Analyzing shifts in age-related macular degeneration research trends since 2014: A bibliometric study with triple-map Sankey diagrams (TMSD)

BACKGROUND

Age-related macular degeneration (AMD) is the primary cause of vision impairment in older adults, especially in developed countries. While many articles on AMD exist in the literature, none specifically delve into the trends based on document categories. While bibliometric studies typically use dual-map overlays to highlight new trends, these can become congested and unclear with standard formats (e.g., in CiteSpace software). In this study, we introduce a unique triple-map Sankey diagram (TMSD) to assess the evolution of AMD research. Our objective is to understand the nuances of AMD articles and show the effectiveness of TMSD in determining whether AMD research trends have shifted over the past decade.

METHODS

We collected 7465 articles and review pieces related to AMD written by ophthalmologists from the Web of Science core collection, accumulating article metadata from 2014 onward. To delve into the characteristics of these AMD articles, we employed various visualization methods, with a special focus on TMSD to track research evolution. We adopted the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model, complemented by the follower-leading clustering algorithm (FLCA) for clustering analysis. This synergistic approach proved efficient in identifying and showcasing research focal points and budding trends using network charts within the DDPP framework.

RESULTS

Our findings indicate that: in countries, institutes, years, authors, and journals, the dominant entities were the United States, the University of Bonn in Germany, the year 2021, Dr Jae Hui Kim from South Korea, and the journal "Retina"; in accordance with the TMSD, AMD research trends have not changed significantly since 2014, as the top 4 categories for 3 citing, active, and cited articles have not changed, in sequence (Ophthalmology, Science & Technology - Other Topics, General & Internal Medicine, Pharmacology & Pharmacy).

CONCLUSION

The introduced TMSD, which incorporates the FLCA algorithm and features in 3 columns-cited, active, and citing research categories-offers readers clearer insights into research developments compared to the traditional dual-map overlays from CiteSpace software. Such tools are especially valuable for streamlining the visualization of the intricate data often seen in bibliometric studies.

Citation trends in ophthalmology articles and keywords in mainland China, Hong Kong, and Taiwan since 2013 using temporal bar graphs (TBGs): Bibliometric analysis

BACKGROUND

We selected authors from mainland China, Hong Kong, and Taiwan (CHT) to examine citation trends on articles and keywords. The existence of suitable temporal bar graphs (TBGs) for displaying citation trends is unknown. It is necessary to enhance the traditional TBGs to provide readers with more information about the citation trend. The purpose of this study was to propose an advanced TBG that can be applied to understand the most worth-reading articles by ophthalmology authors in the CHT.

METHODS

Using the search engine of the Web of Science core collection, we conducted bibliometric analyses to examine the article citation trends of ophthalmology authors in CHT since 2013. A total of 6695 metadata was collected from articles and review articles. Using radar plots, the Y-index, and the combining the Y-index with the CJAL scores (CJAL) scores, we could determine the dominance of publications by year, region, institute, journal, department, and author. A choropleth map, a dot plot, and a 4-quadrant radar plot were used to visualize the results. A TBG was designed and provided for readers to display citation trends on articles and keywords.

RESULTS

We found that the majority of publications were published in 2017 (2275), Shanghai city (935), Sun Yat-Sen University (China) (689), the international journal Ophthalmology (1399), the Department of Ophthalmology (3035), and the author Peizeng Yang (Chongqing) (65); the highest CAJL scores were also from Guangdong (2767.22), Sun Yat-Sen University (China) (2147.35), and the Ophthalmology Department (7130.96); the author Peizeng Yang (Chongqing) (170.16) had the highest CAJL; and the enhanced TBG features maximum counts and recent growth trends that are not included in traditional TBGs.

CONCLUSION

Using the Y-index and the CJAL score compared with research achievements of ophthalmology authors in CHT, a 4-quadrant radar plot was provided. The enhanced TBGs and the CJAL scores are recommended for future bibliographical studies.

Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: An observational study

BACKGROUND

An important factor in understanding the spread of COVID-19 is the case fatality rate (CFR) for each county. However, many of research reported CFRs on total confirmed cases (TCCs) rather than per 100,000 people. The disparate definitions of CFR in COVID-19 result in inconsistent results. It remains uncertain whether the incident rate and CFR can be compared to identify countries affected by COVID-19 that are under (or out of) control. This study aims to develop a diagram for dispersing TCC and CFR on a population of 100,000 (namely, TCC100 and CFR100) using the Kano model, to examine selected countries/regions that have successfully implemented preventative measures to keep COVID-19 under control, and to design an app displaying TCC100 and CFR100 for all infected countries/regions.

METHODS

Data regarding confirmed cases and deaths of COVID-19 in countries/regions were downloaded daily from the GitHub website. For each country/region, 3 values (TCC100, CFR100, and CFR) were calculated and displayed on the Kano diagram. The lower TCC100 and CFR values indicated that the COVID-19 situation was more under control. The app was developed to display both CFR100/CFR against TCC100 on Google Maps.

RESULTS

Based on 286 countries/regions, the correlation coefficient (CC) between TCC100 and CFR100 was 0.51 (t = 9.76) in comparison to TCC100 and CFR with CC = 0.02 (t = 0.3). As a result of the traditional scatter plot using CFR and TCC100, Andorra was found to have the highest CFR100 (=6.62%), TCC100 (=935.74), and CFR (=5.1%), but lower CFR than New York (CFR = 7.4%) and the UK (CFR = 13.5%). There were 3 representative countries/regions that were compared: Taiwan [TCC100 (=1.65), CFR100 (=2.17), CFR (=1%)], South Korea [TCC100 (=20.34), CFR100 (=39.8), CFR (=2%), and Vietnam [TCC100 (=0.26), CFR100 (=0), CFR (=0%)].

CONCLUSION

A Kano diagram was drawn to compare TCC100 against CFT (or CFR100) to gain a better understanding of COVID-19. There is a strong association between a higher TCC100 value and a higher CFR100 value. A dashboard was developed to display both CFR100/CFR against TCC100 for countries/regions.

An app for predicting nurse intention to quit the job using artificial neural networks (ANNs) in Microsoft Excel

Background:

Numerous studies have identified factors related to nurses’ intention to leave. However, none has successfully predicted the nurse’s intention to quit the job. Whether the intention to quit the job can be predicted is an interesting topic in healthcare settings. A model to predict the nurse’s intention to quit the job for novice nurses should be investigated. The aim of this study is to build a model to develop an app for the automatic prediction and classification of nurses’ intention to quit their jobs.

Methods:

We recruited 1104 novice nurses working in 6 medical centers in Taiwan to complete 100-item questionnaires related to the nurse’s intention to quit the job in October 2018. The k-mean was used to divide nurses into 2 classes based on 5 items regarding leave intention. Feature variables were selected from the 100-item survey. Two models, including an artificial neural network (ANN) and a convolutional neural network, were compared across 4 scenarios made up of 2 training sets (n = 1104 and n = 804 ≅ 70%) and their corresponding testing (n = 300 ≅ 30%) sets to verify the model accuracy. An app for predicting the nurse’s intention to quit the job was then developed as a website assessment.

Results:

We observed that 24 feature variables extracted from this study in the ANN model yielded a higher area under the ROC curve of 0.82 (95% CI 0.80-0.84) based on the 1104 cases, the ANN performed better than the convolutional neural network on the accuracy, and a ready and available app for predicting the nurse’s intention to quit the job was successfully developed in this study.

Conclusions:

A 24-item ANN model with 53 parameters estimated by the ANN was developed to improve the accuracy of nurses’ intention to quit their jobs. The app would help team leaders take care of nurses who intend to quit the job before their actions are taken.

Key Points

Using sentiment analysis to identify similarities and differences in research topics and medical subject headings (MeSH terms) between Medicine (Baltimore) and the Journal of the Formosan Medical Association (JFMA) in 2020: A bibliometric study

Background:

Little systematic information has been collected about the nature and types of articles published in 2 journals by identifying the latent topics and analyzing the extracted research themes and sentiments using text mining and machine learning within the 2020 time frame. The goals of this study were to conduct a content analysis of articles published in 2 journals, describe the research type, identify possible gaps, and propose future agendas for readers.

Methods:

We downloaded 5610 abstracts in the journals of Medicine (Baltimore) and the Journal of the Formosan Medical Association (JFMA) from the PubMed library in 2020. Sentiment analysis (ie, opinion mining using a natural language processing technique) was performed to determine whether the article abstract was positive or negative toward sentiment to help readers capture article characteristics from journals. Cluster analysis was used to identify article topics based on medical subject headings (MeSH terms) using social network analysis (SNA). Forest plots were applied to distinguish the similarities and differences in article mood and MeSH terms between these 2 journals. The Q statistic and I 2 index were used to evaluate the difference in proportions of MeSH terms in journals.

Results:

The comparison of research topics between the 2 journals using the 737 cited articles was made and found that most authors are from mainland China and Taiwan in Medicine and JFMA, respectively, similarity is supported by observing the abstract mood (Q = 8.3, I 2 = 0, P = .68; Z = 0.46, P = .65), 2 journals are in a common cluster (named latent topic of patient and treatment) using SNA, and difference in overall effect was found by the odds ratios of MeSH terms (Q = 185.5 I 2 = 89.8, P < .001; Z = 5.93, P < .001) and a greater proportion of COVID-19 articles in JFMA.

Conclusions:

SNA and forest plots were provided to readers with deep insight into the relationships between journals in research topics using MeSH terms. The results of this research provide readers with a concept diagram for future submissions to a given journal.

Highlights

The main approaches frequently used in Meta-analysis for drawing forest plots contributed to the following:

Comparison of prediction accuracies between mathematical models to make projections of confirmed cases during the COVID-19 pandamic by country/region

BACKGROUND

The COVID-19 pandemic caused >0.228 billion infected cases as of September 18, 2021, implying an exponential growth for infection worldwide. Many mathematical models have been proposed to predict the future cumulative number of infected cases (CNICs). Nevertheless, none compared their prediction accuracies in models. In this work, we compared mathematical models recently published in scholarly journals and designed online dashboards that present actual information about COVID-19.

METHODS

All CNICs were downloaded from GitHub. Comparison of model R2 was made in 3 models based on quadratic equation (QE), modified QE (OE-m), and item response theory (IRT) using paired-t test and analysis of variance (ANOVA). The Kano diagram was applied to display the association and the difference in model R2 on a dashboard.

RESULTS

We observed that the correlation coefficient was 0.48 (t = 9.87, n = 265) between QE and IRT models based on R2 when modeling CNICs in a short run (dated from January 1 to February 16, 2021). A significant difference in R2 was found (P < .001, F = 53.32) in mean R2 of 0.98, 0.92, and 0.84 for IRT, OE-mm, and QE, respectively. The IRT-based COVID-19 model is superior to the counterparts of QE-m and QE in model R2 particularly in a longer period of infected days (i.e., in the entire year in 2020).

CONCLUSION

An online dashboard was demonstrated to display the association and difference in prediction accuracy among predictive models. The IRT mathematical model was recommended to make projections about the evolution of CNICs for each county/region in future applications, not just limited to the COVID-19 epidemic.

Using the absolute advantage coefficient (AAC) to measure the strength of damage hit by COVID-19 in India on a growth-share matrix

BACKGROUND

The COVID-19 pandemic occurred and rapidly spread around the world. Some online dashboards have included essential features on a world map. However, only transforming data into visualizations for countries/regions is insufficient for the public need. This study aims to (1) develop an algorithm for classifying countries/regions into four quadrants inn GSM and (2) design an app for a better understanding of the COVID-19 situation.

METHODS

We downloaded COVID-19 outbreak numbers daily from the Github website, including 189 countries/regions. A four-quadrant diagram was applied to present the classification of each country/region using Google Maps run on dashboards. A novel presentation scheme was used to identify the most struck entities by observing (1) the multiply infection rate (MIR) and (2) the growth trend in the recent 7 days. Four clusters of the COVID-19 outbreak were dynamically classified. An app based on a dashboard aimed at public understanding of the outbreak types and visualizing of the COVID-19 pandemic with Google Maps run on dashboards. The absolute advantage coefficient (AAC) was used to measure the damage hit by COVID-19 referred to the next two countries severely hit by COVID-19.

RESULTS

We found that the two hypotheses were supported: India (i) is in the increasing status as of April 28, 2021; (ii) has a substantially higher ACC(= 0.81 > 0.70), and (iii) has a substantially higher ACC(= 0.66 < 0.70) as of May 17, 2021.

CONCLUSION

Four clusters of the COVID-19 outbreak were dynamically classified online on an app making the public understand the outbreak types of COVID-19 pandemic shown on dashboards. The app with GSM and AAC is recommended for researchers in other disease outbreaks, not just limited to COVID-19.

Predicting Active NBA Players Most Likely to Be Inducted into the Basketball Hall of Famers Using Artificial Neural Networks in Microsoft Excel: Development and Usability Study

The prediction of whether active NBA players can be inducted into the Hall of Fame (HOF) is interesting and important. However, no such research have been published in the literature, particularly using the artificial neural network (ANN) technique. The aim of this study is to build an ANN model with an app for automatic prediction and classification of HOF for NBA players. We downloaded 4728 NBA players’ data of career stats and accolades from the website at basketball-reference.com. The training sample was collected from 85 HOF members and 113 retired Non-HOF players based on completed data and a longer career length (≥15 years). Featured variables were taken from the higher correlation coefficients (<0.1) with HOF and significant deviations apart from the two HOF/Non-HOF groups using logistical regression. Two models (i.e., ANN and convolutional neural network, CNN) were compared in model accuracy (e.g., sensitivity, specificity, area under the receiver operating characteristic curve, AUC). An app predicting HOF was then developed involving the model’s parameters. We observed that (1) 20 feature variables in the ANN model yielded a higher AUC of 0.93 (95% CI 0.93–0.97) based on the 198-case training sample, (2) the ANN performed better than CNN on the accuracy of AUC (= 0.91, 95% CI 0.87–0.95), and (3) an ready and available app for predicting HOF was successfully developed. The 20-variable ANN model with the 53 parameters estimated by the ANN for improving the accuracy of HOF has been developed. The app can help NBA fans to predict their players likely to be inducted into the HOF and is not just limited to the active NBA players.

Suitability of h- and x-indices for evaluating authors' individual research achievements in a given short period of years: A bibliometric analysis

BACKGROUND

The h-index of a researcher refers to the maximum number h of his/her publications that has at least h citations via the concept of the square area. The x-index is determined by the maximum area of a rectangle under the curve to interpret authors' individual research achievements (IRAs). However, the properties of both metrics have not been compared and discussed before. This study aimed to investigate whether both metrics of h- and x-index are suitable for evaluating IRAs in a short period of years.

METHODS

By searching the PubMed database (Pubmed.com), we used the keyword "PLoS One" (journal) and downloaded 50,000 articles published in 2015 and 2016. A total of 146,346 citations were listed in PubMed Central and 27,035 authors(with h-index ≥1) were divided into 3 parts. Correlation coefficients among metrics (ie, AIF, h, g, Ag, and x-index) were examined. The bootstrapping method used for estimating 95% confidence intervals was applied to compare differences in metrics among author groups. The most cited authors and topic burst were visualized by social network analysis. The most prominent countries/areas were highlighted by the x-index and displayed via choropleth maps.

RESULTS

Results demonstrated that, first, the h-index had the least relation to other metrics and failed to differentiate authors' IRAs among groups, particularly in a short time period. Second, the top 3 highest x-index for countries were the United States, China, and the UK but with the productivity-oriented feature. Third, the most cited medical subject headings (ie, MeSH terms) were genome, metabolome, and microbiology, and the most cited author was Lori Newman (whose x-index = 13.52, and h = 2) from Switzerland with the article (PMID = 26646541) cited 291 times. The need for the x-index combined with a visual map for displaying authors' IRAs was verified and recommended.

CONCLUSIONS

We verified that the h-index failed to differentiate authors' IRAs among author groups in a short time period. The x-index combined with the Kano map is recommended in research for a better understanding of the authors' IRAs in other journals or disciplines, not just limited to the journal of PloS One as we did in this study.

An online time-to-event dashboard comparing the effective control of COVID-19 among continents using the inflection point on an ogive curve: Observational study

BACKGROUND

During the COVID-19 pandemic, one of the frequently asked questions is which countries (or continents) are severely hit. Aside from using the number of confirmed cases and the fatality to measure the impact caused by COVID-19, few adopted the inflection point (IP) to represent the control capability of COVID-19. How to determine the IP days related to the capability is still unclear. This study aims to (i) build a predictive model based on item response theory (IRT) to determine the IP for countries, and (ii) compare which countries (or continents) are hit most.

METHODS

We downloaded COVID-19 outbreak data of the number of confirmed cases in all countries as of October 19, 2020. The IRT-based predictive model was built to determine the pandemic IP for each country. A model building scheme was demonstrated to fit the number of cumulative infected cases. Model parameters were estimated using the Solver add-in tool in Microsoft Excel. The absolute advantage coefficient (AAC) was computed to track the IP at the minimum of incremental points on a given ogive curve. The time-to-event analysis (a.k.a. survival analysis) was performed to compare the difference in IPs among continents using the area under the curve (AUC) and the respective 95% confidence intervals (CIs). An online comparative dashboard was created on Google Maps to present the epidemic prediction for each country.

RESULTS

The top 3 countries that were hit severely by COVID-19 were France, Malaysia, and Nepal, with IP days at 263, 262, and 262, respectively. The top 3 continents that were hit most based on IP days were Europe, South America, and North America, with their AUCs and 95% CIs at 0.73 (0.61-0.86), 0.58 (0.31-0.84), and 0.54 (0.44-0.64), respectively. An online time-event result was demonstrated and shown on Google Maps, comparing the IP probabilities across continents.

CONCLUSION

An IRT modeling scheme fitting the epidemic data was used to predict the length of IP days. Europe, particularly France, was hit seriously by COVID-19 based on the IP days. The IRT model incorporated with AAC is recommended to determine the pandemic IP.

Using Social Network Analysis to Identify Spatiotemporal Spread Patterns of COVID-19 around the World: Online Dashboard Development

The COVID-19 pandemic has spread widely around the world. Many mathematical models have been proposed to investigate the inflection point (IP) and the spread pattern of COVID-19. However, no researchers have applied social network analysis (SNA) to cluster their characteristics. We aimed to illustrate the use of SNA to identify the spread clusters of COVID-19. Cumulative numbers of infected cases (CNICs) in countries/regions were downloaded from GitHub. The CNIC patterns were extracted from SNA based on CNICs between countries/regions. The item response model (IRT) was applied to create a general predictive model for each country/region. The IP days were obtained from the IRT model. The location parameters in continents, China, and the United States were compared. The results showed that (1) three clusters (255, n = 51, 130, and 74 in patterns from Eastern Asia and Europe to America) were separated using SNA, (2) China had a shorter mean IP and smaller mean location parameter than other counterparts, and (3) an online dashboard was used to display the clusters along with IP days for each country/region. Spatiotemporal spread patterns can be clustered using SNA and correlation coefficients (CCs). A dashboard with spread clusters and IP days is recommended to epidemiologists and researchers and is not limited to the COVID-19 pandemic.

The Use of hx-index to compare research achievements for ophthalmology authors in Mainland China, Hong Kong, and Taiwan since 2010

BACKGROUND:

Ophthalmology authors in mainland China, Hong Kong, or Taiwan were interested in knowing their individual research achievements (IRAs). This study was to evaluate the most cited authors, institutes, and regions in the mainland, Hong Kong, and Taiwan in the field of ophthalmology in the recent 10 years using the hx-index and to display the result with visual representations.

METHODS:

Using the PubMed search engine to download data, we conducted an observational study of citation analyses in affiliated research institutes and regions (provinces/areas) of all ophthalmology authors since 2010. A total of 19,364 published articles from 22,393 authors in the mainland, Hong Kong, and Taiwan were analyzed. The x-index and the Kano model were complemental to the hx-index in identifying IRAs. A pyramid plot was used to illustrate the importance of the author-weighted scheme (AWS) used in evaluating IRAs in academics. The hx-index combining both advantages of the h and x-index was proposed to assess individual IRAs. Furthermore, we drew: 1. a choropleth map on Google Maps to visualize the differences of IRA among regions and 2. a visual display to present individual hx-indexes.

RESULTS:

There is a significant rise over time in the number of publications. The top-ranking regions in hx-index were Shanghai (26.82), Guangdong (25.82), and Beijing (25.81). We demonstrated that Dr Wu from Taiwan published 144 articles in PMC and used the example to explain the importance of AWS when IRAs were assessed.

CONCLUSIONS:

With an overall increase in publications in the field of ophthalmology, contributions assessed by hx-indexes and the AWS should be encouraged and promoted more in the future.

Using Kano diagrams to display the most cited article types, affiliated countries, authors and MeSH terms on spinal surgery in recent 12 years

Background

Citation analysis has been increasingly applied to assess the quantity and quality of scientific research in various fields worldwide. However, these analyses on spinal surgery do not provide visualization of results. This study aims (1) to evaluate the worldwide research citations and publications on spinal surgery and (2) to provide visual representations using Kano diagrams onto the research analysis for spinal surgeons and researchers.

Methods

Article abstracts published between 2007 and 2018 were downloaded from PubMed Central (PMC) in 5 journals, including Spine, European Spine Journal, The Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques. The article types, affiliated countries, authors, and Medical subject headings (MeSH terms) were analyzed by the number of article citations using x-index. Choropleth maps and Kano diagrams were applied to present these results. The trends of MeSH terms over the years were plotted and analyzed.

Results

A total of 18,808 publications were extracted from the PMC database, and 17,245 were affiliated to countries/areas. The 12-year impact factor for the five spine journals is 5.758. We observed that (1) the largest number of articles on spinal surgery was from North America (6417, 37.21%). Spine earns the highest x-index (= 82.96). Comparative Study has the highest x-index (= 66.74) among all article types. (2) The United States performed exceptionally in x-indexes (= 56.86 and 44.5) on both analyses done on the total 18,808 and the top 100 most cited articles, respectively. The most influential author whose x-index reaches 15.11 was Simon Dagenais from the US. (3) The most cited MeSH term with an x-index of 23.05 was surgery based on the top 100 most cited articles. The most cited article (PMID = 18164449) was written by Dagenais and his colleagues in 2008. The most productive author was Michael G. Fehlings, whose x-index and the author's impact factor are 13.57(= √(13.16*14)) and 9.86(= 331.57/33.64), respectively.

Conclusions

There was a rapidly increasing scientific productivity in the field of spinal surgery in the past 12 years. The US has extraordinary contributions to the publications. Furthermore, China and Japan have increasing numbers of publications on spinal surgery. This study with Kano diagrams provides an insight into the research for spinal surgeons and researchers.

Predicting article citations using data of 100 top-cited publications in the journal Medicine since 2011: A bibliometric analysis

BACKGROUND

Publications regarding the 100 top-cited articles in a given discipline are common, but studies reporting the association between article topics and their citations are lacking. Whether or not reviews and original articles have a higher impact factor than case reports is a point for verification in this study. In addition, article topics that can be used for predicting citations have not been analyzed. Thus, this study aims to METHODS:: We searched PubMed Central and downloaded 100 top-cited abstracts in the journal Medicine (Baltimore) since 2011. Four article types and 7 topic categories (denoted by MeSH terms) were extracted from abstracts. Contributors to these 100 top-cited articles were analyzed. Social network analysis and Sankey diagram analysis were performed to identify influential article types and topic categories. MeSH terms were applied to predict the number of article citations. We then examined the prediction power with the correlation coefficients between MeSH weights and article citations.

RESULTS

The citation counts for the 100 articles ranged from 24 to 127, with an average of 39.1 citations. The most frequent article types were journal articles (82%) and comparative studies (10%), and the most frequent topics were epidemiology (48%) and blood and immunology (36%). The most productive countries were the United States (24%) and China (23%). The most cited article (PDID = 27258521) with a count of 135 was written by Dr Shang from Shandong Provincial Hospital Affiliated to Shandong University (China) in 2016. MeSH terms were evident in the prediction power of the number of article citations (correlation coefficients  = 0.49, t = 5.62).

CONCLUSION

The breakthrough was made by developing dashboards showing the overall concept of the 100 top-cited articles using the Sankey diagram. MeSH terms can be used for predicting article citations. Analyzing the 100 top-cited articles could help future academic pursuits and applications in other academic disciplines.

Using the bootstrapping method to verify whether hospital physicians have different h-indexes regarding individual research achievement: A bibliometric analysis

BACKGROUND

Individual researchers' achievements (IRA) are determined by both personal publications and article citations such as Author Impact Factor, h-index, and x-index. Due to those indicators not truly supporting a normal distribution, the traditional t-test and Analysis of variance are not allowed for RA comparison in groups. The objective of this study is to use the bootstrapping method to verify whether hospital physicians have different h-indexes.

METHODS

We downloaded 63,266 journal articles with their corresponding citations for 2128 researchers from a Taiwan university website on December 10, 2019. Their IRAs were assessed using the bibliometric h-index. A pyramid plot was used to compare the h-index patterns between institutes. The x-index and the Kano model were found to be complemental to the h-index for identifying the group IRA characteristics and rankings, including colleges and departments in the university study, the School of Medicine, and the Affiliated Hospital. The bootstrapping method was applied with an estimated 95% confidence interval (CI) to distinguish the differences in physicians between the Internal Medicine and Surgery departments. The stronger-than-the-next coefficient (SC) for the highest represents the RA strength.

RESULTS

The highest h-indices were found in the College of Engineering, School of Medicine, and the Department of Internal Medicine in groups of colleges (SC = 0.71), all departments (SC = 0.83), the School of Medicine (SC = 0.74), and the Affiliated Hospital (SC = 0.56), respectively. No difference in h-index for hospital physicians was found between departments in Internal Medicine (Mean = 2.14, 95% CI = 1.02,3.26) and Surgery (mean = 2.5, 95%CI = 1.48, 3.52).

CONCLUSIONS

The x-index and the Kano models can complement the h-index for identifying group IRA characteristics. The bootstrapping method allows estimation of the sampling distribution for almost any statistic using random sampling methods and gains measures of accuracy (as defined by 95% CI). The finding of no difference in h-index for hospital physicians between departments in Internal Medicine and Surgery requires further investigation in the future.

An App for Classifying Personal Mental Illness at Workplace Using Fit Statistics and Convolutional Neural Networks: Survey-Based Quantitative Study

BACKGROUND

Mental illness (MI) is common among those who work in health care settings. Whether MI is related to employees' mental status at work is yet to be determined. An MI app is developed and proposed to help employees assess their mental status in the hope of detecting MI at an earlier stage.

OBJECTIVE

This study aims to build a model using convolutional neural networks (CNNs) and fit statistics based on 2 aspects of measures and outfit mean square errors for the automatic detection and classification of personal MI at the workplace using the emotional labor and mental health (ELMH) questionnaire, so as to equip the staff in assessing and understanding their own mental status with an app on their mobile device.

METHODS

We recruited 352 respiratory therapists (RTs) working in Taiwan medical centers and regional hospitals to fill out the 44-item ELMH questionnaire in March 2019. The exploratory factor analysis (EFA), Rasch analysis, and CNN were used as unsupervised and supervised learnings for (1) dividing RTs into 4 classes (ie, MI, false MI, health, and false health) and (2) building an ELMH predictive model to estimate 108 parameters of the CNN model. We calculated the prediction accuracy rate and created an app for classifying MI for RTs at the workplace as a web-based assessment.

RESULTS

We observed that (1) 8 domains in ELMH were retained by EFA, (2) 4 types of mental health (n=6, 63, 265, and 18 located in 4 quadrants) were classified using the Rasch analysis, (3) the 44-item model yields a higher accuracy rate (0.92), and (4) an MI app available for RTs predicting MI was successfully developed and demonstrated in this study.

CONCLUSIONS

The 44-item model with 108 parameters was estimated by using CNN to improve the accuracy of mental health for RTs. An MI app developed to help RTs self-detect work-related MI at an early stage should be made more available and viable in the future.

Therapeutic Duplication in Taiwan Hospitals for Patients With High Blood Pressure, Sugar, and Lipids: Evaluation With a Mobile Health Mapping Tool

BACKGROUND

Cardiovascular disease causes approximately half of all deaths in patients with type 2 diabetes. Duplicative prescriptions of medication in patients with high blood pressure (hypertension), high blood sugar (hyperglycemia), and high blood lipids (hyperlipidemia) have attracted substantial attention regarding the abuse of health care resources and to implement preventive measures for such abuse. Duplicative prescriptions may occur by patients receiving redundant medications for the same condition from two or more sources such as doctors, hospitals, and multiple providers, or as a result of the patient's wandering among hospitals.

OBJECTIVE

We evaluated the degree of duplicative prescriptions in Taiwanese hospitals for outpatients with three types of medications (antihypertension, antihyperglycemia, and antihyperlipidemia), and then used an online dashboard based on mobile health (mHealth) on a map to determine whether the situation has improved in the recent 25 fiscal quarters.

METHODS

Data on duplicate prescription rates of drugs for the three conditions were downloaded from the website of Taiwan's National Health Insurance Administration (TNHIA) from the third quarter of 2010 to the third quarter of 2016. Complete data on antihypertension, antihyperglycemia, and antihyperlipidemia prescriptions were obtained from 408, 414, and 359 hospitals, respectively. We used scale quality indicators to assess the attributes of the study data, created a dashboard that can be traced using mHealth, and selected the hospital type with the best performance regarding improvement on duplicate prescriptions for the three types of drugs using the weighted scores on an online dashboard. Kendall coefficient of concordance (W) was used to evaluate whether the performance rankings were unanimous.

RESULTS

The data quality was found to be acceptable and showed good reliability and construct validity. The online dashboard using mHealth on Google Maps allowed for easy and clear interpretation of duplicative prescriptions regarding hospital performance using multidisciplinary functionalities, and showed significant improvement in the reduction of duplicative prescriptions among all types of hospitals. Medical centers and regional hospitals showed better performance with improvement in the three types of duplicative prescriptions compared with the district hospitals. Kendall W was 0.78, indicating that the performance rankings were not unanimous (Chi square₂=4.67, P=.10).

CONCLUSIONS

This demonstration of a dashboard using mHealth on a map can inspire using the 42 other quality indicators of the TNHIA by hospitals in the future.

Geographic risk assessment of COVID-19 transmission using recent data: An observational study

BACKGROUND

The US Centers for Disease Control and Prevention (CDC) regularly issues "travel health notices" that address disease outbreaks of novel coronavirus disease (COVID)-19 in destinations worldwide. The notices are classified into 3 levels based on the risk posed by the outbreak and what precautions should be in place to prevent spreading. What objectively observed criteria of these COVID-19 situations are required for classification and visualization? This study aimed to visualize the epidemic outbreak and the provisional case fatality rate (CFR) using the Rasch model and Bayes's theorem and developed an algorithm that classifies countries/regions into categories that are then shown on Google Maps.

METHODS

We downloaded daily COVID-19 outbreak numbers for countries/regions from the GitHub website, which contains information on confirmed cases in more than 30 Chinese locations and other countries/regions. The Rasch model was used to estimate the epidemic outbreak for each country/region using data from recent days. All responses were transformed by using the logarithm function. The Bayes's base CFRs were computed for each region. The geographic risk of transmission of the COVID-19 epidemic was thus determined using both magnitudes (i.e., Rasch scores and CFRs) for each country.

RESULTS

The top 7 countries were Iran, South Korea, Italy, Germany, Spain, China (Hubei), and France, with values of {4.53, 3.47, 3.18, 1.65, 1.34 1.13, 1.06} and {13.69%, 0.91%, 47.71%, 0.23%, 24.44%, 3.56%, and 16.22%} for the outbreak magnitudes and CFRs, respectively. The results were consistent with the US CDC travel advisories of warning level 3 in China, Iran, and most European countries and of level 2 in South Korea on March 16, 2020.

CONCLUSION

We created an online algorithm that used the CFRs to display the geographic risks to understand COVID-19 transmission. The app was developed to display which countries had higher travel risks and aid with the understanding of the outbreak situation.

Evaluating the research domain and achievement for a productive researcher who published 114 sole-author articles: A bibliometric analysis

BACKGROUND

Team science research includes authors from various fields collaborating to publish their work on certain topics. Despite the numerous papers that discussed the ordering of author names and the contributions of authors to an article, no paper evaluatedIn addition, few researchers publish academic articles without co-author collaboration. Whether the bibliometric indexes (eg, h-/x-index) of sole-author researchers are higher than those of other types of multiple authors is required for comparison. We aimed to evaluate a productive author who published 114 sole-author articles with exceptional RA and RD in academics.

METHODS

By searching the PubMed database (Pubmed.com), we used the keyword of (Taiwan[affiliation]) from 2016 to 2017 and downloaded 29,356 articles. One physician (Dr. Tseng from the field of Internal Medicine) who published 12 articles as a single author was selected. His articles and citations were searched in PubMed. A comparison of various types of author ordering placements was conducted using sensitivity analysis to inspect whether this sole author earns the highest metrics in RA. Social network analysis (SNA), Gini coefficient (GC), pyramid plot, and the Kano diagram were applied to gather the following data for visualization: RESULTS:: We observed that CONCLUSIONS:: The metrics on RA are high for the sole author studied. The author's RD can be denoted by the MeSH terms and measured by the GC. The author-weighted scheme is required for quantifying author credits in an article to evaluate the author's RA. Social network analysis incorporating the Kano diagrams provided insights into the relationships between actors (eg, coauthors, MeSH terms, or journals). The methods used in this study can be replicated to evaluate other productive studies on RA and RD in the future.

The computation of case fatality rate for novel coronavirus (COVID-19) based on Bayes theorem: An observational study

BACKGROUND

When a new disease such starts to spread, the commonly asked questions are how deadly is it? and how many people are likely to die of this outbreak? The World Health Organization (WHO) announced in a press conference on January 29, 2020 that the death rate of COVID-19 was 2% on the case fatality rate (CFR). It was underestimated assuming no lag days from symptom onset to deaths while many CFR formulas have been proposed, the estimation on Bays theorem is worthy of interpretation. Hence, it is hypothesized that the over-loaded burdens of treating patients and capacities to contain the outbreak (LSBHRS) may increase the CFR.

METHODS

We downloaded COVID-19 outbreak numbers from January 21 to February 14, 2020, in countries/regions on a daily basis from Github that contains information on confirmed cases in >30 Chinese locations and other countries/regions. The pros and cons were compared among the 5 formula of CFR, including [A] deaths/confirmed; [B] deaths/(deaths + recovered); [C] deaths/(cases x days ago); [D] Bayes estimation based on [A] and the outbreak (LSBHRS) in each country/region; and [E] Bayes estimation based on [C] deaths/(cases x days ago). The coefficients of variance (CV = the ratio of the standard deviation to the mean) were applied to measure the relative variability for each CFR. A dashboard was developed for daily display of the CFR across each region.

RESULTS

The Bayes based on (A)[D] has the lowest CV (=0.10) followed by the deaths/confirmed (=0.11) [A], deaths/(deaths + recoveries) (=0.42) [B], Bayes based on (C) (=0.49) [E], and deaths/(cases x days ago) (=0.59) [C]. All final CFRs will be equal using the formula (from, A to E). A dashboard was developed for the daily reporting of the CFR. The CFR (3.7%) greater than the prior CFR of 2.2% was evident in LSBHRS, increasing the CFR. A dashboard was created to present the CFRs on COVID-19.

CONCLUSION

We suggest examining both trends of the Bayes based on both deaths/(cases 7 days ago) and deaths/confirmed cases as a reference to the final CFR. An app developed for displaying the provisional CFR with the 2 CFR trends can improve the underestimated CFR reported by WHO and media.

An App for Detecting Bullying of Nurses Using Convolutional Neural Networks and Web-Based Computerized Adaptive Testing: Development and Usability Study

Background

Workplace bullying has been measured in many studies to investigate its effects on mental health issues. However, none have used web-based computerized adaptive testing (CAT) with bully classifications and convolutional neural networks (CNN) for reporting the extent of individual bullying in the workplace.

Objective

This study aims to build a model using CNN to develop an app for automatic detection and classification of nurse bullying-levels, incorporated with online Rasch computerized adaptive testing, to help assess nurse bullying at an earlier stage.

Methods

We recruited 960 nurses working in a Taiwan Ch-Mei hospital group to fill out the 22-item Negative Acts Questionnaire-Revised (NAQ-R) in August 2012. The k-mean and the CNN were used as unsupervised and supervised learnings, respectively, for: (1) dividing nurses into three classes (n=918, 29, and 13 with suspicious mild, moderate, and severe extent of being bullied, respectively); and (2) building a bully prediction model to estimate 69 different parameters. Finally, data were separated into training and testing sets in a proportion of 70:30, where the former was used to predict the latter. We calculated the sensitivity, specificity, and receiver operating characteristic curve (area under the curve [AUC]), along with the accuracy across studies for comparison. An app predicting the respondent bullying-level was developed, involving the model’s 69 estimated parameters and the online Rasch CAT module as a website assessment.

Results

We observed that: (1) the 22-item model yields higher accuracy rates for three categories, with an accuracy of 94% for the total 960 cases, and accuracies of 99% (AUC 0.99; 95% CI 0.99-1.00) and 83% (AUC 0.94; 95% CI 0.82-0.99) for the lower and upper groups (cutoff points at 49 and 66 points) based on the 947 cases and 42 cases, respectively; and (2) the 700-case training set, with 95% accuracy, predicts the 260-case testing set reaching an accuracy of 97. Thus, a NAQ-R app for nurses that predicts bullying-level was successfully developed and demonstrated in this study.

Conclusions

The 22-item CNN model, combined with the Rasch online CAT, is recommended for improving the accuracy of the nurse NAQ-R assessment. An app developed for helping nurses self-assess workplace bullying at an early stage is required for application in the future.

An App Developed for Detecting Nurse Burnouts Using the Convolutional Neural Networks in Microsoft Excel: Population-Based Questionnaire Study

Background

Burnout (BO), a critical syndrome particularly for nurses in health care settings, substantially affects their physical and psychological status, the institute’s well-being, and indirectly, patient outcomes. However, objectively classifying BO levels has not been defined and noticed in the literature.

Objective

The aim of this study is to build a model using the convolutional neural network (CNN) to develop an app for automatic detection and classification of nurse BO using the Maslach Burnout Inventory–Human Services Survey (MBI-HSS) to help assess nurse BO at an earlier stage.

Methods

We recruited 1002 nurses working in a medical center in Taiwan to complete the Chinese version of the 20-item MBI-HSS in August 2016. The k-mean and CNN were used as unsupervised and supervised learnings for dividing nurses into two classes (n=531 and n=471 of suspicious BO+ and BO−, respectively) and building a BO predictive model to estimate 38 parameters. Data were separated into training and testing sets in a proportion 70%:30%, and the former was used to predict the latter. We calculated the sensitivity, specificity, and receiver operating characteristic curve (area under the curve) across studies for comparison. An app predicting respondent BO was developed involving the model’s 38 estimated parameters for a website assessment.

Results

We observed that (1) the 20-item model yields a higher accuracy rate (0.95) with an area under the curve of 0.97 (95% CI 0.94-0.95) based on the 1002 cases, (2) the scheme named matching personal response to adapt for the correct classification in model drives the prior model’s predictive accuracy at 100%, (3) the 700-case training set with 0.96 accuracy predicts the 302-case testing set reaching an accuracy of 0.91, and (4) an available MBI-HSS app for nurses predicting BO was successfully developed and demonstrated in this study.

Conclusions

The 20-item model with the 38 parameters estimated by using CNN for improving the accuracy of nurse BO has been particularly demonstrated in Excel (Microsoft Corp). An app developed for helping nurses to self-assess job BO at an early stage is required for application in the future.

The Most-Cited Authors Who Published Papers in JMIR mHealth and uHealth Using the Authorship-Weighted Scheme: Bibliometric Analysis

Background

Many previous papers have investigated most-cited articles or most productive authors in academics, but few have studied most-cited authors. Two challenges are faced in doing so, one of which is that some different authors will have the same name in the bibliometric data, and the second is that coauthors’ contributions are different in the article byline. No study has dealt with the matter of duplicate names in bibliometric data. Although betweenness centrality (BC) is one of the most popular degrees of density in social network analysis (SNA), few have applied the BC algorithm to interpret a network’s characteristics. A quantitative scheme must be used for calculating weighted author credits and then applying the metrics in comparison.

Objective

This study aimed to apply the BC algorithm to examine possible identical names in a network and report the most-cited authors for a journal related to international mobile health (mHealth) research.

Methods

We obtained 676 abstracts from Medline based on the keywords “JMIR mHealth and uHealth” (Journal) on June 30, 2018. The author names, countries/areas, and author-defined keywords were recorded. The BCs were then calculated for the following: (1) the most-cited authors displayed on Google Maps; (2) the geographical distribution of countries/areas for the first author; and (3) the keywords dispersed by BC and related to article topics in comparison on citation indices. Pajek software was used to yield the BC for each entity (or node). Bibliometric indices, including h-, g-, and x-indexes, the mean of core articles on g(Ag)=sum (citations on g-core/publications on g-core), and author impact factor (AIF), were applied.

Results

We found that the most-cited author was Sherif M Badawy (from the United States), who had published six articles on JMIR mHealth and uHealth with high bibliometric indices (h=3; AIF=8.47; x=4.68; Ag=5.26). We also found that the two countries with the highest BC were the United States and the United Kingdom and that the two keyword clusters of mHealth and telemedicine earned the highest indices in comparison to other counterparts. All visual representations were successfully displayed on Google Maps.

Conclusions

The most cited authors were selected using the authorship-weighted scheme (AWS), and the keywords of mHealth and telemedicine were more highly cited than other counterparts. The results on Google Maps are novel and unique as knowledge concept maps for understanding the feature of a journal. The research approaches used in this study (ie, BC and AWS) can be applied to other bibliometric analyses in the future.

An App for Identifying Children at Risk for Developmental Problems Using Multidimensional Computerized Adaptive Testing: Development and Usability Study

BACKGROUND

The use of multidomain developmental screening tools is a viable strategy for pediatric professionals to identify children at risk for developmental problems. However, a specialized multidimensional computer adaptive testing (MCAT) tool has not been developed to date.

OBJECTIVE

We developed an app using MCAT, combined with Multidimensional Screening in Child Development (MuSiC) for toddlers, to help patients and their family members or clinicians identify developmental problems at an earlier stage.

METHODS

We retrieved 75 item parameters from the MuSiC literature item bank for 1- to 3-year-old children, and simulated 1000 person measures from a normal standard distribution to compare the efficiency and precision of MCAT and nonadaptive testing (NAT) in five domains (ie, cognitive skills, language skills, gross motor skills, fine motor skills, and socioadaptive skills). The number of items saved and the cutoff points for the tool were determined and compared. We then developed an app for a Web-based assessment.

RESULTS

MCAT yielded significantly more precise measurements and was significantly more efficient than NAT, with 46.67% (=(75-40)/75) saving in item length when measurement differences less than 5% were allowed. Person-measure correlation coefficients were highly consistent among the five domains. Significantly fewer items were answered on MCAT than on NAT without compromising the precision of MCAT.

CONCLUSIONS

Developing an app as a tool for parents that can be implemented with their own computers, tablets, or mobile phones for the online screening and prediction of developmental delays in toddlers is useful and not difficult.

Altered p-JAK1 expression is associated with estrogen receptor status in breast infiltrating ductal carcinoma

The mammalian Janus kinase (JAK) family consists of four members, namely JAK1, JAK2, JAK3 and TYK2, which play a critical role in cytokine/growth factor signaling and is increasingly associated with human cancers. Aberrant activation of these non-receptor tyrosine kinases may contribute to carcinogenesis. Herein, we focused on exploring the potential role of p-JAK1 in breast cancer. The expression profiles of p-JAK1 were analyzed in 68 pairs of cancer and non-cancer breast tissues from the same infiltrating ductal carcinoma case by using immunoblotting technique. The results obtained were further correlated with clinicopathological characteristics. Intriguingly, p-JAK1 expression was decreased in 55.9% of breast cancer tissues as compared to the matched non-cancer tissues. Further immunohistochemistry study showed an intense p-JAK1 staining predominantly in adjacent normal breast tissues but not the matched cancer lesions. Decreased p-JAK1 expression in breast cancer tissues was significantly correlated with positive estrogen receptor (ER) status and increased tumor size (p=0.010 and 0.009). We also found that p-JAK1 expression was high in ERalpha-negative breast cancer cell lines but was low in ERalpha-positive breast cell lines. Transfection of ERalpha-positive MCF-7 cells with an ERalpha-specific siRNA upregulated the expression of p-JAK1. In summary, our results indicated that an altered p-JAK1 expression might be involved in the development of breast infiltrating ductal carcinoma in an ERalpha-related manner.

Hyperleptinaemia and hypoadiponectinaemia are associated with gallstone disease

BACKGROUND

Gallstone disease has been regarded as an obesity-related disease. Therefore, we hypothesized that leptin and adiponectin, mainly produced by adipose tissue, may play roles in gallstone disease.

PATIENTS AND METHODS

The RIA method was used to analyze serum leptin and adiponectin levels of 90 gallstone patients and 91 healthy subjects.

RESULTS

Our results showed that BMI, fasting glucose, serum AST and ALT, and leptin were significantly increased in the gallstone patients as compared with the healthy subjects (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.013, respectively). Intriguingly, serum adiponectin was the only variable to be significantly decreased in the gallstone patients (P = 0.002). Furthermore, serum AST, leptin, and adiponectin were significantly associated with gallstone disease (P < 0.001, P = 0.021, and P = 0.006, respectively). Overweight (BMI >or= 25 kg m(-2)), but not normal-weight, gallstone patients had an increased serum leptin and a decreased serum adiponectin level as compared with matched healthy subjects (P < 0.001 and P = 0.024, respectively). In addition, serum leptin was positively correlated with BMI and serum cholesterol, while serum adiponectin was inversely correlated with serum triglyceride in the gallstone patients.

CONCLUSIONS

Our study indicated that hyperleptinaemia and hypoadiponectinaemia might be involved in the occurrence of gallstone disease. However, the causal relationship of hyperleptinaemia and hypoadiponectinaemia with gallstone disease might require further investigation.

Noncommutative D-brane in a nonconstant NS-NS B field background

We show that, when the field strength H of the NS-NS B field does not vanish, the coordinates x and momenta p of open string end points satisfy a set of mixed commutation relations among themselves. Identifying x and p with the coordinates and derivatives of the D-brane world volume, we find a new type of noncommutative space which is very different from those associated with a constant B field background.