bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutritional status and structure of macronutrient consumption in tuberculosis patients with different drug resistance profiles
Authors: Pasechnik O. A. , Vilms E. A. , Turchaninov D. V. , Yarusova I. V. , Batischeva T. L. , Sitnikova S. V.
Published: May 2020

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.

Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.

Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders.
New Trends in Raman Spectroscopy: From High-Resolution Geochemistry to Planetary Exploration
Authors: Beyssac Olivier
Published: May 2020

This article reviews nonconventional Raman spectroscopy techniques and discusses present and future applications of these techniques in the Earth and planetary sciences. Time-resolved spectroscopy opens new ways to limit or exploit luminescence effects, whereas techniques based on coherent anti-Stokes Raman scattering (CARS) or surface-enhanced Raman spectroscopy (SERS) allow the Raman signal to be considerably enhanced even down to very high spatial resolutions. In addition, compact portable Raman spectrometers are now routinely used out of the laboratory and are even integrated to two rovers going to Mars in the near future.
Paradigma Dakwah Kultural: Dimensi Sufisme dalam Kontruksi Karakter Bima pada Pewayangan Jawa
Authors: Hidayatullah Ahmad
Published: May 2020

Wayang as a pride of Javanese culture is well known not only for artistic dimension, but also for a spiritual dimension. It can be seen from a compositions of wayang characters, namely Bima. This research is a qualitative research that focuses on library research about Mahabharata books, Javanese culture (wayang), Walisongo, and dakwah. This research is data analysis that uses descriptive analysis, as an effort to describe and analyze the siprirtiual dimensions are manifested in aspects of dakwah and sufism in the construction of the Bima character. The results of this study indicate that the character of Bima shows the construction for dimensions of dakwah and Sufism. The dimension of dakwah lies in the process of islamization of Hindu that contained in wayang that finally changes the character and storyline of the wayang itself. While the dimension of Sufism is in the process of conveying the values of Sufism, such as in the depiction of the soul (nafs) and manunggaling Kawula Gusti in the Dewaruci play.

 
Evaluation of critical path of construction projects by using the new BWABAC method under uncertainty
Authors: Noshadpoor Keivan
Published: May 2020

The project’s scheduling and planning project is a crucial factor in achieving success. In order to better scheduling and planning, critical path method (CPM) is extended by adding some efficient criteria to the old CPM. In this paper, to determine the critical path of projects by useful criteria, a new MCDM method named BWABAC is proposed. For determining the weight of important criteria, the best-worst method (BWM) is applied. Furthermore, the multi-attributive border approximation area comparisons (MABAC) procedure is used to rank all paths of project network. Finally, the new MCDM method is extended under type-2 fuzzy sets (T2FSs) to tackle the uncertainty. T2FSs are much stronger tool than classic fuzzy sets because the membership grade of T2FSs is a classic fuzzy set. Moreover, the BWABAC method is compared with the COPRAS method to drown the validity. Eventually, an illustrative example is solved to display the strengths of BWABAC method.
Magnetic field shielding in electric vehicles by vibration energy harvesting dampers
Authors: Nerubenko George , Panovko Grigory , Shokhin Alexander
Published: May 2020

The passengers of electric vehicles are exposed to strong magnetic ﬁelds associating to the vehicle equipment, devices and electric motors. The aim of study is to demonstrate the necessity of an implementation of the authors US Patent which has 4 combined functions in electric vehicle application: mitigate the torsional vibrations of rotating part, serve as a flywheel improving the quality of rotation, generate additional electricity and shielding the magnetic fields. The mathematical modeling, simulation analysis and experimental study were done for electric vehicle. It is shown that the usage of proposed energy harvesting damper could generate up to 11 kW of additional electricity, while reducing the levels of torsional vibrations in driveline, improving the quality of rotation and eliminate the impact of magnetic fields.
Dynamic response of auxetic structures
Authors: Proffit Matthieu , Kennedy John
Published: May 2020

Auxetic materials have been investigated since the 1990’s, they are defined by a negative Poisson’s ratio which gives them interesting capabilities in energy and shock absorption. They are usually lattice structures (2D or 3D array of unit cells), which gives them high stiffness to weight properties and their properties can be tuned to suit a given application. Several papers have been published on new auxetic designs, their static equivalent mechanical properties, shock absorption properties and their manufacturing. Their dynamic behavior has not been studied to date and this is the main purpose of this paper. We will present a novel design that facilitates 3D printing with SLA printers and then examine the dynamic behavior of an auxetic structure between 0 and 1 kHz. In order to explain the unusual behavior of the structure, an initial theoretical model of non-linear spring has been developed with partial success.
Electronic Government Rukun Tetangga Model
Authors: Antoni Darius , Akbar Muhamad , Fatoni Fatoni
Published: May 2020

E-government is the one of facilities of government to interact and communicate with the citizen as the government's ability to improve service performance. However, not all citizen, including the poor, can benefit the e-government services. To answer the issue, this research developed e-government model of Rukun Tetangga (RT) based on eight factors consisting of Content providers, Direct-to-consumer, Value-net-Integrations, Full-service providers, Infrastructure service providers, Market, Collaboration and Virtual Communities.  Quantitative research was used to collect data through interview with 24 participants including Head of RT, Citizen and Employees District Office in Palembang. The findings of this study showed that an e-government RT model was required to help Palembang Government to meet needs of the citizen, which had impacts to improve services to entire levels of society.
Strategy to Use Local Government’s Facebook Page to Improve Public Services
Authors: Puspitaningrum Ari cahaya
Published: May 2020

The population of internet users in Indonesia increase continuously form year to year along with the development of information technology infrastructure in Indonesia. This underlies the management of social media in the government agencies. The government sector could communicated with the citizens through social media such as Facebook as a form of direct communication to disseminate information for the citizens. Through current government social media accounts, it could be seen that the posting  of official government Facebook account were still rare. Based on existing studies, it has not yet been reviewed the relationship of post and comment categorization on Facebook to improve the government's Facebook management strategy and public service improvement strategy. Therefore, this study was conducted so that the results could help the local government to maximize the management of Facebook accounts to be right on target, provide trustful information, and get a good response from the citizens. There were 30 Local Government Facebook accounts that have been analysed, resulting number of statuses and comment ranks in last 2 months. Then performing frequency analysis on 30-often-used words which will be used as a trigger to categorize. The results of the study are in the form of strategic suggestions for local governments to improve the content of each category through Facebook. Local governments are suggested to convey information from many aspects in a balanced manner in accordance with the needs of the citizens.

 

Keywords– social media; categorization; strategy; local government
Copula-based drought severity-area-frequency curve and its uncertainty, a case study of Heihe River basin, China
Authors: Li Zhanling , Shao Quanxi , Tian Qingyun , Zhang Louie
Published: May 2020

Copulas are appropriate tools in drought frequency analysis. However, uncertainties originating from copulas in such frequency analysis have not received significant consideration. This study aims to develop a drought severity-areal extent-frequency (SAF) curve with copula theory and to evaluate the uncertainties in the curve. Three uncertainty sources are considered: different copula functions, copula parameter estimations, and copula input data. A case study in Heihe River basin in China is used as an example to illustrate the proposed approach. Results show that: (1) the dependence structure of drought severity and areal extent can be modeled well by Gumbel; Clayton and Frank depart the most from Gumbel in estimating drought SAF curves; (2) both copula parameter estimation and copula input data contribute to the uncertainties of SAF curves; uncertainty ranges associated with copula input data present wider than those associated with parameter estimations; (3) with the conditional probability decreasing, the differences in the curves derived from different copulas are increasing, and uncertainty ranges of the curves caused by copula parameter estimation and copula input data are also increasing. These results highlight the importance of uncertainty analysis of copula application, given that most studies in hydrology and climatology use copulas for extreme analysis.
Rivers as political borders: a new subnational geospatial dataset
Authors: Popelka Sarah J. , Smith Laurence C.
Published: May 2020

Rivers are commonly used to define political borders, but no global study has quantified the importance of rivers on territorial delimitation at subnational scales. This paper presents Global Subnational River-Borders (GSRB), a first comprehensive geospatial dataset of subnational, as well as national, political borders set by large rivers. GSRB incorporates three previous vector datasets (GAUL, GRWL + +, and WDBII) to map and quantify the use of large rivers as political borders at local, state, and national scales. GSRB conservatively finds that at least 58,588 km (23%) of the world's interior (non-coastal) national borders, 199,922 km (17%) of the world's interior state/province borders, and 459,459 km (12%) of the world's interior local-level political borders are set by large rivers. GSRB finds 222, 2,350, and 14,808 dyads sharing river-borders at these three administrative scales, respectively. While previous studies have emphasized transboundary rivers separating nations, GSRB highlights the abundance of river-borders at subnational scales, where numerous domestic stakeholders share jurisdiction in water resource management. These participants, identified with GSRB, ought not to be ignored when crafting water policy and instituting whole-basin management regimes. GSRB should prove useful for global, geospatial analyses of riparian stakeholders across administrative scales. The GSRB dataset (DOI: 10.5281/zenodo.3906566) can be found via the following link https://zenodo.org/record/3906567#.XvN-GGhKjIU.
Community water fluoridation perceptions and practice in the United States: challenges in governance and implementation
Authors: Walker Thomas , Dickes Lori , Crouch Elizabeth
Published: May 2020

The primary objective of this research is to reveal potential challenges in achieving the finalized water fluoridation recommendation made by the Federal Water Fluoridation Panel in the United States (U.S.) with data extracted from consumer confidence reports. A secondary objective is to understand community water system manager's perceptions of and ability to meet this new standard using a survey instrument. Mean fluoridation levels are above the recommended level. The confidence interval does not capture the nationally recommended 0.7 mg/L. The t-test revealed two statistically significant results: that the sample mean is not equal to 0.7 mg/L and that the sample mean is higher than 0.7 mg/L. Respondents felt engaged in the policy process, but preferred state over federal policymaking. There is evidence that the optimal fluoridation level may not have been reached by water systems and that some water systems are under-fluoridating, while others are over-fluoridating. Several large water systems and pockets across the U.S. are not practicing artificial water fluoridation which reduces the effectiveness of this policy. Regular engagement by states with water system managers and feedback from water management professionals could be encouraged to better understand local constraints in meeting the federal recommendation.
Towards a Choice of Correctional Computer Programs for Cognitive Rehabilitation of Cardiac Patients
Authors: Solodukhin Anton V. , Yanitskii Mikhail S. , Seryi Andrei V.
Published: May 2020

Introduction. The present review aims to examine computer programs used in psycho-correctional practice for cognitive rehabilitation of cardiac patients. Currently, there is a high prevalence of cognitive disorders among the elderly population in Russia. The disease has an impact on cognitive functioning of cardiac patients, which leads to difficulties in social adjustment and reduces their quality of life. In this regard, assessing the performance of existing computer programs for cognitive rehabilitation of cardiac patients is important. Theoretical Basis. This paper presents an overview of the main criteria for choosing cognitive rehabilitation programs for patients suffering from cardiac diseases, as well as characteristics of cognitive rehabilitation. The analysis of previous studies enabled the authors to develop a number of recommendations and restrictions for using cognitive rehabilitation programs. Results and Discussion. The authors (a) provide a description of the structure of cognitive impairment in cardiac patients, (b) describe specific patterns of cognitive impairment in cardiac patients, and (c) concentrate on impairments of frontal lobe functions, including goal choice, concentration, and attention switching. The following platforms are currently used for cognitive rehabilitation: Constant Therapy, Cognifit, Brain +, My Aphasia Coach, Lingraphica, Prologue2go, Tactus therapy, Soch Genie, Lumosity, Neuro Nation, Memorado, Wikium, Brain Apps, and B-trainika. When choosing a correctional computer program, it is important to take into account the presence of a flexible system of settings and modular architecture, as well as the possibility of changing the complexity of tasks in accordance with the degree of cognitive impairment in patients. Conclusion. This paper may be of interest to physicians, medical psychologists, defectologists, and programmers when choosing or developing the programs for cognitive rehabilitation of cardiac patients.
The Proteins Interacting with Prmt5 in Medaka (Oryzias latipes) Identified by Yeast Two-Hybridization
Authors: Shen Hao , Zhang Xiaosha , Al Hafiz Md. Abdullah , Liang Xiaoting , Yao Qiting , Guo Maomao , Xu Gongyu , Zhong Xueping , Zhou Qingchun , Zhao Haobin
Published: May 2020

Background:

Prmt5 plays major role in regulation of gene expression, RNA processing,
cell growth and differentiation, signal transduction, germ cell development, etc., in mammals.
Prmt5 is also related to cancer. Knowing the proteins interacting with Prmt5 is important to understand
Prmt5’s function in cells. Although there have been reports on proteins binding with Prmt5 in
mammals, the partner proteins of Prmt5 in fish are still unclear.

Objectives:

The objective was to obtain proteins that bind with Prmt5 in medaka, a model fish.

Methods:

Yeast two hybridization was adopted to achieve the objective. Medaka Prmt5 was used
as a bait to fish the prey, binding proteins in a cDNA library of medaka. Co-immunoprecipitation
and in silicon analysis were performed to study the interaction of medaka Mep50 and Prmt5.

Results:

Eight proteins were identified to bind with Prmt5 from 69 preliminary positive colonies.
The binding proteins are methylosome protein 50 (Mep50), apolipoprotein A-I-like (Apo-AI), PR
domain containing protein 1a with zinc fingers (Prdm1a), Prdm1b, T-cell immunoglobulin mucin
family member 3 (Tim-3), phosphoribosylaminoimidazole carboxylase and phosphoribosylaminoimidazolesuccinocarboxamide
synthase (Paics), NADH dehydrogenase subunit 4 (ND4) and
sciellin (Scl). Co-immunoprecipitation confirmed the interaction of medaka Prmt5 and Mep50.
Predicted structures of medaka Prtm5 and Mep50 are similar to that of human PRMT5 and
MEP50.

Conclusion:

Medaka Mep50, Prdm1a, Prdm1b, Apo-AI, Tim-3, Paics, ND4, and Scl bind with
Prmt5.
Diaryliodonium Salts: Structures and Synthesis
Authors: Wang Yu , An Guoqiang , Wang Limin , Han Jianwei
Published: May 2020

Due to similar reactivity in comparison with aromatic organometallic reagents,
diaryliodonium salts are currently in broad usage as less toxic, highly efficient, stable and
mild electrophilic reagents in organic synthesis. The hypervalent iodine center of diaryliodonium
salts can lead to unique reactivity, which thus is frequently presented in metal-free
arylations or metal-involved elementary reactions such as oxidative addition, reduction
elimination, ligand coupling and ligand exchange reaction. As such, diaryliodonium salts
have experienced explosive growth by transferring aromatics to the target molecules. In
contrast to the reviews on the synthetic utility or aryl transformations by using diaryliodonium
salts, this review provides a summary of their structures and the synthetic strategies
towards them during recent decades.
Effects of Mulberry on The Central Nervous System: A Literature Review
Authors: Tam Dao Ngoc Hien , Nam Nguyen Hai , Elhady Mohamed Tamer , Tran Linh , Hassan Osama Gamal , Sadik Mohamed , Tien Phan Thi My , Elshafei Ghada Amr , Huy Nguyen Tien
Published: May 2020

Background:

Mulberry, including several species belonging to genus Morus, has been widely used as a traditional medicine for a long time. Extracts and active components of mulberry have many positive neurological and biological effects and can become potential candidates in the search for new drugs for neurological disorders.

Objectives:

We aimed to systematically review the medical literature for evidence of mulberry effects on the central nervous system.

Methods:

We conducted a systematic search in nine databases. We included all in vivo studies investigating the effect of mulberry on the central nervous system with no restrictions.

Results:

We finally included 47 articles for quality synthesis. Our findings showed that mulberry and its components possessed an antioxidant effect, showed a reduction in the cerebral infarct volume after stroke. They also improved the cognitive function, learning process, and reduced memory impairment in many animal models. M. alba and its extracts ameliorated Parkinson's disease-like behaviors, limited the complications of diabetes mellitus on the central nervous system, possessed anti-convulsant, anti-depressive, and anxiolytic effects.

Conclusion:

Mulberry species proved beneficial to many neurological functions in animal models. The active ingredients of each species, especially M. alba, should be deeper studied for screening potentially candidates for future treatments
Recent Findings on the Effects of Pharmacological Agents on the Nerve Regeneration after Peripheral Nerve Injury
Authors: Bolandghamat Samira , Behnam-Rassouli Morteza
Published: May 2020

Peripheral nerve injuries (PNIs) are accompanied with neuropathic pain and functional
disability. Despite improvements in surgical repair techniques in recent years, the functional recovery
is yet unsatisfied. Indeed a successful nerve repair depends not only on the surgical strategy but
also on the cellular and molecular mechanisms involved in traumatic nerve injury. In contrast to all
strategies suggested for nerve repair, pharmacotherapy is a cheap, accessible and non-invasive
treatment that can be used immediately after nerve injury. This study aimed to review the effects of
some pharmacological agents on the nerve regeneration after traumatic PNI evaluated by functional,
histological and electrophysiological assessments. In addition, some cellular and molecular mechanisms
responsible for their therapeutic actions, restricted to neural tissue, are suggested. These findings
can not only help to find better strategies for peripheral nerve repair, but also to identify the
neuropathic effects of various medications and their mechanisms of action.
Evaluation of the Antioxidant and Antimicrobial Activity of Ziziphora clinopodiodes Essential Oil Eluted at Different Times
Authors: Alizadeh Mojgan , Arianfar Akram , Mohammadi Ameneh
Published: May 2020

Objective:

Ziziphora clinopodioides is an edible medicinal plant belonging to the Labiatae
family that is widespread all over Iran. It used in culinary and also in cold and cough treatments
in Iran. The aim of the present work was to evaluate the effect of different timeframes during hydrodistillation
on essential oil composition, antimicrobial and antioxidant activity.

Materials and Methods:

The essential oil of Z. clinopodiodes was extracted via
hydrodistillation with Clevenger apparatus. The fractions of essential oil were captured at 6 times
from the beginning of the distillation: (10, 20, 60, 120, 180 and 240 min). The fractions of
essential oil were analyzed by GC/MS and their antibacterial, antifungal and antioxidant
activities were studied by Disk - well diffusion and DPPH methods respectively.

Results:

Six distillation times and whole essential oil were captured during the hydrodistillation.
Essential oil yield dropped off significantly during distillation progressed (1.0% for 10 min and
0.025 for 240 min). 1,8 Cineol, Isomenthone, Pulegone, Piperitenone and Citronellic acid were
major compounds in fractions and they were affected by distillation times. Pulegone was major
compound in all of essential oils. In antioxidant activity assay, whole essential oil was stronger
than was stronger than positive control and fractions of essential oil, because of higher levels of
Isomenthone, Piperitenone and Citronellic acid. Strongest antimicrobial activity against S.
aureus, E. coli and C. albicans was observed from 10 min fraction.

Conclusion:

Our results indicated that distillation time can create essential oils with specific
properties and we can achieve to more efficient essential oil in short times.
Anticoagulant Activity of Sulfated Polysaccharides and Polyphenols Extracted from Marine Algae
Authors: Saidani Karima , Ziani Nadia , Touati Naima , Merzouk Hafida , Bedjou Fatiha
Published: May 2020

Background:

Recent studies have provided evidence that marine algae sulfated
polysaccharides and phlorotannins play an important role in human health. The aim of this study
was to evaluate the anticoagulant activity of five marine algae extracts from Bejaia’s coast
(Algeria).

Methods:

Phenolic and sugar contents of the five marine algae were assessed using folin ciocalteu
and anthrone reagents, respectively. The anticoagulant activity was evaluated by the Activated Partial
Thromboplastin Time (APTT) and Prothrombin Time (PT).

Results:

Higher contents of phenolic compounds were obtained with ethanol for Cystoseira humilis,
Halopteris scoparia, Padina pavonica, and Rhodomela confervoides (8.55±0.29, 7.84±0.47,
6.41±0.14 and 4.16±0.04 mg CE/g of dw, respectively). Whereas, for Sargassum vulgare, the extraction
with acetone showed higher content (3.04±0.071 mg CE/g of dw). The determination of sugar
content showed that acetone extract of the five seaweeds was the richest in sugar, this rate increasingly
dropped in ethanol extract and the fractions A and B. The red algae Rhodomela confervoides
showed a significant anticoagulant activity in ethanol extract and the fractions A, B, and C,
with elongation up to 407.97±58.12 s in the fraction C, at a concentration of 10 mg/mL. Anticoagulant
activity was observed in the fractions A, B, and C of all the brown seaweeds. Procoagulant activity
was observed in the fractions A and B of Cystoseira humilis and Sargassum vulgare, as well
as the fraction B of Padina pavonica for an indeterminate period, at 10 mg/mL.

Conclusion:

The sulfated polysaccharides present in the fractions A, B and C of the studied marine
algae may be responsible for the anticoagulant activity. So, they can be developed as a novel anticoagulant
in the pharmaceutical industry.
Schiff Bases and Complexes: A Review on Anti-Cancer Activity
Authors: Matela Garima
Published: May 2020

Development in the field of bio-inorganic chemistry increased the interest in Schiff base and its complexes due to its biological importance in many fields, including anticancer activity. Discovery of the antitumor activity of Schiff base and its complexes against various tumor cell lines fascinates the researchers to develop new anticancer drugs without any side effects. Thus, the present review focuses on the anticancer activity of Schiff bases and their metal complexes.
Understanding the Effects of Material Properties on Nanoindentation Responses Through Data Analysis
Authors: Hu Zhong , Hu Yuchi
Published: May 2020

Background:

Nanoindentation is arguably the most versatile and effective method for
measuring materials’ mechanical properties at nanoscale. However, due to the complexity of the deformation
process during the nanoindentation tests, many experimental factors can significantly affect
the nanoindentation results.

Objective:

This research aims to investigate the quantitative effects of material properties on
nanoindentation responses and apply these relationships to the evaluation of broader material properties
through nanoindentation.

Methods:

This study uses intensive computer modeling based on finite element analysis and modeling
data analysis through curve fitting.

Results:

Nanoindentation responses (indentation load versus depth data) were numerically modeled by
computer modeling, considering the effects of the mechanical properties of the materials (low-carbon
steel AISI1018, steel alloy AISI4340, and aluminum alloy 6061-T6) and the indenter geometries
(Berkovich, cylindrical, and spherical indenters). Through data analysis, the quantitative relationships
between indentation load and indentation depth were established. The parameters in the formulae were
optimized by the least-squares method, and high accuracy of the correlation coefficients between the
modeling results and the formulae was achieved.

Conclusion:

It was found that the parameters of the formulae directly reflect the material properties of
a testing specimen, and more material properties can be estimated through nanoindentation.
Peer-to-Peer Health Communication in Older Adults’ Online Communities: Protocol for a Qualitative Netnographic Study and Co-Design Approach (Preprint)
Authors: Lawless Michael Thomas , Archibald Mandy , Pinero de Plaza Maria Alejandra , Drioli-Phillips Phoebe , Kitson Alison
Published: May 2020

BACKGROUND

Online communities provide an environment in which people with similar health concerns can interact and access content that can support the self-management of long-term conditions (LTCs). Recently, the importance of online social networks as sources of health information and social support has been brought into focus with the emergence and widespread societal impacts of COVID-19. Although online communities exist for older adults, little is known about the specific health and self-care topics that older people discuss in such environments and how these relate to users’ support needs and outcomes. A better understanding of users’ needs and peer-to-peer communication in these communities is necessary to inform the design of information and communication technology (ICT) interventions that are relevant to older people and their peer supporters.

OBJECTIVE

This study aims to use a two-phase, web-based ethnographic (netnography) and co-design approach to explore specific health care and self-care topics that older adults discuss in a UK-based online community and how peer supporters respond to these queries with informational and/or social support and engage with stakeholders to define the needs and requirements for new ICT-based interventions capable of reducing social isolation and facilitating LTC self-management support.

METHODS

The first phase of the research will involve a qualitative netnographic analysis of posts in discussion forums in a publicly accessible online community. The second phase will involve co-design workshops with health care consumers (ie, older adults and carers) and service providers to determine the needs and requirements for new ICT-based interventions and digital innovations. Constructivist grounded theory will be used in the first phase; in the second phase, the co-design workshops will be audiorecorded and analyzed thematically.

RESULTS

This research project is in progress. Permission was obtained from the website administrator to use materials from the social media forum; data collection for the first phase began in April 2020. The second phase of the study is expected to begin in late 2020. This study is due to be completed by the end of 2021.

CONCLUSIONS

This study is the first, to the best of our knowledge, to combine qualitative netnography with an iterative co-design framework to specify the needs and requirements for new ICT-based interventions. The findings from this study will inform the next phase of the multiphase knowledge translation project and will provide insights into the potential of online peer health communities to reduce social isolation and facilitate chronic illness self-management support and self-care.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/19834
Advances in Dental Pulp Stem Cell Biology for Biomedical Engineering (Preprint)
Authors: Bae Sejin , Kang Byeonguk , Lee Hyungbin , Luu Harrison , Mullins Eric , Kingsley Karl
Published: May 2020

BACKGROUND

Many studies in stem cell biology have demonstrated that dental pulp stem cells (DPSC) may be highly proliferative and capable of pluripotent differentiation into many different tissue types. Recent advances in stem cell research have outlined methods for directing in vitro or in vivo differentiation of DPSC - although much remains to be discovered.

OBJECTIVE

Based upon this information, the primary objective of this study was to understand the biology and biotechnology needed to more effectively direct DPSC differentiation.

METHODS

Previously collected and isolated samples of DPSC from an existing repository were used. Due to the use of previously collected, non-identifiable samples this protocol was granted exemption from Human Subjects review. Previously established stem cell biomarkers (Sox-2, Oct-4, NANOG) from each isolate were correlated with their proliferation rates or doubling times to categorize them into rapid, intermediate, or slow-dividing multipotent DPSC. Growth factors and other dental biomaterials were subsequently tested to evaluate DPSC responses in proliferation, viability and morphology.

RESULTS

Differential responses were observed among DPSC isolates to growth factors, including vascular endothelial growth factor (VEGF) and bone morphogenic protein (BMP-2), and biomaterials such as mineralized trioxide aggregates (MTA). The responsiveness of DPSC isolates did not correlate with any single factor but rather with a combination of proliferation rate and biomarker expression.

CONCLUSIONS

These data strongly suggest that some, but not all DPSC isolates are capable of a robust and significant in vitro response to differentiation stimuli, although this response is not universal. Although some biomarkers and phenotypes that distinguish and characterize these DPSC isolates may facilitate the ability to predict differentiation potential, more research is needed to determine the other intrinsic and extrinsic factors that may contribute to and modulate these DPSC responses for biotechnology and bioengineering applications.

CLINICALTRIAL

N/A (not applicable)
Utilization of Self-Diagnosis Health Chatbots in Real-World Settings: Case Study (Preprint)
Authors: Fan Xiangmin , Chao Daren , Zhang Zhan , Wang Dakuo , Li Xiaohua , Tian Feng
Published: May 2020

BACKGROUND

Artificial intelligence (AI)-driven chatbots are increasingly being used in health care, but most chatbots are designed for a specific population and evaluated in controlled settings. There is little research documenting how health consumers (eg, patients and caregivers) use chatbots for self-diagnosis purposes in real-world scenarios.

OBJECTIVE

The aim of this research was to understand how health chatbots are used in a real-world context, what issues and barriers exist in their usage, and how the user experience of this novel technology can be improved.

METHODS

We employed a data-driven approach to analyze the system log of a widely deployed self-diagnosis chatbot in China. Our data set consisted of 47,684 consultation sessions initiated by 16,519 users over 6 months. The log data included a variety of information, including users’ nonidentifiable demographic information, consultation details, diagnostic reports, and user feedback. We conducted both statistical analysis and content analysis on this heterogeneous data set.

RESULTS

The chatbot users spanned all age groups, including middle-aged and older adults. Users consulted the chatbot on a wide range of medical conditions, including those that often entail considerable privacy and social stigma issues. Furthermore, we distilled 2 prominent issues in the use of the chatbot: (1) a considerable number of users dropped out in the middle of their consultation sessions, and (2) some users pretended to have health concerns and used the chatbot for nontherapeutic purposes. Finally, we identified a set of user concerns regarding the use of the chatbot, including insufficient actionable information and perceived inaccurate diagnostic suggestions.

CONCLUSIONS

Although health chatbots are considered to be convenient tools for enhancing patient-centered care, there are issues and barriers impeding the optimal use of this novel technology. Designers and developers should employ user-centered approaches to address the issues and user concerns to achieve the best uptake and utilization. We conclude the paper by discussing several design implications, including making the chatbots more informative, easy-to-use, and trustworthy, as well as improving the onboarding experience to enhance user engagement.
Considerations for an Individual-Level Population Notification System for Pandemic Response: A Review and Prototype (Preprint)
Authors: Sakib Mohammad Nazmus , Butt Zahid A , Morita Plinio Pelegrini , Oremus Mark , Fong Geoffrey T , Hall Peter A
Published: May 2020

UNSTRUCTURED

The outbreak of the coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, spread worldwide after its emergence in China. Whether rich or poor, all nations are struggling to cope with this new global health crisis. The speed of the threat’s emergence and the quick response required from public health authorities and the public itself makes evident the need for a major reform in pandemic surveillance and notification systems. The development and implementation of a graded, individual-level pandemic notification system could be an effective tool to combat future threats of epidemics. This paper describes a prototype model of such a notification system and its potential advantages and challenges for implementation. Similar to other emergency alerts, this system would include a number of threat levels (level 1-5) with a higher level indicating increasing severity and intensity of safety measures (eg, level 1: general hygiene, level 2: enhanced hygiene, level 3: physical distancing, level 4: shelter in place, and level 5: lockdown). The notifications would be transmitted to cellular devices via text message (for lower threat levels) or push notification (for higher threat levels). The notification system would allow the public to be informed about the threat level in real time and act accordingly in an organized manner. New Zealand and the United Kingdom have recently launched similar alert systems designed to coordinate the ongoing COVID-19 pandemic response more efficiently. Implementing such a system, however, faces multiple challenges. Extensive preparation and coordination among all levels of government and relevant sectors are required. Additionally, such systems may be effective primarily in countries where there exists at least moderate trust in government. Advance and ongoing public education about the nature of the system and its steps would be an essential part of the system, such that all members of the public understand the meaning of each step in advance, similar to what has been established in systems for other emergency responses. This educational component is of utmost importance to minimize adverse public reaction and unintended consequences. The use of mass media and local communities could be considered where mobile phone penetration is low. The implementation of such a notification system would be more challenging in developing countries for several reasons, including inadequate technology, limited use of data plans, high population density, poverty, mistrust in government, and tendency to ignore or failure to understand the warning messages. Despite the challenges, an individual-level pandemic notification system could provide added benefits by giving an additional route for notification that would be complementary to existing platforms.
Why African Americans Are a Potential Target for COVID-19 Infection in the United States (Preprint)
Authors: Hamidian Jahromi Alireza , Hamidianjahromi Anahid
Published: May 2020

UNSTRUCTURED

Since the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic, significant changes have occurred in the United States as the infection spread reached and passed its exponential phase. A stringent analysis of COVID-19 epidemiologic data requires time and would generally be expected to happen with significant delay after the exponential phase of the disease is over and when the focus of the health care system is diverted away from crisis management. Although much has been said about high-risk groups and the vulnerability of the elderly and patients with underlying comorbidities, the impact of race on the susceptibility of ethnic minorities living in indigent communities has not been discussed in detail worldwide and specifically in the United States. There are currently some data on disparities between African American and Caucasian populations for COVID-19 infection and mortality. While health care authorities are reorganizing resources and infrastructure to provide care for symptomatic COVID-19 patients, they should not shy away from protecting the general public as a whole and specifically the most vulnerable members of society, such as the elderly, ethnic minorities, and people with underlying comorbidities.
Human Factor Considerations in Using Personal Protective Equipment in the COVID-19 Pandemic Context: Binational Survey Study (Preprint)
Authors: Parush Avi , Wacht Oren , Gomes Ricardo , Frenkel Amit
Published: May 2020

BACKGROUND

Full level 1 personal protective equipment (PPE) is used in various domains and contexts. Prior research has shown influences of such equipment on performance, comfort, and contamination levels. The coronavirus disease (COVID-19) pandemic forced a pervasive requirement of PPE, with little preparation, rushed deployment, inadequate time for training, and massive use by personnel who are inexperienced or not qualified in its effective use.

OBJECTIVE

This study aims to examine the key human factors (physical and ergonomic, perceptual and cognitive) that influence the use of level 1 PPE when attending to patients with suspected or confirmed COVID-19.

METHODS

The research approach consisted of a short survey disseminated to health care professionals in two countries, Israel and Portugal, with similar demographics and health care systems. The survey included 10 items with a 5-point Likert scale regarding the key human factors involved in level 1 PPE, as identified in prior research.

RESULTS

A total of 722 respondents from Israel and 301 respondents from Portugal were included in the analysis. All the respondents reported using level 1 PPE with patients with COVID-19 in the range of several hours daily to several hours weekly. The Cronbach α was .73 for Israel and .75 for Portugal. Responses showed high levels of difficulty, with medians of 4 for items related to discomfort (n=539/688, 78% in Israel; n=328/377, 87% in Portugal), hearing (n=236/370, 64% in Portugal; n=321/642, 50% in Israel), seeing (n=697/763, 89% in Israel; n=317/376, 84% in Portugal), and doffing (n=290/374, 77% in Portugal; n=315/713, 44% in Israel). A factor analysis showed a set of strongly related variables consisting of hearing, understanding speech, and understanding the situation. This suggests that degradation in communication was strongly associated with degradation in situational awareness. A subsequent mediation analysis showed a direct effect of PPE discomfort on situational awareness (P<.001); this was also influenced (mediated) by difficulties in communicating, namely in hearing and understanding speech.

CONCLUSIONS

In 2020, the COVID-19 pandemic is paving the way for updating PPE design. The use of already deployed technology affords ample opportunities to improve, adapt, and overcome caveats. The findings here suggest that the use of level 1 PPE with patients with COVID-19 has perceptual and cognitive effects, in addition to physical and ergonomic influences. Efforts should be taken to mitigate the harmful effects of such influences, both regarding the performance of medical actions and the risk of contamination to health care workers. Such efforts involve the design of PPE; the introduction of technologies to enhance vision, hearing, and communicating during the use of PPE; and training staff in using the equipment and in effective communication and teamwork protocols.
Plasma Endothelin-1 and Risk of Death and Hospitalization in Patients Undergoing Maintenance Hemodialysis
Authors: Li Ping , Schmidt Insa M. , Sabbisetti Venkata , Tio Maria Clarissa , Opotowsky Alexander R. , Waikar Sushrut S.
Published: May 2020

Background and objectives

Endothelin-1 is a potent endothelium-derived vasoconstrictor peptide implicated in the pathogenesis of hypertension, congestive heart failure, and inflammation, all of which are critical pathophysiologic features of CKD.

Design, setting, participants, & measurements

To test the hypothesis that plasma endothelin-1 levels are associated with increased risks of mortality and hospitalization in patients with chronic kidney failure, we measured plasma endothelin-1 levels in a prospective cohort of 794 individuals receiving maintenance hemodialysis. The primary outcomes were time to death and time to hospitalization.

Results

The median plasma endothelin-1 level was 2.02 (interquartile range, 1.57–2.71) pg/ml. During a median follow-up period of 28 (interquartile range, 21–29) months, 253 individuals (32%) died and 643 individuals (81%) were hospitalized at least once. In multivariable models adjusted for demographic, clinical, and laboratory variables, individuals in the highest quartile of plasma endothelin-1 had a 2.44-fold higher risk of death (hazard ratio, 2.44; 95% confidence interval, 1.61 to 3.70) and a 1.54-fold higher risk of hospitalization (hazard ratio, 1.54; 95% confidence interval, 1.19 to 1.99) compared with individuals in the lowest quartile. The Harrell C-statistic of the fully adjusted model increased from 0.73 to 0.74 after addition of natural log-transformed plasma endothelin-1 (P<0.001) for all-cause mortality, and increased from 0.608 to 0.614 after addition of natural log-transformed plasma endothelin-1 (P=0.002) for hospitalization.

Conclusions

Higher plasma endothelin-1 is associated with adverse clinical events in patients receiving hemodialysis independent of previously described risk factors.

Podcast

This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_05_15_CJN11130919.mp3
IN VITRO ANTI-PLATELET AGGREGATION ACTIVITY OF HYDROXYPROPYL CELLULOSE–CYSTEAMINE BASED NANOPARTICLES CONTAINING CRUDE BROMELAIN
Authors: RAHMAT DENI , NURHIDAYATI LILIEK , MARCELLA MARCELLA , SUMARNY ROS , LAKSMITAWATI DIAN RATIH
Published: May 2020

Objective: The aim of the present study was to formulate bromelain into nanoparticles in order to improve its stability and activity.

Methods: Crude bromelain was prepared by protein precipitation from the pineapple stem juice using ammonium sulphate at the concentration of 60% (w/v). Nanoparticles containing crude bromelain were generated using the ionic gelation method with hydroxypropyl cellulose–cysteamine (HPC-cysteamine) conjugate as a matrix. Crude bromelain was then added to the HPC-cysteamine solution for ionic interaction to construct the nanoparticles, which were then analyzed for their particle size and zeta potential. The resulting nanoparticles were mixed with adenosine diphosphate (ADP) to perform anti-platelet aggregation.

Results: The nanoparticle had 928.3 nm in particle size and-7.25 mV in zeta potential. Anti-platelet activity of crude bromelain and the nanoparticles were determined with modification of light transmission aggregometry (LTA), in which ADP was used to induce an aggregation while a spectrophotometer UV-Vis was used to measure the absorbance at the wavelength of 600 nm. The result showed that crude bromelain and the nanoparticles rendered percentage inhibition of 8.00±1.17% and 48.56±11.19%, respectively.

Conclusion: Based on the result of a one-way analysis of variance (ANOVA), it was concluded that there was a significant difference in percentage inhibition between the two samples. The nanoparticles demonstrated a better anti-platelet aggregation activity compared to crude bromelain.