bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial characteristics of the DMFT index in a high HIV prevalence setting
Authors: Kalanzi Dunstan , Kizza Harriet Mayanja , Nakanjako Damalie , Mboowa Gerald , Mbabali Muhammad , Kigozi Edgar , Ashaba Fred , Sserwadda Ivan , Kateete David Patrick , Acan Beatrice , Sewankambo Nelson K , Muwonge Adrian
Published: May 2020

Background: Oral disease pathogenesis is primarily driven by microbial dysbiosis although diagnosis is routinely macroscopic. To improve early detection especially in HIV patients who are disproportionately affected, there is need to reconcile macroscopic and microscopic characteristics of disease. This study aimed to use amplicon sequencing data to characterize oral microbiota changes along the decayed, missing, filled teeth (DMFT) index.Methods: Amplicon sequencing of the V6-V8 region of the 16S rRNA gene was done on DNA recovered from whole unstimulated saliva of 59 HIV positive and 29 HIV negative individuals, respectively. The microbial structure, composition and co-occurrence networks were characterized using QIIME-2, Phyloseq, Microbiome-1.9.2 and Metacoder in R.Results: From a total of 2.6 million high quality sequence reads obtained, we characterized the oral microbiota into 2,093 operational taxonomic units (OTUs), 21 phyla and 239 genera. While oral microbiota did not cluster participants into distinct groups that track with the DMFT index, we observed the following: a) A steady increase in accessory microbiota while the core size (~50% of richness) remained stable. b) The abundance of core genera such as Stomatobaculum, Peptostreptococcus and Campylobacter increased at onset of pathology (low DMFT), c) A general increase in oral microbial biomass with a typical log difference between gingivitis and periodontitis. d) The onset of pathology (low DMFT) was associated with massive reduction in oral microbial entropy.Conclusions: Although oral microbial shifts along the DMFT index are not distinct, we have demonstrated the potential utility of microbiota dynamics to inform oral disease characteristics. We therefore propose a framework to inform future clinical oral metagenomic studies especially among HIV positive persons in resource limited settings.
Dental Students’ Notetaking: a Thematic, Material-based Interview Study
Authors: Lindberg Viveca , Jounger Sofia Louca , Christidis Maria , Christidis Nikolaos
Published: May 2020

Background
The transition from upper secondary to higher education and from higher education to professional practice require that students need to adapt to new literacy practices, academic and professional. The aim of this study was to map what characterizes dental students’ notetaking and secondarily what dental students express regarding their notetaking.
Methods
Three undergraduate dental students participated in this material-based, semi-structured interview study, that was framed within a New Literacy Studies approach. To analyze the outcome of the interviews a thematic analysis was used.
Results
Eight themes that relate to what, how and for what purpose students write were discerned. These include a) what: T1-Professional vocabulary; T2-Core content; T3-Clinical example; b) how: T4-Multimodal accentuation; T5-Synthesis; and c) for what purpose: T6-Mnemonic strategies; T7-Academic purposes; and T8 professional purposes.
Conclusions
The digital development has changed the notetaking which has evolved from just synchronous to become both multimodal and asynchronous and is more of a writing practice. Students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter. Results showed that students, half-way through their dental education, are aware of that notetaking is not only for passing exams but also for learning for their profession.
Hypoxia-inducible factor-2α but not hypoxia-inducible factor-1α increases iron traffic in astrocytes
Authors: Xu Manman , Chen Zhiqiang , Ma Xizhen , Xu Hangrui , Fan Changsheng , Xie Junxia , Wang Jun
Published: May 2020

Background: Disrupted iron homeostasis in the substantia nigra (SN) is an important mechanism in Parkinson’s disease (PD). In our previous studies using cultured neurons, we showed that 6-hydroxydopamine (6-OHDA) treatment increased the expression of divalent metal transporter-1 (DMT1) gating iron influx and decreased the expression of ferroportin 1 (FPN1) gating iron efflux, leading to increased iron deposition. In astrocytes, 6-OHDA increased both DMT1 and FPN1 expressions and iron traffic. However, the underlying mechanisms mediating these processes remain elusive. Hypoxia-inducible factors (HIFs) are important regulators of iron homeostasis.Methods: Using western blots, we observed HIFs, DMT1 and FPN1 expressions in primary cultured astrocytes and ventral mesencephalic (VM) treated with 6-OHDA, inhibitors of HIF-1α and HIF-2α, protein kinase C (PKC) inhibitor and PKC activator, radical scavenger and inducible NO synthase (iNOS) inhibitor . The ferrous iron traffic of astrocytes was determined by measuring the quenching or reversing of calcein fluorescence.Results: Using primary rat cell cultures, we observed that 6-OHDA treatment significantly increased the expressions of HIF-1α and HIF-2α in cultured astrocytes but not in VM neurons. Moreover, we observed that HIF-2α inhibitor, but not HIF-1α inhibitor reversed the 6-OHDA-induced upregulation of DMT1 and FPN1 and ferrous iron traffic. Blocking protein kinase C (PKC) pathway by bisindolylmaleimide I hydrochloride (Bisl) or N-acetyl-l-cysteine (NAC) or Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME) inhibits Phorbol 12-myristate 13-acetate (PMA) or 6-OHDA induced activation of HIF-2α, whereas activating by PMA or 6-OHDA was sufficient to activate HIF-2α. Notably, blocking of PKC delta (PKC δ) phosphorylation by NAC, or L-NAME inhibits 6-OHDA induced activation of HIF-2α.Conclusion: Our data indicate that astrocytic HIF-2α, but not HIF-1α, may be an important regulator of DMT1 and FPN1 expressions by activating the PKC -dependent pathway.
Diesel Exhaust Particle Exposure Reduces Expression of the Epithelial Tight Junction Protein Tricellulin
Authors: Smyth Timothy , Veazey Janelle , Eliseeva Sophia , Chalupa David , Elder Alison , Georas Steve
Published: May 2020

Background
While exposure to diesel exhaust particles has been linked to aberrant immune responses in allergic diseases such as asthma, little attention has been payed to their effects on the airway epithelium. In this study, we sought to determine the effect of diesel exhaust exposure on airway epithelial barrier function and composition using in vitro and in vivo model systems. 16HBE14o- human bronchial epithelial cells were grown on collagen coated Transwell inserts and exposed to 5 to 50 µg/cm2 SRM 2975 diesel particulate matter (DEP) suspended in cell culture medium or vehicle controls. Changes in barrier function were assessed by measuring transepithelial electrical resistance (TEER) and permeability to 4 kDa FITC Dextran. Neonatal BALB/c mice were exposed to aerosolized DEP (255 ± 89 µg/m3; 2 hours per day for 5 days) and changes in the tight junction protein Tricellulin were assessed two weeks post exposure.
Results
A six-hour incubation of epithelial cells with diesel exhaust particles caused a significant concentration-dependent reduction in epithelial barrier integrity as measured by decreased TEER and increased permeability to 4 kDa FITC-Dextran. This reduction in epithelial barrier integrity corresponded to a significant reduction in expression of the tight junction protein Tricellulin. siRNA mediated knockdown of Tricellulin recapitulated changes in barrier function caused by DEP exposure. Neonatal exposure to aerosolized DEP caused a significant reduction in lung Tricellulin two weeks post exposure at both the protein and mRNA level.
Conclusion
Short term exposure to DEP causes a significant reduction in epithelial barrier integrity through a reduction in the tight junction protein Tricellulin. Neonatal exposure to aerosolized DEP caused a significant and sustained reduction in Tricellulin protein and mRNA in the lung, suggesting that early life exposure to inhaled DEP may cause lasting changes in airway epithelial barrier function.
Fear of missing out (FoMO) and gaming disorder among Chinese university students: Impulsivity and game time as mediators
Authors: Li Li , Griffiths Mark D. , Niu Zhimin , Mei Songli
Published: May 2020

Background and aims: Research into the fear of missing out (FoMO) has greatly increased in recent years. Given the negative consequences of gaming disorder (GD) among a small minority of individuals, there is an increasing need for research examining the impact of FoMO on GD. However, little is known about the roles of impulsivity and gaming time as mediators in the relationship between FoMO and GD. The present study examined whether impulsivity and gaming time mediated the relationship between FoMO (trait-FoMO and state-FoMO) and GD among Chinese university students, as well as the prevalence of GD.Methods: A total of 1127 university students completed an online survey including the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOS-C), the Barratt Impulsiveness Scale-Brief (BIS-Brief), gamine time survey, and the Chinese Gaming Disorder Scale (CGDS).Results: The prevalence of GD was 6.4% among Chinese university students. Trait-FoMO was found to indirectly impact GD via impulsivity and gamine time, whereas the direct effect of trait-FoMO on GD and the mediation effects of gaming time were not confirmed. State-FoMO impacted on GD both directly, and indirectly via the mediation effects of impulsivity as well as impulsivity and gaming time.Conclusion: Trait-FoMO on GD was fully mediated via impulsivity and gaming time, whereas state-FoMO on GD was partly mediated via impulsivity and gaming time. Individuals with high levels of FoMO were more likely to show impulsivity and spent a longer time gaming, and was associated with GD. These findings provide insights to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.
The mutational load and a T-cell inflamed tumor phenotype identify ovarian cancer patients rendering tumor-reactive T cells from PD-1+ tumor-infiltrating lymphocytes
Authors: Salas-Benito Diego , Conde Enrique , Tamayo-Uria Ibon , Mancheño Uxua , Elizalde Edurne , Garcia-Ros David , Aramendia Jose M. , Muruzabal Juan C. , Alcaide Julia , Guillen-Grima Francisco , Minguez Jose A. , Amores-Tirado Jose , Gonzalez-Martin Antonio , Sarobe Pablo , Lasarte Juan J. , Ponz-Sarvise Mariano , Andrea Carlos E. De , Hervas-Stubbs Sandra
Published: May 2020

Background: Adoptive immunotherapy with tumor-infiltrating lymphocytes (TIL) may benefit from the use of selective markers, such as programmed cell death protein 1 (PD-1), for tumor-specific T-cell enrichment, as well as predictive biomarkers that help identify those patients capable of rendering tumor-reactive TIL products. We have investigated this in ovarian cancer (OC) patients as candidate for TIL therapy implementation. Methods: PD-1- and PD-1+ CD8 TILs were isolated from resected ovarian tumors and, after polyclonal expansion, TIL products were tested against autologous tumor cells. Reactivity was assessed by IFNg production (ELISPOT) and upregulation of CD137. Baseline tumor samples were examined using flow cytometry, multiplexed quantitative immunofluorescence, Nanostring technology, for gene expression profile (GEP) analyses, as well as a next generation sequencing gene panel, for tumor mutational burden (TMB) calculation, to identify those features that distinguished patients with tumor-reactive and non-tumor-reactive TIL products.Results: Tumor-reactive TILs were detected in half of patients and were exclusively present in cells derived from the PD-1+ fraction. Flow-cytometric studies revealed that fresh tumors from patients rendering tumor-reactive TILs presented a significantly higher frequency of CD137+ cells within the PD1+CD8+ subset. Multiplexed immunofluorescence supported this finding, which was particularly striking in intraepithelial CD8 TILs. Baseline GEP analysis showed that patients rendering tumor-reactive TILs exhibited a significantly higher T-cell inflamed signature. Despite no correlation between TMB and GEP, both parameters stratified tumors, with patients with higher TMB and/or T-cell inflamed signature score rendering tumor-reactive TILs. Conclusion: We have demonstrated that PD-1 identifies autologous-tumor specific CD8 T cells infiltrating ovarian tumors and have uncovered predictive factors that identify OC patients who are likely to render tumor-reactive cells from PD-1+ TILs. These findings have important implications for improving the efficacy of TIL therapy in OC.
“We try our best to offer them the little that we can” Coping Strategies of Ghanaian Community Psychiatric Nurses: A Qualitative Study
Authors: Opare Frederick Yaw , Aniteye Patience , Afaya Agani , Glover-Meni Nathaniel
Published: May 2020

Introduction Addressing strategies of coping among community psychiatric nurses (CPNs) could help increase an individual’s ability to cope effectively and as a result, reduce experienced levels of stress. It is known that the level of work stress experienced by CPNs is remarkably high, because psychiatric nurses face more intense relationships with their patients, trying to prevent self-harm, and most at times face challenging situations with aggressive patient behaviors in the working environment. Therefore, the study aimed to explore the coping strategies employed by CPNs during healthcare delivery in the community. Methods An exploratory qualitative study design using an interpretative approach was employed. A total of 13 CPNs were purposively sampled, and data gathered through individual interviews using an interview guide. The interviews were audio-taped, transcribed verbatim and analyzed thematically, describing some of the coping strategies employed by CPNs in Ghana. Results Participants’ ages ranged from 26-60years. They comprised 3 males and 10 females. An inductive thematic analysis identified the following major coping strategies of community psychiatric nurses; self-disguise (wearing of mufti), reliance on religious faith, self-motivation and reduction in the number of home visits. Conclusion Coping strategies among community psychiatric nurses are essential for both individuals and organisations. Thus, community psychiatric nurses must acquire personal-mastery coping strategies such as the reduction in the number of home visits, self-disguise (wearing mufti) the use of faith to motivate themselves in the face the challenging working environment. The coping strategies adopted by community psychiatric nurses was not to only help them deliver care, but also as a way of protecting the clients so that people would not tag them as ‘mental patients’
Phone-based audience response system as an adjunct in orthodontic teaching of undergraduate dental students: a cross-over randomised controlled trial
Authors: Alharbi Fahad , Alazmi Khulud , Momani Bashar R. El , Almukhtar Anas , Al-Muzian Lubna , Almuzian Mohammed
Published: May 2020

Background: The advent of electronic teaching facilities opened doors towards a better tutor-student communication. The aim of this study is to explore the effectiveness of phone-based ARS (PB-ARS) using text- and multimedia-based questions on information retention by male dental undergraduate students and to explore the students’ perception and acceptance of ARS. Methods: A cross-over clustered randomised control trial was conducted at the College of Dentistry, Prince Sattam Bin Abdulaziz University/Alkharj/ Saudi Arabia. Students were allocated to one of two event groups (G1 or G2) using computer generated randomization. During the first intervention (lecture 1), G1 received ARS assisted lecture and G2 acts as a control group, then crossed over during the second intervention (lecture 2). Data for short- and long-term information retention were treated on intention to treat analysis basis and tested using Mann–Whitney U and t-test in addition to qualitative assessment of students’ perception and acceptance. Results : The results showed marginal improvements in short and long term retention of information in addition to positive attitude of students towards the ARS system. 87.5% of students in ARS group showed an improvement in their quiz score compared to 79.3% for control group. No statistically significant differences were observed between the intervention and control groups. Conclusion : the ARS system could be considered as an adjunctive teaching method to improve on information retention and interest in Orthodontics taught materials.
Hydroxychloroquine-Induced Stevens-Johnson Syndrome in COVID-19: A rare Case Report
Authors: Davoodi Lotfollah , Jafarpour Hamed , Kazeminejad Armaghan , Soleymani Eissa , Akbari Zahra , Razavi Alireza
Published: May 2020

Background: The international outbreak of respiratory illness termed coronavirus disease 2019 (COVID-19) began in December 2019 that has affected more than 0.8 million individuals. To date, there are no specific therapeutic agents for coronavirus infections. One of the drugs that have an effective role in improving the condition of patients with COVID-19 is hydroxychloroquine (HCQ). This drug is not a definitive treatment for this disease and has a supportive role. Like all medications, HCQ has side effects and may occur in COVID-19 patients. Stevens-Johnson syndrome caused by HCQ is very rare.Case presentation: A 42-year-old woman, presented with fever and dry cough in the past two days to her family physician. Lab tests revealed elevated lactate dehydrogenase (LDH, 648 units/liter (U/L)), C-reactive protein level (CRP, 52 milligrams/Liter (mg/L), normal: <10 mg/L), aspartate aminotransferase (AST, 59 U/L, normal: 10-40 U/L), thrombocytopenia, and leukopenia. Mild bilateral patchy ground-glass opacity was seen in lung CT-Scan. Due to COVID-19 pandemic and clinical findings, the nasopharyngeal swab test was done and SARS-CoV-2 nucleic acid was detected by RT-PCR. HCQ 200 mg twice daily was started. After two days, the patient presented with a pruritic erythematous maculopapular rash and ﬂat atypical targets that started from the distal of upper extremities and rapidly, involved the entire body, and torn blisters which were only be seen as ulcers on orolabial area. The Nikolsky sign was positive. Due to the likelihood of a drug reaction, HCQ was discontinued, and COVID-19 treatment was changed to lopinavir/ritonavir (LPV/RTV) 400 mg twice daily. Finally, she was discharged after five days with nonpruritic scalded skin on the distal of upper extremities. Conclusions: It is worth noting that although HCQ appears to be safe and has mild side effects, however, the boundary between therapeutic and toxic doses is narrow and severe disorders of their use can life-threatening. One of the side effects of HCQ is SJS caused by the drug, and given the worldwide pandemic of COVID-19 and the increasing need for this drug, we need to be careful about its use in order to control and manage the side effects of this drug.
Association between ibuprofen exposure and severe COVID-19 infection: a nationwide register-based study
Authors: Kragholm Kristian , Gerds Thomas A. , Fosbøl Emil , Andersen Mikkel Porsborg , Phelps Matthew , Butt Jawad H. , Østergaard Lauge , Gislason Gunnar , Schou Morten , Køber Lars , Torp-Pedersen Christian
Published: May 2020

Background: Initially, the World Health Organization (WHO) and national health boards issued a warning against NSAID use in corona virus disease 2019 (COVID-19) patients and recommended that paracetamol or acetaminophen instead should be administered. However, later and current WHO and European Medicine Agency recommendations do not call for avoidance of ibuprofen in COVID-19 patients. Given the current uncertainty of drug safety for NSAID use in patients with COVID-19, we performed a nationwide register-based study on the association of recent ibuprofen exposure and COVID-19 severity.Methods: Using national administrative databases, we identified COVID-19 patients in Denmark between end of February 2020 and April 2, 2020. Patients <30 years of age and heart failure, for whom ibuprofen is not recommended, were excluded. Ibuprofen exposure was defined using the Danish National Prescription Registry, where we had information until January 31, 2020. Endpoint was a composite of severe COVID-19 diagnosis with acute respiratory syndrome, intensive care unit admission or death. Results: Among 1,872 patients, 46 (2.5%) were exposed to ibuprofen prior to COVID-19 infection. Patients with recent ibuprofen exposure tended to be older and more likely to have hypertension, diabetes, myocardial infarction, chronic obstructive pulmonary disease, and cancer, though all insignificant (P>0.05). When adjusting for these covariates, odds ratio was 1.57 [95% CI 0.72-3.38], with 12 ibuprofen-exposed patients meeting the endpoint (26.1% [95% CI 13.4-38.8%]) versus 272 unexposed patients (14.9% [95% CI 13.4-16.4%]), P=0.15. Conclusion: The association between ibuprofen and severe COVID-19 was insignificant, although with a trend towards increased disease severity risk.
KERUKUNAN DALAM KEANEKARAGAMAN: Struktur Keberagamaan Masyarakat Pucakwangi
Authors: Mas'udi Mas'udi
Published: May 2020

This study aims to determine the religious structure of the community of Pucakwangi Village, Pucakwangi District, Pati Regency, Central Java Province. Religious awareness is an important foundation for the formation of religious harmony in diversity. With a qualitative functional structural approach, this study analyzes the structures that form community harmony in its diversity. The results of the study show some basic structures found in the midst of the diversity of the Pucakwangi Village community. Building an attitude of sympathy among followers of religion created with the participation of Christians in "tahlilan" activities, visiting each other in commemoration of religious holidays is another part of the forms of harmony they build together. Counteracting religious radicalism is another aspect of harmony that is built by the community with an awareness of the inter­relationships of their recent lives with their ancestors.
ANALISIS PREDIKSI FINANCIAL DISTRESS DENGAN METODE SPRINGATE (S-SCORE) PADA PT GARUDA INDONESIA TBK
Authors: Fitriani Marisa , Huda Nurul
Published: May 2020

Abstrak: Analisis Prediksi Financial Distress Dengan Metode Springate (S-Score) Pada PT Garuda Indonesia Tbk Penelitian ini bertujuan untuk mengetahui seberapa besarnya prediksi financial distress dan potensi kebangkrutan pada PT Garuda Indonesia Tbk. Jenis penelitian deskriptif kuantitatif. Populasi yang digunakan adalah laporan keuangan PT Garuda Indonesia Tbk yang diakses melalui website www.idx.co.id dalam bentuk laporan neraca (posisi keuangan) dan laba rugi selama delapan tahun terakhir yaitu tahun 2011-2018. Teknik sampling yang digunakan yaitu teknik purposive sampling dengan memperoleh sampel selama tujuh tahun terakhir yaitu tahun 2012-2018. Teknik analisis yang digunakan yaitu metode Sprigate Score (S-score) yang menggunakan empat rasio yaitu rasio modal kerja terhadap total aset (X1), rasio laba sebelum bunga dan pajak terhadap total aset (X2), rasio laba sebelum pajak terhadap total liabilitas (X3), dan rasio penjualan terdapap total aset (X4) serta menggunakan uji t-test one sample. Hasil penelitian ini diperoleh nilai thitung lebih kecil dari pada ttabel (-3.628<1.943). sehingga hipotesis Ho yang berbunyi yaitu:   Sprigate Score (S-Score) pada PT Garuda Indonesia Tbk kurang dari 0.862 dari yang diharapkan diterima yang artinya bahwa PT Garuda Indonesia, Tbk dikategorikan dalam kondisi financial distress dan berpotensi mengalami kebangkrutan selama tujuh tahun terakhir yaitu dari tahun 2012-2018.Kata Kunci: Financial Distress, Kebangkrutan, Springate Score.
Modifications to Electronic Nicotine Delivery Systems: Content Analysis of YouTube Videos
Authors: Massey Zachary B , Li Yachao , Holli Jessica , Churchill Victoria , Yang Bo , Henderson Katherine , Ashley David L , Huang Jidong , Popova Lucy
Published: May 2020

Background

As user modification can alter the addictiveness and toxicity of electronic nicotine delivery systems (ENDS), more research is needed to understand the types, motivations, risks, and information sources that lead to these product alterations. YouTube has been identified as a major platform where ENDS users obtain and share information about ENDS products and modifications. However, a comprehensive study of ENDS modification videos on YouTube is lacking.

Objective

This study aimed to analyze the content of YouTube videos depicting modifications of ENDS.

Methods

YouTube was searched in March 2019 to identify videos depicting ENDS modifications. Search terms were derived from interviews with ENDS users and current literature. We used 28 search phrases that combined the words vape and vaping with modification-related key terms (eg, custom build, modification, and dripping). The final sample included 168 videos.

Results

Videos were 1 to 108 min long (median 9.55). Presenters were largely male (117/168, 69.6%), white (94/168, 56.0%), and older than 25 years (94/168, 56.0%). Most videos gave how to instructions (148/168, 88.1%), but few offered warnings (30/168, 17.9%) or mentioned commercial alternatives to modifications they presented (16/168, 9.5%). The ENDS devices most often featured were drippers (63/168, 37.5%) and refillable tanks (37/168, 22.0%). The most often modified ENDS components were coils (82/168, 48.8%) and e-liquids (34/168, 20.2%), which included adding other substances, such as cannabis, to the e-liquids (6/168, 3.6%). Most videos portrayed ENDS modifications positively (106/168, 63.1% positive; 60/168, 35.7% neutral; and 2/168, 1.2% negative) and were either neutral or positive in their overall portrayal of ENDS devices (78/168, 46.4% positive; 89/168, 53.0% neutral; and 1/168, 0.6% negative).

Conclusions

This study identified several concerning trends in popular YouTube videos on ENDS modifications, including lack of warnings, the addition of marijuana derivatives to e-liquids, and the positive portrayal of ENDS devices and modifications. By identifying the types of modifications (coil and e-liquid being the most prevalent), this study sets an agenda for research on the effects of modifications.
A Patient Self-Checkup App for COVID-19: Development and Usage Pattern Analysis (Preprint)
Authors: Heo JoonNyung , Sung MinDong , Yoon Sangchul , Jang Jinkyu , Lee Wonwoo , Han Deokjae , Kim Hyung-Jun , Kim Han-Kyeol , Han Ji Hyuk , Seog Woong , Ha Beomman , Park Yu Rang
Published: May 2020

BACKGROUND

Clear guidelines for a patient with suspected COVID-19 infection are unavailable. Many countries rely on assessments through a national hotline or telecommunications, but this only adds to the burden of an already overwhelmed health care system. In this study, we developed an algorithm and a web application to help patients get screened.

OBJECTIVE

This study aims to aid the general public by developing a web-based application that helps patients decide when to seek medical care during a novel disease outbreak.

METHODS

The algorithm was developed via consultations with 6 physicians who directly screened, diagnosed, and/or treated patients with COVID-19. The algorithm mainly focused on when to test a patient in order to allocate limited resources more efficiently. The application was designed to be mobile-friendly and deployed on the web. We collected the application usage pattern data from March 1 to March 27, 2020. We evaluated the association between the usage pattern and the numbers of COVID-19 confirmed, screened, and mortality cases by access location and digital literacy by age group.

RESULTS

The algorithm used epidemiological factors, presence of fever, and other symptoms. In total, 83,460 users accessed the application 105,508 times. Despite the lack of advertisement, almost half of the users accessed the application from outside of Korea. Even though the digital literacy of the 60+ years age group is half of that of individuals in their 50s, the number of users in both groups was similar for our application.

CONCLUSIONS

We developed an expert-opinion–based algorithm and web-based application for screening patients. This innovation can be helpful in circumstances where information on a novel disease is insufficient and may facilitate efficient medical resource allocation.
#Dissemination: a systematic review of the role of social media in circulating healthcare research (Preprint)
Authors: Farris Olayinka , Todd Anita , Tomlin André , Badenoch Douglas , Lamb Danielle
Published: May 2020

BACKGROUND

Social media is a relatively new and popular means of disseminating information. However, regarding healthcare research there are concerns over the ability of social media to reach healthcare professionals, and its ability to convey a message that is representative of the research itself. To our knowledge, a review was yet to be conducted concerning the effective use of social media in communicating healthcare research

OBJECTIVE

The aim of this review was to assess the effectiveness of social media as a dissemination tool regarding healthcare research to professionals in the field.

METHODS

A scoping review was conducted to inform the search strategy. We searched EMBASE, MEDLINE, PsycINFO, and conducted manual searches from March 2018 to August 2019, for peer-reviewed publications in English describing the effectiveness of social media in disseminating health research to healthcare professionals. No publication time restrictions were imposed. Social media was used to identify additional peer-reviewed papers. For all selected studies, an MMAT quality assessment was undertaken.

RESULTS

Forty-seven studies were identified for inclusion. The papers reviewed suggest that social media was a popular and effective means of disseminating health research findings. In particular, the use of Twitter was highlighted regarding its positive relationship with citations. Crucially, dissemination on social media was advantageous over purely using traditional methods.

CONCLUSIONS

Despite concerns over the value of using social media to encourage awareness of healthcare, overall, our review suggests a positive contribution. It provides a useful way of research to effectively reach healthcare professionals (as indicated by citation levels), whilst not misrepresenting research findings. Unfortunately, only four papers directly compared presence with absence of social media promotion. Given the apparent utility of social media for healthcare research, we would encourage more direct comparisons to be made promptly.

CLINICALTRIAL

PROSPERO Registration: CRD42018102083.
Evaluation of a Stepped-Care eHealth HIV Prevention Program for Diverse Adolescent Men Who Have Sex With Men: Protocol for a Hybrid Type 1 Effectiveness Implementation Trial of SMART (Preprint)
Authors: Mustanski Brian , Moskowitz David A , Moran Kevin O , Newcomb Michael E , Macapagal Kathryn , Rodriguez-Díaz Carlos , Rendina H Jonathon , Laber Eric B , Li Dennis H , Matson Margaret , Talan Ali J , Cabral Cynthia
Published: May 2020

BACKGROUND

Adolescent men who have sex with men (AMSM), aged 13 to 18 years, account for more than 80% of teen HIV occurrences. Despite this disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs. Implementation issues are critical as traditional HIV prevention delivery channels (eg, community-based organizations, schools) have significant access limitations for AMSM. As such, eHealth interventions, such as our proposed SMART program, represent an excellent modality for delivering AMSM-specific intervention material where youth are.

OBJECTIVE

This randomized trial aimed to test the effectiveness of the SMART program in reducing condom-less anal sex and increasing condom self-efficacy, condom use intentions, and HIV testing for AMSM. We also plan to test whether SMART has differential effectiveness across important subgroups of AMSM based on race and ethnicity, urban versus rural residence, age, socioeconomic status, and participation in an English versus a Spanish version of SMART.

METHODS

Using a sequential multiple assignment randomized trial design, we will evaluate the impact of a stepped-care package of increasingly intensive eHealth interventions (ie, the universal, information-based SMART Sex Ed; the more intensive, selective SMART Squad; and a higher cost, indicated SMART Sessions). All intervention content is available in English and Spanish. Participants are recruited primarily from social media sources using paid and unpaid advertisements.

RESULTS

The trial has enrolled 1285 AMSM aged 13 to 18 years, with a target enrollment of 1878. Recruitment concluded in June 2020. Participants were recruited from 49 US states as well as Puerto Rico and the District of Columbia. Assessments of intervention outcomes at 3, 6, 9, and 12 months are ongoing.

CONCLUSIONS

SMART is the first web-based program for AMSM to take a stepped-care approach to sexual education and HIV prevention. This design indicates that SMART delivers resources to all adolescents, but more costly treatments (eg, video chat counseling in SMART Sessions) are conserved for individuals who need them the most. SMART has the potential to reach AMSM to provide them with a sex-positive curriculum that empowers them with the information, motivation, and skills to make better health choices.

CLINICALTRIAL

ClinicalTrials.gov Identifier NCT03511131; https://clinicaltrials.gov/ct2/show/NCT03511131

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/19701
COVID-19 Can Catalyze the Modernization of Medical Education (Preprint)
Authors: Chen Cathy Hsi , Mullen Alexander Joseph
Published: May 2020

UNSTRUCTURED

Amid the coronavirus disease (COVID-19) crisis, we have witnessed true physicianship as our frontline doctors apply clinical problem-solving to an illness without a textbook algorithm. Yet, for over a century, medical education in the United States has plowed ahead with a system that prioritizes content delivery over problem-solving. As resident trainees, we are acutely aware that memorizing content is not enough. We need a preclinical system designed to steer early learners from “know” to “know how.” Education leaders have long advocated for such changes to the medical school structure. For what may be the first time, we have a real chance to effect change. In response to the COVID-19 pandemic, medical educators have scrambled to conform curricula to social distancing mandates. The resulting online infrastructures are a rare chance for risk-averse medical institutions to modernize how we train our future physicians—starting by eliminating the traditional classroom lecture. Institutions should capitalize on new digital infrastructures and curricular flexibility to facilitate the eventual rollout of flipped classrooms—a system designed to cultivate not only knowledge acquisition but problem-solving skills and creativity. These skills are more vital than ever for modern physicians.
A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study (Preprint)
Authors: Alpert Jordan M , Kota Naga S Prabhakar , Ranka Sanjay , Mendoza Tonatiuh V , Solberg Laurence M , Rashidi Parisa , Manini Todd M
Published: May 2020

BACKGROUND

Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized.

OBJECTIVE

The aim of this study is to evaluate a graphical interface that displays patients’ health data from smartwatches, mimicking the integration within the environment of electronic health records.

METHODS

A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text.

RESULTS

The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75).

CONCLUSIONS

Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients’ health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.
A FHIR-based Patient Reported Outcomes Tool for COVID-19: Instrument Validation Study (Preprint)
Authors: Ide Lucienne Marie , Bonistalli Daniel , Valenzuela Lindsey
Published: May 2020

UNSTRUCTURED

The COVID-19 pandemic presents health systems with an unprecedented challenge to manage a dramatic surge of patients needing to be triaged into one of 2 categories: critically ill patients requiring inpatient medical care and those with milder symptoms who may be able to manage this novel disease from home. Ongoing monitoring of the home-isolating patient is required to identify those who are in need of professional care based on concerning symptom progression. To support these demands on triage teams we deployed a novel, Fast Healthcare Interoperability Resources (FHIR)-based patient reported outcomes (PROs) tool to enable screening, triage and monitoring of potential and confirmed cases of COVID-19 in a more efficient and timely manner. An initial pilot test of the tool successfully identified patients who experienced worsening symptoms that required further clinical assessment as well as a meaningful percentage of patients who expressed mental health distress and social needs during their period of quarantine.
Meat Safety Inspection in Senegal: Example of the Dakar Slaughterhouse from 2014 to 2018
Authors: Cheikh Fall S.
Published: May 2020

Meat inspection at slaughterhouses is among the most important responsibilities given to the Directorate of Veterinary Services in Senegal. The objective of this 5-year retrospective (2014–2018) study is to give an overview of the main seizure reasons and quantities of red meat (cattle, sheep, and goats) seized in the Dakar slaughterhouse, the biggest facility in the country. Data were collected from annual reports and analyzed using Microsoft Excel, 2019. In total, red meat seizures in this slaughterhouse represented around 0.15% of the total weight of slaughters and are valued at $123,440 (United States dollars) annually. Tuberculosis, cysticercosis, and putrefaction account for 80% of the weight of cattle carcasses seized. Distomatosis due to Fasciola gigantica represented more than 50% of the total weight of cattle organs seized. The very limited contribution of meat inspection to the animal diseases surveillance system, the absence of laboratory investigations to clarify findings, the lack of identification of slaughter animals, and the noncodification of seizure-reason terminology limit the use of available data. Greater attention should be paid to the quality of data recorded at slaughterhouses and to the occurrence and burden of tuberculosis, distomatosis, and cysticercosis so that control strategies can be developed to address them in Senegal.
STUDENT ATTENTION IN SOLVING FUNCTION PROBLEMS
Authors: Kaliky Syafruddin , Sopamena Patma , Juhaevah Fahruh , Sehuwaky Nurlaila , Kasliyanto
Published: May 2020

This study aims to describe the students' attention processes in solving functional problems. This research is a qualitative descriptive study, with subjects of 2 students taken from 8 students of secondary school. The results show that the students' attention process in solving functional problems was based on attentional characteristics, namely when students who answered correctly in solving questions and interview process, before and after reflection had complete cognitive attention structures. While students who answer incorrectly in solving problems have incomplete attention to cognitive structures, characterized by a lack of concentration in seeing the relationship between one mathematical object and another mathematical object. Attention characteristics in this study begin with recalling previous information and responding or giving feedback to problems by linking previous information with existing problems. Next analyze by breaking down information into smaller parts and easy to understand. The next step looks at the relationship between the decomposition process to get ways that can be used in the settlement process to obtain the final results that are part of decision making.
AN INTRODUCTION TO THE RASCH MEASUREMENT MODEL: A CASE OF MATHEMATICS EDUCATION STUDENTS COMPREHENSIVE TEST
Authors: Elizar Elizar , Khairunnisak Cut
Published: May 2020

Mathematics assessments should be designed for all students, regardless of their background or gender. Rasch analysis, developed based on Item Response Theory (IRT), is one of the primary tools to analyse the inclusiveness of mathematics assessment. However, the mathematics test development has been dominated by Classical Test Theory (CTT). This study is a preliminary study to evaluate the mathematics comprehensive test. This study aims to demonstrate the use of Rasch analysis by assessing the appropriateness of the mathematics comprehensive test to measure students' mathematical understanding. Data were collected from one cycle of mathematics comprehensive test involving 48 undergraduate students of mathematics education department. Rasch analysis was conducted using ACER Conquest 4 software to assess the item difficulty and differential item functioning (DIF). The findings show that the item related to geometry is the easiest question for students, while item concerning calculus as the hardest question. The test is viable to measure students’ mathematical understanding as it shows no evidence of Differential Item Functioning (DIF). Gender has been drawn for each of the test items. The assessment showed that the test was inclusive. More application of Rasch analysis should be conducted to create a thorough and robust mathematics assessment.
A Review Article on Selective Serotonin Reuptake Inhibitors (SSRIS)
Authors: Meena Devi , Subhash Chand Subhash , Kumar Deovrat
Published: May 2020

Depression, tension and mental health have been ignored as a serious issue since ages. Depression can be fatal or life-threatening, if not treated to this problem. Antidepressants are also regularly used to treat many other conditions, such as social phobia, fibromyalgia, panic disorder, anxiety/anxiety depression, PTSD, OCD, PMDD, and menopause. The major antidepressant used in the study followed oral prescribing trends. A “serious adverse reaction means an adverse reaction which is fatal, life-threatening, disabling, incapacitating, or which results in or prolongs hospitalization.” Material method collect from Google, Wikipedia, Elsevier, PubMed, Google scholar, Sci-Hub etc. This is a meta-analysis study. Fluoxetine have the longest half-life, but Fluvoxamine have short half-life. SSRIs increase the serum concentrations of the latter two drugs, potentiating their effects and increasing the risk of toxicity. Fluoxetine and Paroxetine specifically, are known to cause a 5-fold increase in serum TCA concentration upon co-administration. By in the addition of combination therapy SSRIs associated many types of adverse drug reaction and some time it can cause serotonin syndrome also.
The Stages of Drug Discovery and Development Process
Authors: Deore Amol B , Dhumane Jayprabha R , Wagh Rushikesh , Sonawane Rushikesh
Published: May 2020

Drug discovery is a process which aims at identifying a compound therapeutically useful in curing and treating disease. This process involves the identification of candidates, synthesis, characterization, validation, optimization, screening and assays for therapeutic efficacy. Once a compound has shown its significance in these investigations, it will initiate the process of drug development earlier to clinical trials. New drug development process must continue through several stages in order to make a medicine that is safe, effective, and has approved all regulatory requirements. One overall theme of our article is that the process is sufficiently long, complex, and expensive so that many biological targets must be considered for every new medicine ultimately approved for clinical use and new research tools may be needed to investigate each new target.  From initial discovery to a marketable medicine is a long, challenging task. It takes about 12 - 15 years from discovery to the approved medicine and requires an investment of about US $1 billion. On an average, a million molecules screened but only a single is explored in late stage clinical trials and is finally made obtainable for patients. This article provides a brief outline of the processes of new drug discovery and development.
Plataformas Digitais, Uberização do Trabalho e Regulação no Capitalismo Contemporâneo
Authors: Filgueiras Vitor , Antunes Ricardo
Published: May 2020

O objetivo deste texto é analisar a relação entre trabalhadores/as e as “plataformas” e “aplicativos”, bem como as possibilidades de sua regulação, à luz do uso das novas tecnologias da informação e comunicação (TIC). Para tal, apresentamos os principais elementos da narrativa dominante das “plataformas”, contrapondo-os às evidências empíricas oriundas das relações estabelecidas. Ao contrário do ideário empresarial, estas relações são caracterizadas por uma intensa exploração do trabalho. Tecnicamente, nunca foi tão fácil regular o direito do trabalho. Porém, politicamente, talvez nunca tenha sido tão difícil. A narrativa sobre o que são essas empresas, joga papel importante na promoção dessa gestão precarizante, ainda que haja sinais de resistência dos trabalhadores a esse processo.
Considerações sobre o processo de gestão e controle de estoque de merenda escolar realizado em uma instituição de ensino da cidade de São Paulo
Authors: Gonçalves Luiz Claudio , Dos Santos Gabriela , De Lima Valter Paulo
Published: May 2020

Um estoque bem gerido e organizado evita altos custos de manutenção e de falta de produtos. Com base nesses argumentos, esta investigação busca identificar quais são as atividades executadas no processo de gestão e controle de estoque de merenda escolar e, também, quais são as vantagens e desvantagens trazidas por ele para uma instituição de ensino situada na cidade de São Paulo. Como resultados obtidos na pesquisa, observa-se que a instituição faz uso de algumas técnicas e ferramentas descritas na pesquisa, visando auxiliam na melhoria do processo, diminuindo assim, o índice de faltas de produtos. Verificou-se também que, após a implantação do sistema informatizado SAESP, a instituição consegue maior e melhor autonomia para gerenciar o seu cardápio. No atual cenário competitivo, definir métodos efetivos de gestão e controle de estoque torna-se um grande diferencial para que as empresas possam ser competitivas e assim obterem o devido reconhecimento do mercado. Nesse cenário, tanto o gestor quanto sua equipe devem procurar reduzir custos, otimizar tempo e espaço, evitar desperdícios, executar a identificação e disposição adequada de produtos e controlar a sua rotatividade.