Knowledge, perceptions, and exposure to bats in communities living around bat roosts in Bundibugyo district, Uganda: implications for viral haemorrhagic fever prevention and control.

BACKGROUND: Bats are a reservoir for many viruses causing haemorrhagic fevers. Proximity to bats is a risk factor for virus spillover to animals and humans. We conducted this study to assess knowledge, perceptions, and exposure to bats in communities living near bat roosts in Bundibugyo District, Uganda. METHODS: A cross-sectional study using mixed methods with both quantitative and qualitative data was conducted between September and December 2022. Participants for the quantitative data (survey) (n = 384) resided near bat caves and/or roost sites and were selected using multistage random sampling. The survey investigated participants' prior exposure to bats, as well as knowledge and perceptions of bat exposure. Logistic regression was used to determine factors associated with bat exposure. Participants for the qualitative data (focus group discussions) (n = 10, 6-8 participants each) were purposely selected based on engagement in guano mining, hunting, and farming activities. Perceived risk associated with bat-related activities were identified and ranked in the focus group discussions using participatory epidemiology tools. RESULTS: In total, (214/384, 55.7%) had a history of bat exposure and (208/384, 54.2%) had poor knowledge of risk factors associated with bat exposure. Increased exposure to bats was associated with being male (OR = 1.6; 95% CI: 1.0, 2.4 p-value = 0.038), staying in urban areas (OR = 1.9; p-value = 0.010), hunting (OR = 10.9; p-value = 0.024), and positive perception to bat guano being safe as fertiliser (OR = 2.5; p-value = 0.045). During the proportional piling process, a total of 7 risk factors were identified by 10 groups with hunting during an outbreak and consumption of bats being the most frequently identified. Overall, there was a strong statistical agreement in the ranking across the 10 focus groups (W = 0.52; p < 0.01; n = 10). Based on the provided data, the adjusted odds ratio of 0.7 for the good measures (p-value = 0.112), suggests a potential protective effect on the risk of bat exposure. CONCLUSION: Communities living around bat roosts frequently come into contact with bats, yet there is inadequate awareness regarding the behaviors that can lead to the transmission of bat- borne diseases to humans. It is essential to undertake educational initiatives and preventive measures to minimise the risks of bat-related infections. The need for targeted health communication and education efforts to address these knowledge gaps and promote an accurate understanding of bats and disease transmission. Understanding of diseases associated with bats will minimize bat-related health risks especially in communities engaged in wildlife hunting.

Intention to Use an Electronic Community Health Information System Among Health Extension Workers in Rural Northwest Ethiopia: Cross-Sectional Study Using the Unified Theory of Acceptance and Use of Technology 2 Model.

BACKGROUND: IT has brought remarkable change in bridging the digital gap in resource-constrained regions and advancing the health care system worldwide. Community-based information systems and mobile apps have been extensively developed and deployed to quantify and support health services delivered by community health workers. The success and failure of a digital health information system depends on whether and how it is used. Ethiopia is scaling up its electronic community health information system (eCHIS) to support the work of health extension workers (HEWs). For successful implementation, more evidence was required about the factors that may affect the willingness of HEWs to use the eCHIS. OBJECTIVE: This study aimed to assess HEWs' intentions to use the eCHIS for health data management and service provision. METHODS: A cross-sectional study design was conducted among 456 HEWs in 6 pilot districts of the Central Gondar zone, Northwest Ethiopia. A Unified Theory of Acceptance and Use of Technology model was used to investigate HEWs' intention to use the eCHIS. Data were cleaned, entered into Epi-data (version 4.02; EpiData Association), and exported to SPSS (version 26; IBM Corp) for analysis using the AMOS 23 Structural Equation Model. The statistical significance of dependent and independent variables in the model was reported using a 95% CI with a corresponding P value of <.05. RESULTS: A total of 456 HEWs participated in the study, with a response rate of 99%. The mean age of the study participants was 28 (SD 4.8) years. Our study revealed that about 179 (39.3%; 95% CI 34.7%-43.9%) participants intended to use the eCHIS for community health data generation, use, and service provision. Effort expectancy (ß=0.256; P=.007), self-expectancy (ß=0.096; P=.04), social influence (ß=0.203; P=.02), and hedonic motivation (ß=0.217; P=.03) were significantly associated with HEWs' intention to use the eCHIS. CONCLUSIONS: HEWs need to be computer literate and understand their role with the eCHIS. Ensuring that the system is easy and enjoyable for them to use is important for implementation and effective health data management.

Individual and contextual level enablers and barriers determining electronic community health information system implementation in northwest Ethiopia.

BACKGROUND: The government of Ethiopia has envisioned digitalizing primary healthcare units through the electronic community health information system (eCHIS) program as a re-engineering strategy aiming to improve healthcare data quality, use, and service provision. The eCHIS is intended as a community-wide initiative to integrate lower health structure with higher administrative health and service delivery unit with the ultimate goal of improving community health. However, the success or failure of the program depends on the level of identifying enablers and barriers of the implementation. Therefore, this study aimed to explore individual and contextual-level enablers and barriers determining eCHIS implementation. METHOD: We conducted an exploratory study to determine the enablers and barriers to successfully implementing eCHIS in rural Wogera district, northwest Ethiopia. In-depth interviews and key informant interviews were applied at participants from multiple sites. A thematic content analysis was conducted based on the key themes reported. We applied the five components of consolidated framework for implementation research to interpret the findings. RESULTS: First, based on the intervention's characteristics, implementers valued the eCHIS program. However, its implementation was impacted by the heavy workload, limited or absent network and electricity. Outer-setting challenges were staff turnover, presence of competing projects, and lack of incentive mechanisms. In terms of the inner setting, lack of institutionalization and ownership were mentioned as barriers to the implementation. Resource allocation, community mobilization, leaders' engagement, and availability of help desk need emphasis for a better achievement. With regard to characteristics of the individuals, limited digital literacy, older age, lack of peer-to-peer support, and limited self-expectancy posed challenges to the implementation. Finally, the importance of mentoring and engaging community and religious leaders, volunteers, having defined plan and regular meetings were identified elements of the implementation process and need emphasis. CONCLUSION: The findings underlined the potential enablers and barriers of eCHIS program for quality health data generation, use, and service provision and highlighted areas that require emphasis for further scale-up. The success and sustainability of the eCHIS require ongoing government commitment, sufficient resource allocation, institutionalization, capacity building, communication, planning, monitoring, and evaluation.

eHealth policy framework in Low and Lower Middle-Income Countries; a PRISMA systematic review and analysis.

BACKGROUND: Low and lower middle-income countries suffer lack of healthcare providers and proper workforce education programs, a greater spread of illnesses, poor surveillance, efficient management, etc., which are addressable by a central policy framework implementation. Accordingly, an eHealth policy framework is required specifically for these countries to successfully implement eHealth solutions. This study explores existing frameworks and fills the gap by proposing an eHealth policy framework in the context of developing countries. METHODS: This PRISMA-based (PRISMA Preferred Reporting Items For Systematic Reviews and Meta-Analyses) systematic review used Google Scholar, IEEE, Web of Science, and PubMed latest on 23rd May 2022, explored 83 publications regarding eHealth policy frameworks, and extracted 11 publications scrutinizing eHealth policy frameworks in their title, abstract, or keywords. These publications were analyzed by using both expert opinion and Rstudio programming tools. They were explored based on their developing/developed countries' context, research approach, main contribution, constructs/dimensions of the framework, and related categories. In addition, by using cloudword and latent semantic space techniques, the most discussed concepts and targeted keywords were explored and a correlation test was conducted to depict the important concepts mentioned in the related literature and extract their relation with the targeted keywords in the interest of this study. RESULTS: Most of these publications do not develop or synthesize new frameworks for eHealth policy implementation, but rather introduce eHealth implementation frameworks, explain policy dimensions, identify and extract relevant components of existing frameworks or point out legal or other relevant eHealth implementation issues. CONCLUSION: After a thorough exploration of related literature, this study identified the main factors affecting an effective eHealth policy framework, found a gap in the context of developing countries, and proposed a four-step eHealth policy implementation guideline for successful implementation of eHealth in the context of developing. The limitation of this study is the lack of a proper amount of practically implemented eHealth policy framework cases in developing countries published in the literature for the review. Ultimately, this study is part of the BETTEReHEALTH (More information about the BETTEReHEALTH project at https://betterehealth.eu ) project funded by the European Union Horizon's 2020 under agreement number 101017450.

High-resolution polarization-sensitive Fourier ptychography microscopy using a high numerical aperture dome illuminator.

Polarization-sensitive Fourier-ptychography microscopy (pFPM) allows for high resolution imaging while maintaining a large field of view, and without mechanical movements of optical-setup components. In contrast to ordinary light microscopes, pFPM provides quantitative absorption and phase information, for complex and birefringent specimens, with high resolution across a wide field of view. Using a semi-spherical home-built LED illumination array, a single polarizer, and a 10x /0.28NA objective, we experimentally demonstrate high performance pFPM with a synthesized NA of 1.1. Applying the standard quantitative method, a measured half-pitch resolution of 244 nm is achieved for the 1951 USAF resolution test target. As application examples, the polarimetric properties of a herbaceous flowering plant and the metastatic carcinoma of human liver cells are analyzed and quantitatively imaged.

Use of social media for COVID-19-related information and associated factors among health professionals in Northwest Ethiopia: A cross-sectional study.

Background: Social media has become an alternative platform for communication during medical crises like the COVID-19 pandemic. This study aimed to assess social media usage for COVID-19-related information among health professionals. Method: A quantitative cross-sectional study design was conducted among 370 health professionals. The data were analyzed using SPSS version 25 software. Data were collected using a semi-structured, self-administered, and pre-tested questionnaire. Descriptive and binary logistic regression analysis techniques were used to describe respondents' social media usage for COVID-19 information and identify its associated factors. Results: About 54% (95% CI: 48-58%) of the participants had good social media usage for COVID-19-related information. Age≤30 (AOR = 2.02, 95% CI: 1.14-3.58), Wi-Fi/broadband Internet access (AOR = 2.45, 95% CI: 1.38-4.33), taking computer training (AOR = 2.58, 95% CI: 1.37-4.85), basic computer skill (AOR = 3.28, 95% CI: 1.71-6.29), and usefulness of social media (AOR = 3.56, 95% CI: 1.57-8.04) were found to be the significant factors associated with usage of social media for COVID-19-related information. Conclusion: The present study confirms that more than half of health professionals had good social media usage for COVID-19-related information. This shows that social media platforms can be used as a source of COVID-19-related information for health professionals if basic computer training is offered, internet connection is available in the workplace, and the usefulness of social media is emphasized.

Willingness to use telemedicine during COVID-19 among health professionals in a low income country.

INTRODUCTION: The coronavirus disease 2019 pandemic has prompted rapid restructuring of the health-care system in an effort to stop the spread of the pandemic. Thus, telemedicine is more preferable in order to prevent the COVID-19 pandemic when face to face meeting is forbidden, allowing provision of health service over a distance. This study aimed to assess willingness to use telemedicine and factors that will determine their extent of willingness during COIVID-19 among healthcare providers working in south west of Ethiopia. METHODS: Institutional based cross-sectional study design was applied to assess willingness to use telemedicine among healthcare providers working at public health hospitals in south west of Ethiopia. Self-administered questionnaires were used. We have used Epi-info for data entry and Analysis of Moment Structure (AMOS) for analysis. A structural equation modeling was performed to identify factors associated with willingness to use telemedicine at 95% confidence interval (CI). RESULT: In this study, less than half of respondents had high willingness to use telemedicine. Ease of use (ß = 0.79, 95% CI: [0.72, 0.86], p < 0.01), attitude (ß = 0.91, 95% CI: [0.87, 0.95], p < 0.01) and patient-physician relationships (ß = 0.67, 95% CI: [0.54, 0.70], p < 0.01) were variables associated with willingness to use telemedicine. Anxiety towards technology (ß = 0.74, 95% CI: [0.69, 0.79], p < 0.01) and patient-physician relationships (ß = 0.87, 95% CI: [0.81, 0.92], p < 0.01) were determinant factors of attitude to use telemedicine. CONCLUSIONS: The overall willingness to use telemedicine during COVID-19 in this setting is 46.5%. Addressing the problem related with ease of use, attitude and patient-physician relationships will help to increase the overall willingness to use telemedicine during COVID-19. An attempt to improving patient-physician relationship, provision of technical training for ease of use and working on healthcare providers' attitude will help to improve the willingness to use telemedicine.

Unravelling data for rapid evidence-based response to COVID-19: a summary of the unCoVer protocol.

INTRODUCTION: unCoVer-Unravelling data for rapid evidence-based response to COVID-19-is a Horizon 2020-funded network of 29 partners from 18 countries capable of collecting and using real-world data (RWD) derived from the response and provision of care to patients with COVID-19 by health systems across Europe and elsewhere. unCoVer aims to exploit the full potential of this information to rapidly address clinical and epidemiological research questions arising from the evolving pandemic. METHODS AND ANALYSIS: From the onset of the COVID-19 pandemic, partners are gathering RWD from electronic health records currently including information from over 22 000 hospitalised patients with COVID-19, and national surveillance and screening data, and registries with over 1 900 000 COVID-19 cases across Europe, with continuous updates. These heterogeneous datasets will be described, harmonised and integrated into a multi-user data repository operated through Opal-DataSHIELD, an interoperable open-source server application. Federated data analyses, without sharing or disclosing any individual-level data, will be performed with the objective to reveal patients' baseline characteristics, biomarkers, determinants of COVID-19 prognosis, safety and effectiveness of treatments, and potential strategies against COVID-19, as well as epidemiological patterns. These analyses will complement evidence from efficacy/safety clinical trials, where vulnerable, more complex/heterogeneous populations and those most at risk of severe COVID-19 are often excluded. ETHICS AND DISSEMINATION: After strict ethical considerations, databases will be available through a federated data analysis platform that allows processing of available COVID-19 RWD without disclosing identification information to analysts and limiting output to data aggregates. Dissemination of unCoVer's activities will be related to the access and use of dissimilar RWD, as well as the results generated by the pooled analyses. Dissemination will include training and educational activities, scientific publications and conference communications.

SARS-CoV-2 Spike Protein Extrapolation for COVID Diagnosis and Vaccine Development.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led to coronavirus disease 2019 (COVID-19) pandemic affecting nearly 71.2 million humans in more than 191 countries, with more than 1.6 million mortalities as of 12 December, 2020. The spike glycoprotein (S-protein), anchored onto the virus envelope, is the trimer of S-protein comprised of S1 and S2 domains which interacts with host cell receptors and facilitates virus-cell membrane fusion. The S1 domain comprises of a receptor binding domain (RBD) possessing an N-terminal domain and two subdomains (SD1 and SD2). Certain regions of S-protein of SARS-CoV-2 such as S2 domain and fragment of the RBD remain conserved despite the high selection pressure. These conserved regions of the S-protein are extrapolated as the potential target for developing molecular diagnostic techniques. Further, the S-protein acts as an antigenic target for different serological assay platforms for the diagnosis of COVID-19. Virus-specific IgM and IgG antibodies can be used to detect viral proteins in ELISA and lateral flow immunoassays. The S-protein of SARS-CoV-2 has very high sequence similarity to SARS-CoV-1, and the monoclonal antibodies (mAbs) against SARS-CoV-1 cross-react with S-protein of SARS-CoV-2 and neutralize its activity. Furthermore, in vitro studies have demonstrated that polyclonal antibodies targeted against the RBD of S-protein of SARS-CoV-1 can neutralize SARS-CoV-2 thus inhibiting its infectivity in permissive cell lines. Research on coronaviral S-proteins paves the way for the development of vaccines that may prevent SARS-CoV-2 infection and alleviate the current global coronavirus pandemic. However, specific neutralizing mAbs against SARS-CoV-2 are in clinical development. Therefore, neutralizing antibodies targeting SARS-CoV-2 S-protein are promising specific antiviral therapeutics for pre-and post-exposure prophylaxis and treatment of SARS-CoV-2 infection. We hereby review the approaches taken by researchers across the world to use spike gene and S-glycoprotein for the development of effective diagnostics, vaccines and therapeutics against SARA-CoV-2 infection the COVID-19 pandemic.

Knowledge and Attitude Towards Second COVID-19 Vaccine Dose Among Health Professionals Working at Public Health Facilities in a Low Income Country.

BACKGROUND: Several vaccines have been approved in a lot of countries to combat coronavirus disease and distributed throughout the world. Health professional's knowledge and attitude towards a second COVID-19 vaccine dose were poorly implemented and understood in Ethiopia's health facilities. The main purpose of conducting this study was to investigate health professionals' knowledge and attitude towards the second COVID-19 vaccine dose at public hospitals in Ethiopia. METHODS: A cross-sectional study design was conducted from January to March, 2021 to assess the knowledge and attitude towards second COVID-19 vaccine dose among health professionals working at public health facilities in Ethiopia. A multivariable logistic regression was performed to identify predictors that correlate with knowledge and attitude towards a second COVID-19 vaccine dose with a P-value<0.05 as a cut-off point for statistical significance at 95% confidence interval (CI). RESULTS: Four hundred and nine study subjects participated, with a response rate of 96.7%. In this study, more than half of the respondents had high knowledge towards second COVID-19 vaccine doses. Similarly, 95.6% of respondents had a favorable attitude towards second COVID-19 vaccine doses. Educational status (AOR=1.82, 95% CI=1.1-2.2), age (AOR=2.01, 95% CI=1.76-3.01), and profession (AOR=2.32, 95% CI=1.42-3.01) were variables associated with knowledge towards second COVID-19 vaccine doses. Educational status (AOR=5.42, 95% CI=4.1-6.7), age (AOR=12.4, 95% CI=10.54-15.8), professionals (AOR=4.33, 95% CI=2.32-6.87), working experience (AOR=4.33, 95% CI=2.32-6.87), marital status (AOR=2.47, 95% CI=1.33-5.95), risk degree (AOR=2.33, 95% CI=1.31-4.11) and gender (AOR=3.42, 95% CI=2.91-4.98) were determinant factors of attitude towards the second COVID-19 vaccine dose. CONCLUSION: Addressing problems related with risk degree, educational status, and socio-demographic factors will help to increase the overall knowledge and attitude towards second COVID-19 vaccine doses.

A Comparison of Parapoxviruses in North American Pinnipeds.

Parapoxviruses cause nodular lesions on the skin and mucosal membranes of pinnipeds and infections by these viruses have been documented worldwide. Seal parapoxvirus is currently classified as a tentative species of the Parapoxvirus genus. Tissue or swab samples were analyzed from 11 pinnipeds of different host species undergoing rehabilitation on the east and west coasts of the United States of America (USA) that were positive for parapoxvirus. The aim of the study was to compare parapoxvirus sequences of fragments of the B2L, DNA polymerase, GIF and viral interleukin-10 ortholog (vIL-10) genes and to examine the evolutionary relationship between viruses detected in different pinniped species and at different locations with other members of the Parapoxvirus genus, such as Orf virus (ORFV), Bovine papular stomatitis virus (BPSV) and Pseudocowpox virus (PCPV). The sequence analysis showed that the parapoxvirus sequences from the pinnipeds differed significantly from those found in terrestrial hosts and that they formed a separate cluster within the genus. Our results suggest that transmission of the same parapoxvirus strain is possible between different species, including between members of different families (phocids and otariids). Animals belonging to the same species but living in distant geographic locations presented genetically distant parapoxviruses. The findings of this study demonstrate that sealpox lesions in pinnipeds of different species are caused by viruses that belong to the Parapoxvirus genus but have significant genetic differences compared to the established virus species in terrestrial hosts, thus strongly supporting the classification of pinniped parapoxvirus as a new species of the genus.

Applications of e-Health to Support Person-Centered Health Care at the Time of COVID-19 Pandemic.

Background: Many e-health services were launched after countries relaxed their telehealth regulations to combat the coronavirus disease 2019 (COVID-19) pandemic. e-Health technologies that support person-centered health care are crucial for the patient's needs. In this systematic review, we examined how e-health applications are used to support person-centered health care at the time of COVID-19. Methodology: Literature was systematically searched without language restriction and publication status between January 1 and May 25, 2020, to describe e-health's support on the person-centered health care to control the COVID-19 pandemic. PubMed, ScienceDirect, and CINAHL, MedRxiv, and Web of Science were used. Two researchers independently assessed the eligibility of each retrieved record. All included studies were subsequently rescreened by the researchers. The systematic review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. Results: We identified 60 articles and selected 8 studies that met the inclusion criteria. Most of the studies used e-health technologies to facilitate clinical decision support and team care. Patient's engagement and access to health care from their homes were enhanced using telehealth and mobile health. Electronic health records were used to avail reliable data to health care providers and health authorities to make evidence-based decisions. Conclusion: Although there are limited studies to evaluate the effectiveness of e-health technologies for person-centered health care, the reviewed studies indicated e-health's potentials to improve the quality of health care and personalized health systems during COVID-19 pandemic. Further research should be done to better understand applications of e-health to improve the quality of health care and patients' outcomes and evaluate its cost-effectiveness.

What are the challenges in the vaccination of migrants in Norway from healthcare provider perspectives? A qualitative, phenomenological study.

BACKGROUND: Migrant populations in the European Union (EU) suffer a disproportionate burden of infectious diseases and may be particularly vulnerable due to poor conditions in countries of origin or throughout transit to the host country. Given the rising level of migration into Europe, the vaccination of migrant populations has become a key priority, with European countries committing to equitably extending the benefits of vaccination to all. However, in Norway, little is known about the vaccination of migrant populations. OBJECTIVE: The aim of this qualitative research study was to explore the process of vaccinating migrant populations in Norway and elucidate any challenges as perceived by healthcare providers. This involved exploring the challenges faced by healthcare providers in delivering vaccinations to migrants as well as potential barriers faced by migrants in accessing vaccinations in Norway, from the perspectives of healthcare providers. METHODS: In June 2019, the authors conducted semi-structured interviews with seven healthcare providers who are involved in vaccinating migrants in South-Eastern and Western Norway. This included healthcare providers working in general practice, public health and infectious disease clinics, migrant health clinics, and local public health institutes. RESULTS: An inductive, exploratory analysis identified key themes that were reviewed and analysed in light of existing literature. According to the informants, the Childhood Immunisation Programme is effective in including migrant children within the national vaccination schedule. However, gaps in vaccination appear to exist with regards to adult migrants as well as working migrants. There is currently no consistent or structured approach to vaccinating adult migrants in Norway, including no guidelines from governing bodies on how to organise vaccination to adult migrants in municipalities. Furthermore, reasons why adult vaccination is not prioritised were provided, such as tuberculosis screening and treatment taking precedence and the common assumption among healthcare providers that vaccinations are dealt with in childhood. CONCLUSION: The development of equitable immunisation programmes requires an understanding of the multifactorial barriers to immunisation, such as those posed by policies, structures and governance bodies, or lack thereof. It also entails understanding the administration of such policies and the perspectives of those who are responsible for the delivery of vaccination, namely healthcare providers. This qualitative research study demonstrated that challenges exist in the vaccination of migrants in Norway and that they are coherent with those experienced throughout the EU, principally the presence of gaps in vaccinating adult migrants, working migrants and internal EU migrants. This research provides direction for future investigations and highlights the need for the inclusion of migrant status in the Norwegian Immunisation Registry.

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model.

BACKGROUND: Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality service by improving data handling and communication in healthcare setting. EMR implementation in developing countries is increasing exponentially. But, only few of them are successfully implemented. Intention to use EMRs by health care provider is crucial for successful implementation and adoption of EMRs. However, intention of health care providers to use EMR in Ethiopia is unknown. OBJECTIVE: The aim of this study was to assess health care provider's intention to use and its predictors towards Electronic Medical Record systems at three referral hospitals in north-west, Ethiopia, 2019. METHODS: Institutional based cross-sectional explanatory study design was conducted from March to September among 420 health care providers working at three referral hospitals in north-west Ethiopia. Data were analyzed using structural equation model (SEM). Simple and multiple SEM were used to assess the determinants of health care providers intention to use EMRs. Critical ratio and standardized coefficients were used to measure the association of dependent and independent variables, 95% confidence intervals and P-value were calculated to evaluate statistical significance. Qualitative data was analyzed using thematic analysis. RESULT: The mean age of the study subjects was 32.4 years ±8.3 SD. More than two-third 293(69.8%) of the participants were male. Among 420 health care providers, only 167 (39.8%) were scored above the mean of intention to use EMRs. Factors positively associated with intention to use EMRs were performance expectancy (ß = 0.39, p < 0.001), effort expectancy (ß = 0.24,p < 0.001),social influence (ß = 0.18,p < 0.001),facilitating condition (ß = 0.23,p < 0.001), and computer literacy (ß = 0.08,p < 0.001). Performance expectancy was highly associated with intention to use EMRs. CONCLUSION: Generally, about 40 % of health care providers were scored above the mean of intention to use EMRs. Performance expectancy played a major role in determining health care providers' intention to use EMRs. The intention of health care providers to use EMRs was attributed by social influence, facilitating condition in the organization, effort expectancy, performance expectancy and computer literacy. Therefore, identifying necessary prerequisites before the actual implementation of EMRs will help to improve the implementation status.

Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to animals: an updated review.

COVID-19 caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan (Hubei province, China) during late 2019. It has spread across the globe affecting nearly 21 million people with a toll of 0.75 million deaths and restricting the movement of most of the world population during the past 6 months. COVID-19 became the leading health, economic, and humanitarian challenge of the twenty-first century. In addition to the considerable COVID-19 cases, hospitalizations, and deaths in humans, several cases of SARS-CoV-2 infections in animal hosts (dog, cat, tiger, lion, and mink) have been reported. Thus, the concern of pet owners is increasing. Moreover, the dynamics of the disease requires further explanation, mainly concerning the transmission of the virus from humans to animals and vice versa. Therefore, this study aimed to gather information about the reported cases of COVID-19 transmission in animals through a literary review of works published in scientific journals and perform genomic and phylogenetic analyses of SARS-CoV-2 isolated from animal hosts. Although many instances of transmission of the SARS-CoV-2 have been reported, caution and further studies are necessary to avoid the occurrence of maltreatment in animals, and to achieve a better understanding of the dynamics of the disease in the environment, humans, and animals. Future research in the animal-human interface can help formulate and implement preventive measures to combat the further transmission of COVID-19.

Corrigendum to "Association between antimicrobial resistance among Enterobacteriaceae and burden of environmental bacteria in hospital acquired infections: analysis of clinical studies and national reports" [Heliyon 5 (7) (July 2019) e02054].

[This corrects the article DOI: 10.1016/j.heliyon.2019.e02054.].

Association between antimicrobial resistance among Enterobacteriaceae and burden of environmental bacteria in hospital acquired infections: analysis of clinical studies and national reports.

BACKGROUND: WHO has named three groups of gram-negative bacteria "our critical antimicrobial resistance-related problems globally". It is thus a priority to unveil any important covariation of variables behind this three-headed epidemic, which has gained alarming proportions in Low Income Countries, and spreads rapidly. Environmental bacteria including Acinetobacter spp. are common nosocomial pathogens in institutions that have high rates of antimicrobial resistance among other groups of gram-negative bacteria. METHODS: Based on two different data sources, we calculated the correlation coefficient (Pearson's r) between pathogenic burden of Acinetobacter spp. and antimicrobial resistance among Enterobacteriaceae in European and African nosocomial cohorts. CLINICAL REPORTS: Database search for studies on nosocomial sepsis in Europe and Africa was followed by a PRISMA-guided selection process. NATIONAL REPORTS: Data from Point prevalence survey of healthcare-associated infections published by European Centre for Disease Prevention and Control were used to study the correlation between prevalence of Acinetobacter spp. and antimicrobial resistance among K. pneumoniae in blood culture isolates. FINDINGS: The two approaches both revealed a strong association between prevalence of Acinetobacter spp. and rates of resistance against 3. generation cephalosporins among Enterobacteriaceae. In the study of clinical reports (13 selected studies included), r was 0.96 (0.80-0.99) when calculated by proportions on log scale. Based on national reports, r was 0.80 (0.56-0.92) for the correlation between resistance rates of K. pneumoniae and proportion of Acinetobacter spp. INTERPRETATION: The critical antimicrobial resistance-related epidemics that concern enteric and environmental gram-negative bacteria are not independent epidemics; they have a common promoting factor, or they are mutually supportive. Further, accumulation of antimicrobial resistance in nosocomial settings depends on the therapeutic environment. Burden of Acinetobacter spp. as defined here is a candidate measure for this dependence.

Infectious Disease Outbreak Associated With Supplementary Feeding of Semi-domesticated Reindeer.

Supplementary winter feeding of semi-domesticated reindeer (Rangifer tarandus tarandus) has become more common in Sweden and Norway due to reindeer pasture fragmentation and climatic conditions. With increased corralling and feeding, often associated with animal stress, increased animal-to-animal contact, and poor hygienic conditions, an altered range of health challenges and diseases may emerge. An outbreak of three different infectious diseases appeared simultaneously in a reindeer herd in Norrbotten County, Sweden. The animals were corralled and fed silage. Several animals in poor body condition stopped eating, with drool and discoloration of the hair coat around the mouth. There were large, black, necrotic lesions on the tongue and gingiva, with holes perforating the chin, indicative of oral necrobacillosis and Fusobacterium spp. infection. Simultaneously, animals were seen with proliferative lesions in the oral mucosa and on the lips, characteristic of contagious ecthyma and Orf virus infection. Furthermore, three animals had keratoconjunctivitis suggesting exposure to cervid herpesvirus 2 (CvHV2) and possibly secondary bacterial infections. DNA specific for Fusobacterium necrophorum and ORFV was detected in relevant tissue samples. Antibodies against CvHV2 were detected in 10 of 13 diseased and in four of 11 apparently healthy reindeer. Nine animals were found dead or were euthanized during the outbreak. Health risk factors associated with feeding and corralling may severely impact animal welfare and the herder's economy, and may represent an underestimated cost when replacing natural grazing with feeding.

Contaminants in Atlantic walruses in Svalbard part 1: Relationships between exposure, diet and pathogen prevalence.

This study investigated relationships between organohalogen compound (OHC) exposure, feeding habits, and pathogen exposure in a recovering population of Atlantic walruses (Odobenus rosmarus rosmarus) from the Svalbard Archipelago, Norway. Various samples were collected from 39 free-living, apparently healthy, adult male walruses immobilised at three sampling locations during the summers of 2014 and 2015. Concentrations of lipophilic compounds (polychlorinated biphenyls, organochlorine pesticides and polybrominated diphenyl ethers) were analysed in blubber samples, and concentrations of perfluoroalkylated substances (PFASs) were determined in plasma samples. Stable isotopes of carbon and nitrogen were measured in seven tissue types and surveys for three infectious pathogens were conducted. Despite an overall decline in lipophilic compound concentrations since this population was last studied (2006), the contaminant pattern was similar, including extremely large inter-individual variation. Stable isotope ratios of carbon and nitrogen showed that the variation in OHC concentrations could not be explained by some walruses consuming higher trophic level diets, since all animals were found to feed at a similar trophic level. Antibodies against the bacteria Brucella spp. and the parasite Toxoplasma gondii were detected in 26% and 15% of the walruses, respectively. Given the absence of seal-predation, T. gondii exposure likely took place via the consumption of contaminated bivalves. The source of exposure to Brucella spp. in walruses is still unknown. Parapoxvirus DNA was detected in a single individual, representing the first documented evidence of parapoxvirus in wild walruses. Antibody prevalence was not related to contaminant exposure. Despite this, dynamic relationships between diet composition, contaminant bioaccumulation and pathogen exposure warrant continuing attention given the likelihood of climate change induced habitat and food web changes, and consequently OHC exposure, for Svalbard walruses in the coming decades.

Experimental parapoxvirus infection (contagious ecthyma) in semi-domesticated reindeer (Rangifer tarandus tarandus).

Contagious ecthyma (contagious pustular dermatitis, orf) occurs world-wide in sheep and goats and is caused by orf virus (genus Parapoxvirus, family Poxviridae). Contagious ecthyma outbreaks have been described in semi-domesticated reindeer (Rangifer tarandus tarandus) in Sweden, Finland and Norway, occasionally with high mortality. Fourteen one-year-old reindeer were corralled in mid-April. One week after arrival, two animals received a commercial live orf virus vaccine for sheep (Scabivax(®)) on scarified skin of the medial thigh. Four weeks later, the two vaccinated and six additional animals were inoculated in scarified oral mucosa with parapoxvirus obtained from reindeer with clinical contagious ecthyma. The remaining six reindeer were kept as sentinels, sharing feed and water with the inoculated animals. A small whitish lesion appeared on the inoculation site and the labial skin-mucosa junction of three animals five days post inoculation (p.i.). Twelve days p.i., typical ecthyma lesions were visible on the inoculation site in six of eight animals, including both vaccinees. Four inoculated animals (including both vaccinees) and one sentinel seroconverted 12 days p.i., and five animals (including one sentinel) seroconverted 20 days p.i. No contagious ecthyma-like lesions were detected in the sentinels. All animals were euthanized at 26-29 days p.i. Histological examination of lesions showed proliferative dermatitis with epidermal hyperplasia, hyperkeratosis, intra-epithelial pustules and ulcers. Orf virus DNA was detected in mandibular lymph nodes, tonsils and mucosal lesions of four animals, including one sentinel, which showed that virus transmission took place. The commercial orf virus vaccine may be difficult to administer due to the need for close-cropping and its zoonotic nature, and did not indicate significant protection, although the latter has to be verified with a larger number of animals.