bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of the Czech Childhood Cancer Information System: Data Analysis and Interactive Visualization
Authors: Krejčí Denisa , Karolyi Matěj , Pehalová Lucie , Ščavnický Jakub , Zapletalová Michaela , Katinová Ivana , Štěrba Jaroslav , Starý Jan , Šnajdrová Lenka , Komenda Martin , Dušek Ladislav 
Published: April 2021

Background
The knowledge of cancer burden in the population, its time trends, and the possibility of international comparison is an important starting point for cancer programs. A reliable interactive tool describing cancer epidemiology in children and adolescents has been nonexistent in the Czech Republic until recently.

Objective
The goal of this study is to develop a new web portal entitled the Czech Childhood Cancer Information System (CCCIS), which would provide information on childhood cancer epidemiology in the Czech Republic.

Methods
Data on childhood cancers have been obtained from the Czech National Cancer Registry. These data were validated using the clinical database of childhood cancer patients and subsequently combined with data from the National Register of Hospitalised Patients and with data from death certificates. These validated data were then used to determine the incidence and survival rates of childhood cancer patients aged 0 to 19 years who were diagnosed in the period 1994 to 2016 (N=9435). Data from death certificates were used to monitor long-term mortality trends. The technical solution is based on the robust PHP development Symfony framework, with the PostgreSQL system used to accommodate the data basis.

Results
The web portal has been available for anyone since November 2019, providing basic information for experts (ie, analyses and publications) on individual diagnostic groups of childhood cancers. It involves an interactive tool for analytical reporting, which provides information on the following basic topics in the form of graphs or tables: incidence, mortality, and overall survival. Feedback was obtained and the accuracy of outputs published on the CCCIS portal was verified using the following methods: the validation of the theoretical background and the user testing.

Conclusions
We developed software capable of processing data from multiple sources, which is freely available to all users and makes it possible to carry out automated analyses even for users without mathematical background; a simple selection of a topic to be analyzed is required from the user.
Application of the Inverted Classroom Model for Teaching Pathophysiology to Chinese Undergraduate Medical Students: Usability Study
Authors: Lin Hui , Zeng Xiaoping , Zhu Jun , Hu Zhenzhen , Ying Ying , Huang Yonghong , Wang Hongmei 
Published: April 2021

Background
The inverted classroom model differs from the traditional teaching model as it reverses the pattern of knowledge transfer and internalization. In recent years, this new teaching model has received much attention in undergraduate medical education. Pathophysiology is a course in the undergraduate Chinese medical curriculum that is critical in bridging basic medical science and clinical medicine.

Objective
The purpose of this study was to investigate the application of inverted classroom in delivering the course on pathophysiology to Chinese undergraduate medical students.

Methods
In the spring semester of 2018, inverted classroom teaching was implemented for second-year clinical medicine students at the College of Medicine at Nanchang University. The topics of hypoxia and respiratory failure were selected for the inverted classroom study. The effect of the inverted classroom on teaching pathophysiology was evaluated using classroom performance metrics, a final examination, and questionnaires.

Results
This study found that students in the inverted classroom group achieved higher scores in their in-course assessments (82.35 [SD 11.45] vs 81.33 [SD 9.51], respectively) and in their final exams (73.41 [SD 10.37] vs 71.13 [SD 11.22], respectively) than those in the traditional lecture-based group, but the scores were not significantly different (P=.13, unpaired two-tailed t test). There was also no significant difference in the distribution of the score segments in the class quiz (P=.09, chi-square test) and in the final exams (P=.25, chi-square test) between the 2 groups. Further, most of the students reported that the inverted classroom increased their learning motivation, made them more confident, and helped them understand the content on pathophysiology better. The students in the inverted classroom also improved in their problem-solving skills and teamwork abilities. However, some students from the inverted classroom group also reported that the self-learning and preparatory work before class increased their learning burden.

Conclusions
This study shows the feasibility and promise of inverted classroom for teaching pathophysiology to undergraduate Chinese medical students. The inverted classroom improves students’ learning interests and attitudes toward learning. However, further studies are required to assess the benefits of broader acceptance and implementation of the inverted classroom among Chinese undergraduate medical students.
Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation
Authors: Ali Zarqa , Joergensen Kristina Melbardis , Andersen Anders Daniel , Chiriac Andrei , Bjerre-Christensen Theis , Manole Ionela , Dutei Ana-Maria , Deaconescu Irina , Suru Alina , Serban Adina , Isberg Ari Pall , Dahiya Priyanka , Thomsen Simon Francis , Zibert John Robert 
Published: April 2021

Background
Digital imaging of dermatological patients is a novel approach to remote assessment and has recently become more relevant since telehealth and remote decentralized clinical trials are gaining ground.

Objective
We aimed to investigate whether photographs taken by a smartphone are of adequate quality to allow severity assessments to be made and to explore the usefulness of an established atopic dermatitis severity assessment instrument on photograph evaluation.

Methods
During scheduled visits in a previously published study, the investigating doctor evaluated the severity of atopic dermatitis using the Scoring AD (SCORAD) index and took photographs of the most representative lesions (target lesions) with both a smartphone and a digital single-lens reflex camera (DSLR). The photographs were then assessed by 5 dermatologists using the intensity items of the SCORAD (iSCORAD), which consists of erythema, oedema/papulation, excoriations, lichenification, oozing/crusts, and dryness (scale 0-3, maximum score 18). The mean iSCORAD of the photographs was calculated and compared with in-person assessments using Pearson correlation and Bland-Altman plots. Intraclass correlation coefficients were used for interrater reliability.

Results
A total of 942 photographs from 95 patients were assessed. The iSCORAD based on smartphone photographs correlated strongly with the evaluations performed in person (iSCORAD: r=0.78, P<.001; objective SCORAD: r=0.81, P<.001; and total SCORAD: r=0.78, P<.001). For iSCORAD specifically, a Bland-Altman plot showed a difference in mean score of 1.31 for in-person and remote iSCORAD. In addition, the interrater agreement between the 5 rating dermatologists was 0.93 (95% CI 0.911-0.939). A total of 170 lesions were photographed, and the difference in mean scores was 1.32, 1.13, and 1.43 between in-person and remote evaluations based on photographs taken by a DSLR camera, a smartphone without flash, and a smartphone with flash, respectively.

Conclusions
In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera. Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low.
Zero-Effort Ambient Heart Rate Monitoring Using Ballistocardiography Detected Through a Seat Cushion: Prototype Development and Preliminary Study
Authors: Malik Ahmed Raza , Boger Jennifer 
Published: April 2021

Background
Cardiovascular diseases are a leading cause of death worldwide and result in significant economic costs to health care systems. The prevalence of cardiovascular conditions that require monitoring is expected to increase as the average age of the global population continues to rise. Although an accurate cardiac assessment can be performed at medical centers, frequent visits for assessment are not feasible for most people, especially those with limited mobility. Monitoring of vital signs at home is becoming an increasingly desirable, accessible, and practical alternative. As wearable devices are not the ideal solution for everyone, it is necessary to develop parallel and complementary approaches.

Objective
This research aims to develop a zero-effort, unobtrusive, cost-effective, and portable option for home-based ambient heart rate monitoring.

Methods
The prototype seat cushion uses load cells to acquire a user’s ballistocardiogram (BCG). The analog signal from the load cells is amplified and filtered by a signal-conditioning circuit before being digitally recorded. A pilot study with 20 participants was conducted to analyze the prototype’s ability to capture the BCG during five real-world tasks: sitting still, watching a video on a computer screen, reading, using a computer, and having a conversation. A novel algorithm based on the continuous wavelet transform was developed to extract the heart rate by detecting the largest amplitude values (J-peaks) in the BCG signal.

Results
The pilot study data showed that the BCG signals from all five tasks had sufficiently large portions to extract heart rate. The continuous wavelet transform–based algorithm for J-peak detection demonstrated an overall accuracy of 91.4% compared with electrocardiography. Excluding three outliers that had significantly noisy BCG data, the algorithm achieved 94.6% accuracy, which was aligned with that of wearable devices.

Conclusions
This study suggests that BCG acquired through a seat cushion is a viable alternative to wearable technologies. The prototype seat cushion presented in this study is an example of a relatively accessible, affordable, portable, and unobtrusive zero-effort approach to achieve frequent home-based ambient heart rate monitoring.
Evaluating the Experiences of New and Existing Teledermatology Patients During the COVID-19 Pandemic: Cross-sectional Survey Study
Authors: Hamad Judy , Fox Amy , Kammire Maria Suzanne , Hollis Alison Nancy , Khairat Saif 
Published: April 2021

Background
As teledermatology has been widely adopted during the COVID-19 pandemic, it is essential to examine patients’ experiences and satisfaction with teledermatology.

Objective
We aimed to assess the teledermatology experiences of new and existing clinic patients in the context of the rapid shift toward teledermatology practices during the COVID-19 pandemic.

Methods
We conducted a cross-sectional study of 184 teledermatology patients who were assessed during the COVID-19 pandemic at a major southeastern medical center from May 13 to June 5, 2020. The primary outcome was patient satisfaction levels among new and existing patients. The secondary outcome was patients’ willingness to use teledermatology in the future.

Results
Of the 288 teledermatology patients who were assessed during the study period, 184 (63.9%) completed the survey. Patients reported high overall satisfaction with teledermatology, with 86.4% (159/184) of participants reporting positive overall satisfaction and experiences with teledermatology. New patients had significantly higher Likert scores for overall satisfaction with teledermatology than those of follow-up patients (new patients: mean 4.70; existing patients: mean 4.43; P=.03). Overall, patients’ satisfaction with teledermatology did not significantly differ based on age (P=.36), race and ethnicity (P=.46), education level (P=.11), residence (P=.74), or insurance status (P=.74). There were no significant differences in overall satisfaction between patients with and without prior telehealth experience (P=.53), between the video and telephone visit types (P=.17), and among platform types (P=.22). Prior telehealth experience was associated with higher odds of being willing to use telehealth in the future (odds ratio 2.39, 95% CI 1.31-4.35; P=.004).

Conclusions
This cross-sectional survey study demonstrates that during the rapid expansion of teledermatology, new clinic patients had significantly higher scores for overall satisfaction with their teledermatology experience compared to those of established clinic patients (P=.03). Prior telehealth experience was associated with higher odds of being willing to use teledermatology in the future. Overall, teledermatology expansion was met with high levels of patient satisfaction during the COVID-19 pandemic.
Development of an mHealth App for Patients With Psoriasis Undergoing Biological Treatment: Participatory Design Study
Authors: Trettin Bettina , Danbjørg Dorthe Boe , Andersen Flemming , Feldman Steven , Agerskov Hanne 
Published: April 2021

Background
In Denmark, patients with psoriasis undergoing biological treatment have regular follow-ups, typically every 3 months. This may pose a challenge for patients who live far away from the hospital. Mobile health (mHealth) is a promising and reliable tool for the long-term management of patients with psoriasis undergoing biological treatment because the disease course can be properly monitored. Despite recent developments in mHealth, the full potential of teledermatology remains to be tapped by newer, more attractive forms of services focused on patients’ needs.

Objective
This study aims to design and develop an mHealth app to support the self-management of patients with psoriasis using a participatory design.

Methods
Using participatory design, we conducted 1 future workshop, 4 mock-up workshops, and 1 prototype test with patients and health care professionals to co-design a prototype. The process was iterative to ensure that all stakeholders would provide input into the design and outcome; this approach enabled continuous revision of the prototype until an acceptable solution was agreed upon. Data were analyzed according to the steps—plan, act, observe, and reflect—in the methodology of participatory design.

Results
Health care professionals and patients emphasized the importance of a more patient-centered approach, focusing on the communication and maintenance of relationships. Patients perceived consultations to be impersonal and repetitive and wanted the opportunity to contribute to the agenda while attending a consultation. Patients also stated they would prefer not to attend visits in person every 3 months. On the basis of these findings, we designed an mHealth app that could replace in-person visits and support patients at in-person visits. Video consultations, self-monitoring, and registration of patient-reported outcome data were embedded in the app.

Conclusions
Using participatory design facilitated mutual learning and democratic processes that gave end users a significant influence over the solution. Despite the advantages of using participatory design in developing mHealth solutions, organizational conditions may still represent a barrier to the optimization of solutions.
Brain Exercising Games With Consumer-Grade Single-Channel Electroencephalogram Neurofeedback: Pre-Post Intervention Study
Authors: Israsena Pasin , Jirayucharoensak Suwicha , Hemrungrojn Solaphat , Pan-Ngum Setha 
Published: April 2021

Background
The aging population is one of the major challenges affecting societies worldwide. As the proportion of older people grows dramatically, so does the number of age-related illnesses such as dementia-related illnesses. Preventive care should be emphasized as an effective tool to combat and manage this situation.

Objective
The aim of this pilot project was to study the benefits of using neurofeedback-based brain training games for enhancing cognitive performance in the elderly population. In particular, aiming for practicality, the training games were designed to operate with a low-cost consumer-grade single-channel electroencephalogram (EEG) headset that should make the service scalable and more accessible for wider adoption such as for home use.

Methods
Our training system, which consisted of five brain exercise games using neurofeedback, was serviced at 5 hospitals in Thailand. Participants were screened for cognitive levels using the Thai Mental State Examination and Montreal Cognitive Assessment. Those who passed the criteria were further assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) computerized cognitive assessment battery. The physiological state of the brain was also assessed using 16-channel EEG. After 20 sessions of training, cognitive performance and EEG were assessed again to compare pretraining and posttraining results.

Results
Thirty-five participants completed the training. CANTAB results showed positive and significant effects in the visual memory (delayed matching to sample [percent correct] P=.04), attention (median latency P=.009), and visual recognition (spatial working memory [between errors] P=.03) domains. EEG also showed improvement in upper alpha activity in a resting state (open-eyed) measured from the occipital area (P=.04), which similarly indicated improvement in the cognitive domain (attention).

Conclusions
Outcomes of this study show the potential use of practical neurofeedback-based training games for brain exercise to enhance cognitive performance in the elderly population.
Relevance of Anthropometric Measurements in a Multiethnic Obesity Cohort: Observational Study
Authors: Bhatti Rahila , Warshow Usama , Joumaa Mona , ElSaban Mariam , Nawaz Faisal A , Khamis Amar Hassan 
Published: April 2021

Background
The prevalence of obesity is increasing worldwide, and the Middle East is not an exception to this increasing trend. Obesity increases the risk of multiple metabolic complications, such as diabetes mellitus. Measurement of obesity has primarily relied on the BMI to identify risk; however, both bedside and office-based anthropometric measures of obesity can provide more detailed information on risk.

Objective
This study aimed to investigate the prevalence of obesity-related diseases in a multidisciplinary weight management population and to determine its relationship with obesity anthropometric indices.

Methods
This cross-sectional study was conducted at Mediclinic Parkview Hospital (Dubai, the United Arab Emirates). In total, 308 patients have been evaluated from January to September 2019 as part of a multidisciplinary weight management program. Key demographics, anthropometrics, and clinical data were analyzed using SPSS (version 25, SPSS Inc).

Results
Our cohort of 308 patients included 103 (33%) males and 205 (67%) females of 38 nationalities. The mean age of the cohort was 41 (SD 9.6) years, with a median BMI of 34.5 (IQR 6.7) and 33.7 (IQR 7.8) for males and females, respectively. The mean waist circumference (WC) was 113.4 (SD 23.3) cm and 103.5 (SD 16.2) cm, fat percentage was 33.7% (SD 11.6%) and 45% (SD 6.8%), fat mass was 41 (SD 15.2) kg and 41.1 (SD 14.1) kg, and visceral fat mass was 6.5 (SD 3.2) kg and 3.1 (SD 1.8) kg for males and females, respectively. There was a strong correlation between BMI and WC (r=0.65 and r=0.69 in males and females, respectively; P=.01) and visceral fat (r=0.78 and r=0.90 in males and females, respectively). Furthermore, visceral fat was significantly associated with WC in both sexes (r=0.73 and r=0.68 in females and males respectively; P=.01). Furthermore, WC was significantly associated with a risk of diabetes, hypertension, and nonalcoholic fatty liver disease.

Conclusions
BMI and WC are the most representative measures of obesity in our population and correlate with abdominal adiposity– and obesity-related diseases. Further studies are required to assess the benefits of these measures during weight reduction interventions.
Capital Structure and Firm Financial Performance: Moderating Effect of Board Financial Literacy in Nigerian Listed Non-Financial Companies
Authors: Tanko Udisifan Michael , SIYANBOLA Akeem Adetunji , Bako Paul Matudi , DOTUN Olalere Victor 
Published: April 2021

Objective – The study examined the moderating effect of board financial literacy on the relationship between capital structure and firm financial performance of listed non-financial companies in Nigeria. Design/methodology – Capital structure was measured by long term debts to total assets, short term debts to total assets equity to total debt ratio and board financial literacy was measured by ratio of board members that have professional and academic qualification in accounting, finance and economics. Meanwhile financial performance was measured by return on assets. Secondary data was extracted from the sampled firms annual report and accounts and analyzed using Panel Least Square. Results – The study revealed a positive and significant relationship between long term debt and ROA. It also shows that board financial literacy moderate capital structure significantly and increase firm performance. The study recommended that the management of Nigerian listed non-financial firms should optimize the capital structure in order to increase the financial performance. They can do that through ensuring that their capital structure is optimal by using more of current debts and non-current debt than equity. The Board of Directors of Nigerian listed company should be concerned about the level of long term debt, short term debt and include members that are financially literate who will contribute in financing decision of firm in order make optimal capital structure for better financial performance. This is because the findings of this study revealed a positive significant moderating relationship between long term debt, short term debt and financial performance.
“What Does the Fox Say” – A Review of the Grey Fox in Canada and its Current Status as a Threatened Species
Authors: Deere Marina 
Published: April 2021

In Canada, the grey fox (Urocyon cinereoargenteus) is found with certainty in Ontario and Manitoba, but has also been sighted in other provinces. Interestingly, there is little Canadian research on the grey fox, despite its status as “threatened” on both the Ontario Species at Risk list and on the Canadian Species at Risk Act. Possible reasons that the grey fox has not received as much attention as other at-risk species in Canada include its lack of economic value and its high abundance in the United States (US). It is believed that the grey fox was once as widespread as the red fox (Vulpes Vulpes) in Southern Ontario, but today that is no longer the case. It is currently believed that less than 250 individuals are found in Canada and the fate of their population is unknown. This change in population abundance shows the importance of gaining more information on the grey fox’s current distribution in Canada. Within the US, the primary threat to this species is excessive hunting; while in Canada, by-catch, deforestation, and road mortality represent greater dangers. The focus of this presentation will be to summarize current knowledge on Canadian populations of the grey fox with some reference to populations in the US in order to highlight the importance of this trans-boundary species within Canadian ecosystems. I will provide recommendations to both the Federal Government of Ontario and the Municipality of Peelee Island, while outlining possible conservation solutions for the population decline of the grey fox in Canada.