bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Antibiotic-Resistant Pathogenic Bacteria and Level of Antibiotic Residues in Hospital Effluents in Selangor, Malaysia: Protocol for a Cross-sectional Study
Authors: Bakon Sophia Karen , Mohamad Zuraifah Asrah , Jamilan Mohd Azerulazree , Hashim Hazimah , Kuman Mohamed Yazid , Shaharudin Rafiza , Ahmad Norazah , Muhamad Nor Asiah 
Published: February 2023

Background
Antimicrobial resistance (AMR) has emerged as a major global public health challenge due to the overuse and misuse of antibiotics for humans and animals. Hospitals are among the major users of antibiotics, thereby having a large contribution to AMR.

Objective
The aim of this study is to determine the prevalence of antibiotic-resistant pathogenic bacteria and the level of antibiotic residues in the hospital effluents in Selangor, Malaysia.

Methods
A cross-sectional study will be performed in the state of Selangor, Malaysia. Tertiary hospitals will be identified based on the inclusion and exclusion criteria. The methods are divided into three phases: sample collection, microbiological analysis, and chemical analysis. Microbiological analyses will include the isolation of bacteria from hospital effluents by culturing on selective media. Antibiotic sensitivity testing will be performed on the isolated bacteria against ceftriaxone, ciprofloxacin, meropenem, vancomycin, colistin, and piperacillin/tazobactam. The identification of bacteria will be confirmed using 16S RNA polymerase chain reaction (PCR) and multiplex PCR will be performed to detect resistance genes (ermB, mecA, blaNDM-L, blaCTX-M, blaOXA-48, blaSHV, VanA, VanB, VanC1, mcr-1, mcr-2, mcr-3, Intl1, Intl2, and qnrA). Finally, the level of antibiotic residues will be measured using ultrahigh-performance liquid chromatography.

Results
The expected outcomes will be the prevalence of antibiotic-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) bacterial species from the hospital effluents, the occurrence of antibiotic resistance genes (ARGs) from the isolated ESKAPE bacteria, and the level of antibiotic residues that may be detected from the effluent. Sampling has been conducted in three hospitals. Data analysis from one hospital showed that as of July 2022, 80% (8/10) of E. faecium isolates were resistant to vancomycin and 10% (1/10) were resistant to ciprofloxacin. Further analysis will be conducted to determine if the isolates harbor any ARGs and effluent samples are being analyzed to detect antibiotic residues. Sampling activities will be resumed after being suspended due to the COVID-19 pandemic and are scheduled to end by December 2022.

Conclusions
This study will provide the first baseline information to elucidate the current status of AMR of highly pathogenic bacteria present in hospital effluents in Malaysia.

International Registered Report Identifier (IRRID)
DERR1-10.2196/39022
Therapist Feedback and Implications on Adoption of an Artificial Intelligence–Based Co-Facilitator for Online Cancer Support Groups: Mixed Methods Single-Arm Usability Study
Authors: Leung Yvonne W , Ng Steve , Duan Lauren , Lam Claire , Chan Kenith , Gancarz Mathew , Rennie Heather , Trachtenberg Lianne , Chan Kai P , Adikari Achini , Fang Lin , Gratzer David , Hirst Graeme , Wong Jiahui , Esplen Mary Jane 
Published: February 2023

BackgroundThe recent onset of the COVID-19 pandemic and the social distancing requirement have created an increased demand for virtual support programs. Advances in artificial intelligence (AI) may offer novel solutions to management challenges such as the lack of emotional connections within virtual group interventions. Using typed text from online support groups, AI can help identify the potential risk of mental health concerns, alert group facilitator(s), and automatically recommend tailored resources while monitoring patient outcomes.ObjectiveThe aim of this mixed methods, single-arm study was to evaluate the feasibility, acceptability, validity, and reliability of an AI-based co-facilitator (AICF) among CancerChatCanada therapists and participants to monitor online support group participants’ distress through a real-time analysis of texts posted during the support group sessions. Specifically, AICF (1) generated participant profiles with discussion topic summaries and emotion trajectories for each session, (2) identified participant(s) at risk for increased emotional distress and alerted the therapist for follow-up, and (3) automatically suggested tailored recommendations based on participant needs. Online support group participants consisted of patients with various types of cancer, and the therapists were clinically trained social workers.MethodsOur study reports on the mixed methods evaluation of AICF, including therapists’ opinions as well as quantitative measures. AICF’s ability to detect distress was evaluated by the patient's real-time emoji check-in, the Linguistic Inquiry and Word Count software, and the Impact of Event Scale-Revised.ResultsAlthough quantitative results showed only some validity of AICF’s ability in detecting distress, the qualitative results showed that AICF was able to detect real-time issues that are amenable to treatment, thus allowing therapists to be more proactive in supporting every group member on an individual basis. However, therapists are concerned about the ethical liability of AICF’s distress detection function.ConclusionsFuture works will look into wearable sensors and facial cues by using videoconferencing to overcome the barriers associated with text-based online support groups.International Registered Report Identifier (IRRID)RR2-10.2196/21453
Weight Loss Expectations of Adults With Binge Eating: Cross-sectional Study With a Human-Centered Design Approach
Authors: Voss Claire , Liu Jianyi , Chang Angela , Kosmas Jacqueline A , Biehl Abigail , Flynn Rebecca L , Kruzan Kaylee P , Wildes Jennifer E , Graham Andrea K 
Published: February 2023

Background
People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight.

Objective
The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations.

Methods
A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight.

Results
Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape.

Conclusions
In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals’ intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.
Dynamics of the Negative Discourse Toward COVID-19 Vaccines: Topic Modeling Study and an Annotated Data Set of Twitter Posts
Authors: Lindelöf Gabriel , Aledavood Talayeh , Keller Barbara 
Published: February 2023

Background
Since the onset of the COVID-19 pandemic, vaccines have been an important topic in public discourse. The discussions around vaccines are polarized, as some see them as an important measure to end the pandemic, and others are hesitant or find them harmful. A substantial portion of these discussions occurs openly on social media platforms. This allows us to closely monitor the opinions of different groups and their changes over time.

Objective
This study investigated posts related to COVID-19 vaccines on Twitter (Twitter Inc) and focused on those that had a negative stance toward vaccines. It examined the evolution of the percentage of negative tweets over time. It also examined the different topics discussed in these tweets to understand the concerns and discussion points of those holding a negative stance toward the vaccines.

Methods
A data set of 16,713,238 English tweets related to COVID-19 vaccines was collected, covering the period from March 1, 2020, to July 31, 2021. We used the scikit-learn Python library to apply a support vector machine classifier to identify the tweets with a negative stance toward COVID-19 vaccines. A total of 5163 tweets were used to train the classifier, of which a subset of 2484 tweets was manually annotated by us and made publicly available along with this paper. We used the BERTopic model to extract the topics discussed within the negative tweets and investigate them, including how they changed over time.

Results
We showed that the negativity with respect to COVID-19 vaccines has decreased over time along with the vaccine rollouts. We identified 37 topics of discussion and presented their respective importance over time. We showed that popular topics not only consisted of conspiratorial discussions, such as 5G towers and microchips, but also contained legitimate concerns around vaccination safety and side effects as well as concerns about policies. The most prevalent topic among vaccine-hesitant tweets was related to the use of messenger RNA and fears about its speculated negative effects on our DNA.

Conclusions
Hesitancy toward vaccines existed before the COVID-19 pandemic. However, given the dimension of and circumstances surrounding the COVID-19 pandemic, some new areas of hesitancy and negativity toward COVID-19 vaccines have arisen, for example, whether there has been enough time for them to be properly tested. There is also an unprecedented number of conspiracy theories associated with them. Our study shows that even unpopular opinions or conspiracy theories can become widespread when paired with a widely popular discussion topic such as COVID-19 vaccines. Understanding the concerns, the discussed topics, and how they change over time is essential for policy makers and public health authorities to provide better in-time information and policies to facilitate the vaccination of the population in future similar crises.
Attitudes and Experiences of Clinicians After Mandated Implementation of Open Notes by the 21st Century Cures Act: Survey Study
Authors: Leonard Sophia M , Zackula Rosalee , Wilcher Jonathan 
Published: February 2023

Background
On December 13, 2016, the US Congress enacted the 21st Century Cures Act (hereafter the Cures Act), which contained the Final Rule mandate that took effect on April 5, 2021. Since then, health systems have been required to provide patients digital access to their eHealth information “without delay” and without charge.

Objective
This study aimed to assess clinicians’ initial experiences with, and attitudes toward, sharing visit notes with patients after being mandated to do so by the Cures Act and to determine clinician preferences regarding instant record release.

Methods
This cross-sectional survey study was conducted between June 10, 2021, and August 15, 2021, at the University of Kansas Health System, a large academic medical center in Kansas City, Kansas, United States. Participants included clinicians currently employed by the health system, including resident and attending physicians, physician assistants, nurse practitioners, and critical care and emergency medicine registered nurses.

Results
A total of 1574 attending physicians, physician assistants, and nurse practitioners, as well as 506 critical care and emergency medicine nurses, were sent invitations; 538 (34.18%) and 72 (14.2%), respectively, responded. Of 609 resident physicians, 4 (response rate not applicable because it was unknown how many residents viewed the website while the link was available) responded. The majority of respondents were attending physicians (402/614, 65.5%) and within the department of internal medicine (160/614, 26.1%). Most agreed that sharing visit notes was a good idea (355/613, 57.9%) and that it is important to speak with the patients before they accessed their records (431/613, 70.3%). Those who agreed that sharing visit notes is a good idea tended to view the practice as a useful tool for engaging patients (“Agree”: 139/355, 39.2%; “Somewhat agree”: 161/355, 45.4%; P<.001) and experience no change in the clinical value of their notes for other clinicians (326/355, 91.8%; P<.001). Those who disagreed (or were neutral) tended not to encourage patients to read their notes (235/258, 91.1%; P<.001) and were more likely to experience a change in their charting practice (168/257, 65.4%; P<.001) and increased time charting (99/258, 38.4%; P<.001).

Conclusions
The findings of this study may be generalizable to institutions similar to the University of Kansas Health System, and the clinician testimonies gathered in this study may provide valuable insight into the initial opinions and experiences of clinicians at these institutions. In addition, these clinician experiences collected early in the transition period may be used to guide future health policy implementation and to understand how best to prepare clinicians for these changes in practice.
Rapid SARS-CoV-2 Antigen Detection Self-Tests to Increase COVID-19 Case Detection in Peru: Qualitative Study
Authors: Torres-Slimming Paola A , Carcamo Cesar , Martínez-Pérez Guillermo Z , Mallma Patricia , Pflucker Cristina , Shilton Sonjelle 
Published: February 2023

Background
The COVID-19 pandemic heavily impacted many low- and middle-income countries (LMICs), such as Peru, overwhelming their health systems. Rapid antigen detection self-tests for SARS-CoV-2, the virus that causes COVID-19, have been proposed as a portable, safe, affordable, and easy-to-perform approach to improve early detection and surveillance of SARS-CoV-2 in resource-constrained populations where there are gaps in access to health care.

Objective
This study aims to explore decision makers’ values and attitudes around SARS-CoV-2 self-testing.

Methods
In 2021, we conducted a qualitative study in 2 areas of Peru (urban Lima and rural Valle del Mantaro). Purposive sampling was used to identify representatives of civil society groups (RSCs), health care workers (HCWs), and potential implementers (PIs) to act as informants whose voices would provide a proxy for the public’s attitudes around self-testing.

Results
In total, 30 informants participated in individual, semistructured interviews (SSIs) and 29 informants participated in 5 focus group discussions (FGDs). Self-tests were considered to represent an approach to increase access to testing that both the rural and urban public in Peru would accept. Results showed that the public would prefer saliva-based self-tests and would prefer to access them in their community pharmacies. In addition, information about how to perform a self-test should be clear for each population subgroup in Peru. The tests should be of high quality and low cost. Health-informed communication strategies must also accompany any introduction of self-testing.

Conclusions
In Peru, decision makers consider that the public would be willing to accept SARS-CoV-2 self-tests if they are accurate, safe to use, easily available, and affordable. Adequate information about the self-tests’ features and instructions, as well as about postuse access to counseling and care, must be made available through the Ministry of Health in Peru.
Low-Cost Technology-Aided Programs for Supporting People With Motor, Visual, and Intellectual Disabilities in Functional Forms of Occupation and Communication: Proof-of-Concept Study
Authors: Lancioni Giulio E , Singh Nirbhay N , O’Reilly Mark F , Sigafoos Jeff , Alberti Gloria , Chiariello Valeria , Desideri Lorenzo , Buono Serafino 
Published: February 2023

Background
People with motor, visual, and intellectual disabilities may have serious problems in independently accessing various forms of functional daily occupation and communication.

Objective
The study was aimed at developing and assessing new, low-cost technology-aided programs to help people with motor or visual-motor and intellectual disabilities independently engage in functional forms of occupation and communication with distant partners.

Methods
Two programs were set up using a smartphone interfaced with a 2-switch device and a tablet interfaced with 2 pressure sensors, respectively. Single-subject research designs were used to assess (1) the first program with 2 participants who were blind, had moderate hand control, and were interested in communicating with distant partners through voice messages; and (2) the second program with 2 participants who possessed functional vision, had no or poor hand control, and were interested in communicating with their partners through video calls. Both programs also supported 2 forms of occupational engagement, that is, choosing and accessing preferred leisure events consisting of songs and music videos, and listening to brief stories about relevant daily topics and answering questions related to those stories.

Results
During the baseline phase (when only a conventional smartphone or tablet was available), 2 participants managed sporadic access to leisure or leisure and communication events. The other 2 participants did not show any independent leisure or communication engagement. During the intervention (when the technology-aided programs were used), all participants managed to independently engage in multiple leisure and communication events throughout the sessions and to listen to stories and answer story-related questions.

Conclusions
The findings, which need to be interpreted with caution given the nature of the study and the small number of participants, seem to suggest that the new programs may be viable tools for helping people with motor or visual-motor and intellectual disabilities independently access leisure, communication, and other forms of functional engagement.
Gender Equality Training for Students in Higher Education: Protocol for a Scoping Review
Authors: Condron Claire , Power Mide , Mathew Midhun , Lucey Siobhan M 
Published: February 2023

Background
The principles of gender equality are integral to the goals, targets, and indicators of all sustainable development goals. Higher education institutes can be powerful agents for promoting gender equality, diversity, and inclusion not only in the higher education context but also in society as a whole. To address and overcome gender inequality in the higher education environment, experts posit that change needs to occur from day 1 of the student’s academic experience. To this end, training is required. A preliminary review of the literature indicates that multiple gender equality–based training programs or initiatives for students have been designed and evaluated in second and third-level education settings. Examples of educational activities undertaken include delivery of didactic teaching, participation in a face-to-face collaboration project, site visits, case studies, and coaching. Yet, our initial search indicated that, to date, a comprehensive review collating the available evidence on gender equality training for third-level students has not yet been carried out.

Objective
Our review seeks to identify and explore the existing literature on gender equality training interventions for third-level students, with a particular emphasis on training content, methodology, and outcome evaluation.

Methods
This scoping review will be structured using the Arskey and O’Malley’s 5-stage framework and will consider empirical research and other relevant published works that address gender equality training. Systematic searches will be carried out in 6 research databases and the gray literature using key search terms. Inclusion and exclusion criteria have been defined, and a data charting tool created to methodically extract information from selected literature. The free web software Rayyan will be used for primary screening where each reference will be screened in duplicate first by title, then abstract, and finally by full text.

Results
This review forms part of the LIBRA (Balance) study and has received peer-reviewed grant funding from the Irish Higher Education Authority. LIBRA aims to use simulation-based education to develop a gender equality leadership training program for student leaders in higher education. The findings will be summarized in tabular form, and a narrative synthesis produced to inform curriculum development.

Conclusions
This review seeks to inform curriculum design by reporting on the gender equality–enabling skills and leadership skills necessary to foster gender equality. This paper should inform recommendations for training and catalyze future research in this rapidly evolving area.

International Registered Report Identifier (IRRID)
DERR1-10.2196/44584