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Kim, Catherine, Gary Chisholm, Abby Bevolo, Beverly Shelton, Leslie Kian, Carol M. Lewis, Elizabeth A. Garcia, Randal S. Weber, and Michael Frumovitz. "Comparison of Internal Patient Satisfaction Scores at a Cancer Center With Star Ratings on Online Physician-Rating Websites." JCO Oncology Practice 17, no. 8 (August 2021): e1181-e1188. http://dx.doi.org/10.1200/op.20.00564.
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PURPOSE: Patients have been increasingly using physician-rating websites (PRWs); however, few studies have analyzed the validity of star ratings on PRWs. We aimed to compare PRW patient satisfaction scores with internally generated patient satisfaction scores (internal scores) of physicians at a large quaternary cancer center. METHODS: We collected internal scores and PRW scores for physicians at MD Anderson Cancer Center. Internal scores were based on patient responses to the Clinician and Group Consumer Assessment of Healthcare Providers and Systems patient experience (CG-CAHPS) survey. Only physicians with an internal score on the basis of ≥ 30 patient reviews were included. The median numbers of reviews and median scores were compared between internal data and four PRWs (Google, HealthGrades, Vitals, and WebMD). Both internally and on PRWs, possible scores ranged from 1 (least satisfied) to 5 (most satisfied). RESULTS: Of 640 physicians with an internal score, 510 (79.7%) met the inclusion criteria. For these 510 physicians, the median (IQR) number of internal reviews was 49.5 (30-93) and the median (IQR) internal score was 4.89 (4.81-4.93); the median number of reviews on PRWs ranged from 2 to 7, and the median score on PRWs ranged from 4.40 to 5.00. No physician had an internal score < 4, but the proportions with score < 4 on PRWs ranged from 16% to 30%. CONCLUSION: Internal patient satisfaction scores were higher and calculated from more reviews than PRW patient satisfaction scores and correlated weakly with PRW scores. Given that patients rely on PRWs when evaluating potential physicians, we recommend publishing internal scores online to give patients more complete information regarding physician performance.
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Guetz, Bernhard, and Sonja Bidmon. "Awareness of and interaction with physician rating websites: A cross-sectional study in Austria." PLOS ONE 17, no. 12 (December 30, 2022): e0278510. http://dx.doi.org/10.1371/journal.pone.0278510.
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To date, the digital assessment of service experiences represents a decisive process step of a feedback culture in numerous economic areas. In view of this digitalization of service assessments, the importance of Physician Rating Websites (PRWs) has also increased steadily in recent years. Even though these websites could be perceived as a powerful communication tool for the exchange of health specific information, the knowledge about whether and how different population segments use these portals has been limited so far. For this reason, our aim was to investigate the level of awareness regarding PRWs among the study population and to discover how users interact with this specific type of online portals. We performed an online survey including 558 participants. To ensure the attention and integrity of participants, attention checks were included in the questionnaire. Study participants who did not exceed the mentioned security levels were excluded from the study. Statistical analyses were carried out, using IBM SPSS Statistics 27. To illustrate the relationship between demographic variables and dependent variables, two tailed chi square tests were performed. Comparison of means and t-testing was used to investigate the relationship between psychographic variables and the dependent variables. In addition to that, the awareness levels regarding different rating portals were evaluated using descriptive methods. Our results suggest that the general awareness regarding PRWs is relatively high (75.6%, 423/558), especially among female (x21 = 9.880, P = .002), middle-aged (x29 = 26.810, P = .002), more highly educated (x24 = 19.038, P = .001), urban (x21 = 6.274, P = .012), digitally literate (t203 = 2.63, P = .009) individuals and particularly among respondents with a higher eHealth literacy (t203 = 2.37, P = .019). Even though more than three quarters of the respondents know that PRWs exist, compared to other rating platforms, they are only in the lower midfield. The upper ranks are taken by websites on which restaurant visits (98.9%, 552/558), hotel stays (97.7%, 545/558) or movies (95.5%, 533/558) can be rated. The most popular PRWs in Austria include Docfinder.at (31.3%, 175/558; 77.8%, 434/558) followed by the evaluation tools provided by Google.at (8.24%, 46/558; 70.3%, 392/558) and Herold.at (1.61%, 9/558; 44.8%, 250/558). In Austria, PRWs seem to be characterized by a high degree of interaction (89.2%, 498/558) with a wide variety of different types of interactions. While many respondents use PRWs to retrieve general information (83.2%, 464/558), there are significantly fewer who read physicians’ reviews (60.9%, 340/558) and use this portal to select a physician (60.6%, 338/558). Respondents who have already rated a doctor themselves belong to the smallest group accounting for just 14.7% (82/558). Significant effects regarding the interaction with PRWs exist between different genders, ages, education levels, marital statuses, occupations and areas of living. In addition to that, respondents with better feelings towards the internet, greater digital literacy as well as a higher eHealth literacy were also characterized with a higher interaction rate regarding PRWs. According to the high level of awareness of and interaction with PRWs within our study population, PRWs appear to be a successful medium for health-related communication. Especially for female, middle-aged, more highly educated, urban and more technology savvy population segments, PRWs seem to represent an effective tool to support the health-specific decision-making process.
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Nicknam, Afsoon, and Andre Filiatrault. "Direct Displacement-Based Seismic Design of Propped Rocking Walls." Earthquake Spectra 31, no. 1 (February 2015): 179–96. http://dx.doi.org/10.1193/051512eqs187m.
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A direct displacement-based design (DDBD) methodology is described for propped rocking walls (PRWs). PRWs represent a novel seismic force-resisting system that combines passive supplemental damping devices with unbonded post-tensioned concrete rocking walls. The key aspect of the proposed design procedure is the closed-form derivation of the stabilized hysteretic response of PRWs under reverse cyclic loading. This allows the direct application of the DDBD procedure to satisfy desired displacement performance objectives under prescribed levels of seismic intensity. Nonlinear response analyses are conducted on a prototype PRW structure, designed according to the proposed DDBD procedure to evaluate its performance under strong ground shaking.
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Guetz, Bernhard, and Sonja Bidmon. "The Impact of Social Influence on the Intention to Use Physician Rating Websites: Moderated Mediation Analysis Using a Mixed Methods Approach." Journal of Medical Internet Research 24, no. 11 (November 14, 2022): e37505. http://dx.doi.org/10.2196/37505.
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Background Physician rating websites (PRWs) have become increasingly important in the cross-section between health and digitalization. Social influence plays a crucial role in human behavior in many domains of life, as can be demonstrated by the increase in high-profile influential individuals such as social media influencers (SMIs). Particularly in the health-specific environment, the opinion of family and friends has a significant influence on health-related decisions. However, so far, there has been little discussion about the role of social influence as an antecedent of behavioral intention to use PRWs. Objective On the basis of theories of social psychology and technology acceptance and theories from the economic perspective, this study aimed to evaluate the impact of social influence on the behavioral intention to use PRWs. Methods We conducted 2 studies by applying a mixed methods approach including a total of 712 participants from the Austrian population. The impact of social influence on the behavioral intention to use PRWs was investigated through linear regression and mediation and moderated mediation analysis using the PROCESS macro 4.0 in SPSS 27 (IBM Corp). Results The 2 studies show similar results. In study 1, an experiment, no direct effect of social influence on the behavioral intention to use PRWs could be detected. However, an indirect effect of social influence on the behavioral intention to use PRWs via credibility (b=0.572; P=.005) and performance expectancy (b=0.340; P<.001) could be confirmed. The results of study 2, a cross-sectional study, demonstrate that social influence seems to have a direct impact on the behavioral intention to use PRWs (b=0.410; P<.001). However, when calculating the proposed mediation model, it becomes clear that this impact may partly be explained through the 2 mediator variables—credibility (b=0.208; P<.001) and performance expectancy (b=0.312; P<.001). In contrast to the observed direct and indirect effect, neither demographic nor psychographic variables have a significant moderating impact on the influencing chain in study 2. Conclusions This study provides an indication that social influence has at least an indirect impact on the behavioral intention to use PRWs. It was observed that this impact is exerted through credibility and performance expectancy. According to the findings of both studies, social influence has the potential to boost the use of PRWs. As a result, these web-based networks might be a promising future interface between health care and digitalization, allowing health care practitioners to gain a beneficial external impact while also learning from feedback. Social influence nowadays is not just limited to friends and family but can also be exerted by SMIs in the domain of PRW use. Thus, from a marketing perspective, PRW providers could think of collaborating with SMIs, and our results could contribute to stimulating discussion in this vein.
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Shah, Adnan Muhammad, Wazir Muhammad, Kangyoon Lee, and Rizwan Ali Naqvi. "Examining Different Factors in Web-Based Patients’ Decision-Making Process: Systematic Review on Digital Platforms for Clinical Decision Support System." International Journal of Environmental Research and Public Health 18, no. 21 (October 26, 2021): 11226. http://dx.doi.org/10.3390/ijerph182111226.
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(1) Background: The appearance of physician rating websites (PRWs) has raised researchers’ interest in the online healthcare field, particularly how users consume information available on PRWs in terms of online physician reviews and providers’ information in their decision-making process. The aim of this study is to consistently review the early scientific literature related to digital healthcare platforms, summarize key findings and study features, identify literature deficiencies, and suggest digital solutions for future research. (2) Methods: A systematic literature review using key databases was conducted to search published articles between 2010 and 2020 and identified 52 papers that focused on PRWs, different signals in the form of PRWs’ features, the findings of these studies, and peer-reviewed articles. The research features and main findings are reported in tables and figures. (3) Results: The review of 52 papers identified 22 articles for online reputation, 15 for service popularity, 16 for linguistic features, 15 for doctor–patient concordance, 7 for offline reputation, and 11 for trustworthiness signals. Out of 52 studies, 75% used quantitative techniques, 12% employed qualitative techniques, and 13% were mixed-methods investigations. The majority of studies retrieved larger datasets using machine learning techniques (44/52). These studies were mostly conducted in China (38), the United States (9), and Europe (3). The majority of signals were positively related to the clinical outcomes. Few studies used conventional surveys of patient treatment experience (5, 9.61%), and few used panel data (9, 17%). These studies found a high degree of correlation between these signals with clinical outcomes. (4) Conclusions: PRWs contain valuable signals that provide insights into the service quality and patient treatment choice, yet it has not been extensively used for evaluating the quality of care. This study offers implications for researchers to consider digital solutions such as advanced machine learning and data mining techniques to test hypotheses regarding a variety of signals on PRWs for clinical decision-making.
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McLennan, Stuart. "The Content and Nature of Narrative Comments on Swiss Physician Rating Websites: Analysis of 849 Comments." Journal of Medical Internet Research 21, no. 9 (September 30, 2019): e14336. http://dx.doi.org/10.2196/14336.
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Background The majority of physician rating websites (PRWs) provide users the option to leave narrative comments about their physicians. Narrative comments potentially provide richer insights into patients’ experiences and feelings that cannot be fully captured in predefined quantitative rating scales and are increasingly being examined. However, the content and nature of narrative comments on Swiss PRWs has not been examined to date. Objective This study aimed to examine (1) the types of issues raised in narrative comments on Swiss PRWs and (2) the evaluation tendencies of the narrative comments. Methods A random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 3 PRWs (OkDoc, DocApp, and Medicosearch) and Google, and narrative comments were collected. Narrative comments were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. Results The selected physicians had a total of 849 comments. In total, 43 subcategories addressing the physician (n=21), staff (n=8), and practice (n=14) were identified. None of the PRWs’ comments covered all 43 subcategories of the categorization framework; comments on Google covered 86% (37/43) of the subcategories, Medicosearch covered 72% (31/43), DocApp covered 60% (26/43), and OkDoc covered 56% (24/43). In total, 2441 distinct issues were identified within the 43 subcategories of the categorization framework; 83.65% (2042/2441) of the issues related to the physician, 6.63% (162/2441) related to the staff, and 9.70% (237/2441) related to the practice. Overall, 95% (41/43) of the subcategories of the categorization framework and 81.60% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of the physician and staff, infrastructure, and organization and management of the practice) that are considered assessable by patients. Overall, 83.0% (705/849) of comments were classified as positive, 2.5% (21/849) as neutral, and 14.5% (123/849) as negative. However, there were significant differences between PRWs, regions, and specialty regarding negative comments: 90.2% (111/123) of negative comments were on Google, 74.7% (92/123) were regarding physicians in Zurich, and 73.2% (90/123) were from specialists. Conclusions From the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, and it is recommended that physicians should focus on improving these issues. The current suppression of negative comments by Swiss PRWs is concerning, and there is a need for a consensus-based criterion to be developed to determine which comments should be published publicly. Finally, it would be helpful if Swiss patients are made aware of the current large differences between Swiss PRWs regarding the frequency and nature of ratings to help them determine which PRW will provide them with the most useful information.
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Sander, U., A. S. Esslinger, M. Maryschok, O. Schöffski, and M. Emmert. "Public Reporting in Germany: the Content of Physician Rating Websites." Methods of Information in Medicine 51, no. 02 (2012): 112–20. http://dx.doi.org/10.3414/me11-01-0045.
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SummaryBackground: Physician rating websites (PRWs) are gaining in popularity among patients seeking quality information about physicians. However, little knowledge is available about the quantity and type of information provided on the websites.Objective: To determine and structure the quantity and type of information about physicians in the outpatient sector provided on German-language physician rating websites.Methods: In a first step, we identified PRWs through a systematic internet search using German keywords from a patient´s perspective in the two search engines Google and Yahoo. Afterwards, information about physicians available on the websites was collected and categorised according to Donabedian´s structure/process/outcome model. Furthermore, we investigated whether the information was related to the physician himself/ herself or to the practice as a whole.Results: In total, eight PRWs were detected. Our analysis turned up 139 different information items on eight websites; 67 are related to the structural quality, 4 to process quality, 5 to outcomes, and 63 to patient satisfaction/experience. In total, 37% of all items focus specifically on the physician and 63% on the physician’s practice. In terms of the total amount of information provided on the PRWs, results range from 61 down to 13.5 items.Conclusions: A broad range of information is available on German PRWs. While structural information can give a detailed overview of the financial, technical and human resources of a practice, other outcome measures have to be interpreted with caution. Specifically, patient satisfaction results are not risk-adjusted, and thus, are not appropriate to represent a provider’s quality of care. Consequently, neither patients nor physicians should yet use the information provided to make their final decision for or against an individual physician.
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Bidmon, Sonja, Ossama Elshiewy, Ralf Terlutter, and Yasemin Boztug. "What Patients Value in Physicians: Analyzing Drivers of Patient Satisfaction Using Physician-Rating Website Data." Journal of Medical Internet Research 22, no. 2 (February 3, 2020): e13830. http://dx.doi.org/10.2196/13830.
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Background Customer-oriented health care management and patient satisfaction have become important for physicians to attract patients in an increasingly competitive environment. Satisfaction influences patients’ choice of physician and leads to higher patient retention and higher willingness to engage in positive word of mouth. In addition, higher satisfaction has positive effects on patients’ willingness to follow the advice given by the physician. In recent years, physician-rating websites (PRWs) have emerged in the health care sector and are increasingly used by patients. Patients’ usage includes either posting an evaluation to provide feedback to others about their own experience with a physician or reading evaluations of other patients before choosing a physician. The emergence of PRWs offers new avenues to analyze patient satisfaction and its key drivers. PRW data enable both satisfaction analyses and implications on the level of the individual physician as well as satisfaction analyses and implications on an overall level. Objective This study aimed to identify linear and nonlinear effects of patients’ perceived quality of physician appointment service attributes on the overall evaluation measures that are published on PRWs. Methods We analyzed large-scale survey data from a German PRW containing 84,680 surveys of patients rating a total of 7038 physicians on 24 service attributes and 4 overall evaluation measures. Elasticities are estimated from regression models with perceived attribute quality as explanatory variables and overall evaluation measures as dependent variables. Depending on the magnitude of the elasticity, service attributes are classified into 3 categories: attributes with diminishing, constant, or increasing returns to overall evaluation. Results The proposed approach revealed new insights into what patients value when visiting physicians and what they take for granted. Improvements in the physicians’ pleasantness and friendliness have increasing returns to the publicly available overall evaluation (b=1.26). The practices’ cleanliness (b=1.05) and the communication behavior of a physician during a visit (b level between .97 and 1.03) have constant returns. Indiscretion in the waiting rooms, extended waiting times, and a lack of modernity of the medical equipment (b level between .46 and .59) have the strongest diminishing returns to overall evaluation. Conclusions The categorization of the service attributes supports physicians in identifying potential for improvements and prioritizing resource allocation to improve the publicly available overall evaluation ratings on PRWs. Thus, the study contributes to patient-centered health care management and, furthermore, promotes the utility of PRWs through large-scale data analysis.
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McLennan, Stuart. "Rejected Online Feedback From a Swiss Physician Rating Website Between 2008 and 2017: Analysis of 2352 Ratings." Journal of Medical Internet Research 22, no. 8 (August 3, 2020): e18374. http://dx.doi.org/10.2196/18374.
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Background Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate. Objective The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments. Methods The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. Results Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician’s communication (261/1903, 13.7%); (5) the physician’s caring attitude (220/1903, 11.6%); and (6) the physician’s friendliness (203/1903, 10.6%). Conclusions It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.
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González, R. "DYNAMIC CLASSIFICATION OF BELTRAMI FLOWS." Anales AFA 33, Fluidos (August 16, 2022): 1–5. http://dx.doi.org/10.31527/analesafa.2021.33.fluidos.1.
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We study four configurations of Beltrami flows (BFs) defined as ∇ × v = ±γ ±v, where γ > 0 is an eigenvalue and which have a progressive rotating wave dynamics (PRWs) that satisfies the dynamic property (DP) [1], which allows us to classify them on the basis of the eigenvalues that result in each configuration. The first configuration corresponds to an infinite volume domain without contours. The classifier eigenvalue is γ ±ph = 2/ vph± where k is the modulus of the wave vector that forms an angle θ with the rotation axis. The result is a finite-amplitude, transverse, dispersive, circularly polarised, planar PRWs with a continuous spectrum. The second configuration has the same domain as configuration one. The classifying eigenvalue is γ ±ph = 2/ vph± with vph being the phase velocity, with vph+ < 0 and vph− > 0. They are axi-symmetric or non-axi-symmetric along the axis of rotation, of finite amplitude, non-dispersive and with motion between concentric cylinders at which the radial velocity equals zero. In the third configuration the fluid is confined in an infinite cylinder. The classifying eigenvalue is again γ ±ph but it results discretized by the boundary conditions on the cylinder wall. Classification is exemplified for vph+ = −0.1 and three rotating modes with m = 0, m = 1 y m = 2. These are finite amplitude dispersive PRWs. The fourth configuration consists of a rotational-translational flow, characterized by the Rossby number R0 (=U/a Ω) which is an intake flow to a semi-infinite cylinder. The classifying eigenvalue is γ ±ph with vph± = ∓R0. These are PRWs, of the same type as in the infinite cylinder, but dependent on R0. It is shown that these waves exist only in the interval R0 ∈ (0,0.642]. Where for R0 = 0.642 one has only the mode with m = 1 and as R0 decreases the modes m = 0 and m ≥ 2 arise successively. It is observed that, for the same R0, waves of the same sign of frequency do not exchange energy. For each configuration the possibilities and conditions of resonant triadic interactions are analyzed.
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Fogel, Joshua, and Viviane Wahba. "Physician Rating Websites and Use or Non-Use of a Physician After Reading These Reviews." Journal of Electronic Commerce in Organizations 19, no. 2 (April 2021): 55–73. http://dx.doi.org/10.4018/jeco.2021040104.
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This study is about use and non-use of a physician after reading physician rating website (PRW) reviews. College students (n=796) were surveyed about demographics, self-rated perceived health, health insurance, recent physician visits, and many PRW review topics. The study found that a number of PRWs read or typically read PRW reviews; trust, behavioral control, and intentions were each positively associated with increased odds for use and non-use of a physician. Women were associated with increased odds for use of a physician. Writing a PRW review was associated with increased odds for non-use of a physician. In conclusion, healthcare organizations and managers of physician practices should encourage patients to write reviews on PRWs with the hope that the majority of the reviews will be positive. As reviews read is a key factor influencing choosing to use and not use a physician, this way there will be a number of reviews for consumers to read.
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Qubain, Leeann, Evan H. Richman, Vincent Eaton, Joseph C. Brinkman, and Krista M. Goulding. "Analysis of Negative Reviews of Orthopedic Oncology Surgeons: An Investigation of Reviews from Healthgrades, Vitals, and Google." Sarcoma 2022 (December 10, 2022): 1–9. http://dx.doi.org/10.1155/2022/4351427.
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Background. Physician review websites (PRWs) are increasing in usage and popularity. Our purpose is to characterize one-star reviews of orthopedic oncology surgeons to understand factors in healthcare that contribute to patient satisfaction. Methods. Orthopedic oncology surgeons were randomly selected from the Musculoskeletal Tumor Society. A search for one-star reviews was performed on Google Reviews, Healthgrades, and Vitals.com. Reviews were classified as clinical or nonclinical. Statistical analyses were performed regarding the frequency of reviews and complaints for each category. Results. Of the 7,733 reviews discovered, 908 (11.7%) were identified as one-star reviews. Of 907 usable complaints, 362 (40.8%) were clinical and 545 (59.2%) were nonclinical. The most common nonclinical complaints included bedside manner (65%) and limited time with providers (19%). The most common clinical complaints included complications (26%) and disagreements with the treatment plan (26%). There were 120 surgical and 221 nonsurgical reviews. Surgical patients had a higher rate of clinical complaints. Nonsurgical patients had a higher rate of total complaints. Conclusion. To the best of our knowledge, this is the first study examining PRWs regarding orthopedic oncology surgeons. Most one-star reviews were due to nonclinical complaints from nonsurgical patients. The most common factors are bedside manner, limited time with provider, phone communication issues, and rude/unprofessional conduct.
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Shah, Adnan Muhammad, Rizwan Ali Naqvi, and Ok-Ran Jeong. "Detecting Topic and Sentiment Trends in Physician Rating Websites: Analysis of Online Reviews Using 3-Wave Datasets." International Journal of Environmental Research and Public Health 18, no. 9 (April 29, 2021): 4743. http://dx.doi.org/10.3390/ijerph18094743.
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(1) Background: Physician rating websites (PRWs) are a rich resource of information where individuals learn other people response to various health problems. The current study aims to investigate and analyze the people top concerns and sentiment dynamics expressed in physician online reviews (PORs). (2) Methods: Text data were collected from four U.S.-based PRWs during the three time periods of 2018, 2019 and 2020. Based on the dynamic topic modeling, hot topics related to different aspects of healthcare were identified. Following the hybrid approach of aspect-based sentiment analysis, the social network of prevailing topics was also analyzed whether people expressed positive, neutral or negative sentiments in PORs. (3) Results: The study identified 30 dominant topics across three different stages which lead toward four key findings. First, topics discussed in Stage III were quite different from the earlier two stages due to the COVID-19 outbreak. Second, based on the keyword co-occurrence analysis, the most prevalent keywords in all three stages were related to the treatment, questions asked by patients, communication problem, patients’ feelings toward the hospital environment, disease symptoms, time spend with patients and different issues related to the COVID-19 (i.e., pneumonia, death, spread and cases). Third, topics related to the provider service quality, hospital servicescape and treatment cost were the most dominant topics in Stages I and II, while the quality of online information regarding COVID-19 and government countermeasures were the most dominant topics in Stage III. Fourth, when zooming into the topic-based sentiments analysis, hot topics in Stage I were mostly positive (joy be the dominant emotion), then negative (disgust be the dominant emotion) in Stage II. Furthermore, sentiments in the initial period of Stage III (COVID-19) were negative (anger be the dominant emotion), then transformed into positive (trust be the dominant emotion) later. The findings also revealed that the proposed method outperformed the conventional machine learning models in analyzing topic and sentiment dynamics expressed in PRWs. (4) Conclusions: Methodologically, this research demonstrates the ability and importance of computational techniques for analyzing large corpora of text and complementing conventional social science approaches.
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Schulz, Peter Johannes, and Fabia Rothenfluh. "Influence of Health Literacy on Effects of Patient Rating Websites: Survey Study Using a Hypothetical Situation and Fictitious Doctors." Journal of Medical Internet Research 22, no. 4 (April 6, 2020): e14134. http://dx.doi.org/10.2196/14134.
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Background Physician rating websites (PRWs) are a device people use actively and passively, although their objective capabilities are insufficient when it comes to judging the medical performance and qualification of physicians. PRWs are an innovation born of the potential of the Internet and boosted very much by the longstanding policy of improving and encouraging patient participation in medical decision-making. A mismatch is feared between patient motivations to participate and their capabilities of doing so well. Awareness of such a mismatch might contribute to some skepticism of patient-written physician reviews on PRWs. Objective We intend to test whether health literacy is able to dampen the effects that a patient-written review of a physician’s performance might have on physician choice. Methods An experiment was conducted within a survey interview. Participants were put into a fictitious decision situation in which they had to choose between two physicians on the basis of their profiles on a PRW. One of the physician profiles contained the experimental stimulus in the form of a friendly and a critical written review. The dependent variable was physician choice. An attitude differential, trust differential, and two measures of health literacy, the newest vital sign as an example of a performance-based measure and eHealth Literacy Scale as an example of a perception-based measure, were tested for roles as intermediary variables. Analysis traced the influence of the review tendency on the dependent variables and a possible moderating effect of health literacy on these influences. Results Reviews of a physician’s competence and medical skill affected participant choice of a physician. High health literacy dampened these effects only in the case of the perception-based measure and only for the negative review. Correspondingly, the effect of the review tendency appeared to be stronger for the positive review. Attitudes and trust only affected physician choice when included as covariants, considerably increasing the variance explained by regression models. Conclusions Findings sustain physician worries that even one negative PRW review can affect patient choice and damage doctors’ reputations. Hopes that health literacy might raise awareness of the poor basis of physician reviews and ratings given by patients have some foundation.
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Tymiński, Radosław, Michał Walczewski, and Michał Wieczorek. "Identifying patients' criteria for assessment of doctors on Polish physician rating websites." Journal of Medical Science 84, no. 3 (September 30, 2015): 189–96. http://dx.doi.org/10.20883/medical.e16.
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Introduction. Increasingly popular physician ranking websites have lately become a significant factor in choosing a physician.Aim. The aim of this study was to establish the criteria by which patients assessed doctors on PRWs and which of these criteria were the most crucial during the general assessment of the physicians.Material and methods. Selected narrative comments from two Polish PRWs: znanylekarz.pl and rankinglekarzy.pl were analysed on the basis of the following criteria: kindness and propriety, punctuality, communication with patients, condition and equipment of a doctor's office, length of the appointment, cost of the medical advice.Results. Out of 4375 eligible comments kindness and propriety was assessed most frequently (3012 comments, 68.85%), next was communication, which was evaluated in 2343 comments (53.55%). Amongst the 3012 comments with assessed kindness and propriety, 77.66% (2339 comments) were described positively. In the group of comments with positively evaluated kindness and propriety 2230 comments (95.34 %) were generally positive. Furthermore, communication with patient was assessed in 2343 comments and in 1827 cases (77.98%) the assessment was positive. 1810 comments with positively evaluated communication were generally positive (99.07%).Conclusions. There is a connection between the patients' positive assessment and physician's kindness, personal culture and communication skills; if physicians focus on the aforementioned abilities, it might lead to better physician perception, higher effectiveness of treatment and the lower number of potential law suits.
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Shah, Adnan Muhammad, Xiangbin Yan, Syed Asad Ali Shah, and Rizwan Ullah. "Exploring Important Aspects of Service Quality While Choosing a Good Doctor." International Journal of Healthcare Information Systems and Informatics 16, no. 4 (October 2021): 1–23. http://dx.doi.org/10.4018/ijhisi.20211001.oa11.
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Online reviews generated by patients on physician rating Websites (PRWs) have recently received much attention from physicians and their patients. In these reviews, patients exchange opinions as a diverse set of topics regarding different aspects of healthcare quality. This study aimed to propose a novel service quality-based text analytics (SQTA) model with other qualitative methods to mine different aspects of physicians and their clinical relevance in choosing a good doctor. Data included 45,560 online reviews that the authors scraped from a U.S.-based PRW (Healthgrades.com). The resulting topics demonstrate excellent classification results across different disease ranks, with overall accuracy and recall of 98%. The proposed classifier’s performance was 3% better than the existing topic classification methods applied in previous studies. The resulting clinically informative topics could help patients and physicians to maximize the usefulness of online reviews for efficient clinical decisions and improving the quality of care.
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DE SMET, L., PH ROBIJNS, and I. DEGREEF. "Proximal Row Carpectomy in Advanced Kienbock’s Disease." Journal of Hand Surgery 30, no. 6 (December 2005): 585–87. http://dx.doi.org/10.1016/j.jhsb.2005.06.024.
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This retrospective study assessed the outcomes of 21 patients (16 male and 5 female, mean age 39 years) with advanced Kienbock’s disease treated by resection of the proximal carpal row. They were clinically reviewed. The mean follow-up was 67 months, with all but two patients having had a follow-up of 2 years. No or mild pain was being experienced by 13 patients, moderate pain by 3 and severe pain by 5. Grip strength increased from 19 kg preoperatively to 26 kg postoperatively (or 65% of the normal contralateral side). There was a slight increase of mobility. The DASH score was 22 points (range 0–78) and the Patient Rated Wrist Score (PRWS) was 30 points (range 0–84). Two patients developed Complex Regional Pain Syndrome which was ongoing at the time of review and one developed a superficial wound infection. Proximal carpal row resection arthroplasty gave satisfactory results in patients with advanced Kienbock’s disease.
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Zhang, Xiaohong, Nan Sheng, and Rajab Ali Borzooei. "Partial Residuated Implications Induced by Partial Triangular Norms and Partial Residuated Lattices." Axioms 12, no. 1 (January 6, 2023): 63. http://dx.doi.org/10.3390/axioms12010063.
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This paper reveals some relations between fuzzy logic and quantum logic on partial residuated implications (PRIs) induced by partial t-norms as well as proposes partial residuated monoids (PRMs) and partial residuated lattices (PRLs) by defining partial adjoint pairs. First of all, we introduce the connection between lattice effect algebra and partial t-norms according to the concept of partial t-norms given by Borzooei, together with the proof that partial operation in any commutative quasiresiduated lattice is partial t-norm. Then, we offer the general form of PRI and the definition of partial fuzzy implication (PFI), give the condition that partial residuated implication is a fuzzy implication, and prove that each PRI is a PFI. Next, we propose PRLs, study their basic characteristics, discuss the correspondence between PRLs and lattice effect algebras (LEAs), and point out the relationship between LEAs and residuated partial algebras. In addition, like the definition of partial t-norms, we provide the notions of partial triangular conorms (partial t-conorms) and corresponding partial co-residuated lattices (PcRLs). Lastly, based on partial residuated lattices, we define well partial residuated lattices (wPRLs), study the filter of well partial residuated lattices, and then construct quotient structure of PRMs.
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Emmert, Martin, and Stuart McLennan. "One Decade of Online Patient Feedback: Longitudinal Analysis of Data From a German Physician Rating Website." Journal of Medical Internet Research 23, no. 7 (July 26, 2021): e24229. http://dx.doi.org/10.2196/24229.
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Background Feedback from patients is an essential element of a patient-oriented health care system. Physician rating websites (PRWs) are a key way patients can provide feedback online. This study analyzes an entire decade of online ratings for all medical specialties on a German PRW. Objective The aim of this study was to examine how ratings posted on a German PRW have developed over the past decade. In particular, it aimed to explore (1) the distribution of ratings according to time-related aspects (year, month, day of the week, and hour of the day) between 2010 and 2019, (2) the number of physicians with ratings, (3) the average number of ratings per physician, (4) the average rating, (5) whether differences exist between medical specialties, and (6) the characteristics of the patients rating physicians. Methods All scaled-survey online ratings that were posted on the German PRW jameda between 2010 and 2019 were obtained. Results In total, 1,906,146 ratings were posted on jameda between 2010 and 2019 for 127,921 physicians. The number of rated physicians increased constantly from 19,305 in 2010 to 82,511 in 2018. The average number of ratings per rated physicians increased from 1.65 (SD 1.56) in 2010 to 3.19 (SD 4.69) in 2019. Overall, 75.2% (1,432,624/1,906,146) of all ratings were in the best rating category of “very good,” and 5.7% (107,912/1,906,146) of the ratings were in the lowest category of “insufficient.” However, the mean of all ratings was 1.76 (SD 1.53) on the German school grade 6-point rating scale (1 being the best) with a relatively constant distribution over time. General practitioners, internists, and gynecologists received the highest number of ratings (343,242, 266,899, and 232,914, respectively). Male patients, those of higher age, and those covered by private health insurance gave significantly (P<.001) more favorable evaluations compared to their counterparts. Physicians with a lower number of ratings tended to receive ratings across the rating scale, while physicians with a higher number of ratings tended to have better ratings. Physicians with between 21 and 50 online ratings received the lowest ratings (mean 1.95, SD 0.84), while physicians with >100 ratings received the best ratings (mean 1.34, SD 0.47). Conclusions This study is one of the most comprehensive analyses of PRW ratings to date. More than half of all German physicians have been rated on jameda each year since 2016, and the overall average number of ratings per rated physicians nearly doubled over the decade. Nevertheless, we could also observe a decline in the number of ratings over the last 2 years. Future studies should investigate the most recent development in the number of ratings on both other German and international PRWs as well as reasons for the heterogeneity in online ratings by medical specialty.
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Garofolo, Garret, Sheriff D. Akinleye, Elan J. Golan, and Jack Choueka. "Utilization and Impact of Social Media in Hand Surgeon Practices." HAND 15, no. 1 (July 13, 2018): 75–80. http://dx.doi.org/10.1177/1558944718787285.
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Background: Social media is an effective tool to enhance reputation and brand recognition and is being used by more than 40% of patients when selecting a physician. This study aimed to evaluate the use of social media in hand surgeon practices, and to assess the impact that one’s social media presence has on physician-rating website scores (PRWs). Methods: Randomly selected hand surgeons from across the United States were identified. Sequential searches were performed using the physicians name + the respective social media platform (Facebook, LinkedIn, YouTube, Twitter, Instagram, personal website, group website). A comprehensive social media utilization index (SMI) was created for each surgeon. Utilizing descriptive statistics, we assessed the effect of social media on the PRW. Results: A total of 116 board-certified hand surgeons were included in our study. The sample identified 10.3% of the population used Facebook, 1.7% used Twitter, 25.8% used YouTube, 22.4% used LinkedIn, 27.5% used a personal website, and 36.2% used a group website, 0% used Instagram. The average SMI was 1.53 ± 1.42 (0-6). Physicians with a personal website received higher Healthgrades scores than those without one ( P < .05). Analysis of SMI demonstrated that hand surgeons with an index less than 3 received lower Healthgrades scores compared to those with an SMI above 3 ( P < .001). Conclusion: Hand surgeons underutilize social media platforms in their practice. A personal website is single most important social media platform to improve HealthGrades score in hand surgeons.
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Amano, Atsuo, Satoshi Shizukuishi, Hiroshi Horie, Shigenobu Kimura, Ichijiro Morisaki, and Shigeyuki Hamada. "Binding of Porphyromonas gingivalisFimbriae to Proline-Rich Glycoproteins in Parotid Saliva via a Domain Shared by Major Salivary Components." Infection and Immunity 66, no. 5 (May 1, 1998): 2072–77. http://dx.doi.org/10.1128/iai.66.5.2072-2077.1998.
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ABSTRACT Porphyromonas gingivalis, a putative periodontopathogen, can bind to human saliva through its fimbriae. We previously found that salivary components from the submandibular and sublingual glands bind to P. gingivalis fimbriae and that acidic proline-rich protein (PRP) and statherin function as receptor molecules for fimbriae. In this study, we investigated the fimbria-binding components in parotid saliva. Fractionated human parotid saliva by gel-filtration chromatography was immobilized onto nitrocellulose membranes for the overlay assay following sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The salivary components on the membrane were allowed to interact with fimbriae purified fromP. gingivalis ATCC 33277, and the interacted fimbriae were probed with anti-fimbria antibodies. The fimbriae were shown to bind to two forms of proline-rich glycoproteins (PRGs) as well as to acidic PRPs and statherin. Moreover, fimbriae bound to several components of smaller molecular size which appeared to be acidic PRP variants and basic PRPs. Fimbriae bound strongly to the purified PRGs adsorbed onto hydroxyapatite (HAP) beads. In contrast, PRGs in solution failed to inhibit the fimbrial binding to the immobilized PRGs on the HAP beads. These findings suggest that the appearance of binding site(s) of PRGs can be ascribed to their conformational changes. We previously identified the distinct segments within PRP and statherin molecules that are involved in fimbrial binding. The peptides analogous to the binding regions of PRP and statherin (i.e., PRP-C and STN-C) markedly inhibit the binding of fimbriae to PRP and statherin immobilized on the HAP beads, respectively. The PRP-C significantly inhibited the binding of fimbriae to PRG-coated HAP beads as well as to PRP on HAP beads. The peptide did not affect the binding of fimbriae to statherin, whereas the STN-C showed no effect on the fimbrial binding to PRPs or PRGs. In the overlay assay, the PRP-C clearly diminished the interactions between the fimbriae and the various salivary components, including PRPs, the PRGs, and the components with smaller molecular sizes but not statherin. These results strongly suggest that fimbriae bind to salivary components (except statherin) via common peptide segments. It is also suggested that fimbriae bind to saliva through the two distinct binding domains of receptory salivary components: (i) PRGs and PRPs and (ii) statherin.
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Beltrame, Thomas, and Richard L. Hughson. "Aerobic system analysis based on oxygen uptake and hip acceleration during random over-ground walking activities." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 312, no. 1 (January 1, 2017): R93—R100. http://dx.doi.org/10.1152/ajpregu.00381.2016.
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Deteriorated aerobic response to moderate exercise might precede the manifestation of clinical symptoms of noncommunicable diseases. The purpose of the current study was to verify that the use of current wearable technologies for analysis of pulmonary oxygen uptake (V̇o2) dynamics during a pseudorandom ternary sequence (PRTS) over-ground walking protocol is a suitable procedure for the investigation of the aerobic response in more realistic settings. A wearable accelerometer located at the hip assessed the magnitude of the input changes delivered to the aerobic system. Eight adults (24 ± 4 yr old, 174 ± 7 cm, and 71.4 ± 7.4 kg) performed two identical PRTS over-ground walking protocols. In addition, they performed on the cycle ergometer two identical pseudorandom binary sequence (PRBS) protocols and one incremental protocol for maximal V̇o2 determination. In the frequency domain, mean normalized gain amplitude (MNG in %) quantified V̇o2 dynamics. The MNG during PRTS was correlated ( r = −0.80, P = 0.01) with the V̇o2 time constant (τ) obtained during cycling. The MNG estimated during PRBS was similar to the MNG estimated during PRTS ( r = 0.80, P = 0.01). The maximal V̇o2 correlated with the MNG obtained during the PRBS ( r = 0.79, P = 0.01) and PRTS ( r = 0.78, P = 0.02) protocols. In conclusion, PRTS over-ground walking protocol can be used to evaluate the aerobic system dynamics by the simultaneous measurement of V̇o2 and hip acceleration. In addition, the aerobic response dynamics from PRBS and PRTS were correlated to maximal V̇o2. This study has shown that wearable technologies in combination with assessment of MNG, a novel indicator of system dynamics, open new possibilities to monitor cardiorespiratory health under conditions that better simulate activities of daily living than cardiopulmonary exercise testing performed in a medical environment.
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Kossmann, Maarten, and Benjamin D. Suchard. "A reconstruction of the system of verb aspects in proto-Berbero-Semitic." Bulletin of the School of Oriental and African Studies 81, no. 1 (February 2018): 41–56. http://dx.doi.org/10.1017/s0041977x17001355.
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AbstractSeveral verbal forms reconstructed for proto-Semitic strongly resemble reconstructed forms in proto-Berber: compare Semitic yV-PaRRaS to Berber y-əFăRRăS, Semitic yV-PRaS to Berber y-əFRăS, and Semitic yV-PRuS and yV-PRiS to Berber y-ăFRəS. We suggest that these forms are historically related and sketch a line of development from the reconstructed meanings to their attested uses. yVPaRRaS, originally imperfective, retains that value in both Berber and Semitic. yVPRas, originally stative, gained a perfective meaning in Berber and Semitic; the stative meaning is retained in Berber, but was largely lost in Semitic. yVPRus/yVPRiS, originally perfective, retained that meaning in Semitic, merging with the newly perfective yVPRas forms; in Berber, yVPRaS completely replaced perfective yVPRuS/yVPRiS, relegating the latter to non-aspectual uses. We conclude by considering the quality of the first vowel; the alternation seen in Berber y-əFRăS and y-ăFRəS supports reconstructions as yiPRaS and yaPRuS/yaPRiS, conforming to the Barth–Ginsberg Law of Semitic.
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Alghsham, Ruqaih, Zafar Rasheed, Ali Shariq, Abdullah S. Alkhamiss, Fahad A. Alhumaydhi, Abdullah S. M. Aljohani, Sami A. Althwab, et al. "Recognition of Pathogens and Their Inflammatory Signaling Events." Open Access Macedonian Journal of Medical Sciences 10, F (June 3, 2022): 462–67. http://dx.doi.org/10.3889/oamjms.2022.9184.
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The innate immune system is the main and first line of defense mechanism present in the human body, which acts against a foreign antigen. To function it utilize several mechanisms, among those are the primary one is recognizing the foreign antigen which is accomplished via decidedly complicated group of molecules termed as pattern recognition receptors (PRRs), which perceive various diverse structures present on the pathogen known as pathogen-associated molecular patterns (PAMPs). PRPs include several classes of receptors’, functions, and nature of these receptors vary from each other depending upon the molecular composition of PAMPs they detect. However, the Toll-like receptors (TLRs) are among the class of PRPs, which are studied widely. In this review, we have presented the contemporary understanding of pathogens recognition by various receptor classes including PRRs. In addition, we also discuss PRPs associated signaling pathways associated with antimicrobial immune response triggering.
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Wang, Ludi, Marina Triviño, Zongcheng Lin, José Carli, Deborah J. Eaves, Daniёl Van Damme, Moritz K. Nowack, Vernonica E. Franklin-Tong, and Maurice Bosch. "New opportunities and insights into Papaver self-incompatibility by imaging engineered Arabidopsis pollen." Journal of Experimental Botany 71, no. 8 (February 26, 2020): 2451–63. http://dx.doi.org/10.1093/jxb/eraa092.
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Abstract Pollen tube growth is essential for plant reproduction. Their rapid extension using polarized tip growth provides an exciting system for studying this specialized type of growth. Self-incompatibility (SI) is a genetically controlled mechanism to prevent self-fertilization. Mechanistically, one of the best-studied SI systems is that of Papaver rhoeas (poppy). This utilizes two S-determinants: stigma-expressed PrsS and pollen-expressed PrpS. Interaction of cognate PrpS–PrsS triggers a signalling network, causing rapid growth arrest and programmed cell death (PCD) in incompatible pollen. We previously demonstrated that transgenic Arabidopsis thaliana pollen expressing PrpS–green fluorescent protein (GFP) can respond to Papaver PrsS with remarkably similar responses to those observed in incompatible Papaver pollen. Here we describe recent advances using these transgenic plants combined with genetically encoded fluorescent probes to monitor SI-induced cellular alterations, including cytosolic calcium, pH, the actin cytoskeleton, clathrin-mediated endocytosis (CME), and the vacuole. This approach has allowed us to study the SI response in depth, using multiparameter live-cell imaging approaches that were not possible in Papaver. This lays the foundations for new opportunities to elucidate key mechanisms involved in SI. Here we establish that CME is disrupted in self-incompatible pollen. Moreover, we reveal new detailed information about F-actin remodelling in pollen tubes after SI.
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Zaat, T. R., J. P. de Bruin, M. Goddijn, J. Visser, E. M. Kaaijk, C. B. Lambalk, E. R. Groenewoud, M. van Wely, and F. Mol. "Home- or hospital-based monitoring to time frozen embryo transfer in the natural cycle? Patient-reported outcomes and experiences from the Antarctica-2 randomised controlled trial." Human Reproduction 35, no. 4 (April 2020): 866–75. http://dx.doi.org/10.1093/humrep/deaa040.
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ABSTRACT STUDY QUESTION What are the patient-reported outcomes (PROs) and patient-reported experiences (PREs) in home-based monitoring compared to those in hospital-based monitoring of ovulation for scheduling frozen–thawed embryo transfer (FET)? SUMMARY ANSWER Women undergoing either home-based or hospital-based monitoring experience an increase in anxiety/sadness symptoms over time, but women undergoing home-based monitoring felt more empowered during the treatment and classified the monitoring as more discreet compared to hospital-based monitoring. WHAT IS KNOWN ALREADY FET is at the heart of modern IVF. The two types of FET cycles that are mainly are used are artificial cycle FET, using artificial preparation of the endometrium with exogenous progesterone and oestrogen, and natural cycle FET (NC-FET). During a natural cycle FET, women visit the hospital repeatedly and receive an ovulation trigger to time FET (i.e. modified NC-FET or hospital-based monitoring). The previously published Antarctica randomised controlled trial (NTR 1586) showed that modified NC-FET is more cost-effective compared to artificial cycle FET. From the women’s point of view a more natural approach using home-based monitoring of ovulation with LH urine tests to time FET may be desired (true NC-FET or home-based monitoring). Currently, the multicentre Antarctica-2 randomised controlled trial (RCT) is comparing the cost-effectiveness of home-based monitoring of ovulation with that of hospital-based monitoring of ovulation. The Antarctica-2 RCT enables us to study PROs, defined as the view of participating women of their healthcare status, and PREs, defined as the perception of the received care of participating women, in both FET strategies. STUDY DESIGN, SIZE, DURATION PROs and PREs were assessed alongside the Antarctica-2 RCT. PROs were assessed using the validated EuroQol-5D-5L questionnaire. Currently, there are no guidelines for assessing PREs in this population. Therefore, members of the Dutch Patient Organisation for Couples with Fertility Problems (FREYA) filled out an online survey and selected the following PREs to assess (i) anxiety about missing ovulation, (ii) perceived level of partner participation, (iii) level of discretion, (iv) feeling of empowerment and (v) satisfaction with treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS Women participating in the RCT also participated in PRO and PRE assessment. We assessed PROs and PREs at three time points: (i) before randomisation, (ii) at the time of the FET and (iii) at the time of the pregnancy test. A sample size of 200 participants was needed to find a difference of 0.3 with a standard deviation in both groups of 0.7, an alpha of 5%, power of 80% and a drop-out rate of 10%. We performed mixed model analysis for between-group comparison of treatment and time effects. MAIN RESULTS AND ROLE OF CHANCE A total of 260 women were randomised. Of these, 132 women were treated with home-based monitoring and 128 women were treated with hospital-based monitoring. Data before randomisation were available for 232 women (home-based monitoring n = 116, hospital-based monitoring n = 116). For the PROs, we found a significant increase in anxiety/sadness symptoms over time (P < 0.001) in both groups. We found no treatment effect of home-based versus hospital-based monitoring for the PROs (P = 0.8). Concerning the PRES, we found that women felt more empowered during home-based monitoring (P = 0.001) and classified the home-based monitoring as more discreet (P = 0.000) compared to the hospital-based monitoring. LIMITATIONS, REASONS FOR CAUTION The results are applicable only to women undergoing NC-FET and not to women undergoing artificial cycle FET. WIDER IMPLICATIONS OF THE FINDINGS Apart from clinical outcomes, PROs and PREs are also of importance in clinical decision-making and to support tailoring treatment even more specifically to the wishes of patients. Measurement of PROs and PREs should therefore be incorporated in future clinical research. STUDY FUNDING/COMPETING INTEREST(S) The Antarctica-2 RCT is supported by a grant of the Netherlands Organisation for Health Research and Development (ZonMw 843002807). J.B. receives unconditional educational grants from Merck Serono and Ferring and is a member of the medical advisory board of Ferring. C.L. reports that his department receives unrestricted research grants from Ferring, Merck and Guerbet. E.G. receives personal fees from Titus Health Care outside submitted work. The remaining authors have no conflicts of interest. TRIAL REGISTRATION NUMBER Trial NL6414 (NTR6590) TRIAL REGISTER DATE 23 July 2017 DATE OF FIRST PATIENT’S ENROLMENT 10 April 2018
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Katsuki, Masahito, Dan Ozaki, Norio Narita, Naoya Ishida, Ohmi Watanabe, Siqi Cai, Shinya Shimabukuro, and Teiji Tominaga. "Unilateral posterior reversible encephalopathy syndrome characterized with a long and gradually exacerbating course over 3 years and that presented propofol infusion syndrome – A case report." Surgical Neurology International 12 (January 13, 2021): 19. http://dx.doi.org/10.25259/sni_853_2020.
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Background: Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurological symptoms and vasogenic edema, and most patients wholly recover. We report a unilateral PRES patient characterized by a gradual onset followed by propofol infusion syndrome (PRIS) due to general anesthesia therapy. Case Description: A 32-year-old woman had ovarian dysfunction treated by Kaufmann’s treatment for 17 years. Three years ago, she developed seizures, and photophobia and myoclonus sometimes occurred. This time, she had strong photophobia and nausea for 3 months and then developed tonic-clonic seizures for 3 min. Her blood pressure and laboratory test on admission were all within normal limits. She presented no neurological deficits at admission, but the T2-weighted image (T2WI) showed a high-intensity area (HIA), and arterial spin labeling (ASL) image described cerebral blood flow (CBF) increase in the left parieto-occipital region. We diagnosed PRES and started anticonvulsants, antihypertensive, and steroid pulse therapy. However, her aphasia and neuroimaging findings worsened, so we started general anesthesia treatment with propofol on day 29. On day 32, she suddenly developed multiple organ dysfunctions due to PRIS. After intensive care with other sedatives over 2 months, the systemic status and neurological symptoms gradually improved almost as before the onset. On day 90, HIA in the T2WI in the lesion became small, and CBF was severely downregulated in the ASL image. Conclusion: Unilateral PRES’s pathophysiology and the association with the female hormone remain unknown. Some patients undergo gradual onset and long-term courses, and we should care for PRIS during PRES treatment.
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Turusova, E. V., A. N. Lyshchikov, O. E. Nasakin, and A. V. Andreeva. "Formation of ionic associates with pyrogallol complexes of antimony (III) and their application for spectrophotometric determination of antimony." Industrial laboratory. Diagnostics of materials 85, no. 9 (September 28, 2019): 15–21. http://dx.doi.org/10.26896/1028-6861-2019-85-9-15-21.
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The possibility of using water soluble pyrogallol red (PRWS) as a photometric reagent for the quantitative determination of antimony (III) in real objects has been studied. Formation of a colored product is observed in acidic solutions (pH 3.8 - 4.5) with a weak oxidizing agent (iodine) present for preliminary oxidation of SbHg to salts of Sb (III). The excess iodine is eliminated through introduction of sodium thiosulfate solution after obtaining the photometric form. The maximum analytical signal of the colored form is observed at 378 nm (e = 5.936 x 103). A decrease in the acidity of the solution (pH > 7) is accompanied by the formation of sodium salts of the reagent which prevents further complexation, whereas the only one maximum in the absorbance within the recommended pH range directly indicates to the formation of the the only one ionic associate (AI). The ionic associate thus formed appeared low stability in time. Unfortunately, change in the dielectric constant of the solution failed to give a positive effect and measurements of the absorbance of the colored compound were limited to 3 minutes. Determination of the composition and possible mechanism of the ionic associate formation was carried out on using the methods of molar ratios and isomolar series. After stripping of stibine into the absorption system, an ionic associate of the composition M:R = 1:1 is formed with a calculated stability constant of 4.01 x 105. The obtained results are used to develop a spectrophotometric (SP) method for antimony determination with the limits of detection and quantitative determination of the element 1.30 and 4.32 pg/ml, respectively. The developed method is valid in terms of the specificity, linearity, precision and accuracy, and, therefore, can be recommended for determination of the antimony content in any control and analytical laboratory.
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Poulter, Natalie S., Michael J. Wheeler, Maurice Bosch, and Vernonica E. Franklin-Tong. "Self-incompatibility in Papaver: identification of the pollen S-determinant PrpS." Biochemical Society Transactions 38, no. 2 (March 22, 2010): 588–92. http://dx.doi.org/10.1042/bst0380588.
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Many flowering plants are hermaphrodite, posing the problem of self-fertilization and the subsequent loss of the genetic fitness of the offspring. To prevent this, many plants have developed a genetically controlled mechanism called self-incompatibility (SI). When the male and female S-determinants match, self (incompatible) pollen is recognized and rejected before fertilization can occur. In poppy (Papaver rhoeas), the pistil S-determinant (PrsS) is a small secreted protein that interacts with incompatible pollen, initiating a Ca2+-dependent signalling network. SI triggers several downstream events, including depolymerization of the cytoskeleton, phosphorylation of two soluble inorganic pyrophosphatases and an MAPK (mitogen-activated protein kinase). This culminates in PCD (programmed cell death) involving several caspase-like activities. The recent discovery of the Papaver pollen S-determinant PrpS marks a significant step forward in the understanding of the Papaver SI system. PrpS encodes a ~20 kDa predicted transmembrane protein which has no homology with known proteins. It is specifically expressed in pollen, linked to the pistil S-determinant, and displays the high polymorphism expected of an S-locus determinant. The present review focuses on the discovery and characterization of PrpS which strongly support the hypothesis that Papaver SI is triggered by the interaction of PrsS and PrpS.
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Ferrè, Francesca, Sabina De Rosis, Anna Maria Murante, Kendall Jamieson Gilmore, Matteo Ghilli, Donatella Mariniello, Sabina Nuti, and Manuela Roncella. "Systematic and continuous collection of patient-reported outcomes and experience in women with cancer undergoing mastectomy and immediate breast reconstruction: a study protocol for the Tuscany Region (Italy)." BMJ Open 11, no. 1 (January 2021): e042235. http://dx.doi.org/10.1136/bmjopen-2020-042235.
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IntroductionMonitoring how patients feel and what they experience during the care process gives health professionals data to improve the quality of care, and gives health systems information to better design and implement care pathways. To gain new insights about specific gaps and/or strengths in breast cancer care, we measure patient-reported outcomes (PROs) and patient-reported experiences (PREs) for women receiving immediate breast reconstruction (iBR).Methods and analysisProspective, multicentre, cohort study with continuous and systematic web-based data collection from women diagnosed with breast cancer, who have an indication for iBR after mastectomy treated at any Breast Unit (BU) in Tuscany Region (Italy). Patients are classified into one of two groups under conditions of routine clinical practice, based on the type of iBR planned (implant and autologous reconstruction). Patient-reported information are obtained prior to and after surgery (at 3-month and 12-month follow-up). We estimate that there are around 700 annual eligible patients.Descriptive analyses are used to assess trends in PROs over time and differences between types of iBR in PROs and PREs. Additionally, econometric models are used to analyse patient and BU characteristics associated with outcomes and experiences. PREs are evaluated to assess aspects of integrated care along the care pathway.Ethics and disseminationThe study has been reviewed and obtained a nihil obstat from the Tuscan Ethics Committees of the three Area Vasta in 2017. Dissemination of results will be via periodic report, journal articles and conference presentations.
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McCreary, Dylan L., Benjamin C. Sandberg, Debra C. Bohn, Harsh R. Parikh, and Brian P. Cunningham. "Interpreting Patient-Reported Outcome Results: Is One Minimum Clinically Important Difference Really Enough?" HAND 15, no. 3 (November 21, 2018): 360–64. http://dx.doi.org/10.1177/1558944718812180.
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Background: Patient-reported outcomes (PROs) are the gold standard for reporting clinical outcomes in research. A crucial component of interpreting PROs is the minimum clinically important difference (MCID). Patient-Rated Wrist Evaluation (PRWE) is a disease-specific PRO tool developed for use in distal radius fractures. The purpose of this study was to determine the influence of injury characteristics, treatment modality, and calculation methodology on the PRWE MCID in distal radius fractures. We hypothesize the MCID would be significantly influenced by each of these factors. Methods: From 2014 to 2016, 197 patients with a distal radius fracture were treated at a single level I trauma center. Each patient was asked to complete a PRWE survey at preoperative baseline, 6-week postoperative, and 12-week postoperative dates. The MCID was derived utilizing 2 distinct strategies, anchor and distribution. Anchor questions involved overall health anchor and mental and emotional health anchor. Patient variables regarding demographics, injury characteristics, and treatment modality were collected. Results: The MCID was unique between analytical methods at all time points. The distribution MCID presented commonality across assessed variables. However, the anchor MCID was unique by AO/OTA fracture classifications, treatment modality, and time points. Conclusions: Our study found the MCID was heavily influenced by assessment time points, analytical method, treatment modality, and fracture classification. These results suggest that to accurately interpret PRO data in clinical trials, an anchor question should be included so that the MCID can be determined for the specific patient population included in the study.
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Kane, Seth, Abby Thane, Michael Espinal, Kendra Lunday, Hakan Armağan, Adrienne Phillips, Chelsea Heveran, and Cecily Ryan. "Biomineralization of Plastic Waste to Improve the Strength of Plastic-Reinforced Cement Mortar." Materials 14, no. 8 (April 13, 2021): 1949. http://dx.doi.org/10.3390/ma14081949.
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The development of methods to reuse large volumes of plastic waste is essential to curb the environmental impact of plastic pollution. Plastic-reinforced cementitious materials (PRCs), such as plastic-reinforced mortar (PRM), may be potential avenues to productively use large quantities of low-value plastic waste. However, poor bonding between the plastic and cement matrix reduces the strength of PRCs, limiting its viable applications. In this study, calcium carbonate biomineralization techniques were applied to coat plastic waste and improved the compressive strength of PRM. Two biomineralization treatments were examined: enzymatically induced calcium carbonate precipitation (EICP) and microbially induced calcium carbonate precipitation (MICP). MICP treatment of polyethylene terephthalate (PET) resulted in PRMs with compressive strengths similar to that of plastic-free mortar and higher than the compressive strengths of PRMs with untreated or EICP-treated PET. Based on the results of this study, MICP was used to treat hard-to-recycle types 3–7 plastic waste. No plastics investigated in this study inhibited the MICP process. PRM samples with 5% MICP-treated polyvinyl chloride (PVC) and mixed type 3–7 plastic had compressive strengths similar to plastic-free mortar. These results indicate that MICP treatment can improve PRM strength and that MICP-treated PRM shows promise as a method to reuse plastic waste.
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Cabrit, René, Thierry Lambert, Marc Simard, Florence Jonquères, Nadine Delmont, and Philippe-François Bernard. "Données épidémiologiques sur près de 7200 patients pris en charge en nutrition entérale à domicile." Nutrition Clinique et Métabolisme 19, no. 2 (June 2005): 69–78. http://dx.doi.org/10.1016/j.nupar.2005.03.008.
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Rooh Ul Amin, Shahsawar Khan, and Jamaluddin. "Comparative Analysis of Public Relation Strategies & Practices in Peshawar Hospitals." Global Management Sciences Review V, no. IV (December 30, 2020): 31–39. http://dx.doi.org/10.31703/gmsr.2020(v-iv).04.
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This paper comparatively examines the Public Relation (PR) practices in public & private hospitals of Peshawar to investigate the practices followed by the Public Relation Officers (PROs) and the barriers they face in order to develop cordial ties between the internal and external public of health department for effective health care delivery. The Public Relation Departments (PRDs) are struggling to build strong bonds between the patients, accompaniers and health institutions. This research aims to examine the difference between PR practices of Peshawar's public and private hospitals by employing the Grunig and Hunts Four Models as a theoretical framework. The respondents were selected for the research via the purposive sampling technique. A semi-structured interview protocol was developed for this purpose. The study shows that the PROs in these hospitals follow none of the four models. It is recommended that hospitals should hire PR professionals, arrange health communication literacy seminars and conduct research for confidence building between the internal and external public of the health department.
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Murugan, Rajadurai. "Nutraceuticals: Pros and Cons." Chettinad Health City Medical Journal 11, no. 1 (March 30, 2022): 41–44. http://dx.doi.org/10.24321/2278.2044.202208.
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Málaga-Trillo, Edward, and Emily Sempou. "PrPs." Prion 3, no. 3 (July 2009): 129–33. http://dx.doi.org/10.4161/pri.3.3.9651.
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Dean, Blair. "PROS." Strength and Conditioning Journal 24, no. 2 (April 2002): 54. http://dx.doi.org/10.1519/00126548-200204000-00014.
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Burkhardt, Eric, and Tony Moreno. "PROS." Strength and Conditioning Journal 24, no. 6 (December 2002): 46. http://dx.doi.org/10.1519/00126548-200212000-00010.
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Eaves, Deborah J., Carlos Flores-Ortiz, Tamanna Haque, Zongcheng Lin, Nianjun Teng, and Vernonica E. Franklin-Tong. "Self-incompatibility in Papaver: advances in integrating the signalling network." Biochemical Society Transactions 42, no. 2 (March 20, 2014): 370–76. http://dx.doi.org/10.1042/bst20130248.
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Self-fertilization, which results in reduced fitness of offspring, is a common problem in hermaphrodite angiosperms. To prevent this, many plants utilize SI (self-incompatibility), which is determined by the multi-allelic S-locus, that allows discrimination between self (incompatible) and non-self (compatible) pollen by the pistil. In poppy (Papaver rhoeas), the pistil S-determinant (PrsS) is a small secreted protein which interacts with the pollen S-determinant PrpS, a ~20 kDa novel transmembrane protein. Interaction of matching pollen and pistil S-determinants results in self-recognition, initiating a Ca2+-dependent signalling network in incompatible pollen. This triggers several downstream events, including alterations to the cytoskeleton, phosphorylation of sPPases (soluble inorganic pyrophosphatases) and an MAPK (mitogen-activated protein kinase), increases in ROS (reactive oxygen species) and nitric oxide (NO), and activation of several caspase-like activities. This results in the inhibition of pollen tube growth, prevention of self-fertilization and ultimately PCD (programmed cell death) in incompatible pollen. The present review focuses on our current understanding of the integration of these signals with their targets in the SI/PCD network. We also discuss our recent functional expression of PrpS in Arabidopsis thaliana pollen.
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Zhao, Rong-Heng, Zi-Han Zhang, Wu-Quan He, Zong-Ke Lou, and Xiao-Yi Ma. "Synthetical Optimization of a Gravity-Driven Irrigation Pipeline Network System with Pressure-Regulating Facilities." Water 11, no. 5 (May 27, 2019): 1112. http://dx.doi.org/10.3390/w11051112.
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Due to the influence of topographic drops, a large elevation difference often occurs in the middle and lower sections of the main pipe of a gravity-driven irrigation pipe network (GDIPN) system. This elevation difference must be reduced appropriately through pressure reduction facilities (pressure-regulating ponds (PRPs) or pressure-reducing valves (PRVs)). The number and locations of PRPs are crucial factors in regulating and balancing the pressure head of the main pipe of a GDIPN system as well as in reducing the project cost. However, there are few studies on the optimization of this kind of pipe network system. In this paper, first, we generalize such type of GDIPN system, and a simplified mathematical model for such system optimization was established. A genetic algorithm based on a fixed proportion and direct comparison (GA-FPDC) was introduced to solve the model. Two existing projects were tested by the proposed method. The results show that the presented method not only improved the design efficiency and rationality but also greatly decreased the project cost. The presented method is effective and efficient to address optimization design of such GDIPN system problems.
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Lee, Dong-Hyun, Hong-Chan Roh, and Sang-Hyun Park. "PRMS: Page Reallocation Method for SSDs." KIPS Transactions:PartD 17D, no. 6 (December 31, 2010): 395–404. http://dx.doi.org/10.3745/kipstd.2010.17d.6.395.
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Islam, Mohammad Imnul, Manik Kumar Talukdar, and Shahanaa Rahman. "Pattern of Paediatric Rheumatic Diseases: An Experience in a Tertiary Care Hospital, Dhaka, Bangladesh." Bangladesh Journal of Child Health 37, no. 2 (December 4, 2013): 97–101. http://dx.doi.org/10.3329/bjch.v37i2.17267.
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Background: The importance of Paediatric Rheumatic Diseases (PRDs) is increasing globally day by day. These diseases are considered as important chronic cause of childhood morbidity and disability. It is recognized that early recognition and diagnosis as well as timely intervention can improve the outcome of PRDs. Objective: To estimate the pattern of PRDs and to compare the profile of JIA with other studies were done abroad. Method: Retrospective study was done in the paediatric rheumatology clinic and in patient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period from July 2007-December 2012. All the patients fulfilling the ILAR classification criteria of Juvenile idiopathic arthritis (JIA), ACR classification criteria of systemic lupus erythematosus ( SLE), PReS-EULAR-PRINTO classification criteria of childhood vasculitis Bohan A, Peter JB Classification criteria for juvenile dermatomyositis (JDM) and preliminary criteria for the classification of systemic sclerosis (SS) were enrolled in this study. Results: A total of 540 patients were enrolled. Highest number of patients had JIA (77%), which was followed by SLE (10%). Among childhood vasculitis, Henoch Shonlein purpura (HSP) was predominant (4.2%) followed by Polyarteritis nodosa (1.9%) and Kawasaki Disease (0.6%). Juvenile dermatomiositis (JDM), systemic sclerosis (SS) and rheumatic fever was also found in 1.6%, 1.3% and 3% cases respectively. Polyarticular JIA was the commonest type (33 %) in this series, followed by oligoarthritis, systemic onset and enthesitis related arthritis (ERA). Conclusion: JIA was the commonest among the paediatric rheumatic diseases followed by SLE and childhood vasculitis. DOI: http://dx.doi.org/10.3329/bjch.v37i2.17267 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 97-101
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Burger, C. J., S. J. van der Spuy, and T. W. von Backström. "Design of a Compact Crossover Diffuser for Micro Gas Turbines Using a Mean-Line Code." International Journal of Turbo & Jet-Engines 36, no. 4 (November 18, 2019): 347–57. http://dx.doi.org/10.1515/tjj-2017-0021.
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Abstract The design and validation of a Compact Crossover Diffuser (CCD) to replace the size-limited radial diffuser and axial de-swirl cascade of an existing Micro Gas Turbine (MGT) is discussed. A CCD strives to combine the performance of a channel diffuser with the operating range and efficiency of a vaneless diffuser. The development of a one-dimensional Mean-Line Code (MLC) is presented, which aids the designer in preliminary design and performance evaluation of the CCD. Design graphs indicating the performance effects of changing the primary design variables are developed and shown. The MLC is numerically validated using Computational Fluid Dynamics (CFD). Good agreement is seen between the MLC and CFD results, predicting the design point PRss(2-4) to within 1.4 %. A CFD optimized CCD was manufactured and tested. Agreement between the CFD and experimental results for PRts(0-4) is within 7.58 % at 106 kRPM. A numerically predicted increase in PRts(0-4) from 3.31, to 3.53, to 3.83 is seen for the vaneless-, MLC optimized-, and CFD optimized-design respectively. An experimental increase of 82.3 % in engine thrust and 80.0 % in total-to-static pressure recovery across the compressor stage was measured when retrofitting the BMT120KS with a new impeller and CCD.
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Thoma, Achilleas, and Felmont F. Eaves. "The Pros and Cons of the PROs." Aesthetic Surgery Journal 38, no. 3 (January 9, 2018): 343–45. http://dx.doi.org/10.1093/asj/sjx265.
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Martinelli, I. "Pros and cons of thrombophilia testing: pros." Journal of Thrombosis and Haemostasis 1, no. 3 (February 26, 2003): 410–11. http://dx.doi.org/10.1046/j.1538-7836.2003.00167.x.
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Małłek, Janusz. "The history of the landtag of the Duchy of Prussia in 1566." Masuro-Warmian Bulletin 306, no. 4 (January 30, 2020): 695–761. http://dx.doi.org/10.51974/kmw-134811.
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Artykuł poświęcony jest dziejom sejmu Prus Książęcych z roku 1566, który stał się przełomowym w relac�jach miedzy panującym ks. Albrechtem a stanami pruskimi oraz między lennem pruskim a państwem zwierzch�nim Polską. Jego rezultatem było udaremnienie absolutystycznego zamachu stanu tzw. nowych radców książę�cych i przejęcie na okres najbliższego dziesięciolecia de facto władzy w Księstwie Pruskim przez stany pruskie, a dokładniej przez oligarchię pruską. Była też szansa, choć niewykorzystana, wprowadzenia polskiego namiest�nika, który rządziłby księstwem z powodu niedołężności starego księcia Albrechta (1490–1568) i zbyt młodego do sprawowania tutaj władzy, bo 13-letniego księcia Albrechta Fryderyka. Jednak nadzór Polski nad księstwem został powiększony, choć w mniejszym zakresie. Zagwarantowano szlachcie pruskiej prawo zwracania się do króla polskiego i Korony Polskiej o pomoc w wypadku gdyby książę pruski naruszał jej przywileje. Poza tym władca ten, nie miał prawa zawiązywać żadnych sojuszów bez zgody Korony Polskiej i stanów pruskich.
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Jung, Il-Won, and Deg-Hyo Bae. "A Study on PRMS Applicability for Korean River Basin." Journal of Korea Water Resources Association 38, no. 9 (September 1, 2005): 713–25. http://dx.doi.org/10.3741/jkwra.2005.38.9.713.
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Sohn, Jun-Hyung, Sung-Ho Shin, Eun-Mi Lee, Soon-Tae Kim, Min-Hee Cho, and Mun-Jo Yun. "Seroprevalence of porcine reproductive and respiratory syndrome (PRRS) in Gyeongbuk province." Korean Journal of Veterinary Service 38, no. 1 (March 30, 2015): 9–12. http://dx.doi.org/10.7853/kjvs.2015.38.1.9.
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Ølberg, Bjørn. "Spesialiseringens pris." Stat & Styring 25, no. 02 (June 10, 2015): 50–51. http://dx.doi.org/10.18261/issn0809-750x-2015-02-18.
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Horkovičová, Kristína, Elena Hájková, and Vladimír Krásnik. "PRES Syndrome." Czech and Slovak Ophthalmology 76, no. 3 (October 10, 2020): 135–38. http://dx.doi.org/10.31348/2020/23.
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The aim of this review, as well as the case report, is to become familiar with the syndrome, although it is not very common, but may still be encountered by an ophthalmologist during clinical practice. It is also interesting to point out how the clinical unit can be independent and unchangeable in medicine and, on the other hand, in the context of the reversible posterior leukoencephalopathy syndrome (PRES syndrome), the name can be changed. As such, cortex blindness arises after complete destruction of the visual cortex of both occipital lobes, often as a result of vascular circulatory disorders. PRES syndrome is characterized by magnetic resonance imaging or computed tomography, where bilateral irregular hypodensive arteries are present in the occipital lobes that cause transient cortex blindness within the syndrome, which in its name carries the word reversible. Case report: A patient who was hospitalized at the Pneumology Department in which PRES syndrome and transient cortex blindness were diagnosed.