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• A nomogram for predicting hypoglycemia risk in critically ill patients with sepsis. • An online individualized predictive tool was developed. • Predictive model was validated externally in external validation cohort. Few studies have reported the risk factors or developed a risk predictive model of hypoglycemia patients with sepsis. To develop a predictive model to assess the hypoglycemia risk in critically ill patients with sepsis. For this retrospective study, we collected the data from the Medical Information Mart for Intensive Care III and IV (MIMIC-III and MIMIC-IV). All eligible patients from the MIMIC-III were randomly divided into the training set for development of predictive model and testing set for internal validation of the predictive model at a ratio of 8:2. Patients from the MIMIC-IV database were used as the external validation set. The primary endpoint was the occurrence of hypoglycemia. Univariate and multivariate logistic model was used to screen predictors. Adopted receiver operating characteristics (ROC) and calibration curves to estimate the performance of the nomogram. The median follow-up time was 5.13 (2.61–9.79) days. Diabetes, dyslipidemia, mean arterial pressure, anion gap, hematocrit, albumin, sequential organ failure assessment, vasopressors, mechanical ventilation and insulin were identified as the predictors for hypoglycemia risk in critically ill patients with sepsis. We constructed a nomogram for predicting hypoglycemia risk in critically ill patients with sepsis based on these predictors. An online individualized predictive tool: https://ghongyang.shinyapps.io/DynNomapp/. The established nomogram had a good predictive ability by ROC and calibration curves in the training set, testing set and external validation cohort. A predictive model of hypoglycemia risk was constructed, with a good ability in predicting the risk of hypoglycemia in critically ill patients with sepsis. [ABSTRACT FROM AUTHOR]

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In the search for solutions for Integrated Water Resources Management (IWRM), decision-makers frequently face governance-related challenges such as the fragmentation of institutions, the interconnection with other essential services and overlapping competences. In many cases, solutions to these challenges involve strengthening coordination between different actors and sectors. Today different digital tools and resources are available to support related decision-making processes. These tools can (1) offer a context-specific assessment of the water governance system ("Diagnosis") and (2) provide, in some cases, context-specific recommendations to tackle identified deficits ("Therapy"). In this paper, we aim to advance the understanding of the potential of digital tools for water governance and management assessments. After reviewing relevant tools, we introduce the Diagnostic Water Governance Tool (DWGT) that builds on a clear diagnosis-therapy-logic. After presenting the empirical basis and functional logic of the DWGT, we test the DWGT in two case studies: the Guadalquivir river basin in Spain and the Emscher river basin in Germany. We find that the DWGT provides context-specific, evidence-based instrument recommendations that can enhance water governance and management, albeit accompanying suitability evaluations by governance experts remain critical. We conclude by discussing the limitations of digital tools for water governance and management assessments and sketch out fields of future research. • Most water governance online tools do not allow for case-specific assessments. • Diagnostic Water Governance Tool identifies context-specific coordination deficits. • The Tool gives case-sensitive recommendations for governance instruments. • Fuzzy set Qualitative Comparative Analysis provides sound methodological framework. • The Tool's analysis can supplement but not replace expert evaluations. [ABSTRACT FROM AUTHOR]

Water demand strains supply capacity in the Mediterranean coastal areas, affecting negatively the maintenance of natural and cultural heritage. Tackling this subject, the "Coastal areas sustainable tourism water management in the Mediterranean - CASTWATER" project aims to support sustainable tourism water management in Mediterranean (MED) coastal areas, by improving the monitoring and assessment of the water sustainability performance of tourism. To this end, the elaboration of an online tool to monitor and assess sustainable tourism water management was envisaged and developed, primarily addressed to tourism sector small and medium-sized enterprises (SMEs). The CASTWATER online tool was designed to so as to provide two different functionalities. On the one hand, SMEs can self-evaluate their performance in sustainable water management and efficiently acknowledge possible actions that promote water efficiency in their tourism establishments. On the other hand, the tool measures, at both regional and local level, the levels of good governance and the effectiveness of water-tourism policies in order to improve sustainable water management. The approach presented in this work is heavily based on the initial technical specifications and end-user feedback, aiding SMEs in understanding, comparing, assessing and rating their performance regarding water efficiency and sustainable water management. [ABSTRACT FROM AUTHOR]

The Common Core State Standards is a set of standards released by the National Governors Association in June of 2010 and was adopted by 43 states, the District of Columbia, four territories, and the Department of Defense Education Activity (Common Core, 2015). The standards describe what students should know and be able to do in each subject in each grade. They are designed to be academically rigorous, while attainable for students and practical for teachers to teach. The purpose of this study was to investigate and compare the impact of two strategies (Lesson Design with Microsoft Word & Online Tool) used for improving inservice teachers' knowledge, skills and practices on Common Core State Standards (CCSS). This study was implemented with master's degree students (inservice teachers) who enrolled in two graduate level courses in a southeastern university. All of the students who volunteer to participate in the study were included as data source. The results of the study are beneficial to all teachers, districts, teacher education programs and preservice teachers. The study shows positive results that the course module; the activity and the online tool are effective. [ABSTRACT FROM AUTHOR]

People with special needs have always been an inseparable part of our society and that of our education system. If global figures are taken into consideration, we find that about 284 million people are visually impaired worldwide out of which 39 million are blind and 245 million have low vision. It also needs to be mentioned that 90 per cent of the world's visually impaired live in developing countries including India. The development of education for special children has been significant since independence through special schools but it never equalised educational opportunities, rather created a feeling of differentiation among children. The National Policy on Education (NPE, 1986) thus, promoted the concept of integrated education. Despite the numerous advantages of the NPE a visually impaired child faces lots of difficulties in Integrated Education. Although efforts have been made to provide them with equal opportunities; the visually impaired are still faced with numerous hurdles in their journey/pursuit of mainstream education. In India, there is an urgent need to reform the educational methodology for the visually impaired keeping in view their large numbers in the total population. The present paper tries to find out the possibilities of Podcasting as a tool for the effective learning of the visually impaired learners. [ABSTRACT FROM AUTHOR]

An online calculator (http://digiarhiiv.ut.ee/kalkulaator/) for statistical analysis of spatial data is introduced. The calculator is applicable in a wide range of spatial research and for courses involving spatial data analysis. The present version of the calculator contains 35 web pages for statistical functions with several options and settings. The input data for most functions are pure Cartesian coordinates and variable values, which should be copied to the input cell on the page of a particular spatial operation. The source code for the computational part of all functions is freely available in C# programming language. Examples are given for thinning spatially dense observation points to a predefined minimum distance, for calculating spatial autocorrelations, for creating habitat suitability maps and for generalising movement data into spatio-temporal clusters. [ABSTRACT FROM AUTHOR]

People with special needs have always been an inseparable part of our society and that of our education system. If global figures are taken into consideration, we find that about 284 million people are visually impaired worldwide out of which 39 million are blind and 245 million have low vision. It also needs to be mentioned that 90 per cent of the world's visually impaired live in developing countries including India. The development of education for special children has been significant since independence through special schools but it never equalised educational opportunities, rather created a feeling of differentiation among children. The National 1 Policy on Education (NPE, 1986) thus, promoted the concept of integrated education. Despite the numerous advantages of the NPE a visually impaired child faces lots of difficulties in Integrated Education. Although efforts have been made to provide them with equal opportunities; the visually impaired are still faced with numerous hurdles in their journey/pursuit of mainstream education. In India, there is an urgent need to reform the educational methodology for the visually impaired keeping in view their large numbers in the total population. The present paper tries to find out the possibilities of Podcasting as a tool for the effective learning of the visually impaired learners. [ABSTRACT FROM AUTHOR]

Background: Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy.Objective: We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not.Methods: We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety.Results: Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, P<.001; without: mean 8.53, SD 9.4, P<.001) and severity of cannabis use (SDS: with: mean 3.57, SD 3.65, P<.001; without: mean 2.47, SD 3.39, P<.001; CUDIT: with: mean 6.38, SD 5.96, P<.001; without: mean 5.33, SD 6.05, P<.001), as well as anxiety (with: mean 4.31, SD 4.71, P<.001; without: mean 1.84, SD 4.22, P<.001) and depression (with: mean 10.25, SD 10.54; without: mean 4.39, SD 10.22, P<.001). Those who screened positive for attention deficit/hyperactivity disorder also reported significantly decreased attention deficit/hyperactivity disorder scores (mean 4.65, SD 4.44, P<.001). There were no significant differences in change in use (P=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=-0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=-0.09; P=.43). The same was true for the rate of adverse effects (P=.33).Conclusions: Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program's advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users.Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185. [ABSTRACT FROM AUTHOR]

Blogs have evolved from "What's New" Pages and they become arguably the most popular online personal publishing platform on the Internet. Blogs also known as weblogs. are websites that contain frequently updated posts" with the most recent entry at the top and the previous ones displayed reverse-chronologically. The homepages of ten University Libraries' Weblogs were selected for studying the criteria like date of content posted, links to archives, most recent entries, add links, comment facility, subject coverage, links to in-house sources, links to externals sources, and frequency of posting entries to weblog. Finally data is presented in statistical form and conclusion and suggestions are drawn. [ABSTRACT FROM AUTHOR]

The importance of spiritual care for the nursing profession has been long established. In many health care settings, including oncology, patients facing illness, suffering, and imminent death can struggle with existential questions of purpose and meaning-making. Recent research provided a competency-based educational framework to prepare nurses and nursing students to address these spiritual needs. This qualitative study evaluated the impact of the implementation of online educational tools across four nursing bachelor's programs to acquire competencies focused on addressing spiritual care needs. Results showed that the tool added to the awareness of students and impacted among between students, teachers, and patient. The results underscored the need for structural and methodical implementation of technically challenging online tools because this impacts the feasibility and applicability of blended learning. [ABSTRACT FROM AUTHOR]

Background: Italy has experienced severe consequences (ie, hospitalizations and deaths) during the COVID-19 pandemic. Online decision support systems (DSS) and self-triage applications have been used in several settings to supplement health authority recommendations to prevent and manage COVID-19. A digital Italian health tech startup, Paginemediche, developed a noncommercial, online DSS with a chat user interface to assist individuals in Italy manage their potential exposure to COVID-19 and interpret their symptoms since early in the pandemic.Objective: This study aimed to compare the trend in online DSS sessions with that of COVID-19 cases reported by the national health surveillance system in Italy, from February 2020 to March 2021.Methods: We compared the number of sessions by users with a COVID-19-positive contact and users with COVID-19-compatible symptoms with the number of cases reported by the national surveillance system. To calculate the distance between the time series, we used the dynamic time warping algorithm. We applied Symbolic Aggregate approXimation (SAX) encoding to the time series in 1-week periods. We calculated the Hamming distance between the SAX strings. We shifted time series of online DSS sessions 1 week ahead. We measured the improvement in Hamming distance to verify the hypothesis that online DSS sessions anticipate the trends in cases reported to the official surveillance system.Results: We analyzed 75,557 sessions in the online DSS; 65,207 were sessions by symptomatic users, while 19,062 were by contacts of individuals with COVID-19. The highest number of online DSS sessions was recorded early in the pandemic. Second and third peaks were observed in October 2020 and March 2021, respectively, preceding the surge in notified COVID-19 cases by approximately 1 week. The distance between sessions by users with COVID-19 contacts and reported cases calculated by dynamic time warping was 61.23; the distance between sessions by symptomatic users was 93.72. The time series of users with a COVID-19 contact was more consistent with the trend in confirmed cases. With the 1-week shift, the Hamming distance between the time series of sessions by users with a COVID-19 contact and reported cases improved from 0.49 to 0.46. We repeated the analysis, restricting the time window to between July 2020 and December 2020. The corresponding Hamming distance was 0.16 before and improved to 0.08 after the time shift.Conclusions: Temporal trends in the number of online COVID-19 DSS sessions may precede the trend in reported COVID-19 cases through traditional surveillance. The trends in sessions by users with a contact with COVID-19 may better predict reported cases of COVID-19 than sessions by symptomatic users. Data from online DSS may represent a useful supplement to traditional surveillance and support the identification of early warning signals in the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Since the outbreak of COVID-19, the development of dashboards as dynamic, visual tools for communicating COVID-19 data has surged worldwide. Dashboards can inform decision-making and support behavior change. To do so, they must be actionable. The features that constitute an actionable dashboard in the context of the COVID-19 pandemic have not been rigorously assessed.Objective: The aim of this study is to explore the characteristics of public web-based COVID-19 dashboards by assessing their purpose and users ("why"), content and data ("what"), and analyses and displays ("how" they communicate COVID-19 data), and ultimately to appraise the common features of highly actionable dashboards.Methods: We conducted a descriptive assessment and scoring using nominal group technique with an international panel of experts (n=17) on a global sample of COVID-19 dashboards in July 2020. The sequence of steps included multimethod sampling of dashboards; development and piloting of an assessment tool; data extraction and an initial round of actionability scoring; a workshop based on a preliminary analysis of the results; and reconsideration of actionability scores followed by joint determination of common features of highly actionable dashboards. We used descriptive statistics and thematic analysis to explore the findings by research question.Results: A total of 158 dashboards from 53 countries were assessed. Dashboards were predominately developed by government authorities (100/158, 63.0%) and were national (93/158, 58.9%) in scope. We found that only 20 of the 158 dashboards (12.7%) stated both their primary purpose and intended audience. Nearly all dashboards reported epidemiological indicators (155/158, 98.1%), followed by health system management indicators (85/158, 53.8%), whereas indicators on social and economic impact and behavioral insights were the least reported (7/158, 4.4% and 2/158, 1.3%, respectively). Approximately a quarter of the dashboards (39/158, 24.7%) did not report their data sources. The dashboards predominately reported time trends and disaggregated data by two geographic levels and by age and sex. The dashboards used an average of 2.2 types of displays (SD 0.86); these were mostly graphs and maps, followed by tables. To support data interpretation, color-coding was common (93/158, 89.4%), although only one-fifth of the dashboards (31/158, 19.6%) included text explaining the quality and meaning of the data. In total, 20/158 dashboards (12.7%) were appraised as highly actionable, and seven common features were identified between them. Actionable COVID-19 dashboards (1) know their audience and information needs; (2) manage the type, volume, and flow of displayed information; (3) report data sources and methods clearly; (4) link time trends to policy decisions; (5) provide data that are "close to home"; (6) break down the population into relevant subgroups; and (7) use storytelling and visual cues.Conclusions: COVID-19 dashboards are diverse in the why, what, and how by which they communicate insights on the pandemic and support data-driven decision-making. To leverage their full potential, dashboard developers should consider adopting the seven actionability features identified. [ABSTRACT FROM AUTHOR]

Background: Patient-facing digital health tools have been promoted to help patients manage concerns related to COVID-19 and to enable remote care and self-care during the COVID-19 pandemic. It has also been suggested that these tools can help further our understanding of the clinical characteristics of this new disease. However, there is limited information on the characteristics and use patterns of these tools in practice.Objective: The aims of this study are to describe the characteristics of people who use digital health tools to address COVID-19-related concerns; explore their self-reported symptoms and characterize the association of these symptoms with COVID-19; and characterize the recommendations provided by digital health tools.Methods: This study used data from three digital health tools on the K Health app: a protocol-based COVID-19 self-assessment, an artificial intelligence (AI)-driven symptom checker, and communication with remote physicians. Deidentified data were extracted on the demographic and clinical characteristics of adults seeking COVID-19-related health information between April 8 and June 20, 2020. Analyses included exploring features associated with COVID-19 positivity and features associated with the choice to communicate with a remote physician.Results: During the period assessed, 71,619 individuals completed the COVID-19 self-assessment, 41,425 also used the AI-driven symptom checker, and 2523 consulted with remote physicians. Individuals who used the COVID-19 self-assessment were predominantly female (51,845/71,619, 72.4%), with a mean age of 34.5 years (SD 13.9). Testing for COVID-19 was reported by 2901 users, of whom 433 (14.9%) reported testing positive. Users who tested positive for COVID-19 were more likely to have reported loss of smell or taste (relative rate [RR] 6.66, 95% CI 5.53-7.94) and other established COVID-19 symptoms as well as ocular symptoms. Users communicating with a remote physician were more likely to have been recommended by the self-assessment to undergo immediate medical evaluation due to the presence of severe symptoms (RR 1.19, 95% CI 1.02-1.32). Most consultations with remote physicians (1940/2523, 76.9%) were resolved without need for referral to an in-person visit or to the emergency department.Conclusions: Our results suggest that digital health tools can help support remote care and self-management of COVID-19 and that self-reported symptoms from digital interactions can extend our understanding of the symptoms associated with COVID-19. [ABSTRACT FROM AUTHOR]

A wiki can be a useful collaborative Web tool for managing virtual teamwork. Although a wiki is easy to use, the challenge comes with enlisting team members to adopt a wiki for collaborative projects. This article describes uses of a wiki, challenges to maintaining virtual teams, and five recommendations for implementation by universities, agencies, and institutions. [ABSTRACT FROM AUTHOR]