bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Missingness Features in Machine Learning Models for Critical Care: Observational Study
Authors: Singh Janmajay , Sato Masahiro , Ohkuma Tomoko 
Published: December 2021

BackgroundMissing data in electronic health records is inevitable and considered to be nonrandom. Several studies have found that features indicating missing patterns (missingness) encode useful information about a patient’s health and advocate for their inclusion in clinical prediction models. But their effectiveness has not been comprehensively evaluated.ObjectiveThe goal of the research is to study the effect of including informative missingness features in machine learning models for various clinically relevant outcomes and explore robustness of these features across patient subgroups and task settings.MethodsA total of 48,336 electronic health records from the 2012 and 2019 PhysioNet Challenges were used, and mortality, length of stay, and sepsis outcomes were chosen. The latter dataset was multicenter, allowing external validation. Gated recurrent units were used to learn sequential patterns in the data and classify or predict labels of interest. Models were evaluated on various criteria and across population subgroups evaluating discriminative ability and calibration.ResultsGenerally improved model performance in retrospective tasks was observed on including missingness features. Extent of improvement depended on the outcome of interest (area under the curve of the receiver operating characteristic [AUROC] improved from 1.2% to 7.7%) and even patient subgroup. However, missingness features did not display utility in a simulated prospective setting, being outperformed (0.9% difference in AUROC) by the model relying only on pathological features. This was despite leading to earlier detection of disease (true positives), since including these features led to a concomitant rise in false positive detections.ConclusionsThis study comprehensively evaluated effectiveness of missingness features on machine learning models. A detailed understanding of how these features affect model performance may lead to their informed use in clinical settings especially for administrative tasks like length of stay prediction where they present the greatest benefit. While missingness features, representative of health care processes, vary greatly due to intra- and interhospital factors, they may still be used in prediction models for clinically relevant outcomes. However, their use in prospective models producing frequent predictions needs to be explored further.
Adoption and Appropriateness of mHealth for Weight Management in the Real World: A Qualitative Investigation of Patient Perspectives
Authors: Breland Jessica Y , Agha Khizran , Mohankumar Rakshitha 
Published: December 2021

Background
Mobile health (mHealth) interventions for weight management can result in weight loss outcomes comparable to in-person treatments. However, there is little information on implementing these treatments in real-world settings.

Objective
This work aimed to answer two implementation research questions related to mHealth for weight management: (1) what are barriers and facilitators to mHealth adoption (initial use) and engagement (continued use)? and (2) what are patient beliefs about the appropriateness (ie, perceived fit, relevance, or compatibility) of mHealth for weight management?

Methods
We conducted semistructured interviews with patients with obesity at a single facility in an integrated health care system (the Veterans Health Administration). All participants had been referred to a new mHealth program, which included access to a live coach. We performed a rapid qualitative analysis of interviews to identify themes related to the adoption of, engagement with, and appropriateness of mHealth for weight management.

Results
We interviewed 24 veterans, seven of whom used the mHealth program. Almost all participants were ≥45 years of age and two-thirds were White. Rapid analysis identified three themes: (1) coaching both facilitates and prevents mHealth adoption and engagement by promoting accountability but leading to guilt among those not meeting goals; (2) preferences regarding the mode of treatment delivery, usability, and treatment content were barriers to mHealth appropriateness and adoption, including preferences for in-person care and a dislike of self-monitoring; and (3) a single invitation was not sufficient to facilitate adoption of a new mHealth program. Themes were unrelated to participants’ age, race, or ethnicity.

Conclusions
In a study assessing real-world use of mHealth in a group of middle-aged and older adults, we found that—despite free access to mHealth with a live coach—most did not complete the registration process. Our findings suggest that implementing mHealth for weight management requires more than one information session. Findings also suggest that focusing on the coaching relationship and how users’ lives and goals change over time may be an important way to facilitate engagement and improved health. Most participants thought mHealth was appropriate for weight management, with some nevertheless preferring in-person care. Therefore, the best way to guarantee equitable care will be to ensure multiple routes to achieving the same behavioral health goals. Veterans Health Administration patients have the option of using mHealth for weight management, but can also attend group weight management programs or single-session nutrition classes or access fitness facilities. Health care policy does not allow such access for most people in the United States; however, expanded access to behavioral weight management is an important long-term goal to ensure health for all.
Interactive Mobile Phone HIV Adherence Support for Men Who Have Sex With Men in the Philippines Connect for Life Study: Mixed Methods Approach to Intervention Development and Pilot Testing
Authors: O'Connor Cara , Leyritana Katerina , Doyle Aoife M , Lewis James J , Gill Randeep , Salvaña Edsel Maurice 
Published: December 2021

Background
The HIV epidemic in the Philippines is one of the fastest growing epidemics globally, and infections among men who have sex with men are rising at an alarming rate. The World Health Organization recommends the use of mobile health (mHealth) technologies to engage patients in care and ensure high levels of adherence to antiretroviral therapy (ART). Existing mHealth interventions can be adapted and tailored to the context and population served.

Objective
This study aims to create a locally tailored intervention using a mobile phone platform to support treatment adherence for HIV patients on ART in the Philippines.

Methods
A mixed methods approach guided by the Behavior Change Wheel framework was used to adapt an existing mHealth adherence support platform for the local setting and target population. A literature review, retrospective clinical record review, and focus group discussions with patients were conducted to understand the drivers of ART adherence and tailor the intervention accordingly. The resulting intervention was pilot-tested for 8 weeks, followed by focus group discussions with patients who received the intervention to assess the acceptability of the design.

Results
Key issues contributing to nonadherence included side effects, lack of behavioral skills for pill taking, social support, mental health, and substance use. Patients identified mHealth as an acceptable mode of intervention delivery and wanted mHealth services to be highly personalizable. The study team, clinicians, and software developers integrated these findings into the intervention, which included a menu of services as follows: pill reminders, health tips, adherence feedback, appointment reminders, and symptom reporting. During the pilot phase, technical issues in the interactive voice response system (IVRS) were identified and addressed. Patients who participated in the pilot phase expressed a preference for SMS text messaging over the IVRS. Patients responded positively to the appointment reminders and health tips, whereas patient feedback on daily and weekly pill reminders and adherence feedback was mixed.

Conclusions
The mobile phone–based SMS text messaging and IVRS intervention was acceptable to men who have sex with men in Manila, the Philippines, and qualitative analysis suggested that the intervention helped promote ART adherence and appointment attendance.
Health Care Providers’ Trusted Sources for Information About COVID-19 Vaccines: Mixed Methods Study
Authors: Brauer Eden , Choi Kristen , Chang John , Luo Yi , Lewin Bruno , Munoz-Plaza Corrine , Bronstein David , Bruxvoort Katia 
Published: December 2021

Background
Information and opinions shared by health care providers can affect patient vaccination decisions, but little is known about who health care providers themselves trust for information in the context of new COVID-19 vaccines.

Objective
The purpose of this study is to investigate which sources of information about COVID-19 vaccines are trusted by health care providers and how they communicate this information to patients.

Methods
This mixed methods study involved a one-time, web-based survey of health care providers and qualitative interviews with a subset of survey respondents. Health care providers (physicians, advanced practice providers, pharmacists, nurses) were recruited from an integrated health system in Southern California using voluntary response sampling, with follow-up interviews with providers who either accepted or declined a COVID-19 vaccine. The outcome was the type of information sources that respondents reported trusting for information about COVID-19 vaccines. Bivariate tests were used to compare trusted information sources by provider type; thematic analysis was used to explore perspectives about vaccine information and communicating with patients about vaccines.

Results
The survey was completed by 2948 providers, of whom 91% (n=2683) responded that they had received ≥1 dose of a COVID-19 vaccine. The most frequently trusted source of COVID-19 vaccine information was government agencies (n=2513, 84.2%); the least frequently trusted source was social media (n=691, 9.5%). More physicians trusted government agencies (n=1226, 93%) than nurses (n=927, 78%) or pharmacists (n=203, 78%; P<.001), and more physicians trusted their employer (n=1115, 84%) than advanced practice providers (n=95, 67%) and nurses (n=759, 64%; P=.002). Qualitative themes (n=32 participants) about trusted sources of COVID-19 vaccine information were identified: processing new COVID-19 information in a health care work context likened to a “war zone” during the pandemic and communicating information to patients. Some providers were hesitant to recommend vaccines to pregnant people and groups they perceived to be at low risk for COVID-19.

Conclusions
Physicians have stronger trust in government sources and their employers for information about COVID-19 vaccines compared with nurses, pharmacists, and advanced practice providers. Strategies such as role modeling, tailored messaging, or talking points with standard language may help providers to communicate accurate COVID-19 vaccine information to patients, and these strategies may also be used with providers with lower levels of trust in reputable information sources.
Campus Smoking Policies and Smoking-Related Twitter Posts Originating From California Public Universities: Retrospective Study
Authors: Yang Joshua S , Cuomo Raphael E , Purushothaman Vidya , Nali Matthew , Shah Neal , Bardier Cortni , Obradovich Nick , Mackey Tim 
Published: December 2021

Background
The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement.

Objective
The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies.

Methods
Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status.

Results
The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7% vs 66.4%, P=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one’s own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities.

Conclusions
Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one’s own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment.
Mobile Phone–Based Intervention Among Adolescents Living With Perinatally Acquired HIV Transitioning from Pediatric to Adult Care: Protocol for the Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA) Study
Authors: Zanoni Brian C , Archary Moherndran , Sibaya Thobekile , Goldstein Madeleine , Bergam Scarlett , Denton David , Cordero Vincente , Peng Cynthia , Psaros Christina , Marconi Vincent C , Haberer Jessica E 
Published: December 2021

Background
Adolescents living with perinatally acquired HIV often have poor retention in care and viral suppression during the transition from pediatric to adult-based care.

Objective
The aim of this study is to evaluate a mobile phone–based intervention, Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA), among adolescents living with perinatally acquired HIV as they transition from pediatric to adult care in South Africa.

Methods
InTSHA uses encrypted, closed group chats delivered via WhatsApp (Meta Platforms Inc) to develop peer support and improve communication between adolescents, their caregivers, and health care providers. The intervention is based on formative work with adolescents, caregivers, and health care providers and builds on several existing adolescent support programs as well as the Social-ecological Model of Adolescent and Young Adult Readiness for Transition (SMART). The final InTSHA intervention involves 10 modules conducted weekly through moderated WhatsApp group chats with adolescents and separately with their caregivers. We will randomly assign 80 South African adolescents living with perinatally acquired HIV who are aware of their HIV status and aged between 15 and 19 years to receive either the intervention (n=40) or standard of care (n=40).

Results
We will measure acceptability of the intervention as the primary outcome and evaluate feasibility and preliminary effectiveness for retention in care and viral suppression after completion of the intervention and at least 6 months after randomization. In addition, we will measure secondary outcomes evaluating the impact of the InTSHA intervention on peer support, self-esteem, depression, stigma, sexual education, connection to health care providers, and transition readiness. Enrollment began on April 15, 2021. As of December 31, 2021 a total of 78 out of expected 80 participants have been enrolled.

Conclusions
If successful, the intervention will be evaluated in a fully powered randomized controlled trial with a larger number of adolescents from urban and rural populations to further evaluate the generalizability of InTSHA.

Trial Registration
ClinicalTrials.gov NCT03624413; https://clinicaltrials.gov/ct2/show/NCT03624413

International Registered Report Identifier (IRRID)
DERR1-10.2196/35455
Механічна вентиляція легень, керована об’ємом або тиском під час нейрохірургічних операцій. Чи є перевага?
Authors: Merza R.O. , Pidhirnyi Ya.M. 
Published: December 2021

Актуальність. Однією з головних технологій сучасної анестезіології є механічна вентиляція легень (МВЛ). На даний час в інтенсивній терапії широко визнаною є протективна технологія МВЛ. Доцільність застосування даної технології в операційній, особливо у хворих з інтактними легенями, є не такою очевидною. Більшість наукових робіт, що висвітлюють дану проблему, стосується хворих з абдомінальною патологією, і менш висвітленою вона залишається у пацієнтів з нейрохірургічною патологією. Пацієнти, які оперуються з приводу нейрохірургічної патології, відносяться до групи хворих високого хірургічного ризику, це і змотивувало нас провести дане дослідження. Метою дослідження було вивчити доцільність застосування протективної МВЛ під час операційних втручань у нейрохірургічних хворих. Матеріали та методи. Нами обстежено 46 хворих, які знаходилися на стаціонарному лікуванні у КНП «8 МКЛ м. Львова» з приводу патології хребта та яким було виконане операційне втручання — вертебропластика із спондилодезом. Пацієнти були розподілені на дві групи: у першій групі (34 хворі) МВЛ проводили за технологією S-IPPV — синхронізована примусова вентиляція легень з контролем по об’єму, а в другій групі (12 хворих) МВЛ проводилась за технологією PCV — вентиляція, керована тиском. Результати. Ми ретроспективно визначили частоту виникнення післяопераційних легеневих ускладнень (ПОЛУ) у хворих першої та другої групи. З 34 хворих першої групи ознаки ПОЛУ були виявлені у 17 осіб (50 %), а з 12 хворих другої групи ПОЛУ було виявлено у 4 (33,3 %). Слід зауважити, що МВЛ у хворих обох груп не відрізнялася за такими параметрами, як частота дихання, кінцево-альвеолярний тиск на видиху та фракція кисню в дихальній суміші. Висновки. Порівняно невелика кількість хворих не дозволяє, очевидно, робити остаточні висновки, проте слід звернути увагу на те, що МВЛ (особливо керована об’ємом) сприяє виникненню післяопераційних легеневих ускладнень у пацієнтів з інтактними легенями в доопераційний період. А застосування МВЛ, керованої тиском, має тенденцію до зменшення частоти виявлення легеневих ускладнень в післяопераційному періоді. Якщо врахувати, що частота дихання, кінцево-альвеолярний тиск на видиху та фракція кисню в дихальній суміші були порівнянні у хворих обох груп, можна припустити, що фактором, який впливає на частоту виникнення ПОЛУ, є механіка вентиляції легень.
Contribuições da escola no reconhecimento de estudantes com altas capacidades
Authors: Cleto Edilene Reis , Abud Maria José Milharezi 
Published: December 2021

Acredita-se que os melhores meios para contribuir com o desenvolvimento do potencial dos estudantes com capacidade elevada encontram-se na escola. É dela a responsabilidade de prover um projeto que conduza efetivamente ao desenvolvimento das crianças sinalizadas com potencial acima da média. Este trabalho expõe uma pesquisa cujo tema aborda a contribuição da escola no reconhecimento de estudantes mais capazes. Tem como objetivo identificar, na visão dos professores, quando é mais fácil visualizar os sinais de capacidade elevada dos estudantes no ambiente escolar. Como procedimento metodológico para coleta de informações, foi aplicado o questionamento a 36 professores da Rede de Ensino Municipal. As respostas foram analisadas conforme os construtos da Análise de Conteúdo propostos por Bardin (2011). Os resultados revelaram que as dificuldades encontradas pelos professores reiteram a importância e a melhoria das reuniões de formação docente para a tarefa de reconhecimento dos estudantes com altas capacidades.
Activation and installation of orthodontic appliances temporarily impairs mastication:
Authors: Duarte Laís , Bezerra Adriana Pinto , Flores-Mir Carlos , De Luca Canto Graziela , Pereira Luciano José , Vega Gonçalves Thais Marques Simek 
Published: December 2021

ABSTRACTObjectivesTo investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners).Materials and MethodsSix electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed.ResultsOf 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: −4.867 to −0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P &gt; .05). The swallowing threshold remained constant (P &gt; .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P &lt; .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P &lt; .001). Low to very low levels of evidence were found.ConclusionsBased on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.