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The development of an evidence-based street food vending model within a socioecological framework: A guide for African countries
Authors: Jillian Hill aff001; Zandile Mchiza aff002; Thandi Puoane aff002; Nelia P. Steyn aff003
Authors place of work: Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa aff001; School of Public Health, University of the Western Cape, Cape Town, South Africa aff002; Division of Human Nutrition, University of Cape Town, Cape Town, South Africa aff003
Published in the journal: PLoS ONE 14(10)
Category: Research Article
doi: https://doi.org/10.1371/journal.pone.0223535Summary
In the present global economic crisis and continued rapid urbanization, street food (SF) vending has grown into a practical source of income for people in the developing world. SF are not only appreciated for their unique flavours, convenience, and affordability they also contribute to the economy of the country, the perseverance of cultural and social heritage of society, as well as the potential for maintaining and improving the nutritional status of populations. This study aimed to develop a street food vending model (SFVM) that encompasses healthy and safe food options for consumers including hygiene and safety guidelines and viable business and operations for vendors. An evidence-based approach, i.e. “systematically collected proof”, was used to inform the development of this model. Phase 1 included two surveys, one of street food vendors (N = 831) and the other of consumers (N = 1047). These surveys obtained data regarding the vendors’ operations and food items they sold and the consumers’ purchases and their nutrition knowledge. In Phase 2, interviews and focus groups were conducted with government officials. Additionally, regulations and policies regarding street vending were reviewed to determine available regulations and policies for street food vending. In Phase 3, data from the two phases were integrated and participatory action methods involving street food vendors used to validate the findings and inform the development of a SFVM by engaging in focus group discussions with street food vendors (N = 28). The components of the proposed SFVM comprised four parts, namely a food and nutrition component, a hygiene component, a business component and a vending cart. These components serve as a guide and considers various elements of the socioecological framework, namely intrapersonal/individual and interpersonal factors, the physical environment/community as well as the policy environment. The development of this model can serve as an example to countries which have large street food vending components and wish to optimize their value by making them safe and healthy for consumers. Thus, allowing vendors to trade under optimal conditions giving due consideration to regulations and policy.
Keywords:
Food – Finance – Food consumption – Environmental health – Hygiene – Vendors – Regulations
Introduction
The street food (SF) vending business as an informal employment sector has grown significantly in South Africa over the past few decades [1–3]. This has been fuelled by the fact that the formal sector cannot grow fast enough to cater for all the nations’ employment requirements [3, 4]. In the Quarterly Labour Force Survey (QLFS) of Statistics South Africa [5], the unemployment rate was estimated to have risen to 27.7% in the first quarter (January to March 2017). This rate is the highest recorded since 2003 and despite the South African government’s initiatives to grow employment in the country. Furthermore, it has been shown to be the highest among young women aged 15–34 years, the black African population, and those with an education level less than Grade 12.
In response to this high unemployment rate, it is typical that most street traders are of African origin and frequently the sole breadwinners of their families [2]. In a recent survey conducted on the informal economy of the Western Cape Province, over 1800 informal businesses were interviewed. Of these, 40% were in the food and drinks trade, with most of them (46%) making less than R1000 (83USD) profit per month [1]. Evidence exists suggesting that most African street traders are “survivalist” (subsistence) traders [6]. Willemse, 2003 [7], echoes this in stating that street trading encapsulates a survival or coping strategy for the poor to escape hunger by generating a small income. In addition to the street trade being a source of income, it also contributes significantly to the diet of many people living in developing countries, including South Africa [8]. Popular SF in South Africa include cooked food items such as “vetkoek” (fat cake/doughnut) with a protein filling of chicken liver or French polony (very popular in South Africa, consists out of highly processed meat (pork, chicken, beef), also common are high-fat meals of meat with visible fat, starch, fat and vegetables, fish and chips [9]. In the rest of Africa common SF include more traditional foods such as roasted meat, fried snails and fish, fried bean cake, steamed bean cake, roasted and fried yam and plantain, cooked or roasted maize, cassava chips, sugar cane, groundnuts, boiled eggs among others [10]. Street foods are convenient, cheap, and easily accessible [8, 11]. In South Africa, black Africans are the most regular purchasers, with nearly one out of five (19%) consuming SF at least twice a week [12].
In a study undertaken in Kumba, Cameroon, mobile food vending was shown to be part of a survival strategy for the poor, who attempt to maintain and expand the subsistence business [13]. As such, it is imperative that local and regional policy-makers forge strategies directed at growing the economic well-being of poverty-stricken families and develop SF enterprises into city food establishments. Willemse [7] recommends that it will be valuable if policy makers, and researchers, address problems encountered/experienced by the poor who are trying to enter informal trading.
As important as SF vending is, this business increases the strain on local government as it is difficult to manage because of its informal nature, risk of microbial contamination and selling of unhealthy (high fat, salt and sugar, highly processed) foods [2, 14, 15]. For example, regulating what is sold on the streets becomes a challenge, as government officials are not always able to monitor the type of food sold (whether nutritious, hygienic or safe). In this regard, initiatives that foster healthy, safe products, and profit SF vendors are needed to ensure that SF is not sold at the expense of the consumer’s health. In Nairobi researchers found that vendors sell what consumers will buy, demonstrating purchasing power [16]. In SF vendor studies basic hygiene practices such as handwashing between handling food and money as well as toilet breaks, and the use of a hairnet when cooking has been observed in studies in Brazil and South Africa [17, 18]. Both studies also recognized a huge lack of infrastructure and basic services/poor environmental conditions [17, 18]. Ideally, one wishes to create a SF vending business model that would be economically sustainable, and offer healthy foods, which are microbiologically safe to clients. Such a model would provide the greatest benefit to vendors and their clients and would also reduce the monitoring burden on local government.
However, to our knowledge, no-one has developed a sustainable SF vending model (SFVM) in a metropolitan area in South Africa that encompasses good business practices with the sale of nutritious foods which are microbiologically safe to eat. Thus, the overall aim of this study was to develop a SFVM that considers nutrition, hygiene and safety, business and operational aspects of SF vending, including a vending cart. The overall goal of the Global Strategy on Diet, Physical Activity and Health, of the World Health Organization [19] ties in with this model. The strategy is, to “promote and protect health by guiding the development of an enabling environment for sustainable actions at individual, community, national and global levels that, when taken together, will lead to reduced disease and death rates related to unhealthy diet and physical inactivity” [19] [page 3].
Methodology
Overall aim
In this study, which was conducted in three phases, we made use of mixed (quantitative and qualitative) methodology. Phase 1 results have been published [9, 18, 20]. However, Phases 2 and 3 are unpublished and will form the bulk of this article. Fig 1 presents an overview of the study with all its components.
Fig. 1. The process of the development of the street food vending model. Phase 2a. Qualitative data collection from government officials
The main objectives of this phase were to identify the current regulations and policies governing SF vending and to gain insight into SF vending operations from a regulatory perspective. Phase 2a of this study comprised qualitative methodology utilizing in-depth interviews and focus group discussions with staff from the Western Cape Department of Environmental Health (DoEH) and Department of Economic Development (DoED). These two departments are recognized as the only two governmental/municipal departments directly involved in supporting and servicing SF vending. Individual interviews were conducted with one DoEH and one DoED manager. A semi-structured interview schedule was used as a guide to steer the interview. Questions asked, pertained specifically to regulations, bylaws and policies that relate to SF vending, certification, requirements regarding business and hygiene, and support available to vendors. Both key informants spoke freely and openly allowing for rich information. Two focus group discussions were held with the officers from the DoEH (N = 10) and DoED (N = 12).
Individual interviews and focus groups were transcribed, after which a summary of each interview and focus group was written. This process was followed for the interviews and focus group discussions with DoEH and DoED officers. The primary researcher familiarized herself with the data by reading each transcript several times and then used the Computer-Aided Qualitative Data Analysis Software (CAQDAS) package, Atlas ti 7.5.7, to manage the data. The four transcripts were loaded into Atlas ti 7.5.7 as four primary documents. Then the coding process commenced by reviewing the transcripts and allocating codes and giving them a concise label (open coding) [21]. After consultation with team members, the researcher then began reviewing all codes and merging and deleting ones where applicable, which was repeated a few times. The researcher then began grouping quotes under predetermined themes with summarizing sentences, thus, placing them into categories. Codes and their connected quotations were retrieved to explore patterns or tendencies.
Phase 2b. Document review
The objective of Phase 2b was to identify the existing regulations and policies on SF vending. Document review was employed as an additional method of data collection. Documents were accessed through official government websites, nationally, and the City of Cape Town was searched specifically. Documents from websites about street-vending business guidelines were also searched.
Phase 3
The objectives of this phase were to integrate the data obtained from the two earlier phases, assess the relevance, acceptability and feasibility of the identified themes and resulting components with SF vendors, and develop a SFVM. A socioecological framework was applied in this phase to understand, interpret, and apply results of the previous phases to inform this SFVM development.
Step 1: Integration of data: Data from the two surveys undertaken in Phase 1 and the outcomes from Phase 2 were studied, interpreted, and integrated to develop main themes and components which would contribute to the development of the SFVM within a socioecological framework (Table 1).
Tab. 1. Placing the street food model within the context of the socio-ecological model. Step 2: Determining relevance and feasibility of data integration: In this step, we tested the relevance and feasibility of resulting themes and components with the use of participatory action research (PAR) using focus group discussions with SF vendors. Participatory action research recognizes the importance of involving those who are intended to be the beneficiaries of the research, with specific reference to the working class, laborers, those exploited, and the poor in a breakdown of their reality [21]. The aim of PAR is to address the practical concerns of people in a problematic situation as well as the larger goals of social science, with impetus on rigor and relevance [22]. A profound sense of ownership, which a PAR approach enables, would promote the sustainability of the proposed SFVM.
As the main focus of this part of the research study was to assess the proposed SFVM, focus groups were conducted with SF vendors to evaluate the acceptability and practicalities of the proposed model. Data collection took place from September 01 to November 17, 2015. Three focus group discussions took place in central Cape Town, and one took place in Mfuleni (a suburb in the Northern suburbs of Cape Town). Focus groups comprised five to nine participants, totalling to 28, with 20 females and eight males. Face-to-face focus groups were conducted and audio-recorded. A semi-structured focus group schedule was used as a guide to steer the discussion. Questions were specifically geared to assess various components identified in the previous step, i.e. business, food and nutrition, hygiene as well as a proposed SF vending cart.
The focus group discussions were audio-recorded, and the primary researcher listened to these a few times before coding commenced. A pre-determined coding list was used to categorize information into acceptability, practicability, perceived challenges and suggested changes to the proposed SFVM.
The primary researcher followed the same qualitative method as before by listening to each recording and then using the CAQDAS package, Atlas ti 7.5.7, to assist in managing the data. This software allows for basic ‘code retrieval’ of data as well as a more sophisticated analysis using algorithms [23]. The four recordings were loaded into Atlas ti 7.5.7 as four audio files. The researcher then commenced the coding process by listening to the audio files and allocating sound bites to pre-determined codes in consultation with supervisors and senior project consultants. The researcher then began grouping sound bites, transcribed relevant quotes under predetermined themes with summarizing sentences, thus, placing these into categories.
Step 3: Development of the street food vending model: A model can be interpreted as a descriptive strategy that has a broad conceptual framework [24]. Models are characterized using analogies to give a visual illustration, with the aim to simplify phenomenon as a tool for explanation and conceptualization [25].
Sallis et al., [26] indicated that ecological models of health behavior emphasize the environmental and policy context of behavior, though they do include social and psychological issues. In an ecological model, each level of influence is considered, thus, guiding the development of comprehensive interventions. The most relevant potential influences should be considered at each level. These assist researchers/intervention planners in appreciating how people interact with their various environments. In turn, this understanding can be used to develop effective multi-level methodologies to better health practices [26].
The socioecological model used in this study represents a comprehensive approach to designing, implementing, and evaluating interventions which target multiple influences on behavior [27]. The premise of an ecological model/perspective supposes that individual behavior should be considered as being affected by various levels of influence, including individual and environmental determinants [28]. The five levels of influence to health behavior, in particular, include intrapersonal factors, interpersonal processes, primary groups, institutional factors, and community factors as well as public policy [29].
Ethics
This research received ethical approval from the University of the Western Cape’s Ethics Committee (Registration no: 14/4/17). Ethical approval for the larger study to intervene with SF vendors and consumers was previously obtained from the Human Sciences Research Council (Protocol No REC13/20/02/13). In addition, permission to intervene with SF vendors was obtained from the City of Cape Town (ID No. 10341).
All participants were informed that participation was voluntary, with the understanding that they could withdraw from the study at any time without any consequences. Before the interview/focus group, discussion participants who gave informed consent received an information sheet explaining the study in detail and what was expected from them. Anonymity was assured in that their names were not used in any report and the collected data were only accessible to the study investigators.
Results
Phase 2a: Key informant interviews and focus group discussions with government officials
Five broad categories were identified through the analysis process (Table 1): Regulations, business-related issues, food/nutrition/health, environmental health/hygiene, vendor cart, and vendor challenges within the SF operation.
Vendor operations
Participants were asked about what they see as the most important aspects of the SF vending operation. All extracted codes about the business operation of SF vendors were grouped and presented in Table 2.
Tab. 2. Integral elements of the business operations of vendors as identified by participants. As can be observed in Table 2, the most attention given by participants was regarding the legislation, regulations and bylaws to which the SF vendors should adhere to, to run a legally compliant operation. Discussions on the hygiene or environmental health aspects of SF vending were next. Participants also mentioned food, nutrition and trading zones frequently, with food and nutrition-related aspects only mentioned in the focus group discussions and not in the interviews with the managers. The density of the codes presented in Table 2, shows that more robust discussions around the perceived integral elements of the business operations of street vendors took place with officials from the environmental health sector.
Regulations: The Foodstuffs, Cosmetics and Disinfectants Act 54 of 1972 (R962) [30], recently changed to R364, was the regulatory aspect to which interviewees most often referred to in the interviews and the focus group discussions. One key informant referred to this as, “R962 that is the main one that is the Bible.” Another key informant explained that “…the certificate of acceptability is a regulation and has been promulgated under the foodstuffs act.” Participants explained that vendors selling cooked food should be in possession of a certificate of acceptability (COA) requiring the vendor to comply with certain standards for health and safety. The DoEH issues the COA, but before being able to apply for the COA, the vendor would have to apply for a “hawker’s meal trading license” promulgated under the Business License Act of 1991 [31] at the cost of R10 (less than 1USD).
Participants also indicated that regarding the Informal Trading Bylaw of the City of Cape Town, no-one is allowed to trade informally on City property in a trading area without a valid permit. Therefore, a SF vendor potentially should be in possession of three documents to operate legally, namely, a COA, a hawker’s trade license and a permit.
Environmental health and hygiene: This aspect of SF vending was an obvious concern to officials from the DoEH. The importance of including health and hygiene aspects into a business model for vendors was discussed from various perspectives. One participant referred to the importance of temperature control as being key, and in recognizing the limitations that SF vendors experience, the DoEH deems the use of cooler boxes as cooling equipment to be acceptable, “…that is why we accept the cooler boxes. So, if your product goes out of your home in the morning at 4° Celsius, you have ice boxes and cooler bags and things like that. [Then] you can maintain it at a safe temperature unless you are going to leave that bin open or that container open, or you [are] going to open and close … it, and things like that. So that is why I say that [a] business model is very important.” [DoEH manager]
The participant also emphasized that vendors should possess the knowledge to conduct temperature control measures appropriately, “…and then, of course, keeping things hot that is meant to be hot. Don’t make the sausage 10 am this morning then it sits outside [at] room temperature, 28 degrees in the center of town and you are only warming it up again to put it on a roll or something like that.” [DoEH manager]
Participants from the DoEH indicated that SF vendors should at least receive a copy of the WHO’s, Five Keys to Safer Foods [32], endorsed by the South African Department of Health, even if no training is possible. The DoEH manager noted, “The five safer foods [were] developed for Africa and for every region they sort of took certain things under consideration. So, this is really something that has been researched for South Africa. This particular one that we use.” “We use Five Keys, that is one of the things that is [needed by] everybody in the City, we adopt [the] World Organization[‘s] Five Keys that is what we preach”. [DoEH official]
Environmental health officials attested to regular inspections of premises and food sampling of SF vendors. “…because you need to guard against food poisoning, so that is one of the things that can be used as well.” [DoEH official]
Food, nutrition, and health: Food, nutrition, and health were also concerns of the key informants as can be seen from Table 2 and the following quotations. Most of the comments were participants’ concerns about the unhealthy nature of food items for sale by SF vendors.
“So they would sell anything from koeksisters [type of doughnut/oily cakes] to sweets to toffee apples to vetkoek [deep fried bread] …and many of those kids’ parents don’t give them food for lunch so they would get money.”
[DoED official on vendors operating around schools]
“Another sensitive area is your clinics… vendors are all around the fence, and they sell, because now the patients are waiting, they wait in long queues, so it’s chips, it’s cookies, it’s ‘Niknaks’ all of those things and that is carrying into the facility as well.”
[DoED official on vendors operating around clinics]
“A lot of the items that are sold by the SF vendors are unfortunately not very healthy items, and it is not going to change on its own.”
[DoED official]
One key informant felt that he is not sure on how prescriptive one should be regarding what vendors can and cannot sell. Because if the vendor does not make a profit, then the officials will be to blame. “I in my mind, haven’t drawn that line yet. I absolutely understand cigarettes and school children, but to me where do you start drawing the line, what about somebody selling hamburgers where you fry it in oil that is also not healthy.” [DoED manager] “So to me whatever you are selling it is there because the City have [sic] been prescriptive, then who takes the responsibility when that person’s model doesn’t work.” [DoED manager]
Although business plans are not required when applying for a business license, COA or location permit, they should be encouraged to develop such plans, and there is some support available for this, a key informant said. “We have a unit within DoED called business support, and we refer people to do it through that, and then throughout the municipal area, there are organizations which the City funds. We can provide that, and that helps you develop your business plan, your business case, looks at various financial options, so those models are available.” [DoED manager]
“The simplest of logs and the simplest of business plans, where do I buy my things. What do I do to keep it good? What remains of the stock that is left over tonight? Because meat and things like that does [sic] not go off, you can use it, keep it refrigerated and frozen. There’s nothing wrong with using it the next day. But don’t defrost it [and then] freeze it again. And the volumes that they need to get [a profit] and that is where people sometimes get into trouble. And the thing that you throw away is money. The moment that you throw away it is waste, it is absolute money.”
[DoEH manager]
Challenges regarding the street food vending operation: Codes regarding challenges in the vending operation are presented in Table 3. The salient issues regarding challenges in the vendor operation were recognised as a lack of consumer and vendor knowledge regarding health and hygiene. This was directed towards the vendor practices and the consumer not ‘asking’ and thus not knowing any better. “My thinking, and it is a long way to get there, is surely what we should be encouraging. That [is] if a trader wants to then sell healthy food stuff we should be encouraging them. But, we shouldn’t say you must sell healthy food but say if you train them in education these are the better alternatives, these are the better options, and we would encourage [this]. And then if people like this lady who sells fruit and vegetables that is fine, and [if] there is another trader who is selling sushi that is fine, but again what do we do when the mindset of the trader is saying, I will sell what the commuters want. Now, the commuters are not necessary talking about healthy food; they want hamburgers.” [DoED manager] “To me, the approach would be two-fold, one is to educate the trader absolutely, but one needs to also [sic] educate the community.” [DoED manager]
Tab. 3. Codes regarding the challenges affecting the street food vending operation. The issue of healthy foods being expensive came up in one manager’s interview several times, but not in any of the other discussions or interviews, while the challenge of vendors acquiring storage space came up in all the discussions. “The question of storage is [a] personal/private storage arrangements. Most traders have engaged businesses for their private storing purposes. So, they have to get out by a certain time, as obviously businesses must trade, so by 6/7 am. And then they must be in at a certain time as the business closes for the day. Even though there might still be ‘traffic’ in Wynberg [a suburb], they then lose out on that business.” [DoED official] “Irrespective of the design, the issue in my area is storage. I have a situation now where a trader stores her goods in a shop.” [DoED official]
Other challenges were also acknowledged, including crime and the lack of basic facilities such as water and energy sources at many stalls. “When people are complaining about crime and your safety issues … I can see their frustration and things. It would be difficult to operate where you do not have electricity, and so on, but then there are people who are running successful little businesses. That has actually gone in from tiny, tiny starts to bigger things. And have become good caterers, so it is a constraint, but it does not prevent people from trading.” [DoEH manager]
The issue of street vending being difficult to manage because of its mobility and seasonality came up in three of the four discussions. “Ja look, I think that is the reality, unfortunately. Because some of the constraints that we have that colleagues find, is the fact that you have a very seasonal thing, and you have a very occasional sense. End-of-month things, end-of-week things, lots of people actually operate on a Friday, Saturday, Sunday. And they spring up; some may operate for four, five, six weeks or two months and then all of a sudden, they are no longer there, or whatever the case may be.” [DoEH manager]
Waste management also appears to be a key issue when considering the vendors’ operations.
“It’s a big issue for us, especially what do you do with waste? So you’ve got to try and build in some… waste minimization strategy because people don’t like to take the waste home.”
[DoEH official]
Cart requirements/suggestions: When key-informants were asked to raise an opinion regarding the use of a cart/mobile unit for SF vendors, a few themes emerged which is noted in Table 4. Emphasis was placed on the fact that any cart designed for vendors’ use should comply with health and hygiene regulations as stipulated by Act R962, recently replaced by R364, the Foodstuffs, Cosmetics and Disinfectants Act, 1972 [30].
Tab. 4. Street food vending cart considerations. One challenge identified about the cart was that of finances as it may be too costly for the average street vendor to purchase. Lack of storage space for such a vehicle was another challenge. The key informants could provide some examples of existing carts and initiatives for designing an “ideal cart” which researchers could explore.
“I think the main thing is that gas and stuff like a cooling facility, the most important ones are usually your gas or whatever your preparation things [are] that you use and then your storage facilities. Your cool bags or cool facility, and something to wash hands. I think that is the main aspect of the preparation thing, that cold-chain stuff, the cooling system and your cleaning system.” [DoEH official] “You see what the people usually do, they put in something like a little washing basin thing like they do in a caravan with a 25-L or 20-L plastic can, draining it down at the bottom where your waste water is going, which you can empty tonight, because that is what they usually do.”
[DoEH official]
“Maybe what I could say regarding the cart, it is a very good idea but just looking at the financing. Have you looked at [whether] the people can afford this?” [DoED official] “…the units are fantastic on one side because if you’ve got a healthy-looking unit, it attracts people to buy and be selling healthy food even better. But there are [an] enormous amount of challenges around the units, and the key of that is to forget the finance, it costs money to build a unit but the storage and the ability so when operating at BTI [Bellville transport interchange] where do you store it?”
[DoED manager]
“I think the cart of the Cape Winelands (an area using a cart) will bring with it some answers to what you are looking for. They had a safe component in it. There is, I cannot remember if it is a tap or 25-L water container–clean water thing in which one can use the sink maybe to wash maybe your vegetables or whatever meat or anything and then at the bottom, there is also an empty 25-L container to drain (the water). So it’s a typical–an ideal model that really satisfies us DoEH practitioners because it has all the components we are looking for. And I think, also has a space for them to label their stalls because our regulations R962 requires that if it is a stall that you are selling from then it must be clearly labelled with your name and everything.”
[DoED official]
Hygiene standards: About hygiene training provided to the SF vendors in Cape Town, the Five Keys to Safer Food developed by the WHO, 2006 [32] appears to be the main document in use by the DoEH officials. The officials from the DoEH discussed issues around the Five Keys to Safer Food as noted in Table 5. The five keys to safety cover the following aspects: keep everything clean; separate raw and cooked food; cook thoroughly; keep food at safe temperatures, and use safe water and raw materials. “Training in this regard, we don’t really [give training], but we try and get (reach) the hawkers (vendors) through the Five Keys to Safer Food initiative. I know in Khayelitsha (suburb) they have a nice thing going with the hawkers, they actually get them in from time to time, and train them. But it is not a pre-requisite for us.” [DoEH official]
Tab. 5. Five Keys to Safer Food codes. Phase 2b Document review
In Table 6, the 13 regulations and bylaws that directly or indirectly affect SF vendors in the Western Cape Province are shown. Most of these regulations are South African laws, while a smaller number are City of Cape Town bylaws, and as such effect only those vendors trading within Cape Town.
Tab. 6. Regulations and bylaws deemed applicable for street vending. Phase 3
Step 7 Data integration
The data from the survey on vendors and consumers (Phase 1) and key informants and government officials (Phase 2) were integrated (Table 7).
Tab. 7. Key themes from surveys and key informant interviews and focus groups. Step 2: Relevance, acceptability, and feasibility of the integrated themes
All SF vendor participants in the four focus group discussions agreed to the relevance, acceptability, and feasibility of including the components business and operational issues, food and nutrition, hygiene and safety, and cart with basic facilities, in a SFVM. In the previous step of data integration, this model was identified (Table 7). In the following section, we present and discuss the perceptions of vendors on the components of the four main themes, as reflected during the group discussions.
Business and operational issues: In Table 8 some of the reflections and ideas that vendors shared concerning the business-related themes and components proposed for the SFVM are presented. The inclusion of licensing and granting of a COA seems to be important to include in a business and operational component of the SFVM. The reason being that most participants were not in possession of any form of licensing and were keen to know where to go, what process is involved, and how long this would take.
Tab. 8. Vendors’ perceptions of the proposed business and operation’s component of a street food vending model. Vendors commented on the fact that inspectors come to their premises asking for a food license, but do not always explain the process of applying for a license. Similarly, in Cameroon, the lack of certification of SF vendors, suggests that amid the fast-growing SF sector, it is of great importance for the urban councils to make the SF vendors an essential part of local plans. As Acho-Chi [13] [page137] mentioned, this is “to encourage a competitive modern urban delivery system”. In such a system, licensing would be an essential component.
The group discussions showed that vendors regarded business guidelines as important and they liked the idea of doing research before starting a business. Of the vendors who participated in the discussions, 57% started their business because they were unemployed and needed a means of income. Therefore, they did not give much consideration to the facts and challenges involved in SF vending; they simply seized the opportunity. Though, in retrospect, they recognized that research beforehand might have been very helpful, particularly regarding location, safety, and foot traffic.
Another item of great interest to vendors was the financial considerations. One vendor strongly felt that one should save money before starting a business, “If I can just try to save because there is nowhere to go for financial support.” They were very keen to know whether there was any financial support available to vendors and what the process involved. Regarding buying food items wholesale, there were aspects that the proposed model did not consider. For example, vendors do not have the money to purchase large amounts of stock, and the perishable stock was a risk since the vendor could lose much through spoilage if the business were slow. Vendors were, however, very open to the idea of starting a vendor-purchasing club, i.e. buying wholesale as a group, and saving in this manner.
Regarding attracting clientele, most vendors rely on rapport with their clients. They indicated that it was important to make the stall look attractive and to be friendly to one’s clients. Also, regarding the general look and feel of the business operation, being clean, welcoming, and attractive. The participating vendors, although some kept logbooks, did not understand the necessity for keeping records. The comments and reflections in Table 7 attest to the importance of a business component in a model that wishes to facilitate SF vending operations. This component should consider guidelines regarding laws and regulation, basic market research, financial implications and available support, and other operational issues such as purchasing of stock and equipment, storage, and record-keeping.
Food and nutrition: The discussion on the nutrition theme invited some scepticism from vendors as is reflected by some quotations in Table 9 regarding selling healthy foods.
Tab. 9. Vendors’ perceptions of the proposed food and nutrition component of a street food vending model. Vendors believed that many SF consumers would prefer unhealthy foods. However, some vendors indicated that some of their clients do not want fatty and/or salty foods (Table 9) reflecting two types of consumers. Those who are conscious of what they consume and those who are either not conscious thereof or do not consider this important. Some vendors appeared to be open to trying healthier ways of preparing foods if they were provided with information and support in this regard.
Portion size was another obstacle that was identified, as consumers want value for their money. Vendors want to retain their clientele, so they serve large portions. Nutrition education is likely to be a bridging strategy in this regard to improve nutrition knowledge of vendors and consumers and to create an enabling environment and make healthier choices possible.
Hygiene and safety: A few comments regarding the hygiene components are reflected in Table 10.
Tab. 10. Vendors’ perceptions of the proposed hygiene and safety component of a street food vending model. Most vendors were not familiar with the Five Keys to Safer Foods, which were identified as being an integral part of environmental health by the DoEH officials. Only three vendors had seen these. One at her previous workplace, one had the guidelines in the stall she was renting, and the third vendor learnt about these at a workshop presented by the Cape Peninsula University of Technology. Only two vendors recalled receiving training with regards to hygiene. The reflections in Table 10 attest to the fact that there is a gap in hygiene knowledge and training, which would be key to improving hygiene practices.
Basic facilities: A well-equipped vending cart is proposed as an essential aspect of SF vending if no basic facilities are available (Table 11). Such a recommendation was also made following a study in Kumba, Cameroon, suggesting the introduction of suitable modern preservation technologies. For example, affordable refrigeration and heating units which would enable the storage and reheating of leftover foods, since food losses were found to be a common occurrence, owing to low demand and/or poor quality. Furthermore, with reliable heating and cooling facilities, SF vendors would be able to improve their income [13].
Tab. 11. Vendors’ perceptions of the basic facilities component of a street food vending model. Vendors indicated that the cart would be an asset for someone starting up a SF business, and not necessarily for someone who is already operating with a container or stall which is provided by the local authorities. However, when it came to financing the cart, they were very wary. They first wanted to see the final product and be informed about the terms of payment. Vendors also had some concerns around the vending cart regarding the storage, its transportation and the refuse container on the cart attracting flies. This proposed component would require further exploration and piloting in the field before additional recommendations can be made.
Step 3: Developing the street food vending model
In Fig 2, the process followed in developing the SFVM within the socioecological theoretical framework is depicted.
Fig. 2. How the data sources influenced the development of the street food model. The street food vending model components: From the findings of the previous phases and the integration of data in Table 1, the components of the proposed model can be divided into four areas, i.e. a business component, a food and nutrition component, a hygiene component, and a vending cart (Fig 3). These four areas, in turn, influence various areas of the socioecological framework, namely, intrapersonal/individual and interpersonal factors, the physical environment/community as well as the policy environment.
Fig. 3. The proposed street food model with its tools [tools available upon request from corresponding author]. Sustaining any public health effort requires not only addressing the individual and their practices but also the context in which they live [33]. The guidelines provided here have been made as generic as possible to be useful to those in low - and middle-income countries and are visually depicted in Fig 3.
Business guidelines: The findings of the previous phases necessitate basic operational guidelines that will ensure good (legal) practice. The data showed that most vendors practised without any form of licensing or certification. Research from earlier phases showed that many vendors worked long hours, up to seven days a week, but still made less than R1 000 (71 USD) per week. Few vendors made use of a log book or inventory. Instead of buying at wholesalers in bulk, vendors made use of supermarkets or similar shops hence reducing their profits. Many carried their money in their pocket instead of keeping it in a safe place.
Thus, it is proposed that the business operation guidelines consisting of 12 concise messages be introduced to potential vendors looking to start a food vending business as well as to existing vendors. The 12 messages are, to do research; start-up finance; food type/s to sell; contact the DoED re: laws applying to street vendors; obtaining a business license/certificate; the vending cart/unit/stand; storage area for inventory and cart; purchasing wholesale; attracting clientele; promoting the business; keeping log books; safeguarding money.
Food and nutrition guidelines: Findings from the surveys of SF vendors and consumers indicated that most vendors sell packaged snacks, sweets, and sweetened beverages [9, 20]. Many consumers also purchased cooked foods [9]. The survey results also showed that vendors and consumers had poor nutrition knowledge. Basic food and nutrition guidelines can empower the vendors, providing knowledge, and thus enabling them to make better decisions concerning the food they sell and foods available at their homes. The South African food-based based dietary guidelines (FBDG) are recommended as a reference source for SF vendors (Table 12). These FBDG have been specifically designed. They are “short, positive, science-based messages that aim to change the eating behaviour of the general population towards more optimal diets that meet energy and nutrient requirements, while simultaneously helping to protect against the development of non-communicable diseases” [34].
Tab. 12. Revised general food-based dietary guidelines for South Africans. The hygiene component: The findings of the SF vendor survey indicated that hygiene and food safety were not optimal [9, 20]. Interviews with key informants from the DoEH indicated that this Department makes use of the Five Keys to Safer Food [32] to ensure food safety. During the document review phase, guidelines for conducting a food-vending business (Hawking in meals, 9 [31]) were obtained, which can be used in conjunction with the Five Keys to Safer Food [32].
The proposed street food vending cart: The vendor survey highlighted the lack of facilities available to SF vendors as did key informants. So, a mobile cart which adheres to basic requirements, as stipulated by the key informants (especially regarding size and applicable bylaws), as well as the guidelines for conducting a food vending business, should inform the design of a SF vending cart.
The resources outlined, i.e. business guidelines, nutrition guidelines, hygiene guidelines and a proposed cart can either be offered to the vendors as a package/toolkit, with or without training. Both existing and new vendors could access the entire toolkit or parts thereof as required.
Discussion
Literature indicate that numerous uneducated, those with a low-level education as well as unemployed individuals, often women, find street vending a plausible way to earn money, with little monetary investment necessary [3, 8]. In phase one of this study the vendor survey concluded that SF vendors in the Cape Town and surrounding areas work long hours, up to seven days a week, and only make a minimal income. The types of food items sold by vendors, their nutrition knowledge and their hygiene practices were not ideal. Findings also highlighted the vendors’ struggle because of the lack of basic facilities and services, so essentially operating in a non-conducive (disabling) environment. An environment that enables unhygienic practices. Similarly, findings from Ghana conveyed that the settings where food vending is commonly practiced are scarcely resourced with low environmental and sanitary standards posing a major threat to food safety [35]. Bhowmik, (2005) [36] reported that vendors generally do not make much profit and as a result they tend to be mobile in the hope of finding better markets and increasing profits.
Concerning the nutritional value of food, the cooked foods sold as reflected in the literature are culturally-based dishes and not considered that unhealthy [35, 37–41]. However, the reviewed literature did not refer to packaged snacks, such as chips/crisps and sweets, which were popular items sold by the vendors who partook in the phase one survey.
The main findings of the consumer survey (phase one) indicated that people consume SF frequently (2–3 times per week). They spend a significant amount of their income on SF, and they are open to buying healthier options should these be available for purchasing. Thus, one could assume that should healthy SF be available [at a reasonable price], SF consumers would access these. Consumers’ nutrition knowledge, however, was not ideal. These findings resound findings from previous studies which reported that in developing countries, households which fall into the lower-income category spend up to 50–70% of household income on SF [11]. Chakravarty and Canet, (1996) [42] suggested SF as possibly the most affordable method of finding a nutritionally well-balanced meal option outside of the home environment. However, they added that the consumer should be educated and capable of choosing a healthy meal.
In phase two, key insights from government officials from the Departments of Environmental Health and Economic Development were that SF-vending business should be guided by the national legislature as well as by provincial bylaws. Government officials also strongly recognised the need for vendor and consumer education. For vendors, nutrition and hygiene as well as awareness of regulations for SF vending were emphasised, while health, food and nutrition education were considered important for consumers specifically. In a study conducted in Calcutta, vendors shared the desire to adhere to regulations, even though they were unaware of stipulated food regulations and had no training in food and nutrition. The vendors appreciated the fact that in order for the SF sector to be acknowledged and licensed they would have to comply with the specified regulations and guidelines as well as be open to inspection and food sampling [42], as is the case in this study. A study in Nairobi also recognised a lack of training in food preparation and hygiene practices and thus recommended the institution of SF centres with adequate facilities, training of SF vendors on hygiene as well as setting up a code of conduct for the SF trade [43].
The three phases and three distinct participant categories in this study allowed the research objectives to be explored from various perspectives. Themes from qualitative data echoed the findings of the survey data, such as the aspects pertaining to the business operation of the SF vendors, challenges faced by vendors as well as nutrition and hygiene. Discrepancies were also recognised in the data between key informants and vendors. Key informants felt that certification and licensing are relatively simple, and that support is available to vendors. However, survey results showed most vendors were unlicensed and without any form of certification, and it was noted in their challenges as something they find difficult and with which they would need assistance.
The data from the first two phases and step one and two of phase three were integrated within a socio-ecological framework to develop the proposed SFVM (step 3). The socio-ecological model represents a comprehensive approach to designing, implementing and evaluating interventions which target multiple influences on behaviour [27]. The components of the proposed model are divided into four areas, i.e. a business component, a food and nutrition component, a hygiene component and a vending cart. These four areas, in turn, impact on various areas of the socio-ecological framework, i.e. intrapersonal/individual, interpersonal, the physical environment/community as well as the policy environment as displayed in Fig 3. A proposed tool has been drafted for each component, which would need further development, research and evaluation (Tools available on request from author).
Conclusion
In literature regarding SF, hygiene considerations are often the most important issues at hand, while the nutritional aspect of foods, the business operation and the guiding legislation are often overlooked. The literature readily acknowledges the contribution that the SF trade has on the economy but fails to explore how one could go about improving the trade and growing the vendors’ knowledge and skills. This research study thus embarked on developing a SFVM that would entail nutrition, hygiene and safety, and business and operational aspects of street-food vending. This was done within a socio-ecological framework, which considers an individual as part of a greater whole. Important elements such as the individual’s physical environment, the policy environment and also basics such as the individual’s knowledge and ‘support’ environment is considered.
This proposed SFVM will hopefully be taken forward, piloted, and adapted as needed to improve the SF-vending trade. Eventually it is endeavoured to not only make the SF trade more lucrative, the vendor more knowledgeable and aware, but also to make the product sold a healthier one. In turn, this should improve the overall nutrition and health of consumers who frequently purchase SF.
Limitations
Although this was a mixed-methodology study, which enabled a broader contextual appreciation, understanding the vending operation from the ground (the vendor) as well as from the user (the consumer) and from a regulatory point of view (government/municipal officials). The integration step in this study which was the main focus of this paper remain a qualitative process, in which bias cannot be totally excluded.
Supporting information
Zdroje
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- Switching to bedaquiline for treatment of rifampicin-resistant tuberculosis in South Africa: A retrospective cohort analysis
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- The cost of illness and economic burden of endometriosis and chronic pelvic pain in Australia: A national online survey
- Refined distributed emotion vector representation for social media sentiment analysis
- Enhancing timeliness of drug overdose mortality surveillance: A machine learning approach
- A real-time gesture recognition system using near-infrared imagery
- Alcohol use and its association with sexual risk behaviors in the Armed Forces of the Republic of the Congo
- Improved survival rates in patients with H1N1 acute respiratory failure in Korea between 2009 and 2016
- Electroencephalographic features of discontinuous activity in anesthetized infants and children
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- Mutant prevention concentration of ozenoxacin for quinolone-susceptible or -resistant Staphylococcus aureus and Staphylococcus epidermidis
- The Echobot: An automated system for stimulus presentation in studies of human echolocation
- Evaluation of clinical manifestations, health risks, and quality of life among women with polycystic ovary syndrome
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- Agrobacterium tumefaciens-mediated transformation of a hevein-like gene into asparagus leads to stem wilt resistance
- Effect of a Mentor Mother Programme on retention of mother-baby pairs in HIV care: A secondary analysis of programme data in Uganda
- Utilizing multiplex fluor LAMPs to illuminate multiple gene expressions in situ
- Genetic relationships between the RACK1 homolog cpc-2 and heterotrimeric G protein subunit genes in Neurospora crassa
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- A comparison of the risk of congestive heart failure-related hospitalizations in patients receiving hemodialysis and peritoneal dialysis - A retrospective propensity score-matched study
- A tailored approach to fusion transcript identification increases diagnosis of rare inherited disease
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- The Nordic Maintenance Care Program: Does psychological profile modify the treatment effect of a preventive manual therapy intervention? A secondary analysis of a pragmatic randomized controlled trial
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- Comparison of conventional BLUP and single-step genomic BLUP evaluations for yearling weight and carcass traits in Hanwoo beef cattle using single trait and multi-trait models
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- Molecular phylogeny and morphology reveal a new epiphytic species of Habenaria (Orchidaceae; Orchideae; Orchidinae) from Nepal
- Nitrogen nutrition is a key modulator of the sugar and organic acid content in citrus fruit
- Understanding variation in health service coverage and maternal health outcomes among districts in Rwanda – A qualitative study of local health workers’ perceptions
- Biased cognition in East Asian and Western cultures
- Physical fitness and physical self-concept of male and female young adults in Qatar
- Robust policy evaluation from large-scale observational studies
- Improved semi-supervised autoencoder for deception detection
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- Are spasticity, weakness, selectivity, and passive range of motion related to gait deviations in children with spastic cerebral palsy? A statistical parametric mapping study
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- Conspicuous and cryptic reef fishes from a unique and economically important region in the northern Red Sea
- Time scale of resilience loss: Implications for managing critical transitions in water quality
- Effectiveness of physical and cognitive-behavioural intervention programmes for chronic musculoskeletal pain in adults: A systematic review and meta-analysis of randomised controlled trials
- Relationship between feed efficiency indexes and performance, body measurements, digestibility, energy partitioning, and nitrogen partitioning in pre-weaning dairy heifers
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- Evidence of ritual breakage of a ground stone tool at the Late Natufian site of Hilazon Tachtit cave (12,000 years ago)
- Whole genome sequencing to identify predictive markers for the risk of drug-induced interstitial lung disease
- A systematic review and thematic synthesis of Canada’s LGBTQ2S+ employment, labour market and earnings literature
- The occurrence of ‘Sleeping Beauty’ publications in medical research: Their scientific impact and technological relevance
- Analysis of the protein composition of the spindle pole body during sporulation in Ashbya gossypii
- Assessing undergraduate student and faculty views on animal research: What do they know, whom do they trust, and how much do they care?
- The views and experiences of general dental practitioners (GDP’s) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research
- Compare HIV/syphilis infections between age groups and explore associated factors of HIV/syphilis co-infections among men who have sex with men in Shenzhen, China, from 2009 to 2017
- Ceftiofur formulation differentially affects the intestinal drug concentration, resistance of fecal Escherichia coli, and the microbiome of steers
- Effect of exclusive breastfeeding cessation time on childhood morbidity and adverse nutritional outcomes in Ethiopia: Analysis of the demographic and health surveys
- Dual antiplatelet therapy in patients with cirrhosis and acute myocardial infarction – A 13-year nationwide cohort study
- Relationships between electrolyte and amino acid compositions in sweat during exercise suggest a role for amino acids and K+ in reabsorption of Na+ and Cl- from sweat
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- Anabolic steroids among resistance training practitioners
- Factors associated with unsafe abortion practices in Nepal: Pooled analysis of the 2011 and 2016 Nepal Demographic and Health Surveys
- New methods of removing debris and high-throughput counting of cyst nematode eggs extracted from field soil
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- What has reproductive health decision-making capacity got to do with unintended pregnancy? Evidence from the 2014 Ghana Demographic and Health Survey
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- Penetration of linezolid into bone tissue 24 h after administration in patients with multidrug-resistant spinal tuberculosis
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- The accumulation of deficits approach to describe frailty
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- Turing complete neural computation based on synaptic plasticity
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- Correction: Perspectives of general dental practitioners on preventive, patient-centred, and evidence-based oral healthcare—A Q-methodology study
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- Patient navigation services for cancer care in low-and middle-income countries: A scoping review
- Weather extremes and perinatal mortality – Seasonal and ethnic differences in northern Sweden, 1800-1895
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- Extensive culturomics of 8 healthy samples enhances metagenomics efficiency
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- Correction: Low dose naltrexone: Effects on medication in rheumatoid and seropositive arthritis. A nationwide register-based controlled quasi-experimental before-after study
- Correction: Human indole(ethyl)amine-N-methyltransferase (hINMT) catalyzed methylation of tryptamine, dimethylsulfide and dimethylselenide is enhanced under reducing conditions - A comparison between 254C and 254F, two common hINMT variants
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- Determinants of temperature sensitivity of soil respiration with the decline of a foundation species
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- Sex affects immunolabeling for histone 3 K27me3 in the trophectoderm of the bovine blastocyst but not labeling for histone 3 K18ac
- A survey of public attitudes toward uterus transplantation, surrogacy, and adoption in Japan
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- Environmental conditions for Jamestown Canyon virus correlated with population-level resource selection by white-tailed deer in a suburban landscape
- The contribution of linear perspective cues and texture gradients in the perceptual rescaling of stimuli inside a Ponzo illusion corridor
- Cerebral blood flow imbalance is associated with motor outcome after pediatric arterial ischemic stroke
- Particularly neglected in countries with other challenges: High Toxoplasma gondii seroprevalence in pregnant women in Kabul, Afghanistan, while a low proportion know about the parasite
- Implementing advance care planning in routine nursing home care: The development of the theory-based ACP+ program
- Identifying genetic lineages through shape: An example in a cosmopolitan marine turtle species using geometric morphometrics
- The causality of borrowing: Lexical loans in Eurasian languages
- The uptake of the pharmacy-dispensed naloxone kit program in Ontario: A population-based study
- Gaze and body cues interplay during interactive requests
- Acetylcholine-mediated top-down attention improves the response to bottom-up inputs by deformation of the attractor landscape
- Deep architectures for long-term stock price prediction with a heuristic-based strategy for trading simulations
- Vaccination status of patients using anti-TNF therapy and the physicians’ behavior shaping the phenomenon: Mixed-methods approach
- Organizational justice and illness reporting among Japanese employees with chronic diseases
- CavBench: A benchmark for protein cavity detection methods
- Antimicrobial resistance (AMR) and molecular characterization of Neisseria gonorrhoeae in Ghana, 2012-2015
- Prevalence of methicillin-resistant Staphylococcus aureus in healthy Chinese population: A system review and meta-analysis
- Suppression treatment differentially influences the microbial community and the occurrence of broad host range plasmids in the rhizosphere of the model cover crop Avena sativa L.
- Risk of pneumonia among residents living near goat and poultry farms during 2014-2016
- Lipid levels after childbirth and association with number of children: A population-based cohort study
- Birth outcomes in women who have taken adalimumab in pregnancy: A prospective cohort study
- ECMO with vasopressor use during early endotoxic shock: Can it improve circulatory support and regional microcirculatory blood flow?
- Effects of dietary intake and nutritional status on cerebral oxygenation in patients with chronic kidney disease not undergoing dialysis: A cross-sectional study
- Micro-RNA 150-5p predicts overt heart failure in patients with univentricular hearts
- Flexible learning spaces facilitate interaction, collaboration and behavioural engagement in secondary school
- Clinical significance and prognostic role of hypoxia-induced microRNA 382 in gastric adenocarcinoma
- Genome-wide investigation of superoxide dismutase (SOD) gene family and their regulatory miRNAs reveal the involvement in abiotic stress and hormone response in tea plant (Camellia sinensis)
- Classifying recurrent Mycobacterium tuberculosis cases in Georgia using MIRU-VNTR typing
- Prevalence of Trypanosoma cruzi infection in active military population of The Colombian National Army gathered in five departments
- An observational study comparing HPV prevalence and type distribution between HPV-vaccinated and -unvaccinated girls after introduction of school-based HPV vaccination in Norway
- Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma
- Increased aggression and reduced aversive learning in honey bees exposed to extremely low frequency electromagnetic fields
- Attending to design when developing complex health interventions: A qualitative interview study with intervention developers and associated stakeholders
- Increased fecundity of Aphis fabae on Vicia faba plants following seed or leaf inoculation with the entomopathogenic fungus Beauveria bassiana
- Is summer food intake a limiting factor for boreal browsers? Diet, temperature, and reproduction as drivers of consumption in female moose
- Characterization of sound scattering layers in the Bay of Biscay using broadband acoustics, nets and video
- Conducting human challenge studies in LMICs: A survey of researchers and ethics committee members in Thailand
- eNOS-NO-induced small blood vessel relaxation requires EHD2-dependent caveolae stabilization
- Clinical use of SAND battery to evaluate language in patients with Progressive Supranuclear Palsy
- The interplay of personality and attitudes toward own aging across two decades of later life
- Robust automated reading of the skin prick test via 3D imaging and parametric surface fitting
- Reconstructing the population history of the sandy beach amphipod Haustorioides japonicus using the calibration of demographic transition (CDT) approach
- A psychoacoustic application for the adjustment of electrical hearing thresholds in cochlear implant patients
- Correction: Blue light-dependent human magnetoreception in geomagnetic food orientation
- Re-evaluation of a Tn5::gacA mutant of Pseudomonas syringae pv. tomato DC3000 uncovers roles for uvrC and anmK in promoting virulence
- Sugar-sweetened beverages and colorectal cancer risk in the California Teachers Study
- Illuminating biological pathways for drug targeting in head and neck squamous cell carcinoma
- The impact of shared knowledge on speakers’ prosody
- Effects of insecticides, fipronil and imidacloprid, on the growth, survival, and behavior of brown shrimp Farfantepenaeus aztecus
- Prevalence of pectus excavatum (PE), pectus carinatum (PC), tracheal hypoplasia, thoracic spine deformities and lateral heart displacement in thoracic radiographs of screw-tailed brachycephalic dogs
- Validation of the vignette-based German Exercise Causality Orientation Scale (G-ECOS)
- Hierarchical classification of snowmelt episodes in the Pyrenees using seismic data
- A national survey of videolaryngoscopes and alternative intubation devices in Hungary
- The relevance of U.S. Strategic Highway Safety Plans in a future context
- Inhaled nebulized glatiramer acetate against Gram-negative bacteria is not associated with adverse pulmonary reactions in healthy, young adult female pigs
- Anti-inflammatory effects induced by ultralow concentrations of bupivacaine in combination with ultralow concentrations of sildenafil (Viagra) and vitamin D3 on inflammatory reactive brain astrocytes
- Access to unauthorized hepatitis C generics: Perception and knowledge of physicians, pharmacists, patients and non-healthcare professionals
- Urban commuting dynamics in response to public transit upgrades: A big data approach
- Intestinal mucosal injury induced by obstructive jaundice is associated with activation of TLR4/TRAF6/NF-κB pathways
- When resolution does matter: Modelling indirect contacts in dairy farms at different levels of detail
- Molecular epidemiology of Mycoplasma hyorhinis porcine field isolates in the United States
- Liquorice ingestion attenuates vasodilatation via exogenous nitric oxide donor but not via β2-adrenoceptor stimulation
- Adolescents living with HIV are at higher risk of death and loss to follow up from care: Analysis of cohort data from eight health facilities in Ethiopia
- Identification of social relation within pedestrian dyads
- Blood donation and health status based on SF-36: The mediating effect of cognition in blood donation
- The cost-effectiveness of controlling cervical cancer using a new 9-valent human papillomavirus vaccine among school-aged girls in Australia
- Inactivation of chronic wasting disease prions using sodium hypochlorite
- Analysing linear multivariate pattern transformations in neuroimaging data
- Ecological aesthetic assessment of a rebuilt wetland restored from farmland and management implications for National Wetland Parks
- A method for predicting background advertisement exposure parameters in sporting events: Televised football game approach
- Self-reported and experimentally induced self-disgust is heightened in Parkinson’s disease: Contribution of behavioural symptoms
- Associations between nocturnal sleep duration, midday nap duration and body composition among adults in Southwest China
- Short-term effects of video gaming on brain response during working memory performance
- Molecular detection and genetic characterization of Bartonella species from rodents and their associated ectoparasites from northern Tanzania
- Estimation of the number of HCV-positive patients in Italy
- Comparative cost analysis of point-of-care versus laboratory-based testing to initiate and monitor HIV treatment in South Africa
- Insights into the behavior of six rationally designed peptides based on Escherichia coli’s OmpA at the water-dodecane interface
- Identification of muscle-specific candidate genes in Simmental beef cattle using imputed next generation sequencing
- A game theoretic setting of capitation versus fee-for-service payment systems
- In utero exposure to economic fluctuations and birth outcomes: An analysis of the relevance of the local unemployment rate in Brazilian state capitals
- QTL mapping for aluminum tolerance in RIL population of soybean (Glycine max L.) by RAD sequencing
- Establishing an infrastructure for collaboration in primate cognition research
- Evaluation of left ventricular dimension and systolic function by standard transthoracic echocardiography before and 24-hours after percutaneous closure of patent ductus arteriosus in 120 dogs
- Modeling environmental variability and network formation among pastoral nomadic households: Implications for the rise of the Mongol Empire
- Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study
- Correction: Homology analysis of malware based on ensemble learning and multifeatures
- Illness beliefs and emotional responses in mildly disabled stroke survivors: A qualitative study
- Extended-wavelength diffuse reflectance spectroscopy with a machine-learning method for in vivo tissue classification
- Modeling the natural history of fatty liver using lifestyle–related risk factors: Effects of body mass index (BMI) on the life–course of fatty liver
- Development of a recombinant replication-deficient rabies virus-based bivalent-vaccine against MERS-CoV and rabies virus and its humoral immunogenicity in mice
- Educational achievement at age 9.5 years of children born to mothers maintained on methadone during pregnancy
- Comparative transcriptome analysis of galls from four different host plants suggests the molecular mechanism of gall development
- Experiences with peer support for breastfeeding in Beirut, Lebanon: A qualitative study
- Elucidating optical field directed hierarchical self-assembly of homogenous versus heterogeneous nanoclusters with femtosecond optical tweezers
- Structure establishment of three-dimensional (3D) cell culture printing model for bladder cancer
- Elevated serum alpha-1 antitrypsin is a major component of GlycA-associated risk for future morbidity and mortality
- Correction: Functional atlases for analysis of motor and neuropsychological outcomes after medial globus pallidus and subthalamic stimulation
- Correction: Estimating Body Composition in Adolescent Sprint Athletes: Comparison of Different Methods in a 3 Years Longitudinal Design
- Quality of labor and birth care in Sindh Province, Pakistan: Findings from direct observations at health facilities
- A comparison of sLASER and MEGA-sLASER using simultaneous interleaved acquisition for measuring GABA in the human brain at 7T
- Urinary Activin A is a novel biomarker reflecting renal inflammation and tubular damage in ANCA-associated vasculitis
- Intrabladder pressure as predictor of intra-abdominal pressure in horses
- Pollock avoided hydrodynamic instabilities to paint with his dripping technique
- Metabolomic analysis of the occurrence of bitter fruits on grafted oriental melon plants
- Photo-degradation dynamics of five neonicotinoids: Bamboo vinegar as a synergistic agent for improved functional duration
- Use of acoustic emission to identify novel candidate biomarkers for knee osteoarthritis (OA)
- Cetacean biodiversity, spatial and temporal trends based on stranding records (1920-2016), Victoria, Australia
- Neutrophil elastase inhibitor purification strategy from cowpea seeds
- Correction: Hafting of Middle Paleolithic tools in Latium (central Italy): New data from Fossellone and Sant’Agostino caves
- Coherent poly propagation materials with 3-dimensional photonic control over visible light
- Characterization of Worldwide Olive Germplasm Banks of Marrakech (Morocco) and Córdoba (Spain): Towards management and use of olive germplasm in breeding programs
- Can non-pharmacological interventions reduce hospital admissions in people with dementia? A systematic review
- Metarhizium robertsii ammonium permeases (MepC and Mep2) contribute to rhizoplane colonization and modulates the transfer of insect derived nitrogen to plants
- Genotyping and antimicrobial resistance of Streptococcus uberis isolated from bovine clinical mastitis
- Isotopic compositions of ground ice in near-surface permafrost in relation to vegetation and microtopography at the Taiga–Tundra boundary in the Indigirka River lowlands, northeastern Siberia
- Financial inclusion and intimate partner violence: What does the evidence suggest?
- Are intestinal helminths playing a positive role in tuberculosis risk? A systematic review and meta-analysis
- Single-cell qPCR demonstrates that Repsox treatment changes cell fate from endoderm to neuroectoderm and disrupts epithelial-mesenchymal transition
- Defective base excision repair in the response to DNA damaging agents in triple negative breast cancer
- Take one step backward to move forward: Assessment of genetic diversity and population structure of captive Asian woolly-necked storks (Ciconia episcopus)
- Money doesn’t matter! Householders’ intentions to reduce standby power are unaffected by personalised pecuniary feedback
- Validating a scale to measure engineers’ perceived self-efficacy for engineering education outreach
- Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder
- Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study
- Inter-method and anatomical correlates of episodic memory tests in the Alzheimer’s Disease spectrum
- Knowledge, attitudes and medical practice regarding hepatitis B prevention and management among healthcare workers in Northern Vietnam
- Development and validation of a symptom assessment tool for postmicturition dribble: A prospective, multicenter, observational study in Korea
- Identification of closely related Ixodes species by protein profiling with MALDI-TOF mass spectrometry
- When calculators lie: A demonstration of uncritical calculator usage among college students and factors that improve performance
- Socio-economic characteristics and career intentions of the WiSDOM health professional cohort in South Africa
- Correction: Neural computational model GrowthEstimate: A model for studying living resources through digestive efficiency
- Social proximity in dairy calves is affected by differences in pessimism
- Amphibian skin-associated Pigmentiphaga: Genome sequence and occurrence across geography and hosts
- Expanded consumer niche widths may signal an early response to spatial protection
- Moral grandstanding in public discourse: Status-seeking motives as a potential explanatory mechanism in predicting conflict
- Adipose stem cells in reparative goat mastitis mammary gland
- Seventy-five mosses and liverworts found frozen with the late Neolithic Tyrolean Iceman: Origins, taphonomy and the Iceman’s last journey
- Hyaluronic acid and epidermal growth factor improved the bovine embryo quality by regulating the DNA methylation and expression patterns of the focal adhesion pathway
- Associations among knowledge, attitudes, and practices toward palliative care consultation service in healthcare staffs: A cross-sectional study
- A novel, wearable, electronic visual aid to assist those with reduced peripheral vision
- Genetic diversity and population structure of the Mediterranean sesame core collection with use of genome-wide SNPs developed by double digest RAD-Seq
- Celecoxib enhances the sensitivity of non-small-cell lung cancer cells to radiation-induced apoptosis through downregulation of the Akt/mTOR signaling pathway and COX-2 expression
- Mobile health-based physical activity intervention for individuals with spinal cord injury in the community: A pilot study
- Factors influencing cultivated ginseng (Panax ginseng C. A. Meyer) bioactive compounds
- Estimation of soil pH with geochemical indices in forest soils
- Multiplexed editing of a begomovirus genome restricts escape mutant formation and disease development
- Correlates of longitudinal leukocyte telomere length in the Costa Rican Longevity Study of Healthy Aging (CRELES): On the importance of DNA collection and storage procedures
- Collaboration and followership: A stochastic model for activities in social networks
- Evaluating access to oral anti-diabetic medicines: A cross-sectional survey of prices, availability and affordability in Shaanxi Province, Western China
- Comparison of corneal elevation and pachymetry measurements made by two state of the art corneal tomographers with different measurement principles
- Use of a pressure-sensing walkway system for biometric assessment of gait characteristics in goats
- Current status and direct medical cost of amyotrophic lateral sclerosis in the region of Catalonia: A population-based analysis
- Engineering a single-chain antibody against Trypanosoma cruzi metacyclic trypomastigotes to block cell invasion
- Can work climate foster pro-environmental behavior inside and outside of the workplace?
- Gene editing of PKLR gene in human hematopoietic progenitors through 5’ and 3’ UTR modified TALEN mRNA
- Pelvic alignment changes during the perinatal period
- Interatrial blocks prevalence and risk factors for human immunodeficiency virus-infected persons
- Life-course trajectories of body mass index and subsequent cardiovascular risk among Chinese population
- Inhibitory interaction networks among coevolved Streptomyces populations from prairie soils
- Exploiting contextual information to improve call prediction
- Visual inputs decrease brain activity in frontal areas during silent lipreading
- The synergistic effects of TaAGP.L-B1 and TaSSIVb-D mutations in wheat lead to alterations of gene expression patterns and starch content in grain development
- Live-attenuated H1N1 influenza vaccine candidate displays potent efficacy in mice and ferrets
- Robust, real-time generic detector based on a multi-feature probabilistic method
- Maize leaves drought-responsive genes revealed by comparative transcriptome of two cultivars during the filling stage
- Xenon lamps used for fruit surface sterilization can increase the content of total flavonols in leaves of Lactuca sativa L. without any negative effect on net photosynthesis
- An alternative procedure to obtain the mortality rate with non-linear functions: Application to the case of the Spanish population
- Exosomes and STUB1/CHIP cooperate to maintain intracellular proteostasis
- Longitudinal assessment of post-surgical physical activity in endometrial and ovarian cancer patients
- THINGS: A database of 1,854 object concepts and more than 26,000 naturalistic object images
- Evaluation of ranibizumab and aflibercept for the treatment of diabetic macular edema in daily clinical practice
- Proteomic analysis of Escherichia coli detergent-resistant membranes (DRM)
- Correction: Effect of curcuminoids and curcumin derivate products on thioredoxin-glutathione reductase from Taenia crassiceps cysticerci. Evidence suggesting a curcumin oxidation product as a suitable inhibitor
- Correction: Predicting childhood obesity using electronic health records and publicly available data
- Correction: Estimating the value of tropical coastal wetland habitats to fisheries: Caveats and assumptions
- Correction: The effects of sympathetic activity induced by ice water on blood flow and brachial artery flow-mediated dilatation response in healthy volunteers
- Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing
- Supporting informed clinical trial decisions: Results from a randomized controlled trial evaluating a digital decision support tool for those with intellectual disability
- BMAL1 associates with chromosome ends to control rhythms in TERRA and telomeric heterochromatin
- Antimicrobial resistance genotypes and phenotypes of Campylobacter jejuni isolated in Italy from humans, birds from wild and urban habitats, and poultry
- Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography
- Early and long-term outcomes of coronary artery bypass surgery with and without use of heart-lung machine and with special respect to renal function - A retrospective study
- Analysis of determinants for in vitro resistance to the small molecule deubiquitinase inhibitor b-AP15
- The FTO genetic variants are associated with dietary intake and body mass index amongst Emirati population
- Expression of Concern: The Coordination of Cell Growth during Fission Yeast Mating Requires Ras1-GTP Hydrolysis
- Correction: Lentivirus-Mediated Knockdown of Astrocyte Elevated Gene-1 Inhibits Growth and Induces Apoptosis through MAPK Pathways in Human Retinoblastoma Cells
- Relationship between self-disclosure to first acquaintances and subjective well-being in people with schizophrenia spectrum disorders living in the community
- Remarkable cell recovery from cerebral ischemia in rats using an adaptive escalator-based rehabilitation mechanism
- Integrating environmental and neighborhood factors in MaxEnt modeling to predict species distributions: A case study of Aedes albopictus in southeastern Pennsylvania
- Post-overdose interventions triggered by calling 911: Centering the perspectives of people who use drugs (PWUDs)
- The prevalence of intimate partner violence among couples signing up for universally offered parent preparation
- Analysis of gear surface morphology based on gray level co-occurrence matrix and fractal dimension
- Abiotic, present-day and historical effects on species, functional and phylogenetic diversity in dry grasslands of different age
- Clonality analysis of pulmonary tumors by genome-wide copy number profiling
- A relictual troglomorphic harvestman discovered in a volcanic cave of western Argentina: Otilioleptes marcelae, new genus, new species, and Otilioleptidae, new family (Arachnida, Opiliones, Gonyleptoidea)
- HIV drug resistance in persons who inject drugs enrolled in an HIV prevention trial in Indonesia, Ukraine, and Vietnam: HPTN 074
- Dietary acid load significantly predicts 10-years survival in patients underwent coronary artery bypass grafting (CABG) surgery
- Regulation of nitrogen availability results in changes in grain protein content and grain storage subproteomes in barley (Hordeum vulgare L.)
- Diagnostic test evaluation methodology: A systematic review of methods employed to evaluate diagnostic tests in the absence of gold standard – An update
- Longitudinal trends of and factors associated with inappropriate antibiotic prescribing for non-bacterial acute respiratory tract infection in Japan: A retrospective claims database study, 2012–2017
- Revealing users’ experience and social interaction outcomes following a web-based smoking prevention intervention for adolescents: A qualitative study
- Coordination of human movements resulting in motor strategies exploited by skilled players during a throwing task
- Impact of pericardiectomy on exercise capacity and sleep of patients with chronic constrictive pericarditis
- Blue-violet light decreases VEGFa production in an in vitro model of AMD
- Identification of protein changes in the blood plasma of lung cancer patients subjected to chemotherapy using a 2D-DIGE approach
- Speed of processing training and depression in assisted and independent living: A randomized controlled trial
- Induced cardiomyocyte maturation: Cardiac transcription factors are necessary but not sufficient
- What happens in the brain of meditators when perception changes but not the stimulus?
- Comparison of HIV-1 Vif and Vpu accessory proteins for delivery of polyepitope constructs harboring Nef, Gp160 and P24 using various cell penetrating peptides
- Are degree of urbanisation and travel times to healthcare services associated with the processes of care and outcomes of heart failure? A retrospective cohort study based on administrative data
- A PDGFRβ-PI3K signaling axis mediates periosteal cell activation during fracture healing
- Influence of transcutaneous vagus nerve stimulation on cardiac vagal activity: Not different from sham stimulation and no effect of stimulation intensity
- Co-prescription network reveals social dynamics of opioid doctor shopping
- Contractile properties of superficial skeletal muscle affect postural control in healthy young adults: A test of the rambling and trembling hypothesis
- Does intrauterine crowding affect the force generating capacity and muscle composition of the piglet front limb?
- Correction: Measuring compassionate healthcare with the 12-item Schwartz Center Compassionate Care Scale
- Facilitators and barriers to traditional medicine use among cancer patients in Malawi
- Expression of CMV protein pp65 in cutaneous malignant melanoma
- The evolution of mental health outcomes across a combat deployment cycle: A longitudinal study of a Guam-based National Guard unit
- Caesarean section delivery and childhood obesity in a British longitudinal cohort study
- Incidence, characteristics, and mortality of infective endocarditis in France in 2011
- Pfcyp51 exclusively determines reduced sensitivity to 14α-demethylase inhibitor fungicides in the banana black Sigatoka pathogen Pseudocercospora fijiensis
- Evaluation of the bacterial ocular surface microbiome in clinically normal cats before and after treatment with topical erythromycin
- Histological and developmental insights into the herbivorous dentition of tapinocephalid therapsids
- Differential immunomodulation of T-cells by immunoglobulin replacement therapy in primary and secondary antibody deficiency
- A longitudinal study on perceived health in cardiovascular patients: The role of conscientiousness, subjective wellbeing and cardiac self-efficacy
- The effectiveness of interferon beta versus glatiramer acetate and natalizumab versus fingolimod in a Polish real-world population
- Interactions of Streptococcus suis serotype 9 with host cells and role of the capsular polysaccharide: Comparison with serotypes 2 and 14
- Honey bee and native solitary bee foraging behavior in a crop with dimorphic parental lines
- A flexible formula for incorporating distributive concerns into cost-effectiveness analyses: Priority weights
- Correction: Lack of association between hypothyroxinemia of prematurity and transient thyroid abnormalities with adverse long term neurodevelopmental outcome in very low birth weight infants
- A reconnaissance survey of farmers’ awareness of hypomagnesaemic tetany in UK cattle and sheep farms
- Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria
- Conformational flexibility of fork-remodeling helicase Rad5 shown by full-ensemble hybrid methods
- The increasing importance of fellowships and career development awards in the careers of early-stage biomedical academic researchers
- Occurrence and stability of hetero-hexamer associations formed by β-carboxysome CcmK shell components
- Auxin driven indoleamine biosynthesis and the role of tryptophan as an inductive signal in Hypericum perforatum (L.)
- Dynamic activation of Wnt, Fgf, and Hh signaling during soft palate development
- Distance to large rivers affects fish diversity patterns in highly dynamic streams of Central Amazonia
- Real vs. immersive-virtual emotional experience: Analysis of psycho-physiological patterns in a free exploration of an art museum
- Modulation of brain tumor risk by genetic SNPs in PARP1gene: Hospital based case control study
- Processed meat intake and chronic disease morbidity and mortality: An overview of systematic reviews and meta-analyses
- Modeling ENSO impact on rice production in the Mekong River Delta
- The feasibility of a behavioral group intervention after weight-loss surgery: A randomized pilot trial
- EMR-integrated minimal core dataset for routine health care and multiple research settings: A case study for neuroinflammatory demyelinating diseases
- A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital
- Increased BMI has a linear association with late-onset preeclampsia: A population-based study
- Autoantibody production significantly decreased with APRIL/BLyS blockade in murine chronic rejection kidney transplant model
- Vancomycin-resistance gene cluster, vanC, in the gut microbiome of acute leukemia patients undergoing intensive chemotherapy
- Telomere length in COPD: Relationships with physical activity, exercise capacity, and acute exacerbations
- Mutual role of ecto-5'-nucleotidase/CD73 and concentrative nucleoside transporter 3 in the intestinal uptake of dAMP
- Impact of faecal calprotectin measurement on clinical decision-making in patients with Crohn’s disease and ulcerative colitis
- Additive effects of a small molecular PCNA inhibitor PCNA-I1S and DNA damaging agents on growth inhibition and DNA damage in prostate and lung cancer cells
- Autophagy is important to the acidogenic metabolism of Aspergillus niger
- Continuous ratings of movie watching reveal idiosyncratic dynamics of aesthetic enjoyment
- Sensitivity and specificity of serum soluble interleukin-2 receptor for diagnosing sarcoidosis in a population of patients suspected of sarcoidosis
- Enhancing genomic selection by fitting large-effect SNPs as fixed effects and a genotype-by-environment effect using a maize BC1F3:4 population
- Quantitation and modeling of post-translational modifications in a therapeutic monoclonal antibody from single- and multiple-dose monkey pharmacokinetic studies using mass spectrometry
- Microbial induced solidification and stabilization of municipal solid waste incineration fly ash with high alkalinity and heavy metal toxicity
- Extracellular vesicles in human semen modulate antigen-presenting cell function and decrease downstream antiviral T cell responses
- A fault-tolerant aware scheduling method for fog-cloud environments
- Correction: BCG vaccination and tuberculosis prevention: A forty years cohort study, Monastir, Tunisia
- Correction: Perceptions among transgender women of factors associated with the access to HIV/AIDS-related health services in Yogyakarta, Indonesia
- Assessing the convergent validity between the automated emotion recognition software Noldus FaceReader 7 and Facial Action Coding System Scoring
- Deep learning based banana plant detection and counting using high-resolution red-green-blue (RGB) images collected from unmanned aerial vehicle (UAV)
- Comparison of cardiorespiratory fitness between preschool children with normal and excess body adipose ~ An observational study
- Intraregional differences in renal function in the Northern Netherlands: The Lifelines Cohort Study
- Effects of MCHM on yeast metabolism
- Signaling impacts of GMO labeling on fruit and vegetable demand
- Dietary specialization depending on ecological context and sexual differences in Asiatic black bears
- Electronic device use and beverage related sugar and caffeine intake in US adolescents
- Isolation and characterization of five novel probiotic strains from Korean infant and children faeces
- Correction: Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: A randomized, double-blind, placebo controlled trial
- Correction: Anatomical analysis of antebrachial cutaneous nerve distribution pattern and its clinical implications for sensory reconstruction
- Endothelial nitric oxide synthase limits host immunity to control disseminated Candida albicans infections in mice
- Lack of detection of Candida nivariensis and Candida bracarensis among 440 clinical Candida glabrata sensu lato isolates in Kuwait
- Nonlinear dynamics captures brain states at different levels of consciousness in patients anesthetized with propofol
- Visual encounters on line transect surveys under-detect carnivore species: Implications for assessing distribution and conservation status
- Menstrual health communication among Indian adolescents: A mixed-methods study
- Fast fluorescence in situ hybridisation for the enhanced detection of MET in non-small cell lung cancer
- The influence of personality on the effect of iTBS after being stressed on cortisol secretion
- Parental and peer support and modelling in relation to domain-specific physical activity participation in boys and girls from Germany
- Oral delivery of water-soluble compounds to the phytoseiid mite Neoseiulus californicus (Acari: Phytoseiidae)
- Force perceptual bias caused by muscle activity in unimanual steering
- Correction: Comparison of risk models for mortality and cardiovascular events between machine learning and conventional logistic regression analysis
- Correction: Genetic variants linked to myopic macular degeneration in persons with high myopia: CREAM Consortium
- Providencia entomophila sp. nov., a new bacterial species associated with major olive pests in Tunisia
- Safety of intravitreal ziv-aflibercept in choroido-retinal vascular diseases: A randomised double-blind intervention study
- A novel framework for evaluating the impact of individual decision-making on public health outcomes and its potential application to study antiviral treatment collection during an influenza pandemic
- Reduction of the rocuronium-induced withdrawal reflex by MR13A10A, a generic rocuronium with a novel solution: A randomized, controlled study
- Emotionally expressed voices are retained in memory following a single exposure
- Megabenthic communities of the Ligurian deep continental shelf and shelf break (NW Mediterranean Sea)
- Election forensics: Using machine learning and synthetic data for possible election anomaly detection
- A randomized crossover trial comparing the Nifty cup to a medicine cup in preterm infants who have difficulty breastfeeding at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana
- The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease
- Genomic impact of severe population decline in a nomadic songbird
- Evolution of high-sensitivity troponin-T and echocardiography parameters in patients undergoing high efficiency on-line hemodiafiltration versus conventional low-flux hemodialysis
- Full genome characterization of 12 citrus tatter leaf virus isolates for the development of a detection assay
- Intake of myo-inositol hexaphosphate and urinary excretion of inositol phosphates in Wistar rats: Gavage vs. oral administration with sugar
- Enhancing financial security of female sex workers through a community-led intervention in India: Evidence from a longitudinal survey
- In-silico prediction of novel genes responsive to drought and salinity stress tolerance in bread wheat (Triticum aestivum)
- Genetic diversification of Panstrongylus geniculatus (Reduviidae: Triatominae) in northern South America
- Partitioning the risk of tuberculosis transmission in household contact studies
- Recommendation system in social networks with topical attention and probabilistic matrix factorization
- Using satellite-measured relative humidity for prediction of Metisa plana’s population in oil palm plantations: A comparative assessment of regression and artificial neural network models
- A drug interaction study investigating the effect of Rifabutin on the pharmacokinetics of Maraviroc in healthy subjects
- Emotional and behavioral problems, social competence and risk factors in 6–16-year-old students in Beijing, China
- Clinicopathologic and prognostic significance of tumor-associated macrophages in patients with hepatocellular carcinoma: A meta-analysis
- Involution of retinopathy of prematurity and neurodevelopmental outcomes after intravitreal bevacizumab treatment
- Travel demand and distance analysis for free-floating car sharing based on deep learning method
- Genome-wide identification, characterization, expression and enzyme activity analysis of coniferyl alcohol acetyltransferase genes involved in eugenol biosynthesis in Prunus mume
- Population analysis of D6-like plasmid prophage variants associated with specific IncC plasmid types in the emerging Salmonella Typhimurium ST213 genotype
- The high resource impact of reformatting requirements for scientific papers
- Egg yolk-free cryopreservation of bull semen
- Fine epitope mapping of glycoprotein Gn in Guertu virus
- Are hospital nurse staffing practices associated with postoperative cardiac events and death? A systematic review
- Dysregulation of macrophage development and phenotype in diabetic human macrophages can be rescued by Hoxa3 protein transduction
- Aging and the wandering brain: Age-related differences in the neural correlates of stimulus-independent thoughts
- Elucidating stygofaunal trophic web interactions via isotopic ecology
- Experimental characterization of two archaeal inosine 5'-monophosphate cyclohydrolases
- Scientist and data architect collaborate to curate and archive an inner ear electrophysiology data collection
- No effect of triple-pulse TMS medial to intraparietal sulcus on online correction for target perturbations during goal-directed hand and foot reaches
- Correction: Controlling Social Stress in Virtual Reality Environments
- TNF-α is responsible for the contribution of stromal cells to osteoclast and odontoclast formation during orthodontic tooth movement
- Viral respiratory infections and the oropharyngeal bacterial microbiota in acutely wheezing children
- Alteration of humoral, cellular and cytokine immune response to inactivated influenza vaccine in patients with Sickle Cell Disease
- To tweet or not to tweet, that is the question: A randomized trial of Twitter effects in medical education
- Visualizing a field of research: A methodology of systematic scientometric reviews
- True Colors: Commercially-acquired morphological genotypes reveal hidden allele variation among dog breeds, informing both trait ancestry and breed potential
- Impact of the detection of ζ-globin chains and hemoglobin Bart’s using immunochromatographic strip tests for α0-thalassemia (--SEA) differential diagnosis
- Cognitive impairment and medication adherence post-stroke: A five-year follow-up of the ASPIRE-S cohort
- Correction: Increased proliferation and altered cell cycle regulation in pancreatic stem cells derived from patients with congenital hyperinsulinism
- Correction: Lower prevalence of Blastocystis sp. infections in HIV positive compared to HIV negative adults in Ghana
- Correction: Precision public health: Mapping socioeconomic disparities in opioid dispensations at Swedish pharmacies by Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA)
- Epidemiological, clinical and laboratory characteristics of the measles resurgence in the Republic of Serbia in 2014-2015
- Macro-charcoal accumulation in floodplain wetlands: Problems and prospects for reconstruction of fire regimes and environmental conditions
- Stage at diagnosis and stage-specific survival of breast cancer in Latin America and the Caribbean: A systematic review and meta-analysis
- Correction: Retraction: Stiffening-Induced High Pulsatility Flow Activates Endothelial Inflammation via a TLR2/NF-κB Pathway
- TEM8/ANTXR1-specific CAR T cells mediate toxicity in vivo
- Clinical impact of intraoperative hyperlactatemia during craniotomy
- Intubation with channeled versus non-channeled video laryngoscopes in simulated difficult airway by junior doctors in an out-of-hospital setting: A crossover manikin study
- Age and growth of stocked juvenile Shoal Bass in a tailwater: Environmental variation and accuracy of daily age estimates
- Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer
- The impact of electroconvulsive therapy on the spatial QRS-T angle and cardiac troponin T concentration in psychiatric patients
- BDNF, NT-3 and Trk receptor agonist monoclonal antibodies promote neuron survival, neurite extension, and synapse restoration in rat cochlea ex vivo models relevant for hidden hearing loss
- Investigation on the hereditary basis of colorectal cancers in an African population with frequent early onset cases
- Comparison of cancer prevalence between patients with glomerulonephritis and the general population at the time of kidney biopsy
- Predictors of time to unfavorable treatment outcomes among patients with multidrug resistant tuberculosis in Oromia region, Ethiopia
- Experimentally validated simulation of coronary stents considering different dogboning ratios and asymmetric stent positioning
- The membrane effects of melittin on gastric and colorectal cancer
- Exclusive breastfeeding policy, practice and influences in South Africa, 1980 to 2018: A mixed-methods systematic review
- Hippocampal subfield volumes and pre-clinical Alzheimer’s disease in 408 cognitively normal adults born in 1946
- Uncorrected low hyperopia in young subjects induces postural instability even in those with clear visual acuity
- Membrane associated proteins of two Trichomonas gallinae clones vary with the virulence
- Awareness, current use of electronic cigarettes and associated smoking factors in Zhejiang Chinese adolescents
- Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample
- Effects of continuous ketamine infusion on hemodynamics and mortality in critically ill children
- Optofluidic laser speckle image decorrelation analysis for the assessment of red blood cell storage
- Complete chloroplast genome sequence and phylogenetic analysis of Spathiphyllum 'Parrish'
- Strategic science communication as planned behavior: Understanding scientists’ willingness to choose specific tactics
- Understanding spatial patterns of soils for sustainable agriculture in northern Ethiopia’s tropical mountains
- Does Japan’s national nutrient-based dietary guideline improve lifestyle-related disease outcomes? A retrospective observational cross-sectional study
- Agitation near the end of life with dementia: An ethnographic study of care
- Tick-borne encephalitis virus infections in Germany. Seasonality and in-year patterns. A retrospective analysis from 2001-2018
- Encouraging perspective taking: Using narrative writing to induce empathy for others engaging in negative health behaviors
- Considerations of target surface area and the risk of radiosurgical toxicity
- Correction: A comparative study of RNA-Seq and microarray data analysis on the two examples of rectal-cancer patients and Burkitt Lymphoma cells
- Effect of using immobilization device in fluoroscopic study in pediatric patient: Focused on radiation dose reduction in voiding cystourethrogram
- Temporal trends in breast cancer survival by race and ethnicity: A population-based cohort study
- Contamination of hospital surfaces with respiratory pathogens in Bangladesh
- The impact on the bioenergetic status and oxidative-mediated tissue injury of a combined protocol of hypothermic and normothermic machine perfusion using an acellular haemoglobin-based oxygen carrier: The cold-to-warm machine perfusion of the liver
- Association between hospital interval and survival in patients with oral cancer: A waiting time paradox
- Translating a stress management intervention for rural Latina breast cancer survivors: The Nuevo Amanecer-II
- Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
- Proteomic characterisation of the Chlamydia abortus outer membrane complex (COMC) using combined rapid monolithic column liquid chromatography and fast MS/MS scanning
- Harnessing therapeutic viruses as a delivery vehicle for RNA-based therapy
- Korean soybean core collection: Genotypic and phenotypic diversity population structure and genome-wide association study
- Resistance profile of the HIV-1 maturation inhibitor GSK3532795 in vitro and in a clinical study
- Measurement of structural integrity of the spinal cord in patients with amyotrophic lateral sclerosis using diffusion tensor magnetic resonance imaging
- Typological analysis of public-private partnerships in the veterinary domain
- Improved clinical outcome after medial open-wedge osteotomy despite cartilage lesions in the lateral compartment
- Rapid and structure-specific cellular uptake of selected steroids
- Avoiding gambling harm: An evidence-based set of safe gambling practices for consumers
- Epidemiology of chronic pain in Ukraine: Findings from the World Mental Health Survey
- PIAS1 is not suitable as a urothelial carcinoma biomarker protein and pharmacological target
- Double triage to identify poorly annotated genes in maize: The missing link in community curation
- N-acetyl cysteine restores the fertility of vitrified–warmed mouse oocytes derived through ultrasuperovulation
- Architecture of population-differentiated polymorphisms in the human genome
- Linguistic neutrosophic power Muirhead mean operators for safety evaluation of mines
- Extracellular vesicles nanoarray technology: Immobilization of individual extracellular vesicles on nanopatterned polyethylene glycol-lipid conjugate brushes
- Exercise intensity-dependent effects of arm and leg-cycling on cognitive performance
- How information about perpetrators’ nature and nurture influences assessments of their character, mental states, and deserved punishment
- Stringent response governs the oxidative stress resistance and virulence of Francisella tularensis
- In silico assessment of human Calprotectin subunits (S100A8/A9) in presence of sodium and calcium ions using Molecular Dynamics simulation approach
- Sustained activity of novel THIOMAB antibody-antibiotic conjugate against Staphylococcus aureus in a mouse model: Longitudinal pharmacodynamic assessment by bioluminescence imaging
- Measurable residual disease monitoring for patients with acute myeloid leukemia following hematopoietic cell transplantation using error corrected hybrid capture next generation sequencing
- Characteristics of complementary medicine therapists in Switzerland: A cross-sectional study
- Lack of generalization between explicit and implicit visuomotor learning
- Diet modulates cecum bacterial diversity and physiological phenotypes across the BXD mouse genetic reference population
- Effects of temperature and salinity on respiratory losses and the ratio of photosynthesis to respiration in representative Antarctic phytoplankton species
- Self-reported non-receipt of HIV test results: A silent barrier to HIV epidemic control in Mozambique
- Plasma midkine concentrations in healthy children, children with increased and decreased adiposity, and children with short stature
- Echocardiography overestimates LV mass in the elderly as compared to cardiac CT
- Efficacy of cotrimoxazole (Sulfamethoxazole-Trimethoprim) as a salvage therapy for the treatment of bone and joint infections (BJIs)
- Molecular mechanism of antimicrobial activity of chlorhexidine against carbapenem-resistant Acinetobacter baumannii
- First identification of the benzimidazole resistance-associated F200Y SNP in the beta-tubulin gene in Ascaris lumbricoides
- Green synthesis of silver nanoparticles using Solanum mammosum L. (Solanaceae) fruit extract and their larvicidal activity against Aedes aegypti L. (Diptera: Culicidae)
- Enterovirus 71 seroepidemiology in Taiwan in 2017 and comparison of those rates in 1997, 1999 and 2007
- Effect of statin on life prognosis in Japanese patients undergoing hemodialysis
- 13C and 15N NMR identification of product compound classes from aqueous and solid phase photodegradation of 2,4,6-trinitrotoluene
- Off-target effects of CRISPRa on interleukin-6 expression
- Exploring the antimicrobial properties of dark-operating ceramic-based nanocomposite materials for the disinfection of indoor air
- Experienced males recognise and avoid mating with non-virgin females in the western flower thrips
- Liver transplantation in patients with a history of migration—A German single center comparative analysis
- Retraction: The Different Role of Notch1 and Notch2 in Astrocytic Gliomas
- Correction: Understanding climate change from a global analysis of city analogues
- Comparison of 4D Flow MRI to 2D Flow MRI in the pulmonary arteries in healthy volunteers and patients with pulmonary hypertension
- The relationship between sleep quality, inappropriate medication use and frailty among older adults in aged care homes in Malaysia
- Clonal diversity and spatial genetic structure in the long-lived herb, Prairie trillium
- Medication histories documentation at the community pharmacy setting: A study from Jordan
- Population dynamics of an invasive bird parasite, Philornis downsi (Diptera: Muscidae), in the Galapagos Islands
- Because you had a bad day: General and daily relations between reactive temperament, emotion regulation, and depressive symptoms in youth
- Socioeconomic status and alcohol use disorders across the lifespan: A co-relative control study
- Generation of deletions and precise point mutations in Dictyostelium discoideum using the CRISPR nickase
- Polymorphisms in vasoactive eicosanoid genes of kidney donors affect biopsy scores and clinical outcomes in renal transplantation
- Adjuvant therapeutic potential of tonabersat in the standard treatment of glioblastoma: A preclinical F98 glioblastoma rat model study
- Validation and perception of a key feature problem examination in neurology
- Gender affirmative HIV care framework: Decisions on feminizing hormone therapy (FHT) and antiretroviral therapy (ART) among transgender women
- Quantifying international human mobility patterns using Facebook Network data
- Localization and characterization of thyroid microcalcifications: A histopathological study
- Young children are the main victims of fast food induced obesity in Brazil
- Understanding self-reported importance of religion/spirituality in a North American sample of individuals at risk for familial depression: A principal component analysis
- Standing balance of professional ballet dancers and non-dancers under different conditions
- 30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany
- Physical exercise stimulates salivary secretion of cystatins
- Vintage electronics for trusted radiation measurements and verified dismantlement of nuclear weapons
- Keepin’ it real: Linguistic models of authenticity judgments for artificially generated rap lyrics
- Carbon emission reduction and profit distribution mechanism of construction supply chain with fairness concern and cap-and-trade
- Modulations of microbehaviour by associative memory strength in Drosophila larvae
- Changes in peak expiratory flow rates using two head-tilt/chin-lift maneuver angles in young healthy conscious volunteers
- 3D image analysis reveals differences of CD30 positive cells and network formation in reactive and malignant human lymphoid tissue (classical Hodgkin Lymphoma)
- Change in larval fish assemblage in a USA east coast estuary estimated from twenty-six years of fixed weekly sampling
- 2-methylquinazoline derivative F7 as a potent and selective HDAC6 inhibitor protected against rhabdomyolysis-induced acute kidney injury
- Correction: Reducing growth and developmental problems in children: Development of an innovative postnatal risk assessment
- Comparative analysis of the vertebral pneumatization in pterosaurs (Reptilia: Pterosauria) and extant birds (Avialae: Neornithes)
- Associations between cognitive performance and sigma power during sleep in children with attention-deficit/hyperactivity disorder, healthy children, and healthy adults
- Retraction: MiR-375 Is Epigenetically Downregulated by HPV-16 E6 Mediated DNMT1 Upregulation and Modulates EMT of Cervical Cancer Cells by Suppressing lncRNA MALAT1
- Comparing growth patterns of three species: Similarities and differences
- Iron is increased in the brains of ageing mice lacking the neurofilament light gene
- Economic evaluation of community acquired pneumonia management strategies: A systematic review of literature
- A participatory community case study of periurban coastal flood vulnerability in southern Ecuador
- Chemotherapy-induced cellular senescence suppresses progression of Notch-driven T-ALL
- Mitochondrial dysfunctions in leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL)
- MRI-based visualization of rTMS-induced cortical plasticity in the primary motor cortex
- Knowledge, attitudes, and practices related to anthrax and animal care: A case-control study in Georgia
- Information diffusion in signed networks
- Nurses’ perspectives on their communication with patients in busy oncology wards: A qualitative study
- Inflammation in acute coronary syndrome: Expression of TLR2 mRNA is increased in platelets of patients with ACS
- ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM
- Retraction: Fluid–Structure Interaction-Based Biomechanical Perception Model for Tactile Sensing
- Correction: Role of Caveolin-1 in Atrial Fibrillation as an Anti-Fibrotic Signaling Molecule in Human Atrial Fibroblasts
- The French adaptation and validation of the Partners in Health (PIH) scale among patients with chronic conditions seen in primary care
- Depth inversion with a 3D structure influences brightness perception
- Analysis of group evolution prediction in complex networks
- Effect of aridity and dune type on rhizosphere soil bacterial communities of Caragana microphylla in desert regions of northern China
- Knowledge, attitudes, and practices related to TB among the general population of Ethiopia: Findings from a national cross-sectional survey
- Correction: Personality traits in companion dogs—Results from the VIDOPET
- MANET 3.0: Hierarchy and modularity in evolving metabolic networks
- Agreement study on gait assessment using a video-assisted rating method in patients with idiopathic normal-pressure hydrocephalus
- Single fixed low-dose rituximab as induction therapy suppresses de novo donor-specific anti-HLA antibody production in ABO compatible living kidney transplant recipients
- Myomesin is part of an integrity pathway that responds to sarcomere damage and disease
- Acute normobaric hypoxia does not affect the simultaneous exercise-induced increase in circulating BDNF and GDNF in young healthy men: A feasibility study
- Systematic investigation on quad-metallic AgAuPdPt and tri-metallic AuPdPt NPs through the solid-state dewetting of quad-layer Ag/Au/Pd/Pt thin films on c-plane sapphire
- Video lecturing in Clicker-assisted English flipped class
- Significant changes of the choroid in patients with ocular ischemic syndrome and symptomatic carotid artery stenosis
- Skewed T cell responses to Epstein-Barr virus in long-term asymptomatic kidney transplant recipients
- Candidate genes expression profiling during wilting in chickpea caused by Fusarium oxysporum f. sp. ciceris race 5
- Host plants influence the composition of the gut bacteria in Henosepilachna vigintioctopunctata
- ‘We are all serving the same Ugandans’: A nationwide mixed-methods evaluation of private sector surgical capacity in Uganda
- The association between flavor capsule cigarette use and sociodemographic variables: Evidence from Chile
- Relations between gross motor skills and executive functions, controlling for the role of information processing and lapses of attention in 8-10 year old children
- Linalool acts as a fast and reversible anesthetic in Hydra
- Double burden of maternal and child malnutrition and socioeconomic status in urban Sri Lanka
- Using isotemporal substitution to predict the effects of changing physical behaviour on older adults’ cardio-metabolic profiles
- Adherence to general medical checkup and cancer screening guidelines according to self-reported smoking status: Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012
- Do older English adults exhibit day-to-day compensation in sedentary time and in prolonged sedentary bouts? An EPIC-Norfolk cohort analysis
- Linoleic acid supplementation of cell culture media influences the phospholipid and lipid profiles of human reconstructed adipose tissue
- Correction: Factors associated with hospitalization and death among TB/HIV co-infected persons in Porto Alegre, Brazil
- An ex vivo tissue model of cartilage degradation suggests that cartilage state can be determined from secreted key protein patterns
- Reporting adverse events related to medical devices: A single center experience from a tertiary academic hospital
- Enterohemorrhagic Escherichia coli infection inhibits colonic thiamin pyrophosphate uptake via transcriptional mechanism
- Estimating biodiversity changes in the Camargue wetlands: An expert knowledge approach
- Decreased risk of Parkinson’s disease in diabetic patients with thiazolidinediones therapy: An exploratory meta-analysis
- Retraction: Carboxyamidotriazole-Orotate Inhibits the Growth of Imatinib-Resistant Chronic Myeloid Leukaemia Cells and Modulates Exosomes-Stimulated Angiogenesis
- Lipoarabinomannan from Mycobacterium indicus pranii shows immunostimulatory activity and induces autophagy in macrophages
- A measure of inconsistencies in intertemporal choice
- A novel radiopaque tissue marker for soft tissue localization and in vivo length and area measurements
- Anatomical, histological and computed tomography comparisons of the eye and adnexa of crab-eating fox (Cerdocyon thous) to domestic dogs
- Subpopulation augmentation among habitat patches as a tool to manage an endangered Mojave Desert wetlands-dependent rodent during anthropogenic restricted water climate regimes
- Characteristics of CD5-positive diffuse large B-cell lymphoma among Koreans: High incidence of BCL2 and MYC double-expressors
- Fossil tabulate corals reveal outcrops of Paleozoic sandstones in the Atlantic Coastal Plain Province, Southeastern USA
- Coming and going – Historical distributions of the European oyster Ostrea edulis Linnaeus, 1758 and the introduced slipper limpet Crepidula fornicata Linnaeus, 1758 in the North Sea
- Behavioral predictors of subsequent respiratory illness signs in dogs admitted to an animal shelter
- Novel chemotherapeutic agent, FND-4b, activates AMPK and inhibits colorectal cancer cell proliferation
- Can emotional intelligence be improved? A randomized experimental study of a business-oriented EI training program for senior managers
- Genetic variability in landraces populations and the risk to lose genetic variation. The example of landrace ‘Kyperounda’ and its implications for ex situ conservation
- Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study
- Age, sex and primary care setting differences in patients’ perception of community healthcare seeking behaviour towards health services
- Kinematic analyses including finite helical axes of drop jump landings demonstrate decreased knee control long after anterior cruciate ligament injury
- Effects of model inaccuracies on reaching movements with intermittent control
- C-reactive protein to albumin ratio predicts the outcome in renal cell carcinoma: A meta-analysis
- A new synthetic lure for management of the invasive giant African snail, Lissachatina fulica
- Bridging solvent molecules mediate RNase A – Ligand binding
- Variation in methods, results and reporting in electronic health record-based studies evaluating routine care in gout: A systematic review
- The use of prophylactic intra-aortic balloon pump in high-risk patients undergoing coronary artery bypass grafting
- Compliance with clinical guidelines for breast cancer management: A population-based study of quality-of-care indicators in France
- Dysregulated T helper type 1 (Th1) and Th17 responses in elderly hospitalised patients with infection and sepsis
- Acute effects of differential learning on football kicking performance and in countermovement jump
- Escherichia coli and Salmonella spp. isolated from Australian meat chickens remain susceptible to critically important antimicrobial agents
- Play like me: Similarity in playfulness promotes social play
- Awareness of family health history in a predominantly young adult population
- Care pathways during a child’s final illness in rural South Africa: Findings from a social autopsy study
- Intranasal lidocaine for acute migraine: A meta-analysis of randomized controlled trials
- Evaluating case management as a complex intervention: Lessons for the future
- Allele-specific enhancer interaction at the Peg3 imprinted domain
- Has the “M” word been framed? Marijuana, cannabis, and public opinion
- Is spontaneous normalization of systolic blood pressure within 24 hours after ischemic stroke onset related with favorable outcomes?
- Mixotrophic cultivation of Spirulina platensis in dairy wastewater: Effects on the production of biomass, biochemical composition and antioxidant capacity
- Constitutive expression of an A-5 subgroup member in the DREB transcription factor subfamily from Ammopiptanthus mongolicus enhanced abiotic stress tolerance and anthocyanin accumulation in transgenic Arabidopsis
- Stable carbon isotope diagnostics of mammalian metabolism, a high-resolution isotomics approach using amino acid carboxyl groups
- Factors associated with depressive symptoms in patients with ankylosing spondylitis in Northern Taiwan
- A multicenter prospective study of 515 febrile neutropenia episodes in Argentina during a 5-year period
- Retraction: Reversal Effect of ST6GAL 1 on Multidrug Resistance in Human Leukemia by Regulating the PI3K/Akt Pathway and the Expression of P-gp and MRP1
- Potential role for microRNA-16 (miR-16) and microRNA-93 (miR-93) in diagnosis and prediction of disease progression in mycosis fungoides in Egyptian patients
- Rapid visual categorization is not guided by early salience-based selection
- Relative contribution of climate and non-climate drivers in determining dynamic rates of boreal birds at the edge of their range
- A simple-to-use nomogram to predict long term survival of patients undergoing coronary artery bypass grafting (CABG) using bilateral internal thoracic artery grafting technique
- Effects of sonication parameters on transcranial focused ultrasound brain stimulation in an ovine model
- Antenatal and intrapartum interventions for reducing caesarean section, promoting vaginal birth, and reducing fear of childbirth: An overview of systematic reviews
- Relative species abundance successfully predicts nestedness and interaction frequency of monthly pollination networks in an alpine meadow
- Correction: RCER: Reliable Cluster-based Energy-aware Routing protocol for heterogeneous Wireless Sensor Networks
- Amphibians on the hotspot: Molecular biology and conservation in the South American Atlantic Rainforest
- Role of psychosocial status in predicting health-related quality of life at 1-year follow-up among newly diagnosed people living with HIV
- Application of national pollutant inventories for monitoring trends on dioxin emissions from stationary industrial sources in Australia, Canada and European Union
- The association between vaccination confidence, vaccination behavior, and willingness to recommend vaccines among Finnish healthcare workers
- Retraction: Interleukin-1β-Induced Autophagy-Related Gene 5 Regulates Proliferation of Embryonic Stem Cell-Derived Odontoblastic Cells
- A localized sanitation status index as a proxy for fecal contamination in urban Maputo, Mozambique
- E2 protein is the major determinant of specificity at the human papillomavirus origin of replication
- “You’re kind of at war with yourself as a nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder
- A refinement approach in a mouse model of rehabilitation research. Analgesia strategy, reduction approach and infrared thermography in spinal cord injury
- Circulating cell-free DNA from plasma undergoes less fragmentation during bisulfite treatment than genomic DNA due to low molecular weight
- Understanding fatigue in adults with visual impairment: A path analysis study of sociodemographic, psychological and health-related factors
- Retraction: Mouse-Induced Pluripotent Stem Cells Differentiate into Odontoblast-Like Cells with Induction of Altered Adhesive and Migratory Phenotype of Integrin
- A novel analytical method to assess the effect of imipenem/cilastatin on liver function laboratory indexes in Chinese underage inpatients: Probability distribution curve
- The cause of anorexia and proportion of its recovery in older adults without underlying disease: Results of a retrospective study
- Referral and admission to intensive care: A qualitative study of doctors’ practices in a Tanzanian university hospital
- Agreement between clinical and non-clinical digital manometer for assessing maximal respiratory pressures in healthy subjects
- Heads or tails? Differential translational regulation in cercarial heads and tails of schistosome worms
- Horizontal seed dispersal by dung beetles reduced seed and seedling clumping, but did not increase short-term seedling establishment
- The coupling of the M2 muscarinic receptor to its G protein is voltage dependent
- Subsidy strategy of pharmaceutical e-commerce platform based on two-sided market theory
- Shoulder girdle injuries involving the medial clavicle differ from lateral clavicle injuries with a focus on concomitant injuries and management strategies: A retrospective study based on nationwide routine data
- Unraveling middle childhood attachment-related behavior sequences using a micro-coding approach
- Divergence history and hydrothermal vent adaptation of decapod crustaceans: A mitogenomic perspective
- Duration of solid fuel cookstove use is associated with increased risk of acute lower respiratory infection among children under six months in rural central India
- Evolving flocking in embodied agents based on local and global application of Reynolds’ rules
- Non-invasive contrast enhanced ultrasound molecular imaging of inflammation in autoimmune myocarditis for prediction of left ventricular fibrosis and remodeling
- Care coordination for chronic and complex health conditions: An experienced based co-design study engaging consumer and clinician groups for service improvement
- Association between socioeconomic status and diet quality in Mexican men and women: A cross-sectional study
- Surveillance of panicle positions by unmanned aerial vehicle to reveal morphological features of rice
- Is Betula carpatica genetically distinctive? A morphometric, cytometric and molecular study of birches in the Bohemian Massif with a focus on Carpathian birch
- Correction: Sequential analysis of myocardial gene expression with phenotypic change: Use of cross-platform concordance to strengthen biologic relevance
- The genome of the migratory nematode, Radopholus similis, reveals signatures of close association to the sedentary cyst nematodes
- Factors associated with pneumococcal carriage and density in infants and young children in Laos PDR
- Overlap between telangiectasia and photoreceptor loss increases with progression of macular telangiectasia type 2
- The role of hope for health professionals in rehabilitation: A qualitative study on unfavorable prognosis communication
- Expression of miR-34a-5p is up-regulated in human colorectal cancer and correlates with survival and clock gene PER2 expression
- Molecular characterization and In Vitro synthesis of infectious RNA of a Turnip vein-clearing virus isolated from Alliaria petiolata in Hungary
- Assessment of client satisfaction with pharmacist services at outpatient pharmacy of Tikur Anbessa Specialized Hospital
- Thermogravimetric analysis of the co-combustion of coal and polyvinyl chloride
- Roles of leptin in the recovery of muscle and bone by reloading after mechanical unloading in high fat diet-fed obese mice
- Unexpected high seroprevalence of hepatitis E virus in patients with alcohol-related cirrhosis
- APOL1-G0 protects podocytes in a mouse model of HIV-associated nephropathy
- Integrating a gait analysis test in hospital rehabilitation: A service design approach
- Correction: Bioactivity-guided isolation of rosmarinic acid as the principle bioactive compound from the butanol extract of Isodon rugosus against the pea aphid, Acyrthosiphon pisum
- Soil-borne fungi influence seed germination and mortality, with implications for coexistence of desert winter annual plants
- Applying Corrigan’s progressive model of self-stigma to people with depression
- Do psychosocial factors modify the negative association between disability and life satisfaction in old age?
- Public perception of coastal habitat loss and habitat creation using artificial floating islands in the UK
- Transcriptional foliar profile of the C3-CAM bromeliad Guzmania monostachia
- Application of tuned liquid column ball damper (TLCBD) for improved vibration control performance of multi-storey structure
- Do protection gradients explain patterns in herbivore densities? An example with ungulates in Zambia’s Luangwa Valley
- Consequences of chronic bacterial infection in Drosophila melanogaster
- The effects of environmental parameters on the microbial activity in peat-bog lakes
- Differences in protein structural regions that impact functional specificity in GT2 family β-glucan synthases
- Correction: Identification of lysine methylation in the core GTPase domain by GoMADScan
- Changes of absorbed dose rate in air in metropolitan Tokyo relating to radiocesium released from the Fukushima Daiichi Nuclear Power Plant accident: Results of a five-year study
- Histological chorioamnionitis, antenatal steroids, and neonatal outcomes in very low birth weight infants: A nationwide study
- A machine learning approach for the prediction of pulmonary hypertension
- Altered microbiota, fecal lactate, and fecal bile acids in dogs with gastrointestinal disease
- Impaired processing of threat in psychopathy: A systematic review and meta-analysis of factorial data in male offender populations
- Dimethyl disulfide (DMDS) as an effective soil fumigant against nematodes in China
- Risk factors for hepatitis C infection among adult patients in Kedah state, Malaysia: A case–control study
- Factoring a 2 x 2 contingency table
- The development of connectives in three to five-year-old monolingual Spanish-speaking children
- Foliar plasticity related to gradients of heat and drought stress across crown orientations in three Mediterranean Quercus species
- The evolution of haploid chromosome numbers in Meliponini
- Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey
- Facial features and unethical behavior – Doped athletes show higher facial width-to-height ratios than non-doping sanctioned athletes
- Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study
- Left ventricular simulation of cardiac compression: Hemodynamics and regional mechanics
- Are we ready for scaling up restoration actions? An insight from Mediterranean macroalgal canopies
- Age-related changes in size, bone microarchitecture and volumetric bone mineral density of the mandible in the harbor seal (Phoca vitulina)
- Parasitism modifies the direct effects of warming on a hemiparasite and its host
- Analytic performance of PANArray HPV and HPV 9G DNA chip tests for genotyping of high-risk human papillomavirus in cervical ThinPrep PreservCyt samples
- Transcript profile of skeletal muscle lipid metabolism genes affected by diet in a piglet model of low birth weight
- Differential impact of smoking on cardiac or non-cardiac death according to age
- Influence of injectate volume on paravertebral spread in erector spinae plane block: An endoscopic and anatomical evaluation
- Correction: Nitrogen starvation induces distinct photosynthetic responses and recovery dynamics in diatoms and prasinophytes
- Healthcare needs and programmatic gaps in transition from pediatric to adult care of vertically transmitted HIV infected adolescents in India
- Retraction: Neuronal Differentiation Dictates Estrogen-Dependent Survival and ERK1/2 Kinetic by Means of Caveolin-1
- Correction: Disability and its association with sociodemographic factors among elderly persons residing in an urban resettlement colony, New Delhi, India
- Antibacterial activity of varying UMF-graded Manuka honeys
- Correction: Synthesis of IL-6 by Hepatocytes Is a Normal Response to Common Hepatic Stimuli
- Detection and genetic characterization of Echinococcus granulosus mitochondrial DNA in serum and formalin-fixed paraffin embedded cyst tissue samples of cystic echinococcosis patients
- Deep-learning-based risk stratification for mortality of patients with acute myocardial infarction
- Links between meaning in life and physical quality of life after rehabilitation: Mediating effects of positive experiences with physical exercises and mobility
- The estrogen effect; clinical and histopathological evidence of dichotomous influences in dogs with spontaneous mammary carcinomas
- The association between socioeconomic status, psychopathological symptom burden in mothers, and early childhood caries of their children
- Increased rate of FEV1 decline in HIV patients despite effective treatment with HAART
- Parallels between stream and coastal water quality associated with groundwater discharge
- Determinants of anemia among pregnant women attending antenatal care in Horo Guduru Wollega Zone, West Ethiopia: Unmatched case-control study
- Depression and anxiety among pregnant women living with HIV in Kilimanjaro region, Tanzania
- Shift in trophic niches of soil microarthropods with conversion of tropical rainforest into plantations as indicated by stable isotopes (15N, 13C)
- On the development of sleep states in the first weeks of life
- CCR5 receptor antagonism inhibits hepatitis C virus (HCV) replication in vitro
- Investigation into pathophysiology of naturally occurring palatal instability and intermittent dorsal displacement of the soft palate (DDSP) in racehorses: Thyro-hyoid muscles fatigue during exercise
- Correction: Reducing phenolic off-flavors through CRISPR-based gene editing of the FDC1 gene in Saccharomyces cerevisiae x Saccharomyces eubayanus hybrid lager beer yeasts
- MitoToxy assay: A novel cell-based method for the assessment of metabolic toxicity in a multiwell plate format using a lactate FRET nanosensor, Laconic
- Correction: Evidence for plant-derived xenomiRs based on a large-scale analysis of public small RNA sequencing data from human samples
- Correction: Prognostic impact of systolic blood pressure variability in people with diabetes
- Retraction: Sialoglycosylation of RBC in Visceral Leishmaniasis Leads to Enhanced Oxidative Stress, Calpain-Induced Fragmentation of Spectrin and Hemolysis
- Too much? Mortality and health service utilisation among Danish children 1999-2016: A register-based study
- Effects of sodium-glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors on diabetic retinopathy and its progression: A real-world Korean study
- Shipworm bioerosion of lithic substrates in a freshwater setting, Abatan River, Philippines: Ichnologic, paleoenvironmental and biogeomorphical implications
- Genetic codes optimized as a traveling salesman problem
- Effect of antenatal detection of small-for-gestational-age newborns in a risk stratified retrospective cohort
- Using family network data in child protection services
- Transcriptome sequencing reveals the effect of biochar improvement on the development of tobacco plants before and after topping
- Volatile anesthetics versus total intravenous anesthesia in patients undergoing coronary artery bypass grafting: An updated meta-analysis and trial sequential analysis of randomized controlled trials
- Cumulative fluid balance predicts mortality and increases time on mechanical ventilation in ARDS patients: An observational cohort study
- Stated-preference research in HIV: A scoping review
- Correction: Survival of infants ≤24 months of age with brain tumors: A population-based study using the SEER database
- Antinociceptive compounds and LC-DAD-ESIMSn profile from Dictyoloma vandellianum leaves
- Time series experimental design under one-shot sampling: The importance of condition diversity
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