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Smokeless tobacco (SLT) use is widespread across many nations and populations, and India shares more than three-quarters of the global burden of SLT consumption. Tobacco use in India has been largely viewed as a male-dominant behaviour. However, evidence from medical, social and behavioural sciences show significant SLT use among women and young girls. This paper highlights key dimensions of SLT use among women in India including prevalence and determinants, the health effects arising from SLT use and cessation behaviours. The paper concludes by providing recommendations with the aim of setting research priorities and policy agenda to achieve a tobacco-free society. The focus on women and girls is essential to achieve the national targets for tobacco control under the National Health Policy, 2017, and Sustainable Development Goals 3 of ensuring healthy lives and promote well-being for all.

The gut microbiota is recognized as having major impact in health and disease. Sample storage is an important aspect to obtain reliable results. Mostly recommended is immediate freezing, however, this is not always feasible. Faecal occult blood test (FOBT) papers are an appealing solution in such situations, and most studies find these to be applicable, showing no major changes within 7 days storage at room temperature (RT). As fieldwork often requires RT storage for longer periods, evaluation of this is warranted. We performed 16S rRNA gene sequencing of 19 paired faecal samples immediately frozen or kept five weeks and five months at RT on FOBT papers. Alpha-diversity evaluation revealed no effect of FOBT storage, and evaluation of beta-diversity showed that host explained 65% of community variation, while storage method explained 5%. Evaluation of community dispersion and the Firmicutes/Bacteroidetes ratio revealed a larger effect of storage time for fresh-frozen samples. Single taxa evaluation (order-to-genus level) showed significant alterations of four (of 37) genera after five weeks and five genera after five months. When comparing the two timepoints, alterations were only detectable for fresh-frozen samples. Our findings reveal that long term storage on FOBT papers is an applicable approach for microbiota research.

Invasive species can be particularly disruptive when they intersect with organisms of conservation concern. Stabilizing the declining eastern migratory population of monarch butterflies (Danaus plexippus) is projected to require extensive habitat restoration across multiple land use sectors including metropolitan areas. Numerous conservation programs encourage urban citizens to plant gardens with milkweeds, the obligate larval host plants of the monarch. Here, we show that predation by Polistes dominula, an invasive paper wasp that is particularly abundant in urban settings, can turn such sites into ecological traps for monarch larvae. Polistes dominula was the predominant paper wasp seen foraging in central Kentucky pollinator gardens. In 120 observed encounters with monarch larvae on milkweeds in gardens, most second to fourth instars were killed, whereas most fifth instars escaped by thrashing or dropping. The wasps bit and carried off second instars whole, whereas third and fourth instar kills were first gutted, then processed and carried away piecemeal. Predation on sentinel larvae was much higher in urban gardens than in rural settings. The wasps exploited ornamental butterfly “hibernation boxes” in pollinator gardens as nesting habitat. Polistes dominula is an under-recognized predator that may diminish the urban sector’s contributions to monarch habitat restoration.

Background The development of new genetic testing methods and the approval of the first treatments raises questions regarding when and how to perform screening for inherited neuromuscular conditions. Screening directives and access to the different techniques is not uniform across Europe. The patient advisory board of the European reference network for rare neuromuscular diseases (NMD) conducted a qualitative study to understand the state of play of screening for inherited NMD in Europe and patients’ needs. Results We collected answers from 30 patient organisations (POs) from 18 European countries. Fifteen acknowledge the existence of pre-implantation genetic diagnosis in their country. Regarding prenatal screening, we had 25 positive answers and 5 negative ones. Twenty-four POs mentioned that newborn screening was available in their country. We had some contradictory answers from POs from the same country and in some cases; diseases said to be part of the screening programmes were not hereditary disorders. Twenty-eight organisations were in favour of screening tests. The reasons for the two negative answers were lack of reimbursement and treatment, religious beliefs and eventual insurance constrains. Most POs (21) were in favour of systematic screening with the option to opt-out. Regarding the timing for screening, “at birth”, was the most consensual response. The main priority to perform screening for NMDs was early access to treatment, followed by shorter time to diagnostic, preventive care and genetic counselling. Conclusions This is the first study to assess knowledge and needs of POs concerning screening for NMDs. The knowledge of POs regarding screening techniques is quite uneven. This implies that, even in communities highly motivated and knowledgeable of the conditions they advocate for, there is a need for better information. Differences in the responses to the questions “how and when to screen” shows that the screening path depends on the disease and the presence of a disease modifying treatment. The unmet need for screening inherited NMDs should follow an adaptive pathway related to the fast moving medical landscape of NMDs. International coordination leading to a common policy would certainly be a precious asset tending to harmonize the situation amongst European countries.

Smartphone technology has spread rapidly around the globe. According to a report released by the Korea Information Society Development Institute, about 95% of Koreans aged more than 30 years old owned smartphones. Recently, blood pressure (BP) measurement using a photoplethysmography-based smartphone algorithm paired with the smartwatch is continuously evolving. In this document, the Korean Society of Hypertension intends to remark the current results of smartphone / smartwatch-based BP measurement and recommend optimal BP measurement methods using a smartphone device. We aim to increase the likelihood of success in implementing these new technologies into improved hypertension awareness, diagnosis, and control.

Urgent care practice (UCP) is a novel concept for India. Urgent care primarily deals with injuries or illnesses requiring immediate care. Medical emergency and urgency can happen anywhere unannounced. Research has shown that 90% of the morbidities can be resolved within the community by primary care physicians lead teams. Given the changing professional demands, non-specialists tend to refer away far too many cases to specialists, undermining generalist medical care, particularly in Indian settings. The spillover of the patient load from the primary care setting to the tertiary care centers is enormous leading to resource mismatch. Family physicians and other primary care providers are best positioned to develop practices and provide good quality urgent care to society. Family physicians, general practitioners, and medical officers are already functioning as the frontline care providers for any emergency or medical urgency arising within communities. Urgent care is essentially ambulatory care or outpatient care outside of a traditional hospital emergency room. "UCP aims to provide timely support, which is easily accessible with a focus on good clinical outcomes, e.g. survival, recovery, lack of adverse events, and complications. Core interventions of urgent care are centered on the 4Rs - Rescue, Resuscitate, Relate, and Refer. At present, there are no available, established training model for future faculty, residents, and medical students on "UCP" in India.

Family medicine is the internationally recognized nomenclature for the academic discipline, knowledge domain, and medical specialty of primary care doctors, working in the community setting. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences in the community setting. The distinction of family medicine lies in the tradition of medical generalism, promoting whole person care, in a life cycle mode; providing optimal preventive, promotive, and curative healthcare services in a wide spectrum of setting from home to hospital. In 2016, 92nd report of the department-related parliamentary standing committee on health and family welfare on the “Functioning of the Medical Council of India” has emphasized the need for postgraduate in family medicine. The committee report has noted that “the medical education system is designed in a way that the concept of family physicians has been ignored. The committee recommends that the Government of India in coordination with State Governments should establish robust PG Programs in Family Medicine and facilitate introduction of Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous healthcare for the individuals and families. The successive National Health Policies of Government of India–NHP 2002 and 2017 have emphasized the need of family medicine training in India. The recently enacted National Medical Commission Act 2019 has mandated NMC to promote training in family medicine at both undergraduate and postgraduate levels. Therefore, in the background of the stated policies of the Government of India the concept of family doctors, which was earlier neglected should be institutionalized within the mainstream medical education system of India. It is now time to accelerate and upgrade family medicine training and thereby strengthen the concept of comprehensive primary care in India. This white paper presents the review of family medicine training in India and proposes a way forward.

Context: Scientific studies are often presented primarily to a group of colleagues at annual scientific meetings. All year rounds are turned into products in congresses. Aims: The aim of the study is to evaluate the extent of the hand surgery in plastic surgery and plastic surgeons' papers related with hand surgery in national congresses; the past eight plastic surgery congresses were classified and presented. Settings and Design: The abstract books of Turkish National Congresses of Plastic, Reconstructive, and Aesthetic Surgery between 2011 and 2018 have been evaluated retrospectively. Subjects and Methods: Distribution of hand surgery according to the topics was evaluated according to the European White Book rules and standards. Distribution of oral and posters and distribution by years were shown. Results: The ratio of hand surgery reports to all reports was 17.3%. Hand and upper extremity surgery topics were presented at 19.7% in the 38th congress, which is the most hand surgery-included congress. The most frequently presented subjects were tumors, flaps, trauma, congenital anomalies, and replantation. Conclusions: Although there are arguments that plastic surgeons have disregarded hand surgery, there is no similar situation for Turkish plastic surgeons in the national platform. It has been found that the most common topics such as tumor excision and repair of the tissue defect were the most presented issues rather than arthroscopy, paralytic hand, and arthritis, which are specific to the hand surgery. Increasing the number of plastic surgery specialists who have been trained with hand surgery as a subspecialty will bring up the subjects that have not been presented in the hand surgery so far, in the future congresses.

In this study, polyacrylic acid modified filter paper (FP/PAA) was synthesized by in-situ polymerization of acrylic acid, which was used as a matrix to chelate nano-scale zero valent iron (nZVI). The loading content of nZVI in the filter paper reached 24.8%. The fabricated composite FP/PAA/nZVI was characterized by SEM, FT-IR and TGA respectively. Moreover, it was used for the removal of methyl blue and methylene blue as model anionic and cationic dyes. The effect of initial dye concentration on decolorization efficiency was investigated. The results showed that FP/PAA/nZVI enhanced the removal of dye from the simulated dye wastewater and the decolorization efficiency exceeded 95% for the dye solutions lower than 20 mg/L. More importantly, the filter paper supported nZVI realized the continuous treatment of simulated dye wastewater by a simple filtration process. This study hopes to serve as a basis for the application of nZVI in textile wastewater treatment.

Background : E-Learning or web-based technology can be used to train undergraduate medical students’ clinical reasoning skills. Currently, many learning methods are being developed using web-based environment to replace paper-based because they are more efficient in terms of paper usage and are flexible for a student in accessing materials. This study aims to explore student’s working durationaccess time and scores upon the usage of webbased test, to compare students’ scores to paper-based test scores, to explore the advantages anddisadvantages, and suggestions to improve the web-based learning method. Method : This study randomly enlisted 60 medical students of Universitas Gadjah Mada, Yogyakarta, Indonesia and divided them into web-based (n = 30) and paper- based test (n = 30) groups. Students answered 15 disaster management questions and completed a questionnaire. The scores and times needed to answer the questions were compared using the Mann-Whitney and Independent Sample tests. Results : The duration to answer in the web-based group was shorter than in paper- based group (p = 0.001), but the average scores difference was not significant (p = 0.169). In the web-based group, similar numbers of students accessed the website during and after working hours. Survey questionnaire results showed that most students realized the advantages of this program and gave appropriate suggestions. Conclusion : Practicing clinical reasoning skills using web-based learning method is more time-efficient compared to the paper-based test. Its high-accessibility improves the learning interest and motivation of the student, with an equal outcome to the paper-based test.

Metal oxides based graphene nanocomposites were used for ammonia vapour sensing. The self-assembly process was adopted to prepare freestanding flexible pure rGO, CeO2-rGO and SnO2-rGO composite papers. The structural studies confirmed the formation of rGO composite papers. The ammonia vapor sensing was demonstrated using an impedance analyzer at different humidity levels as well as concentration. The CeO2-rGO composite paper achieved a sensitivity of 51.70 ± 1.2%, which was higher than that of pure rGO and SnO2-rGO composite paper. Both the surfaces (top and bottom) of the papers are active in efficiently sensing ammonia, which makes the present work unique. The results reveal that metal oxide/rGO papers can be effectively utilized in real time sensor application.

The world is passing through a global pandemic of COVID 19. The number of positive cases has crossed over twenty thousand as of April 2020. Like everyone else, it is indeed a very challenging situation for family physicians and primary care providers as most of the guidelines presently have focused on screening, quarantine, isolation, and hospital-based management. Limited information or clarity is available on running small private clinics during pandemic times. The key concern is professional obligation versus risks of community transmission. Family physicians see routine flu-like illnesses throughout the year with seasonal variation within their practices. This document is intended to develop consensus and standard practices for the family physicians and other primary care providers during the pandemic, ensuring optimal continuity of care. This document was reviewed by the national executive of the Academy of Family Physicians of India and approved for dissemination among members. However, due to the dynamic status of the pandemic, all practitioners are advised to closely follow the instructions, guidelines, and advisories of national, state and local health authorities as well.

Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.

We present a rapid (

The intersection of art and science is a space useful not only to communicate scientific concepts to the general public but also to allow those of us studying biology in depth to view our work in a different light. I myself enjoy playing with the universality of anatomy, that is its bits and pieces that compose every human being. In mixing these with an array of mediums, colours, and textures, I hope to evoke a multiplicity of emotions in the viewer.

Allergic reactions to stings of Hymenoptera species can have serious or even fatal consequences. If the identification of the culprit insect is possible, venom-specific immunotherapy effectively cures Hymenoptera venom allergies. Although component-resolved diagnostics has strongly evolved in recent years, the differentiation between allergies to closely related species such as Polistes dominula and Vespula spp. is still challenging. In order to generate the basis for new diagnostic and therapeutic strategies, this study aims at resolving the venom proteomes (venomes) of these species. The venoms of P. dominula and Vespula spp. (V. germanica, V. vulgaris) were analyzed by liquid chromatography-mass spectrometry. Resulting proteins were characterized regarding their function, localization and biochemical properties. The analyses yielded 157 proteins in Vespula spp. and 100 in P. dominula venom, 48 proteins, including annotated allergens, were found in both samples. In addition to a variety of venom trace molecules, new allergen candidates such as icarapin-like protein and phospholipase A2 were identified. This study elucidates the venomes of closely related allergy-eliciting Hymenoptera species. The data indicates that relying on marker allergens to differentiate between P. dominula and Vespula spp. venom allergy is probably insufficient and that strategies using cross-reactive major allergens could be more promising.

Highly cited papers in the Essential Science Indicators database refer to papers with citations in the top 1% of all papers in a research field, and they are considered to be symbols of scientific excellence and top performance of the past ten years. This study provided an informetric analysis of 7791 highly cited papers in the environmental sciences category during 2009&ndash, 2019. Informetric indicators and visualization tools were applied to evaluate and present the performances of journals, countries/territories, institutions, top cited papers, and research hotspots. The results showed that the cumulative number of publications has increased exponentially, suggesting strong development of the environmental sciences category. There were 211 journals publishing highly cited papers, with Energy &amp, Environmental Science as the leading journal. The USA ranked first with the highest number of publications and occupied the core position in the collaboration network, while Mainland China took the first place in independent research output. Review articles have an obvious advantage in terms of achieving high citations. &ldquo, Adsorption&rdquo, &ldquo, climate change&rdquo, and &ldquo, heavy metal&rdquo, were the most frequent keywords, with &ldquo, microplastic&rdquo, rising rapidly as a new research frontier in recent years. Five research hotspots were visualized from highly cited papers via cluster analysis.

Here, we follow the stable propagation of a roughening crack using simultaneously Digital Image Correlation and Infra-Red imaging. In a quasi-two-dimensional paper sample, the crack tip and ahead of that the fracture process zone follow the slowly, diffusively moving “hot spot” ahead of the tip. This also holds when the crack starts to roughen during propagation. The well-established intermittency of the crack advancement and the roughening of the crack in paper are thus subject to the dissipation and decohesion in the hot spot zone. They are therefore not only a result of the depinning of the crack in a heterogeneous material.

In the age of Evidence-Based Medicine, Clinical Guidelines (CGs) are recognized to be an indispensable tool to support physicians in their daily clinical practice. Medical Informatics is expected to play a relevant role in facilitating diffusion and adoption of CGs. However, the past pioneering approaches, often fragmented in many disciplines, did not lead to solutions that are actually exploited in hospitals. Process Mining for Healthcare (PM4HC) is an emerging discipline gaining the interest of healthcare experts, and seems able to deal with many important issues in representing CGs. In this position paper, we briefly describe the story and the state-of-the-art of CGs, and the efforts and results of the past approaches of medical informatics. Then, we describe PM4HC, and we answer questions like how can PM4HC cope with this challenge? Which role does PM4HC play and which rules should be employed for the PM4HC scientific community? This research received no external funding

Since Internal Medicine (IM) is the most frequent setting of hospitalization for both patients with advanced liver disease and those with comorbidities and risk factors for infection, through this position paper FADOI aims to promote and disseminates its vision regarding the current and potential role of IM in managing hepatitis C virus (HCV) infection (screening, diagnosis, linkage-to-care, treatment). The Internist plays an important role in identifying new cases, in selecting the appropriate diagnostic work-up for liver disease staging and prognosis, and in initiating antiviral therapy, coordinating care and communication with other specialists, the Hepatology outpatient clinic and General Practitioners. Since the Internist is naturally accustomed to the management of multiple comorbidities, he has a fundamental role in the identification of extrahepatic diseases associated with HCV infection and in the diagnosis of comorbidities, some of which are potential factors of liver disease progression. Moreover, in the prescription of the antiviral therapy, it is important to consider the possible drug interactions, and this ideally fits the role of the Internist who can weigh the risk/benefit ratio of possible alternatives, by considering the patient’s clinical situation, especially in case of multiple comorbidities. Moreover, it seems appropriate that the ability to prescribe antiviral therapy is guaranteed to all IM hepatology clinics, favoring a spread of awareness as well as an increase in national coverage and therefore patient access to therapies. The network of IM can also contribute to homogenizing the management policies of HCV treatment, which sometimes differ between Italian Regions.

Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR) On February 2020, Italy, especially the northern regions, was hit by an epidemic of the new SARS-Cov-2 coronavirus that spread from China between December 2019 and January 2020. The entire healthcare system had to respond promptly in a very short time to an exponential growth of the number of subjects affected by COVID-19 (Coronavirus disease 2019) with the need of semi-intensive and intensive care units.

Orphanet journal of rare diseases: OJRD 15(1), 144 (2020). doi:10.1186/s13023-020-01420-w, Published by BioMed Central, London

Objective Stool repositories are a valuable resource for retrospective analyses including quantitative PCR assays to distinguish between asymptomatic shedding and clinical disease. The suitability of archival specimens for this purpose is unclear and requires assessment. We conducted a pilot study to evaluate pathogen detection by TaqMan Array Card (TAC) in travelers’ diarrhea (TD) stool specimens stored for 1–13 years, as well as the impact of transporting specimens on Whatman FTA Elute cards (FTA Cards) on detection. Results The positive percent agreement (PPA) for TAC on stool vs. microbiologic testing was lower than our a priori PPA estimate of 80% for most pathogens: Shigella spp. (100% [95%CI 69–100%]), enterotoxigenic E coli (ETEC) (63% [95%CI 49–75%]), Campylobacter spp. (66% [95%CI 43–85%]) and Norovirus (37% [95%CI 16–61%]). Use of the FTA card resulted in a further reduction of PPA. Our findings suggest that archival specimens may lead to insensitive detection on quantitative PCR assays due to degradation of nucleic acid with prolonged storage, although our limited sample size precluded us from evaluating the impact of storage duration on nucleic acid yield. Additional studies are needed to understand the impact of storage duration on quantitative PCR data.

Introduction: Translational science has gained prominence in medicine, but there is still much work to be done before scientific results are used optimally and incorporated into everyday health practice. As the main focus is still on generating new scientific data with financial resources primarily available for that purpose, other activities that are necessary in the transition from research to community benefit are considered less needy. The European Statistical Office of the European Commission has recently reported that 1.7 million people under 75 years of age died in Europe in 2016, with around 1.2 million of those deaths being avoidable through effective primary prevention and public health intervention. Therefore, Academia Europaea, one of the five Pan-European networks that form SAPEA (Science Advice for Policy by European Academies), a key element of the European Commission&rsquo, s Scientific Advice Mechanism (SAM), has launched a project to develop a model to facilitate and accelerate the utilisation of scientific knowledge for public and community benefit. Methods: During the process, leaders in the field, including prominent basic and clinical researchers, editors-in-chief of high-impact journals publishing translational research articles, translational medicine (TM) centre leaders, media representatives, academics and university leaders, developed the TM cycle, a new model that we believe could significantly advance the development of TM. Results: This model focuses equally on the acquisition of new scientific results healthcare, understandable and digestible summation of results, and their communication to all participants. We have also renewed the definition in TM, identified challenges and recommended solutions. Conclusion: The authors, including senior officers of Academia Europaea, produced this document to serve as a basis for revising thinking on TM with the end result of enabling more efficient and cost-effective healthcare.

Paper Spray Ionization (PSI) is commonly applied for the analysis of small molecules, including drugs, metabolites, and pesticides in biological fluids, due to its high versatility, simplicity, and low costs. In this study, a new setup called Solvent Assisted Paper Spray Ionization (SAPSI), able to increase data acquisition time, signal stability, and repeatability, is proposed to overcome common PSI drawbacks. The setup relies on an integrated solution to provide ionization potential and constant solvent flow to the paper tip. Specifically, the ion source was connected to the instrument fluidics along with the voltage supply systems, ensuring a close control over the ionization conditions. SAPSI was successfully applied for the analysis of different classes of biomolecules: amyloidogenic peptides, proteins, and N-glycans. The prolonged analysis time allowed real-time monitoring of processes taking places on the paper tip, such as amyloid peptides aggregation and disaggregation phenomena. The enhanced signal stability allowed to discriminate protein species characterized by different post translational modifications and adducts with electrophilic compounds, both in aqueous solutions and in biofluids, such as serum and cerebrospinal fluid, without any sample pretreatment. In the next future, application to clinical relevant modifications, could lead to the development of quick and cost-effective diagnostic tools.

Introduction: Proper orientation of endoscopic mucosal biopsies is crucial for accurate histomorphologic assessment. Aim: To compare the morphology on two different templates, filter paper and gelfoam for orientation of biopsies. Materials and Methods: In this study a total of 21 duodenal biopsies were studied which were taken from the same site, fixed and oriented on wet filter paper and gelfoam in formalin, from patients who presented with malabsorptive symptoms. Histomorphological parameters studied were villous architecture, crypt architecture, intraepithelial lymphocyte (IEL) count per 100 enterocytes, villous tip IEL count per 20 enterocytes, inflammatory cells in lamina propria. Statistical analysis was done using IBM- SPSS software version 21. p-value

Paper degradation on a macroscopic scale is characterised primarily by yellowing, an increase in brittleness, and other destructive changes caused by the hydrolysis of glycoside bonds and oxidation reactions. Until now, lignin has been believed to cause these changes. However, contemporary analysis has not confirmed this assumption and has attributed low paper resistance to ageing with acidification owing to the production in acid environments that involve aluminium sulfate. In view of the common belief this manuscript presents studies on the accelerated ageing of papers with different lignin contents that are produced in neutral environments. To achieve the objective, artificially aged papers under conditions of increased humidity and temperature were investigated using chromatographic (SEC) and spectroscopic (FTIR and UV–Vis spectroscopy) techniques. Mechanical tests were used to determine the decrease in tensile properties of the samples. We observed no effects of the lignin content on the ageing rate of paper produced at neutral pH. This work also reveals the extent to which spectroscopic methods are useful for studying the papers containing lignin.

Background When a journal receives a duplicate publication, the ability to identify the submitted work as previously published, and reject it, is an assay to publication ethics best practices. The aim of this study was to evaluate how three different types of journals, namely open access (OA) journals, subscription-based journals, and presumed predatory journals, responded to receiving a previously published manuscript for review. Methods We performed a quasi-experimental study in which we submitted a previously published article to a random sample of 602 biomedical journals, roughly 200 journals from each journal type sampled: OA journals, subscription-based journals, and presumed predatory journals. Three hundred and three journals received a Word version in manuscript format, while 299 journals received the formatted publisher’s PDF version of the published article. We then recorded responses to the submission received after approximately 1 month. Responses were reviewed, extracted, and coded in duplicate. Our primary outcome was the rate of rejection of the two types of submitted articles (PDF vs Word) within our three journal types. Results We received correspondence back from 308 (51.1%) journals within our study timeline (32 days); (N = 46 predatory journals, N = 127 OA journals, N = 135 subscription-based journals). Of the journals that responded, 153 received the Word version of the paper, while 155 received the PDF version. Four journals (1.3%) accepted our paper, 291 (94.5%) journals rejected the paper, and 13 (4.2%) requested a revision. A chi-square test looking at journal type, and submission type, was significant (χ2 (4) = 23.50, p Conclusion Few journals accepted our submitted paper. However, our findings suggest that all three types of journals may not have adequate safeguards in place to recognize and act on plagiarism or duplicate submissions.

Microsatellite loci are commonly used markers in population genetic studies. In this study, we present 40 novel and polymorphic microsatellite loci elaborated for the ichneumonid parasitoid Latibulus argiolus (Rossi, 1790). Reaction condition optimisation procedures allowed 14 of these loci to be co-amplified in two PCRs and loaded in two multiplex panels onto a genetic analyser. The assay was tested on 197 individuals of L. argiolus originating from ten natural populations obtained from the host nests of paper wasps. The validated loci were polymorphic with high allele numbers ranging from eight to 27 (average 17.6 alleles per locus). Both observed and expected heterozygosity values were high, ranging between 0.75 and 0.92 for HO (mean 0.83) and from 0.70 to 0.90 for HE (mean 0.85). The optimized assay showed low genotyping error rate and negligible null allele frequency. The designed multiplex panels could be successfully applied in relatedness analyses and genetic variability studies of L. argiolus populations, which would be particularly interesting considering the coevolutionary context of this species with its social host.

The membrane process had been applied for the advanced treatment of pig farm biogas slurry. As studied, this physical pretreatment, with low cost and high efficiency of the suspended solids removal and nutrient retention, is required to control membrane fouling. The combined process of paper filtration and ultrafiltration in a pilot scale was applied in the present study. The main objective was to explore and identify the feasibility of the new process for the pretreatment of the separation liquid of pig farm biogas slurry. A precision identification experiment of paper filtration and the multi-batch repetitive experiments of the combined process were designed. The results showed, at the identified paper filtration precision of 50&mu, m and an operating pressure of 0.3 bar of the ultrafiltration process, that the flux rate at the stable stage of the multi-batch operation was around 295.00 L/h. The combined process achieved an overall processing rate of 345.41 &plusmn, 18.81 L/h and a volume permeation proportion of 82.45% &plusmn, 0.85%. The TSS was removed by 95.71%, but total nitrogen (TN) and ammonia nitrogen (NH3-N) were retained by 76.29% &plusmn, 2.04% and 73.74% &plusmn, 2.10%, respectively. Comprehensively, the requirement for the pretreatment was obtained.

Ovarian cancer is the fifth leading cause of female cancer mortality in the U.S. and accounts for five percent of all cancer deaths among women. No environmental risk factors for ovarian cancer have been confirmed. We previously reported that ovarian cancer incidence rates at the state level were significantly correlated with the extent of pulp and paper manufacturing. We evaluated that association using county-level data and advanced geospatial methods. Specifically, we investigated the relationship of spatial patterns of ovarian cancer incidence rates with toxic emissions from pulp and paper facilities using data from the Environmental Protection Agency&rsquo, s Toxic Release Inventory (TRI). Geospatial analysis identified clusters of counties with high ovarian cancer incidence rates in south-central Iowa, Wisconsin, New York, Pennsylvania, Alabama, and Georgia. A bivariate local indicator of spatial autocorrelation (LISA) analysis confirmed that counties with high ovarian cancer rates were associated with counties with large numbers of pulp and paper mills. Regression analysis of state level data indicated a positive correlation between ovarian cancer and water pollutant emissions. A similar relationship was identified from the analysis of county-level data. These data support a possible role of water-borne pollutants from pulp and paper mills in the etiology of ovarian cancer.

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products., Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016)., Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p, Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well.

Amphimeriasis, a fish-borne zoonotic disease caused by the liver fluke Amphimerus spp., has recently been reported as an emerging disease affecting an indigenous Ameridian group, the Chachi, living in Ecuador. The only method for diagnosing amphimeriasis was the microscopic detection of eggs from the parasite in patients' stool samples with very low sensitivity. Our group developed an ELISA technique for detection of anti-Amphimerus IgG in human sera and a molecular method based on LAMP technology (named LAMPhimerus) for specific and sensitive parasite DNA detection. The LAMPhimerus method showed to be much more sensitive than classical parasitological methods for amphimeriasis diagnosis using human stool samples for analysis. The objective of this work is to demonstrate the feasibility of using dried stool samples on filter paper as source of DNA in combination with the effectiveness of our previously designed LAMPhimerus assay for successfully Amphimerus sp. detection in clinical stool samples. A total of 102 untreated and undiluted stool samples collected from Chachi population were spread as thin layer onto common filter paper for easily transportation to our laboratory and stored at room temperature for one year until DNA extraction. When LAMPhimerus method was applied for Amphimerus sp. DNA detection, a higher number of positive results was detected (61/102; 59.80%) in comparison to parasitological methods (38/102; 37.25%), including 28/61 (45.90%) microscopy-confirmed Amphimerus sp. infections. The diagnostic parameters for the sensitivity and specificity werecalculated for our LAMPhimerus assay, which were 79.17% and 65.98%, respectively. We demonstrate, for the first time, that common filter paper is useful for easy collection and long-term storage of human stool samples for later DNA extraction and molecular analysis of human-parasitic trematode eggs. This simple, economic and easily handling method combined with the specific and sensible LAMPhimerus assay has the potential to beused as an effective molecular large-scale screening test for amphimeriasis-endemic areas.

The present work was focused to design a cheap, rapid, portable and easy to use filter paper based assay for the qualitative and quantitate analysis of acetone. Sodium alginate gel was loaded with the acetone specific optical signal probe, and subsequently coated onto filter paper surface to design portable colorimetric assays for acetone monitoring. The color of the paper sensor strip was observed to change from dark yellow to light yellowish in the presence of varying concentrations of acetone. Three different color analyzing models including RGB, HSV, and LAB were employed to probe the output optical signal, and their performance was compared in terms of better interpretation of the generated signal. The LAB model was found to provide better analytical figures of merit with a linear response for the acetone concentration ranging from 2.5 to 1500 ppm, and a limit of detection of 0.5 ppm. Furthermore, the specificity of the designed filter paper based sensor was demonstrated against different common interfering compounds. The results demonstrated the potential of our proposed filter paper based sensor as a novel tool for the analysis of acetone.

Introduction \ud Data collection using paper-based questionnaires can be time consuming and return errors affect data accuracy, completeness, and information quality in health surveys. We compared smartphone and paper-based data collection systems in the Burden of Obstructive Lung Disease (BOLD) study in rural Sudan. \ud Methods \ud This exploratory pilot study was designed to run in parallel with the cross-sectional household survey. The Open Data Kit was used to programme questionnaires in Arabic into smartphones. We included 100 study participants (83% women; median age = 41.5 ± 16.4 years) from the BOLD study from 3 rural villages in East-Gezira and Kamleen localities of Gezira state, Sudan. Questionnaire data were collected using smartphone and paper-based technologies simultaneously. We used Kappa statistics and inter-rater class coefficient to test agreement between the two methods. Results Symptoms reported included cough (24%), phlegm (15%), wheezing (17%), and shortness of breath (18%). One in five were or had been cigarette smokers. The two data collection methods varied between perfect to slight agreement across the 204 variables evaluated (Kappa varied between 1.00 and 0.02 and inter-rater coefficient between 1.00 and -0.12). Errors were most commonly seen with paper questionnaires (83% of errors seen) vs smartphones (17% of errors seen) administered questionnaires with questions with complex skip-patterns being a major source of errors in paper questionnaires. Automated checks and validations in smartphone-administered questionnaires avoided skip-pattern related errors. Incomplete and inconsistent records were more likely seen on paper questionnaires. \ud Conclusion \ud Compared to paper-based data collection, smartphone technology worked well for data collection in the study, which was conducted in a challenging rural environment in Sudan. This approach provided timely, quality data with fewer errors and inconsistencies compared to paper-based data collection. We recommend this method for future BOLD studies and other population-based studies in similar settings.

A scientific article including limitations, their results and the ways how these results can be reduced has invaluable importance in terms of researchers, readers, society, scientific progress and the quality of scientific papers. However, in our country, particularly in the field of health, theoretical knowledge on this subject is rather limited. The purpose of this review article is to demonstrate the importance of limitations section in scientific articles, its characteristics, what kind of limitations researchers may encounter in scientific research process, and the ways that can be followed to overcome them. It appears that limitations section is mostly ignored; either not written at all or incomplete or poorly written in the present articles in the field of health including the ones in our country. Moreover, there is no information about the results caused by the limitations and the ways to reduce or eliminate them. This situation adversely affects the validity, reliability and generalizability of the research findings. Such a result is related to the knowledge, writing skills, perspectives, and approaches of the authors, the editorial policy of periodicals and the assessment of editors and peer reviewers. If there are limitations in scientific articles and graduation theses, they must absolutely be written and guidelines and instructions regarding correct writing of this section should be developed [TAF Prev Med Bull 2015; 14(6.000): 496-505]

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives.

BackgroundThe rise in popularity of “mindfulness colouring books” has led to the development of colouring applications as an alternative to the traditional pen-and-paper versions. There have been no investigations exploring these applications in regards to mindfulness.Participants and procedureIn two randomised experiments, this study examined whether there were any differences in state mindfulness and anxiety between (a) paper-and-pen and a colouring application (i.e., Experiment 1; n = 100), and (b) two different methods of colouring within an application (i.e., tapping or swiping; i.e., Experiment 1; n = 100).ResultsExperiments 1 and 2 showed a significant decrease in anxiety symptoms following a single colouring session, irrespective of different conditions. Also, Experiment 1, but not Experiment 2, revealed that colouring through the application significantly aided the increase in mindfulness.ConclusionsApp-based colouring may be a contemporary time- and cost-effective intervention in reducing anxiety. However, the non-significant increase in mindfulness appears challenging when attempting to justify the results. The effectiveness of colouring apart from mindfulness is seen through potential constructs such as flow, and display a limitation that requires further reflections on guidance to enhance mindfulness through colouring. Future directions are discussed.

Outbreaks of infectious diseases can occur after natural disasters as vital services are disrupted and populations move into evacuation centres. National notifiable disease surveillance may be inadequate in these situations because of resource-consuming disease confirmation or system interruptions. Although syndromic surveillance has been used as an alternative in post-disaster situations, no systematic evaluations of it have been published. We evaluated the ad hoc paper-based syndromic surveillance system implemented in evacuation centres in Ibaraki prefecture after the 2011 Great East Japan Earthquake and Tsunami. We assessed the simplicity, acceptability, data quality, timeliness and portability of this system and reviewed its usefulness. We concluded that the system was simple, acceptable, portable and useful. The documentation and monitoring of disease events and trends were useful for developing interventions in evacuation centres and have since been used to improve post-disaster infectious disease and surveillance knowledge in Japan. We believe timeliness was a challenge due to the chain of data transmission and communication passing through an intermediary. Future implementations of this system could consider a more direct chain of data transmission and communication from collectors to analysers. Too few key informant interviewees and the inability to obtain original paper-based data from evacuation centres limited our findings; we conducted this evaluation four years after the response occurred. Future evaluations should be completed closer to when operations cease. The usefulness of the system suggests adopting it in future disasters. A simple, plain-language manual should be developed to improve future employment.

International audience; Background: Identification of the source of mosquito blood meals is an important component for disease control and surveillance. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) profiling has emerged as an effective tool for mosquito blood meal identification, using the abdomens of freshly engorged mosquitoes. In the field, mosquito abdomens are crushed on Whatman filter papers to determine the host feeding patterns by identifying the origin of their blood meals. The aim of this study was to test whether crushing engorged mosquito abdomens on Whatman filter papers was compatible with MALDI-TOF MS for mosquito blood meal identification. Both laboratory reared and field collected mosquitoes were tested.Material and methods: Sixty Anopheles gambiae Giles were experimentally engorged on the blood of six distinct vertebrate hosts (human, sheep, rabbit, dog, chicken and rat). The engorged mosquito abdomens were crushed on Whatman filter papers for MALDI-TOF MS analysis. 150 Whatman filter papers, with mosquitoes engorged on cow and goat blood, were preserved. A total of 77 engorged mosquito abdomens collected in the Comoros Islands and crushed on Whatman filter papers were tested with MALDI-TOF MS. Results The MS profiles generated from mosquito engorged abdomens crushed on Whatman filter papers exhibited high reproducibility according to the original host blood. The blood meal host was correctly identified from mosquito abdomens crushed on Whatman filter papers by MALDI-TOF MS. The MS spectra obtained after storage were stable regardless of the room temperature and whether or not they were frozen. The MS profiles were reproducible for up to three months. For the Comoros samples, 70/77 quality MS spectra were obtained and matched with human blood spectra. This was confirmed by molecular tools.Conclusion: The results demonstrated that MALDI-TOF MS could identify mosquito blood meals from Whatman filter papers collected in the field during entomological surveys. The application of MALDI-TOF MS has proved to be rapid and successful, making it a new and efficient tool for mosquito-borne disease surveillance.

Bisphenol A (BPA) is an endocrine disrupting chemical used in a wide range of consumer products including photoactive dyes used in thermal paper. Recent studies have shown that dermal absorption of BPA can occur when handling these papers. Yet, regulatory agencies have largely dismissed thermal paper as a major source of BPA exposure. Exposure estimates provided by agencies such as the European Food Safety Authority (EFSA) are based on assumptions about how humans interact with this material, stating that ‘typical’ exposures for adults involve only one handling per day for short periods of time (30% of individuals hold thermal paper with more than three fingertips, and >60% allow the paper to touch their palm. Only 11% of the participants we observed were consistent with the EFSA model for time of contact and dermal surface area. Mathematical modeling based on handling times we measured and previously published transfer coefficients, concentrations of BPA in paper, and absorption factors indicate the most conservative estimated intake from handling thermal paper in this population is 51.1 ng/kg/day, similar to EFSA’s estimates of 59 ng/kg/day from dermal exposures. Less conservative estimates, using published data on concentrations in thermal paper and transfer rates to skin, indicate that exposures are likely significantly higher. Based on our observational data, we propose that the current models for estimating dermal BPA exposures are not consistent with normal human behavior and should be reevaluated.

Throughout the last decade, the expansion of food testing has been gradually moving towards ordinary high throughput screening methods performed on-site. The demand for point-of-care testing, able to distinguish molecular signatures with high accuracy, sensitivity and specificity has been significantly increasing. This new requirement relies on the on-site detection and monitorization of molecular signatures suitable for the surveillance of food production and processing. The widespread use of antibiotics has contributed to disease control of livestock but has also created problems for the dairy industry and consumers. Its therapeutic and subtherapeutic use has increased the risk of contamination in milk in enough concentrations to cause economic losses to the dairy industry and have a health impact in highly sensitive individuals. This study focuses on the development of a simple Surface-Enhanced Raman Spectroscopy (SERS) method for fast high throughput screening of tetracycline (TET) in milk. For this, we integrate a paper-based low-cost, fully recyclable and highly stable SERS platform, with a minimal sample preparation protocol. A two-microliter sample of milk solutions spiked with TET (from 0.01 to 1000 ppm) is dried on a silver nanoparticle coated cardboard substrate and measured via a Raman spectrophotometer. The SERS substrate showed to be extremely stable with a shelf life of several months. A global spectrum principal component analysis approach was used to test all the detected vibrational modes and their correlation with TET concentration. Peak intensity ratios (455 cm−1/1280 cm−1 and 874 cm−1/1397 cm−1) were found to be correlated with TET concentrations in milk, achieving a sensitivity as low as 0.1 ppm. Results indicate that this SERS method combined with portable Raman spectrometer is a potential tool that can be used on-site for the monitoring of TET residues and other antibiotics.

Background: The coronavirus disease 2019 (COVID-19) pandemic had increased population-level anxiety and had elicited panic buying behaviour across the world. The over-hoarding of toilet paper has received a lot of negative public attention. In this work, we used Twitter data to qualitatively analyse tweets related to panic buying of toilet paper during the crisis. Methods: A total of 255,171 tweets were collected. Of these 4,081 met our inclusion criteria and 100 tweets were randomly selected to develop a coding scheme in the initial phase. Random samples of tweets in folds of 100 were then qualitatively analysed in the focused coding phase until saturation was met at 500 tweets analysed. Results: Five key themes emerged: (1) humour or sarcasm, (2) marketing or profiteering, (3) opinion and emotions, (4) personal experience, and (5) support or information. About half of the tweets carried negative sentiments, expressing anger or frustration towards the deficiency of toilet paper and the frantic situation of toilet paper hoarding, which were among the most influential tweets. Discussion: Panic buying of toilet paper was seen during the 2020 pandemic period with a mass amount of related content spread across social media. The spontaneous contagion of fear and panic through social media could fuel psychological reactions in midst of crises. The high level of negative social media posts regarding the toilet paper crisis acts as an emotional trigger of public anxiety and panic. Conclusions: Social media data can provide rapid infodemiology of public mental health. In a pandemic or crisis situation, real-time data could be monitored and content-analysed for authorities to promptly address public concerns.

We present a simple all-in-one paper-based sensor for E. coli detection using a composite ink made of a fluorogenic DNAzyme probe for bacterial recognition and signal generation, lysozyme that lyses whole bacterial cells, and pullulan/trehalose sugars that stabilize printed bioactive molecules. The paper sensor is capable of producing a fluorescence signal as a readout within 5 minutes upon contacting E. coli, can achieve a limit of detection of 100 cells/mL, in a variety of sample matrixes, without sample enrichment, and remains stable for at least 6 months when stored at ambient temperature. Therefore, this simple paper sensor provides rapid bacterial testing on site, and can be shipped and stored under ambient conditions to benefit users living in resource-limited regions.

BACKGROUND The lack of information regarding the burden of acute bacterial meningitis in Latin America leads to a reduction in the estimated incidence rates of the disease, and impairs public health decisions on the use and follow-up of preventive interventions, particularly, the evaluation of existing vaccination policies. The use of the real-time PCR in diagnostic routine procedures has resulted in a substantial increase in confirmed bacterial meningitis cases. However, in resource-poor countries, these assays are only available in reference laboratories. Sample transportation to these laboratories is a critical constraint, as it requires specialized, high cost courier services. To overcome this barrier we evaluated the use of FTATM Elute filter paper cards for the conservation and processing of samples under normal environmental conditions, as they would be when transported from remote and under-equipped healthcare facilities to the reference centers. A total of 401 samples received in 2015 as part of Sao Paulo's national surveillance for routine diagnosis were selected for this study. METHODS The sensitivity and specificity of real-time PCR were evaluated using fresh serum and cerebrospinal fluid (CSF) samples processed using our laboratory's standard DNA extraction, and processing the same samples after being dried and stored on FTATM card, and DNA extracted following the manufacturer's instructions. RESULTS The sensitivities for detection of Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae from CSF dried and stored on FTATM cards were 98%, 92%, and 100%, respectively, and with serum samples were 73%, 88%, and 100%, respectively. When compared to our laboratory's standard methodology, results showed high concordance, with Kappa index ranges of 0.9877-1.00 for CSF, and 0.8004-1.00 for serum samples. CONCLUSION The use of FTATM cards for CSF and serum conservation and transport represents a rapid, reliable, and cost-effective alternative that will allow obtaining valuable epidemiological information that would otherwise be lost.

Introduction: Diastasis recti abdominis (DRA) is defined as the increase between two abdominal rectal muscles located on both sides of the linea alba at the height of the navel. It occurs in pregnant and postpartum women due to the loosening of the linea alba during pregnancy under the influence of hormones and the developing foetus. The most common risk factors for dehiscence are: large foetus, large volume of foetal waters, multiple pregnancy, excessive abdominal muscle overload during the third trimester, obesity and too intense pressure during delivery. Study aim: The aim of the study was to present diagnostics and surgical as well as non-operative treatment for women with abdominal muscle diastasis due to pregnancy and during the puerperium period. Diagnosis of dehiscence primarily includes palpation, calliper measurements, ultrasound and CT scan. Materials and methods: Scientific bases such as Pubmed, Sciencedirect, Google Scholar and Ebsco were searched. Results: A total of 48 scientific reports from Pubmed, Sciencedirect and Google Scholar were collected. Conclusions: Diastasis of the rectus abdominis muscle can be treated preventively by introducing appropriate prophylaxis, which aims to strengthen the transverse and the rectus abdominis muscles, as well as learning the right posture and principles of proper performance of activities such as lifting heavy objects. In the event of diastasis occurring in the puerperium period, its size can be reduced in a non-invasive manner or even completely eliminated after introducing appropriate exercises, being supported with orthopaedic equipment if necessary. Exercises should be individually selected by a therapist and performed under his/her supervision at the initial stage of training to teach the patient to properly activate the transverse abdominal muscle. Pregnant women who do not have contraindications to physical activity can reduce the risk of the DRA by performing appropriate exercises.

The success of a scientist depends on their production of scientific papers and the impact factor of the journal in which they publish. Because most major scientific journals are published in English, success is related to publishing in this language. Currently, 98% of publications in science are written in English, including researchers from English as a Foreign Language (EFL) countries. Colombia is among the countries with the lowest English proficiency in the world. Thus, understanding the disadvantages that Colombians face in publishing is crucial to reducing global inequality in science. This paper quantifies the disadvantages that result from the language hegemony in scientific publishing by examining the additional costs that communicating in English creates in the production of articles. It was identified that more than 90% of the scientific articles published by Colombian researchers are in English, and that publishing in a second language creates additional financial costs to Colombian doctoral students and results in problems with reading comprehension, writing ease and time, and anxiety. Rejection or revision of their articles because of the English grammar was reported by 43.5% of the doctoral students, and 33% elected not to attend international conferences and meetings due to the mandatory use of English in oral presentations. Finally, among the translation/editing services reviewed, the cost per article is between one-quarter and one-half of a doctoral monthly salary in Colombia. Of particular note, we identified a positive correlation between English proficiency and higher socioeconomic origin of the researcher. Overall, this study exhibits the negative consequences of hegemony of English that preserves the global gap in science. Although having a common language is important for science communication, generating multilinguistic alternatives would promote diversity while conserving a communication channel. Such an effort should come from different actors and should not fall solely on EFL researchers.

Paper has been pursued as an interesting substrate material for sensors in applications such as microfluidics, bio-sensing of analytes and printed microelectronics. It offers advantages of being inexpensive, lightweight, environmentally friendly and easy to use. However, currently available paper-based mechanical sensors suffer from inadequate range and accuracy. Here, using the principle of supercapacitive sensing, we fabricate force sensors from paper with ultra-high sensitivity and unprecedented configurability. The high sensitivity comes from the sensitive dependence of a supercapacitor’s response on the contact area between a deformable electrolyte and a pair of electrodes. As a key component, we develop highly deformable electrolytes by coating ionic gel on paper substrates which can be cut and shaped into complex three-dimensional geometries. Paper dissolves in the ionic gel after determining the shape of the electrolytes, leaving behind transparent electrolytes with micro-structured fissures responsible for their high deformability. Exploiting this simple paper-based fabrication process, we construct diverse sensors of different configurations that can measure not just force but also its normal and shear components. The new sensors have range and sensitivity several orders of magnitude higher than traditional MEMS capacitive sensors, in spite of their being easily fabricated from paper with no cleanroom facilities.

Background: Computer-based examination (CBE) has become increasingly popular as a testing modality in underand postgraduate health sciences education. Since 2013, Prince Sultan military college of health sciences (PSMCHS) has utilized CBE to conduct the preparatory year examination in first year assessments with multiple choice questions, column matching, and the modified essay question paper. Aims: To evaluate the test anxiety levels among students during computer-based and traditional paper-and-pen examination. Settings and Design: The descriptive survey based study was conducted in PSMCHS. Methods and Material: A sample of 199 male and female students of the preparatory year of allied health sciences was selected by random sampling technique. Test anxiety was quantified by using Westside anxiety scale. Statistical analysis: Descriptive statistics were used to analyze data. Mean anxiety scores were compared by unpaired t-test. Results: Of 199 students, 109 (54.8%) and 89 (45.2%) were males and females. A statistically significant decrease in mean anxiety score on WTA scales was observed in students administered with computer-based examination when compared with pen-and-paper based examination (2.48 vs. 3.90; P

Introduction: Medical quality indicators (QI) are important tools in the evaluation of medical quality. Their development is subject to specific methodological requirements, which include practical applicability. This is especially true for intensive care medicine with its complex processes and their interactions. This methods paper presents the status quo and shows necessary methodological developments for intensive care QI. For this purpose, a cooperation with the Association of the Scientific Medical Societies’ Institute for Medical Knowledge Management (AWMF-IMWi) was established. Methodology: Review of published German manuals for QI development from guidelines and narrative review of quality indicators with a focus on evidence and consensus-based guideline recommendations. Future methodological adaptations of indicator development for improved operationalization, measurability and pilot testing are presented, and a development process is proposed. Results: The development of intensive care quality indicators in Germany is based on an established process. In the future, additional evaluation criteria (QUALIFY criteria) will be applied to assess the evidence base. In addition, a continuous exchange between the national steering committee of the DIVI responsible for QI development and guideline development groups involved in intensive care medicine is planned. Conclusion: Intensive care quality indicators will have to meet improved methodological requirements in the future by means of an improved development process. Future QI development is intended to improve the structure of the development process, with a focus on scientific evidence and a link to guideline projects. This is intended to achieve the goal of a broad application of QI and to further evaluate its relevance for patient outcome and performance of institutions., Einleitung: Medizinische Qualitätsindikatoren (QI) stellen ein wichtiges Werkzeug bei der Betrachtung medizinischer Qualität dar. Ihre Entwicklung unterliegt methodischen Anforderungen, die auch ihre praktische Anwendbarkeit einschließen. Dies gilt insbesondere für die Intensivmedizin mit ihren komplexen Prozessen und Interaktionen. Dieses Methodenpapier dient der Darstellung des Status quo und zeigt erforderliche methodische Weiterentwicklungen intensivmedizinischer QI auf. Dazu erfolgte eine Kooperation mit dem Institut für Medizinisches Wissensmanagement der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF-IMWi). Methodik: Rückgriff auf publizierte deutsche Manuale zur QI-Ableitung aus Leitlinien und narratives Review zu Qualitätsindikatoren mit Fokus auf die Beziehung zu evidenz- und konsensbasierten Leitlinienempfehlungen. Die notwendigen methodischen Anpassungen der Indikatorentwicklung wie Operationalisierbarkeit, Messbarkeit und Pilotierung werden dargestellt, und ein Vorschlag für einen Entwicklungsprozess wird erarbeitet. Ergebnisse: Die Entwicklung intensivmedizinischer Qualitätsindikatoren in Deutschland geschieht in einem etablierten Verfahren. Dieses soll künftig durch die Aufnahme zusätzlicher Bewertungskriterien (QUALIFY-Kriterien) u.a. zur Beurteilung der Evidenzbasierung erweitert werden. Ergänzend ist ein kontinuierlicher Austausch der für die QI verantwortlichen nationalen Steuerungsgruppe der DIVI mit den Leitliniengruppen geplant, die intensivmedizinische Fragestellungen bearbeiten. Schlussfolgerung: Intensivmedizinische Qualitätsindikatoren können durch einen verbesserten Entwicklungsprozess in Zukunft gestiegenen methodischen Anforderungen genügen. Die beschriebenen Weiterentwicklungen sollen den Erstellungsprozess besser strukturieren, wissenschaftlicher gestalten und in Zukunft mit Leitlinienprojekten vernetzen. Dadurch soll das Ziel einer flächendeckenden Anwendung der QI erreicht werden und schließlich ihre Relevanz für das Outcome bezogen auf Patienten und Einrichtungen geprüft werden., GMS German Medical Science; 18:Doc09