a dinâmica hidrogeomofológica da superfície. O objetivo dessa pesquisa foi avaliar a influência das atividades agrícolas na rugosidade superficial do solo, ao longo de um ano em uma área de cultivo do tabaco e como essas mudanças podem interferir na retenção de água no solo. Foram utilizadas parcelas com perfis transversais para identificar como as atividades alteram a microtopografia da superfície do solo no período de safra (setembro a fevereiro) e entressafra (março a agosto). Ao término da pesquisa concluímos que as atividades alteram a rugosidade superficial, interferindo na retenção de água no solo. Durante a colheita do tabaco (dezembro a fevereiro) o agricultor deixou de revolver a superfície do solo e as atividades se intensificam, havendo redução da rugosidade superficial. Neste caso, observamos maior escoamento superficial das entrelinhas durante as chuvas.
Escorregamentos rasos em São Luiz do Paraitinga (SP, Brasil) (2009-2010)
Authors: Bonini José Eduardo , Sanches Ross Jurandyr Luciano , Martins Tiago D. , Vieira Bianca Carvalho
Published: January 2021

Escorregamentos e inundações estão entre as tipologias de desastres que geram os maiores danos no Brasil. No verão de 2009-2010 algumas cidades no Planalto de Paraitinga-Paraibuna (SP), dentre elas São Luiz do Paraitinga, foram atingidas por precipitações intensas que deflagraram centenas de escorregamentos e uma grande inundação. O objetivo deste artigo foi caracterizar as áreas afetadas por escorregamentos considerando aspectos geológicos, geomorfológicos e de uso da terra, tendo como área de estudo três bacias hidrográficas em São Luiz do Paraitinga com grande quantidade de registros de escorregamentos rasos. Os resultados mostraram um predomínio de vertentes embasadas por granitoides, com ângulos até 23º, com curvatura côncava e cobertas por pastos com terracetes de pisoteio. Os escorregamentos rasos de 2009-2010 ocorreram, sobretudo, em vertentes embasadas por rochas granitoides e migmatíticas, com ângulos entre 25º e 37º. Estudos futuros podem avaliar a relação entre o uso da terra e os escorregamentos de 2009-2010 no Planalto de Paraitinga-Paraibuna, além de avaliações mais detalhadas sobre as propriedades dos solos e os fatores deflagradores dos escorregamentos.
Leveraging Genetic Reports and Electronic Health Records for the Prediction of Primary Cancers: Algorithm Development and Validation Study
Authors: Zong Nansu , Ngo Victoria , Stone Daniel J , Wen Andrew , Zhao Yiqing , Yu Yue , Liu Sijia , Huang Ming , Wang Chen , Jiang Guoqian
Published: January 2021

Background

Precision oncology has the potential to leverage clinical and genomic data in advancing disease prevention, diagnosis, and treatment. A key research area focuses on the early detection of primary cancers and potential prediction of cancers of unknown primary in order to facilitate optimal treatment decisions.

Objective

This study presents a methodology to harmonize phenotypic and genetic data features to classify primary cancer types and predict cancers of unknown primaries.

Methods

We extracted genetic data elements from oncology genetic reports of 1011 patients with cancer and their corresponding phenotypical data from Mayo Clinic’s electronic health records. We modeled both genetic and electronic health record data with HL7 Fast Healthcare Interoperability Resources. The semantic web Resource Description Framework was employed to generate the network-based data representation (ie, patient-phenotypic-genetic network). Based on the Resource Description Framework data graph, Node2vec graph-embedding algorithm was applied to generate features. Multiple machine learning and deep learning backbone models were compared for cancer prediction performance.

Results

With 6 machine learning tasks designed in the experiment, we demonstrated the proposed method achieved favorable results in classifying primary cancer types (area under the receiver operating characteristic curve [AUROC] 96.56% for all 9 cancer predictions on average based on the cross-validation) and predicting unknown primaries (AUROC 80.77% for all 8 cancer predictions on average for real-patient validation). To demonstrate the interpretability, 17 phenotypic and genetic features that contributed the most to the prediction of each cancer were identified and validated based on a literature review.

Conclusions

Accurate prediction of cancer types can be achieved with existing electronic health record data with satisfactory precision. The integration of genetic reports improves prediction, illustrating the translational values of incorporating genetic tests early at the diagnosis stage for patients with cancer.
Ride-Hailing Services and Alcohol Consumption: Longitudinal Analysis (Preprint)
Authors: Burtch Gordon , Greenwood Brad N , McCullough Jeffrey S
Published: January 2021

BACKGROUND

Alcohol consumption is associated with a wide range of adverse health consequences and a leading cause of preventable deaths. Ride-hailing services such as Uber have been found to prevent alcohol-related motor vehicle fatalities. These services may, however, facilitate alcohol consumption generally and binge drinking in particular.

OBJECTIVE

The goal of the research is to measure the impact of ride-hailing services on the extent and intensity of alcohol consumption. We allow these associations to depend on population density as the use of ride-hailing services varies across markets.

METHODS

We exploit the phased rollout of the ride-hailing platform Uber using a difference-in-differences approach. We use this variation to measure changes in alcohol consumption among a local population following Uber’s entry. Data are drawn from Uber press releases to capture platform entry and the Behavioral Risk Factor Surveillance Systems (BRFSS) Annual Survey to measure alcohol consumption in 113 metropolitan areas. Models are estimated using fixed-effects Poisson regression. Pre- and postentry trends are used to validate this approach.

RESULTS

Ride-hailing has no association with the extent of alcohol consumption in high (0.61 [95% CI –0.05% to 1.28%]) or low (0.61 [95% CI –0.05% to 1.28%]) density markets, but is associated with increases in the binge drinking rate in high-density markets (0.71 [95% CI 0.13% to 1.29%]). This corresponds to a 4% increase in binge drinking within a Metropolitan Statistical Area.

CONCLUSIONS

Ride-hailing services are associated with an increase in binge drinking, which has been associated with a wide array of adverse health outcomes. Drunk driving rates have fallen for more than a decade, while binge drinking continues to climb. Both trends may be accelerated by ride-hailing services. This suggests that health information messaging should increase emphasis on the direct dangers of alcohol consumption and binge drinking.
Attitudes Toward Technology and Use of Fall Alert Wearables in Caregiving: Survey Study (Preprint)
Authors: Vollmer Dahlke Deborah , Lee Shinduk , Smith Matthew Lee , Shubert Tiffany , Popovich Stephen , Ory Marcia G
Published: January 2021

BACKGROUND

Wearable technology for fall alerts among older adult care recipients is one of the more frequently studied areas of technology, given the concerning consequences of falls among this population. Falls are quite prevalent in later life. While there is a growing amount of literature on older adults’ acceptance of technology, less is known about how caregivers’ attitudes toward technology can impact care recipients’ use of such technology.

OBJECTIVE

The objective of our study was to examine associations between caregivers’ attitudes toward technology for caregiving and care recipients’ use of fall alert wearables.

METHODS

This study examined data collected with an online survey from 626 caregivers for adults 50 years and older. Adapted from the technology acceptance model, a structural equation model tested the following prespecified hypotheses: (1) higher perceived usefulness of technologies for caregiving would predict higher perceived value of and greater interest in technologies for caregiving; (2) higher perceived value of technologies for caregiving would predict greater interest in technologies for caregiving; and (3) greater interest in technologies for caregiving would predict greater use of fall alert wearables among care recipients. Additionally, we included demographic factors (eg, caregivers’ and care recipients’ ages) and caregiving context (eg, caregiver type and caregiving situation) as important predictors of care recipients’ use of fall alert wearables.

RESULTS

Of 626 total respondents, 548 (87.5%) with all valid responses were included in this study. Among care recipients, 28% used fall alert wearables. The final model had a good to fair model fit: a confirmatory factor index of 0.93, a standardized root mean square residual of 0.049, and root mean square error of approximation of 0.066. Caregivers’ perceived usefulness of technology was positively associated with their attitudes toward using technology in caregiving (b=.70, P<.001) and interest in using technology for caregiving (b=.22, P=.003). Greater perceived value of using technology in caregiving predicted greater interest in using technology for caregiving (b=.65, P<.001). Greater interest in using technology for caregiving was associated with greater likelihood of care recipients using fall alert wearables (b=.27, P<.001). The caregiver type had the strongest inverse relationship with care recipients’ use of fall alert wearables (unpaid vs paid caregiver) (b=–.33, P<.001).

CONCLUSIONS

This study underscores the importance of caregivers’ attitudes in care recipients’ technology use for falls management. Raising awareness and improving perception about technologies for caregiving may help caregivers and care recipients adopt and better utilize technologies that can promote independence and enhance safety.
Community Case Managers’ (CCMs) perspectives’ collaborating with primary care services when managing complex patients in the community: a qualitative study. (Preprint)
Authors: Yeo Gilbert Tian Seng , Kannan Predeebha , Lee Eng Sing , Smith Helen Elizabeth
Published: January 2021

BACKGROUND

Strong collaboration between community case managers (CCMs) and medical professionals are vital for the continuity of complex patients’ care in the community. Key challenges can influence or even deter successful collaboration.

OBJECTIVE

The objective of this qualitative study was to understand the challenges encountered by CCMs when collaborating with primary care services.

METHODS

This exploratory qualitative descriptive study used individual in-depth interviews. CCMs were selected using maximum variation and snowball sampling. The interviews were semi-structured, guided by a topic guide. Data were analyzed alongside ongoing data collection. Thematic content analysis was used to analyze the transcripts. Initial codes were obtained independently. These codes were then further explored, clarified and iteratively grouped into themes.

RESULTS

Fourteen individual in-depth interviews were conducted. Six themes emerged from the data i.e. self-identity, patient factor, inter-professional factor, collaborative culture, confidentiality and organizational structure. Challenges that resonated with previous studies were self-identity, inter-professional factors and confidentiality, whereas other challenges such as patient factors, collaborative culture, and organizational structure, were unique to Singapore’s health care landscape.

CONCLUSIONS

Significant challenges were encountered by CCMs when collaborating with primary care services. Understanding these challenges is key to refining intervention in current models of comprehensive community care between medical and non-medical professionals.
Telemedicine for Adults With Cochlear Implants in the United Kingdom (CHOICE): Protocol for a Prospective Interventional Multisite Study (Preprint)
Authors: Cullington Helen , Kitterick Padraig , Darnton Philippa , Finch Tracy , Greenwell Kate , Riggs Carol , Weal Mark , Walker Dawn-Marie , Sibley Andrew
Published: January 2021

BACKGROUND

Cochlear implants provide hearing to approximately 750,000 people with deafness worldwide; these patients require lifelong follow-up. Care for adults with implants in the United Kingdom occurs at one of 19 centers, which may be far from the patients’ homes. In a previous randomized controlled trial, we successfully introduced person-centered care. We designed, implemented, and evaluated the following remote care pathway: a personalized web-based support tool, home hearing check, self–device adjustment, and upgrading of sound processors at home rather than in the clinic. The remote care group had a significant increase in empowerment after using the tools, and the patients and clinicians were keen to continue. We would now like to scale up these improvements as an option for >12,000 UK adults using implants; we are commissioning an independent evaluation of this intervention and rollout to establish if it achieves its aims of more empowered and confident patients; more accessible and equitable care; stable hearing; more efficient, person-centered, and scalable service; and more satisfied and engaged patients and clinicians.

OBJECTIVE

This study aims to evaluate the impact and rollout of a person-centered clinical care pathway via telemedicine for adults with cochlear implants in the United Kingdom, using both outcomes and process evaluation.

METHODS

This project will scale up and evaluate a person-centered long-term follow-up pathway for adults using cochlear implants through a personalized website, including a home hearing check, uploading photos of cochlear implant site, listening in noise and music practice, ordering of spares, questionnaires, and other resources. Both quantitative and qualitative analyses will be conducted, and they will be both an outcome and process evaluation.

RESULTS

As of July 2021, the trial is closed, and all data collection is complete. The evaluation report is expected to be published in December 2021, and the research data have not yet been analyzed.

CONCLUSIONS

This project will present the results of the first scaling up of a remote care pathway for adults with cochlear implants in the United Kingdom.

CLINICALTRIAL

International Standard Randomized Controlled Trial Number ISRCTN51668922; https://www.isrctn.com/ISRCTN51668922

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/27207
Deep Convolutional Neural Network–Based Computer-Aided Detection System for COVID-19 Using Multiple Lung Scans: Design and Implementation Study (Preprint)
Authors: Ghaderzadeh Mustafa , Asadi Farkhondeh , Jafari Ramezan , Bashash Davood , Abolghasemi Hassan , Aria Mehrad
Published: January 2021

BACKGROUND

Owing to the COVID-19 pandemic and the imminent collapse of health care systems following the exhaustion of financial, hospital, and medicinal resources, the World Health Organization changed the alert level of the COVID-19 pandemic from high to very high. Meanwhile, more cost-effective and precise COVID-19 detection methods are being preferred worldwide.

OBJECTIVE

Machine vision–based COVID-19 detection methods, especially deep learning as a diagnostic method in the early stages of the pandemic, have been assigned great importance during the pandemic. This study aimed to design a highly efficient computer-aided detection (CAD) system for COVID-19 by using a neural search architecture network (NASNet)–based algorithm.

METHODS

NASNet, a state-of-the-art pretrained convolutional neural network for image feature extraction, was adopted to identify patients with COVID-19 in their early stages of the disease. A local data set, comprising 10,153 computed tomography scans of 190 patients with and 59 without COVID-19 was used.

RESULTS

After fitting on the training data set, hyperparameter tuning, and topological alterations of the classifier block, the proposed NASNet-based model was evaluated on the test data set and yielded remarkable results. The proposed model's performance achieved a detection sensitivity, specificity, and accuracy of 0.999, 0.986, and 0.996, respectively.

CONCLUSIONS

The proposed model achieved acceptable results in the categorization of 2 data classes. Therefore, a CAD system was designed on the basis of this model for COVID-19 detection using multiple lung computed tomography scans. The system differentiated all COVID-19 cases from non–COVID-19 ones without any error in the application phase. Overall, the proposed deep learning–based CAD system can greatly help radiologists detect COVID-19 in its early stages. During the COVID-19 pandemic, the use of a CAD system as a screening tool would accelerate disease detection and prevent the loss of health care resources.
Use of the Urine-to-Plasma Urea Ratio to Predict ADPKD Progression
Authors: Heida Judith E. , Gansevoort Ron T. , Messchendorp A. Lianne , Meijer Esther , Casteleijn Niek F. , Boertien Wendy E. , Zittema Debbie ,   on behalf of the DIPAK Consortium
Published: January 2021

Background and objectives

Predicting disease progression in patients with autosomal dominant polycystic kidney disease (ADPKD) poses a challenge, especially in early-stage disease when kidney function is not yet affected. Ongoing growth of cysts causes maximal urine-concentrating capacity to decrease from early on. We therefore hypothesized that the urine-to-plasma urea ratio, as a reflection of the urine-concentrating capacity, can be used as a marker to predict ADPKD progression.

Design

The urine-to-plasma urea ratio was calculated by dividing concentrations of early morning fasting spot urine urea by plasma urea. First, this ratio was validated as surrogate marker in 30 patients with ADPKD who underwent a prolonged water deprivation test. Thereafter, association with kidney outcome was evaluated in 583 patients with ADPKD with a broad range of kidney function. Multivariable mixed-model regression was used to assess association with eGFR slope, and logarithmic regression to identify patients with rapidly progressive disease, using a cutoff of −3.0 ml/min per 1.73 m2 per year. The urine-to-plasma urea ratio was compared with established predictors, namely, sex, age, baseline eGFR, Mayo Clinic height-adjusted total kidney volume class, and PKD gene mutation.

Results

The maximal urine-concentrating capacity and urine-to-plasma urea ratio correlated strongly (R=0.90; P<0.001). Next, the urine-to-plasma urea ratio was significantly associated with rate of eGFR decline during a median follow-up of 4.0 (interquartile range, 2.6–5.0) years, both crude and after correction for established predictors (β=0.58; P=0.02). The odds ratio of rapidly progressive disease was 1.35 (95% confidence interval, 1.19 to 1.52; P<0.001) for every 10 units decrease in urine-to-plasma urea ratio, with adjustment for predictors. A combined risk score of the urine-to-plasma urea ratio, Mayo Clinic height-adjusted total kidney volume class, and PKD mutation predicted rapidly progressive disease better than each of the predictors separately.

Conclusions

The urine-to-plasma urea ratio, which is calculated from routine laboratory measurements, predicts disease progression in ADPKD in addition to other risk markers.

Podcast

This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_01_27_CJN10470620_final.mp3
Picking Our Environmental Battles: Removal of Harmful Subsidies or Carbon Taxation?
Authors: Pereira Alfredo M. , Pereira Rui M.
Published: January 2021

In this paper, we compare the effects of removing harmful fossil fuel subsidies with the replacement of the energy taxation by a carbon tax in Portugal. Since energy taxes focus on the energy content of the different energy products eliminating these provisions only brings their prices in line with their energy content. On the other hand, replacing the energy tax system with a tax on the emissions content of the energy products aligns the fossil fuel prices with their emissions content. We show that while replacing the energy with a carbon tax is a policy of a magnitude about eight times as large as the removal of the harmful subsidies, the effects of emissions are twenty times larger and the adverse economic and distributional effects only about twice as large. Accordingly, replacing the energy tax with a carbon tax is a much more cost-effective way of reducing emissions. This may suggest that focusing on the removal of harmful fossil fuel subsidies may be an environmental red herring.