bluuebunny/crossref_metadata_2025_split huggingface dataset:
Actitudes hacia la investigación en estudiantes de enfermería de una universidad privada de Lima Norte
Authors: Colquehuanca Huamani Lumy Denisse 
Published: August 2022

Objetivo: Determinar las actitudes hacia la investigación en estudiantes de enfermería de una Universidad Privada de Lima Norte.
Materiales y métodos: El estudio es de enfoque cuantitativo, decriptivo y transversal. Se contó con una población de 140 estudiantes de enfermería de la Universidad de Ciencias y Humanidades. La técnica de recolección de datos fue la encuesta y el instrumento utilizado fue la escala de actitudes hacia la investigación desarrollado por Papanastasiou.
Resultados: En cuanto a las actitudes hacia la investigación predomino el medianamente favorable con 77,5% (n=104), seguido del nivel favorable con 18,9% (n=30) y finalmente el desfavorable con 3,6% (n=6), entre sus dimensiones más afectadas fueron la dificultad de investigación con 25,0% (n=35) y ansiedad de investigación con 14,3% (n=20).
Conclusiones: En las actitudes hacia la investigación predomino el medianamente favorable y sus dimensiones más afectadas fueron la dificultad de investigación y la ansiedad de investigación.
Assessing the Generalizability of Deep Learning Models Trained on Standardized and Nonstandardized Images and Their Performance Against Teledermatologists: Retrospective Comparative Study
Authors: Oloruntoba Ayooluwatomiwa I , Vestergaard Tine , Nguyen Toan D , Yu Zhen , Sashindranath Maithili , Betz-Stablein Brigid , Soyer H Peter , Ge Zongyuan , Mar Victoria 
Published: August 2022

Background
Convolutional neural networks (CNNs) are a type of artificial intelligence that shows promise as a diagnostic aid for skin cancer. However, the majority are trained using retrospective image data sets with varying image capture standardization.

Objective
The aim of our study was to use CNN models with the same architecture—trained on image sets acquired with either the same image capture device and technique (standardized) or with varied devices and capture techniques (nonstandardized)—and test variability in performance when classifying skin cancer images in different populations.

Methods
In all, 3 CNNs with the same architecture were trained. CNN nonstandardized (CNN-NS) was trained on 25,331 images taken from the International Skin Imaging Collaboration (ISIC) using different image capture devices. CNN standardized (CNN-S) was trained on 177,475 MoleMap images taken with the same capture device, and CNN standardized number 2 (CNN-S2) was trained on a subset of 25,331 standardized MoleMap images (matched for number and classes of training images to CNN-NS). These 3 models were then tested on 3 external test sets: 569 Danish images, the publicly available ISIC 2020 data set consisting of 33,126 images, and The University of Queensland (UQ) data set of 422 images. Primary outcome measures were sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Teledermatology assessments available for the Danish data set were used to determine model performance compared to teledermatologists.

Results
When tested on the 569 Danish images, CNN-S achieved an AUROC of 0.861 (95% CI 0.830-0.889) and CNN-S2 achieved an AUROC of 0.831 (95% CI 0.798-0.861; standardized models), with both outperforming CNN-NS (nonstandardized model; P=.001 and P=.009, respectively), which achieved an AUROC of 0.759 (95% CI 0.722-0.794). When tested on 2 additional data sets (ISIC 2020 and UQ), CNN-S (P<.001 and P<.001, respectively) and CNN-S2 (P=.08 and P=.35, respectively) still outperformed CNN-NS. When the CNNs were matched to the mean sensitivity and specificity of the teledermatologists on the Danish data set, the models’ resultant sensitivities and specificities were surpassed by the teledermatologists. However, when compared to CNN-S, the differences were not statistically significant (sensitivity: P=.10; specificity: P=.053). Performance across all CNN models as well as teledermatologists was influenced by image quality.

Conclusions
CNNs trained on standardized images had improved performance and, therefore, greater generalizability in skin cancer classification when applied to unseen data sets. This finding is an important consideration for future algorithm development, regulation, and approval.
The Apple Watch for Monitoring Mental Health–Related Physiological Symptoms: Literature Review
Authors: Lui Gough Yumu , Loughnane Dervla , Polley Caitlin , Jayarathna Titus , Breen Paul P 
Published: August 2022

Background
An anticipated surge in mental health service demand related to COVID-19 has motivated the use of novel methods of care to meet demand, given workforce limitations. Digital health technologies in the form of self-tracking technology have been identified as a potential avenue, provided sufficient evidence exists to support their effectiveness in mental health contexts.

Objective
This literature review aims to identify current and potential physiological or physiologically related monitoring capabilities of the Apple Watch relevant to mental health monitoring and examine the accuracy and validation status of these measures and their implications for mental health treatment.

Methods
A literature review was conducted from June 2021 to July 2021 of both published and gray literature pertaining to the Apple Watch, mental health, and physiology. The literature review identified studies validating the sensor capabilities of the Apple Watch.

Results
A total of 5583 paper titles were identified, with 115 (2.06%) reviewed in full. Of these 115 papers, 19 (16.5%) were related to Apple Watch validation or comparison studies. Most studies showed that the Apple Watch could measure heart rate acceptably with increased errors in case of movement. Accurate energy expenditure measurements are difficult for most wearables, with the Apple Watch generally providing the best results compared with peers, despite overestimation. Heart rate variability measurements were found to have gaps in data but were able to detect mild mental stress. Activity monitoring with step counting showed good agreement, although wheelchair use was found to be prone to overestimation and poor performance on overground tasks. Atrial fibrillation detection showed mixed results, in part because of a high inconclusive result rate, but may be useful for ongoing monitoring. No studies recorded validation of the Sleep app feature; however, accelerometer-based sleep monitoring showed high accuracy and sensitivity in detecting sleep.

Conclusions
The results are encouraging regarding the application of the Apple Watch in mental health, particularly as heart rate variability is a key indicator of changes in both physical and emotional states. Particular benefits may be derived through avoidance of recall bias and collection of supporting ecological context data. However, a lack of methodologically robust and replicated evidence of user benefit, a supportive health economic analysis, and concerns about personal health information remain key factors that must be addressed to enable broader uptake.
Using the Positive Peers Mobile App to Improve Clinical Outcomes for Young People With HIV: Prospective Observational Cohort Comparison
Authors: Step Mary M , McMillen Smith Jennifer , Lewis Steven A , Avery Ann K 
Published: August 2022

Background
Disparities in HIV outcomes persist among racial, gender, and sexual minorities in the United States. Younger people face a greater risk of contracting HIV, often living without knowledge of their HIV status for long periods. The Positive Peers App (PPA) is a multifunctional HIV support tool designed to improve HIV-related clinical outcomes for young people with HIV. The app was designed according to the specifications of an in-care young adult HIV community in Northeast Ohio. Data provided in this study provide preliminary evidence of the usefulness of PPA as a relevant tool for engaging this clinical patient population in care and facilitating viral suppression.

Objective
In this study, we aimed to describe variations in PPA use and examine the associations between use and HIV clinical outcomes between self-selected user and nonuser cohorts in the same clinical population.

Methods
The PPA was offered free of charge to persons with HIV, aged 13 to 34 years of age, diagnosed with HIV within the last 12 months, out of care for 6 months during the last 24 months, or not virally suppressed (HIV viral load >200 copies/mL) in the prior 24 months. Baseline and 6- and 12-month surveys were administered via an audio computer-assisted self-interviewing system to all participants. The app’s user activity was tracked natively by the app and stored in a secure server. Participant demographic and HIV care data were extracted from clinical records within 12 months before the start of the study and across the duration of the study period. HIV care outcomes of PPA users (n=114) were compared with those of nonusers (n=145) at the end of the study period (n=259).

Results
The analysis showed that younger PPA users (aged 13-24 years) were more likely to obtain HIV laboratories (adjusted odds ratio 2.85, 95% CI 1.03-7.90) and achieve sustained viral suppression than nonusers (adjusted odds ratio 4.2, 95% CI 1.2-13.9).

Conclusions
The PPA appears to help younger users sustain HIV suppression. The app offers an important tool for addressing this critical population. The PPA remains in the field and is currently being adopted by other localities to facilitate their efforts to end the HIV epidemic. Although our reported observational results require additional validation and stringent ongoing surveillance, the results represent our best efforts in a pilot study to provide a measure of efficacy for the PPA. Next steps include a large-scale evaluation of the PPA acceptability and effectiveness. Given the building evidence of user reports and outcomes, the freely available PPA could be a helpful tool for achieving Ending the HIV Epidemic goals.
Real-world Implementation of an eHealth System Based on Artificial Intelligence Designed to Predict and Reduce Emergency Department Visits by Older Adults: Pragmatic Trial
Authors: Belmin Joël , Villani Patrick , Gay Mathias , Fabries Stéphane , Havreng-Théry Charlotte , Malvoisin Stéphanie , Denis Fabrice , Veyron Jacques-Henri 
Published: August 2022

Background
Frail older people use emergency services extensively, and digital systems that monitor health remotely could be useful in reducing these visits by earlier detection of worsening health conditions.

Objective
We aimed to implement a system that produces alerts when the machine learning algorithm identifies a short-term risk for an emergency department (ED) visit and examine health interventions delivered after these alerts and users’ experience. This study highlights the feasibility of the general system and its performance in reducing ED visits. It also evaluates the accuracy of alerts’ prediction.

Methods
An uncontrolled multicenter trial was conducted in community-dwelling older adults receiving assistance from home aides (HAs). We implemented an eHealth system that produces an alert for a high risk of ED visits. After each home visit, the HAs completed a questionnaire on participants’ functional status, using a smartphone app, and the information was processed in real time by a previously developed machine learning algorithm that identifies patients at risk of an ED visit within 14 days. In case of risk, the eHealth system alerted a coordinating nurse who could then inform the family carer and the patient’s nurses or general practitioner. The primary outcomes were the rate of ED visits and the number of deaths after alert-triggered health interventions (ATHIs) and users’ experience with the eHealth system; the secondary outcome was the accuracy of the eHealth system in predicting ED visits.

Results
We included 206 patients (mean age 85, SD 8 years; 161/206, 78% women) who received aid from 109 HAs, and the mean follow-up period was 10 months. The HAs monitored 2656 visits, which resulted in 405 alerts. Two ED visits were recorded following 131 alerts with an ATHI (2/131, 1.5%), whereas 36 ED visits were recorded following 274 alerts that did not result in an ATHI (36/274, 13.4%), corresponding to an odds ratio of 0.10 (95% IC 0.02-0.43; P<.001). Five patients died during the study. All had alerts, 4 did not have an ATHI and were hospitalized, and 1 had an ATHI (P=.04). In terms of overall usability, the digital system was easy to use for 90% (98/109) of HAs, and response time was acceptable for 89% (98/109) of them.

Conclusions
The eHealth system has been successfully implemented, was appreciated by users, and produced relevant alerts. ATHIs were associated with a lower rate of ED visits, suggesting that the eHealth system might be effective in lowering the number of ED visits in this population.

Trial Registration
clinicaltrials.gov NCT05221697; https://clinicaltrials.gov/ct2/show/NCT05221697.
Understanding Patient Beliefs in Using Technology to Manage Diabetes: Path Analysis Model From a National Web-Based Sample (Preprint)
Authors: Zahed Karim , Mehta Ranjana , Erraguntla Madhav , Qaraqe Khalid , Sasangohar Farzan 
Published: August 2022

BACKGROUND

With 425 million individuals globally living with diabetes, it is critical to support the self-management of this life-threatening condition. However, adherence and engagement with existing technologies are inadequate and need further research.

OBJECTIVE

The objective of our study was to develop an integrated belief model that helps identify the significant constructs in predicting intention to use a diabetes self-management device for the detection of hypoglycemia.

METHODS

Adults with type 1 diabetes living in the United States were recruited through Qualtrics to take a web-based questionnaire that assessed their preferences for a device that monitors their tremors and alerts them of the onset of hypoglycemia. As part of this questionnaire, a section focused on eliciting their response to behavioral constructs from the Health Belief Model, Technology Acceptance Model, and others.

RESULTS

A total of 212 eligible participants responded to the Qualtrics survey. Intention to use a device for the self-management of diabetes was well predicted (<i>R</i><sup>2</sup>=0.65; <i>F</i><sub>12,199</sub>=27.19; <i>P</i>&lt;.001) by 4 main constructs. The most significant constructs were <i>perceived usefulness</i> (β=.33; <i>P</i>&lt;.001) and <i>perceived health threat</i> (β=.55; <i>P</i>&lt;.001) followed by <i>cues to action</i> (β=.17; <i>P</i>&lt;.001) and a negative effect from <i>resistance to change</i> (β=−.19; <i>P</i>&lt;.001). Older age (β=.025; <i>P</i>&lt;.001) led to an increase in their <i>perceived health threat</i>.

CONCLUSIONS

For individuals to use such a device, they need to perceive it as useful, perceive diabetes as life-threatening, regularly remember to perform actions to manage their condition, and exhibit less <i>resistance to change</i>. The model predicted the intention to use a diabetes self-management device as well, with several constructs found to be significant. This mental modeling approach can be complemented in future work by field-testing with physical prototype devices and assessing their interaction with the device longitudinally.
Tendencias en la modelación matemática de biorreactores con membranas sumergidas para el tratamiento de aguas residuales
Authors: Jauregui Haza Ulises , González Hernández Yusmel 
Published: August 2022

En las últimas dos décadas, las tecnologías de los Biorreactores con Membranas Sumergidas han crecido exponencialmente debido a las ventajas que ofrecen sobre los procesos convencionales de tratamiento de aguas residuales, tales como: menor impacto ambiental, mejor calidad de los efluentes y un mejor control de los procesos; sin embargo, la principal desventaja de esta tecnología lo constituyen los costos asociados al proceso de colmatación de la membrana. La experimentación en estos sistemas demanda de un consumo considerable de recursos, tiempo y esfuerzos, razón por la cual la modelación matemática constituye una alternativa para la optimización de estos sistemas con un considerable ahorro de recursos y de tiempo. En el presente trabajo se realiza un análisis de la evolución de la modelación matemática de esos sistemas, específicamente de los modelos que integran los procesos biológicos con los procesos de filtración. Estos modelos integrados están constituidos por una versión extendida de los modelos de lodos activados (ASM), enlazados con modelos empíricos y/o determinísticos que describen la deposición de lodo sobre la membrana, que permiten predecir el comportamiento de la presión transmembranal. El enlace entre el sistema biológico y el sistema de colmatación de la membrana se realiza teniendo en cuenta la influencia de los sólidos suspendidos totales y de las sustancias poliméricas extracelulares solubles y enlazadas al flóculo en el proceso de colmatación de la membrana.
Contribution to Competing Species Modeling with Distributed Delay
Authors: Cavani Mario 
Published: August 2022

In this paper a competing species model is analyzed taking into account the seminal paper of Hsu, Hubbell and Waltman (1978), where two predators compete for a common prey without interference between rivals. Here a distributed delay is introduced in each one of the equations of the predator populations in the same way as suggested by Wolkowicz, Xia & Ruan (1997), in order to model the conversion time lag of consumed prey biomass into predator biomass. Using the linear trick chain technique, the solutions are analyzed from an “equivalent system” of ordinary differential equations looking to answer under what conditions will neither, one, or both species of predator populations survive, giving the appropriate insight of the biological point of view.
Antegrade Endobiliary Forceps Biopsy Improves Diagnosis of Klatskin Tumor Compared to Brush Biopsy
Authors: Kozlov A. V. , Tarazov P. G. , Polikarpov A. A. , Moiseenko A. V. , Urbansky A. I. , Yutkin M. V. , Yakshieva G. M. , Granov D. A. 
Published: August 2022

Aim. To evaluate the safety and accuracy of percutaneous transhepatic biliary biopsy in patients with suspected Klatskin tumor.Materials and methods. Between 2013–2020, percutaneous transhepatic biliary drainage (PTBD) was performed in 52 patients with Klatskin tumor, complicated by obstructive jaundice. After successful PTBD, the diagnosis was verified by antegrade access. 74 procedures were performed: brush (n = 36; 48.6 %) or forceps biopsies (n = 38; 51.4 %).Results. There were no adverse events associated with a brush biopsy. Only grade I complications were after the forceps technique: 3 patients (7.9 %) developed hemobilia, which was corrected conservatively. Malignant lesions of the biliary tract were detected by forceps technique in 79.0 %, brush biopsy in 66.7 % (p >0,05). The degree of tumor differentiation was determined in 60.0 % (n = 18) vs 12.5 % (n = 3) (p < 0,01), respectively.Sensitivity and specificity of forceps biopsy were slightly higher than in brush: 82.4 % and 75.0 % vs 73.3 % and 66.7 % (p >0,05).Conclusions. Antegrade percutaneous transhepatic biliary biopsy is safe for both brush and forceps techniques. However, forceps biopsy has higher sensitivity and specificity in the diagnosis Klatskin tumor and better possibility of determining the degree of malignancy differentiation.
Antitoxic Effects of Chicory Herb Extract Fractions in Rats with Toxic Hepatitis
Authors: Lupanova I. A. , Saybel O. L. , Kurmanova E. N. , Ferubko E. V. , Martynchik I. A. , Mizina P. G. 
Published: August 2022

Aim. To evaluate the antitoxic activity of chicory herb extract fractions in rats with toxic hepatitis.Materials and methods. There were 64 male rats were divided into groups of 6 animals that received the whole chicory herb extract, its fractions, or the reference drug (RD) and 2 groups did not receive any drug. The Silimar substance (a dry purified extract obtained from the fruits of milk thistle [Silybum marianum]) was chosen as RD. Animals from one of the groups that did not receive the drug (control group) and the groups that received drugs were injected with CCl4 to simulate toxic liver damage. The last group of animals received neither drugs nor CCl4 (intact animals). The changes in the activity of biotransformation enzymes (cytochrome P450 [cytР450] and glutathione transferase [GT]) in hepatocytes and serum liver enzymes (AST, ALT and AP) were assessed.Results. There was a decrease in cytР450 and GT activity in the liver microsomes of control rats (having CCl4 hepatitis without treatment) compared with intact animals. These parameters were more in the animals that were administrated with chicory herb extract, its fractions, and RD than in control animals. The administration of the whole extract, aqueous fraction, and RD led to an increase in the activity of cytP450 and GT enzymes almost to the level of the same indicators in intact animals. Pronounced grown in the activity of serum liver enzymes (ALT, AST and AP) were found after CCl4 injection. Administration of common chicory herb fractions before toxic liver damage caused a decrease in the grown of the activity of these enzymes. The greatest inhibitory effect on the grown of the activity of these liver enzymes had RD, aqueous and butanolic fractions of chicory herb. Despite a significant decrease in hyperfermentemia found in groups of animals treated with fractions of chicory herb, AST, ALT and AP activities did not reach the level that was in the intact animal group.Conclusion. The aqueous and butanolic fractions of the chicory herb extract had the highest antitoxic activity in experimental animal toxic liver injury.
Development and validation of UV Spectrophotometric method for simultaneous estimation of Efonidipine hydrochloride ethanolate and Chlorthalidone in their synthetic mixture
Authors: Solanki Dipika , Patel Dhara , Meshram Dhananjay 
Published: August 2022

Efonidipine Hydrochloride Ethanolate and Chlorthalidone is used in management of hypertension and under clinical phase 3 study. The development of quality control method is required for accurate analysis of both drugs. Two simple, precise and economical UV spectrophotometric methods have been developed for the simultaneous estimation of Efonidipine Hydrochloride Ethanolate and Chlorthalidone in their synthetic mixture. Method I is simultaneous equation method (Vierodt’s Method), which is based on measurement of absorption at 251 and 227 nm i.e. λmax of Efonidipine Hydrochloride Ethanolate and Chlorthalidone, respectively. Method II is first order derivative was based on the measurement of absorbance of Efonidipine Hydrochloride Ethanolate measure at 283.2 nm (ZCP of Chlorthalidone) and absorbance of Chlorthalidone measure at 250.8 nm (ZCP of Efonidipine Hydrochloride Ethanolate). Linearity was observed in the concentration range of 6.4-38.4 µg.mL-1 for Efonidipine hydrochloride ethanolate and 2-12 µg.mL-1 for Chlorthalidone using methanol as a solvent. The accuracy of methods was assessed by recovery studies and was found to be within range of 98-102% for both the drugs. Precision of the methods was estimated by repeatability and intermediate precision studies. The % RSD values were found to be less than 2, proving methods were precise. Two methods were compared using F- test. The results were validated statistically as per ICH Q2 R1 guideline and were found to be satisfactory.