bluuebunny/crossref_metadata_2025_split huggingface dataset:
A home-based pulmonary rehabilitation mHealth system to enhance the exercise capacity of patients with COPD: development and evaluation
Authors: Deng Ning , Sheng Leiyi , Jiang Wangshu , Hao Yongfa , Wei Shuoshuo , Wang Bei , Duan Huilong , Chen Juan 
Published: November 2021

Abstract
Background
Patients with chronic obstructive pulmonary disease (COPD) experience deficits in exercise capacity and physical activity as their disease progresses. Pulmonary rehabilitation (PR) can enhance exercise capacity of patients and it is crucial for patients to maintain a lifestyle which is long-term physically active. This study aimed to develop a home-based rehabilitation mHealth system incorporating behavior change techniques (BCTs) for COPD patients, and evaluate its technology acceptance and feasibility.

Methods
Guided by the medical research council (MRC) framework the process of this study was divided into four steps. In the first step, the prescription was constructed. The second step was to formulate specific intervention functions based on the behavior change wheel theory. Subsequently, in the third step we conducted iterative system development. And in the last step two pilot studies were performed, the first was for the improvement of system functions and the second was to explore potential clinical benefits and validate the acceptance and usability of the system.

Results
A total of 17 participants were enrolled, among them 12 COPD participants completed the 12-week study. For the clinical outcomes, Six-Minute Walk Test (6MWT) showed significant difference (P = .023) over time with an improvement exceeded the minimal clinically important difference (MCID). Change in respiratory symptom (CAT score) was statistically different (P = .031) with a greater decrease of − 3. The mMRC levels reduced overall and showed significant difference. The overall compliance of this study reached 82.20% (± 1.68%). The results of questionnaire and interviews indicated good technology acceptance and functional usability. The participants were satisfied with the mHealth-based intervention.

Conclusions
This study developed a home-based PR mHealth system for COPD patients. We showed that the home-based PR mHealth system incorporating BCTs is a feasible and acceptable intervention for COPD patients, and COPD patients can benefit from the intervention delivered by the system. The proposed system played an important auxiliary role in offering exercise prescription according to the characteristics of patients. It provided means and tools for further individuation of exercise prescription in the future.
Evaluation of a flexible and integrative psychiatric care model in a department of child and adolescent psychiatry in Tübingen, Germany: study protocol (EVA_TIBAS)
Authors: Neumann Anne , Hense Helene , Baum Fabian , Kliemt Roman , Seifert Martin , Harst Lorenz , Kubat Denise , Maicher Birgit , Schrey Christopher , Schmitt Jochen , Pfennig Andrea , Weinhold Ines , Swart Enno , Soltmann Bettina 
Published: November 2021

Abstract
Background
Model projects for flexible and integrated treatment (FIT) in Germany aim at advancing the quality of care for people with mental disorders. A new FIT model project was established in 2017 at the Department of child and adolescent psychiatry (KJP) of the University Hospital Tübingen (Universitätsklinikum Tübingen, UKT). The study design of EVA_TIBAS presented here describes the evaluation of the FIT model project at the KJP of the UKT. This evaluation aims at quantifying the anticipated FIT model project changes, which are to improve patients’ cross-sectoral care at the same maximum cost as standard care.

Methods
EVA_TIBAS is a controlled cohort study using a mix of quantitative and qualitative methods. The FIT evaluation consists of three modules. In Module A, anonymized claims data of a statutory health insurance fund will be used to compare outcomes (duration of inpatient and day care psychiatric treatment, inpatient and day care psychiatric length of stay, outpatient psychiatric treatment in hospital, inpatient hospital readmission, emergency admission rate, direct medical costs) of patients treated in the model hospital with patients treated in structurally comparable control hospitals (estimated sample size = ca. 600 patients). In Module B, patient-reported outcomes (health related quality of life, symptom burden, return to psychosocial relationships (e.g. school, friends, hobbies), treatment satisfaction, societal costs) will be assessed quantitatively using validated questionnaires for the model and two control hospitals (estimated sample size = ca. 300 patients). A subsequent health economic evaluation will be based on cost-effectiveness analyses from both the insurance fund’s and the societal perspective. In Module C, about 30 semi-structured interviews will examine the quality of offer, effects and benefits of the service offered by the social service of the AOK Baden-Württemberg (for stabilizing the overall situation of care in the family) in the model hospital. A focus group discussion will address the quality of cooperation between employees of the university hospital and the social services.

Discussion
The results of this evaluation will be used to inform policy makers whether this FIT model project or aspects of it should be implemented into standard care.

Trial registration
This study was registered at ClinicalTrials.gov PRS (ID: NCT04727359, date: 27 January 2021).
The disparities in health insurance ownership of hospital-based birth deliveries in eastern Indonesia
Authors: Laksono Agung Dwi , Wulandari Ratna Dwi , Zuardin Zuardin , Nopianto Nopianto 
Published: November 2021

Abstract
Background
Development in Eastern Indonesia tends to be left behind compared to other Indonesian regions, including development in the health sector. The study aimed at analyzing the health insurance ownership disparities in hospital delivery in Eastern Indonesia.

Methods
The study draws on secondary data from the 2017 Indonesia Demographic and Health Survey. The study population was women aged 15–49 years who had given birth in the last five years in Eastern Indonesia. The study analyzes a weighted sample size of 2299 respondents. The study employed hospital-based birth delivery as a dependent variable. Apart from health insurance ownership, other variables analyzed as independent variables are province, residence type, age group, marital status, education level, employment status, parity, and wealth status. The final stage analysis used binary logistic regression.

Results
The results showed that insured women were 1.426 times more likely than uninsured women to undergo hospital delivery (AOR 1.426; 95% CI 1.426–1.427). This analysis indicates that having health insurance is a protective factor for women in Eastern Indonesia for hospital delivery. There is still a disparity between insured and uninsured women in hospital-based birth deliveries in eastern Indonesia. Insured women are nearly one and a half times more likely than uninsured women to give birth in a hospital.

Conclusion
The study concludes that there are health insurance ownership disparities for hospital delivery in eastern Indonesia. Insured women have a better chance than uninsured women for hospital delivery.
Genome-wide DNA methylation analysis of pulmonary function in middle and old-aged Chinese monozygotic twins
Authors: Wang Tong , Wang Weijing , Li Weilong , Duan Haiping , Xu Chunsheng , Tian Xiaocao , Zhang Dongfeng 
Published: November 2021

Abstract
Background
Previous studies have determined the epigenetic association between DNA methylation and pulmonary function among various ethnics, whereas this association is largely unknown in Chinese adults. Thus, we aimed to explore epigenetic relationships between genome-wide DNA methylation levels and pulmonary function among middle-aged Chinese monozygotic twins.

Methods
The monozygotic twin sample was drawn from the Qingdao Twin Registry. Pulmonary function was measured by three parameters including forced expiratory volume the first second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Linear mixed effect model was used to regress the methylation level of CpG sites on pulmonary function. After that, we applied Genomic Regions Enrichment of Annotations Tool (GREAT) to predict the genomic regions enrichment, and used comb-p python library to detect differentially methylated regions (DMRs). Gene expression analysis was conducted to validate the results of differentially methylated analyses.

Results
We identified 112 CpG sites with the level of P < 1 × 10–4 which were annotated to 40 genes. We identified 12 common enriched pathways of three pulmonary function parameters. We detected 39 DMRs located at 23 genes, of which PRDM1 was related to decreased pulmonary function, and MPL, LTB4R2, and EPHB3 were related to increased pulmonary function. The gene expression analyses validated DIP2C, ASB2, SLC6A5, and GAS6 related to decreased pulmonary function.

Conclusion
Our DNA methylation sequencing analysis on identical twins provides new references for the epigenetic regulation on pulmonary function. Several CpG sites, genes, biological pathways and DMRs are considered as possible crucial to pulmonary function.
Association of circulating proprotein convertase subtilisin/kexin type 9 concentration, prothrombin time and cardiovascular outcomes: a prospective cohort study
Authors: Peng Jia , Liu Ming-Ming , Liu Hui-Hui , Guo Yuan-Lin , Wu Na-Qiong , Dong Qian , Qian Jie , Dou Ke-Fei , Zhu Cheng-Gang , Li Jian-Jun 
Published: November 2021

Abstract
Background
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is considered to have multiple roles in the development of atherosclerosis, which is recently reported to participate in the thrombotic process. We aimed to examine the relationship between PCSK9 concentration, coagulation indexes and cardiovascular events.

Methods
A total of 2293 consecutive patients with angina-like chest pain and without lipid-lowering drugs treatment were enrolled and followed up for major adverse cardiovascular events (MACEs). Circulating PCSK9 concentration was determined by ELISA. The routine coagulation tests including activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time were performed. The associations between PCSK9 concentration, routine coagulation indicators and MACEs were analyzed.

Results
Patients with high PCSK9 levels had lower PT and APTT levels (all p <  0.05). However, PCSK9 concentration was only independently and negatively correlated with PT (β = − 0.115, p <  0.001). During a mean of 38.3 months, 186 (8.1%) MACEs were occurred. Multiple Cox regression analysis indicated high PCSK9 or low PT levels as risk factors related to MACEs. When the prognosis was analyzed by the combination of PCSK9 and PT levels, patients with high PCSK9 and low PT had higher incidence of MACEs compared to those with low PCSK9 and high PT.

Conclusions
Our study firstly suggested that PCSK9 concentration was negatively correlated with plasma levels of PT. Furthermore, high PCSK9 and low PT were associated with MACEs and the combination of PCSK9 with PT had an addictive effect on predicting cardiovascular outcomes in patients with chest pain, which was useful for further subdivision of cardiovascular risks.
Infection prevention strategies are highly protective in COVID-19 units while main risks to healthcare professionals come from coworkers and the community
Authors: Gohil Shruti K. , Quan Kathleen A. , Madey Keith M. , King-Adelsohn Suzanne , Tjoa Tom , Tifrea Delia , Crews Bridgit O. , Monuki Edwin S. , Khan Saahir , Schubl Sebastian D. , Bittencourt Cassiana E. , Detweiler Neil , Chang Wayne , Willis Lynn , Khusbu Usme , Saturno Antonella , Rezk Sherif A. , Figueroa Cesar , Jain Aarti , Assis Rafael , Felgner Philip , Edwards Robert , Hsieh Lanny , Forthal Donald , Wilson William C. , Stamos Michael J. , Huang Susan S. 
Published: November 2021

AbstractBackgroundEarly evaluations of healthcare professional (HCP) COVID-19 risk occurred during insufficient personal protective equipment and disproportionate testing, contributing to perceptions of high patient-care related HCP risk. We evaluated HCP COVID-19 seropositivity after accounting for community factors and coworker outbreaks.MethodsPrior to universal masking, we conducted a single-center retrospective cohort plus cross-sectional study. All HCP (1) seen by Occupational Health for COVID-like symptoms (regardless of test result) or assigned to (2) dedicated COVID-19 units, (3) units with a COVID-19 HCP outbreak, or (4) control units from 01/01/2020 to 04/15/2020 were offered serologic testing by an FDA-authorized assay plus a research assay against 67 respiratory viruses, including 11 SARS-CoV-2 antigens. Multivariable models assessed the association of demographics, job role, comorbidities, care of a COVID-19 patient, and geocoded socioeconomic status with positive serology.ResultsOf 654 participants, 87 (13.3%) were seropositive; among these 60.8% (N = 52) had never cared for a COVID-19 patient. Being male (OR 1.79, CI 1.05–3.04,p = 0.03), working in a unit with a HCP-outbreak unit (OR 2.21, CI 1.28–3.81,p < 0.01), living in a community with low owner-occupied housing (OR = 1.63, CI = 1.00–2.64,p = 0.05), and ethnically Latino (OR 2.10, CI 1.12–3.96,p = 0.02) were positively-associated with COVID-19 seropositivity, while working in dedicated COVID-19 units was negatively-associated (OR 0.53, CI = 0.30–0.94,p = 0.03). The research assay identified 25 additional seropositive individuals (78 [12%] vs. 53 [8%],p < 0.01).ConclusionsPrior to universal masking, HCP COVID-19 risk was dominated by workplace and community exposures while working in a dedicated COVID-19 unit was protective, suggesting that infection prevention protocols prevent patient-to-HCP transmission.Article summaryPrior to universal masking, HCP COVID-19 risk was dominated by workplace and community exposures while working in a dedicated COVID-19 unit was protective, suggesting that infection prevention protocols prevent patient-to-HCP transmission.
Feminist trends in distance and hybrid higher education: a scoping review
Authors: Jiménez-Cortés Rocío , Aires Luisa 
Published: November 2021

AbstractHigher distance education models can be described from the theoretical and practical foundation of feminist pedagogy. The objective of this work is to know what feminist approaches are identified in the pedagogical models adopted by distance and hybrid education at the University and what curricular characteristics they have. The scoping review is carried out on a total of 126 journals bringing together 60 indexed, 30 specialized in gender and 6 in education. The final sample is made up of 10 papers that meet the established inclusion criteria. The review method is based on three phases of collection, description, and analysis with different tasks and the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) protocol is followed. The results obtained from mixed methodology applied show three perspectives that set trends in distance and hybrid higher education models from feminist approaches: (a) feminist-pragmatist, (b) eco-dialogical feminist and (c) intersectional-technofeminist. These trends show the application of feminist principles to curriculum design and their implementation in distance and hybrid higher education.
Negative 18F-FET PET/CT in brain metastasis recurrence: a teaching case report
Authors: Alshehri Samirah , Prior John , Moshebah Mohammed , Schiappacasse Luis , Dunet Vincent 
Published: November 2021

AbstractPositron emission tomography (PET) using O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) PET has been shown to be a useful tool for differentiating radiation therapy outcomes, such as brain metastasis recurrence or radiation necrosis. We present the case of a female patient with brain metastases from pulmonary mucinous adenocarcinoma with suspicion of tumor recurrence on follow-up magnetic resonance imaging (MRI) after radiosurgery. 18F-FET PET/computed tomography (CT) was indicative of radiation necrosis. Due to the patient's medical history and the discrepancy between the brain MRI and PET/CT results, surgical biopsies were decided, which were positive for brain metastasis recurrence. The diagnosis of metastasis recurrence may also be challenging on 18F-FET PET/CT. In case of discrepancies between MRI and PET/CT results, false-negative 18F-FET PET/CT remains a possibility and requires careful follow-up or biopsy.
Association between ultrasound images and patient-reported outcomes in the treatment of rheumatoid arthritis: a retrospective study
Authors: Nawata Masao , Someya Kazuki , Funada Masashi , Fujita Yuya , Nagayasu Atsushi , Saito Kazuyoshi , Tanaka Yoshiya 
Published: November 2021

Abstract
Background
Improvements in the treatment of rheumatoid arthritis (RA) have made it possible to achieve treatment goals. It has been reported that both residual synovitis caused by RA and the patients’ subjective symptoms remain even after achieving the treatment goals; however, there are limited reports showing a relationship between them. Furthermore, no studies have evaluated the relationship between patient-reported outcomes (PROs) and subclinical synovitis measured by musculoskeletal ultrasonography (MSUS) in the treatment of RA. This study aimed to investigate residual symptoms and residual synovitis due to remission (REM) or low disease activity (LDA).

Methods
We performed MSUS on 300 patients with RA who attended our hospital for routine care, and we analysed them cross-sectionally by disease activity. Grayscale (GS) and power Doppler (PD) synovitis was evaluated in 22 bilateral hand joints using MSUS. We first performed univariate and multivariate analysis by dividing the data by disease activity. Next, we analysed each PRO in the obtained MSUS results.

Results
A multivariate analysis of high disease activity (HDA)/moderate disease activity (MDA) vs. LDA/ REM group identified tender joint count (TJC), pain visual analog scale (VAS) score, and presence or absence of GS score ≥ 2. The one-way analysis of the relationship between the presence or absence of GS score ≥ 2 and each PRO showed a significant difference. In contrast, a multivariate analysis of LDA vs. REM group identified TJC and fatigue VAS score. In REM, PROs alone were relevant, and there was no correlation with MSUS.

Conclusion
We found that the residual inflammation in the ultrasound images was associated with PROs in the LDA group, but not in the REM group.
Trial registration Retrospectively registered.
The Paradox of Automation: QWERTY and the Neuter Keyboard
Authors: Resnikoff Jason 
Published: November 2021

AbstractWith the neutering of the QWERTY keyboard in the early 1980s following largely successful clerical worker organizing, male workers in offices began taking on clerical work that, until recently, they would have considered beneath both their job descriptions and their manhood. Paradoxically, the men who now began typing, filing, and performing data entry for themselves did not generally consider the imposition of these new tasks an increase in work. Rather, they called it “automation.” Employers’ and computer manufacturers’ regendering of the QWERTY keyboard from feminine to neuter in the last quarter of the twentieth century was an example of the uses and power of the automation discourse, an ideological commitment that obscured the intensification of human labor behind utopian rhetoric and technological enthusiasm. Employers regendered the keyboard to get more work out of their employees, and as they did so, they claimed that no one did the work at all. Obscuring human labor behind technological marvels, the claims that the work was done by “automation” proved persuasive, even as human labor was sped up and intensified.
Προσδοκίες ή αντιλήψεις; Σύγκριση μετρήσεων της ποιότητας των εκπαιδευτικών υπηρεσιών: Μία εμπειρική μελέτη με την κλίμακα EppaikQual
Authors: Αθανασιάδης (Athanasiadis) Αναστάσιος (Anastasios) 
Published: November 2021

Στο πεδίο της ποιότητας των υπηρεσιών εντοπίζονται ελλείψεις σε εμπειρικά δεδομένα που εξετάζουν την αποτελεσματικότητα των μετρήσεων της ποιότητας των υπηρεσιών μεταξύ διαφορετικών μεθοδολογιών. Σκοπός της εμπειρικής μελέτης είναι ο έλεγχος της σύμπτωσης ή της απόκλισης των μετρήσεων της ποιότητας των εκπαιδευτικών υπηρεσιών σε ένα πρόγραμμα παιδαγωγικής κατάρτισης για υποψήφιους εκπαιδευτικούς. Ο έλεγχος πραγματοποιείται με τη χρήση της κλίμακας EppaikQual βάσει της μεθοδολογίας ServQual και ServPerf.Η παρούσα έρευνα αποτελεί μία έρευνα επισκόπησης στο πεδίο της μέτρησης της ποιότητας των εκπαιδευτικών υπηρεσιών. Για τον έλεγχο της ερευνητικής υπόθεσης εφαρμόζονται συγκεκριμένες στατιστικές μέθοδοι οι οποίες σχετίζονται με την ποσοτική διάσταση της εμπειρικής μελέτης. Στην έρευνα συμμετείχαν συνολικά 481 καταρτιζόμενοι υποψήφιοι εκπαιδευτικοί, ενώ τα δεδομένα συνελέχθησαν με τη χρήση ηλεκτρονικού ερωτηματολογίου.Η εμπειρική μελέτη καταλήγει στην ύπαρξη στατιστικά σημαντικών διαφορών στις μετρήσεις μεταξύ των δύο μεθοδολογιών. Ωστόσο δεν προτείνει καμία μεθοδολογία μέτρησης ως αποτελεσματικότερη, εξαιτίας των οριακών αποκλίσεων που εντοπίστηκαν αλλά και εξαιτίας της ανάγκης για την εκμετάλλευση των πλεονεκτημάτων που η κάθε προσέγγιση προσφέρει, στην προσπάθεια για μία ολιστική αξιολόγηση της ποιότητας των εκπαιδευτικών υπηρεσιών.Η έρευνα εστιάζει σε ένα μόνο πρόγραμμα παιδαγωγικής κατάρτισης στην Ελλάδα και επομένως τα συμπεράσματα δεν μπορούν να γενικευτούν για το σύνολο των παιδαγωγικών προγραμμάτων κατάρτισης. Το άρθρο περιλαμβάνει μία προτεινόμενη μεθοδολογία μέτρησης της ποιότητας των εκπαιδευτικών υπηρεσιών με τη χρήση της κλίμακας EppaikQual μέσω του συνδυασμού δύο ευρέως χρησιμοποιούμενων μεθοδολογιών μέτρησης, παρέχοντας χρήσιμες πληροφορίες στη διοίκηση των εκπαιδευτικών προγραμμάτων για την αποτελεσματικότερη διαχείριση της ποιότητας των προγραμμάτων που προσφέρουν. Επιπλέον, μέσω της έρευνας παρέχονται εμπειρικά δεδομένα τα οποία ενισχύουν τη συζήτηση στο πεδίο της μέτρησης της ποιότητας των υπηρεσιών.