bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring the Time to Deterioration for Health-Related Quality of Life in Patients With Metastatic Breast Cancer Using a Web-Based Monitoring Application: Longitudinal Cohort Study
Authors: Brusniak Katharina , Feisst Manuel , Sebesteny Linda , Hartkopf Andreas , Graf Joachim , Engler Tobias , Schneeweiss Andreas , Wallwiener Markus , Deutsch Thomas Maximilian 
Published: October 2021

Background
Health-related quality of life (HRQoL) is used to evaluate the treatment of metastatic breast cancer. In a long-term therapy setting, HRQoL can be used as an important benchmark for treatment success. With the help of digital apps, HRQoL monitoring can be extended to more remote areas and be administered on a more frequent basis.

Objective
This study aims to evaluate 3 common HRQoL questionnaires in metastasized breast cancer in terms of TTD in a digital, web-based setting. We further aim to examine the development of the HRQoL in different systemic treatment groups in each of these evaluation instruments.

Methods
A total of 192 patients with metastatic breast cancer were analyzed in this bicentric prospective online cohort study at two German university hospitals. Patients completed questionnaires on HRQoL (EuroQol Visual Analog Scale [EQ-VAS], EuroQol 5 Dimension 5 Level [EQ-5D-5L], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 item [EORTC QLQ-C30]) via an online platform over a 6-month period. Treatment schedules and medical history were retrieved from medical records. Unadjusted Cox regression analysis on treatment-related factors was performed. We conducted subgroup analyses in regard to TTD events between different treatments.

Results
The EQ-VAS showed a higher rate of deterioration after 8 weeks (84/179, 46.9%) than the EQ-5D-5L (47/163, 28.8%) and EORTC QLQ-C30 (65/176, 36.9%). Unadjusted Cox regression revealed significant connections between known metastases in the liver (P=.03, HR 1.64, 95% CI 1.06-2.52) and pleura (P=.04, HR 0.42, 95% CI 0.18-0.96) in the EQ-VAS. Significant relations between EQ-VAS events and single EQ-5D-5L items and the EQ-5D-5L summary score were demonstrated. All treatment groups significantly differed from the CDK4/6 inhibition subgroup in the EQ-VAS.

Conclusions
Compared to the EQ-5D-5L and QLQ-C30, the EQ-VAS showed a higher rate of deterioration after 8 weeks. Significant connections to certain metastatic locations were only detected in the EQ-VAS. The EQ-VAS is capable of reflecting the distinctive HRQoL profiles of different systemic treatments as well as the different aspects of HRQoL presented in the EQ-5D-5L. TTD with the EQ-VAS is an adequate mean of examining longitudinal development of HRQoL among breast cancer patients.
Clinician Preimplementation Perspectives of a Decision-Support Tool for the Prediction of Cardiac Arrhythmia Based on Machine Learning: Near-Live Feasibility and Qualitative Study
Authors: Matthiesen Stina , Diederichsen Søren Zöga , Hansen Mikkel Klitzing Hartmann , Villumsen Christina , Lassen Mats Christian Højbjerg , Jacobsen Peter Karl , Risum Niels , Winkel Bo Gregers , Philbert Berit T , Svendsen Jesper Hastrup , Andersen Tariq Osman 
Published: October 2021

Background
Artificial intelligence (AI), such as machine learning (ML), shows great promise for improving clinical decision-making in cardiac diseases by outperforming statistical-based models. However, few AI-based tools have been implemented in cardiology clinics because of the sociotechnical challenges during transitioning from algorithm development to real-world implementation.

Objective
This study explored how an ML-based tool for predicting ventricular tachycardia and ventricular fibrillation (VT/VF) could support clinical decision-making in the remote monitoring of patients with an implantable cardioverter defibrillator (ICD).

Methods
Seven experienced electrophysiologists participated in a near-live feasibility and qualitative study, which included walkthroughs of 5 blinded retrospective patient cases, use of the prediction tool, and questionnaires and interview questions. All sessions were video recorded, and sessions evaluating the prediction tool were transcribed verbatim. Data were analyzed through an inductive qualitative approach based on grounded theory.

Results
The prediction tool was found to have potential for supporting decision-making in ICD remote monitoring by providing reassurance, increasing confidence, acting as a second opinion, reducing information search time, and enabling delegation of decisions to nurses and technicians. However, the prediction tool did not lead to changes in clinical action and was found less useful in cases where the quality of data was poor or when VT/VF predictions were found to be irrelevant for evaluating the patient.

Conclusions
When transitioning from AI development to testing its feasibility for clinical implementation, we need to consider the following: expectations must be aligned with the intended use of AI; trust in the prediction tool is likely to emerge from real-world use; and AI accuracy is relational and dependent on available information and local workflows. Addressing the sociotechnical gap between the development and implementation of clinical decision-support tools based on ML in cardiac care is essential for succeeding with adoption. It is suggested to include clinical end-users, clinical contexts, and workflows throughout the overall iterative approach to design, development, and implementation.
COVID-19 Vaccine Hesitancy on Social Media: Building a Public Twitter Data Set of Antivaccine Content, Vaccine Misinformation, and Conspiracies
Authors: Muric Goran , Wu Yusong , Ferrara Emilio 
Published: October 2021

Background
False claims about COVID-19 vaccines can undermine public trust in ongoing vaccination campaigns, posing a threat to global public health. Misinformation originating from various sources has been spreading on the web since the beginning of the COVID-19 pandemic. Antivaccine activists have also begun to use platforms such as Twitter to promote their views. To properly understand the phenomenon of vaccine hesitancy through the lens of social media, it is of great importance to gather the relevant data.

Objective
In this paper, we describe a data set of Twitter posts and Twitter accounts that publicly exhibit a strong antivaccine stance. The data set is made available to the research community via our AvaxTweets data set GitHub repository. We characterize the collected accounts in terms of prominent hashtags, shared news sources, and most likely political leaning.

Methods
We started the ongoing data collection on October 18, 2020, leveraging the Twitter streaming application programming interface (API) to follow a set of specific antivaccine-related keywords. Then, we collected the historical tweets of the set of accounts that engaged in spreading antivaccination narratives between October 2020 and December 2020, leveraging the Academic Track Twitter API. The political leaning of the accounts was estimated by measuring the political bias of the media outlets they shared.

Results
We gathered two curated Twitter data collections and made them publicly available: (1) a streaming keyword–centered data collection with more than 1.8 million tweets, and (2) a historical account–level data collection with more than 135 million tweets. The accounts engaged in the antivaccination narratives lean to the right (conservative) direction of the political spectrum. The vaccine hesitancy is fueled by misinformation originating from websites with already questionable credibility.

Conclusions
The vaccine-related misinformation on social media may exacerbate the levels of vaccine hesitancy, hampering progress toward vaccine-induced herd immunity, and could potentially increase the number of infections related to new COVID-19 variants. For these reasons, understanding vaccine hesitancy through the lens of social media is of paramount importance. Because data access is the first obstacle to attain this goal, we published a data set that can be used in studying antivaccine misinformation on social media and enable a better understanding of vaccine hesitancy.
Mixed Reality and Haptic–Based Dental Simulator for Tooth Preparation: Research, Development, and Preliminary Evaluation
Authors: Li Yaning , Ye Hongqiang , Wu Siyu , Zhao Xiaohan , Liu Yunsong , Lv Longwei , Zhang Ping , Zhang Xiao , Zhou Yongsheng 
Published: October 2021

Background
Virtual reality (VR) dental simulators are currently used in preclinical skills training. However, with the development of extended reality technologies, the use of mixed reality (MR) has shown significant advantages over VR.

Objective
This study aimed to describe the research and development of a newly developed MR and haptic–based dental simulator for tooth preparation and to conduct a preliminary evaluation of its face validity.

Methods
A prototype of the MR dental simulator for tooth preparation was developed by integrating a head-mounted display (HMD), special force feedback handles, a foot pedal, computer hardware, and software program. We recruited 34 participants and divided them into the Novice group (n=17) and Skilled group (n=17) based on their clinical experience. All participants prepared a maxillary right central incisor for an all-ceramic crown in the dental simulator, completed a questionnaire afterward about their simulation experience, and evaluated hardware and software aspects of the dental simulator.

Results
Of the participants, 74% (25/34) were satisfied with the overall experience of using the Unidental MR Simulator. Approximately 90% (31/34, 91%) agreed that it could stimulate their interest in learning, and 82% (28/34) were willing to use it for skills training in the future. Differences between the 2 study groups in their experience with the HMD (resolution: P=.95; wearing comfort: P=.10), dental instruments (P=.95), force feedback of the tooth (P=.08), simulation of the tooth preparation process (P=.79), overall experience with the simulation (P=.47), and attitude toward the simulator (improves skills: P=.47; suitable for learning: P=.36; willing to use: P=.89; inspiring for learning: P=.63) were not significant. The Novice group was more satisfied with the simulator’s ease of use (P=.04). There were significant positive correlations between the overall experience with the simulation and the HMD’s resolution (P=.03) and simulation of the preparation process (P=.001).

Conclusions
The newly developed Unidental MR Simulator for tooth preparation has good face validity. It can achieve a higher degree of resemblance to the real clinical treatment environment by improving the positional adjustment of the simulated patients, for a better training experience in dental skills.
Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
Authors: García-Muñoz Cristina , Cortés-Vega María-Dolores , Hernández-Rodríguez Juan-Carlos , Fernández-Seguín Lourdes M , Escobio-Prieto Isabel , Casuso-Holgado María Jesús 
Published: October 2021

Background
Dizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS.

Objective
The aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention.

Methods
This case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device.

Results
After implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16% in the physical health area at T2; 33.56% in the mental health area at T2). The patient rated the usability of the system as 90%, based on the System Usability Scale, and gave the system a grade of A.

Conclusions
Although further research is needed, this study provided initial evidence that the first VRi vestibular protocol for the MS population can improve dizziness, balance, gait, impact of fatigue, quality of life, and muscular tone through an exergame intervention. This study may help establish a standardized VRi protocol for vestibular rehabilitation.
Exploring Middle School Students’ Perspectives on Using Serious Games for Cancer Prevention Education: Focus Group Study
Authors: Abraham Olufunmilola , Szela Lisa , Khan Mahnoor , Geddam Amrita 
Published: October 2021

Background
Cancer in the United States is a leading cause of mortality. Educating adolescents about cancer risks can improve awareness and introduce healthy lifestyle habits. Public health efforts have made significant progress in easing the burden of cancer through the promotion of early screening and healthy lifestyle advocacy. However, there are limited interventions that educate the adolescent population about cancer prevention. Previous studies have demonstrated the effectiveness of serious games (SGs) to teach adolescents about healthy lifestyle choices, but few research efforts have examined the utility of using SGs to educate youth specifically on cancer prevention.

Objective
This study aimed to investigate middle school students’ preferences for the use of SGs for cancer prevention education. The study also characterized the students’ perceptions of desired game design features for a cancer prevention SG.

Methods
Focus groups were held to allow adolescents to review a game playbook and discuss gaming behaviors and preferences for an SG for cancer education. The game playbook was developed based on “Cancer, Clear & Simple,” a curriculum intended to educate individuals about cancer, prevention, self-care, screening, and detection. In the game, the player learns that they have cancer and is given the opportunity to go back in time to reduce their cancer risk. A focus group discussion guide was developed and consisted of questions about aspects of the playbook and the participants’ gaming experience. The participants were eligible if they were 12 to 14 years old, could speak and understand English, and had parents who could read English or Spanish. Each focus group consisted of 5 to 10 persons. The focus groups were audio recorded and professionally transcribed; they were then analyzed content-wise and thematically by 2 study team members. Intercoder reliability (kappa coefficient) among the coders was reported as 0.97. The prevalent codes were identified and categorized into themes and subthemes.

Results
A total of 18 focus groups were held with 139 participants from a Wisconsin middle school. Most participants had at least “some” gaming experience. Three major themes were identified, which were educational video games, game content, and purpose of game. The participants preferred customizable characters and realistic story lines that allowed players to make choices that affect the characters’ outcomes. Middle school students also preferred SGs over other educational methods such as lectures, books, videos, and websites. The participants desired SGs to be available across multiple platforms and suggested the use of SGs for cancer education in their school.

Conclusions
Older children and adolescents consider SGs to be an entertaining tool to learn about cancer prevention and risk factors. Their design preferences should be considered to create a cancer education SG that is acceptable and engaging for youth.
Performance of Artificial Intelligence Imaging Models in Detecting Dermatological Manifestations in Higher Fitzpatrick Skin Color Classifications
Authors: Aggarwal Pushkar 
Published: October 2021

Background
The performance of deep-learning image recognition models is below par when applied to images with Fitzpatrick classification skin types 4 and 5.

Objective
The objective of this research was to assess whether image recognition models perform differently when differentiating between dermatological diseases in individuals with darker skin color (Fitzpatrick skin types 4 and 5) than when differentiating between the same dermatological diseases in Caucasians (Fitzpatrick skin types 1, 2, and 3) when both models are trained on the same number of images.

Methods
Two image recognition models were trained, validated, and tested. The goal of each model was to differentiate between melanoma and basal cell carcinoma. Open-source images of melanoma and basal cell carcinoma were acquired from the Hellenic Dermatological Atlas, the Dermatology Atlas, the Interactive Dermatology Atlas, and DermNet NZ.

Results
The image recognition models trained and validated on images with light skin color had higher sensitivity, specificity, positive predictive value, negative predictive value, and F1 score than the image recognition models trained and validated on images of skin of color for differentiation between melanoma and basal cell carcinoma.

Conclusions
A higher number of images of dermatological diseases in individuals with darker skin color than images of dermatological diseases in individuals with light skin color would need to be gathered for artificial intelligence models to perform equally well.
Kinetic Study of Biogas Production from Animal Manure and Organic Waste in Semarang City by Using Anaerobic Digestion Method
Authors: Arifan Fahmi , Abdullah Abdullah , Sumardiono Siswo 
Published: October 2021

The biogas fermentation from animal manure and organic waste was investigated with a comparison percentage of raw material used inside the digester with the anaerobic digestion process. Animal manure consists of cow dung and chicken manure, while organic waste consists of tofu liquid waste and cabbage waste. This study used a batch process that was operated at 55 °C incubator temperature for 90 days. The results of experimental data were predicted with a modified Gompertz model and first-order kinetic model. The equation of the modified Gompertz model to predict biogas production was with is cumulative production of methane; P∞ = methane production potential; Rm = maximum specific speed methane production; λ = is lag phase period or minimum time to produce biogas; e = math constant (2.7182) and t = biogas production cumulative time. The equation first-order kinetic model was Y = Ym (1-exp(-k). The highest biogas yield was obtained by variable 3 in both kinetic studies compared to 70% cow dung, 15% chicken manure, and 15% tofu liquid waste. Gompertz's kinetic study predicted variable three would produce 3273.20 mL/g of total solid (TS). In comparison, the first-order kinetic model predicted that variable three would produce 3517.95 mL/(g Ts).
Ecología y evolución de enfermedades emergentes en anfibios: una revisión de ranavirus y quitridiomicosis
Authors: Basanta María Delia 
Published: October 2021

Las enfermedades infecciosas emergentes son una de las principales causas en el declive de especies de anfibios a nivel global. Estas enfermedades son causadas por patógenos que pueden ampliar rápidamente su rango geográfico y de hospedadores, convirtiéndose en epidémicas. Enfermedades emergentes de anfibios como ranavirus y quitridiomicosis, han ocasionado grandes declives en poblaciones del mundo, donde factores ecológicos y evolutivos están implicados tanto en su emergencia como en la variación en la susceptibilidad de las especies. En este trabajo se presenta una revisión de las enfermedades ranavirus y quitridiomicosis, en relación a los factores ecológicos y evolutivos que caracterizan a estas infecciones, sus efectos sobre las poblaciones de anfibios a nivel mundial, y la posible aplicación de medidas de prevención y conservación.
Влияние работы энергопотребителей при возведении малоэтажных жилых зданий на состояние окружающей среды
Authors: Король Елена , Журавлева Анастасия 
Published: October 2021

На основании анализа структуры энергетических затрат при возведении малоэтажных жилых зданий со стенами из кирпича, керамзитобетонных блоков, несъёмной пенополистирольной опалубки и SIP-панелей установлены две основ­ные группы потребителей - машины и механизмы и инфра­структура строительной площадки. Декомпозиция расхода топливно-энергетических ресурсов (ТЭР) на строительной площадке для каждого из приведённых выше конструктивно­технологических решений малоэтажных зданий позволила получить потребление электроэнергии (в кВт) и жидкого топлива (в литрах). Посредством приведения различных количественных значений энергозатрат к универсальной единице - килограмму условного топлива, был осуществлён сравнительный анализ общего (суммарного) энергопотребле­ния строительной площадки.
Поскольку при возведении зданий работа энергопотребителей неразрывно связана с характерными выбросами вредных веществ в окружающую среду, были рассчитаны их количественные и качественные показатели. Они исполь­зованы для сравнительной оценки состояния окружающей среды при возведении малоэтажных жилых зданий различных конструктивно-технологических систем.
Hubungan Sanitasi Lingkungan Dengan Kejadian Stunting Pada Balita di Indonesia (Studi Literatur)
Authors: Hasanah Siti , Handayani Sarah , Wilti Ikhwan Ridha 
Published: October 2021

Stunting merupakan suatu keadaan yang menggambarkan status gizi kurang yang bersifat kronik pada masa pertumbuhan dan perkembangan terjadi sejak bayi dalam kandungan sampai bayi dilahirkan. Tujuan penelitian ini adalah untuk mengetahui hubungan sanitasi lingkungan dengan kejadian stunting pada balita di Indonesia. Penelitian ini merupakan penelitian studi literatur. Literatur yang diulas diperoleh dari penelusuran artikel penelitian-penelitian ilmiah dari rentang tahun 2014-2019 dengan menggunakan database Google Scholar, PubMed Central, dan Biomel Central. Data yang digunakan adalah data sekunder, yaitu data yang diperoleh dari hasil penelitian yang telah dilakukan oleh peneliti-peneliti terdahulu. Penelitian ini dilakukan antara bulan Juni hingga Agustus 2020. Berdasarkan penelusuran judul dan abstrak didapatkan 76 artikel namun hanya 20 artikel yang memenuhi kriteria inklusi. Hasil telaah terhadap literatur terdapat hubungan signifikan antara variabel sumber air bersih, akses sanitasi, pengelolaan limbah rumah tangga, pengelolaan sampah rumah tangga, kejadian diare dan kejadian ISPA dengan kejadian stunting pada balita di Indonesia.
Kata Kunci : Balita, Indonesia, Sanitasi Lingkungan, Stunting