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O'Hanlon R, Altice FL, Lee RKW, LaViolette J, Mark G, Papakyriakopoulos O, Saha K, De Choudhury M, Kumar N. Misogynistic Extremism: A Scoping Review. Trauma Violence Abuse 2024; 25:1219-1234. [PMID: 37272372 DOI: 10.1177/15248380231176062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In recent years, the concept of "misogynistic extremism" has emerged as a subject of interest among scholars, governments, law enforcement personnel, and the media. Yet a consistent understanding of how misogynistic extremism is defined and conceptualized has not yet emerged. Varying epistemological orientations may contribute to the current conceptual muddle of this topic, reflecting long-standing and on-going challenges with the conceptualization of its individual components. To address the potential impact of misogynistic extremism (i.e., violent attacks), a more precise understanding of what this phenomenon entails is needed. To summarize the existing knowledge base on the nature of misogynistic extremism, this scoping review analyzed publications within English-language peer-reviewed and gray literature sources. Seven electronic databases and citation indexes were systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist and charted using the 2020 PRISMA flow diagram. Inclusion criteria included English peer-reviewed articles and relevant gray literature publications, which contained the term "misogynistic extremism" and other closely related terms. No date restrictions were imposed. The search strategy initially yielded 475 publications. After exclusion of ineligible articles, 40 publications remained for synthesis. We found that misogynistic extremism is most frequently conceptualized in the context of misogynistic incels, male supremacism, far-right extremism, terrorism, and the black pill ideology. Policy recommendations include increased education among law enforcement and Countering and Preventing Violent Extremism experts on male supremacist violence and encouraging legal and educational mechanisms to bolster gender equality. Violence stemming from misogynistic worldviews must be addressed by directly acknowledging and challenging socially embedded systems of oppression such as white supremacy and cisheteropatriarchy.
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Affiliation(s)
- Robin O'Hanlon
- John Jay College of Criminal Justice, CUNY | The CUNY Graduate Center, USA
| | | | - Roy Ka-Wei Lee
- Singapore University of Technology and Design, Singapore
| | | | | | | | - Koustuv Saha
- Microsoft Research Lab - Montréal, Redmond, WA, USA
| | | | - Navin Kumar
- Yale University School of Medicine, New Haven, CT, USA
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Borghouts J, Huang Y, Gibbs S, Hopfer S, Li C, Mark G. Understanding underlying moral values and language use of COVID-19 vaccine attitudes on twitter. PNAS Nexus 2023; 2:pgad013. [PMID: 36896130 PMCID: PMC9991494 DOI: 10.1093/pnasnexus/pgad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 03/11/2023]
Abstract
Public sentiment toward the COVID-19 vaccine as expressed on social media can interfere with communication by public health agencies on the importance of getting vaccinated. We investigated Twitter data to understand differences in sentiment, moral values, and language use between political ideologies on the COVID-19 vaccine. We estimated political ideology, conducted a sentiment analysis, and guided by the tenets of moral foundations theory (MFT), we analyzed 262,267 English language tweets from the United States containing COVID-19 vaccine-related keywords between May 2020 and October 2021. We applied the Moral Foundations Dictionary and used topic modeling and Word2Vec to understand moral values and the context of words central to the discussion of the vaccine debate. A quadratic trend showed that extreme ideologies of both Liberals and Conservatives expressed a higher negative sentiment than Moderates, with Conservatives expressing more negative sentiment than Liberals. Compared to Conservative tweets, we found the expression of Liberal tweets to be rooted in a wider set of moral values, associated with moral foundations of care (getting the vaccine for protection), fairness (having access to the vaccine), liberty (related to the vaccine mandate), and authority (trusting the vaccine mandate imposed by the government). Conservative tweets were found to be associated with harm (around safety of the vaccine) and oppression (around the government mandate). Furthermore, political ideology was associated with the expression of different meanings for the same words, e.g. "science" and "death." Our results inform public health outreach communication strategies to best tailor vaccine information to different groups.
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Affiliation(s)
- Judith Borghouts
- Department of Medicine, University of California Irvine, Irvine, CA 92617, USA
| | - Yicong Huang
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Sydney Gibbs
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Suellen Hopfer
- Department of Health, Society & Behavior in the Program in Public Health, University of California Irvine, Irvine, CA 92697, USA
| | - Chen Li
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
| | - Gloria Mark
- Department of Computer Science, University of California Irvine, Irvine, CA 92697, USA
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Garcia Bolao I, Gras D, D'Onofrio A, Mark G, Nair D, Lellouche N, Novak M, Lo R, Chew E, Wright D, Kaplan A, Veraghtert S, Hu Y, Yong P, Gardner RS. Strategic management to optimize response to cardiac resynchronization therapy registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) is guideline-recommended for the treatment of symptomatic heart failure (HF) in patients (pts) with reduced LVEF and prolonged QRS. Clinical trials report Clinical Composite Score (CCS) response rates from 60 to 75%. However, patients with common comorbidities, such as atrial fibrillation, are often under-represented in clinical trials. The Strategic MAnagement to optimize response to cardiac Resynchronization Therapy (SMART) Registry (NCT03075215) was designed to examine outcomes in CRT patients in the real world.
Methods
The SMART Registry was a global, multicenter, prospective, clinical registry that enrolled subjects undergoing a de novo CRT-D implant or upgrade from pacemaker to CRT-D using a quadripolar LV lead. CCS was assessed at 12 months post-implant.
Results
For study design and CCS outcomes see Figure 1. CCS at 12 months showed that 58.8% of pts improved and 20.1% stabilized. Of the 21.1% of pts that worsened, 8.4% were due to death, 7.8% non-fatal heart failure event, and 5% worsening of NYHA or patient global assessment. Notably, this registry had a high prevalence of pts with NYHA I/II (51%), Non-LBBB (50%), AF (37%), diabetes (35%), and bradycardia (31%) at baseline. Age (>65), diabetes, ischemia, non-LBBB, atrial fibrillation (AF) and renal dysfunction correlated with worsened CCS outcomes. NYHA III/IV patients had significantly higher HF hospitalization (HFH) rates than NYHA I/II (P-value <0.001) (Figure 2a) and patients with AF had higher HFH rates than those without (P-value <0.001) (Figure 2b). Similar effects of NYHA score and AF were seen on mortality. The use of ACE/ARB, or ARNI, and MRA correlated with better outcomes, whereas diuretics and anticoagulants correlated with poorer outcomes.
Conclusions
In this large registry, clinical outcomes across important sub-populations are in line with expectations, with older age, ischemia, renal dysfunction, AF, non-LBBB, and diabetes associated with a lower likelihood of response to CRT. By including these patients, this study provides a clearer picture of the effectiveness of CRT in the real world. Future studies should examine optimization approaches to facilitate CRT effectiveness in these under studied patient populations.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This registry was funded by Boston Scientific (BSC)
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Affiliation(s)
| | - D Gras
- L'Hopital Prive du Confluent , Nantes , France
| | - A D'Onofrio
- AORN Ospedali dei Colli - Monaldi Hospital , Naples , Italy
| | - G Mark
- Cardiology Associates of the Delaware Valley, PA , Haddon Heights , United States of America
| | - D Nair
- Arrhythmia Research Group , Jonesboro , United States of America
| | | | - M Novak
- Faculty Hospital U sv Anny , Brno , Czechia
| | - R Lo
- VA Loma Linda , Loma Linda , United States of America
| | - E Chew
- Belfast City Hospital Trust , Belfast , United Kingdom
| | - D Wright
- Liverpool Heart and Chest Hospital , Liverpool , United Kingdom
| | - A Kaplan
- Cardiovascular Associates of Mesa , Mesa , United States of America
| | - S Veraghtert
- Boston Scientific Corporation , St. Paul , United States of America
| | - Y Hu
- Boston Scientific Corporation , St. Paul , United States of America
| | - P Yong
- Boston Scientific Corporation , St. Paul , United States of America
| | - R S Gardner
- Golden Jubilee National Hospital, Scottish National Advanced Heart Failure Service , Clydebank , United Kingdom
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Martinez GJ, Grover T, Mattingly SM, Mark G, D'Mello S, Aledavood T, Akbar F, Robles-Granda P, Striegel A. Alignment Between Heart Rate Variability From Fitness Trackers and Perceived Stress: Perspectives From a Large-Scale In Situ Longitudinal Study of Information Workers. JMIR Hum Factors 2022; 9:e33754. [PMID: 35925662 PMCID: PMC9389384 DOI: 10.2196/33754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Stress can have adverse effects on health and well-being. Informed by laboratory findings that heart rate variability (HRV) decreases in response to an induced stress response, recent efforts to monitor perceived stress in the wild have focused on HRV measured using wearable devices. However, it is not clear that the well-established association between perceived stress and HRV replicates in naturalistic settings without explicit stress inductions and research-grade sensors. OBJECTIVE This study aims to quantify the strength of the associations between HRV and perceived daily stress using wearable devices in real-world settings. METHODS In the main study, 657 participants wore a fitness tracker and completed 14,695 ecological momentary assessments (EMAs) assessing perceived stress, anxiety, positive affect, and negative affect across 8 weeks. In the follow-up study, approximately a year later, 49.8% (327/657) of the same participants wore the same fitness tracker and completed 1373 EMAs assessing perceived stress at the most stressful time of the day over a 1-week period. We used mixed-effects generalized linear models to predict EMA responses from HRV features calculated over varying time windows from 5 minutes to 24 hours. RESULTS Across all time windows, the models explained an average of 1% (SD 0.5%; marginal R2) of the variance. Models using HRV features computed from an 8 AM to 6 PM time window (namely work hours) outperformed other time windows using HRV features calculated closer to the survey response time but still explained a small amount (2.2%) of the variance. HRV features that were associated with perceived stress were the low frequency to high frequency ratio, very low frequency power, triangular index, and SD of the averages of normal-to-normal intervals. In addition, we found that although HRV was also predictive of other related measures, namely, anxiety, negative affect, and positive affect, it was a significant predictor of stress after controlling for these other constructs. In the follow-up study, calculating HRV when participants reported their most stressful time of the day was less predictive and provided a worse fit (R2=0.022) than the work hours time window (R2=0.032). CONCLUSIONS A significant but small relationship between perceived stress and HRV was found. Thus, although HRV is associated with perceived stress in laboratory settings, the strength of that association diminishes in real-life settings. HRV might be more reflective of perceived stress in the presence of specific and isolated stressors and research-grade sensing. Relying on wearable-derived HRV alone might not be sufficient to detect stress in naturalistic settings and should not be considered a proxy for perceived stress but rather a component of a complex phenomenon.
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Affiliation(s)
- Gonzalo J Martinez
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Ted Grover
- Informatics Department, University of California, Irvine, CA, United States
| | - Stephen M Mattingly
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Gloria Mark
- Informatics Department, University of California, Irvine, CA, United States
| | - Sidney D'Mello
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, United States
| | | | - Fatema Akbar
- Informatics Department, University of California, Irvine, CA, United States
| | - Pablo Robles-Granda
- Thomas M Siebel Center for Computer Science, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Aaron Striegel
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
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Martinez GJ, Mattingly SM, Robles-Granda P, Saha K, Sirigiri A, Young J, Chawla N, De Choudhury M, D'Mello S, Mark G, Striegel A. Predicting Participant Compliance With Fitness Tracker Wearing and Ecological Momentary Assessment Protocols in Information Workers: Observational Study. JMIR Mhealth Uhealth 2021; 9:e22218. [PMID: 34766911 PMCID: PMC8663716 DOI: 10.2196/22218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/23/2021] [Accepted: 09/24/2021] [Indexed: 01/27/2023] Open
Abstract
Background Studies that use ecological momentary assessments (EMAs) or wearable sensors to track numerous attributes, such as physical activity, sleep, and heart rate, can benefit from reductions in missing data. Maximizing compliance is one method of reducing missing data to increase the return on the heavy investment of time and money into large-scale studies. Objective This paper aims to identify the extent to which compliance can be prospectively predicted from individual attributes and initial compliance. Methods We instrumented 757 information workers with fitness trackers for 1 year and conducted EMAs in the first 56 days of study participation as part of an observational study. Their compliance with the EMA and fitness tracker wearing protocols was analyzed. Overall, 31 individual characteristics (eg, demographics and personalities) and behavioral variables (eg, early compliance and study portal use) were considered, and 14 variables were selected to create beta regression models for predicting compliance with EMAs 56 days out and wearable compliance 1 year out. We surveyed study participation and correlated the results with compliance. Results Our modeling indicates that 16% and 25% of the variance in EMA compliance and wearable compliance, respectively, could be explained through a survey of demographics and personality in a held-out sample. The likelihood of higher EMA and wearable compliance was associated with being older (EMA: odds ratio [OR] 1.02, 95% CI 1.00-1.03; wearable: OR 1.02, 95% CI 1.01-1.04), speaking English as a first language (EMA: OR 1.38, 95% CI 1.05-1.80; wearable: OR 1.39, 95% CI 1.05-1.85), having had a wearable before joining the study (EMA: OR 1.25, 95% CI 1.04-1.51; wearable: OR 1.50, 95% CI 1.23-1.83), and exhibiting conscientiousness (EMA: OR 1.25, 95% CI 1.04-1.51; wearable: OR 1.34, 95% CI 1.14-1.58). Compliance was negatively associated with exhibiting extraversion (EMA: OR 0.74, 95% CI 0.64-0.85; wearable: OR 0.67, 95% CI 0.57-0.78) and having a supervisory role (EMA: OR 0.65, 95% CI 0.54-0.79; wearable: OR 0.66, 95% CI 0.54-0.81). Furthermore, higher wearable compliance was negatively associated with agreeableness (OR 0.68, 95% CI 0.56-0.83) and neuroticism (OR 0.85, 95% CI 0.73-0.98). Compliance in the second week of the study could help explain more variance; 62% and 66% of the variance in EMA compliance and wearable compliance, respectively, was explained. Finally, compliance correlated with participants’ self-reflection on the ease of participation, usefulness of our compliance portal, timely resolution of issues, and compensation adequacy, suggesting that these are avenues for improving compliance. Conclusions We recommend conducting an initial 2-week pilot to measure trait-like compliance and identify participants at risk of long-term noncompliance, performing oversampling based on participants’ individual characteristics to avoid introducing bias in the sample when excluding data based on noncompliance, using an issue tracking portal, and providing special care in troubleshooting to help participants maintain compliance.
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Affiliation(s)
- Gonzalo J Martinez
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Stephen M Mattingly
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Pablo Robles-Granda
- Thomas M Siebel Center for Computer Science, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Koustuv Saha
- Microsoft Research, Montreal, QC, Canada.,School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Anusha Sirigiri
- Indian School of Business Gachibowli, Hyderabad Telangana, India
| | - Jessica Young
- Center for Research Computing, University of Notre Dame, Notre Dame, IN, United States
| | - Nitesh Chawla
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Sidney D'Mello
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, United States
| | - Gloria Mark
- Informatics Department, University of California, Irvine, Irvine, CA, United States
| | - Aaron Striegel
- Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
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Montgomery RM, Brandysky L, Neary M, Eikey E, Mark G, Schneider M, Stadnick NA, Zheng K, Mukamel DB, Sorkin DH, Schueller SM. Curating the Digital Mental Health Landscape With a Guide to Behavioral Health Apps: A County-Driven Resource. Psychiatr Serv 2021; 72:1229-1232. [PMID: 34030454 DOI: 10.1176/appi.ps.202000803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With more than 10,000 mental health apps available, consumers and clinicians who want to adopt such tools can be overwhelmed by the multitude of options and lack of clear evaluative standards. Despite the increasing prevalence of curated lists, or app guides, challenges remain. Organizations providing mental health services to consumers have an opportunity to address these challenges by producing guides that meet relevant standards of quality and are tailored to local needs. This column summarizes an example of the collaborative process of app guide development in a publicly funded mental health service context and highlights opportunities and barriers identified through the process.
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Affiliation(s)
- Robert M Montgomery
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Lamar Brandysky
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Martha Neary
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Elizabeth Eikey
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Gloria Mark
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Margaret Schneider
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Nicole A Stadnick
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Kai Zheng
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Dana B Mukamel
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Dara H Sorkin
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
| | - Stephen M Schueller
- Department of Psychology, California State University, Northridge (Montgomery); Kern County Behavioral Health and Recovery Services, Bakersfield, California (Brandysky); Department of Psychological Science (Neary, Schueller), Department of Informatics (Mark, Zheng, Schueller), Department of Population Health and Disease Prevention (Schneider), and Department of Medicine (Mukamel, Sorkin), University of California, Irvine; Department of Family Medicine and Public Health (Eikey), and Department of Psychiatry (Stadnick), University of California, San Diego. Dror Ben-Zeev, Ph.D., is editor of this column
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Hopfer S, Fields EJ, Lu Y, Ramakrishnan G, Grover T, Bai Q, Huang Y, Li C, Mark G. The social amplification and attenuation of COVID-19 risk perception shaping mask wearing behavior: A longitudinal twitter analysis. PLoS One 2021; 16:e0257428. [PMID: 34555060 PMCID: PMC8460003 DOI: 10.1371/journal.pone.0257428] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Twitter represents a mainstream news source for the American public, offering a valuable vehicle for learning how citizens make sense of pandemic health threats like Covid-19. Masking as a risk mitigation measure became controversial in the US. The social amplification risk framework offers insight into how a risk event interacts with psychological, social, institutional, and cultural communication processes to shape Covid-19 risk perception. METHODS Qualitative content analysis was conducted on 7,024 mask tweets reflecting 6,286 users between January 24 and July 7, 2020, to identify how citizens expressed Covid-19 risk perception over time. Descriptive statistics were computed for (a) proportion of tweets using hyperlinks, (b) mentions, (c) hashtags, (d) questions, and (e) location. RESULTS Six themes emerged regarding how mask tweets amplified and attenuated Covid-19 risk: (a) severity perceptions (18.0%) steadily increased across 5 months; (b) mask effectiveness debates (10.7%) persisted; (c) who is at risk (26.4%) peaked in April and May 2020; (d) mask guidelines (15.6%) peaked April 3, 2020, with federal guidelines; (e) political legitimizing of Covid-19 risk (18.3%) steadily increased; and (f) mask behavior of others (31.6%) composed the largest discussion category and increased over time. Of tweets, 45% contained a hyperlink, 40% contained mentions, 33% contained hashtags, and 16.5% were expressed as a question. CONCLUSIONS Users ascribed many meanings to mask wearing in the social media information environment revealing that COVID-19 risk was expressed in a more expanded range than objective risk. The simultaneous amplification and attenuation of COVID-19 risk perception on social media complicates public health messaging about mask wearing.
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Affiliation(s)
- Suellen Hopfer
- Department of Health, Society & Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Emilia J. Fields
- Department of Health, Society & Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Yuwen Lu
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Ganesh Ramakrishnan
- Department of Psychological Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Ted Grover
- Department of Informatics, University of California, Irvine, Irvine, California, United States of America
| | - Quishi Bai
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Yicong Huang
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Chen Li
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, Irvine, California, United States of America
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Borghouts J, Eikey EV, Mark G, De Leon C, Schueller SM, Schneider M, Stadnick N, Zheng K, Mukamel DB, Sorkin DH. Understanding Mental Health App Use Among Community College Students: Web-Based Survey Study. J Med Internet Res 2021; 23:e27745. [PMID: 34519668 PMCID: PMC8479606 DOI: 10.2196/27745] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/06/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
Background Mental health concerns are a significant issue among community college students, who often have less access to resources than traditional university college students. Mobile apps have the potential to increase access to mental health care, but there has been little research investigating factors associated with mental health app use within the community college population. Objective This study aimed to understand facilitators of and barriers to mental health app use among community college students. Methods A web-based survey was administered to a randomly selected sample of 500 community college students from April 16 to June 30, 2020. Structural equation modeling was used to test the relationships between the use of mental health apps, perceived stress, perceived need to seek help for mental health concerns, perceived stigma, past use of professional mental health services, privacy concerns, and social influence of other people in using mental health apps. Results Of the 500 participants, 106 (21.2%) reported use of mental health apps. Perceived stress, perceived need to seek help, past use of professional services, and social influence were positively associated with mental health app use. Furthermore, the effect of stress was mediated by a perceived need to seek help. Privacy concerns were negatively associated with mental health app use. Stigma, age, and gender did not have a statistically significant effect. Conclusions These findings can inform development of new digital interventions and appropriate outreach strategies to engage community college students in using mental health apps.
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Affiliation(s)
- Judith Borghouts
- Department of Medicine, University of California Irvine, Irvine, CA, United States
| | - Elizabeth V Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, United States.,The Design Lab, University of California, San Diego, San Diego, CA, United States
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, Irvine, CA, United States
| | - Cinthia De Leon
- Department of Medicine, University of California Irvine, Irvine, CA, United States
| | - Stephen M Schueller
- Department of Informatics, University of California, Irvine, Irvine, CA, United States.,Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Margaret Schneider
- Department of Public Health, University of California, Irvine, Irvine, CA, United States
| | - Nicole Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.,Dissemination and Implementation Science Center, UC San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, United States.,Child and Adolescent Services Research Center, San Diego, CA, United States
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, Irvine, CA, United States
| | - Dana B Mukamel
- Department of Medicine, University of California Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- Department of Medicine, University of California Irvine, Irvine, CA, United States
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9
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Akbar F, Mark G, Warton EM, Reed ME, Prausnitz S, East JA, Moeller MF, Lieu TA. Physicians' electronic inbox work patterns and factors associated with high inbox work duration. J Am Med Inform Assoc 2021; 28:923-930. [PMID: 33063087 DOI: 10.1093/jamia/ocaa229] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/05/2020] [Accepted: 09/03/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Electronic health record systems are increasingly used to send messages to physicians, but research on physicians' inbox use patterns is limited. This study's aims were to (1) quantify the time primary care physicians (PCPs) spend managing inboxes; (2) describe daily patterns of inbox use; (3) investigate which types of messages consume the most time; and (4) identify factors associated with inbox work duration. MATERIALS AND METHODS We analyzed 1 month of electronic inbox data for 1275 PCPs in a large medical group and linked these data with physicians' demographic data. RESULTS PCPs spent an average of 52 minutes on inbox management on workdays, including 19 minutes (37%) outside work hours. Temporal patterns of electronic inbox use differed from other EHR functions such as charting. Patient-initiated messages (28%) and results (29%) accounted for the most inbox work time. PCPs with higher inbox work duration were more likely to be female (P < .001), have more patient encounters (P < .001), have older patients (P < .001), spend proportionally more time on patient messages (P < .001), and spend more time per message (P < .001). Compared with PCPs with the lowest duration of time on inbox work, PCPs with the highest duration had more message views per workday (200 vs 109; P < .001) and spent more time on the inbox outside work hours (30 minutes vs 9.7 minutes; P < .001). CONCLUSIONS Electronic inbox work by PCPs requires roughly an hour per workday, much of which occurs outside scheduled work hours. Interventions to assist PCPs in handling patient-initiated messages and results may help alleviate inbox workload.
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Affiliation(s)
- Fatema Akbar
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, USA
| | - Gloria Mark
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, USA
| | - E Margaret Warton
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Mary E Reed
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Stephanie Prausnitz
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Jeffrey A East
- The Permanente Medical Group, Oakland, California, USA.,Department of Adult and Family Medicine, Kaiser Permanente Richmond, Richmond, California, USA
| | - Mark F Moeller
- The Permanente Medical Group, Oakland, California, USA.,Department of Adult and Family Medicine, Kaiser Permanente Napa, Napa, California, USA
| | - Tracy A Lieu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.,The Permanente Medical Group, Oakland, California, USA
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10
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Robles-Granda P, Lin S, Wu X, Martinez GJ, Mattingly SM, Moskal E, Striegel A, Chawla NV, D'Mello S, Gregg J, Nies K, Mark G, Grover T, Campbell AT, Mirjafari S, Saha K, De Choudhury M, Dey AK. Jointly Predicting Job Performance, Personality, Cognitive Ability, Affect, and Well-Being. IEEE COMPUT INTELL M 2021. [DOI: 10.1109/mci.2021.3061877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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11
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Mattingly SM, Grover T, Martinez GJ, Aledavood T, Robles-Granda P, Nies K, Striegel A, Mark G. The effects of seasons and weather on sleep patterns measured through longitudinal multimodal sensing. NPJ Digit Med 2021; 4:76. [PMID: 33911176 PMCID: PMC8080821 DOI: 10.1038/s41746-021-00435-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Previous studies of seasonal effects on sleep have yielded unclear results, likely due to methodological differences and limitations in data size and/or quality. We measured the sleep habits of 216 individuals across the U.S. over four seasons for slightly over a year using objective, continuous, and unobtrusive measures of sleep and local weather. In addition, we controlled for demographics and trait-like constructs previously identified to correlate with sleep behavior. We investigated seasonal and weather effects of sleep duration, bedtime, and wake time. We found several small but statistically significant effects of seasonal and weather effects on sleep patterns. We observe the strongest seasonal effects for wake time and sleep duration, especially during the spring season: wake times are earlier, and sleep duration decreases (compared to the reference season winter). Sleep duration also modestly decreases when day lengths get longer (between the winter and summer solstice). Bedtimes and wake times tend to be slightly later as outdoor temperature increases.
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Affiliation(s)
- Stephen M Mattingly
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA.
| | - Ted Grover
- Department of Informatics, University of California, Irvine, CA, USA
| | - Gonzalo J Martinez
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | | | - Pablo Robles-Granda
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Kari Nies
- Department of Informatics, University of California, Irvine, CA, USA
| | - Aaron Striegel
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, CA, USA
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12
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Akbar F, Mark G, Prausnitz S, Warton EM, East JA, Moeller MF, Reed ME, Lieu TA. Physician Stress During Electronic Health Record Inbox Work: In Situ Measurement With Wearable Sensors. JMIR Med Inform 2021; 9:e24014. [PMID: 33908888 PMCID: PMC8116996 DOI: 10.2196/24014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/02/2021] [Accepted: 03/21/2021] [Indexed: 01/08/2023] Open
Abstract
Background Increased work through electronic health record (EHR) messaging is frequently cited as a factor of physician burnout. However, studies to date have relied on anecdotal or self-reported measures, which limit the ability to match EHR use patterns with continuous stress patterns throughout the day. Objective The aim of this study is to collect EHR use and physiologic stress data through unobtrusive means that provide objective and continuous measures, cluster distinct patterns of EHR inbox work, identify physicians’ daily physiologic stress patterns, and evaluate the association between EHR inbox work patterns and physician physiologic stress. Methods Physicians were recruited from 5 medical centers. Participants (N=47) were given wrist-worn devices (Garmin Vivosmart 3) with heart rate sensors to wear for 7 days. The devices measured physiological stress throughout the day based on heart rate variability (HRV). Perceived stress was also measured with self-reports through experience sampling and a one-time survey. From the EHR system logs, the time attributed to different activities was quantified. By using a clustering algorithm, distinct inbox work patterns were identified and their associated stress measures were compared. The effects of EHR use on physician stress were examined using a generalized linear mixed effects model. Results Physicians spent an average of 1.08 hours doing EHR inbox work out of an average total EHR time of 3.5 hours. Patient messages accounted for most of the inbox work time (mean 37%, SD 11%). A total of 3 patterns of inbox work emerged: inbox work mostly outside work hours, inbox work mostly during work hours, and inbox work extending after hours that were mostly contiguous to work hours. Across these 3 groups, physiologic stress patterns showed 3 periods in which stress increased: in the first hour of work, early in the afternoon, and in the evening. Physicians in group 1 had the longest average stress duration during work hours (80 out of 243 min of valid HRV data; P=.02), as measured by physiological sensors. Inbox work duration, the rate of EHR window switching (moving from one screen to another), the proportion of inbox work done outside of work hours, inbox work batching, and the day of the week were each independently associated with daily stress duration (marginal R2=15%). Individual-level random effects were significant and explained most of the variation in stress (conditional R2=98%). Conclusions This study is among the first to demonstrate associations between electronic inbox work and physiological stress. We identified 3 potentially modifiable factors associated with stress: EHR window switching, inbox work duration, and inbox work outside work hours. Organizations seeking to reduce physician stress may consider system-based changes to reduce EHR window switching or inbox work duration or the incorporation of inbox management time into work hours.
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Affiliation(s)
- Fatema Akbar
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - Gloria Mark
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - Stephanie Prausnitz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - E Margaret Warton
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Jeffrey A East
- The Permanente Medical Group, Oakland, CA, United States.,Department of Adult and Family Medicine, Kaiser Permanente, Richmond, CA, United States.,Department of Adult and Family Medicine, Kaiser Permanente, San Rafael, CA, United States
| | - Mark F Moeller
- The Permanente Medical Group, Oakland, CA, United States.,Department of Adult and Family Medicine, Kaiser Permanente, Napa, CA, United States
| | - Mary E Reed
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Tracy A Lieu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.,The Permanente Medical Group, Oakland, CA, United States
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13
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Borghouts J, Eikey E, Mark G, De Leon C, Schueller SM, Schneider M, Stadnick N, Zheng K, Mukamel D, Sorkin DH. Barriers to and Facilitators of User Engagement With Digital Mental Health Interventions: Systematic Review. J Med Internet Res 2021; 23:e24387. [PMID: 33759801 PMCID: PMC8074985 DOI: 10.2196/24387] [Citation(s) in RCA: 219] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/24/2020] [Accepted: 02/08/2021] [Indexed: 01/14/2023] Open
Abstract
Background Digital mental health interventions (DMHIs), which deliver mental health support via technologies such as mobile apps, can increase access to mental health support, and many studies have demonstrated their effectiveness in improving symptoms. However, user engagement varies, with regard to a user’s uptake and sustained interactions with these interventions. Objective This systematic review aims to identify common barriers and facilitators that influence user engagement with DMHIs. Methods A systematic search was conducted in the SCOPUS, PubMed, PsycINFO, Web of Science, and Cochrane Library databases. Empirical studies that report qualitative and/or quantitative data were included. Results A total of 208 articles met the inclusion criteria. The included articles used a variety of methodologies, including interviews, surveys, focus groups, workshops, field studies, and analysis of user reviews. Factors extracted for coding were related to the end user, the program or content offered by the intervention, and the technology and implementation environment. Common barriers included severe mental health issues that hampered engagement, technical issues, and a lack of personalization. Common facilitators were social connectedness facilitated by the intervention, increased insight into health, and a feeling of being in control of one’s own health. Conclusions Although previous research suggests that DMHIs can be useful in supporting mental health, contextual factors are important determinants of whether users actually engage with these interventions. The factors identified in this review can provide guidance when evaluating DMHIs to help explain and understand user engagement and can inform the design and development of new digital interventions.
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Affiliation(s)
| | - Elizabeth Eikey
- University of California San Diego, San Diego, CA, United States
| | - Gloria Mark
- University of California Irvine, Irvine, CA, United States
| | | | | | | | - Nicole Stadnick
- University of California San Diego, San Diego, CA, United States
| | - Kai Zheng
- University of California Irvine, Irvine, CA, United States
| | - Dana Mukamel
- University of California Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- University of California Irvine, Irvine, CA, United States
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14
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Lieu TA, Warton EM, East JA, Moeller MF, Prausnitz S, Ballesca M, Mark G, Akbar F, Awsare S, Chen YFI, Reed ME. Evaluation of Attention Switching and Duration of Electronic Inbox Work Among Primary Care Physicians. JAMA Netw Open 2021; 4:e2031856. [PMID: 33475754 PMCID: PMC7821028 DOI: 10.1001/jamanetworkopen.2020.31856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Primary care physicians (PCPs) report multitasking during workdays while processing electronic inbox messages, but scant systematic information exists on attention switching and its correlates in the health care setting. OBJECTIVES To describe PCPs' frequency of attention switching associated with electronic inbox work, identify potentially modifiable factors associated with attention switching and inbox work duration, and compare the relative association of attention switching and other factors with inbox work duration. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of the work of 1275 PCPs in an integrated group serving 4.5 million patients used electronic health record (EHR) access logs from March 1 to 31, 2018, to evaluate PCPs' frequency of attention switching. Statistical analysis was performed from October 15, 2018, to August 28, 2020. MAIN OUTCOMES AND MEASURES Attention switching was defined as switching between the electronic inbox, other EHR work, and non-EHR periods. Inbox work duration included minutes spent on electronic inbox message views and related EHR tasks. Multivariable models controlled for the exposures. RESULTS The 1275 PCPs studied (721 women [56.5%]; mean [SD] age, 45.9 [8.5] years) had a mean (SD) of 9.0 (7.6) years of experience with the medical group and received a mean (SD) of 332.6 (148.3) (interquartile range, 252-418) new inbox messages weekly. On workdays, PCPs made a mean (SD) of 79.4 (21.8) attention switches associated with inbox work and did a mean (SD) 64.2 (18.7) minutes of inbox work over the course of 24 hours on workdays. In the model for attention switching, each additional patient secure message beyond the reference value was associated with 0.289 (95% CI, 0.217-0.362) additional switches, each additional results message was associated with 0.203 (95% CI, 0.127-0.278) additional switches, each additional request message was associated with 0.190 (95% CI, 0.124-0.257) additional switches, and each additional administrative message was associated with 0.262 (95% CI, 0.166-0.358) additional switches. Having a panel (a list of patients assigned to a primary care team) with more elderly patients (0.144 switches per percentage increase [95% CI, 0.009-0.278]) and higher inbox work duration (0.468 switches per additional minute of inbox work [95% CI, 0.411-0.524]) were also associated with higher attention switching involving the inbox. In the model for inbox work duration, each additional patient secure message beyond the reference value was associated with 0.151 (95% CI, 0.085-0.217) additional minutes, each additional results message was associated with 0.338 (95% CI, 0.272-0.404) additional minutes, each additional request message was associated with 0.101 (95% CI, 0.041-0.161) additional minutes, and each additional administrative message was associated with 0.179 (95% CI, 0.093-0.265) additional minutes. A higher percentage of the panel's patients initiating messages (0.386 minutes per percentage increase [95% CI, 0.026-0.745]) and attention switches (0.373 minutes per switch [95% CI, 0.328-0.419]) were also associated with higher inbox work duration. In addition, working at a medical center where all PCPs had high inbox work duration was independently associated with high or low inbox work duration. CONCLUSIONS AND RELEVANCE This study suggests that PCPs make frequent attention switches during workdays while processing electronic inbox messages. Message quantity was associated with both attention switching and inbox work duration. Physician and patient panel characteristics had less association with attention switching and inbox work duration. Assisting PCPs with message quantity might help modulate both attention switching and inbox work duration.
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Affiliation(s)
- Tracy A. Lieu
- Division of Research, Kaiser Permanente Northern California, Oakland
- The Permanente Medical Group, Oakland, California
| | | | - Jeffrey A. East
- The Permanente Medical Group, Oakland, California
- Department of Adult and Family Medicine, Kaiser Permanente, Richmond, California
- Department of Adult and Family Medicine, Kaiser Permanente, San Rafael, California
| | - Mark F. Moeller
- The Permanente Medical Group, Oakland, California
- Department of Adult and Family Medicine, Kaiser Permanente, Napa, California
| | | | - Manuel Ballesca
- The Permanente Medical Group, Oakland, California
- Department of Adult and Family Medicine, Kaiser Permanente, Napa, California
| | - Gloria Mark
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine
| | - Fatema Akbar
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine
| | | | | | - Mary E. Reed
- Division of Research, Kaiser Permanente Northern California, Oakland
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15
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Aasbo J, Dinerman J, Mark G, Burke MC, El-Chami M, Belott P, Mackall J, Gold M. 916The impact of anesthesia choice on subcutaneous implantable cardioverter defibrillator outcomes: acute and one year results from the post approval study. Europace 2020. [DOI: 10.1093/europace/euaa162.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was financially supported by Boston Scientific
The influence of anesthesia technique on the outcomes of subcutaneous implantable cardioverter defibrillator (SICD) implantation has not been prospectively evaluated.
The aim of the present analysis was to characterize the effect of anesthesia choice acutely and over a year follow-up in the large "real-world" cohort of the SICD Post Approval Study (SICD-PAS).
Patients received either general anesthesia (GA), conscious sedation (CS), or monitored anesthesia care (MAC) at the implanting physicians" discretion. Acute results and complications over one year were compared between GA, CS and MAC.
1,631 patients were studied. 64.3% received GA , 29.2% received CS and 6.6% received MAC. Procedure times were shortest for MAC versus GA and CS (Table 1). Cross-over from CS and MAC to GA occurred in 2.9% and 1.9% of procedures, respectively. The mean left ventricular ejection fraction (LVEF) was lower in the MAC cohort compared with GA and CS. GA patients were less often discharged the same day than CS and MAC. Patients who had GA were more likely to have had intra-operative DFT testing, while successful DFT testing at implant did not differ among groups (Table 1). At one year, freedom from total complications did not differ between groups (93.3% for GA, 92.9% for CS and 87.8% for MAC, p = 0.095) nor did freedom from inappropriate shocks (94% for GA, 94.2% for CS, 88.9% for MAC, p = 0.138) nor appropriate shocks (95.8% for GA, 95% for CS, 95% for MAC, p = 0.747).
All three anesthesia techniques had similar acute and one year outcomes but, despite having worse LVEF, patients who received MAC had shorter procedure times and infrequently required conversion to GA. GA was associated with higher rates of next day patient discharge. These results suggest that MAC may be preferred for the majority of patients. This observation should be confirmed with prospective trials.
Table 1:Characteristics and Outcomes Parameter Conscious Sedation General Anesthesia Monitored Anesthesia Care P value Gender[%(N/Total)] Male 68.1 (324/476) 69.3 (726/1048) 66.4 (71/107) 0.77 Age (years) mean ± SD 54 ± 15 53 ± 15 54 ± 13 0.61 Body Mass Index mean ± SD 30 ± 7 30 ± 8 29 ± 6 0.41 Creatinine (mg/dL) mean ± SD 2 ± 2 2 ± 4 2 ± 2 0.43 LVEF (%) mean ± SD 33 ± 15 32 ± 15 26 ± 9 <0.001 Procedure Time (min) mean ± SD 85 ± 42 75 ± 33 65 ± 30 <0.001 Same Day Discharge % 70.3% 64.3% 72.6% 0.03 DFT Attempted % 84% 89.1% 81.3% 0.004 Successful DFT % 98.7% 98.6% 98.8% 0.97
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Affiliation(s)
- J Aasbo
- Baptist Health Lexington, Lexington, United States of America
| | - J Dinerman
- The Heart Center at Huntsville Hospital, Hunstville Alabama, United States of America
| | - G Mark
- The Heart House / Cooper University Hospital, Camden, United States of America
| | - M C Burke
- CorVita Science Foundation, Chicago, United States of America
| | - M El-Chami
- Emory University Hospital, Atlanta, United States of America
| | - P Belott
- Sharp Grossmont Hospital, La Mesa California, United States of America
| | - J Mackall
- University Hospitals Cleveland Medical Center, Cleveland, United States of America
| | - M Gold
- Medical University of South Carolina, Charleston, United States of America
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Zaman S, Wesley A, Silva DRDC, Buddharaju P, Akbar F, Gao G, Mark G, Gutierrez-Osuna R, Pavlidis I. Stress and productivity patterns of interrupted, synergistic, and antagonistic office activities. Sci Data 2019; 6:264. [PMID: 31704939 PMCID: PMC6841929 DOI: 10.1038/s41597-019-0249-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/09/2019] [Indexed: 11/09/2022] Open
Abstract
We describe a controlled experiment, aiming to study productivity and stress effects of email interruptions and activity interactions in the modern office. The measurement set includes multimodal data for n = 63 knowledge workers who volunteered for this experiment and were randomly assigned into four groups: (G1/G2) Batch email interruptions with/without exogenous stress. (G3/G4) Continual email interruptions with/without exogenous stress. To provide context, the experiment's email treatments were surrounded by typical office tasks. The captured variables include physiological indicators of stress, measures of report writing quality and keystroke dynamics, as well as psychometric scores and biographic information detailing participants' profiles. Investigations powered by this dataset are expected to lead to personalized recommendations for handling email interruptions and a deeper understanding of synergistic and antagonistic office activities. Given the centrality of email in the modern office, and the importance of office work to people's lives and the economy, the present data have a valuable role to play.
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Affiliation(s)
- Shaila Zaman
- Computational Physiology Laboratory, University of Houston, Houston, USA
| | - Amanveer Wesley
- Computational Physiology Laboratory, University of Houston, Houston, USA
| | | | - Pradeep Buddharaju
- Computational Physiology Laboratory, University of Houston, Houston, USA
| | - Fatema Akbar
- Department of Informatics, University of California, Irvine, USA
| | - Ge Gao
- College of Information Studies, University of Maryland, College Park, USA
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, USA
| | - Ricardo Gutierrez-Osuna
- Perception, Sensing, and Instrumentation Laboratory, Texas A & M University, College Station, USA
| | - Ioannis Pavlidis
- Computational Physiology Laboratory, University of Houston, Houston, USA.
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17
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Grover T, Bayraktaroglu E, Mark G, Rho EHR. Moral and Affective Differences in U.S. Immigration Policy Debate on Twitter. Comput Support Coop Work 2019. [DOI: 10.1007/s10606-019-09357-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Abstract
We present artificial intelligent (AI) agents that act as interviewers to engage with a user in a text-based conversation and automatically infer the user's personality traits. We investigate how the personality of an AI interviewer and the inferred personality of a user influences the user's trust in the AI interviewer from two perspectives: the user's willingness to confide in and listen to an AI interviewer. We have developed two AI interviewers with distinct personalities and deployed them in a series of real-world events. We present findings from four such deployments involving 1,280 users, including 606 actual job applicants. Notably, users are more willing to confide in and listen to an AI interviewer with a serious, assertive personality in a high-stakes job interview. Moreover, users’ personality traits, inferred from their chat text, along with interview context, influence their perception of and their willingness to confide in and listen to an AI interviewer. Finally, we discuss the design implications of our work on building hyper-personalized, intelligent agents.
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Esposito M, Kuchibhotla S, Catalina B, Ryan O, Pedicini R, Andrew M, Annamalai S, Mark G, Kiernan M, Pham D, Anderson M, Morris D, Batsides G, Danny R, Kapur N. Increased Right Ventricular Afterload Is Associated with Poor Survival Among Patients Receiving Biventricular Impella (BiPella) Support for Cardiogenic Shock. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Abstract
Background With the increasing quality of smartphone cameras, taking photos has become ubiquitous. This paper investigates how smartphone photography can be leveraged to help individuals increase their positive affect. Methods Applying findings from positive psychology, we designed and conducted a 4-week study with 41 participants. Participants were instructed to take one photo every day in one of the following three conditions: a selfie photo with a smiling expression, a photo of something that would make oneself happy and a photo of something that would make another person happy.
Findings After 3 weeks, participants’ positive affect in all conditions increased. Those who took photos to make others happy became much less aroused. Qualitative results showed that those in the selfie group observed changes in their smile over time; the group taking photos to improve their own affect became more reflective and those taking photos for others found that connecting with family members and friends helped to relieve stress. Conclusions The findings can offer insights for designers to create systems that enhance emotional well-being.
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Affiliation(s)
- Yu Chen
- Department of Informatics, University of California, Irvine, 92697 USA
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, 92697 USA
| | - Sanna Ali
- Department of Informatics, University of California, Irvine, 92697 USA
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Cai Y, Qasem A, Melki C, Butlin M, Ayer J, Harmer J, Toelle B, Mark G, Alvolio A, Celermajer D, Skilton M. Central blood pressure measurement in children - development and validation of a paediatric transfer function. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Behera MK, Sharma A, Dutta S, Sharma S, Julka PK, Rath GK, Kil WJ, Ko C, Kaushal A, Warran K, Ning H, Camphausen K, Smart D, Vern-Gross TZ, McMullen KP, Case LD, Bourland JD, Ellis TL, Lawrence JA, Tatter SB, Shaw EG, Urbanic JJ, Chan MD, Jensen RL, Shrieve DC, Mohindra P, Robins HI, Tome WA, Howard SP, Chen C, Damek D, Gaspar LE, Ney D, Waziri A, Lillehei K, Kavanagh BD, Wang CC, Floyd S, Chang CH, Warnke P, Chio CC, Kasper E, Mahadevan A, Wong E, Jeyapalan S, Chen C, Mahajan A, Grosshans D, McAleer MF, Brown PD, Chintagumpala M, Vats T, Puduvalli V, Yock T, Schulder M, Herschmann Y, Ghaly M, Knisely J, Ghaly M, Kapur A, Schulder M, Knisely J, Goetz P, Lwu S, Ebinu J, Arayee M, Monsalves E, Laperriere N, Menard C, Bernstein M, Zadeh G, Loganathan AG, Chan MD, Alphonse N, Peiffer AM, Johnson A, McMullen KP, Urbanic JJ, Saconn PA, Bourland JD, Munley MT, Shaw EG, Tatter SB, Ellis TL, Lwu S, Goetz P, Aryaee M, Monsalves E, Laperriere N, Menard C, Bernstein M, Zadeh G, Mahajan A, Lowe C, McAleer MF, Grosshans D, DeGroot J, Mark G, Vats T, Brown PD, Ruda R, Trevisan E, Magliola U, Bertero L, Bosa C, Ricardi U, Soffietti R, Rajappa P, Margetis K, Wernicke AG, Sherr DL, Lavi E, Fine RL, Schwartz T, Pannullo SC, Laack N, Blanchard M, Buckner J, Glass J, Andrews DW, Werner-Wasik M, Evans J, Lawrence YR, Shi W, Strauss I, Corn BW, Matceyevsky D, Alani S, Gez E, Shtraus N, Kanner AA, Spasic M, Choy W, Nagasawa D, Yang I, Noel M, Woolf E, Smith R, Castillo-Rojas P, Sorenson S, Smith K, Scheck AC, Han SJ, Oh MC, Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, Parsa AT, Redmond KJ, Horska A, Ishaq O, Ford E, McNutt T, Batra S, Kleinberg L, Wharam M, Mahone M, Terezakis S, Ryu S, Rock J, Movsas B, Mikkelsen T, Rosenblum M, Sabsevitz D, Bovi JA, Leo P, LaViolette P, Rand S, Mueller W, Phillips A, Venkatramani R, Olch A, Grimm J, Davidson T, Brown R, Dhall G, Finlay J, Wong K. RADIATION THERAPY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
OBJECTIVES This study investigated the relationships between job characteristics and coping in predicting levels of anxiety and depression in nurses. The study was based on current theories of occupational stress, and predictors included job demands, social support, decision authority and skill discretion control, effort, over-commitment, rewards, and ways of coping. It was predicted that job demands, extrinsic effort, over-commitment, and negative coping behaviours would be positively associated with depression and anxiety, and social support, rewards, decision authority, skill discretion control, and positive coping would be negatively associated with depression and anxiety. METHODS Participants were 870 nurses, who responded to a bulk mail sent randomly to 4,000 nurses from the south of England. RESULTS The results showed that job demands, extrinsic effort, and over-commitment were associated with higher levels of anxiety and depression. Social support, rewards, and skill discretion were negatively associated with mental health problems. Few interactions were found between the variables. Coping behaviours significantly added to the explanation of variance in anxiety and depression outcomes, over and above the use of demand-control-support, and effort-reward factors alone. CONCLUSION The results from the study demonstrated the importance of coping factors in work-stress research, in accordance with the multi-factorial premise of transactional stress models. It is argued that multi-factor research is needed to help develop effective organizational interventions.
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Affiliation(s)
- G Mark
- Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, 63 Park Place, Cardiff, UK
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Mark G. Die Methode der schrägen Tomographie und ihre Bedeutung für die Lagebestimmung von Lungenprozessen. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1232260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mark G. Beitrag zur Frage der Nebenwirkungen des Streptomycins. Respiration 2009. [DOI: 10.1159/000191233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Mark G. Die traumatisierende Wirkung der intrathorakalen Scapula bei der Thorakoplastik. Respiration 2009. [DOI: 10.1159/000191492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Mark G. Beitrag zur Frage des sogenannten rauhen Flüssigkeitsspiegels beim Hydropneumothorax. Respiration 2009. [DOI: 10.1159/000191373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Haefliger E, Mark G. Die Bedeutung der Lungensegmente für die klinische Pathologie der Tuberkulose. Respiration 2009. [DOI: 10.1159/000191587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schibli-Beer S, Mark G, Canova M. Ergebnisse nach alleiniger Trapezektomie und Kapselraffung bei der Behandlung der Rhizarthrose. HANDCHIR MIKROCHIR P 2008; 40:169-74. [DOI: 10.1055/s-2007-989389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Behr R, Mark G, Bartik H, Hölper B. Bilateral Electrical Stimulation of the Cochlear Nucleus: Surgical and Technical Feasibility. Skull Base 2007. [DOI: 10.1055/s-2006-957295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mark G, Poltrock S. Groupware adoption in a distributed organization: transporting and transforming technology through social worlds. Information and Organization 2004. [DOI: 10.1016/j.infoandorg.2004.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lange KW, Tucha O, Alders GL, Preier M, Csoti I, Merz B, Mark G, Herting B, Fornadi F, Reichmann H, Vieregge P, Reiners K, Becker G, Naumann M. Differentiation of parkinsonian syndromes according to differences in executive functions. J Neural Transm (Vienna) 2003; 110:983-95. [PMID: 12938023 DOI: 10.1007/s00702-003-0011-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Groups of patients with Parkinson's disease (PD), striatonigral degeneration-type multiple system atrophy (MSA) or progressive supranuclear palsy (PSP) with motor disability stages II and III according to Hoehn and Yahr, and a healthy control group were compared using neuropsychological tests of executive functions. The results indicate that all three patient groups were impaired in the tests of executive functions. In comparison with healthy subjects, the three patient groups showed impaired performance regarding verbal fluency, problem solving and verbal and figural working memory. Patients with PD differed significantly from healthy subjects in a test of verbal recency, while patients with MSA or PSP were unimpaired. The comparison of patient groups revealed no differences between PD and MSA patients. However, patients with PSP showed greater impairment in both phonemic and semantic fluency than patients with PD or MSA. Using discriminant function analysis, it was found that variables derived from four verbal fluency tasks (simple and alternate semantic and phonemic fluency) discriminated among the three patient groups at a level significantly exceeding chance. Over 90% of patients with PSP were correctly classified. Patients with PD and MSA were correctly classified in over 70% of cases. These results suggest that verbal fluency tasks may be sensitive measures in the differential diagnosis of PD, MSA and PSP.
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Affiliation(s)
- K W Lange
- Institute of Experimental Psychology, University of Regensburg, Regensburg, Germany.
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Rosahl SK, Mark G, Herzog M, Pantazis C, Gharabaghi F, Matthies C, Brinker T, Samii M. Far-field responses to stimulation of the cochlear nucleus by microsurgically placed penetrating and surface electrodes in the cat. J Neurosurg 2001; 95:845-52. [PMID: 11702876 DOI: 10.3171/jns.2001.95.5.0845] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT A new generation of penetrating electrodes for auditory brainstem implants is on the verge of being introduced into clinical practice. This study was designed to compare electrically evoked auditory brainstem responses (EABRs) to stimulation of the cochlear nucleus (CN) by microsurgically implanted surface electrodes and insertion electrodes (INSELs) with stimulation areas of identical size. METHODS Via a lateral suboccipital approach, arrays of surface and penetrating microelectrodes with geometric stimulation areas measuring 4,417 microm2 (diameter 75 microm) were placed over and inserted into the CN in 10 adult cats. After recording the auditory brainstem response (ABR) at the mastoid process, the CN, and the level of the inferior colliculus, EABRs to stimulation of the CN were recorded using biphasic, charge-balanced stimuli with phase durations of 80 microsec, 160 microsec, and 240 microsec at a repetition rate of 22.3 Hz. Waveform, threshold, maximum amplitude, and the dynamic range of the responses were compared for surface and penetrating electrodes. The EABR waveforms that appeared for both types of stimulation resembled each other closely. The mean impedance was slightly lower (30 +/- 3.4 kohm compared with 31.7 +/- 4.5 kohm, at 10 kHz), but the mean EABR threshold was significantly higher (51.8 microA compared with 40.5 microA, t = 3.5, p = 0.002) for surface electrode arrays as opposed to penetrating electrode arrays. Due to lower saturation levels of the INSEL array, dynamic ranges were almost identical between the two types of stimulation. Sectioning of the eighth cranial nerve did not abolish EABRs. CONCLUSIONS Microsurgical insertion of electrodes into the CN complex may be guided and monitored using techniques similar to those applied for implantation of surface electrodes. Lower thresholds and almost equivalent dynamic ranges indicate that a more direct access to secondary auditory neurons is achieved using penetrating electrodes.
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Affiliation(s)
- S K Rosahl
- Department of Neurosurgery, Nordstadt Hospital, Hannover, Germany.
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Chan TW, Mark G, Huynh H. Induction of mammary epithelial cell differentiation and inhibition of dimethylbenz(A)anthracene-induced mammary tumour by co-administration of a pure antiestrogen ICI 182,780 and testosterone enanthate. Int J Oncol 2001; 19:263-9. [PMID: 11445837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Epidemiological studies have shown that early first pregnancy is associated with a life-long reduction in breast cancer risk. The terminal differentiation associated with pregnancy and lactation has been proposed as a mechanism underlying the protective effect of pregnancy. We report that treatment of rats with ICI 182,780 (ICI) caused a marked reduction in epithelial cells and Ki-67 labelling index as compared to controls and testosterone enanthate-treated (TE) mammary glands. TE increased the Ki-67 labelling index, stimulated lobuloalveolar and ductal growth, as well as the secretory activity of acinar cells. Co-administration of TE and ICI resulted in a reduction in Ki-67 labelling index. Mammary epithelial cells became differentiated, resembling that observed at the end of pregnancy and during lactation as indicated by marked increase in secretory activity, lipid accumulation and presence of basal nuclei. The expression of differentiation markers such as whey acidic protein, mammary derived growth inhibitor, alpha-casein and beta-casein was detected only in TE plus ICI treated mammary tissues. Unlike TE, ICI caused a significant reduction in DMBA-induced tumour incidence, number of tumour bearing and tumour size. Tumour incidence was reduced to 8% when both ICI and TE were co-administered. Our data provide the novel molecular interactions between the estrogen and androgen in regulation of mammary growth and differentiation. These observations may give insight into novel actions of ICI and TE on breast differentiation and protection against carcinogenesis which may be useful in designing novel strategies for cancer prevention and/or treatment based on maximizing mammary epithelial cell differentiation.
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MESH Headings
- 9,10-Dimethyl-1,2-benzanthracene/administration & dosage
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Cell Differentiation/drug effects
- Cell Division/drug effects
- Drug Therapy, Combination
- Epithelial Cells/chemistry
- Epithelial Cells/cytology
- Epithelial Cells/drug effects
- Estradiol/analogs & derivatives
- Estradiol/pharmacology
- Estradiol/therapeutic use
- Female
- Fulvestrant
- Immunohistochemistry
- Ki-67 Antigen/analysis
- Mammary Glands, Animal/chemistry
- Mammary Glands, Animal/cytology
- Mammary Glands, Animal/drug effects
- Mammary Neoplasms, Experimental/chemically induced
- Mammary Neoplasms, Experimental/pathology
- Mammary Neoplasms, Experimental/prevention & control
- Rats
- Rats, Sprague-Dawley
- Testosterone/analogs & derivatives
- Testosterone/pharmacology
- Testosterone/therapeutic use
- Time Factors
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Affiliation(s)
- T W Chan
- Laboratory of Molecular Endocrinology, Division of Cellular and Molecular Research, National Cancer Centre of Singapore, Singapore 169610
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Chan T, Mark G, Huynh H. Induction of mammary epithelial cell differentiation and inhibition of dimethylbenz(A)anthracene-induced mammary tumour by co-administration of a pure antiestrogen ICI 182,780 and testosterone enanthate. Int J Oncol 2001. [DOI: 10.3892/ijo.19.2.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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40
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Walliser M, Beer S, Mark G. [Anterior interosseous nerve syndrome as differential diagnosis of closed isolated flexor tendon lesion]. Swiss Surg 2001; 7:218-21. [PMID: 11678021 DOI: 10.1024/1023-9332.7.5.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
Lesions of the anterior interosseus nerve can result in a variety of clinical manifestations, depending on location and degree of axonal damage. Clinical presentation with an isolated palsy of the flexor pollicis longus muscle is difficult to distinguish from a closed tendon rupture, especially when a trauma occurred. We would like to present five of our cases and discuss the diagnostic and therapeutic modalities.
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Affiliation(s)
- M Walliser
- Handchirurgischer Dienst der Chirurgischen Klinik, Kantonsspital Chur
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Reichmann H, Sommer U, Fuchs G, Hefter H, Mark G, Müller T, Thümler R, Ulm G, Vieregge P. Workshop IV: drug treatment guidelines for the long-term management of Parkinson's disease. J Neurol 2000; 247 Suppl 4:IV/40-1. [PMID: 11199819 DOI: 10.1007/pl00007776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An attempt was made to establish a decision algorithm for the treatment of idiopathic Parkinson's disease at various stages and in different subgroups such as akinetic-rigid or tremor dominance type. We suggest treating young patients with selegiline and a dopamine agonist. In the tremor dominance type we use either budipine or a dopamine agonist. Due to levodopa-induced dyskinesia, we try to avoid levodopa in the early stages of the disease and use it only later in more advanced situations in a combination therapy with dopamine agonists. Since IPS is not only based upon dopamine deficiency but also on resulting glutamatergic overstimulation, we advocate the use of a glutamate antagonist such as amantadine or budipine. Catechol-O-methyl inhibitors are very helpful when wearing-off occurs. Anticholinergics are only used in the early stages of tremor-dominant IPS because we fear enhancing the risk of dementia.
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Affiliation(s)
- H Reichmann
- Dept. of Neurology, University of Dresden, Germany
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Affiliation(s)
- G. Mark
- Max-Planck-Institut für Strahlenchemie Stiftstrasse 34-36 D-45413 Mülheim/Ruhr, Germany
| | - H.-P. Schuchmann
- Max-Planck-Institut für Strahlenchemie Stiftstrasse 34-36 D-45413 Mülheim/Ruhr, Germany
| | - C. von Sonntag
- Max-Planck-Institut für Strahlenchemie Stiftstrasse 34-36 D-45413 Mülheim/Ruhr, Germany
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Liang X, Munshi S, Shendure J, Mark G, Davies ME, Freed DC, Montefiori DC, Shiver JW. Epitope insertion into variable loops of HIV-1 gp120 as a potential means to improve immunogenicity of viral envelope protein. Vaccine 1999; 17:2862-72. [PMID: 10438057 DOI: 10.1016/s0264-410x(99)00125-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report on the properties of a set of HIV-1 IIIB Env mutants carrying a linear gp41 epitope insertion (LLELDKWASL) in the V1, V2, V3 or V4 variable loop. Insertion of the epitope, which is defined by the HIV-1 neutralizing MAb 2F5, was well tolerated in the V1, V2 and V4 loops, as these mutants were properly expressed, retained reactivity to conformation-dependent monoclonal antibodies and exhibited patterns similar to the parental Env molecule. However, insertion of this epitope in the V3 loop was associated with drastically reduced protein expression. Relative to parental Env molecule, the V1, V2 and V4 insertion mutants demonstrated significantly increased binding to mAb 2F5 in vitro. To evaluate immunogenicity, mice and guinea pigs were immunized with plasmid expression vectors for the mutant proteins. For both mice and guinea pigs, all four mutants elicited anti-gp120 antibody responses. In mice the V1 and V3 insertion mutants, but neither the V2 or V4 insertion mutant nor the parental env, elicited significant titers against the epitope peptide, whereas in guinea pigs, V2 insertion mutant was most effective in eliciting anti-2F5 peptide antibody responses. While original V2 2F5 insertion mutant failed to elicit anti-2F5 peptide responses in mice, studies with 14 additional V2 insertion mutants revealed several insertion sites at which the epitope was able to induce epitope-specific antibody responses. This indicates that the precise position at which the epitope insertion takes place dictates the ability of the mutant to induce the epitope-specific antibody responses. When tested for virus neutralization activity, the guinea pig sera that contain high titers of anti-2F5 peptide antibody failed to enhance the virus neutralizing activity, suggesting that the configuration of 2F5 epitope plays a critical role in inducing neutralizing antibody responses. The results from this study may have potential implications with respect to modification of the HIV-1 Env molecule for the purpose of improving HIV-1 Env immunogenicity.
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Affiliation(s)
- X Liang
- Department of Virus and Cell Biology, Merck Research Laboratories, Westpoint, PA 19486, USA.
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Abstract
As organizations become more globally distributed, and as the fast growth of the Internet, multimedia, and collaborative software environments enable more opportunities for virtual groups to form and conduct business, it is important to understand how the technology affects group interaction. One such company interested in implementing virtual collocation technologies, The Boeing Company, has recently begun to seriously investigate the technology requirements for virtually collocated teams [4]. This paper reports on an empirical study of four virtual teams at The Boeing Company conducted over a three-month period in Spring of 1998. The goal of this research was to gain an understanding of the behavioral effects on work teams who are using such technologies.
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Pfeifer A, Mark G, Leung S, Dougherty M, Spillare E, Kasid U. Effects of c-raf-1 and c-myc expression on radiation response in an in vitro model of human small-cell-lung carcinoma. Biochem Biophys Res Commun 1998; 252:481-6. [PMID: 9826556 DOI: 10.1006/bbrc.1998.9660] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In this study we examined the radiation survival response of simian virus 40 large tumor antigen-immortalized human bronchial epithelial cells (BEAS-2B) stably transfected with c-raf-1 and/or c-myc. C-raf-1 transfectants (2B-raf), and c-raf-1 and c-myc double transfectants (2B-raf/myc) were relatively radioresistant compared with c-myc (2B-myc) or control vector transfectants (2B-neo) (2B-raf, D0 = 2.445 Gy; 2B-raf/myc, D0 = 2.46 Gy; 2B-myc, D0 = 1.501 Gy; 2B-neo, D0 = 2.029 Gy). The steady state level of superoxide dismutase (SOD) mRNA was higher in radioresistant cells (2B-raf and 2B-raf/myc). In addition, 2B-raf but not 2B-raf/myc or 2B-myc transfectants revealed relatively higher number of cells in G2+M phase of the cell cycle. These findings present experimental evidence that Raf-1 expression correlates with the radiation-resistant response of 2B-raf or 2B-raf/myc transfectants and suggest a role of SOD in Raf-1-associated radiation resistance. Because 2B-raf transfectants are non-tumorigenic, and double transfectants (2B-raf/myc) are tumorigenic with some phenotypic traits found in small-cell lung carcinomas, our data imply a dissociation between the Raf-1-mediated mechanisms of radiation protection and progression of lung neoplasia.
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Affiliation(s)
- A Pfeifer
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Mambrey P, Mark G, Pankoke-Babatz U. User Advocacy in Participatory Design: Designers' Experiences with a New Communication Channel. Comput Support Coop Work 1998. [DOI: 10.1023/a:1008687122083] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mark G, Tauber A, Laupert R, Schuchmann HP, Schulz D, Mues A, von Sonntag C. OH-radical formation by ultrasound in aqueous solution--Part II: Terephthalate and Fricke dosimetry and the influence of various conditions on the sonolytic yield. Ultrason Sonochem 1998; 5:41-52. [PMID: 11270336 DOI: 10.1016/s1350-4177(98)00012-1] [Citation(s) in RCA: 199] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Terephthalate and Fricke dosimetry have been carried out to determine the sonolytic energy yields of the OH free radical and of its recombination product H2O2 in aqueous solutions under various operating conditions (nature of operating gas, power, frequency, temperature). For example, in the sonolysis of Ar-saturated terephthalate solutions at room temperature, a frequency of 321 kHz, and a power of 170 W kg-1, the total yield [G(.OH) + 2 G(H2O2)], equals 16 x 10(-10) mol J-1. This represents the total of .OH that reach the liquid phase from gas phase of the cavitating bubble. The higher the solute concentration, the lower the H2O2 production as more of the OH free radicals are scavenged, in competition with their recombination. Fricke dosimetry, in the absence and presence of Cu2+ ions, shows that the yield of H atom reaching the liquid phase is much lower, with G(H.) of the order of 3 x 10(-10) mol J-1. These sonolytic yields are smaller in solutions that are at the point of gas saturation, and increase to an optimum as the initial sonication-induced degassing and effervescence subsides. The probing of the sonic field has shown that the rate of sonolytic free-radical formation may vary across the sonicated volume depending on frequency and power input.
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Affiliation(s)
- G Mark
- Max-Planck-Institut für Strahlenchemie, Stiftstrasse 34-36, P.O. Box 101365, D-45470 Mülheim an der Ruhr, Germany
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Steib A, Freys G, Collin F, Launoy A, Mark G, Boudjema K. Does N-acetylcysteine improve hemodynamics and graft function in liver transplantation? Liver Transpl Surg 1998; 4:152-7. [PMID: 9516568 DOI: 10.1002/lt.500040204] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The release of toxic oxidative free radicals induced by ischemia and reperfusion may jeopardize liver graft function. N-acetylcysteine (NAC) has shown protective effects on hypothermic and warm ischemia reperfusion liver injury in animals. NAC improves hemodynamics and survival rates in patients with fulminant hepatic failure. The aim of this study was to investigate whether intraoperative treatment with NAC would improve hemodynamics and postoperative graft function in liver transplantation. Sixty patients with chronic end-stage liver disease were included in a prospective randomized placebo-controlled study. NAC or the same volume of 5% glucose was started during the anhepatic phase. Hemodynamic data and calculated tissue oxygenation parameters were compared throughout the procedure. Postoperative graft function was assessed by measurements of aminotransferases, prothrombin time, and monoethylglycinexylidide test over the 3 first postoperative days. Patient demographics were similar before the infusion of NAC or glucose. Hemodynamic parameters, oxygen consumption, oxygen delivery, oxygen extraction ratio, and lactates were not different throughout the procedure. One hour after the revascularization of the hepatic artery, the oxygen extraction ratio by the liver was similar (17% +/- 7.6% v 17% +/- 6.2%) in both groups. Postoperative graft function was comparable within the 3 first postoperative days. This study failed to show any beneficial effect of the intraoperative administration of NAC on hemodynamics and graft function in liver transplantation in patients with chronic liver disease.
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Affiliation(s)
- A Steib
- Department of Anesthesiology, Hôpitaux Universitaires de Strasbourg, France
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Mark G, Kuhn M, Allemann J. [Granulomatous tumor of the flexor tendon sheath as first manifestation of sarcoidosis]. HANDCHIR MIKROCHIR P 1998; 30:122-4. [PMID: 9592700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
While osseous tumors of the phalanges are more common, soft-tissue manifestations in the hand are uncommon in patients with sarcoidosis. Our patient presented with a large but painless tumor on the palmar aspect of the right index finger limiting finger flexion. Histology of a biopsy specimen was interpreted as a granuloma of sarcoidosis. Further X-ray investigations revealed large bilateral formations in the hila of the lung interpreted as stage I sarcoidosis in an otherwise healthy individual. Tuberculosis and polyarthritis were excluded by standard tests. The tumor was then radically excised, as it was located within the flexor tendon sheath. After uneventful wound healing the patient had regained full function of his finger at six weeks follow up. Interestingly enough, a chest film at that time showed the hilar changes to have decreased as well, which is considered quite typical for this disease.
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Affiliation(s)
- G Mark
- Handchirurgischen Dienst der Chirurgischen Klinik, Rätisches Kantons- und Regionalspital Chur
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