bluuebunny/crossref_metadata_2025_split huggingface dataset:
Steady-state Security Assessment Based on K-Means Clustering Algorithm and Phasor Measurement Units
Authors: Hemade Bassam A. , Ibrahim Hamed A. , Talaat Hossam E.A. 
Published: August 2019

Background:
The security assessment plays a crucial role in the operation of the modern
interconnected power system network.

Methods:
Hence, this paper addresses the application of k-means clustering algorithm equipped
with Principal Component Analysis (PCA) and silhouette analysis for the classification of system
security states. The proposed technique works on three principal axes; the first stage involves contingency
quantification based on developed insecurity indices, the second stage includes dataset
preparation to enhance the overall performance of the proposed method using PCA and silhouette
analysis, and finally the application of the clustering algorithm over data.

Results:
The proposed composite insecurity index uses available synchronized measurements from
Phasor Measurement Units (PMUs) to assess the development of cascading outages. Considering
different operational scenarios and multiple levels of contingencies (up to N-3), Fast Decoupled
Power Flow (FDPF) have been used for contingency replications. The developed technique applied
to IEEE 14-bus and 57-bus standard test system for steady-state security evaluation.

Conclusion:
The obtained results ensure the robustness and effectiveness of the established procedure
in the assessment of the system security irrespective of the network size or operating conditions.
AVALIAÇÃO, REGULAÇÃO E AUTONOMIA DO ENSINO SUPERIOR EM ANGOLA: PERSPECTIVAS E DESAFIOS
Authors: Tauchen Gionara , Borges Daniele Simões , Correia Filho João Manuel 
Published: August 2019

A demanda pela formação de profissionais, aliada ao entendimento do Ensino Superior como fator de desenvolvimento, contribuíram com a ampliação dos sistemas de ensino na África Subsaariana, demandando ações dos Estados como organizadores, supervisores e fiscalizadores da qualidade das instituições. Situado neste contexto, o presente artigo tem por objetivo contextualizar a organização do Ensino Superior em Angola e analisar o papel regulador do Estado na avaliação e acreditação das instituições. O estudo é de natureza qualitativa, do tipo narrativa. Por meio da análise dos dados, produziu-se o eixo narrativo Autonomia: dilemas entre avaliação e regulação. Concluímos que em Angola os marcos legais reforçam princípios reguladores do Estado-avaliador, coexistindo com a ideia de autonomia como ampliação da participação política e social. Neste sentido, é necessário articular os processos de avaliação e de regulação, pois o primeiro comporta a autonomia e a diversidade das instituições e sujeitos educativos, os quais podem subsidiar e fundamentar as decisões no âmbito da regulação do Estado.
Educação de Jovens e Adultos a Distância: impedimentos e superações
Authors: Reis Geraldo Ananias , Lopes Carlos 
Published: August 2019

O artigo analisa as trajetórias de quatro egressos de uma instituição pública: o Centro de Educação de Jovens e Adultos da Asa Sul (CESAS), em Brasília, DF, em curso a distância. Apreende a origem social dos egressos, o capital cultural, as dificuldades, limitações e opção pela EaD. Como o capital cultural e as imposições das condições de vida dos egressos da EJA/EaD impulsionaram o retorno aos estudos? A resposta a essa questão, em um enfoque descritivo e exploratório, em conexão com os dados de entrevistas, dialoga com Bourdieu e Lahire, concluindo: os egressos da EJA, com exceção de um, têm origem familiar com posição social homóloga e baixo capital cultural institucionalizado; imposições estruturais provocam a prioridade do trabalho e não do capital cultural institucionalizado e, em outro momento da trajetória, o trabalho influencia o retorno aos estudos. Esse regresso, via EJA/EaD, dá aos sujeitos um sentimento de valoração, principalmente, por possibilitar conciliar trabalho e estudo, tendo a escolha um sentido prático.
RELAÇÕES ÉTNICO-RACIAIS E O ENSINO DE CIÊNCIAS: UM MAPEAMENTO DAS PESQUISAS SOBRE O TEMA
Authors: De Jesus Jeobergna , Santos da Paixão Marília Costa , Vianna Prudêncio Christiana Andrea 
Published: August 2019

O presente artigo realiza um levantamento sobre quais aspectos das relações étnico-raciais e o ensino de ciências tem sido evidenciados nas pesquisas em Educação em Ciências, tendo como base as atas de um dos maiores eventos da área no Brasil, o Encontro Nacional de Pesquisa em Educação em Ciências (ENPEC). Essa necessidade surge de cumprir demandas sociais históricas, reforçadas pela promulgação da Lei nº 10.639/03, que torna obrigatória a abordagem da história e cultura africana e afro-brasileira em todas as disciplinas. Contudo, a literatura aponta que a área de Ciências carece de discussões sobre essas questões. Com o objetivo de traçar um panorama das pesquisas sobre educação em Ciências e sua interface com as relações étnico-raciais, analisamos as atas do ENPEC de 2003 a 2015. Os resultados demonstraram que dentre as categorias que elencamos para classificar as pesquisas (concepções de alunos e professores, ensino, formação inicial e continuada de professores e material didático) destaca-se a produção em ensino e material didático. Além disso, é notada a necessidade de mais pesquisas que atentem para a elaboração de estratégias para a inserção das discussões sobre as relações étnico-raciais nas aulas de Ciências. As pesquisas mostram ainda que a área de Ciências é a que mais possui produção, seguida da Biologia e da Química. No entanto, nenhum trabalho foi encontrado na área da Física. Os temas mais comumente pesquisados são: a formação de professores, com o objetivo de pensar práticas para as discussões raciais e o ensino de Ciências. Evidenciamos assim que as relações étnico-raciais precisam ser mais contempladas no ensino de Ciências, pois mesmo que a Lei nº 10.639/03 as tenha tornado obrigatórias, ainda existe uma série de dificuldades para seu efetivo cumprimento, dentre elas a falta de materiais didáticos específicos e as limitações que os docentes possuem para incorporar essa temática em suas disciplinas.
Adapting the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) in a Sample of Greek and Cypriot Carers of People With Dementia: Reliability and Validation Study
Authors: Efthymiou Areti , Middleton Nicos , Charalambous Andreas , Papastavrou Evridiki 
Published: August 2019

Background
As the population ages, many more people will be in need of long-term care. According to a recent report by Alzheimer's Disease International and the Karolinska Institute, 84% of people with dementia are cared for at home and 16% in nursing homes. Several Web-based interventions have been developed to assist the work of carers at home. Measuring the levels of electronic health (eHealth) literacy is of top priority to facilitate inclusion of this population and develop training programs to enhance eHealth literacy skills.

Objective
This study aimed to adapt the eHealth Literacy Scale (eHeals) for carers of people with dementia, who speak Greek as their native language and live in Greece and Cyprus, and to test the reliability and validity of the scale for carers.

Methods
The content validity of the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) was assessed with an expert panel (N=10). A descriptive study with face-to-face interviews among 101 primary carers of people with dementia was conducted. In addition to the eHeals-Carer to assess their perceived eHealth literacy, participants responded to a brief questionnaire regarding characteristics of internet use and provided sociodemographic data. The internal consistency of the tool and the construct validity via an exploratory factor analysis (EFA) were explored.

Results
The Mean Item-Level Content Validity Index (CVI) and Scale-Level CVI Average was 0.93. The participants were mostly women (75.2%, 76/101), aged less than 60 years (67.3%, 68/101) with secondary education. The internal consistency was estimated at a Cronbach alpha of .83. Two factors were extracted from the EFA: information seeking questions 1 to 5 (factor 1) and evaluation questions 6 to 8 (factor 2).

Conclusions
eHeals-Carer is the first perceived eHealth literacy tool adapted for carers of people with dementia. The use of Web-based services available for carers could help them and improve the health care system in the long term. In Greece and Cyprus, there is a lack of services, and improving the digital skills of carers could provide them with the means to support themselves at home and improve care provision.

International Registered Report Identifier (IRRID)
RR2-10.2196/resprot.8080
Complementary and Alternative Medicine in Patients With Breast Cancer: Exploratory Study of Social Network Forum Data
Authors: Lognos Béatrice , Carbonnel François , Boulze Launay Isabelle , Bringay Sandra , Guerdoux-Ninot Estelle , Mollevi Caroline , Senesse Pierre , Ninot Gregory 
Published: August 2019

Background
Patients and health care professionals are becoming increasingly preoccupied in complementary and alternative medicine (CAM) that can also be called nonpharmacological interventions (NPIs). In just a few years, this supportive care has gone from solutions aimed at improving the quality of life to solutions intended to reduce symptoms, supplement oncological treatments, and prevent recurrences. Digital social networks are a major vector for disseminating these practices that are not always disclosed to doctors by patients. An exploration of the content of exchanges on social networks by patients suffering from breast cancer can help to better identify the extent and diversity of these practices.

Objective
This study aimed to explore the interest of patients with breast cancer in CAM from posts published in health forums and French-language social media groups.

Methods
The retrospective study was based on a French database of 2 forums and 4 Facebook groups between June 3, 2006, and November 17, 2015. The extracted, anonymized, and compiled data (264,249 posts) were analyzed according to the occurrences associated with the NPI categories and NPI subcategories, their synonyms, and their related terms.

Results
The results showed that patients with breast cancer use mainly physical (37.6%) and nutritional (31.3%) interventions. Herbal medicine is a subcategory that was cited frequently. However, the patients did not mention digital interventions.

Conclusions
This exploratory study of the main French forums and discussion groups indicates a significant interest in CAM during and after treatments for breast cancer, with primarily physical and nutritional interventions complementing approved treatments. This study highlights the importance of accurate information (vs fake medicine), prescription and monitoring of these interventions, and the mediating role that health professionals must play in this regard.
Access to Primary Care and Internet Searches for Walk-In Clinics and Emergency Departments in Canada: Observational Study Using Google Trends and Population Health Survey Data
Authors: Ssendikaddiwa Joseph , Lavergne Ruth 
Published: August 2019

Background
Access to primary care is a challenge for many Canadians. Models of primary care vary widely among provinces, including arrangements for same-day and after-hours access. Use of walk-in clinics and emergency departments (EDs) may also vary, but data sources that allow comparison are limited.

Objective
We used Google Trends to examine the relative frequency of searches for walk-in clinics and EDs across provinces and over time in Canada. We correlated provincial relative search frequencies from Google Trends with survey responses about primary care access from the Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries and the 2016 Canadian Community Health Survey.

Methods
We developed search strategies to capture the range of terms used for walk-in clinics (eg, urgent care clinic and after-hours clinic) and EDs (eg, emergency room) across Canadian provinces. We used Google Trends to determine the frequencies of these terms relative to total search volume within each province from January 2011 to December 2018. We calculated correlation coefficients and 95% CIs between provincial Google Trends relative search frequencies and survey responses.

Results
Relative search frequency of walk-in clinic searches increased steadily, doubling in most provinces between 2011 and 2018. Relative frequency of walk-in clinic searches was highest in the western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba. At the provincial level, higher walk-in clinic relative search frequency was strongly positively correlated with the percentage of survey respondents who reported being able to get same- or next-day appointments to see a doctor or a nurse and inversely correlated with the percentage of respondents who reported going to ED for a condition that they thought could have been treated by providers at usual place of care. Relative search frequency for walk-in clinics was also inversely correlated with the percentage of respondents who reported having a regular medical provider. ED relative search frequencies were more stable over time, and we did not observe statistically significant correlation with survey data.

Conclusions
Higher relative search frequency for walk-in clinics was positively correlated with the ability to get a same- or next-day appointment and inversely correlated with ED use for conditions treatable in the patient’s regular place of care and also with having a regular medical provider. Findings suggest that patient use of Web-based tools to search for more convenient or accessible care through walk-in clinics is increasing over time. Further research is needed to validate Google Trends data with administrative information on service use.
Mental Health Apps in China: Analysis and Quality Assessment
Authors: Shang Jie , Wei Shaoming , Jin Jianbo , Zhang Puhong 
Published: August 2019

Background
Mental disorders have been a great burden on health care systems, affecting the quality of life of millions of people worldwide. Developing countries, including China, suffer from the double burden of both the increasing mental health issues in population and the deficiency in mental health care resources. The use of mobile health technologies, especially for mobile phone apps, can be a possible solution.

Objective
This review aimed to describe the features and assess the quality of mental health apps in major mobile phone app markets in China and further discuss the priorities for mental health app development.

Methods
Keywords including psychology, psychological health, psychological hygiene, psychological health service(s), mental, mental health, mental hygiene, mental health service(s), depression, and anxiety were searched in Chinese in 3 Android app markets (Baidu Mobile Assistant, Tencent MyApp, and 360 Mobile Assistant) and iOS App Store independently. Mental health apps were then selected according to established criteria for in-depth analysis and quality assessment by the Mobile App Rating Scale.

Results
In total, 63 of 997 mental health apps were analyzed in depth, of which 78% (49/63) were developed by commercial entities for general population, 17% (11/63) were for patients or clients of specialized psychiatric hospitals or counseling agencies, 3% (2/63) were by government or local Centers for Disease Control and Prevention for general information, and 2% (1/63) for students of a university. Major built-in features of the apps included counseling services, mental health education, and self-assessment of mental health status by validated self-rating scales. The overall quality score of the MH apps was acceptable.

Conclusions
Mental health apps are emerging in the area of mobile health in China. Popular mental health apps usually provide a synthetic platform organizing resources of information, knowledge, counseling services, self-tests, and management for the general population with mental health-related inquiries. The quality of the apps was rated as acceptable on average, suggesting some space for improvement. Official guidelines and regulations are urgently required for the field in the future.
Usability Factors Associated With Physicians’ Distress and Information System–Related Stress: Cross-Sectional Survey
Authors: Heponiemi Tarja , Kujala Sari , Vainiomäki Suvi , Vehko Tuulikki , Lääveri Tinja , Vänskä Jukka , Ketola Eeva , Puttonen Sampsa , Hyppönen Hannele 
Published: August 2019

BackgroundConstantly changing and difficult-to-use information systems have arisen as a significant source of stress in physicians’ work. Physicians have reported several usability problems, system failures, and a lack of integration between the systems and have experienced that systems poorly support the documentation and retrieval of patient data. This stress has kept rising in the 21st century, and it seems that it may also affect physicians’ well-being.ObjectiveThis study aimed to examine the associations of (1) usability variables (perceived benefits, technical problems, support for feedback, and user-friendliness), (2) the number of systems in daily use, (3) experience of using information systems, and (4) participation in information systems development work with physicians’ distress and levels of stress related to information systems (SRIS) levels.MethodsA cross-sectional survey was conducted among 4018 Finnish physicians (64.82%, 2572 out of 3968 women) aged between 24 and 64 years (mean 46.8 years) in 2017. The analyses of covariance were used to examine the association of independent variables with SRIS and distress (using the General Health Questionnaire) adjusted for age, gender, employment sector, specialization status, and the electronic health record system in use.ResultsHigh levels of technical problems and a high number of systems in daily use were associated with high levels of SRIS, whereas high levels of user-friendliness, perceived benefits, and support for feedback were associated with low levels of SRIS. Moreover, high levels of technical problems were associated with high levels of psychological distress, whereas high levels of user-friendliness were associated with low distress levels. Those who considered themselves experienced users of information systems had low levels of both SRIS and distress.ConclusionsIt seems that by investing in user-friendly systems with better technical quality and good support for feedback that professionals perceive as being beneficial would improve the work-related well-being and overall well-being of physicians. Moreover, improving physicians’ skills related to information systems by giving them training could help to lessen the stress that results from poorly functioning information systems and improve physicians’ well-being.
Use of Patient-Reported Data to Match Depression Screening Intervals With Depression Risk Profiles in Primary Care Patients With Diabetes: Development and Validation of Prediction Models for Major Depression
Authors: Jin Haomiao , Wu Shinyi 
Published: August 2019

Background
Clinical guidelines recommend screening for depression in the general adult population but recognizes that the optimum interval for screening is unknown. Ideal screening intervals should match the patient risk profiles.

Objective
This study describes a predictive analytics approach for mining clinical and patient-reported data from a large clinical study for the identification of primary care patients at high risk for depression to match depression screening intervals with patient risk profiles.

Methods
This paper analyzed data from a large safety-net primary care study for diabetes and depression. A regression-based data mining technique was used to examine 53 demographics, clinical variables, and patient-reported variables to develop three prediction models for major depression at 6, 12, and 18 months from baseline. Predictors with the strongest predictive power that require low information collection efforts were selected to develop the prediction models. Predictive accuracy was measured by the area under the receiver operating curve (AUROC) and was evaluated by 10-fold cross-validation. The effectiveness of the prediction algorithms in supporting clinical decision making for six “typical” types of patients was demonstrated.

Results
The analysis included 923 patients who were nondepressed at the study baseline. Five patient-reported variables were selected in the prediction models to predict major depression at 6, 12, and 18 months: (1) Patient Health Questionnaire 2-item score; (2) the Sheehan Disability Scale; (3) previous problems with depression; (4) the diabetes symptoms scale; and (5) emotional burden of diabetes. All three depression prediction models had an AUROC>0.80, comparable with published depression prediction studies. Among the 6 “typical” types of patients, the algorithms suggest that patients who reported impaired daily functioning by health status are at an elevated risk for depression in all three periods.

Conclusions
This study demonstrated that leveraging patient-reported data and prediction models can help improve identification of high-risk patients and clinical decisions about the depression screening interval for diabetes patients. Implementation of this approach can be coupled with application of modern technologies such as telehealth and mobile health assessment for collecting patient-reported data to improve privacy, reducing stigma and costs, and promoting a personalized depression screening that matches screening intervals with patient risk profiles.
Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial
Authors: Li Yiran , Guo Yan , Hong Y Alicia , Zhu Mengting , Zeng Chengbo , Qiao Jiaying , Xu Zhimeng , Zhang Hanxi , Zeng Yu , Cai Weiping , Li Linghua , Liu Cong 
Published: August 2019

Background
People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide.

Objective
This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators.

Methods
A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses.

Results
The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect.

Conclusions
Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression.

Trial Registration
Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019