bluuebunny/crossref_metadata_2025 huggingface dataset:
The contribution of the NarB and NarGHI enzymes to nitrate reduction in Mycobacterium smegmatis
Authors: Cardoso Nicole Collette , Kana Bavesh Davandra
Published: April 2019

Background: Nitrate reduction in bacteria is an essential step in the nitrogen cycle. For this, the reduction of nitrate to nitrite is catalyzed by a variety of nitrate reductase enzymes. In the pathogen Mycobacterium tuberculosis, nitrate reduction is driven by the NarGHI respiratory and assimilatory nitrate reductase. In addition to this enzyme, Mycobacterium smegmatis carries a second putative narB-encoded nitrate reductase and the contribution of this enzyme to nitrate reduction remains unknown. Herein, we set out to investigate this.

Results: To assess the relative contribution of NarGHI and NarB, the corresponding gene loci we deleted using two-step allelic replacement, individually and in combination, followed by investigation of nitrate reduction using the Griess assay. However, previous reports demonstrated that this assay was unable to report on nitrate reduction in M. smegmatis, as it yielded no detectable levels of the nitrite product. To address this, we modified the assay through the addition of zinc, which reduces nitrate remaining in the reaction to nitrite thus allowing for assessment of nitrate depletion. This then serves as a surrogate for nitrate reductase activity. The mutant strains lacking narB and/or narGHJI retained the ability to reduce nitrate at levels comparable to the wild type. We further investigated nitrate assimilation and all strains defective for these enzymes were able to grow on nitrate as the sole nitrogen source.

Conclusions: Collectively, these data confirm that NarB and NarGHI are individually and collectively dispensable for both respiratory and assimilatory nitrate reduction in M. smegmatis. Furthermore, we identified MSMEG_4206 as a putative, previously unannotated, nitrate reductase in this organism.
Clinical Features of Patients With Familiar Multiple Sclerosis in Lithuania
Authors: Andrijauskis Denas , Balnyte Renata , Keturkaite Ieva , Vaitkus Antanas
Published: April 2019

Background. Most multiple sclerosis (MS) cases are sporadic, however about 20 percent are hereditary [2]. It is still unclear whether heredity affects the progression and severity of the disease. The aim of this study is to assess the effect of heredity on the development of multiple sclerosis and on the course of disease by analyzing the results of disability, severity scales and clinical studies, and comparing them with sporadic cases.
Methods. Our study included 104 patients with MS. The study group was comprised of 38 patients with family history of MS; the control group consisted of 66 patients with no family history. The survey included questions about demographic and clinical characteristics. Diagnostic results were evaluated retrospectively from medical records. Disability assessment was made according to EDSS. MSSS score was calculated using conversion table.
Results. Patients with a family history tend to have slower onset of the disease, while control group is more likely to have an acute onset (p <0.001). Study group more often complained of symptoms related to pyramidal (74 % vs. 50 %) and brainstem (68 % vs. 20 %), cognitive dysfunction (47 % vs. 20 %), headache (37 % vs. 9 %), back pain (32 % vs. 9 %) than those in control group, p <0.05. EDSS and MSSS scores were higher in familiar cases (p <0.05). The number of exacerbations per year was also higher in study group (1.4 vs. 0.8; p <0.05). Patients with a family history have a higher incidence of MRI changes in brainstem (74% vs. 30%) and cerebellum (58% vs. 30%) than the control group (p <0.01).
Conclusions. Patients with a family history tend to have slower onset of the disease, while control group is more likely to have an acute onset. Patients with a family history of MS more often complained of brainstem and cortical dysfunction, and pain in head or back. Both EDSS and MSSS scores were higher in familiar cases. They also have a higher number of exacerbations per year. Patients with a family history have a higher incidence of MRI changes in brainstem and cerebellum.
Premature “aging” of placenta: myth or reality?
Authors: A.R. Sleptsov, D.A. Sleptsova
Published: April 2019

There was performed a retrospective analysis of pregnancy outcomes in 585 women with different placental
maturity. There is given an assessment of premature “aging” of placenta in the prognosis of fetal and newborn
development. The third degree of maturity of placenta at 32–34 weeks of gestation was observed more often
with normal body weight of children at birth than with slowing fetal growth. In 62.5 % of cases of placental
degree registration at 32–34 weeks were born newborns weighing 4000 g. The results suggest that the 3rd degree
of placental maturity less than 36 weeks doesn't have a significant impact on the condition and development of
the fetus and newborn.
Research on the multi-objective optimal operation of cascade reservoirs in the upper and middle Yellow River basin
Authors: Bian Jia-qi , Dong Zeng-chuan , Jia Yi-fei , Zhong Dun-yu
Published: April 2019

The reservoirs (hydro plants) along the upper Yellow River are typical cascade reservoirs, with multiple objectives regarding flood control, ice control, water supply, power generation, and ecological security. The competition among these multiple objectives reflects the competition among various agencies with different interests. There has been a certain degree of conflict between ‘power scheduling’, which aims at obtaining greater power generation from the cascade reservoirs, and ‘water regulation’, which is currently being implemented. Questions of how to reasonably use the comprehensive regulation capacity of the cascade reservoirs, in order to relieve the conflicts among multiple objectives, and understand the nature of the competition between ‘power scheduling’ and ‘water regulation’, require urgent research and solutions. Based on an analysis of the current situation regarding water supply, electricity demand, flood control, ice control, and ecology, a multi-objective optimal operation model for the cascade reservoirs in the upper and middle reaches of the Yellow River has been constructed to reveal the relationships between power generation and other objectives. This study provides theoretical evidence for the informed operation of the cascade reservoirs and will be of great significance for coordinating the relationship between power generation and water regulation.
Diversidade de abelhas (Hymenoptera: Apoidea) em mata de araucária em Santa Catarina
Authors: Liebl Francine Tschoeke Liebl , Dec Enderlei , Mouga Denise M. D. da
Published: April 2019

Visando conhecer a apifauna existente em floresta ombrófila mista, realizou-se estudo em duas áreas de mata de araucária em Mafra (SC), de setembro de 2016 a agosto de 2017. Foi amostrado um total de 1.304 indivíduos de 56 táxons, 32 gêneros e cinco subfamílias. Índices de diversidade e equabilidade foram calculados. As plantas visitadas somam 48 espécies de 16 famílias. Asteraceae foi visitada com mais frequência (41,7% dos táxons). Abelhas dos táxons Meliponini, Ceratinini e Halictinae foram prevalentes. A sequência de predominância de subfamílias quanto à diversidade (Apinae seguida de Halictinae) seguiu o padrão transicional entre porções subtropicais e temperadas da região neotropical, com pequeno número de espécies abundantes e alta proporção de singletons, assim como variação sazonal. Apis mellifera correspondeu, em abundância, a 36,34%. A variação dos índices revelou diferença entre as duas áreas em relação à abundância, dominância e riqueza das espécies, evidenciando influência da antropização e sucessão ecológica. A diversidade e a abundância de abelhas estão diminuídas em comparação a estudos anteriores em ambientes próximos ou similares.
Entrevista com Eula Carvalho Pinheiro
Authors: Souza Giane Maria
Published: April 2019

A entrevista realizada com Eula Carvalho Pinheiro evidencia que não somente Saramago possuía a pedra como uma estrutura fundamental da sua escrita e da sua leitura de mundo. Eula, como pedra3, por ora sustenta-se e por ora movimenta-se. E assim guia nosso olhar de forma poética para recompor o tom da sua vida e da sua trajetória acadêmica ao mostrar como são belas as aprendizagens da pesquisa, da doença e fundamentalmente das superações. As histórias e as memórias da entrevistada carregam do início ao fim a paixão pela literatura e pela obra de Saramago, como a arquitetura da sua própria existência.
Structural Diversity Attributed by Aza-Diels-Alder Reaction in Synthesis of Diverse Quinoline Scaffolds
Authors: Singh Dharmender , Kumar Vipin , Malakar Chandi C. , Singh Virender
Published: April 2019

In recent years, the synthesis of quinoline scaffold using various methodological
devices has attracted considerable attention in synthetic chemist community. The most feasible
method to serve this purpose is Aza-Diels-Alder reaction which provides flexibility and diversity
in the synthesis of quinoline decorated with different functionalities over the scaffold.
Diversity in this functionality improvises the susceptibility of the quinoline scaffold for various
protein targets. This review encompasses multifactorial aspects of Aza-Diels-Alder reaction
as well as provides insights into the synthetic schemes for quinoline scaffold.
Major Kinds of Drug Targets in Chagas Disease or American Trypanosomiasis
Authors: Duschak Vilma G.
Published: April 2019

American Trypanosomiasis, a parasitic infection commonly named Chagas disease, affects millions of people all over Latin American countries. Presently, the World Health Organization (WHO) predicts that the number of international infected individuals extends to 7 to 8 million, assuming that more than 10,000 deaths occur annually. The transmission of the etiologic agent, Trypanosoma cruzi, through people migrating to non-endemic world nations makes it an emergent disease. The best promising targets for trypanocidal drugs may be classified into three main groups: Group I includes the main molecular targets that are considered among specific enzymes involved in the essential processes for parasite survival, principally Cruzipain, the major antigenic parasite cysteine proteinase. Group II involves biological pathways and their key specific enzymes, such as Sterol biosynthesis pathway, among others, specific antioxidant defense mechanisms, and bioenergetics ones. Group III includes the atypical organelles /structures present in the parasite relevant clinical forms, which are absent or considerably different from those present in mammals and biological processes related to them. These can be considered potential targets to develop drugs with extra effectiveness and fewer secondary effects than the currently used therapeutics. An improved distinction between the host and the parasite targets will help fight against this neglected disease.
İNTERNET’E YÖNELİK ARAŞTIRMA VE SORGULAMA BECERİLERİ ALGISI ÖLÇEĞİNİN GELİŞTİRİLMESİ
Authors: Kahyaoğlu Erdoğmuş Yasemin , Akpınar Ercan
Published: April 2019

Bu araştırmada öğretmen adaylarının İnternete yönelik araştırma ve
sorgulama becerilerine ilişkin algılarının belirlenmesinde kullanılabilecek bir
ölçek geliştirmek amaçlanmıştır. Araştırma kapsamında 590 öğretmen adayından
veri toplanmıştır. 37 madde olarak geliştirilen ölçeğin kapsam geçerliği için
uzman görüşünden yararlanılmıştır. Ölçeğin yapı geçerliği için açımlayıcı
faktör analizi yürütülmüş, ölçek maddelerinin 2 faktörde toplandığı
görülmüştür. İki faktörün varyansı açıklama oranı %46 olarak bulunmuştur. Faktör
analizi ve madde analizi sonuçlarına göre faktör dışı kalan ve uygun değerleri
taşımayan maddeler ölçekten çıkarılmıştır. Ölçeğin son halinin 25 maddeden
oluştuğu belirlenmiştir. Ölçeğin Cronbach Alfa güvenirlik katsayısı 0.91,
faktörlerin güvenirlik katsayıları ise sırasıyla 0.91 ve 0.86 bulunmuştur.
Geliştirilen ölçek için ayrıca doğrulayıcı faktör analizi yürütülmüştür.
Doğrulayıcı faktör analizi sonuçlarına göre ölçeğin iki faktörlü yapısı
doğrulanmıştır. Araştırmanın sonucunda ölçeğin geçerli ve güvenilir bir veri
toplama aracı olarak araştırmacılar tarafından kullanılabileceği sonucuna
ulaşılmıştır.
In vitro efficacy of cypermethrin against Hyalomma anatolicum anatolicum
Authors: Prasad L. , Bagherwal R. K. , Jayra A. K. , Rajput N. , Yadav N. , Shakyar M. , Thakur P.
Published: April 2019

The present investigation was undertaken to evaluate in vitro efficacy of cypermethrin against H. a.anatolicum. The engorged H. a.anatolicum females dropped on ground were collected from dairy farms of nearby villages of Mhow and were
maintained in the laboratory till hatching of the eggs and larvae were used for further study. Larvae were placed in filter paper packets impregnated with 100, 200, 400, and 800 ppm concentrations of cypermethrin for 24 hours which revealed the per
cent mortality 89.84, 93.70, 100 and 100%, while the corrected percent mortality and efficacy was found 89.30, 93.36, 100 and 100%
Ultrasonographic Fetometry and Fetal Structures during Early Pregnancy in Surti Buffaloes
Authors: Gaur Mitesh , Purohit G. N.
Published: April 2019

Ultrasonographic evaluations of early pregnant Surti buffaloes revealed that the uterine fluid was visible on Day 18 of pregnancy, yet this was not a sure sign of pregnancy. The amniotic vesicle could be detected by Day 26 and was a sure sign
of pregnancy. The embryo appeared on Day 26 but with clarity on Day 30. Fetal heart beats were visible from Day 26 and increased significantly (p less than 0.05) from Day 42 compared to Day 30, 34 and 38 of gestation and remained elevated till Day 62
of gestation. The crown rump length (CRL) of the embryo / fetus could be measured using inbuilt callipers starting from Day 30 till Day 58.
Factors affecting sustainable adoption of e-health systems in Resource-Limited settings: an exploratory survey of Ethiopian hospitals from the perspective of healthcare professionals. (Preprint)
Authors: Hayelom Mulugeta
Published: April 2019

BACKGROUND

Electronic health (e-health) is becoming a prominent component of the health care system. The implementation and sustainable adoption of e-health systems is now taking as a big agenda in developing countries like Ethiopia, hence it all about saving a millions of lives. Even though there are some pilot e-health implementations, the success and sustainability of the systems are found less than the expected. So, this study aims to fill the gap in identifying the factors affecting sustainable adoption of e-health systems using the revised technology acceptance model at five referral hospitals of Amhara regional state of Ethiopia.

OBJECTIVE

To identify the factors affecting sustainable adoption of e-health systems using the revised technology acceptance model at five referral hospitals of Amhara regional state of Ethiopia.

METHODS

Institutional based cross-sectional study design was conducted among a total of 384 health care professionals. Self-administered questionnaire was used to collect the data. And the data were entered and the descriptive data were analyzed using Epi-info version 7 and SPSS version 20 respectively. Structural equation modeling, using AMOS 22, was also used to measure and clarify the degree of relationships between variables.

RESULTS

The findings of the structural equation modeling (SEM) indicates that perceived usefulness has significance influence on attitude (β =0.29, P<0.01) and intention to use e-health (β =0.38, P<0.01); technical infrastructure has significance influence on attitude (β =0.41, P<0.01) and intention to use e-health (β =0.34, P<0.01); staffs IT experience has significance influence on attitude (β =0.26, P<0.05); security concerns of a system has significance influence on attitude (β =0.34, P<0.05) and intention to use e-health (β =0.33, P<0.01); and attitude has also significance influence on intention to use e-health (β =0.52, P<0.01), respectively.

CONCLUSIONS

Electronic health system implementers and executives in resource limited settings are in urgent need of adoption models to design proper implementation strategies. The constructs; perceived usefulness, technical infrastructure, staffs IT experience, security concerns and attitude portrayed in the revised TAM model were found with a strong positive relationship with the dependent variable, intention to use e-health. Therefore, the implementers should give a priority in enhancing technical infrastructures of the organizations, staffs IT skill, and their attitude towards e-health by giving continuous support.
Automatic Detection of Hypoglycemic Events From the Electronic Health Record Notes of Diabetes Patients: Empirical Study (Preprint)
Authors: Jin Yonghao , Li Fei , Vimalananda Varsha G , Yu Hong
Published: April 2019

BACKGROUND

Hypoglycemic events are common and potentially dangerous conditions among patients being treated for diabetes. Automatic detection of such events could improve patient care and is valuable in population studies. Electronic health records (EHRs) are valuable resources for the detection of such events.

OBJECTIVE

In this study, we aim to develop a deep-learning–based natural language processing (NLP) system to automatically detect hypoglycemic events from EHR notes. Our model is called the High-Performing System for Automatically Detecting Hypoglycemic Events (HYPE).

METHODS

Domain experts reviewed 500 EHR notes of diabetes patients to determine whether each sentence contained a hypoglycemic event or not. We used this annotated corpus to train and evaluate HYPE, the high-performance NLP system for hypoglycemia detection. We built and evaluated both a classical machine learning model (ie, support vector machines [SVMs]) and state-of-the-art neural network models.

RESULTS

We found that neural network models outperformed the SVM model. The convolutional neural network (CNN) model yielded the highest performance in a 10-fold cross-validation setting: mean precision=0.96 (SD 0.03), mean recall=0.86 (SD 0.03), and mean F1=0.91 (SD 0.03).

CONCLUSIONS

Despite the challenges posed by small and highly imbalanced data, our CNN-based HYPE system still achieved a high performance for hypoglycemia detection. HYPE can be used for EHR-based hypoglycemia surveillance and population studies in diabetes patients.
Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis (Preprint)
Authors: Yerrakalva Dharani , Yerrakalva Dhrupadh , Hajna Samantha , Griffin Simon
Published: April 2019

BACKGROUND

High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living.

OBJECTIVE

We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults.

METHODS

We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment.

RESULTS

Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness.

CONCLUSIONS

mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.
Preventing Emerging and Re-emerging Infections in the Eastern Mediterranean Region: Gaps, Challenges, and Priorities (Preprint)
Authors: Araj Rawan , Alqasrawi Sultan , Samy Sahar , Alwahdanee Ghaya , Wadi Jamal , Mofleh Jawad , Alsanouri Tarek
Published: April 2019

BACKGROUND

The Eastern Mediterranean Public Health Network, supported by the Biosecurity Engagement Program, contributed significantly to strengthening the preparedness and response to the emerging and re-emerging infections in the region.

OBJECTIVE

This study aimed to determine the gaps, challenges, and priorities for preventing the emerging and re-emerging infections, with a focus on biosafety and biosecurity in four countries of the region, namely, Egypt, Iraq, Jordan, and Morocco.

METHODS

A total of two different methods were used to determine the gaps and priorities for preventing the emerging and re-emerging infections. The first method was a rapid assessment for the preparedness and response to the emerging and re-emerging infections in four countries of the region, with a focus on biosafety and biosecurity. The second method was a face-to-face round table meeting of the participating teams for two days, where the teams from all countries presented their countries’ profiles, findings, priorities, and gaps based on the countries’ assessments.

RESULTS

The assessment and meeting resulted in several priorities and recommendations for each of the countries in the areas of legislation and coordination, biosafety and biosecurity, surveillance and human resources, case management and response, infection control and prevention, and risk communication and laboratory capacity.

CONCLUSIONS

Many recommendations were relatively consistent throughout, including improving communication or building collaborations to improve the overall health of the country.
Proposal for the User-Centered Design Approach for Health Apps Based on Successful Experiences: Integrative Review (Preprint)
Authors: Molina-Recio Guillermo , Molina-Luque Rafael , Jiménez-García Ana M. , Ventura-Puertos Pedro E , Hernández-Reyes Alberto , Romero-Saldaña Manuel
Published: April 2019

BACKGROUND

Different strategies encompassed within mHealth have shown themselves to be effective for maintaining good health or controlling certain diseases. However, there is usually a very high rate of abandonment of health apps. Therefore, it would seem obvious that there is a need for involving the end users (whether they are health professionals, patients, or both) in the design process from the early stages in order to enable their needs and characteristics to be identified. In this sense, it is common knowledge that focusing on the user permits the consideration of valuable details aimed at making the correct adjustment between the patient, the technology, and the organization of attention.

OBJECTIVE

The goal of the research was to propose a methodology based on the review of previous successful user experiences in setting up health apps by using qualitative techniques (focus groups and discussion groups) that includes the participation of information technology and health professionals and the patients themselves.

METHODS

An integrative review was made of studies in which a qualitative methodology was employed mainly through focus and/or discussion groups for the design and development of health apps, consulting diverse databases (PubMed, Scopus, and Proquest) with the following search strategy: “mHealth AND apps AND focus group OR discussion group.” A total of 69 papers were included in the review.

RESULTS

A proposal structured in 4 sessions of variable duration was made in which information technology and health professionals and patients take part: composing, preparing, and organizing contents (session 1); testing structure and usability (session 2); does the app fit the needs of end users? (session 3); and last testing—keep on improving (session 4). Throughout the sessions, we propose studying aspects like previous user experiences in mHealth, barriers to the adoption of mHealth, interface contents, management and browsability, usability, perceived quality, security and privacy, capacity to self-manage disease with the app, ergonomics, and glanceability, etc. Specific tools that have proved useful in previous research for measuring these aspects are presented.

CONCLUSIONS

These work sessions would be based on predominantly qualitative methodologies although, as they evolve, validated questionnaires permitting the assessment of the objectivity of certain technical aspects could be incorporated. With this proposal, a project centered on end users could be effected, responding to their needs. However, this requires validation that will be made via implementation in the development of health apps, with the subsequent measurement of results in terms of adherence and improvement in the clinical variables of the end users.
Longitudinal Magnetic Resonance Imaging as a Potential Correlate in the Diagnosis of Alzheimer Disease: Exploratory Data Analysis (Preprint)
Authors: Khan Afreen , Zubair Swaleha
Published: April 2019

BACKGROUND

Alzheimer disease (AD) is a degenerative progressive brain disorder where symptoms of dementia and cognitive impairment intensify over time. Numerous factors exist that may or may not be related to the lifestyle of a patient that result in a higher risk for AD. Diagnosing the disorder in its beginning period is important, and several techniques are used to diagnose AD. A number of studies have been conducted on the detection and diagnosis of AD. This paper reports the empirical study performed on the longitudinal-based magnetic resonance imaging (MRI) Open Access Series of Brain Imaging dataset. Furthermore, the study highlights several factors that influence the prediction of AD.

OBJECTIVE

This study aimed to correlate the effect of various factors such as age, gender, education, and socioeconomic background of patients with the development of AD. The effect of patient-related factors on the severity of AD was assessed on the basis of MRI features, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), estimated total intracranial volume (eTIV), normalized whole brain volume (nWBV), and Atlas Scaling Factor (ASF).

METHODS

In this study, we attempted to establish the role of longitudinal MRI in an exploratory data analysis (EDA) of AD patients. EDA was performed on the dataset of 150 patients for 343 MRI sessions (mean age 77.01 [SD 7.64] years). The T1-weighted MRI of each subject on a 1.5-Tesla Vision (Siemens) scanner was used for image acquisition. Scores of three features, MMSE, CDR, and ASF, were used to characterize the AD patients included in this study. We assessed the role of various features (ie, age, gender, education, socioeconomic status, MMSE, CDR, eTIV, nWBV, and ASF) on the prognosis of AD.

RESULTS

The analysis further establishes the role of gender in the prevalence and development of AD in older people. Moreover, a considerable relationship has been observed between education and socioeconomic position on the progression of AD. Also, outliers and linearity of each feature were determined to rule out the extreme values in measuring the skewness. The differences in nWBV between CDR=0 (nondemented), CDR=0.5 (very mild dementia), and CDR=1 (mild dementia) are significant (ie, P<.01).

CONCLUSIONS

A substantial correlation has been observed between the pattern and other related features of longitudinal MRI data that can significantly assist in the diagnosis and determination of AD in older patients.
The Acute Flaccid Paralysis (AFP) Surveillance System in Yemen, 2010-2015: Descriptive Study Based on Secondary Data Analysis (Preprint)
Authors: Almoayed Khaled Abdullah , Bin Break Ali , Al-Qassimi Mutahar , Assabri Ali , Khader Yousef
Published: April 2019

BACKGROUND

Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication.

OBJECTIVE

This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates.

METHODS

This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system.

RESULTS

A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively.

CONCLUSIONS

The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.
Comparison of Assessment by a Virtual Patient and by Clinician-Educators of Medical Students' History-Taking Skills: Exploratory Descriptive Study (Preprint)
Authors: Setrakian Jean , Gauthier Geneviève , Bergeron Linda , Chamberland Martine , St-Onge Christina
Published: April 2019

BACKGROUND

A virtual patient (VP) can be a useful tool to foster the development of medical history–taking skills without the inherent constraints of the bedside setting. Although VPs hold the promise of contributing to the development of students’ skills, documenting and assessing skills acquired through a VP is a challenge.

OBJECTIVE

We propose a framework for the automated assessment of medical history taking within a VP software and then test this framework by comparing VP scores with the judgment of 10 clinician-educators (CEs).

METHODS

We built upon 4 domains of medical history taking to be assessed (breadth, depth, logical sequence, and interviewing technique), adapting these to be implemented into a specific VP environment. A total of 10 CEs watched the screen recordings of 3 students to assess their performance first globally and then for each of the 4 domains.

RESULTS

The scores provided by the VPs were slightly higher but comparable with those given by the CEs for global performance and for depth, logical sequence, and interviewing technique. For breadth, the VP scores were higher for 2 of the 3 students compared with the CE scores.

CONCLUSIONS

Findings suggest that the VP assessment gives results akin to those that would be generated by CEs. Developing a model for what constitutes good history-taking performance in specific contexts may provide insights into how CEs generally think about assessment.
Validity of the Polar M430 Activity Monitor in Free-Living Conditions: Validation Study (Preprint)
Authors: Henriksen André , Grimsgaard Sameline , Horsch Alexander , Hartvigsen Gunnar , Hopstock Laila
Published: April 2019

BACKGROUND

Accelerometers, often in conjunction with heart rate sensors, are extensively used to track physical activity (PA) in research. Research-grade instruments are often expensive and have limited battery capacity, limited storage, and high participant burden. Consumer-based activity trackers are equipped with similar technology and designed for long-term wear, and can therefore potentially be used in research.

OBJECTIVE

We aimed to assess the criterion validity of the Polar M430 sport watch, compared with 2 research-grade instruments (ActiGraph and Actiheart), worn on 4 different locations using 1- and 3-axis accelerometers.

METHODS

A total of 50 participants wore 2 ActiGraphs (wrist and hip), 2 Actihearts (upper and lower chest position), and 1 Polar M430 sport watch for 1 full day. We compared reported time (minutes) spent in sedentary behavior and in light, moderate, vigorous, and moderate to vigorous PA, step counts, activity energy expenditure, and total energy expenditure between devices. We used Pearson correlations, intraclass correlations, mean absolute percentage errors (MAPEs), and Bland-Altman plots to assess criterion validity.

RESULTS

Pearson correlations between the Polar M430 and all research-grade instruments were moderate or stronger for vigorous PA (r range .59-.76), moderate to vigorous PA (r range .51-.75), steps (r range .85-.87), total energy expenditure (r range .88-.94), and activity energy expenditure (r range .74-.79). Bland-Altman plots showed higher agreement for higher intensities of PA. MAPE was high for most outcomes. Only total energy expenditure measured by the hip-worn ActiGraph and both Actiheart positions had acceptable or close to acceptable errors with MAPEs of 6.94% (ActiGraph, 3 axes), 8.26% (ActiGraph, 1 axis), 14.54% (Actiheart, upper position), and 14.37% (Actiheart, lower position). The wrist-worn ActiGraph had a MAPE of 15.94% for measuring steps. All other outcomes had a MAPE of 22% or higher. For most outcomes, the Polar M430 was most strongly correlated with the hip-worn triaxial ActiGraph, with a moderate or strong Pearson correlation for sedentary behavior (r=.52) and for light (r=.7), moderate (r=.57), vigorous (r=.76), and moderate to vigorous (r=.75) PA. In addition, correlations were strong or very strong for activity energy expenditure (r=.75), steps (r=.85), and total energy expenditure (r=.91).

CONCLUSIONS

The Polar M430 can potentially be used as an addition to established research-grade instruments to collect some PA variables over a prolonged period. However, due to the high MAPE of most outcomes, only total energy expenditure can be trusted to provide close to valid results. Depending on the variable, the Polar M430 over- or underreported most metrics, and may therefore be better suited to report changes in PA over time for some outcomes, rather than as an accurate instrument for PA status in a population.
Trend of Cutaneous Leishmaniasis in Jordan From 2010 to 2016: Retrospective Study (Preprint)
Authors: Alhawarat Mohammad , Khader Yousef , Shadfan Bassam , Kaplan Nasser , Iblan Ibrahim
Published: April 2019

BACKGROUND

Cutaneous leishmaniasis (CL) is endemic in the Middle East, with countries such as Syria reporting high incidence rates.

OBJECTIVE

This study aimed to assess the trends in the incidence of cutaneous leishmaniasis (CL) in Jordan from 2010 to 2016.

METHODS

This retrospective study included all cases of CL that had been reported to the Leishmaniasis Surveillance System in the Department of Communicable Diseases at the Jordan Ministry of Health during the period from 2010 to 2016. A total of 1243 cases were reported and met the case definition.

RESULTS

A total of 1243 cases (60.65% [754/1243] males and 39.34% [489/1243] females) were diagnosed during the study period. Of this sample, 233 patients (19.13%) were aged <5 years old, 451 (37.03%) were aged between 5-14 years old, 190 (15.60%) were aged between 15-24 years old, and 344 (28.24%) were aged ≥25 years old. Of those, 646 (51.97%) were Jordanians and 559 (44.97%) were Syrians. The average annual incidence rate of 1.70 per 100,000 people between 2010 and 2013 increased to 3.00 per 100,000 people in the years 2014 to 2016. There was no difference in incidence rates between Jordanians and Syrian refugees between 2010 and 2012. After 2012, the incidence rate increased significantly among Syrian refugees from 1.20 per 100,000 people in 2012 to 11.80 per 100,000 people in 2016. On the contrary, the incidence rate did not change significantly among Jordanians.

CONCLUSIONS

The incidence rate of leishmaniasis in Jordan has increased in the last three years because of the influx of Syrian refugees into Jordan. A massive effort toward reservoir and vector control, along with actively pursuing diagnosis in endemic foci, will be helpful. Proper and studious reporting of cases is also a necessity for the eradication of this disease.
It’s a learning curve: A mixed method study on improving knowledge about pregnancy for Deaf South African women of reproductive age through an SMS-based information campaign (Preprint)
Authors: Haricharan Hanne Jensen , Heap Marion , Hacking Damian , Lau Yan Kwan
Published: April 2019

BACKGROUND

Signing Deaf South Africans have limited access to health information and consequently limited knowledge about health. Maternal and neonatal mortality rates are high. Cell phone usage is high, making it a potentially important way of communicating about maternal and child health.

OBJECTIVE

The primary aim of this study was to assess whether an SMS-based health information campaign could improve knowledge about pregnancy, antenatal care and healthy living during pregnancy for signing Deaf South African women of reproductive age. A secondary aim was to evaluate the acceptability of such an intervention.

METHODS

The study was designed as a pre-test-post-test study. A baseline questionnaire assessed participants’ knowledge about pregnancy, antenatal care and healthy living during pregnancy before an SMS-based information campaign was conducted. After the campaign, an exit questionnaire was conducted, containing the same questions as the baseline questionnaire with additional questions about general acceptability and communication preferences. Results were compared between baseline and exit, using McNemar’s test and Wilcoxon signed-rank test. A focus group aimed to get further information on the impact and acceptability of SMSs. The focus group was analysed inductively.

RESULTS

The research showed a statistically significant improvement in overall health knowledge amongst participants. Despite this, some participants found the medical terminology difficult to understand. Several ways of improving SMS-campaigns for the Deaf were identified, including using MMSs (Multimedia Services) with a person signing messages and linking information campaigns to an interactive communication service that would enable Deaf people to pose questions. The focus group also suggested that SMSs might play a role in motivating healthy behaviour during pregnancy.

CONCLUSIONS

The SMS-campaign was effective in improving Deaf women’s knowledge about pregnancy, antenatal care and healthy living during pregnancy amongst Deaf women of reproductive age and has potential to impact on healthy behaviour. This contrasts with a similar study with hearing pregnant women. This suggests that SMSs may be particular effective in improving Deaf people’s health knowledge. However, attention should be given to Deaf participants’ specific needs and communication preferences to optimise impact. The potential for using SMS-campaigns to impact on behaviour should be studied.

CLINICALTRIAL

The research was registered with the Pan African Clinical Trial Registry on December 1, 2015. Identification numbers: PACTR201512001352180.
Modular Catheter Systems in Minimally Invasive Interventional Medical Procedures: Case Study (Preprint)
Authors: Beach Bradley , Scansen Brian A
Published: April 2019

BACKGROUND

Medical device catheters that are used in minimally invasive interventional medical procedures all follow the same integrated design and use paradigm. The features and elements of any catheter device are combined in a single unitary construction. A modular approach to the design, construction and use of these types of interventional catheters may provide significant advantages and benefits not available with an integrated design paradigm.

OBJECTIVE

The objective of this paper is to present the design of a Modular Catheter System and the findings from an initial veterinary use as a case study for the potential of Modular Catheter Systems in general.

METHODS

A Modular Catheter System was designed using a commercially available angioplasty balloon dilatation catheters as one module in the system and a custom designed Scoring Adapter as the other module. The Scoring Adapter incorporates wires to add scoring features to the angioplasty balloon catheter to improve the dilatation performance during a pulmonary valvuloplasty procedure. The Scoring Adapter also includes a novel Attachment Mechanism to couple the Scoring Adapter to any .035” guidewire compatible angioplasty balloon catheter.

RESULTS

The Modular Catheter System was successfully designed, manufactured and used in an initial minimally invasive veterinary cardiovascular intervention to treat a case of canine subvalvular pulmonary stenosis. The Scoring Adapter and angioplasty balloon catheter were successfully combined “tableside” in the operating room at the time of the procedure and used to successfully dilated the subvalvular obstruction.

CONCLUSIONS

The successful design and use of the presented Modular Catheter System demonstrates the feasibility and potential advantages of this type of paradigm to enable physicians to create interventional catheter devices at the time of a procedure guided by the procedural needs.
The Impact of War in Yemen on Immunization Coverage of Children Under One Year of Age: Descriptive Study (Preprint)
Authors: Torbosh Amr , Al Amad Mohammed Abdulla , Al Serouri Abdulwahed , Khader Yousef
Published: April 2019

BACKGROUND

After 2 years of war that crippled the capacity of the Yemeni National Health System and left only 45% of health facilities functioning, Yemen faced increasing vaccine-preventable disease (VPD) outbreaks and may be at high risk of polio importation.

OBJECTIVE

The aim of this study was to determine the impact of the 2015 war on the immunization coverage of children under 1 year.

METHODS

Data on vaccination coverage for 2012-2015 were obtained from the national Expanded Program on Immunization (EPI). The vaccination coverage was calculated at the national and governorate levels by dividing the number of actually vaccinated children by the estimated population of children under 1 year.

RESULTS

Although there was an increase from 2012 to 2014 in the national coverage for penta-3 vaccine (82% in 2012 vs 88% in 2014) and measles vaccine (70% in 2012 vs 75% in 2014), the coverage was still below the national target (≥95%). Furthermore, the year 2015 witnessed a marked drop in the national coverage compared with 2014 for the measles vaccine (66% in 2015 vs 75% in 2014), but a slight drop in penta-3 vaccine coverage (84% in 2015 vs 88% in 2014). Bacillus Calmette–Guérin vaccine also showed a marked drop from 73% in 2014 to 49% in 2015. These reductions were more marked in governorates that witnessed armed confrontations (eg, Taiz, Lahj, and Sa’dah governorates). On the other hand, governorates that did not witness armed confrontations showed an increase in coverage (eg, Raymah and Ibb), owing to an increase in their population because of displacement from less secure and confrontation-prone governorates.

CONCLUSIONS

This analysis demonstrated the marked negative impact of the 2015 war on immunization coverage, especially in the governorates that witnessed armed confrontations. This could put Yemen at more risk of VPD outbreaks and polio importation. Besides the ongoing efforts to stop the Yemeni war, strategies for more innovative vaccine delivery or provision and fulfilling the increasing demands are needed, especially in governorates with confrontations. Enhancing EPI performance through supportable investments in infrastructure that was destroyed by the war and providing decentralized funds are a prerequisite.
Indonesian Teacher’s Code Switching and Mixing in EFL Context
Authors: Syafrizal Syafrizal , Gailea Nurhaeda , Pratiwi Fitriani
Published: April 2019

The objectives of research are to investigate the frequency of teacher’s code switching and code mixing, the function of teacher’s code switching and code mixing in EFL Classroom, and teacher and students’ attitude toward it. This research focuses on analyzing EFL teacher’s utterances at 10th grade and by using Poplack, Musyken and Wardhaugh theory. The method of this study is case study. The data of the research is in the form of written recording utterances during teaching and learning process in the classroom, interview and questionnaire. Based on the analysis of the data, reveals that there are three major conclusions about teacher’s code switching and code mixing in EFL classroom. First, code switching and code mixing exist in EFL classroom. Second, the use of code switching and code mixing in EFL classroom has various functions includes topic switch, affective, repetitive, directive and phatic function, as proposed by Sert (2005) and Apple and Musyken (2006). Third, the data from the questionnaire reflects the positive attitude toward the use of code switching and code mixing along teaching and learning activities in the classroom. While both teacher and students agreed that code switching and code mixing can promote better understanding and be effective to make students understand their teacher’s practice instructions and material explanation.
Factors influencing the adoption of smart farming by Brazilian grain farmers
Authors: Pivoto Dieisson , Barham Bradford , Waquil Paulo Dabdab , Foguesatto Cristian Rogério , Corte Vitor Francisco Dalla , Zhang Debin , Talamini Edson
Published: April 2019

Smart farming (SF) is a relatively new concept referring to the use of information and communication technology in farm management, focusing simultaneously on productivity, profitability, and conservation of natural resources. However, despite the benefits, the adoption rate of some SF technologies has not been uniform in some countries. The aim of this paper was to identify the barriers and determining factors influencing the decisions of grain farmers regarding adopting SF technologies. A sample of farmers in southern Brazil (n=119) was analyzed through descriptive analysis, Logit and Poisson models. The results showed there was no strict pattern in farmers’ profile, especially in terms of socioeconomic characteristics, to explain the adoption of SF technologies as a package. Adoption of some technologies requires more years of education and knowledge about how technology works, other technologies demand more scale. Broadly speaking, SF requires farmers to be open and receptive to this concept of agriculture.