bluuebunny/crossref_metadata_2025 huggingface dataset:
NUTRIENT AND ANTINUTRIENT COMPOSITION OF DIFFERENT VARIETY OF CASSAVA (Manihot esculenta Crantz) LEAVES
Authors: Jamil Siti Sarah , Bujang Aishah
Published: October 2019

The aim of this study was to determine the nutrient and anti-nutrient composition of six varieties of cassava leaf namely Medan, Sri Pontian, Putih, Kuning, Sri Kanji 1 and Sri Kanji 2. Proximate composition, minerals, cyanide and tannin content were analyzed. The results obtained showed that composition of nutrients and antinutrients in cassava leaves is different among the varieties. Cassava leaf of variety Medan has significantly high moisture content, while Sri Pontian has significantly high fibre content and Putih has significantly high content of protein compared to the other varieties. Highest ash content was found in both Putih and Sri Kanji 1 variety, while highest lipid was observed in both Sri Pontian and Sri Kanji 2. Both Medan and Sri Kanji 1 varieties showed significantly high in carbohydrate content. Among the varieties, Sri Pontian has the highest Ca content while Sri Kanji 1 has the highest Na content. Variety Kuning and Sri Kanji 1 have similarly high content of K, while Mg was found to be highest in both Medan and Sri Kanji 1 variety. For anti-nutrients composition, both cyanide and tannin were found to be significantly high in Sri Pontian variety compared to the other varieties. This study showed that cassava leaves has appreciable amount of nutrients and minerals that can be a good source of nutrients in a diet. However, proper pretreatments must be employed prior to consumption to reduce the anti-nutrients content in the leaves.
A FUZZY LOGIC CONTROLLER TO LINE STARTING PERFORMANCE SYNCHRONOUS MOTOR FOR A CRANE SYSTEM USING VECTOR CONTROL
Authors: Birowo Birowo , Ahmad Robiah , Zamzuri Hairi , Priyono Agus
Published: October 2019

This paper presents the design process of a synchronous motor of crane system using vector control of line starting [1]. The preliminary design is d-q model armature rotor line start synchronous motor with vector control for decreasing a starting current and torque. The design allows the synchronous motor to operate at both starting and synchronous speed. The basic equations for park transformation of the rotor-stator for proposed vector control to synchronous motor are presented [2]. The starting performance of synchronous motor, for example in crane application, requires rapid dynamics and precise regulation; hence the need of direct control is becoming an urgent demand. This type of control providesanindependent vector control of torqueand current, whichis similar to a separatelyexcited synchronous motor and offersa number ofattractivefeatures. Synchronous motorhasahighstartingtorquewhileseparately synchronous motorcanoperate abovethebase low speedinthe line starting current [3]. This paper designs study and highlights the effectiveness of the  proposed vector control methods for a line starting performance of synchronous motor model parameter, using a fuzzy logic controller methods both simulation and manufacturers measured experimental data. Asteady state and transient analysis of the synchronous motor is performed belowand abovebase line starting current.
FLUORESCENT LIGHT (FL), RED LED AND BLUE LED SPECTRUMS EFFECTS ON IN VITRO SHOOTS MULTIPLICATION
Authors: Azmi Nurul Syahirah , Ahmad Robiah , Ibrahim Rusli
Published: October 2019

Tissue culture in ornamental plants is one of the relevant factors that beat production of vegetables and fruit production worldwide. It has been recognized as an effective tool to enhance large scale of plant multiplication. However, the conventional lighting system may contain unnecessary wavelength that are low quality to promote growth. In this study, experiment was conducted by using Light Emitting Diodes (LED) as an alternative source of lighting. Red and blue LEDs along with fluorescent light (FL) were applied to determine the best source of light in multiplication of rose. Under the same media regimes which are MS media basal and BAP shoot hormone, blue LED had shown more shoots and leaves.
A COMPARISON OF HEURISTICS FOR SCHEDULING PROBLEMS IN TEXTILE INDUSTRY
Authors: E. Nugraheni Cecilia , Abednego Luciana
Published: October 2019

Scheduling is an important problem in textile industry. The scheduling problem in textile industry generally belongs to the flow shop scheduling problem (FSSP). There are many heuristics for solving this problem. Eight heuristics, namely FCFS, Gupta, Palmer, NEH, CDS, Dannenbring, Pour, and MOD are considered and compared. Experimental results show the best heuristic is NEH and the worst heuristic is FCFS.
CLASSIFICATION OF EEG-BASED HAND GRASPING IMAGINATION USING AUTOREGRESSIVE AND NEURAL NETWORKS
Authors: Djamal Esmeralda Contessa , Suprijanto Suprijanto , J. Setiadi Steven
Published: October 2019

In the development of Brain Computer Interface (BCI), one important issue is the classification of hand grasping imagination. It is helpful for realtime control of the robotic or a game of the mind. BCI uses EEG signal to get information on the human. This research proposed methods to classify EEG signal against hand grasping imagination using Neural Networks.  EEG signal was recorded in ten seconds of four subjects each four times that were asked to imagine three classes of grasping (grasp, loose, and relax). Four subjects used as training data and four subjects as testing data. First, EEG signal was modeled in order 20 Autoregressive (AR) so that got AR coefficients being passed Neural Networks. The order of the AR model chosen based optimization gave a small error that is 1.96%. Then, it has developed a classification system using multilayer architecture and Adaptive Backpropagation as training algorithm. Using AR made training of the system more stable and reduced oscillation. Besides, the use of the AR model as a representation of the EEG signal improved the classification system accuracy of 68% to 82%. To verify the performance improvement of the proposed classification scheme, a comparison of the Adaptive Backpropagation and the conventional Backpropagation in training of the system. It resulted in an increase accuracy of 76% to 82%. The system was validated against all training data that produced an accuracy of 91%. The classification system that has been implemented in the software so that can be used as the brain computer interface.
IMPEDANCE MODELLING OF METAMATERIAL STRUCTURE BASED ON DOUBLE QUAD-SQUARE SLOT SPLIT RING RESONATOR (DQSS-SRR) AT 4.6 GHZ
Authors: Azman Adibah , Salleh Azahari , Abd Aziz Mohamad Zoinol Abidin , Suaidi Mohd Kadim , Sulaiman Hamzah Asyrani
Published: October 2019

This paper represents the impedance modelling of metamaterial structure based on Double Quad-Square Slot Split ring Resonator (DQSS-SRR). The impedance was modelled for DQSS-SRR design structures. This structure simulation works had been done in CST Microwave Studio simulation software while the impedance was modelled by using polynomial type in Matlab for resistance, R, and reactance, X, of the impedance. The modelling of the impedance was based on the length of U-slot arm (Larm) and the width of U-slot arm gap (Wgap) of the DQSS-SRR design structure .The impedances were divided into the certain ranges of length and width for dimensions of DQSS-SRR so that an accurate impedance modelling was produced. The impedance was modelled for the resonant frequency of 4.6 GHz. This DQSS-SRR structure has potential application to improve of pyramidal microwave absorber for certain frequency range.
MORPHOMETRIC BRAIN MEASUREMENT OF PRENATAL ULTRASOUND-INDUCED RABBIT FETUS USING MICRO-COMPUTED TOMOGRAPHY (MICRO-CT)
Authors: W. A. Zaiki Farah , Dom S. M.
Published: October 2019

Prenatal ultrasound is widely used and became an integral part of the clinical practice, particularly in obstetrics and gynecology. However, the advances in the capability of ultrasound equipment nowadays, trigger a greater image processing power, hence might as well increase the fetal exposure. Hence premises the morphometric brain measurement to be assessed in this study as an evidence of the ultrasound interruptions during the fetal neuronal development. This research randomly analyzed a total of 18 ultrasound-induced rabbit fetuses for fetal brain volume and surface after being exposed prenatally to the ultrasound exposure (duration=60 minutes; frequency = 7.09 MHz; spatial peak temporal average intensity (ISPTA) = 49.4 W/cm2; power = 56.0 W; thermal index (TI) = 0.2; mechanical index (MI) = 1.0). The fetuses were analyzed for morphometric brain measurement of brain volume and surface using Skyscan™ 1176 Micro-computed Tomography (Micro-CT). There were significant differences in the measurement of brain volume and surface at the 2nd and 3rd stage of gestation (P < 0.05). Results suggested that there are significant differences in the brain volume and surface between the controls and the 2nd and 3rd stage of gestation. There are also a significant reduction in the brain volume and surface in the exposed groups at all stages of gestation (P < 0.05).
THE EFFECTS OF PHYLLANTHUS GOMPHOCARPUS HOOK. F. AQUEOUS EXTRACT SUPPLEMENTATION ON ANDROGENIC HORMONAL LEVEL AND HISTOLOGICAL TESTES MORPHOMETRY
Authors: Anuar Bahari Ebby , Ismail Mohd Azrul Hisham , Dasiman Razif , Haron Norhisham , Amom Zulkhairi
Published: October 2019

Phyllanthus gomphocarpus Hook. F is a herb found in tropical rainforest countries and has been widely used in traditional medicine especially in Peninsular Malaysia to treat male infertility problems and increase human health. Ten percent aqueous extraction of PGR was prepared by heating in 40º C for 12 hours and its decoction were freeze dried to obtain crude extract. Total numbers of 24 male rats were randomly divided into 4 groups which NEC, POC, PGR50 and PGR800. Except for NEC group, other groups were induced genitotoxicity by oral supplementation of 200 mg/kg of BPA for 21 consecutive days.  For PGR50 and PGR800 groups, the animals were concomitantly supplemented with 50 mg/kg and 800 mg/kg of PGR extracts respectively. Blood and testes sample were collected for hormonal and testes morphometric analysis. Results clearly showed that that testosterone (T), the most important hormone in spermatogenesis process were significantly increased in PGR supplemented groups (p<0.05) compared to NEC and POC groups. For the level of DHT, FSH, and LH hormonal level, the results were varies and can be explained with the deterioration effects of BPA and the hormonal regulations itself. Testes morphometric study showed no significant difference in the seminiferous tubule diameter in each groups but was significantly increased (p<0.05) in the epithelium height, which indicates higher rate of spermatogenesis process. In addition, PGR possessed a protective effect against the toxicity effects of BPA. In conclusion, PGR was suggested to enhance male fertility through improvement of androgenic hormones and possessed a protective effect against genitotoxicity of BPA.
RADIOGRAPHIC IMAGE ENHANCEMENT USING HYBRID ALGORITHM
Authors: Chouvatut Varin , Boonchieng Ekkarat
Published: October 2019

Radiographic image quality is important in the medical field since it can increase the visibility of anatomical structures and even improve the medical diagnosis. Because the image quality depends on contrast, noise, and spatial resolution, images with low contrast, a lot of noises, or low resolution will decrease image quality, leading to an incorrect diagnosis. Therefore, radiographic images should be enhanced to facilitate medical expertise in making correct diagnosis. In this paper, radiographic images are enhanced by hybrid algorithms based on the idea of combining three image processing techniques: Contrast Limited Adaptive Histogram Equalization for enhancing image contrast, Median Filter for removing noises, and Unsharp Masking for increasing spatial resolution. Two series of medical images consisting of 20 x-ray images and 20 computed radiography images are enhanced with this method. Peak Signal to Noise Ratio (PSNR) and image contrast are computed in order to measure image quality. The results indicate that the enhanced images have better PSNR.
TOOL PATH GENERATION OF CONTOUR PARALLEL BASED ON ANT COLONY OPTIMISATION
Authors: Abdullah Haslina , Ramli Rizauddin , Abd Wahab Dzuraidah , Abu Qudeiri Jaber
Published: October 2019

In today’s competitive market of manufacturing industry, shorter machining time is one of important factor for reducing the manufacturer’s cost. This paper presents the minimisation of machining time of computer numerical control (CNC) by eliminating the uncut region of sharp corner based on contour parallel milling method.  Each uncut region at sharp corner is represented by uncut line which consists of two nodes in x and y directions.  An Ant Colony Optimisation (ACO) method is used to optimize the tool path length because of its capability to find the shortest tool path length. The optimisation of tool path length based on ACO algorithm ascertained that the cutting tool remove the uncut line once and able to eliminate the uncut region in the shortest tool path length. To observe the effectiveness of the ACO performance, the simulation results are compared with the results obtained by the previous method.  Finally the simulation results show the reduction of 5% machining time compared to previous method.
PREDICTING THE TRANSMISSIBILITY OF A GLOVE MATERIAL TO THE PALM USING A SIMPLE LUMPED PARAMETER MODEL OF THE HAND AND THE GLOVE
Authors: Rezali K.A.M. , As’arry A. , Zulkefli Z.A. , Samin R. , Jalil N.A.A.
Published: October 2019

Assessing a glove for its ability to reduce vibration transmitted to the hand can be improved if the transmissibility of the glove to the hand can be predicted. This study proposes a simple lumped parameter model of the hand and the glove for predicting the transmissibility of a glove to the hand. The model of the hand consists of three main body segments: the palm, the fingers, and the palm tissues, connected via translational and rotational springs and dampers. The glove material was represented by translational spring and damper. The results showed that the glove transmissibility predicted using the model overestimated the glove transmissibility measured experimentally at frequencies greater than 62 Hz, implying that a simple three degree-of-freedom model of the hand and the glove may not be able to provide a reasonable prediction of glove transmissibility.
EVALUATION OF FEATURE EXTRACTION AND CLASSIFICATION TECHNIQUES FOR EEG-BASED SUBJECT IDENTIFICATION
Authors: Handayani Dini , Wahab Abdul , Yaacob Hamwira
Published: October 2019

The ability to identify a subject is indispensable in affective computing research due to its wide range of applications. User profiling was created based on the strength of emotional patterns of the subject, which can be used for subject identification. Such system is made based on the emotional states of happiness and sadness, indicated by the electroencephalogram (EEG) data. In this paper, we examine several techniques used for subject profiling or identification purposed. Those techniques include feature extraction and classification techniques. In the experimental study, we compare three techniques for feature extraction namely, Power Spectral Density (PSD), Kernel Density Estimation (KDE), and Mel Frequency Cepstral Coefficients (MFCC). As for classification we compare three classification techniques, they are; Multilayer Perceptron (MLP), Naive Bayesian (NB), and Support Vector Machine (SVM). The best result achieved was 59.66%, using the MFCC and MLP-based techniques using 5-fold cross validation. The experiment results indicated that these profiles could be more accurate in identifying subject compared to NB and SVM. The comparisons demonstrated that profile-based methods for subject identification provide a viable and simple alternative to this problem.
M-DENGUE: UTILIZING CROWDSOURCING AND TELECONSULTATION FOR LOCATION-BASED DENGUE MONITORING AND REPORTING SYSTEM
Authors: Husain Wahidah , Abdul Aziz Fatin Syazana , Abdul Rashid Nur’ Aini , Jothi Neesha
Published: October 2019

Dengue fever has become a major public health concern in recent years. The number of deaths caused by dengue is increasing over the years thus putting it in an alarming state. Public should be informed about the latest dengue cases around them. Most of them have to access various source of information to get this updates. M-Dengue, a web-based system has been proposed as a location-based platform for monitoring and reporting dengue cases, which allows information sharing in real time. It also includes dashboard that represent the data and act as a tool for analyzing, visualizing, classifying and geo-referencing dengue reports. The dashboard will helps the health staff to monitor this disease and make quick decisions. The system is proposed to benefit the community and to improve their health as well as the health of those around them. It is also aimed to engage the public as participants in the public health process as they could issue reports and share information regarding this threatening disease. The system is developed for the health staff and general public. Users are expected to be able to monitor dengue disease and gain the latest information regarding dengue cases in the country.
QUANTITATIVE STRUCTURE ACTIVITY RELATIONSHIPS IN COMPUTER AIDED MOLECULAR DESIGN
Authors: Hamza Hentabli , Salim Naomie , Saeed Faisal
Published: October 2019

The drug development process requires the complete evaluation and identification of the chosen substance as well as its properties. It involves extensive chemical examination to achieve the best therapeutic effects which demands huge expenditure both in terms of time and money. Computer aided molecular design (CAMD) allows the production of new substances with pre-decided properties. Additionally, in order to illustrate and determine the interrelationship between the chemical structure of a compound and its biological activity, Quantitative Structure Activity Relationship (QSAR) is applied by employing a mathematical model and arranging molecular descriptors. This paper presents review of CAMD and QSAR techniques. The most common chemometric techniques are also emphasized. CAMD and QSAR are considered to be extremely efficient instruments in molecular design and accelerate the initial steps of drug development process. Furthermore, they enhance the effectiveness and reduce the cost of newly developed drugs.
Maternal obesity accelerates rat offspring metabolic ageing in a sex‐dependent manner
Authors: Rodríguez‐González Guadalupe L. , Reyes‐Castro Luis A. , Bautista Claudia J. , Beltrán Azucena A. , Ibáñez Carlos A. , Vega Claudia C. , Lomas‐Soria Consuelo , Castro‐Rodríguez Diana C. , Elías‐López Ana L. , Nathanielsz Peter W. , Zambrano Elena
Published: October 2019

Key points

Maternal obesity predisposes to metabolic dysfunction in male and female offspring

Maternal high‐fat diet consumption prior to and throughout pregnancy and lactation accelerates offspring metabolic ageing in a sex‐dependent manner

This study provides evidence for programming‐ageing interactions

Human epidemiological studies show that maternal obesity (MO) shortens offspring life and health span. Life course cellular mechanisms involved in this developmental programming‐ageing interaction are poorly understood. In a well‐established rat MO model, female Wistar rats ate chow (controls (C)) or high energy, obesogenic diet to induce MO from weaning through pregnancy and lactation. Females were bred at postnatal day (PND) 120. Offspring (F1) of mothers on control diet (CF1) and MO diet (MOF1) delivered spontaneously at terms. Both CF1 and MOF1 ate C diet from weaning throughout the study. Offspring were killed at PND 36, 110, 450 and 650. We determined body and liver weights, liver and serum metabolite concentrations, hormones and oxidative stress biomarkers. Male and female CF1 body weight, total fat, adiposity index, serum leptin, insulin, insulin resistance, and liver weight, fat, triglycerides, malondialdehyde, reactive oxygen species and nitrotyrosine all rose with differing ageing trajectories. Female CF1 triglycerides were unchanged with age. Age‐related increases were greater in MOF1 than CF1 in both sexes for all variables except glucose in males and females and cholesterol in males. Cholesterol fell in CF1 females but not MOF1. Serum corticosterone levels were higher in male and female MOF1 than CF1 and declined with age. DHEA serum levels were lower in male and female MOF1 than CF1. Liver antioxidant enzymes decreased with age (CF1 and MOF1). Conclusions: exposure to the developmental challenge of MO accelerates progeny ageing metabolic and endocrine profiles in a sex specific manner, providing evidence for programming‐ageing interactions.
Uranium tetrafluoride (UF4) powder analyzed by XPS
Authors: Feng Xu , D’Souza Brendan , Zhang Jinsuo
Published: October 2019

XPS was performed on as-received and Ar+-sputtered uranium tetrafluoride (UF4) powder. The as-received powder surface exhibits stoichiometric UF4 with hydrocarbon contamination and surface impurities of uranium dioxide (UO2) and uranyl fluoride (UO2F2). Sputtering removes a majority of surface contamination and impurities, while also partially reduces the powder surface to uranium trifluoride (UF3).
PAF and the inflammasome
Authors: Foley John F.
Published: October 2019

The phospholipid PAF stimulates NLRP3 inflammasome activation and inflammatory cytokine production independently of its GPCR.
Lake Andrei: A Pliocene pluvial lake in Eureka Valley, eastern California
Authors: Knott* Jeffrey R. , Wan Elmira , Deino Alan L. , Casteel Mitch , Reheis Marith C. , Phillips Fred M. , Walkup Laura , McCarty† Kyle , Manoukian§ David N. , Nunez Jr.# Ernest
Published: October 2019

We used geologic mapping, tephrochronology, and 40Ar/39Ar dating to describe evidence of a ca. 3.5 Ma pluvial lake in Eureka Valley, eastern California, that we informally name herein Lake Andrei. We identified six different tuffs in the Eureka Valley drainage basin, including two previously undescribed tuffs: the 3.509 ± 0.009 Ma tuff of Hanging Rock Canyon and the 3.506 ± 0.010 Ma tuff of Last Chance (informal names). We focused on four Pliocene stratigraphic sequences. Three sequences are composed of fluvial sandstone and conglomerate, with basalt flows in two of these sequences. The fourth sequence, located ~1.5 km south of the Death Valley/Big Pine Road along the western piedmont of the Last Chance Range, included green, fine-grained, gypsiferous lacustrine deposits interbedded with the 3.506 Ma tuff of Last Chance that we interpret as evidence of a pluvial lake. Pluvial Lake Andrei is similar in age to pluvial lakes in Searles Valley, Amargosa Valley, Fish Lake Valley, and Death Valley of the western Great Basin. We interpret these simultaneous lakes in the region as indirect evidence of a significant glacial climate in western North America during marine isotope stages Mammoth/Gilbert 5 to Mammoth 2 (MIS MG5/M2) and a persistent Pacific jet stream south of 37°N.
Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases
Authors: Hu Kaimin , Ding Peili , Wu Yinan , Tian Wei , Pan Tao , Zhang Suzhan
Published: October 2019

Objectives

Disparities in the global burden of breast cancer have been identified. We aimed to investigate recent patterns and trends in the breast cancer incidence and associated mortality. We also assessed breast cancer-related health inequalities according to socioeconomic development factors.

Design

An observational study based on the Global Burden of Diseases.

Methods

Estimates of breast cancer incidence and mortality during 1990–2016 were obtained from the Global Health Data Exchange database. Subsequently, data obtained in 2016 were described using the age-standardised and age-specific incidence, mortality and mortality-to-incidence (MI) ratios according to sociodemographic index (SDI) levels. Trends were assessed by measuring the annual percent change using the joinpoint regression. The Gini coefficients and concentration indices were used to identify between-country inequalities.

Results

Countries with higher SDI levels had worse disease incidence burdens in 2016, whereas inequalities in the breast cancer incidence had decreased since 1990. Opposite trends were observed in the mortality rates of high and low SDI countries. Moreover, the decreasing concentration indices, some of which became negative, among women aged 15–49 and 50–69 years suggested an increase in the mortality burdens in undeveloped regions. Conversely, inequality related to the MI ratio increased. In 2016, the MI ratios exhibited distinct gradients from high to low SDI regions across all age groups.

Conclusions

The patterns and trends in breast cancer incidence and mortality closely correlated with the SDI levels. Our findings highlighted the primary prevention of breast cancer in high SDI countries with a high disease incidence and the development of cost-effective diagnostic and treatment interventions for low SDI countries with poor MI ratios as the two pressing needs in the next decades.
Translation and cultural adaptation of the web and printed versions of a decision aid to support men’s prostate cancer screening choice: a protocol
Authors: Baptista Sofia , Heleno Bruno , Pinto Marta , Teixeira Andreia , Taylor Kathryn L , Martins Carlos
Published: October 2019

Introduction

Prostate cancer is one of the most frequent cancers among men. However, screening for prostate cancer carries many risks and a small benefit. Thus, based on the available evidence, most medical organisations advocate a shared decision-making process, in which decision aids may play an important role. Nevertheless, to date there is no such instrument to be used by Portuguese men. Our goal is to translate and perform the cultural adaptation of an English language prostate cancer screening decision aid called ‘Making the best choice’, in web and printed formats, which has been developed and tested by a workgroup from Georgetown University (USA).

Methods and analysis

Culturally and technically inappropriate recommendations in the original decision aid will be reviewed by the process coordinator and a linguistic expert. Two forward translations from English to Portuguese will be done, followed by a back-translation and an independent expert review. We will further improve the decision aid through an iterative process of data collection, data analysis and decision aid review. Individual semistructured cognitive interviews will be conducted and audiotaped with 55–69-year-old men recruited from the local community (urban and suburban) of Oporto district. We plan a total sample size of 30 participants (15 interviews per format). All participants will receive written information about the study and will sign individual consent forms. After verbatim transcription of the audiofiles, a thematic categorical analysis will be conducted using Ligre Software.

Ethics and dissemination

The study protocol was approved by the Health Ethics Committee from Centro Hospitalar de São João/Faculdade de Medicina da Universidade do Porto. Results from this study will be disseminated in peer-reviewed publications and the Portuguese decision aid will available to Portuguese men.
Non-communicable disease (NCD) corners in public sector health facilities in Bangladesh: a qualitative study assessing challenges and opportunities for improving NCD services at the primary healthcare level
Authors: Rawal Lal B , Kanda Kie , Biswas Tuhin , Tanim Md. Imtiaz , Poudel Prakash , Renzaho Andre M N , Abdullah Abu S , Shariful Islam Sheikh Mohammed , Ahmed Syed Masud
Published: October 2019

Objective

To explore healthcare providers’ perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level.

Design

We used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners’ service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted.

Setting

Twelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions.

Participants

Participants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters.

Results

Participants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments’ initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems.

Conclusion

The initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.
Variation in spend on young mental health across Clinical Commissioning Groups in England: a cross-sectional observational study
Authors: Rocks Stephen , Fazel Mina , Tsiachristas Apostolos
Published: October 2019

Objectives

To investigate whether the rate of spend on child and adolescent mental health is influenced by demand for other competing services in local commissioning decisions.

Design

Analysis of spend data by Clinical Commissioning Groups (CCG), including other publicly available data to control for variation in need.

Setting

Local commissioning decisions in the National Health Service.

Participants

Commissioning of health services across 209 CCGs.

Main outcome measures

Association between the rate of child and adolescent mental health spend and demand for child and adolescent mental health services (CAMHS), adult mental health services and physical health services after adjusting for confounding factors.

Results

An additional percentage point in the proportion of children in care is associated with 4% higher child and young person mental health (CYP MH) spend per person aged 0–18 (ratio of means: 1.04; 95% CI 1.00 to 1.07). Spending £100 more on physical health services was associated with 9% lower spend in CYP MH per person aged 0–18 (ratio of means: 0.91; 95% CI 0.84 to 0.99).

Conclusions

Healthcare commissioners in England face a challenge in balancing competing needs. This paper contributes to our understanding of this by quantifying the possible extent of the trade-off between physical health and CYP MH when allocating budgets. Any attempt to explain the variation in CAMHS spend must also take account of demand for other services.
Scoping review to map evidence on mechanism of action, pharmacokinetics, effectiveness and side effects of centchroman as a contraceptive pill
Authors: Kabra Rita , Allagh Komal Preet , Ali Moazzam , Jayathilaka Chandani Anoma , Mwinga Kasonde , Kiarie James
Published: October 2019

Objective

To systematically identify and map the available evidence on effectiveness, side effects, pharmacokinetics and mechanism of action of centchroman as a contraceptive pill.

Introduction

Centchroman was introduced in the Indian national family planning programme in 2016 as a once-a-week short-term contraceptive pill/oral contraceptive. At present there are no WHO recommendations on this method of contraception. We examined the available evidence through a scoping review.

Methods

A search was conducted inclusive to the years 1970–2019 on electronic databases, grey literature sources and reference lists of included studies to identify studies. The five stages of Arksey and O’Malley’s scoping review framework were applied in undertaking this scoping review.

Results

The review identified 33 studies conducted between 1976 and 2017. Two studies reported mechanism of action of centchroman. Pharmacokinetics was reported by five studies among non-breastfeeding women and four studies among breastfeeding women. Eight studies reported on effectiveness ranging from 93% to 100%. Pregnancies due to user failure ranged from 2.6% to 10.2%. Although side effects were reported in 13 studies, the incidence varied greatly between the studies. Continuous bleeding and prolonged cycles >45 days were the most commonly reported side effects. All studies conducted had a small sample size and the duration of follow-up of women was 12 months or less. Fifty-five per cent of studies were by the developers of the pill (Central Drug Research Institute) and results of the phase IV clinical trial were unavailable.

Conclusions

The scoping review shows that studies with robust designs and conducted in international context are lacking. Insufficient evidence exists on centchroman use as a postcoital contraceptive pill. The broad uncertainty in range of side effects and effectiveness in the studies implies insufficient evidence to make global recommendations on centchroman that is currently licensed as a contraceptive in India.
A mixed-methods study of challenges and benefits of clinical academic careers for nurses, midwives and allied health professionals
Authors: Trusson Diane , Rowley Emma , Bramley Louise
Published: October 2019

Objectives

The clinical academic trajectory for doctors and dentists is well-established, with research embedded in their career development. Recent years have also seen a burgeoning interest and push for nurses, midwives and allied health professionals (NMAHPs) to pursue a clinical academic career. However, the National Institute for Health Research (NIHR) 10-year review suggested that there may be problems with progression post Master’s degree level for this group, with nurses and midwives receiving less NIHR funding than allied health professionals. This study responds to these concerns, tracking the progression and exploring experiences of NMAHPs in the East Midlands region of England.

Design

An online survey and in-depth interviews were used to capture a wide range of experiences.

Participants

67 NMAHPs who were pursuing a clinical academic career were surveyed, supplemented by 16 semi-structured in-depth interviews.

Results

Three themes emerged during data analysis: Embarking on a clinical academic career, overcoming barriers and benefits.

Conclusions

NMAHPs are motivated to pursue a clinical academic career by a drive to improve services for the benefit of patients and the National Health Service more widely, as well as for personal development and career progression. People working in these roles have opportunities to explore possible solutions to issues that they encounter in their clinical role through academic study. Findings reveal benefits emanating from the individual level through to (inter)national levels, therefore academic study should be encouraged and supported. However, investment is needed to establish more clinical academic roles to enable NMAHPs to continue to use their experience and expertise post-PhD, otherwise the full extent of their value will not be recognised.
Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
Authors: Hidaka Tomoo , Endo Shota , Kasuga Hideaki , Masuishi Yusuke , Kakamu Takeyasu , Kumagai Tomohiro , Saito Keiko , Abe Kouichi , Fukushima Tetsuhito
Published: October 2019

Objectives

Pre-emptive conversations (PCs) about end-of-life (EOL) preferences are beneficial for both elderly people and their families to understand and share the preferences. However, the factors which promote/inhibit PCs have yet to be clarified. We therefore aimed to determine the factors related to having PCs with hypothesis that age, subjective economic status and subjective health status are associated with having PC experience.

Design

A cross-sectional study administering a questionnaire and using stratified random sampling by gender and region.

Setting

Residents aged 65 years or older who were not receiving nursing care as of 1 November 2016, were extracted from the Japanese long-term care insurance system registry in Koriyama City, Fukushima Prefecture, Japan.

Participants

1575 participants (717 males and 858 females).

Outcome

Presence or absence of PC experience with family or friends (yes/no).

Results

The mean age of the participants was 74.0 years. A multivariable logistic-regression analysis revealed that having PC experience was significantly associated with gender (OR=1.907; 95% CI=1.556 to 2.337; p<0.001), subjective economic status (OR=0.832; 95% CI=0.716 to 0.966; p=0.016) and subjective happiness (OR=0.926; 95% CI=0.880 to 0.973; p=0.003).

Conclusions

Poor subjective economic status of elderly people may result in the absence of EOL conversation experience with their families and friends, hindering the elderly from sharing and understanding the EOL preferences. To promote PCs about EOL, gerontology and public health professionals should give special consideration to the subjective economic status of elderly people.
Serum soluble urokinase type plasminogen activated receptor and focal segmental glomerulosclerosis: a systematic review and meta-analysis
Authors: Shuai Tiankui , Pei Jing Yan , Huang Qiangru , Xiong Huaiyu , Liu Jingjing , Zhu Lei , Yang Kehu , Jian Liu
Published: October 2019

Objectives

Soluble urokinase plasminogen activated receptor (suPAR) is a biomarker that may predict the occurrence of focal segmental glomerulosclerosis (FSGS); however, there is still controversy about whether suPAR can predict FSGS. In this study, we performed a systematic evaluation and meta-analysis to prove whether suPAR can predict FSGS, and to detect a threshold concentration of suPAR that can be used to diagnose FSGS. In addition, a threshold concentration of suPAR for the diagnosis of FSGS was proposed.

Design

Systematic review and meta-analysis.

Data sources

We systematically searched PubMed, Embase, Cochrane Library, Web of Science and China Biology Medicine databases for studies published from the inception dates to 1 December 2018.

Eligibility criteria

(1) Data involving the suPAR level were from blood samples; (2) FSGS was diagnosed by biopsy; and (3) randomised controlled trials, cohort studies, case–control studies and cross-sectional studies.

Data extraction and synthesis

Initially, a total of 364 studies were searched, among which 29 studies were finally included. In addition, seven studies described the cut-off value of suPAR, which ranged from 2992.6 to 5500 pg/mL.

Results

The results showed that the suPAR levels in the primary FSGS group were significantly higher when compared with that in the normal control group (p<0.001; standard mean difference (SMD): 2.56; 95% CI 1.85 to 3.28), and significant differences were observed in the secondary FSGS and in the normal control group (p<0.001; SMD: 1.68; 95% CI 1.37 to 1.98). A suPAR concentration of 3000 pg/mL may be the best threshold for the diagnosis of primary FSGS (sensitivity=0.72; specificity=0.88; area under the curve=0.85).

Conclusion

Our results suggested that suPAR might be a potential biomarker for predicting primary and secondary FSGS. In addition, our data showed that a suPAR concentration of 3000 pg/mL might be used as a threshold for the diagnosis of FSGS.

Trial registration number

CRD42019120948.
Association between quantitative sensory testing and pain or disability in paediatric chronic pain: protocol for a systematic review and meta-analysis
Authors: Schoth Daniel Eric , Blankenburg Markus , Wager Julia , Broadbent Philippa , Zhang Jin , Zernikow Boris , Liossi Christina
Published: October 2019

Introduction

This protocol describes the objective and methods of a systematic review of the association between quantitative sensory testing (QST) measures and pain intensity or disability in paediatric chronic pain (PCP). The review will also assess whether the relationship strength is moderated by variables related to the QST method and pain condition; the use of QST in PCP (modalities, outcome measures and anatomical test sites as well as differentiating between pain mechanisms (eg, neuropathic vs nociceptive) and in selecting analgesics); the reliability of QST across the paediatric age range; the ability of QST to differentiate patients with chronic pain from healthy controls; and differences between anatomical test sites.

Methods and analysis

Medline, PsycINFO, CINHAL, Web of Science, Scopus, Cochrane Library and OpenGrey will be searched. English language studies will be eligible if they recruit a sample aged 6–24 (inclusive) with chronic pain, including primary and secondary pain; apply at least one of the following QST modalities: chemical, electrical, mechanical (subgroups include pressure, punctate/brush and vibratory) or thermal stimulus to measure perception of noxious or innocuous stimuli applied to skin, muscle or joint; use a testing protocol to control for stimulus properties: modality, anatomical site, intensity, duration and sequence. Following title and abstract screening, the full texts of relevant records will be independently assessed by two reviewers. For eligible studies, one reviewer will extract study characteristics and data, and another will check for accuracy. Both will undertake independent quality assessments using the Appraisal Tool for Cross-Sectional Studies. A qualitative synthesis will be presented with discussion centred around different QST modalities. Where eligible data permit, meta-analyses will be performed separately for different QST modalities using comprehensive meta-analysis.

Ethics and dissemination

Review findings will be reported in a peer-reviewed journal and presented at conferences. The study raises no ethical issues.

PROSPERO registration number

CRD42019134069.
Examining consensus for a standardised patient assessment in community paramedicine home visits: a RAND/UCLA-modified Delphi Study
Authors: Leyenaar Matthew S , Strum Ryan P , Batt Alan M , Sinha Samir , Nolan Michael , Agarwal Gina , Tavares Walter , Costa Andrew P
Published: October 2019

Objective

Community paramedicine programme are often designed to address repeated and non-urgent use of paramedic services by providing patients with alternatives to the traditional ‘treat and transport’ ambulance model of care. We sought to investigate the level of consensus that could be found by a panel of experts regarding appropriate health, social and environmental domains that should be assessed in community paramedicine home visit programme.

Design

We applied the RAND/UCLA Appropriateness Method in a modified Delphi method to investigate the level of consensus on assessment domains for use in community paramedicine home visit programme.

Setting and participants

We included a multi-national panel of 17 experts on community paramedicine and in-home assessment from multiple settings (paramedicine, primary care, mental health, home and community care, geriatric care).

Measures

A list of potential assessment categories was established after a targeted literature review and confirmed by panel members. Over multiple rounds, panel members scored the appropriateness of 48 assessment domains on a Likert scale from 0 (not appropriate) to 5 (very appropriate). Scores were then reviewed at an in-person meeting and a finalised list of assessment domains was generated.

Results

After the preliminary round of scoring, all 48 assessment domains had scores that demonstrated consensus. Nine assessment domains (18.8%) demonstrated a wider range of rated appropriateness. No domains were found to be not appropriate. Achieving consensus about the appropriateness of assessment domains on the first round of scoring negated the need for subsequent rounds of scoring. The in-person meeting resulted in re-grouping assessment domains and adding an additional domain about urinary continence.

Conclusion

An international panel of experts with knowledge about in-home assessment by community paramedics demonstrated a high level of agreement on appropriate patient assessment domains for community paramedicine home visit programme. Community paramedicine home visit programme are likely to have similar patient populations. A standardised assessment instrument may be viable in multiple settings.
Protocol for a feasibility exploratory multicentre study of factors influencing trauma patients’ outcomes of traffic crashes in Saudi Arabia
Authors: Alharbi Rayan , Miller Charne , Lewis Virginia
Published: October 2019

Introduction

Road traffic injury is a leading cause of death for people of all ages. The burden of road traffic injuries is well established in developed countries. However, there has been limited investigation of the incidence and burden of road traffic injury in low/middle-income countries. With a proportionally high number of road users, there is a need to explore the factors in prehospital and hospital care in Saudi Arabia (SA) that are associated with mortality for adult trauma patients following road traffic crashes (RTCs). This paper outlines the method for the planned research.

Methods and analysis

A feasibility exploratory multicentre study will be conducted at three purposefully selected hospitals with different trauma care resources in differing geographic locations of SA. The study sample will include all adult trauma patients who are involved in RTCs in SA and have been admitted to a study site in a 3-month period from May to July 2019. Data regarding the characteristics of the crashes and prehospital health care factors will be extracted from hospital databases where it is available. Information will be collected from patients or carers and hospital records in the two sites that do not have a registry. Patient status at 30 days post-injury, particularly mortality, will be assessed through hospital records. The relative contribution of a range of factors to predicting mortality will be explored using logistic regression analysis.

Ethics and dissemination

This study was approved by the Institutional Review Board Committee at King Saud Medical City (H-01-R-053), the General Department of Research and Studies at the Ministry of Health in SA (1440-1249939) and (1440-1398648), and the La Trobe University Human Research Ethics Committee (HEC19095). The results will be reported in a thesis and in peer-reviewed journal articles and conference presentations.