Attitude toward second opinions in Germany – a survey of the general population

Background Second medical opinions (SOs) can assist patients in making informed treatment decisions and improve the understanding of their diagnosis. In Germany, there are different approaches to obtain a structured SO procedure: SO programs by health insurers and SOs according to the SO Directive. Through a direct survey of the population, we aimed to assess how structured SOs should be provided to fulfil patients’ needs. Methods A stratified sample of 9990 adults (≥18 years) living in the federal states of Berlin and Brandenburg (Germany) were initially contacted by post in April and sent a reminder in May 2020. The survey results were analyzed descriptively. Results Among 1349 participants (response rate 14%), 56% were female and the median age was 58 years (interquartile range (IQR) 44–69). Participants wanted to be informed directly and personally about the possibility of obtaining an SO (89%; 1201/1349). They preferred to be informed by their physician (93%; 1249/1349). A majority of participants would consider it important to obtain an SO for oncological indications (78%; 1049/1349). Only a subset of the participants would seek an SO via their health insurer or via an online portal (43%; 577/1349 and 16%; 221/1349). A personally delivered SO was the preferred route of SO delivery, as 97% (1305/1349) would (tend to) consider this way of obtaining an SO. Participants were asked to imagine having moderate knee pain for years, resulting in a treatment recommendation for knee joint replacement. They were requested to rate potential qualification criteria for a physician providing the SO. The criteria rated to be most important were experience with the recommended diagnosis/treatment (criterion (very) important for 93%; 1257/1349) and knowledge of the current state of research (criterion (very) important for 86%; 1158/1349). Participants were willing to travel 60 min (median; IQR 60–120) and wait 4 weeks (median; IQR 2–4) for their SO in the hypothetical case of knee pain. Conclusion In general, SOs were viewed positively. We found that participants have clear preferences regarding SOs. We propose that these preferences should be taken into account in the future design and development of SO programs.

Decision-Making Strategy for Digital Transformation: A Two-Year Analytical Study and Follow-Up Concerning Innovative Improvements in University e-Services

Universities worldwide strive to provide the best student services possible, particularly those that support student achievements and career goals. Therefore, academic advising continues to be a significant part of the student experience, one which universities need to fully understand in terms of its objectives, application processes, and required skill. As a result of significant technological improvements since the turn of the millennium, including expanding internet applications and digital transformations, universities have established computer information systems that support academic advising and course registration services. This study examined the effects of modifications to the electronic academic advising and course registration systems at King Abdulaziz University in 2018, and then again in 2020, following a university-wide system failure in 2018 resulting from a demand overload. In 2018, a preliminary statistical analysis and student feedback survey were conducted by the authors to measure student satisfaction with the online portal On-Demand University Services (ODUS Plus). In addition to recommendations suggested by the 2018 analysis such as balancing the load distribution of the university’s network, organizational (i.e., non-technical) solutions, rules, and regulations were adjusted such as progressive course registration that prioritized those expected to graduate first. The survey and analysis were repeated by the authors in 2020 to assess improvements in student satisfaction. As a result of the changes, the investigation revealed improved student satisfaction with the performance of ODUS Plus and network access. Overall, students were significantly more satisfied in 2020 than in 2018. This research shows that some technical challenges can be resolved using re-engineered processes and organizational solutions.

Cyber bullying: an emerging problem in COVID-19 times among students taking online classes undergoing graduation in North India

Background: As COVID-19 continues, academics have shifted from practical and virtual classes to web-based online lectures. Being an online portal, virtual offences can also take place. One of them is cyberbullying. Students are already undergoing phase of psychosocial changes because of this scenario. If an incident of cyberbullying happens with them or with their friends and siblings, it causes a great impact on their mental health. To determine the prevalence of cyberbullying among students who were currently taking online classes.Methods: An online cross-sectional study was conducted through Google form from July to September 2020 on the students >18 years taking online classes. All the students who gave consent and filled the form were included. The aim of the study was explained. Information collected was kept strictly confidential.Results: A total of 462 participants (mean age=22±4 years) completed an online survey comprising of about 55% females and 45% males. Around 22% of the study subjects had reported that they were bullied either in schools or previously also. Through this online survey nearly 11% of the study subjects reported that they were cyber bullied in the past 2-3 months and about 13% were not sure whether they were cyberbullied or not. There is statistically significant difference (p value=0.0081) between gender and cyberbullying and also among medical and non-medical students (p value=0.0001).Conclusions: Cyberbullying is increasing along with online classes which is more experienced with girls. According to this study, it is more experienced by the girls now a days. There is a marked difference in the occurrence of cyberbullying among medical and non-medical streams.

Mengenal Spina Bifida dan Pencegahannya

Neural tube defects (NTD) are one of the birth defects or congenital abnormalities that occur in the brain and spine, and commonly find in newborns worldwide. Anencephaly and spina bifida are the two prevalent forms of NTD. The incidence of spina bifida happen on average 1 in 1000 cases of birth worldwide and there are 140,000 cases per year worldwide. Source searches were carried out on the online portal of journal publications as many as 20 sources from MedScape, Google Scholar and the Nation Center for Biotechnology Information / NCBI with the keywords “Neural tube defects (NTD), prevention, and spina bifida”. Spina bifida is a congenital abnormality that occurs in the womb due to a failure of closing process the neural tube during the first few weeks of embryonic development which causes the spine not completely close around the developing spinal cord nerves. NTD can ensue multifactorial conditions such as genetic, environmental, and folate deficiency. The use of folic acid supplementation starting at least 3 months before pregnancy, those are 400 mcg (0.4 mg) per day and 800 mcg per day during pregnancy can reduce the risk of developing neural tube defects such as spina bifida. Generally, spina bifida is undertaking by surgery and the regulation of patients comorbid. Public can find out prevention to avoid or reduce the risk of spina bifida so that the incidence of spina bifida can decrease along with the increasing awareness of the community regarding this disease.

Mengenal Lebih Dekat Dampak Aktivitas Work from Home (WFH) dan Neck Pain di Masa Pandemi

Since the pandemic, all countries have implemented Work From Home (WFH) policies, which are new policies that utilize the virtual world. As for the negative effects that can be given from WFH, such as the occurrence of Neck Pain. Neck Pain is pain in the cervical spine from the superior line of the first thoracic spinous nuchal process. Reported cases of neck pain in office workers as much as 15% to 34.4%. Source searches were carried out on the online portal of journal publications as many as 27 sources from Medscape, Google Scholar, National Center for Biotechnology Information (NCBI) with the keywords WFH and Neck Pain. Sitting in a chair or bed without a table while working on a computer or laptop can cause neck pain and the upper or lower back area. When fatigue occurs in the neck muscles, it can cause static muscle contractions that last a long time, if this condition occurs continuously there will be pain and discomfort in the neck muscle area which can eventually lead to disability. In this study, the author uses a qualitative method with a literature review research paradigm. Qualitative research methods are carried out in natural conditions and carried out on direct data sources. The purpose of the qualitative method is to gain an understanding of the meaning of the problem to be studied.

Gambaran Radiologis pada Bidang Neurologis Tumor Otak

Along with increasing life expectancy and advances in medical technology, the incidence of brain tumors continues to increase. Brain tumors can cause changes in mental status, neurological deficits, and create a large social burden. The incidence of benign brain tumors is 71% and these benign brain tumors develop twice as often in women as in men. Diagnosis brain tumors requires radiological examinations that can quickly diagnose brain tumors and must be done immediately. Source searches were carried out on the online portal of journal publications as many as 20 sources from MedScape, Google Scholar and the Nation Center for Biotechnology Information / NCBI with the keywords "brain tumor" and "radiology of brain tumor". Brain tumors cause progressive neurological disorders. Neurologic disorders in brain tumors are usually caused by two factors, namely focal disturbances due to tumors and increased intracranial pressure. The most commonly used radiological techniques are T1/T2-Weighted MRI, MR Spectroscopy, Diffusion MRI, Perfusion MRI, and Brain Tumor CT Scan. MRI is a powerful and flexible instrument for evaluating patients with primary brain tumors. Integration of the RANO criteria into treatment evaluation helps reduce premature discontinuation of effective therapy due to treatment-related imaging changes.

Transforming the Generative Pretrained Transformer Into Augmented Business Text Writer

This study uses transformers architecture of Artificial neural networks to generate artificial business text for a given topic or theme. The implication of the study is to augment the business report writing, and general business writings process with help of Generative pretrained transformers (GPT) networks. Main focus of study is to provide practical use case for GPTs models with help of big data. Our study model has 355 million model parameters and trained for three months on GPU enable devices using 2.3 billion text tokens(is available as open-source data now). Text tokens are collected with help of rigorous preprocessing, which includes; shortlisting of Subreddits of Fortune 500 companies and industries, listed on US-based social news aggregation online portal called "Reddit". After shortlisting, millions of submission of users during the five years, are parsed to collect the URLs out of it. 1.8 million working URLs are scrutinized. Business text is parsed, cleaned, and converted into word embeddings out of URLs. The result shows that both models; conditional interactive and random sampling, generate text paragraphs that are grammatically accurate and stick to the given topic.

Developing Instructional Support for MEDSReM-2 Through Human Factors Design Principles

Appropriate instruction is critical for ensuring the MEDSReM-2 system (i.e., smartphone app, blood pressure monitor, online portal) will be easily and effectively used and will, therefore, be more likely to be adopted. We will present our iterative processes for developing instructional support for MEDSReM 2 using human factors design principles (e.g., task analyses, comparative analyses, expert evaluation of mock-ups with screen flows). The instructional supports include user manuals, videos, as well as instructions within the MEDSReM 2 app. We will also highlight design principles used to empower the user and the benefits of using an interdisciplinary approach (i.e., gerontology, cognitive psychology, educational psychology, design, community health) to develop instructional support for older adult users.

Development of IOT Device for Sensing Weather and Environmental Pollutants

Pollutants emitted into the atmosphere, such as ozone, which raises temperature, contributes to climate change. This may have inverse effect on the local air quality. However, other Particulate Matter (PM) components can heat or cool the temperature. Weather and environmental pollution can cause headaches, heart disease, respiratory problems, acid rain, fever, and other symptoms that are harmful to both people and the environment. This research center on development of smart sensors to monitor our environment's exposure to weather and environmental contaminants. This was made possible by developing an interface between data collection and monitoring equipment that interfaced with a website and analysis software. The online portal records and analyzes the measured data from the monitoring device in accordance with the WHO (World Health Organization) standard. It also compares the measured data from various locations. The main microcontroller in this work is an Arduino UNO which helps in data collection; and the CoolTerm application which helps exchange data with hardware connected to serial ports with the microcontroller. The system monitors environmental changes such as temperature and precipitation. The data is displayed as graphical statistics on the web site's design in the form of web portal information. Offices on the Federal Polytechnic Ile Oluji campus, in addition to the production powerhouse, are used to test the equipment. Each dataset was generated in three minutes and compared to the WHO standard. People who live near generators, according to the findings, face a greater risk to their health.

Comparison of IL-6 and TNF-Alfa Serum Levels in Pre and Post Radiotherapy Nasopharyngeal Carcinoma Patients at the NTB Provincial Hospital

Nasopharyngeal carcinoma is often found in Asia, especially in South and Southeast China, with Indonesia being the fourth most common malignancy after breast cancer, cervical cancer, and lung cancer. NPC can generally be diagnosed only in the late stages, so it can increase morbidity and mortality. One of the recommendations for therapy for NPC is radiotherapy, but radiotherapy still fails due to a chronic inflammatory process involving several inflammatory cytokines such as IL-6 and TNF-Alfa. Cytokines play a role in various signaling pathways that can lead to increased proliferation, migration, invasion, angiogenesis, and inhibit apoptosis and even have an effect on resistance to therapy in many cancer cells, especially NPC. A good understanding of this pro-inflammatory cytokine, is expected to improve the prognosis in NPC patients in the future, knowing serum levels of IL-6 and TNF-Alfa pre and post radiotherapy. This is a preliminary study or literature study before the main study is conducted. Sources include scientific journals accessed through an online portal, namely NCBI. Poor prognosis in NPC patients with high serum levels of IL-6 and TNF-Alfa. The higher the levels of IL-6 and TNF-Alfa in post-radiotherapy NPC patients, the worse the condition is because these pro-inflammatory cytokines can activate various signaling pathways.