Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Background Mobile health technology can improve medication safety for older adults, for instance, by educating patients about the risks associated with anticholinergic medication use. Objective This study's objective was to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Methods Twenty-three primary care patients aged ≥60 years and using anticholinergic medications participated in summative, task-based usability testing of Brain Buddy. Self-report usability was assessed by the System Usability Scale and performance-based usability data were collected for each task through observation. A subset of 17 participants contributed data on feasibility, assessed by self-reported attitudes (feeling informed) and behaviors (speaking to a physician), with confirmation following a physician visit. Results Overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task and a mean System Usability Scale score of 78.8, corresponding to “Good” to “Excellent” usability. Observed usability issues included higher rates of errors, hesitations, and need for assistance on three tasks, particularly those requiring data entry. Among participants contributing to feasibility data, 100% felt better informed after using Brain Buddy and 94% planned to speak to their physician about their anticholinergic related risk. On follow-up, 82% reported having spoken to their physician, a rate independently confirmed by physicians. Conclusion Consumer-facing technology can be a low-cost, scalable intervention to improve older adults’ medication safety, by informing and empowering patients. User-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change

Drug use evaluation of ceftriaxone in medical ward of Dessie Referral Hospital, North East Ethiopia

Background: Assessment of antimicrobial use can be performed by evaluating their use. Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. The objective of this study was to evaluate the rational use of ceftriaxone in Medical ward of Dessie referral Hospital, Dessie-Ethiopia.Methods: Retrospective systematic study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 316 patients, who received ceftriaxone during hospitalization at Medical ward of Dessie referral Hospital from December 30, 2011 to January, 2013. A systematic sampling method was used to select inpatient prescriptions in this ward with ceftriaxone and patient cards were located based on the medical record number on the prescription papers. Data was collected by using structured format and evaluated against WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia.Results: Most patients were dosed as 2 g/day (79.4%). The duration of therapy was found to be high in the range 2-7 days (51.69%). Ceftriaxone was mainly used as pneumonia treatment (38.8%). Maintenance fluids were the most commonly co-administered medications with a frequency of 62.16%. The use of ceftriaxone was appropriate only in 170 cases (55.8%) for the justification of use. Most of inappropriate uses were seen in terms of duration during treatment of pneumonia followed by frequency for the treatment of meningitis. Consistency of prescriber to the national standard treatment guideline was found to be low.Conclusions: To improve rational use and prevent the development of resistance; prescribers should adhere to the national standard treatment guideline. Intensification of short term trainings and antibiotic control systems are some of the possible solutions the hospital has to do.ceftriaxone therapy does not meet the current STG of Ethiopia

A High-Density Linkage Map of the Ancestral Diploid Strawberry, Fragaria iinumae, Constructed with Single Nucleotide Polymorphism Markers from the IStraw90 Array and Genotyping by Sequencing

Fragaria iinumae Makino is recognized as an ancestor of the octoploid strawberry species, which includes the cultivated strawberry, Fragaria ×ananassa Duchesne ex Rozier. Here we report the construction of the first high-density linkage map for F. iinumae. The F. iinumae linkage map (Fii map) is based on two high-throughput techniques of single nucleotide polymorphism (SNP) genotyping: the IStraw90 Array (hereafter “Array”), and genotyping by sequencing (GBS). The F2 generation mapping population was derived by selfing F. iinumae hybrid F1D, the product of a cross between two divergent F. iinumae accessions collected from Hokkaido, Japan. The Fii map consists of seven linkage groups (LGs) and has an overall length of 451.7 cM as defined by 496 loci populated by 4173 markers: 3280 from the Array and 893 from GBS. Comparisons with two versions of the Fragaria vesca ssp. vesca L. ‘Hawaii 4’ pseudo-chromosome (PC) assemblies reveal substantial conservation of synteny and colinearity, yet identified differences that point to possible genomic divergences between F. iinumae and F. vesca, and/or to F. vesca genomic assembly errors. The Fii map provides a basis for anchoring a F. iinumae genome assembly as a prerequisite for constructing a second diploid reference genome for Fragaria

Agro-ecological niche of bacterial wilt (Xanthomonas campestris pv. musacearum) of enset (Ensete ventricosum (Welw.) Cheessman) in Gamo highlands of Ethiopia

In Ethiopia, nearly 20 million people depend on Enset (Ensete ventricosum (Welw.) Cheessman) for food, animal feed and fibre. Most of its cultivation is concentrated in the South and South-Western parts of the country. Enset based farming system is common in the Gamo highlands, with 11, 150 ha currently covered by it. Enset is supplemented with the cultivation of cereals, pulses and other root and tuber crops. Diverse high yielding clones of different ages are available all year round and can withstand dry spells, making Enset the most important food security crop in these densely populated highlands. Despite its relevance, Enset remains very poorly studied. One of the most important problems is Bacterial Wilt disease caused by Xanthomonas campestris pv. musacearum, destructive to Enset at all growth stages and present in all Enset growing areas of the country. As a plant takes up to 8 years to mature, an attack of Bacterial Wilt can leave a family vulnerable to famine for years. It is most likely spread by infected farm tools, harvesting knives, plant debris and repeated transplanting of corms. Adoption of the control package by farmers has been less effective and all known varieties are susceptible, putting a great challenge on controlling the epidemic. Despite being present in the entire Enset belt, the severity of a Bacterial Wilt infection varies greatly from region to region. Hence, this study aims at correlating the distribution and severity of the disease to environmental factors such as soil type, fertility, climate and altitude, and to the socio-economical status of the farm households. A better knowledge of the influence of these factors would help in developing more targeted measures to control the disease

Collective Efficacy: Development and Validation of a Measurement Scale for Use in Public Health and Development Programmes.

Impact evaluations of water, sanitation, and hygiene interventions have demonstrated lower than expected health gains, in some cases due to low uptake and sustained adoption of interventions at a community level. These findings represent common challenges for public health and development programmes relying on collective action. One possible explanation may be low collective efficacy (CE)-perceptions regarding a group's ability to execute actions related to a common goal. The purpose of this study was to develop and validate a metric to assess factors related to CE. We conducted this research within a cluster-randomised sanitation and hygiene trial in Amhara, Ethiopia. Exploratory and confirmatory factor analyses were carried out to examine underlying structures of CE for men and women in rural Ethiopia. We produced three CE scales: one each for men and women that allow for examinations of gender-specific mechanisms through which CE operates, and one 26-item CE scale that can be used across genders. All scales demonstrated high construct validity. CE factor scores were significantly higher for men than women, even among household-level male-female dyads. These CE scales will allow implementers to better design and target community-level interventions, and examine the role of CE in the effectiveness of community-based programming

Modeling the 5-Fluorouracil Area Under the Curve Versus Dose Relationship to Develop a Pharmacokinetic Dosing Algorithm for Colorectal Cancer Patients Receiving FOLFOX6

5-Fluorouracil (5-FU) is administered based on standard body surface area (BSA) dosing. BSA administration results in highly variable exposure, measured as the area under the concentration-time curve (AUC). An immunoassay (OnDose®; Myriad Genetic Laboratories, Inc., Salt Lake City, UT) that measures plasma 5-FU concentration and reports an AUC in mg · h/L has been developed to optimize therapy using pharmacokinetic (PK) dosing. The results of an analysis to model the 5-FU AUC-dose relationship are presented

Statistička analiza nanokapsuliranja niskomolekularnog heparina

The objective of this study was to use Box-Behnken design (BBD) to investigate the influence of formulation variables on the properties of heparin-loaded poly(lactic-co-glycolic acid) (PLGA)-Eudragit-RLPO (E-RLPO) nanoparticles (NP) in terms of mean diameter (as size) and drug encapsulation efficiency. The NPs were prepared by the double emulsion solvent evaporation method. The independent variables were: X1 olymer mass ratio (PLGA:E-RLPO) in the oil phase, X2 concentration of polyvinyl alcohol (PVA) as emulsion stabilizer, and X3 volume of the external aqueous phase (W2). Particle size (analyzed by dynamic light scattering) and encapsulation efficiency (EE, estimated by spectrophotometry) were the investigated responses. The polynomial equation obtained from regression analysis of the reduced model (p = 0.0002, F = 25.7952 and R2 = 0.96) provided an excellent fit. The optimal size for the NP was found to be 134.2 ± 16.5 nm with formulation variables of 48.2:61.8, 0.321 (%, m/V) and 263 mL for X1, X2 and X3, respectively. Probably, due to electrostatic interaction between the negatively charged drug and the positively charged E-RLPO, the percent EE of heparin was between 74.4 ± 6.5 % (lowest value) and 92.1 ± 5.3 % (highest value). The data suggest that BBD is a useful tool in rational design of heparin-loaded NPs.Box-Behnkenovo dizajniranje (BBD) primijenjeno je za praćenje utjecaja formulacijskih varijabli na svojstva nanočestica (NP) s heparinom. Za izradu nanočestica korišten je kopolimer mliječne i glikolne kiseline (PLGA) i Eudragit-RLPO (E-RLPO). Nanočestice su pripravljene metodom dvostruke evaporacije otapala iz emulzije. Nezavisne varijable bile su: X1 omjer masa polimera (PLGA : E-RLPO) u uljnoj fazi, X2 koncentracija polivinil alkohola (PVA) kao stabilizatora emulzije i X3 volumen vanjske vodene faze (W2). Zavisne varijable bile su veličina čestica (analizirana pomoću dinamičkog rasapa svjetlosti) i učinkovitost inkapsuliranja (EE) (praćena spektrofotometrijski). Polinomska jednadžba dobivena regresijskom analizom reduciranog modela odlično je odgovarala (p = 0,0002, F = 25,7952 i R2 = 0,96). Optimalna veličina nanočestica bila je 134,2 ± 16,5 nm s formulacijskim varijablama 48,2:61,8, 0,321 (%, m/V) i 263 mL for X1, X2 odnosno X3. Vjerojatno je zbog elektrostatskih interakcija između negativno nabijene ljekovite tvari i pozitivno nabijenog E-RLPO učinkovitost inkapsuliranja heparina varirala od 74,4 ± 6,5 % (najniža vrijednost) do 92,1 ± 5,3 % (najviša vrijednost). Rezultati sugeriraju da je BBD vrlo korisno u racionalnom dizajniranju nanočestica s heparinom

Potential hidden Plasmodium vivax malaria reservoirs from low parasitemia Duffy-negative Ethiopians: Molecular evidence

BACKGROUND: The interaction between the Plasmodium vivax Duffy-binding protein and the corresponding Duffy Antigen Receptor for Chemokines (DARC) is primarily responsible for the invasion of reticulocytes by P. vivax. The Duffy-negative host phenotype, highly prevalent in sub-Saharan Africa, is caused by a single point mutation in the GATA-1 transcription factor binding site of the DARC gene promoter. The aim of this study was to assess the Duffy status of patients with P. vivax infection from different study sites in Ethiopia. METHODS: A cross-sectional study was conducted from February 2021 to September 2022 at five varying eco-epidemiological malaria endemic sites in Ethiopia. Outpatients who were diagnosed with P. vivax infection (pure and mixed P. vivax/P. falciparum) by microscopy and Rapid Diagnostic Test (RDT) were subjected to PCR genotyping at the DARC promoter. The associations between P. vivax infection, host genotypes and other factors were evaluated. RESULT: In total, 361 patients with P. vivax infection were included in the study. Patients with pure P. vivax infections accounted for 89.8% (324/361), while the remaining 10.2% (37/361) had mixed P. vivax/P. falciparum infections. About 95.6% (345/361) of the participants were Duffy-positives (21.2% homozygous and 78.8%, heterozygous) and 4.4% (16/361) were Duffy-negatives. The mean asexual parasite density in homozygous and heterozygous Duffy-positives was 12,165 p/μl (IQR25-75: 1,640-24,234 p/μl) and11,655 p/μl (IQR25-75: 1,676-14,065 p/μl), respectively, significantly higher than that in Duffy-negatives (1,227p/μl; IQR25-75: 539-1,732p/μl). CONCLUSION: This study confirms that Duffy-negativity does not provide complete protection against P. vivax infection. The development of P. vivax-specific elimination strategies, including alternative antimalarial vaccines should be facilitated by a better understanding of the epidemiological landscape of vivax malaria in Africa. More importantly, low parasitemia associated with P. vivax infections in Duffy-negative patients may represent hidden reservoirs of transmission in Ethiopia. Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose

Combining machine learning and spatial data processing techniques for allocation of large-scale nature-based solutions

This is the final version. Available on open access from IWA Publishing via the DOI in this recordData availability statement: All relevant data are available from an online repository or repositories: (https://developers.google.com/earth-engine/datasets; https://search.asf.alaska.edu/#/; https://geo.gob.bo/; https://www.openstreetmap.org/#map=7/52.154/5.295; https://rsis.ramsar.org/; https://www.arcgis.com/apps/mapviewer/index.html?layers=cfcb7609de5f478eb7666240902d4d3d; https://land.copernicus.eu/en/products/corine-land-cover; https://worldcover2020.esa.int/viewer).The escalating impacts of climate change trigger the necessity to deal with hydro-meteorological hazards. Nature-based solutions (NBSs) seem to be a suitable response, integrating the hydrology, geomorphology, hydraulic, and ecological dynamics. While there are some methods and tools for suitability mapping of small-scale NBSs, literature concerning the spatial allocation of large-scale NBSs is still lacking. The present work aims to develop new toolboxes and enhance an existing methodology by developing spatial analysis tools within a geographic information system (GIS) environment to allocate large-scale NBSs based on a multi-criteria algorithm. The methodologies combine machine learning spatial data processing techniques and hydrodynamic modelling for allocation of large-scale NBSs. The case studies concern selected areas in the Netherlands, Serbia, and Bolivia, focusing on three large-scale NBS: rainwater harvesting, wetland restoration, and natural riverbank stabilisation. Information available from the EC H2020 RECONECT project as well as other available data for the specific study areas was used. The research highlights the significance of incorporating machine learning, GIS, and remote sensing techniques for the suitable allocation of large-scale NBSs. The findings may offer new insights for decision-makers and other stakeholders involved in future sustainable environmental planning and climate change adaptation.European Union Horizon 202