Continued Use Research Articles

The Optimized Use of a Contact-Free Continuous Monitoring System on Clinical Outcomes During COVID-19

Objectives The purpose of this study was to examine the impact of a contact-free continuous monitoring system on clinical outcomes including unplanned intensive care unit (ICU) transfer (primary), length of stay (LOS), code blue, and mortality. A secondary aim was to evaluate the return on investment associated with implementing the contact-free continuous monitoring program during the COVID public health emergency. Methods An interrupted time series evaluation was conducted to examine the association between the use of contact-free continuous monitoring and clinical outcomes. A cost-benefit analysis was planned to evaluate the return on investment. Results Use of contact-free continuous monitoring was not significantly associated with unplanned ICU transfers, deaths, ICU LOS, and or rapid response team calls. However, there were significant increases in code blue events (P = 0.02) and mean hospital LOS (P = 0.01) in the postimplementation period when compared with the preimplementation period. Due to the lack of improvement, costs were calculated but a cost-benefit analysis was not conducted. Conclusions Contact-free continuous monitoring bed use during the COVID-19 public health emergency was not associated with improvements in clinical outcomes, although there was substantial confounding. Future studies should include large randomized controlled trials to control for factors not under direct experimental control including unit staffing, staff turnover, and differences in the patient population related to surges in the COVID-19 pandemic.

Enhancing User Experience and Sustainability in Open Banking Using PLS-SEM

A framework empowering third-party providers to access individual financial data has revolutionized the financial services landscape. Despite the user-centric nature of FinTech solutions, research on post-adoption behavior remains relatively scarce. Given the pivotal role of FinTech in the modern financial industry, understanding the factors driving sustained adoption and continued usage is crucial. This study aims to explore the key determinants influencing users’ decisions to remain engaged with Open Banking solutions. We propose a model examining the impacts of various factors on user satisfaction and their intention to continue using Open Banking. Partial least squares structural equation modeling (PLS-SEM) was employed to validate this model. Our findings reveal that user satisfaction with the usage experience is the sole predictor of continued use intention, explaining 62% of the variance in continuance use intention (R2 = 0.62). Additionally, user satisfaction is influenced by perceived usefulness (β = 0.33, p < 0.001), trust (β = 0.24, p = 0.003), and convenience (β = 0.25, p = 0.006), accounting for 70.5% of the variance in satisfaction (R2 = 0.705). The practical implications of this study suggest that Open Banking providers should prioritize enhancing user satisfaction by improving the perceived usefulness and convenience of their applications while fostering trust to maintain user engagement. Furthermore, our findings emphasize that convenience and trust are critical levers that Open Banking providers can utilize to ensure long-term customer loyalty and adoption, particularly in developing economies.

Chronic pain among primary fentanyl users: The concept of self-medication.

Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users. A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report. The majority of participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (SD = 1.9). Majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication. The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain. Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.

Exploring the Extraction and Application of Anthocyanins in Food Systems

The continued use of synthetic additives in food production and preservation has raised concerns among consumers, given their potential negative health effects. Researchers and food industry experts have been exploring plants with potent functional compounds as an alternative source of natural compounds such as anthocyanins, which can be utilized to produce safe food additives. Given their various biological activities, great potential exists for anthocyanins to be used as additives to preserve food or produce functional foods with health benefits. However, to fully realize the economic and health benefits of anthocyanins, a deep understanding of the different plant sources of anthocyanins, as well as their composition, extraction techniques, and function in various products, is warranted. Therefore, this paper critically reviews the different plant sources of anthocyanins and their application in the food and nutraceutical industries, highlighting emerging extraction techniques, health benefits, and challenges in the use of anthocyanins in the food industry. This review also offers insights that could be used in future research and help establish novel and sustainable methods for manufacturing anthocyanin-based value-added products and ingredients.

THE IMPACT OF TELEMEDICINE ON ACCESS TO PRIMARY CARE

The COVID-19 pandemic has driven the implementation of telemedicine as a solution for maintaining access to healthcare, transforming the primary care landscape in many parts of the world. In Brazil, telemedicine has established itself as an essential tool for overcoming geographical and social barriers, facilitating access to basic care for populations that traditionally faced difficulties in accessing health services. This study seeks to investigate the impact of telemedicine on access to primary care, analyzing its main challenges and opportunities in the context of post-pandemic primary care. This study seeks to analyze the impact of telemedicine on access to primary care, exploring the main challenges and opportunities that arise with this modality of care. It also aims to identify practices and policies that can strengthen the implementation of telemedicine in Primary Care, ensuring that remote care is effective, safe and inclusive. This is a literature review, based on a qualitative approach, using the Scielo, Google Scholar and PubMed databases. To refine the research, the health descriptors “telemedicine”, “primary care”, “COVID-19”, and “equity in access to health” were selected, with a time frame between 2021 and 2023. Through a literature review, the study explores recent data on telemedicine in primary care, focusing on the main opportunities it offers, such as improved access and efficiency of services, as well as the challenges, including limited technological infrastructure in poor regions, privacy and confidentiality issues, and the need for adequate training for health professionals. Telemedicine enables more agile care and coverage of a larger population, but still faces obstacles related to digital accessibility and maintaining quality and continuity of care, especially for vulnerable groups. Telemedicine has therefore proved to be a strategic tool for expanding access to primary care, offering a viable alternative for reducing gaps in primary care. However, in order to maximize its impact, it is essential to overcome the technological challenges, guarantee information security and train health professionals in this new type of care. The continued use of telemedicine in the post-pandemic context presents an opportunity to strengthen the Unified Health System (SUS) in Brazil, expanding the reach of primary care and promoting greater equity in access to health.

Effects of frequently prescribed antiseizure medications on motor vehicle driving performance: Narrative review based on a tiered approach for the assessment of clinically meaningful driving impairment in the Ministry of Health, Labour, and Welfare guideline.

Patients with epilepsy often require long-term treatment with antiseizure medications, and their impact on daily activities, particularly driving, is of significant concern. The recently published "Guideline for Evaluating Effects of Psychotropic Drugs on the Performance to Drive a Motor Vehicle" in Japan provides a framework that can be referred to for not only the evaluation of new drugs but also the reevaluation of approved drugs. This study conducted a literature review regarding the effects of carbamazepine, valproate, lamotrigine, lacosamide, and levetiracetam, which are frequently prescribed for epilepsy, on driving performance following the guideline's tiered evaluation approach. Analyses of pharmacological, pharmacodynamic, and adverse events suggested that these drugs primarily affect arousal function. Driving studies showed that acute administration of carbamazepine, but not chronic monotherapy with carbamazepine, valproate, lamotrigine, and levetiracetam, significantly impairs driving performance. Epidemiological studies have not identified a definitive association between these drugs and traffic accidents. Initial administration of these five antiseizure medications may affect driving performance, warranting special attention, but the influence appears to diminish with continued use. Nevertheless, while long-term administration of these five drugs may not have a clinically meaningful effect on driving performance, safe driving is not guaranteed for each individual patient, and appropriate individualized guidance is important in clinical practice.

Fentanyl Initiation Rate Following the Requirement for Specialist Approval.

Healthcare organizations attempt to address unwarranted fentanyl use, which often leads to increased risk of addiction and overdose. To assess the impact of a requirement for a specialist's approval on fentanyl initiation for non-oncological pain. A retrospective cohort study based on observational data. All 4.4 million non-oncological members of Clalit Health Services were included, from July 20, 2021, to July 19, 2023. The rate of fentanyl initiation was assessed before and after the implementation of the requirement for specialist's approval, which was introduced on July 2022, and expanded 6months later for continued use. A sub-group analysis by age group was performed, and patient characteristics and indications were assessed. We also compared total opioid dispensation in the 6th and 12th months after the implementation with the predicted rate based on pre-implementation rates. Fentanyl initiation rate in the year before the requirement was 711 per million capita, which decreased following the requirement by - 81% (95% CI: - 77%; - 85%). The decrease attenuated with age. The prevalence of diagnosis with substance abuse disorders at the time of fentanyl initiation decreased from 6 to 3%. In the 6th and 12th months after the requirement was implemented, the morphine milligram equivalent (MME) from dispensation of total opioids was lower than predicted based on pre-implementation rates by 7% and 26%, respectively. Requiring specialist approval for fentanyl initiation for non-oncological chronic pain was associated with a decrease in fentanyl prescription initiations, especially among non-elderly patients. A decrease also occurred gradually in total opioid dispensations, further decreasing following the extension of the requirement to continuous fentanyl. The requirement for specialist approval upon fentanyl initiation and continuous fentanyl may present an effective tool for limiting the use of fentanyl and total opioids in healthcare systems.

Metformin Inhibited GSDME to Suppress M2 Macrophage Pyroptosis and Maintain M2 Phenotype to Mitigate Cisplatin-Induced Intestinal Inflammation

Background: The continuous clinical use of cisplatin is prevented by gastrointestinal toxicity. Methods: Cisplatin was used to treat THP-1-derived macrophages to see its differential effects on different subtypes of macrophages. Wild-type and Gsdme−/− mice models were used to examine the effect of cisplatin and metformin on intestinal inflammation in vivo. The effect of GSDME on macrophage polarization was further confirmed by GSDME knockdown. Results: We found that M2 macrophages, with more cell blebbing and GSDME cleavage, were more sensitive to cisplatin-induced pyroptosis than M1 macrophages. Cisplatin was capable of enhancing the M1 phenotype, which was reversed by GSDME knockdown. GSDME contributed to M1 polarization and GSDME knockdown promoted M2 phenotype via STAT6 activation. Reduced intestinal inflammation and increased M2 macrophage numbers was detected in cisplatin-treated GSDME-knockout mice. Furthermore, metformin alleviated cisplatin-induced intestinal inflammation by reducing M2 pyroptosis and enhancing M2 phenotype through GSDME inhibition. Conclusion: This is the first study to reveal the non-pyroptotic role of GSDME in macrophage polarization, revealing that metformin could be used in combination with cisplatin to reduce intestinal toxicity.

Older Adults Benefit From Virtual Support for Continuous Glucose Monitor Use But Require Longer Visits.

Older adults may be less comfortable with continuous glucose monitoring (CGM) technology or require additional education to support use. The Virtual Diabetes Specialty Clinic study provided the opportunity to understand glycemic outcomes and support needed for older versus younger adults living with diabetes and using CGM. Prospective, virtual study of adults with type 1 diabetes (T1D, N = 160) or type 2 diabetes (T2D, N = 74) using basal-bolus insulin injections or insulin pump therapy. Remote CGM diabetes education (3 scheduled visits over 1 month) was provided by Certified Diabetes Care and Education Specialists with additional visits as needed. CGM-measured glycemic metrics, HbA1c and visit duration were evaluated by age (<40, 40-64 and ≥65 years). Median CGM use was ≥95% in all age groups. From baseline to 6 months, time 70 to 180 mg/dL improved from 45% ± 22 to 57% ± 16%; 50 ± 25 to 65 ± 18%; and 60 ± 28 to 69% ± 18% in the <40, 40-64, and ≥65-year groups, respectively (<40 vs 40-64 years P = 0.006). Corresponding values for HbA1c were 8.0% ± 1.6 to 7.3% ± 1.0%; 7.9 ± 1.6 to 7.0 ± 1.0%; and 7.4 ± 1.4 to 7.1% ± 0.9% (all P > 0.05). Visit duration was 41 min longer for ages ≥65 versus <40 years (P = 0.001). Adults with diabetes experience glycemic benefit after remote CGM use training, but training time for those >65 years is longer compared with younger adults. Addressing individual training-related needs, including needs that may vary by age, should be considered.

Initiation and continued use of oral pre-exposure prophylaxis among pregnant and postpartum women in South Africa (PrEP-PP): a demonstration cohort study

When used effectively, oral pre-exposure prophylaxis (PrEP; tenofovir disoproxil fumarate and emtricitabine) prevents maternal HIV acquisition and reduces the risk of vertical transmission. Our study aimed to better understand PrEP initiation, continued use, and adherence in pregnant and postpartum women. The PrEP in Pregnancy and Postpartum (PrEP-PP) study is a demonstration cohort study that enrolled pregnant women aged 16 years and older without HIV attending their first antenatal care visit in Cape Town, South Africa, between Aug 29, 2019, and Oct 10, 2021. Eligible, consenting women were followed up quarterly up to 12 months postpartum with regular HIV testing and offer of PrEP with ongoing adherence counselling. The primary outcome was distribution of women across the PrEP cascade (ie, initiation and continuation up to 12 months postpartum) with crude and adjusted hazard ratios (HRs). We also report on HIV incidence by pregnancy and postpartum status. Overall, 1195 pregnant women were recruited and followed up (median age 26 years, IQR 23-31; median gestational age 21 weeks, IQR 15-31); 1009 (84·4%) started PrEP at enrolment. Among women who initiated PrEP at enrolment, 668 (67·5%) of 990 continued PrEP at the 1-month follow-up, 485 (49·9%) of 972 continued at 3 months, 392 (39·4%) of 994 at 6 months, and 275 (27·4%) of 1005 at 12 months. Of 186 women who did not accept PrEP at enrolment, 70 (37·6%) of 186 subsequently initiated PrEP. Overall, 200 (18·6%) of 1076 women continued PrEP at 12 months postpartum. Of 186 women who did not initiate PrEP at baseline, 70 (37·6%) subsequently initiated PrEP during the study. Factors associated with PrEP discontinuation up to 12 months postpartum included being married or cohabiting (adjusted HR 1·32, 95% CI 1·16-1·50), condomless sex since last visit (1·43, 1·23-1·65), reporting intimate partner violence (2·03, 1·59-2·59), or depression in the past 12 months (1·53, 1·14-2·05). Overall, 16 women seroconverted over 1673·8 woman-years (HIV incidence rate 0·96 per 100 woman-years, 95% CI 0·49-1·42); 14 discontinued PrEP use and two never initiated PrEP. HIV incidence was 0·28 per 100 woman-years during pregnancy (95% CI 0·22-0·33), and the incidence rate ratio was 1·77 per 100 woman-years (0·53-5·90) 0-6 months postpartum and 2·19 per 100 woman-years (0·61-7·83) 6-12 months postpartum compared with pregnant women. There is an urgent need for the integration of PrEP into antenatal and postnatal care and interventions that address barriers to continued use, including targeted counselling during pregnancy and postpartum to reduce PrEP discontinuation. National Institute of Mental Health and Fogarty International, US National Institutes of Health. For the French translation of the abstract see Supplementary Materials section.

Mothers’ perspectives on the use and acceptability of 3d printed prosthesis by their children with congenital upper limb difference in India: a qualitative study

Purpose Children with congenital upper limb difference (CULD) in India have limited access to treatment with conventional prostheses. 3D printed prosthetic devices (3DPP) can function as transitional prostheses for growing children with congenital transverse deficiency. They are low-cost and the designs are easily customized. However, functional outcomes, access, and acceptability are still unexplored in many clinical settings. This qualitative study sought perspectives from Indian mothers of children with CULD using 3DPP for the first time. The objective was to enhance understanding of 3DPP acceptability and to explore how their children utilized these devices. Method Semi-structured interviews were conducted with seven mothers of children aged 3 to 11 years with varying levels of CULD who had been fitted with a 3DPP for at least 1 month prior. The interviews aimed to gather insights into the children’s daily experiences with the devices and the mothers’ perceptions of 3DPP. Thematic analysis was carried out using an inductive approach. Results Four major themes were identified through thematic analysis. They were: 1. Design and functionality of 3DPP, 2. Adaptation patterns, 3. Social attitudes and perceptions, and 4. Access to the Center for congenital hand differences: location and its services. Conclusion Our study explores the early-stage use and acceptance of 3DPP in India. Mothers reported several reasons for prosthesis abandonment including functional limitations, pain, and unmet expectations. The acceptability of 3DPP was moderate among close family, but social stigmatization was still a barrier to continued use. Addressing these issues and offering tailored solutions could be important to achieve successful 3DPP adaptation.

The Effect of K-Beauty Franchise Selection Attributes on Brand Satisfaction and Continuous Use Intention: Mediating Effect of Brand Experience

This study analyzed the effect of K-beauty franchise selection attributes on brand satisfaction and continuous use intention, focusing on the mediating effect of brand experience. This study targeted foreign beauty consumers who have experienced K-beauty franchises. Using quantitative research methods, seven hypotheses were verified. The results indicated that selection attributes, such as service expertise, reliability, price, and store image, significantly effect brand experience and brand satisfaction. Also, brand experience, including aesthetic, entertainment, educational, and escapist experiences, was verified to mediate the relationship between selection attributes and brand satisfaction. Through the above results, this study provided theoretical and practical guidance and reference materials for the global strategic development of K-beauty franchises.

Identifying the Internal and External Pressures of Quantifying the Impacts of Sustainability-Oriented Innovation

The sustainability-oriented innovation (SOI) has emerged as a critical approach for an organisation that addresses environmental, social, and economic challenges. The proposed study aims to identify key internal and external pressures by uncovering the main factors within and outside the organisation influencing the quantification of SOI impacts. In the given study’s research design adopts a primary qualitative approach to explore internal and external pressures affecting the quantification of sustainability-oriented innovation (SOI) that impacts the economic context. Qualitative research was chosen for its ability to provide an in-depth insight into a complex phenomenon that captures the nuances of the participant’s experience, attitudes and perception. The findings show that a leadership team’s commitment to sustainability and the proactive mindset of our employees fosters an environment where innovation thrives. The conclusion is that the implementation of internal policies and incentives encouraged sustainable practices and continuous improvement. SOI has been influenced by concepts like a crucial economy that promotes a continuation use of resources through its recycling and remanufacturing and to share economy, emphasizing access to over ownership.

Distinct populations suppress or escalate intake of cocaine paired with aversive quinine

BackgroundOnly a subset of individuals who encounter illicit drugs become persons with a substance use disorder. Individual differences in aversive reactions to drug-associated phenomena like smoke inhalation and unpleasant taste are predictors for continued use. While several preclinical studies have explored self-administration involving aversive cues, none have simultaneously introduced aversion with the initial drug self-administration. We aimed to develop such a model by pairing intravenous cocaine with intraoral quinine self-administration from the outset and investigate whether repeated exposure to an aversive stimulus would alter its hedonic value under laboratory conditions. MethodsTwenty-seven male and female Sprague Dawley rats self-administered intravenous/intraoral (cocaine/quinine) for 2h/day over 14 days. This was followed by a 1-day quinine-only extinction session, a 3-day return to self-administration, and an intraoral infusion session to assess quinine taste reactivity (TR). ResultsWe identified three distinct groups. The first self-administered very little cocaine, while the second sharply escalated cocaine intake. Both groups had similar aversive TR to quinine, suggesting that the escalating group did not habituate to the aversive cue but pursued drug despite it. We also identified a third group with high initial intake that decreased over time. This decrease predicted high aversive TR, and we argue this group may represent individuals who engage in excessive use on their first encounter and subsequently find self-administration to be aversive. ConclusionsOur novel model yields three distinct groups that differ in self-administration patterns and aversive cue valuation.

Exploring Challenges Influencing the Discontinued Utilisation of the Flipped Classroom Pedagogy: A Case of South Africa Underprivileged High School and Organic Chemistry

The COVID-19 pandemic accelerated technological advancements in education. However, when the threat of COVID-19 subsided some schools discontinued the use of technology-enhanced flipped classroom. This study reports on challenges that could have influenced the discontinued utilisation of technology-mediated flipped classroom model that supported some of the underprivileged high schools of South Africa during the COVID-19 era. While acknowledging that the final decision on whether to discontinue rests with the teachers, learner challenges are equally important as they can contribute to the teachers’ decisions. Hence, this study, anchored by the TPACK framework and Maslow’s hierarchy of needs theory, explored both learner and teacher challenges that influence discontinuation of the use of the flipped learning model. This entailed using semi-structured interviews of purposively selected teachers and learners (N=8) to close this gap in the literature on the use of flipped classroom in the post-COVID-19 era focusing on organic chemistry. Using deductive thematic analysis, the key challenges that could have contributed to the discontinuation of the use of this teaching model were identified as lack of access to Internet services, stable Wi-Fi and ability to navigate the online learning system, competence, motivation, effect of lack of support from the educational institutions and teacher overloading. These findings contribute to the literature on the continued use of this teaching model beyond emergencies such as COVID-19 by highlighting challenges that educational practitioners should be wary of. Additionally, the study has implications for the need to fast-track infrastructure and teacher professional development in underprivileged high schools.

Evaluation of ALS-Resistant Yellow Nutsedge (Cyperus esculentus) in Georgia Peanut

Abstract Accounting for 53% of United States peanuts (Arachis hypogaea L.), Georgia is the top peanut-producing state with approximately 1.42 billion kg produced in 2023. Peanut producers often use the ALS imidazolinone herbicide imazapic but reduced yellow nutsedge (Cyperus esculentus L.) control was reported in Georgia peanuts after four-years of continuous imazapic use. This study aimed to determine the level of resistance (LD50, I50, and GR50), potential cross-resistance for the suspected resistant population, and identify the associated genetic mutations conferring resistance. A susceptible biotype was treated with 0, 0.0088, 0.0175, 0.035, 0.07, 0.14, 0.28, and 0.56 kg ai ha-1, and a resistant biotype was sprayed with 0, 0.07, 0.14, 0.28, 0.56, 1.13, 2.26, and 4.5 kg ai ha-1 of imazapic. To determine if the suspected resistant biotype was cross-resistant to halosulfuron-methyl, an ALS herbicide used to control nutsedge spp., both biotypes were treated with 0, 0.0117, 0.0233, 0.0466, 0.0933, 0.187, 0.373, and 0.746 g ai ha-1 of halosulfuron-methyl. Plants were rated for injury 7, 14, and 28 days after treatment (DAT), and above-ground biomass harvested at 28 DAT. For imazapic, LD50 was 0.041 and 1.503 kg ai ha-1 and the GR50 was estimated to be 0.0128 and 1.853 kg ai ha-1 for Sus and Res biotypes, respectively, indicating 36 and 145-fold increase in resistance of the Res biotype for I50 and GR50, respectively. Both biotypes responded similarly to applications of halosulfuron-methyl, with biomass reductionat rates greater than 0.023 kg ai ha-1. Transcriptome profiles revealed a mutation in the target-site gene of the resistant biotype, causing an amino acid substitution from Alanine to Valine at position 205 (Ala205Val). Growers should continue to rotate chemistries and implement integrated weed management approaches for control of C. esculentus as the use of imazapic over consecutive years has led to resistance in C. esculentus.

Young Adults Journey with Digital Fitness Tools-A Qualitative Study on Use of Fitness Tracking Device

Background Physical activity trackers possess the potential to encourage increased physical activity. However, users often exhibit poor long-term adherence to these devices, which may stem from a lack of understanding of the factors influencing their use, as well as changes in health behavior. This study aims to provide new insights into the types of health-related apps and devices that young people discover, select, and utilize, along with the underlying reasons for their choices. Methods Young adults aged between 18-25 years reporting the use and nonuse of health apps and wearables were recruited and participated in focus group discussions about app choice, features, their perceptions towards the physical activity trackers, and reasons for continued use and for not using one. A total of Nine FGDS were conducted among users, nonusers, and former users of physical activity tracker usage. Data was recorded, transcribed, and analyzed for themes in an iterative approach. Results The physical activity tracker users group stated that they had a sense of achievement, validation, and other motivational feedback, which helped with adherence. All three groups (user, non-user, and former user) had similar concerns about cost, reliability, accuracy, and dependency. Former users also reported that the idea of accomplishing the goals would create anxiety and, in turn, harm the body. Former users and nonusers expressed their concerns regarding lack of time and loss of motivation to track their physical activity. Nonusers had issues with the functionality of the device (ease of use, battery, notifications, apps hang) and were also aware of all the health benefits of using wearables. Conclusion Physical activity users group, former users group, and nonusers group shared concerns about accuracy, cost, and battery.

Maojok: Akulturasi Ilmu Gramatika Arab di Minangkabau (Studi Kasus Pondok Pesantren Nurul Yaqin, Ringan-Ringan)

This research aims to describe the process of acculturation of Arabic grammar in Minangkau using the maojok method. The method used in the research is a qualitative method. Data was obtained by means of interviews, observations and documents. The results of this research show that the maojok method which is an integral part of the learning process at the Nurul Yaqin Islamic Boarding School is a real implementation of the concept of acculturation. Assimilation occurs through combining Arabic language patterns with Minangkabau language in this method. Integration is realized in an effort to maintain local cultural identity while combining elements of Arab culture. Accommodation is seen in joint efforts between teachers and students to create a harmonious learning situation by combining the two cultures. Meanwhile, cultural defense is reflected in the continued use of the maojok method as a cultural heritage of Islamic boarding schools that must be maintained.

“Interest‐holders”: A new term to replace “stakeholders” in the context of health research and policy

AbstractBackgroundGiven the colonial connotations of the term “stakeholder”, its continued use may be perceived as disrespectful to Indigenous Peoples. While several groups have introduced alternative terms, each has its own limitations. The objective of this article is to introduce “interest‐holders” as an alternative term to “stakeholders” and describe the discussions underpinning the adoption of the new term by the MuSE Consortium.MethodsThe MuSE Consortium is an international network of over 160 individuals with interest and expertise in different aspects relevant to engagement in research. Members of MuSE explored alternative terms and considered their respective merits and limitations. The deliberations considered the literature on the topic and the results of two consultations with the wider MuSE membership on the alternative terms.ResultsWe define “interest‐holders” as groups with legitimate interests in the health issue under consideration. The interests arise and draw their legitimacy from the fact that people from these groups are responsible for or affected by health‐related decisions that can be informed by research evidence.ConclusionAs groups other than the MuSE Consortium have started to adopt “interest‐holders,” we hope its use will reduce confusion related to the multitude of terms used and convey the intended meaning without any negative connotations.

Bulb Yield and Economic Return of Onion (Allium cepa L.) as Influenced by the Application of Integrated Nutrient Management at Selekleka, Northwestern Zone of Tigray, North Ethiopia

Onion is an important crop as a condiment and income generation for smallholder farmers in northwestern Zone of Tigray. However, Continuous use of inorganic fertilizers and inappropriate soil fertility management practices are among the major factors limiting onion productivity in the North Western Tigray. Therefore, a field experiment was undertaken in selekleka district from October 2015 to June 2016 to assess the effects of integrated nutrient management on bulb yield and economic return of onion (Allium cepa L.). The treatments consisted of combinations of two rates of farmyard manure (FYM) (10 and 20 t ha-1) and two rates of vermicompost (VC) (2.5 and 5 t ha-1) each combined with three rates of nitrogen (25, 50 and 75) of recommended N fertilizers, RDF. In addition, 100% RDF N (69 kg N ha-1), 100% (5 t ha-1) of VC, 100% (20 t ha-1) FYM and zero rates (unfertilized treatment) were used for comparison. The experiment was laid out in a randomized complete block design with three replications. (ANOVA) revealed that combined application of 5 t ha-1 VC+50% inorganic N fertilizers recorded the highest bulb yield (35.13 t ha-1) and economic return (246,354 Birr ha-1). On the other hand, the lowest bulb yield (18.48 t ha-1) and economic net return (143,018 Birr ha-1) were obtained from the control. It could, thus, be concluded that, based on the partial budget analysis and bulb yield result the application of 5 t ha-1 vermicompost and 50 % recommended inorganic nitrogen was the appropriate combination for better onion production and economic return in the study area.