bluuebunny/crossref_metadata_2025 huggingface dataset:
ENTRE
Authors: Resende Camila , Souza Natalya Cristina de Lima , Linhares Igor , Magalhães Guilherme , Silva Danyel , Batista Daniel
Published: February 2022

Como parte do concurso de ideias de um módulo habitacional para contextos de catástrofes, realizado no “Ateliê Virtual Internacional de Projeto de Arquitetura Projetando on line 2021", o presente artigo tem como objetivo detalhar a experiência interdisciplinar que resultou no projeto intitulado “ENTRE: abrigo temporário adaptável”, elaborado pela equipe de alunos da graduação e pós-graduação da UFRN. O resumo expandido apresenta o relato da experiência de exercício projetual, onde, inicialmente, contextualiza-se o problema, em seguida, tecem-se comentários sobre o processo de projeto, culminando com a apresentação do resultado final da proposta, seguido das considerações finais, que refletem sobre a importância da temática e iniciativa do evento. O contexto do ENTRE partiu da ideia de um abrigo temporário adaptável que pode ser implantado em regiões de fronteiras para atender famílias desabrigadas durante o processo migratório provocado por crises humanitárias e catástrofes naturais. “Entre”, neste caso, tem um sentido ambíguo, primeiro no modo convidativo, bem como na atribuição de entre duas coisas, aludindo à transição, conceito pensado devido a mudança na vida das pessoas e dos espaços transformados rapidamente em situações de catástrofe. A concepção formal partiu do quadrado, e a partir dele, pensou-se no cubo modular cujas divisões internas e aberturas seguiram as linhas do jogo Tangram (quebra-cabeça geométrico chinês). Acredita-se que o projeto apresentado atendeu aos objetivos do concurso de ideias, principalmente pela coerência nas soluções adotadas e níveis de detalhamento quanto a funcionalidade, materialidade e decisões estruturais.
A Comprehensive Investigation of Molecular Signatures and Pathways
Linking Alzheimer’s Disease and Epilepsy via Bioinformatic Approaches
Authors: Wu Jiao , Zhu Shu , Zhao Chenyang , Xu Xiaoxue
Published: February 2022

Background:

Epileptic activity frequently occurs in patients with Alzheimer’s disease
(AD), which may accelerate AD progression; however, the relationship between AD and epilepsy remains
unclear.

Objective:

We aimed to investigate the molecular pathways and genes linking AD and epilepsy using
bioinformatics approaches.

Methods:

Gene expression profiles of AD (GSE1297) and epilepsy (GSE28674) were derived from
the Gene Expression Omnibus (GEO) database. The top 50% expression variants were subjected to
weighted gene co-expression network analysis (WGCNA) to identify key modules associated with
these diseases. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses
for the key modules were performed, and the intersected terms of functional enrichment and common
genes within the key modules were selected. The overlapping genes were subjected to analyses of
protein-protein interaction (PPI) network, transcription factor (TF)-mRNA network, microRNA
(miRNA)-mRNA network, and drug prediction.

Results:

We identified 229 and 1187 genes in the AD-associated purple and epilepsy-associated blue
modules, respectively. Six shared functional terms between the two modules included “calcium ion
binding” and “calcium signaling pathway.” According to 17 common genes discovered, 130 TFmRNA
pairs and 56 miRNA-mRNA pairs were established. The topological analyses of the constructed
regulatory networks suggested that TF - FOXC1 and miRNA - hsa-mir-335-5p might be vital
co-regulators of gene expression in AD and epilepsy. In addition, CXCR4 was identified as a hub
gene, becoming the putative target for 20 drugs.

Conclusion:

Our study provided novel insights into the molecular connection between AD and epilepsy,
which might be beneficial for exploring shared mechanisms and designing disease-modifying therapies.
In Silico Evaluation of Some Commercially Available Flavonoids as Galactofuranoyltransferase-
2 Inhibitors in the Management of Tuberculosis
Authors: Madeswaran Arumugam , Midhuna Premavathi Gunasekaran
Published: February 2022

Background:

Background: Galactofuranoyltransferase-2 (GlfT2) enzyme involved in the galactan polymerization of the arabinogalactan (AG) region of the mycolylarabinogalactan-peptidoglycan (mAGP) complex, an important component of the mycobacterial cell wall

Objective:

Objective: With the existing challenge the study focused into identifying certain commercially available flavonoids through molecular docking studies against the Galactofuranoyltransferase-2 enzyme.

Methods:

Methods: The initial pharmacokinetic screening was carried out using Lipinski’s rule of 5 with the help of Molinspiration software. In this perspective, Apigenin, Kaempferol, Rutin, Silibinin and Vitexicarpin were selected for the current study. Except for rutin all other selected flavonoids did not show any violations and thereby selected for the docking studies using AutoDock 4.2.

Results:

Results: The docking results showed that the selected flavonoids have excellent binding energy values between −8.98 to −6.58 kcal/mol against the GlfT2 enzyme. The theoretical inhibition constant was found to be in the range of 260.90 nM to 15.13 µM which coincides with the binding energies of the selected compounds.

Conclusion:

Conclusion: From the selected flavonoids, Silibinin showed excellent binding scores and it has the potential to inhibit the GlfT2 enzyme. Silibinin could act as a novel GlfT2 inhibitor with promising therapeutic activity with low toxicity profile against tuberculosis
Drug Resistance in the HIV-1 Subtype C Protease Enzyme: A High Throughput Virtual Screening Approach in Search of New Ligands with Activity
Authors: Sarron Arthur , Lobb Kevin A.
Published: February 2022

Background:

HIV-1 subtype C protease is a strategic target for antiretroviral treatment. However, resistance to protease inhibitors appears after months of treatment. Chromones and 2- biscoumarin derivatives show potential for inhibition of the HIV- subtype C protease.

Objective:

Different heterocyclic structures from the ZINC database were docked against Human Immunodeficiency Virus-1 (HIV) subtype C protease crystal structure 2R5Q and 2R5P. The 5 best molecules were selected to be docked against 62 homology models based on HIV-protease sequences from infants failing antiretroviral protease treatment. This experimentation was performed with two molecular docking programs: Autodock and Autodock Vina. These molecules were modified by substituting protons with different moieties, and the derivatives were docked against the same targets. Ligand-protein interactions, physical/chemical proprieties of the molecules, and dynamics simulations were analyzed.

Methods:

Docking of all of the molecules was performed to find out the binding sites of HIV-1 subtype C proteases. An in-house script was made to substitute protons of molecules with different moieties. According to the Lipinski rule of five, physical and chemical properties were determined. Complexes of certain ligands-protease were compared to the protein alone in molecular dynamics simulations.

Results:

From the first docking results, the 5 best (lowest energy) ligands (dibenz[a,h]acridine, dibenz[a, i]acridine, NSC114903, dibenz[c,h]acridine, benzo[a]acridine) were selected. The binding energy of the modified ligands increased, including the poorest-performing molecules. A correlation between nature, the position, and the resulting binding energy was observed. According to the Lipinski rules, the physico-chemical characteristics of the five best-modified ligands are ideal for oral bioavailability. Molecular dynamics simulations show that some lead-protease complexes were stable.

Conclusion:

Dibenz[a,h]acridine, dibenz[a, i]acridine, NSC114903, dibenz[c,h]acridine, benzo[ a]acridine and their derivatives might be considered as promising HIV-1 subtype C protease inhibitors. This could be confirmed through synthesis and subsequent in vitro assays.
Frequency of Helicobacter pylori Infection in Patients with Peptic Ulcer
Referred to the Endoscopy Departments of Khorramabad City Hospitals,
Iran, During 2013-2016
Authors: Ramezani Fatemeh , Shakib Pegah , Soroush Setareh , Rezaei Faranak , Moradniani Mosayeb , Delfani Somayeh
Published: February 2022

Background:

The present study investigated the prevalence of Helicobacter pylori infection
in peptic ulcer patients referred to the endoscopy departments in Khorramabad hospitals during 2013-
2016.

Methods:

The early pool of the study included all patients who had been referred to the endoscopy
department and whose endoscopic and pathology reports were available and complete. After recording
endoscopic reports, 1224 peptic ulcer (gastric or duodenal ulcer) cases, in which biopsy assays were
performed to examine the type of ulcer and the presence of Helicobacter pylori bacteria, were selected.
Pathology reports were collected by referring to the pathology departments. The information in the
pathology report, including demographic information, was included in a pre-designed questionnaire to
match the endoscopic reports, the location of the pathology sample, and other details, including the
presence or absence of Helicobacter pylori bacteria. Finally, the data were analyzed using SPSS, version
21.

Results:

For all the 1224 patients studied, the mean age was 15.5 ± 17.5 years old. A total of 664
(54.2%) cases had gastric ulcers, 445 (36.4%) cases had duodenal ulcers, and 115 (9.4%) had both
gastric and duodenal ulcers. Among gastric ulcer patients, 512 (65.7%) had a gastric ulcer in the antrum
area, and 74.3% (579 patients) of the gastric ulcers were clean base type.

Conclusion:

The prevalence of infection was statistically significant in terms of the type, location, and
number of peptic ulcers, including both gastric ulcer and duodenal ulcer.
A Framework for Estimating Future Traffic Operation and Safety Performance of Restricted Crossing U-Turn (RCUT) Intersections
Authors: Molan Amirarsalan M. , Howard Jonathan , Islam Mouyid , Pande Anurag
Published: February 2022

Background:

Despite numerous studies demonstrating the effectiveness of Restricted Crossing U-Turn (RCUT) intersection design, its implementation remains uneven and close to zero in some large states, including California. This paper provides a comprehensive framework to estimate the operational and safety performance of future RCUT designs. The framework is demonstrated for a geometrically constrained intersection located on a high-speed rural expressway. The operational evaluation relies on microscopic simulation models of existing TWSC and alternate RCUT designs used to estimate network-wide performance measures.

Methods:

Two approaches are demonstrated for future safety estimation; first, an HSM-prescribed Empirical Bayes (EB) approach that uses Safety Performance Function (SPF) predictions combined with the crash history of the site. For typical applications, EB estimates may be combined with CMFs for RCUT found in the literature. This approach remains the preferred option for safety estimation. However, for geometrically constrained locations where atypical RCUT designs need to be evaluated, a surrogate measure-based approach that uses trajectory data from the simulation model is described.

Results:

Surrogate measure-based safety analysis revelated that the RCUT design with no-left turn from mainline would be the most appropriate design for this location.

Conclusion:

The framework demonstrated here may be used by agencies to estimate the future benefits of the first-time application of treatments that have been successful elsewhere.
Upaya Pemberdayaan Masyarakat Melalui Pembentukan Satgas COVID-19 Untuk Pencegahan Penyebaran Covid-19 Kecamatan SukunKota Malang
Authors:   Ilmu Keperawatan, Fakultas Kedokteran,Universitas Brawijaya, Merdikawati Ayut , Wuri Kartika Annisa , Panca Lydia Fatma Endah , Amaliya Sholihatul , Choiriyah Muladefi , Azizah Nurona ,   Ilmu Keperawatan, Fakultas Kedokteran,Universitas Brawijaya
Published: February 2022

Upaya pencegahan penyebaran virus COVID-19 dan menanggulangi dampak pandemi memerlukan peran serta elemen masyarakat. Tingkat kejadian Covid-19 di RW 09 Kelurahan Tanjung rejo Kecamatan Sukun yang berjumlah 15 kasus dengan jumlah meninggal 1 warga pada bulan Desember 2020. Kurangnya pengetahuan warga mengenai Covid-19 dan upaya pencegahannya dilihat dari masih banyak warga yang kurang patuh dalam melakukan protokol kesehatan, membuat pentingnya intervensi kesehatan berbasis masyarakat di wilayah RW. Intervensi dilaksanakan dengan tiga program utama yaitu gerakan pembentukan Satuan Tugas (Satgas) Covid-19, masyarakat hidup sehat (GERMAS), gerakan masyarakat menggunakan masker, antiseptik dan desinfektan (GEMAD). Hasil intervensi menunjukkan terbentuknya satgas Covid-19 yang bertugas menyebarkan informasi yang tepat serta meningkatkan dukungan sosial dalam upaya pencegahan Covid-19, dan adanya peningkatan pengetahuan pada Satgas Covid-19 dan kader kesehatan setelah dilakukan kegiatan penyuluhan. Setelah intervensi, diharapkan seluruh RW di Kecamatan Sukun dapat memberdayakan masyarakat untuk membentuk satgas Covid-19 dalam upayapencegahan penyebaran Covid-19
Identifikasi Kecurangan Laporan Keuangan Menggunakan Fraud Pentagon(Studi Empiris Perusahaan Jasa Yang Terdaftar Di Bursa Efek Indonesia)
Authors:   Program Studi Keuangan & Perbankan Program Pendidikan Vokasi, Universitas Brawijaya., Sukmawati Anisya
Published: February 2022

Kecurangan laporan keuangan merupakan permasalahan yang masih menjadi tema hangat untuk diperbincangkan, terlebih dengan mencuatnya kasus manipulasi laporan keuangan yang terjadi beberapa tahun belakangan ini. Tindakan fraud pada laporan keuangan saat ini semakin meningkat. Dampak dari tindakan tersebut tidak hanya dirasakan oleh para investor secara individual namun juga berdampak terhadap stabilitas ekonomi secara global. Telah banyak dilakukan penelitian terkait fraud dengan menggunakan fraud triangle yang terdiri dari pressure, opportunity dan rationalization. Selanjutnya fraud triangle berkembang menjadi fraud diamond yang menambahkan capability sebagai faktor pendorong fraud. Saat ini juga telah muncul fraud pentagon yang menambahkan arrogance sebagai faktor tambahan pendorong terjadinya fraud. Tujuan dari penelitian ini adalah untuk mengidentifikasi potensi kecurangan laporan keuangan dengan menggunakan teori fraud pentagon. Sampel yang digunakan dalam penelitian ini adalah perusahaan jasa go public yang terdaftar di BEI dengan menggunakan data tahun 2019. Metode analisis data menggunakan analisis regresi berganda, dimana pengolahannya dibantu oleh program SPSS 21. Hasil dari pengujian hipotesis menunjukkan bahwa competence, pressure dan opportunity berpengaruh terhadap fraud, sedangkan rationalization dan arrogance tidak berpengaruh terhadap fraud pada laporan keuangan.
Empowerment of Siwalan Processed Small Enterprises Group Through Strengthening GMP (Good Manufacturing Practice) in Tuban Regency
Authors:   Faculty of Agricultural Technology, University of Brawijaya, Malang, Indonesia, Putri W.D.R. , W. Andayani ,   Faculty of Business Economics, University of Brawijaya, Malang, Indonesia, S.M. Sutan ,   Faculty of Agricultural Technology, University of Brawijaya, Malang, Indonesia, A.L. Rucitra ,   Faculty of Agricultural Technology, University of Brawijaya, Malang, Indonesia, Firdausyi I.A. ,   Faculty of Agricultural Technology, University of Brawijaya, Malang, Indonesia
Published: February 2022

Siwalan is palm type plants, which one of the prime agricultural commodities in Tuban Regency. Siwalan production has increased from year to year. Abundant production provides great potential for siwalan farmers and groups of siwalan processed enterprises into other processed products. Legen drinks and siwalan fruit are products that become typical souvenirs of Tuban and are favored by local tourists. However, problems related to product hygiene and low storage are a challenge for the siwalan palmers. So far, technological innovation has not touched on the processing of legen or siwalan fruit, so that the development of its marketing is very limited and it has not been able to broader the welfare of society. The purpose of this activity is to examine the relationship between aspects of attitude towards food security with aspects of business performance and the importance on strengthening GMP (Good Manufacturing Practice). The results ofthe activities show that there is no significant relationship between aspects of attitude towards food safety with aspects of business performance. This is consistent with the findings found that most of the craftsmen ignore the aspect of food safety especially in the legen beverage production process. Some producer also add food additives and carry out further processing to extend the shelflife of legen. This has an impact on the taste of legen and also in terms of food security. Therefore, socialization and training related to GMP is a key factor for improving business performance and achieving sustainable development
Effectiveness of Mobile Phone and Web-Based Interventions for Diabetes and Obesity Among African American and Hispanic Adults in the United States: Systematic Review
Authors: Enyioha Chineme , Hall Matthew , Voisin Christiane , Jonas Daniel
Published: February 2022

Background

Mobile health (mHealth) and web-based technological advances allow for new approaches to deliver behavioral interventions for chronic diseases such as obesity and diabetes. African American and Hispanic adults experience a disproportionate burden of major chronic diseases.

Objective

This paper reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults.

Methods

Literature searches of PubMed/Medline, The Cochrane Library, EMBASE, CINAHL Plus, Global Health, Scopus, and Library & Information Science Source were conducted for relevant English-language articles. Articles identified through searches were reviewed by 2 investigators and, if they met the inclusion criteria, were extracted and assessed for risk of bias. Findings were summarized in tabular and narrative format. The overall strength of the evidence was assessed as high, moderate, low, or insufficient on the basis of risk of bias, consistency of findings, directness, precision, and other limitations.

Results

Searches yielded 2358 electronic publications, 196 reports were found to be eligible for inclusion, and 7 studies met the eligibility criteria. All 7 included studies were randomized control trials. Five studies evaluated the effectiveness of an mHealth intervention for weight loss, including one that evaluated the effectiveness for diabetes and two studies focused on diabetes. Of all the studies that focused on weight loss, 3 reported significant differences in weight loss in participants in the intervention group compared with those in the usual care group. Although all studies on diabetes control showed greater improvement in glycemic control for the intervention group compared to that in the control group, only one study showed a significant difference between the 2 groups.

Conclusions

This analysis indicates that there are few published studies that assessed mHealth interventions among minority populations and focused on weight or diabetes. Although the overall strength of evidence was low for diabetes control, it was moderate for weight loss, and our findings suggest that mHealth and web-based interventions may provide a promising approach for interventions among African American and Hispanic adults who have obesity or diabetes.
Assessing the Legal Aspects of Information Security Requirements for Health Care in 3 Countries: Scoping Review and Framework Development
Authors: Yeng Prosper Kandabongee , Fauzi Muhammad Ali , Sun Luyi , Yang Bian
Published: February 2022

Background

The loss of human lives from cyberattacks in health care is no longer a probabilistic quantification but a reality that has begun. In addition, the threat scope is also expanding to involve a threat of national security, among others, resulting in surging data breaches within the health care sector. For that matter, there have been provisions of various legislation, regulations, and information security governance tools such as policies, standards, and directives toward enhancing health care information security–conscious care behavior among users. Meanwhile, in a research scenario, there are no comprehensive required security practices to serve as a yardstick in assessing security practices in health care. Moreover, an analysis of the holistic view of the requirements that need more concentration of management, end users, or both has not been comprehensively developed. Thus, there is a possibility that security practice research will leave out vital requirements.

Objective

The objective of this study was to systematically identify, assess, and analyze the state-of-the-art information security requirements in health care. These requirements can be used to develop a framework to serve as a yardstick for measuring the future real security practices of health care staff.

Methods

A scoping review was, as a result, adopted to identify, assess, and analyze the information security requirement sources within health care in Norway, Indonesia, and Ghana.

Results

Of 188 security and privacy requirement sources that were initially identified, 130 (69.1%) were fully read by the authors. Subsequently, of these 188 requirement documents, 82 (43.6%) fully met the inclusion criteria and were accessed and analyzed. In total, 253 security and privacy requirements were identified in this work. The findings were then used to develop a framework to serve as a benchmark for modeling and analyzing health care security practices.

Conclusions

On the basis of these findings, a framework for modeling, analyzing, and developing effective security countermeasures, including incentivization measures, was developed. Following this framework, research results of health care security practices would be more reliable and effective than relying on incomprehensive security requirements.
Behavioral and Emotional Problems Among Jordanian and Syrian Refugee Children in Noncamp Settings
Authors: Sarsour Bayan , Aqel Sr Ashraf , Khader Yousef
Published: February 2022

Background

Refugee children have an increased risk of physical and psychological illness. Data on behavioral and emotional problems among Jordanian and Syrian refugee children in noncamp settings are scarce.

Objective

This study aimed to assess the behavioral and emotional problems among Syrian school children refugees living outside camps in Jordan and their Jordanian counterparts.

Methods

A cross-sectional study was conducted among Syrian and Jordanian school children, aged 12-17 years, studying in the same schools in 4 Jordanian cities with the highest density of Syrian refugees. A self-reported questionnaire was used to collect information about the sociodemographic characteristics of the children. The Strengths and Difficulties Questionnaire was used to measure behavioral and emotional problems among these children.

Results

This study included a total of 1878 Jordanian adolescents (45.6% male and 54.4% female) and 1773 Syrian refugee adolescents (43.9% male and 56.1% female). The parents of the Syrian adolescents were significantly less educated and had significantly lower total family income than Jordanian parents. More than half of the Jordanian and Syrian adolescents had peer relation problems (53.6% and 55.5%, respectively), 36.9% of Jordanian and 35.5% of Syrian adolescents had hyperactivity or inattention problems, 44.8% of Jordanian and 47.6% of Syrian adolescents had conduct problems, and 30.8% of Jordanian and 32.0% of Syrian adolescents had emotional symptoms. On the other hand, 43.0% of Jordanian and 42.5% of Syrian adolescents had prosocial behaviors. In the multivariate analysis, Jordanian and Syrian children differed significantly in emotional symptoms and peer relationship problems. Compared with Jordanian children, Syrian children were less likely to experience emotional problems (odds ratio 0.81; P=.04) and peer relationship problems (odd ratio 0.80; P=.03).

Conclusions

Emotional and behavioral problems are common among Syrian refugee schoolchildren as well as Jordanian school children. They are all in need of urgent psychosocial support.
Estimation of Out-of-Pocket Expenditure on COVID-19 Management Among Patients Treated at Home, Iraq, 2020
Authors: Abdul kader Saeed Falah , Lami Faris
Published: February 2022

Background

There is a global consensus that the socioeconomic impact of the COVID-19 crisis has had a substantial effect on health programs and health insurance, with losses of jobs and rising prices causing growing poverty.

Objective

This study aims to estimate the out-of-pocket expenditure spent on the management of patients with COVID-19 exclusively treated at home.

Methods

A cross-sectional study was conducted, and data were collected from participating patients with COVID-19 in Iraq through snowball sampling by using a questionnaire. Enrollment occurred from November 1 to December 31, 2020, and excluded individuals who were entering the hospitals.

Results

Among 589 participating patients with COVID-19, 328 (55.7%) were female. Female patients spent more than male patients to get cured of the illness; the mean amount of money spent by women was statistically higher than men (IQD 644,617 [US $402] and IQD 461,653 [US $307], respectively). The average total money expenditures spent was IQD 643,304 (US $428; range IQD 505,096-5,595,000 [US $336-US $3730]) among patients exclusively treated at home. The average money spent by patients with inadequate monthly income (IQD 901,424 [US $600], range IQD 220,000-5,260,000 [US $140-US $3500]) was significantly more than patients with adequate monthly income (IQD 613,252 [US $400], range IQD 48,000-5,500,000 [US $32-US $3600]). Patients with COVID-19 (25.5%) who had chronic diseases spent significantly more money (IQD 696,330 [US $460]) than those without the chronic disease (IQD 625,185 [US $416]).

Conclusions

Financial burdens affected the purchasing power and the economic situation on the management of patients with COVID-19 exclusively treated at home.
Sex-Based Variations in the Clinical Manifestations, Comorbidities, and Outcomes of Patients With COVID-19 in Baghdad, Iraq, 2020
Authors: Ali Nameer A , Lami Faris
Published: February 2022

Background

A higher incidence of COVID-19 in males has been widely reported. However, whether clinical manifestations, comorbidities, severity, and outcomes differ between males and females remains an area of active investigation.

Objective

We aimed to compare the clinical features, comorbidities, severity, and outcomes between male and female patients with COVID-19 from Baghdad, Iraq, in 2020.

Methods

We performed a records-based cross-sectional study by extracting sociodemographic, clinical manifestation, severity, and outcome data from the records of patients with COVID-19 admitted to 2 COVID-19 hospitals in Baghdad, Iraq, between June and August 2020.

Results

We reviewed a total of 2111 patient records with a history of COVID-19, and 1175 (55.7%) patients were males. We found that respiratory symptoms, sore throat, and gastrointestinal manifestations were significantly more common among females. In contrast, males had significantly more “other” manifestations. No significant difference was noted for fever, nasal congestion, conjunctival congestion, headache, and musculoskeletal manifestations. Generally, female patients had a significantly higher proportion of comorbidities than males (42.7% vs 36%; P=.002). The proportion of severe and critical cases was not different between males and females. The mean time from diagnosis to the outcome was significantly longer in females (P=.03), but the duration of the hospital stay was not significantly different between males and females. Finally, the case fatality ratio was higher in males (16.1%) than in females (13.2%).

Conclusions

Sex affects the clinical course and outcomes of patients with COVID-19. Male patients may need more attention, considering the higher case fatality ratio.
Role of Rapid Response Teams in Response to Outbreaks in Yemen, 2020: Descriptive Study
Authors: Qaserah Abdulqawi , Anam Labiba , Alyosfi Reema
Published: February 2022

Background

Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Public Health and Population (MoPH&P) has put in place the Rapid Response Teams (RRTs) mechanism from the national to district level to investigate and initiate the response to public health emergencies. An RRT is a technical, multidisciplinary team that is readily available for quick mobilization and deployment in case of emergencies.

Objective

The aim of this analysis was to summarize the role of RRTs in response to outbreaks in Yemen during 2020.

Methods

Data were obtained from the electronic Diseases Early Warning System (eDEWS) in Excel format covering the period from January to December 2020, including governorates, diseases, and other variables. Data were cleaned and analyzed using Excel 2013. Qualitative data are summarized as percentages. Data are presented using tables, graphs, and maps.

Results

A total of 39,451 field descents were performed. Nearly half of the activities (n=18,565, 47.06%) were for outbreak investigation of various infectious diseases, including cholera (n=9030), severe acute respiratory infection (n=1949), diphtheria (n=1532), measles (n=1328), malaria (n=1012), dengue fever (n=1008), pertussis (n=803), mumps (n=676), chickenpox (n=583), acute flaccid paralysis (n=482), and meningitis (n=162). Approximately 1747 (4.43%) supervision visits were implemented. Regarding health education, 19,139 (48.51%) health education sessions were executed, with 3419 (17.86%) performed at health facilities and 15,720 (82.14%) performed outside health facilities (eg, schools and outdoors). A total of 559,805 people attended the health education sessions.

Conclusions

RRTs support the MoPH&P in reducing or “slowing down” disease transmission as quickly as possible through various activities such as outbreak investigations and health education. Therefore, there is a strong need to continue supporting the RRTs financially and logistically by donors. In addition, governmental financial support to the RRTs is highly recommended to ensure the sustainability of the program.
Public Health Workers’ Knowledge, Attitude, and Practice Regarding COVID-19: The Impact of the Field Epidemiology Training Program in the Eastern Mediterranean Region
Authors: Sami Sahar , Lami Faris , Rashak Hiba Abdulrahman , Al Nsour Mohannad , Eid Alaa , Khader Yousef , Afifi Sr Salma , Elfadul Maisa , Ghaleb Yasser , Letaief Hajer , Ben Alaya Nissaf , Ikram Aamer , Akhtar Hashaam , Barkia Sr Abdelaziz , Taha Hana Ahmad , Adam Reema , Islam Saeed Sr Khwaja Mir , Almudarra Sami , Hassany Mohamed , Abu El Sood Hanaa , ur Rahman Fazal , Saaed Falah Abdul-kader , Hlaiwah Mohammed Sameer
Published: February 2022

Background

Globally, there is a growing need for public health professionals skilled in preventing and responding to the surge of emerging and re-emerging infectious diseases. This is particularly important to the Eastern Mediterranean countries that are facing emergencies in addition to the increased public health risks of unprecedented scale during the COVID-19 pandemic. Public health professionals are instrumental in responding to the COVID-19 pandemic in terms of detecting and monitoring new cases, conducting investigations, tracing contacts, ensuring patients are being tested, applying isolation and quarantine protocols, providing up-to-date information, educating the community, and producing statistics and models to track disease progression.

Objective

This study aims to compare knowledge, attitude, and practice (KAP) regarding COVID-19 between public health workers (PHWs) that attended the Field Epidemiology Training Program (FETP trained) and those who did not attend FETP (non-FETP trained).

Methods

A multicountry cross-sectional survey was conducted among PHWs who participated in the COVID-19 pandemic in 10 countries in the Eastern Mediterranean Region. An online questionnaire that included demographic information and KAP regarding the COVID-19 pandemic was distributed among PHWs. The scoring system was used to quantify the answers; bivariate and multivariate analyses were performed to compare FETP-trained with non-FETP–trained PHWs.

Results

Overall, 1337 PHWs participated, with 835 (62.4%) <40 years of age and 851 (63.6%) male participants. Of them, 423 (31.6%) were FETP trained, including 189 (44.7%) at an advanced level, 155 (36.6%) at an intermediate level, and 79 (18.7%) had basic level training. Compared to non-FETP–trained participants, FETP-trained participants were older and had higher KAP scores. FETP participation was low in infection control and public health laboratories. KAP mean scores for intermediate-level attendees were comparable to the advanced level.

Conclusions

FETP-trained participants had better KAP than non-FETP–trained PHWs. Expanding the intermediate level, maintaining the rapid response training, and introducing the laboratory component are recommended to maximize the benefit from the FETP. Infection control, antimicrobial resistance, and coordination are areas where training should be included.
Evaluation of the National Electronic Disease Surveillance System Amid the COVID-19 Pandemic in Elsahel District, Cairo Governorate, Egypt, 2020
Authors: Girgis Neven , Elnahry Wessam , Afifi Salma , El Shourbagy Sahar , Abu Elsood Hanaa , Eid Alaa
Published: February 2022

Background

The Egypt National Disease Surveillance is a routine system established in 2002. The system electronically reports on 41 infectious diseases including COVID-19. Reporting sites include all Egyptian governorates, districts, governmental infectious disease hospitals, and primary health units. Surveillance is essential during the pandemic to detect cases early, describe the epidemiology of health problems, guide priority setting, and plan and evaluate public health policy and strategies.

Objective

This study aims to evaluate the surveillance system during the pandemic to assess its effectiveness in achieving its objectives and to find and fill the gaps.

Methods

The evaluation was performed using the Centers for Disease Control and Prevention guidelines. A structured questionnaire was used to evaluate the qualitative attributes including simplicity, flexibility, and acceptability through interviewing surveillance teams at the central level, health directorate, and Sahel district. Quantitative attributes, including completeness, timeliness, and predictive positive value, were performed using COVID-19 surveillance data of Sahel district in March-December 2020. Data were assessed for completeness and accuracy. The usefulness of surveillance was assessed in terms of achieving its objectives and use of data.

Results

Of 33 respondents, 90% thought that the system was simple, and 77% thought it was acceptable; work overload reduced the acceptability rate. The system is funded by the Ministry of Health and Population and was operational 53% of the time due to connectivity problems. The system was flexible when adapting to include COVID-19 in a short time with minimal cost. It is quite representative, as it covers 60% of the population. Completeness was 82%, positive value predictive was 58%, and data validity was 86%. The median duration between patient admissions and reporting was 2.7 days.

Conclusions

The evaluation of the Egypt COVID-19 surveillance system indicated that the system partly achieved its objectives in the area of simplicity and flexibility with adequate data quality. There is a need to improve acceptability and timeliness through increasing manpower and to enhance stability through effective connectivity. Expansion of the system to cover all of the Egyptian population is recommended to improve representativeness.
Bacterial Contamination of Intensive Care Units, Sana’a City, Yemen, 2019
Authors: Al Amad Mohammed , Al Shargabi Intesar Abdulsalam , Nasher Samar , Al-Haidari Sami Ahmed , Al-Dubaiee Riham , Moghalles Suaad Ameen , Al Moayad Khaled Abdullah
Published: February 2022

Background

Bacterial contamination of the intensive care unit (ICU) is one of the risk factors responsible for the high incidence of nosocomial infections that can significantly increase the mortality among ICU patients.

Objective

The aim of this study was to investigate the bacterial contamination and pathogen isolates from the ICU environment of hospitals in Sana’a city, Yemen.

Methods

A descriptive cross-sectional study was performed in Sana’a city hospitals from December 5 to December 15, 2019. All hospitals that frequently reported mortality among ICU patients were included. A sterile swab moistened in sterile normal saline was used for sample collection. Seven ICU sites were targeted, including the patient’s bed, bedside table, masks of the oxygen-supplying apparatus, intravenous (IV) stand, door knob, wall, and floor, and two samples from each site were collected. The samples were transported to the National Center of Public Health Laboratory for microbiological culture.

Results

A total of 112 swabs were collected from the ICUs of eight hospitals. Among these, 87 (77.7%) yielded positive bacterial growth and 109 bacterial strains were isolated, including 62.4% (n=68) gram-positive and 37.6% (n=41) gram-negative bacteria. Coagulase-negative Staphylococcus, Staphylococcus aureus, and Bacillus cereus were the predominant gram-positive bacteria isolated, which accounted for 27.5% (n=30), 21.1% (n=23), and 10.1% (n=11) of all 109 bacterial isolates, respectively. Klebsiella species, Pseudomonas species, and Acinetobacter were the main gram-negative isolates obtained, accounting for 12.8% (n=14), 12.8% (n=14), and 11.9% (n=13) of all 109 bacterial isolates, respectively. The common contaminated sites were the patients’ beds/bedside tables (40/109 strains, 36.7%), floors (24/109 strains, 22.0%), walls (15/109 strains, 13.8%), and masks of the oxygen-supplying apparatus (12/109 strains, 11.0%). The door knobs and IV stands were contaminated by 9 strains, representing 8.3% of the total isolated bacteria.

Conclusions

The contamination of ICU environments was high and patients’ surroundings were the most contaminated areas. Implementations of strict quality standards of hygienic practices and effective cleaning of inanimate surfaces by the hospitals’ infection control units along with periodic monitoring by the health authority are highly recommended.
Examining Diurnal Differences in Multidisciplinary Care Teams at a Pediatric Trauma Center Using Electronic Health Record Data: Social Network Analysis (Preprint)
Authors: Durojaiye Ashimiyu , Fackler James , McGeorge Nicolette , Webster Kristen , Kharrazi Hadi , Gurses Ayse
Published: February 2022

BACKGROUND

The care of pediatric trauma patients is delivered by multidisciplinary care teams with high fluidity that may vary in composition and organization depending on the time of day.

OBJECTIVE

This study aims to identify and describe diurnal variations in multidisciplinary care teams taking care of pediatric trauma patients using social network analysis on electronic health record (EHR) data.

METHODS

Metadata of clinical activities were extracted from the EHR and processed into an event log, which was divided into 6 different event logs based on shift (day or night) and location (emergency department, pediatric intensive care unit, and floor). Social networks were constructed from each event log by creating an edge among the functional roles captured within a similar time interval during a shift. Overlapping communities were identified from the social networks. Day and night network structures for each care location were compared and validated via comparison with secondary analysis of qualitatively derived care team data, obtained through semistructured interviews; and member-checking interviews with clinicians.

RESULTS

There were 413 encounters in the 1-year study period, with 65.9% (272/413) and 34.1% (141/413) beginning during day and night shifts, respectively. A single community was identified at all locations during the day and in the pediatric intensive care unit at night, whereas multiple communities corresponding to individual specialty services were identified in the emergency department and on the floor at night. Members of the trauma service belonged to all communities, suggesting that they were responsible for care coordination. Health care professionals found the networks to be largely accurate representations of the composition of the care teams and the interactions among them.

CONCLUSIONS

Social network analysis was successfully used on EHR data to identify and describe diurnal differences in the composition and organization of multidisciplinary care teams at a pediatric trauma center.
Opportunities and Challenges for Professionals in Psychiatry and Mental Health Care Using Digital Technologies During the COVID-19 Pandemic: Systematic Review (Preprint)
Authors: Kane Hélène , Gourret Baumgart Jade , El-Hage Wissam , Deloyer Jocelyn , Maes Christine , Lebas Marie-Clotilde , Marazziti Donatella , Thome Johannes , Fond-Harmant Laurence , Denis Frédéric
Published: February 2022

BACKGROUND

The COVID-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies.

OBJECTIVE

As part of a research project that was cofunded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, the aim of this systematic literature review was to investigate how such uses of digital technologies have been developing.

METHODS

This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was carried out in the MEDLINE (ie, PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts and then on full texts, 61 articles were included.

RESULTS

The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up their experience of remote care and, thus, better identify the possibilities and limits of these digital technologies.

CONCLUSIONS

New uses of such technologies essentially consist of a transition from the classic consultation model toward teleconsultation and make less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The COVID-19 health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular to promote the autonomy and empowerment of mental health service users.
An mHealth App for Fibromyalgia-like Post–COVID-19 Syndrome: Protocol for the Analysis of User Experience and Clinical Data (Preprint)
Authors: Blanchard Marc , Backhaus Lars , Ming Azevedo Pedro , Hügle Thomas
Published: February 2022

BACKGROUND

Post–COVID-19 syndrome, also referred as “long covid,” describes persisting symptoms after SARS-CoV-2 infection, including myalgia, fatigue, respiratory, or neurological symptoms. Objective symptoms are often lacking, thus resembling a fibromyalgia-like syndrome. Digital therapeutics have shown efficiency in similar chronic disorders such as fibromyalgia, offering specific disease monitoring and interventions such as cognitive behavioral therapy or physical and respiratory exercise guidance.

OBJECTIVE

This protocol aims to study the requirements and features of a new mobile health (mHealth) app among patients with fibromyalgia-like post–COVID-19 syndrome in a clinical trial.

METHODS

We created a web application prototype for the post–COVID-19 syndrome called “POCOS,” as a web-based rehabilitation tool aiming to improve clinical outcomes. Patients without organ damage or ongoing inflammation will be included in the study. App use will be assessed through user experience questionnaires, focus groups, and clinical data analysis. Subsequently, we will analyze cross-sectional and longitudinal clinical data.

RESULTS

The developed mHealth app consists of a clinically adapted app interface with a simplified patient-reported outcome assessment, monitoring of medical interventions, and disease activity as well as web-based instructions for specific physical and respiratory exercises, stress reduction, and lifestyle instructions. The enrollment of participants is expected to be carried out in November 2021.

CONCLUSIONS

User experience plays an important role in digital therapeutics and needs to be clinically tested to allow further improvement. We here describe this process for a new app for the treatment of the fibromyalgia-like post–COVID-19 syndrome and discuss the relevance of the potential outcomes such as natural disease course and disease phenotypes.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/32193
Behavioral and Emotional Problems Among Jordanian and Syrian Refugee Children in Noncamp Settings (Preprint)
Authors: Sarsour Bayan , Aqel Sr Ashraf , Khader Yousef
Published: February 2022

BACKGROUND

Refugee children have an increased risk of physical and psychological illness. Data on behavioral and emotional problems among Jordanian and Syrian refugee children in noncamp settings are scarce.

OBJECTIVE

This study aimed to assess the behavioral and emotional problems among Syrian school children refugees living outside camps in Jordan and their Jordanian counterparts.

METHODS

A cross-sectional study was conducted among Syrian and Jordanian school children, aged 12-17 years, studying in the same schools in 4 Jordanian cities with the highest density of Syrian refugees. A self-reported questionnaire was used to collect information about the sociodemographic characteristics of the children. The Strengths and Difficulties Questionnaire was used to measure behavioral and emotional problems among these children.

RESULTS

This study included a total of 1878 Jordanian adolescents (45.6% male and 54.4% female) and 1773 Syrian refugee adolescents (43.9% male and 56.1% female). The parents of the Syrian adolescents were significantly less educated and had significantly lower total family income than Jordanian parents. More than half of the Jordanian and Syrian adolescents had peer relation problems (53.6% and 55.5%, respectively), 36.9% of Jordanian and 35.5% of Syrian adolescents had hyperactivity or inattention problems, 44.8% of Jordanian and 47.6% of Syrian adolescents had conduct problems, and 30.8% of Jordanian and 32.0% of Syrian adolescents had emotional symptoms. On the other hand, 43.0% of Jordanian and 42.5% of Syrian adolescents had prosocial behaviors. In the multivariate analysis, Jordanian and Syrian children differed significantly in emotional symptoms and peer relationship problems. Compared with Jordanian children, Syrian children were less likely to experience emotional problems (odds ratio 0.81; P=.04) and peer relationship problems (odd ratio 0.80; P=.03).

CONCLUSIONS

Emotional and behavioral problems are common among Syrian refugee schoolchildren as well as Jordanian school children. They are all in need of urgent psychosocial support.