NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov

Analysis and Review of NASA Earth Science Metadata: How Automation Plays a Role

The Analysis and Review of the Common Metadata Repository (CMR ARC) Team reviews all EOSDIS metadata. The teams objective is to achieve consistency, correctness, and completeness for all metadata records in the CMR, as well as improve the discoverability of NASA's Earth Science data within the CMR framework. This work is currently being completed at Marshall Space Flight Center. CMR makes a single discovery point possible for NASA's Earth Science data users. The CMR team, in collaboration with three other core metadata teams, contributes to the stewardship of NASA's Earth Science data through a process of continual curation and the ongoing development of the Unified Metadata Model (UMM). A key tool now used in the curation process, referred to as the NASA CMR Dashboard, is an online curation dashboard developed in collaboration with software development company, Element 84. This tool facilitates the review of Earth Science metadata records and subsequent stakeholder collaboration on the resolution of identified issues. A key capability of the new tool is a suite of automated compliance checks written in Python 3.6 that verify the integrity of various metadata elements across multiple standards

Easing the Discovery of NASA and International Near-Real-Time Data Using the Global Change Master Directory

The Global Change Master Directory (GCMD) provides an extensive directory of descriptive and spatial information about data sets and data-related services, which are relevant to Earth science research. The directory's data discovery components include controlled keywords, free-text searches, and map/date searches. The GCMD portal for NASA's Land Atmosphere Near-real-time Capability for EOS (LANCE) data products leverages these discovery features by providing users a direct route to NASA's Near-Real-Time (NRT) collections. This portal offers direct access to collection entries by instrument name, informing users of the availability of data. After a relevant collection entry is found through the GCMD's search components, the "Get Data" URL within the entry directs the user to the desired data. http://gcmd.nasa.gov/r/p/gcmd_lance_nrt

Implementation of evidence-based antenatal care in Mozambique: a cluster randomized controlled trial: study protocol

Background: Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher. WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of the package of evidence-based services included in the WHO ANC model in Mozambique. The primary hypothesis is that the intervention will increase the use of evidence-based practices during ANC visits in comparison to the standard dissemination channels currently used in the country. Methods: This is a demonstration project to be developed through a facility-based cluster randomized controlled trial with a stepped wedge design. The intervention was tailored, based on formative research findings, to be readily applicable to local prenatal care services and acceptable to local pregnant women and health providers. The intervention includes four components: the provision of kits with all necessary medicines and laboratory supplies for ANC (medical and non-medical equipment), a storage system, a tracking system, and training sessions for health care providers. Ten clinics were selected and will start receiving the intervention in a random order. Outcomes will be computed at each time point when a new clinic starts the intervention. The primary outcomes are the delivery of selected healthcare practices to women attending the first ANC visit, and secondary outcomes are the delivery of selected healthcare practices to women attending second and higher ANC visits as well as the attitude of midwives in relation to adopting the practices. This demonstration project is pragmatic in orientation and will be conducted under routine conditions. Discussion: There is an urgent need for effective and sustainable scaling-up approaches of health interventions in low-resource countries. This can only be accomplished by the engagement of the country’s health stakeholders at all levels. This project aims to achieve improvement in the quality of antenatal care in Mozambique through the implementation of a multifaceted intervention on three levels: policy, organizational and health care delivery levels. The implementation of the trial will probably require a change in accountability and behaviour of health care providers and we expect this change in ‘habits’ will contribute to obtaining reliable health indicators, not only related to research issues, but also to health care outcomes derived from the new health care model. At policy level, the results of this study may suggest a need for revision of the supply chain management system. Given that supply chain management is a major challenge for many low-resource countries, we envisage that important lessons on how to improve the supply chain in Mozambique and other similar settings, will be drawn from this study

Appropriateness of colonoscopy indication according to EPAGE II criteria in a Uruguayan university hospital

Background: Prioritization of criteria have been developed to reduce the increased demand. The European Society for Gastrointestinal Endoscopy developed an online program (EPAGE II). The aim of this study is to evaluate the appropriateness of the colonoscopy indication according to the EPAGE II criteria and correlate it with the endoscopic findings. Materials and Methods: Retrospective and analytical study that included all colonoscopies performed in the period March 2018 - March 2019. Colonoscopies with insufficient preparation and missing data, were excluded. They were categorized into having appropriate, inappropriate and uncertain indication, according to EPAGE II criteria. Sociodemographic data, indication, degree of preparation, and the presence of relevant findings were recorded. Results: 648 studies were included, 64.7% were women, and 51.8% were ordered by gastroenterologists. In 62% the preparation was adequate. In 171 (26.4%) the indication was CCR screening. In 525 (81%) the indication was appropriate, in 79 (12,2%) was not appropriate and in 44 (6,8%) was uncertain. An appropriate indication was significantly associated with age older than 50 years (p≤0.001). An endoscopic relevant diagnosis was observed in 55.2%. There was a significant association between appropriate indication and a relevant endoscopic diagnosis (p <0.01). The sensitivity, specificity, PPV and NPV of EPAGE II for an appropriate indication in relation to a relevant endoscopic finding were 84.92 %, 24.14%, 69.72% and 43.75% respectively. Conclusions: In this group of patients the EPAGE II showed high sensitivity and low specificity for the appropriateness of the indication in relation to the findings. Antecedentes: Criterios de priorización han sido desarrollados para disminuir el aumento de la demanda en las unidades de endoscopía. Se ha creado la guía europea sobre la idoneidad de la endoscopía gastrointestinal (EPAGE II). El objetivo de este estudio es evaluar la adecuación de la indicación de colonoscopia según los criterios de la EPAGE II y correlacionarla con los hallazgos endoscópicos. Materiales y Métodos: Estudio retrospectivo y analítico que incluyó todas las colonoscopias realizadas en el período marzo 2018 - marzo 2019. Se excluyeron las colonoscopias con preparación insuficiente y falta de datos. Se clasificaron en indicación apropiada, inapropiada e incierta, de acuerdo con los criterios de EPAGE II. Se registraron datos sociodemográficos, indicación, grado de preparación y presencia de hallazgos relevantes. Resultados: se incluyeron 648 estudios, 64,7% fueron mujeres y 51,8% fueron pedidos por gastroenterólogos. En 62% la preparación fue adecuada. En 171 (26,4%) la indicación fue cribado CCR. En 525 (81%) la indicación fue adecuada, en 79 (12,2%) no fue adecuada y en 44 (6,8%) fue incierta. Una indicación adecuada se asoció significativamente con la edad mayor de 50 años (p≤0,001). Se observó un diagnóstico endoscópico relevante en 55,2%. Hubo una asociación significativa entre la indicación apropiada y un diagnóstico endoscópico relevante (p <0.01). La sensibilidad, especificidad, VPP y VPN de EPAGE II para una indicación adecuada en relación con un hallazgo endoscópico relevante fueron 84,92%, 24,14%, 69,72% y 43,75% respectivamente. Conclusiones: En este grupo de pacientes EPAGE II mostró alta sensibilidad y baja especificidad para la correcta adecuación de la indicación para los hallazgos en VCC en general

Provision of medical supply kits to improve quality of antenatal care in Mozambique: a stepped-wedge cluster randomised trial

Background High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. Methods We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served at least 200 new pregnant women per year; they had Maternal and Child Health (MCH) nurses; and they were willing to participate. All women attending antenatal care visits at the participating clinics were included in the trial. Participating clinics were randomly assigned to shift from control to intervention on prespecified start dates. The intervention involved four components (kits with medical supplies, a cupboard to store these supplies, a tracking sheet to monitor stocks, and a one-day training session). The primary outcomes were the proportion of women screened for anaemia and proteinuria, and the proportion of women who received mebendazole in the first antenatal care visit. The intervention was delivered under routine care conditions, and analyses were done according to the intention-to-treat principle. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201306000550192. Findings Between March, 2014, and January, 2016, 218 277 antenatal care visits were registered, with 68 598 first and 149 679 follow-up visits. We found significant improvements in all three primary outcomes. In first visits, 5519 (14·6%) of 37 826 women were screened for anaemia in the control period, compared with 30 057 (97·7%) of 30 772 in the intervention period (adjusted odds ratio 832·40; 99% CI 666·81–1039·11; p<0·0001); 3739 (9·9%) of 37 826 women were screened for proteinuria in the control period, compared with 29 874 (97·1%) of 30 772 in the intervention period (1875·18; 1447·56–2429·11; p<0·0001); and 17 926 (51·4%) of 34 842 received mebendazole in the control period, compared with 24 960 (88·2%) of 28 294 in the intervention period (1·88; 1·70–2·09; p<0·0001). The effect was immediate and sustained over time, with negligible heterogeneity between sites. Interpretation A supply chain strategy that resolves stockouts at point of care can result in a vast improvement in quality during antenatal care visits, when compared with the routine national process for procurement and distribution of supplies. Funding Government of Flanders and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.Fil: Betrán, Ana Pilar. Organizacion Mundial de la Salud; ArgentinaFil: Bergel, Eduardo. World Health Organization; Suiza. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Griffin, Sally. International Centre For Reproductive Health; MozambiqueFil: Melo, Armando. Mozambique Ministry Of Health; MozambiqueFil: Nguyen, My Huong. World Health Organization; SuizaFil: Carbonell, Alicia. World Health Organization; SuizaFil: Mondlane, Santos. Consultório de Estatística E Serviço de Soluções; MozambiqueFil: Merialdi, Mario. World Health Organization; SuizaFil: Temmerman, Marleen. World Health Organization; SuizaFil: Gülmezoglu, A Metin. World Health Organization; SuizaFil: Aleman, Alicia. World Health Organization; SuizaFil: Althabe, Fernando. World Health Organization; Suiza. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Biza, Adriano. World Health Organization; SuizaFil: Crahay, Beatrice. World Health Organization; SuizaFil: Chavane, Leonardo. World Health Organization; SuizaFil: Colomar, Mercedes. World Health Organization; SuizaFil: Delvaux, Therese. World Health Organization; SuizaFil: Dique Ali, Ussumane. World Health Organization; SuizaFil: Fersurela, Lucio. World Health Organization; SuizaFil: Geelhoed, Diederike. World Health Organization; SuizaFil: Jille-Taas, Ingeborg. World Health Organization; SuizaFil: Malapende, Celsa Regina. World Health Organization; SuizaFil: Langa, Célio. World Health Organization; SuizaFil: Osman, Nafissa Bique. World Health Organization; SuizaFil: Requejo, Jennifer. World Health Organization; SuizaFil: Timbe, Geraldo. World Health Organization; Suiz

Organocatalytic vs. Ru-based electrochemical hydrogenation of nitrobenzene in competition with the hydrogen evolution reaction

The electrochemical reduction of organic contaminants allows their removal from water. In this contribution, the electrocatalytic hydrogenation of nitrobenzene is studied using both oxidized carbon fibres and ruthenium nanoparticles supported on unmodified carbon fibres as catalysts. The two systems produce azoxynitrobenzene as the main product, while aniline is only observed in minor quantities. Although PhNO2 hydrogenation is the favoured reaction, the hydrogen evolution reaction (HER) competes in both systems under catalytic conditions. H2 formation occurs in larger amounts when using the Ru nanoparticle based catalyst. While similar reaction outputs were observed for both catalytic systems, DFT calculations revealed some significant differences related to distinct interactions between the catalytic material and the organic substrates or products, which could pave the way for the design of new catalytic materials

Evaluation of salivary protein patterns among a rural population exposed and non-exposed to arsenic-contaminated drinking water in areas of Tucumán (Argentina): a pilot study

Arsenic contamination in the environment and groundwater is a major global public health problem. Several researchers suggest that the toxicity of arsenic could be related to oral cancer development, usually resulting from potentially malignant lesions. During pathological processes, salivary proteins suffer modifications, which could lead to the discovery of new biomarkers.&nbsp;Objective: To analyze the protein profile in human saliva samples from a rural population exposed to high levels of arsenic in drinking water and its association with potentially malignant lesions.&nbsp;Methodology: This observational, analytic and cross-sectional design included 121 patients from the state of Graneros (Tucumán, Argentina). Arsenic concentration in drinking water was determined and, according to the values obtained, individuals were divided into 2 groups: exposed group and non-exposed group. Saliva samples were obtained, and total protein concentration was measured by Bradford method. Finally, Laemmli SDS-polyacrylamide gel electrophoresis was conducted to obtain the protein profile.&nbsp;Results: Total protein concentration in saliva was lower in the exposed group than in the non-exposed group. Average areas of 20 and 42 KDa bands were significantly lower in exposed group than non-exposed group. Conclusion: Chronic intake of high arsenic concentrations in drinking water produces changes in the salivary protein profile, which is associated with the presence of potentially malignant lesions

Implementation of evidence-based antenatal care in Mozambique : a cluster randomized controlled trial: study protocol

Background: Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher. WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of the package of evidence-based services included in the WHO ANC model in Mozambique. The primary hypothesis is that the intervention will increase the use of evidence-based practices during ANC visits in comparison to the standard dissemination channels currently used in the country. Methods: This is a demonstration project to be developed through a facility-based cluster randomized controlled trial with a stepped wedge design. The intervention was tailored, based on formative research findings, to be readily applicable to local prenatal care services and acceptable to local pregnant women and health providers. The intervention includes four components: the provision of kits with all necessary medicines and laboratory supplies for ANC (medical and non-medical equipment), a storage system, a tracking system, and training sessions for health care providers. Ten clinics were selected and will start receiving the intervention in a random order. Outcomes will be computed at each time point when a new clinic starts the intervention. The primary outcomes are the delivery of selected health care practices to women attending the first ANC visit, and secondary outcomes are the delivery of selected health care practices to women attending second and higher ANC visits as well as the attitude of midwives in relation to adopting the practices. This demonstration project is pragmatic in orientation and will be conducted under routine conditions. Discussion: There is an urgent need for effective and sustainable scaling-up approaches of health interventions in low-resource countries. This can only be accomplished by the engagement of the country's health stakeholders at all levels. This project aims to achieve improvement in the quality of antenatal care in Mozambique through the implementation of a multifaceted intervention on three levels: policy, organizational and health care delivery levels. The implementation of the trial will probably require a change in accountability and behaviour of health care providers and we expect this change in 'habits' will contribute to obtaining reliable health indicators, not only related to research issues, but also to health care outcomes derived from the new health care model. At policy level, the results of this study may suggest a need for revision of the supply chain management system. Given that supply chain management is a major challenge for many low-resource countries, we envisage that important lessons on how to improve the supply chain in Mozambique and other similar settings, will be drawn from this study

Challenges and opportunities for implementing evidence-based antenatal care in Mozambique: a qualitative study

Background: Maternal mortality remains a daunting problem in Mozambique and many other low-resource countries. High quality antenatal care (ANC) services can improve maternal and newborn health outcomes and increase the likelihood that women will seek skilled delivery care. This study explores the factors influencing provider uptake of the recommended package of ANC interventions in Mozambique. Methods: This study used qualitative research methods including key informant interviews with stakeholders from the health sector and a total of five focus group discussions with women with experience with ANC or women from the community. Study participants were selected from three health centers located in Maputo city, Tete, and Cabo Delgado provinces in Mozambique. Staff responsible for the medicines/supply chain at national, provincial and district level were interviewed. A check list was implemented to confirm the availability of the supplies required for ANC. Deductive content analysis was conducted. Results: Three main groups of factors were identified that hinder the implementation of the ANC package in the study setting: a) system or organizational: include chronic supply chain deficiencies, failures in the continuing education system, lack of regular audits and supervision, absence of an efficient patient record system and poor environmental conditions at the health center; b) health care provider factors: such as limited awareness of current clinical guidelines and a resistant attitude to adopting new recommendations; and c) Users: challenges with accessing ANC, poor recognition amongst women about the purpose and importance of the specific interventions provided through ANC, and widespread perception of an unfriendly environment at the health center. Conclusions: The ANC package in Mozambique is not being fully implemented in the three study facilities, and a major barrier is poor functioning of the supply chain system. Recommendations for improving the implementation of antenatal interventions include ensuring clinical protocols based on the ANC model. Increasing the community understanding of the importance of ANC would improve demand for high quality ANC services. The supply chain functioning could be strengthened through the introduction of a kit system with all the necessary supplies for ANC and a simple monitoring system to track the stock levels is recommended