Introduction
============

Tuberculosis (TB) is one of the deadly infectious diseases that have claimed millions of lives worldwide. According to the World Health Organization (WHO), globally, there were 10.4 million new TB cases causing approximately 1.2 million deaths in 2016 \[[@ref1],[@ref2]\]. The mortality rate of TB is disproportionately higher in low- and middle-income countries (LMICs). Over 95% of TB deaths occurred in these countries, and 7 LMICs (India, Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa) accounted for 64% of the total burden \[[@ref3]\]. In fact, previous studies have shown that there is empirical evidence of positive associations between poverty indicators and TB incidence both at the macro and individual levels \[[@ref4]\]. Considering the vicious cycle of poverty and TB, alleviating the burden of TB is more challenging for the LMICs because it requires adequate resources for "prolonged treatment with multiple drugs \[[@ref5]\]." The 6-month course of first-line therapy can be burdensome with the possibility of adverse reactions and the treatment of multidrug-resistant (MDR)-TB requires more toxic and expensive drugs \[[@ref6]\]. For example, the cost of bedaquiline, a second-line medication to treat MDR-TB, was US \$3000 per treatment in middle-income countries and US \$900 in low-income countries \[[@ref7]\]. In fact, premature discontinuation of the treatment, which can lead to MDR-TB, is common among TB patients not only for its toxicity but also for socioeconomic costs associated with it \[[@ref8]\]. Therefore, the management of TB is notoriously difficult especially in LMICs.

In this context, using mobile devices for TB treatment has been recognized as an innovative approach for LMICs where mobile subscription rates have dramatically increased over the past decade. Mobile health (mHealth) interventions involving mobile devices in the management of TB have the potential for reducing costs of information delivery and improving the quality of communication \[[@ref9]\]. mHealth can be useful for TB treatment adherence support such as short message service (SMS) for medication reminders or mobile apps for remote directly observed treatment (DOT) strategy \[[@ref10],[@ref11]\].

Despite the potential of mHealth interventions for improving TB management, the empirical evidence on its effectiveness is mixed. Some studies have demonstrated the effectiveness and feasibility of the mHealth interventions for TB \[[@ref12],[@ref13]\], whereas others have shown no significant impact \[[@ref14],[@ref15]\]. Moreover, no study has attempted to synthesize the results quantitatively to rigorously evaluate the effectiveness of mHealth in TB management. Presumably, one of the reasons for such difficulty in synthesizing and evaluating the findings comes from wide variations in the outcomes reported from the mHealth studies for TB.

To respond to this knowledge gap, this study aimed to systematically review previous mHealth studies for TB management and critically evaluate and categorize the outcome measures for different mobile technologies and study designs. The goal of this study was to provide researchers insights into the development of a core set of outcome measures for mHealth interventions intended to improve TB treatment adherence. In doing so, the study can facilitate the evidence synthesis of mHealth interventions for TB.

Methods
=======

Search Strategy and Review Process
----------------------------------

Electronic databases (MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews) were searched to identify peer-reviewed studies of mHealth interventions for TB. The systematic search was supplemented by reviewing relevant review papers identified from the initial search. The search strategy for the study population includes key terms describing LMICs such as "resource poor" or "developing country." The search strategy for the mHealth intervention combined multiple keywords such as "mHealth" and "text-messaging." As for the target disease, "tuberculosis," "TB," "multi-drug resistant tuberculosis," and "MDR-TB" were used as search terms. No restrictions were applied to the publication type or publication date, but the language filter was applied to identify studies published in English. The search included articles published up to May 2018. The full search strategy is available in [Multimedia Appendix 1](#app1){ref-type="supplementary-material"}.

Furthermore, 3 authors (ShL, YL, and SmL) independently reviewed the retrieved studies throughout the selection process. Each study identified from the databases was screened by 2 reviewers and then a full-text review was conducted for the potentially eligible studies. The disagreement on the selection process was resolved by the other authors who were not involved in the review of the specific study under discussion.

Eligibility for Review
----------------------

The inclusion criteria for this systematic review were as follows: First, studies conducted in the context of LMICs, as defined by the World Bank's income cutoffs \[[@ref16]\]; second, studies involving an intervention using mobile devices (ie, mHealth intervention); third, the target disease of the study should be TB or MDR-TB; fourth, studies designed to evaluate the effectiveness or benefits of mHealth interventions for TB (eg, observational study, mixed-methods study or implementation project, randomized controlled trial \[RCT\]); fifth, studies reporting more than one type of outcome; finally, only full-text studies published in English were considered eligible. In addition, the authors attempted to identify individual studies from reviews or systematic reviews, which were included in this study.

Data Extraction and Analysis
----------------------------

The qualitative synthesis of evidence focused on the outcome measures reported in each type of mHealth intervention. Information about the study setting, mHealth technologies used, target populations, and types of outcome measures was extracted. To classify the diverse types of detailed outcome measures, the following categories were used: (1) treatment outcome; (2) treatment outcome as defined by WHO; (3) adherence; (4) process measure; (5) perception; (6) technical outcome; (7) health outcome; (8) quality of life; (9) knowledge; (10) cost-effectiveness; (11) cost; (12) psychosocial outcome; and (13) mortality. Some explanations about these measures are provided in the next few paragraphs.

The treatment outcome includes any outcome measure that deals with the result of TB treatment, such as sputum smear conversion or microscopy test result. The treatment outcome following the WHO definition was separately categorized \[[@ref17]\]. The WHO definition was developed to make a distinction for treatment outcomes between the drug-susceptible TB and drug-resistant TB, which are mutually exclusive groups. According to the WHO definition, any patient with TB should belong to either group and then 1 of the 7 treatment outcome cohorts: (1) cured; (2) treatment completed; (3) treatment failed; (4) died; (5) lost to follow-up; (6) not evaluated; and (7) treatment success. The WHO definitions for each of these 7 categories differ between the drug-susceptible TB and drug-resistant TB as described in [Multimedia Appendix 2](#app2){ref-type="supplementary-material"}.

The adherence outcome includes medication adherence or treatment adherence. The process measure is any outcome measure related to treatment process, including the receipt of diagnostic test, attendance to appointments, or reporting of adverse events. The perception indicates any outcome measure that captures the user's thoughts on mHealth for TB management. The technical outcome relates to the outcome measures that investigate the technical feasibility such as processing times or system installation. Health outcome, quality of life, knowledge (eg, patients' understanding of the disease or the technology), cost-effectiveness (ie, the extent to which an alternative provides value for money), cost (ie, costs associated with an intervention from different perspectives), psychosocial outcome, and mortality outcomes are additional categories which are self-explanatory.

Risk of Bias: Quality Assessment
--------------------------------

To evaluate the quality of individual studies included for our review, risk of bias was assessed with the existing tools. As this systematic review includes various types of studies, it is important to have a coherent set of quality assessment tools for different study designs. Therefore, we used the modified version of the Critical Appraisal Skills Program (CASP) that provides the checklists specific to various types of studies ranging from RCTs and qualitative studies to economic evaluation \[[@ref18]\]. In case of mixed-methods studies whose CASP tool has not been developed yet, the quality assessment criteria for mixed-methods studies from the previous study were employed \[[@ref19]\]. The quality assessment of studies is presented in [Multimedia Appendix 3](#app3){ref-type="supplementary-material"}.

Results
=======

Overview of Included Studies
----------------------------

Among the 312 studies identified after removing duplicates, 260 articles were excluded during the screening process based on the titles and abstracts. Therefore, 52 articles were assessed for eligibility through a full-text review. Of those, 27 studies were included for the qualitative synthesis of evidence. A flow diagram for the selection process, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, is provided in [Figure 1](#figure1){ref-type="fig"} \[[@ref20]\].

Qualitative Synthesis of Evidence
---------------------------------

[Table 1](#table1){ref-type="table"} presents the results of qualitative synthesis of the mHealth studies for TB management. Approximately, half (15 out of 27) of the studies were conducted in African countries. The study designs were diverse, including 6 RCTs, 5 mixed-methods studies, 1 cohort study, 3 qualitative studies, 4 observational studies, 6 implementation projects, and 2 economic evaluation studies. The types of mHealth technologies utilized were diverse as well: 12 studies employed SMS, 6 studies used mobile app, 5 studies used SMS plus other technology, 3 studies utilized phone calls, and only 1 study applied mHealth for mobile data collection. With regard to the study population, a majority (20 out of 27) of the studies were targeted for TB patients or TB/HIV patients, but there were a few studies that examined the experience of health care workers or general patients at the clinic for TB test results notification.

In terms of the outcome measures, there was a wide range of variants in their definitions even within each category of the outcomes. For instance, both Mohammed et al and Bediang et al defined treatment success as the primary outcome measure of SMS intervention for TB medication adherence in their RCT, but they defined treatment success differently \[[@ref15],[@ref22]\]. Mohammed et al defined it as "the sum of patients clinically reported as cured (ie, a patient whose sputum smear or culture was positive at the beginning of treatment but who was smear- or culture-negative in the last month of treatment and on at least one previous occasion) or treatment completed (ie, a patient who completed treatment but who does not have a negative sputum smear or culture result in the last month of treatment and on at least one previous occasion)" \[[@ref22]\]. On the contrary, Bediang et al defined treatment success as "having completed 6 months treatment and having negative sputum smears at 5 months" \[[@ref15]\].

Summary of Outcome Measures
---------------------------

[Table 2](#table2){ref-type="table"} summarizes the types of outcome measures reported in the included studies, using the categories defined in this review. The most frequently reported outcome type was treatment success. Approximately half of the studies reviewed (14 out of 27) included treatment outcome but only 6 studies among them followed the WHO definition for the treatment outcome ([Multimedia Appendix 2](#app2){ref-type="supplementary-material"}). The second most frequently reported category was perception on the mHealth intervention (13 out of 27). Other categories reported were diverse and included technical outcome, medication or treatment adherence, process measure, etc. However, there was substantial variability within each category of outcome, as shown in [Table 1](#table1){ref-type="table"}. For example, acceptability and satisfaction within the perception category were defined differently from one study to another \[[@ref15],[@ref28]-[@ref30],[@ref32],[@ref35],[@ref36],[@ref40],[@ref44]\]. Also, SMS-only intervention studies did not focus on technical outcome \[[@ref12],[@ref15],[@ref22],[@ref29],[@ref30],[@ref32],[@ref35], [@ref36],[@ref42],[@ref43],[@ref45],[@ref46]\] whereas studies involving other mHealth technologies such as an app or mobile data collection did so \[[@ref21],[@ref28],[@ref33],[@ref37],[@ref39]-[@ref41]\]. On the contrary, outcomes related to cost or cost-effectiveness were reported only via studies involving SMS \[[@ref29],[@ref45],[@ref46]\].

![Flow diagram for selection process following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. mHealth: mobile health; TB: tuberculosis.](mhealth_v7i2e12385_fig1){#figure1}

######

Summary of included studies.

  --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
  Source                                                   Country             Study design                                                                    Mobile health technology           Population                                     Outcome measures                                                                                Outcome category                                                                Purpose
  -------------------------------------------------------- ------------------- ------------------------------------------------------------------------------- ---------------------------------- ---------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------
  Blaya, 2009 \[[@ref21]\]                                 Peru                RCT^a^                                                                          Mobile data collection             Health centers                                 Processing times, frequency of errors, the number of work-hours expended by data collectors                                                                                Technical outcome                                                               For laboratory data collection

  Mohammed, 2016 \[[@ref22]\]                              Pakistan            RCT                                                                             SMS^b^                             TB^c^ patients                                 Primary: clinically recorded treatment success based upon intention-to-treat; Secondary: treatment outcomes (WHO definitions^d^), self-reported medication adherence, self-reported psychological and physical health measures                                                                                Treatment outcome, adherence, health outcome                                    For medication adherence

  Bassett, 2013 \[[@ref23]\]; Bassett, 2016 \[[@ref24]\]   South Africa        RCT protocol (2013); RCT (2016)                                                 SMS and phone calls                Patients at clinic                             Primary: treatment completion; Secondary: mortality, receipt of CD4 count and TB test results, and repeat CD4 counts for those not antiretroviral therapy (ART)--eligible at baseline                                                                                Treatment outcome, mortality, process measure                                   For appointment and test result reminder and psychosocial support

  Huang, 2017 \[[@ref25]\]                                 China               Cluster RCT protocol                                                            Mobile app                         TB patients                                    Primary: TB treatment result (WHO definitions^d^); Secondary: treatment adherence (the percentage of patients receiving TB treatment who missed fewer than 5% of doses), self-reported adherence, knowledge about TB, quality of life (QoL)                                                                                Treatment outcome, adherence, knowledge, QoL                                    For Bracelet- and self-directed observational therapy

  Bediang, 2014 \[[@ref26]\]; Bediang, 2018 \[[@ref15]\]   Cameroon            RCT protocol (2014); RCT (2018)                                                 SMS                                TB patients                                    Primary: cure rate (absence of Koch's bacilli in the sputum), treatment success (having completed 6 months\' treatment and having negative sputum smears at 5 months); Secondary: treatment adherence (drug prescriptions collected and doses taken), attendance to appointments, punctuality of appointments, treatment outcome (WHO definitions^d^), the number of participants who develop resistance, satisfaction                                                         Treatment outcome, adherence, process measure, perception                       For medication adherence

  Khachadourian, 2015 \[[@ref27]\]                         Armenia             RCT protocol                                                                    SMS and phone calls                TB patients                                    Primary: physician-reported treatment outcome (WHO definitions^d^); Secondary: patients' knowledge, depression, QoL, within-family TB-related stigma, family social support, self-reported treatment adherence                                                                                Treatment outcome, knowledge, psychosocial outcome, QoL, adherence              For medication adherence

  Chaiyachati, 2013 \[[@ref28]\]                           South Africa        Mixed-methods study                                                             Mobile app                         Health care workers                            Primary: proportion of weekly adverse events forms submitted vs expected by mobile health care workers; Secondary: acceptability (perceived comfort levels with using mobile phone technology), quality of adverse events monitoring, proportion of reportable adverse events being captured; Technical outcomes: phone usage patterns, technical problems experienced                                                                                Process measure, perception, technical outcome                                  For adverse events reporting

  Howard, 2016 \[[@ref29]\]                                Lesotho             Mixed-methods, cluster-randomized trial protocol                                SMS                                TB/HIV patients, health care workers           Primary: ART initiation, retention, and TB treatment success; Secondary: time to ART initiation, adherence, change in cluster of differentiation 4 (CD4) count, sputum smear conversion, cost-effectiveness, acceptability                                                                                Process measure, treatment outcome, adherence, cost-effectiveness, perception   For treatment adherence

  Iribarren, 2013 \[[@ref30]\]                             Argentina           Mixed-methods study (including RCT)                                             SMS                                TB patients                                    Primary: feasibility (access to mobile phones, familiarity with texting, rate of participant refusal, suboptimal TB understanding), and acceptability (feeling cared for patient's treatment, self-reporting adherence); Secondary: initial efficacy (microscopy test result from positive to negative, treatment outcome)                                                                                Process measure, perception, adherence, treatment outcome                       For treatment adherence

  Hirsch-Moverman, 2017a \[[@ref31]\]                      Lesotho, Ethiopia   Mixed-methods; implementation science study                                     Phone calls                        TB/HIV patients,\                              The number of call attempts per participant for each month, completeness of monthly calls, success rates, challenges                                                                                Process measure                                                                 For medication adherence
                                                                                TB patients

  Hirsch-Moverman, 2017b \[[@ref32]\]                      Lesotho             Mixed-methods implementation science study, cluster-randomized trial protocol   SMS                                TB patients, health care workers, caregivers   Primary: the number of child contacts Isoniazid preventive therapy (IPT) initiation, IPT completion; Secondary: HIV testing, yield of active prevalent TB among child contacts, acceptability, and utilization of community-based intervention components                                                                                Treatment outcome, perception, process measure                                  For medication adherence and appointment reminders

  Nguyen, 2017 \[[@ref33]\]                                Vietnam             Cohort study                                                                    SMS and mobile app                 TB patients                                    Primary: proportion of patients completing all doses of self-administered treatment; Secondary: proportion of videos uploaded as scheduled, proportion of patients discontinuing using Video DOT (VDOT)                                                                                Treatment outcome, technical outcome, process measure                           For medication adherence

  Daftary, 2017 \[[@ref34]\]                               Ethiopia            Qualitative study                                                               Interactive voice response (IVR)   HIV patients                                   Perceptions and attitude, perceived benefits and challenges                                                                                Perception                                                                      For preventive therapy adherence

  Albino, 2014 \[[@ref35]\]                                Peru                Qualitative study                                                               SMS                                TB patients                                    Perceptions and acceptability                                                                                Perception                                                                      For treatment adherence

  Nhavoto, 2017 \[[@ref36]\]                               Mozambique          Qualitative study                                                               SMS                                TB patients, Health care workers               Usefulness, perceived benefits, ease of use, satisfaction, risks of the SMS system                                                                                Perception                                                                      For treatment adherence

  Hoffman, 2010 \[[@ref37]\]                               Kenya               Observational study                                                             Mobile app                         TB patients                                    Primary: technical feasibility (patient and health provider receptivity to remote directly observed treatment \[DOT\]); Secondary: patient preferences and receptivity to receiving TB health message on a mobile phone                                                                                Technical outcome, perception                                                   For Mobile Direct Observation of Treatment

  de Sumari-de Boer, 2016 \[[@ref12]\]                     Tanzania            Observational pilot study                                                       SMS                                HIV patients, TB patients                      Quantitative: percentage of doses taken on time, percentage of sent reminders (divided by total intake prescription), percentage of correct reminders (after missed doses), percentage of incorrect reminders (after opening the pillbox but the signal was not sent), percentage of extra openings, percentage of missed doses, percentage of adherence with the exclusion of doses that were taken after a reminder; Qualitative: general experience with using the device   Process measure, adherence, perception                                          For medication adherence

  Garfein, 2015 \[[@ref38]\]                               Mexico, USA         Observational pilot study                                                       Mobile app                         TB patients                                    Primary: adherence rate (the number of medication doses observed in videos divided by the number of doses expected during the treatment period); Secondary: perceptions of VDOT                                                                                Adherence, perception                                                           For VDOT

  Dwolatzky, 2006 \[[@ref39]\]                             South Africa        Observational pilot study                                                       Mobile app                         Patients at clinic                             Time taken to locate the households                                                                                Technical outcome                                                               For locating patients' homes by global positioning system and personal digital assistant

  Ha, 2016 \[[@ref40]\]                                    Botswana            Implementation project                                                          Mobile app                         TB patients                                    Cases screened for contact tracing, time required to complete TB contact tracing per contact, quality of data collected, user satisfaction with usability, operational considerations                                                                                Technical outcome, perception                                                   For contact tracing

  Cowan, 2016 \[[@ref41]\]                                 Mozambique          Implementation project                                                          SMS and mobile app                 Health facility                                System installation on computers, development of Web-based interface and automated SMS and email messages, test results uploaded to the system, SMS notifications sent to key personnel, the number of users                                                                                Technical outcome                                                               For remote monitoring solution

  Kunawararak, 2011 \[[@ref14]\]                           Thailand            Implementation project                                                          Phone calls                        TB patients                                    Cure rates, completion rates, failure rates and success rates, conversion rates                                                                                Treatment outcome                                                               For medication adherence

  Lorent, 2014 \[[@ref42]\]                                Cambodia            Implementation project                                                          SMS                                General population                             TB case detection- smear-positivity, clinical TB treatment uptake--time to treatment initiation outcome--treatment outcomes (WHO definitions^d^), delay in linkage to care                                                                                Process measure, treatment outcome                                              For test result notification

  Mahmud, 2010 \[[@ref43]\]                                Malawi              Implementation project                                                          SMS                                Health care workers                            Operational net savings, worker time gained, patient enrollment                                                                                Process measure                                                                 For continuity of care

  Narasimhan, 2014 \[[@ref44]\]                            India               Implementation project                                                          SMS and phone calls                TB patients                                    Treatment completion and cure rates (WHO definitions^d^), treatment adherence rates, adverse drug reaction rates, stigma associated with TB, patient satisfaction, usage of the mHealth initiative                                                                                Treatment outcome, adherence, perception                                        For medication adherence

  Broomhead, 2012 \[[@ref45]\]                             South Africa        Cost minimization analysis                                                      SMS                                TB patients                                    Smear conversion rate, TB cure rate, reduced average cost per patient                                                                                Treatment outcome, cost                                                         For treatment adherence

  Hunchangsith, 2012 \[[@ref46]\]                          Thailand            Cost-effective-ness analysis                                                    SMS                                TB patients                                    Disability-adjusted life years (DALYs) averted, costs (health care perspective), effects of interventions, success rate, failure rate, transfer out rate, death rate                                                                                Health outcome, treatment outcome, cost, cost-effective-ness                    For medication adherence
  --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

^a^RCT: randomized controlled trial.

^b^SMS: short message service.

^c^TB: tuberculosis.

^d^World Health Organization definitions: presented in [Multimedia Appendix 2](#app2){ref-type="supplementary-material"}.

######

Reported outcomes by mHealth intervention type.

  -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
  Intervention type (number of studies) and reference         Categories of outcome measure
  ----------------------------------------------------------- ------------------------------- ------ ----- ----- -------- ----- ----- ----- ----- ----- ----- ----- ----- -----
  **Short message service (SMS; 12 studies)**                 \                               \      \     \     \        \     \     \

  \                                                           \[[@ref22]\]                    ✓^c^   ✓     ✓     ---^d^   ---   ---   ✓     ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref15]\]                    ✓      ✓     ✓     ✓        ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref29]\]                    ✓      ---   ✓     ✓        ✓     ---   ---   ---   ---   ✓     ---   ---   ---

  \                                                           \[[@ref30]\]                    ✓      ---   ✓     ✓        ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref32]\]                    ✓      ---   ---   ✓        ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref35]\]                    ---    ---   ---   ---      ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref36]\]                    ---    ---   ---   ---      ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref12]\]                    ---    ---   ✓     ✓        ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref42]\]                    ✓      ✓     ---   ✓        ---   ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref43]\]                    ---    ---   ---   ✓        ---   ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref45]\]                    ✓      ---   ---   ---      ---   ---   ---   ---   ---   ---   ✓     ---   ---

  \                                                           \[[@ref46]\]                    ✓      ---   ---   ---      ---   ---   ✓     ---   ---   ✓     ✓     ---   ---

  **SMS plus others (5 studies)**                             \                               \      \     \     \        \     \     \

  \                                                           \[[@ref24]\]                    ✓      ---   ---   ✓        ---   ---   ---   ---   ---   ---   ---   ---   ✓

  \                                                           \[[@ref27]\]                    ✓      ✓     ✓     ---      ---   ---   ---   ✓     ✓     ---   ---   ✓     ---

  \                                                           \[[@ref33]\]                    ✓      ---   ---   ✓        ---   ✓     ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref41]\]                    ---    ---   ---   ---      ---   ✓     ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref44]\]                    ✓      ✓     ✓     ---      ✓     ---   ---   ---   ---   ---   ---   ---   ---

  **Mobile app (6 studies)**                                  \                               \      \     \     \        \     \     \

  \                                                           \[[@ref25]\]                    ✓      ✓     ✓     ---      ---   ---   ---   ✓     ✓     ---   ---   ---   ---

  \                                                           \[[@ref28]\]                    ---    ---   ---   ✓        ✓     ✓     ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref37]\]                    ---    ---   ---   ---      ✓     ✓     ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref38]\]                    ---    ---   ✓     ---      ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref39]\]                    ---    ---   ---   ---      ---   ✓     ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref40]\]                    ---    ---   ---   ---      ✓     ✓     ---   ---   ---   ---   ---   ---   ---

  **Phone calls or interactive voice response (3 studies)**   \                               \      \     \     \        \

  \                                                           \[[@ref31]\]                    ---    ---   ---   ✓        ---   ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref34]\]                    ---    ---   ---   ---      ✓     ---   ---   ---   ---   ---   ---   ---   ---

  \                                                           \[[@ref14]\]                    ✓      ---   ---   ---      ---   ---   ---   ---   ---   ---   ---   ---   ---

  **Mobile data collection (1 study)**                        \                               \      \     \     \        \

  \                                                           \[[@ref21]\]                    ---    ---   ---   ---      ---   ✓     ---   ---   ---   ---   ---   ---   ---
  -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------

^a^WHO: World Health Organization.

^b^QoL: quality of life.

^c^Tick marks indicate that the specific category of outcome measure was reported.

^d^Outcome measure was not reported.

Discussion
==========

Principal Findings
------------------

This systematic review critically evaluated the outcomes reported in mHealth studies for TB management in LMICs. The reason why rigorous evidence synthesis is warranted is that recent literature for TB reports mixed results despite the rapid implementation of mHealth technology for TB management. The fragmented pieces of evidence on the effectiveness partly resulted from the wide variations in the definitions of outcome measures in TB mHealth interventions. Even though treatment outcome has been reported by many studies, they often did not adopt the standard definition recommended by the WHO \[[@ref17]\].

The WHO definition of TB treatment outcome is part of an effort to standardize outcome measures for TB at the global level. To promote the use of standardized sets of outcome measures for TB, WHO provided the standard definitions and classifications of TB in terms of diagnosis or treatment outcomes \[[@ref17]\]. The intention for this standardization effort was to coordinate international comparison of TB treatment outcomes through health information systems. However, the findings of our review revealed that mHealth studies for TB have not comprehensively adopted this standardized approach for TB treatment. Only 6 out of 27 interventions chose to report the treatment outcome according to the WHO definition. Interventions involving phone calls, interactive voice response, or mobile data collection did not consider the WHO definition.

Our findings also suggest that, to rigorously evaluate the effectiveness of mHealth interventions for TB, future studies should be carefully designed with regard to the selection of outcome measures. Indeed, using standard definitions for outcome measures within some commonly reported categories can improve comparability across different studies. As assessed in this study, examples of such categories include treatment outcome (preferably using the WHO definition), perception, process measure, adherence, and technical outcome.

The value of this systematic review can be found in its potential to motivate and facilitate consensus on standard definitions of outcome measures used in mHealth interventions for TB so that such effort can guide more effective mHealth intervention designs for improving TB management. Although current literature shows considerable variability in the definition of outcome measures, discussion and coordination among researchers can promote standardized methods in measuring outcomes. Specifically, the outcomes should be comparable, promote transparent communication, and maintain consistency in terminology. Coordination at the global level is necessary to develop a core set of outcome measures for TB mHealth interventions by study design and technology type utilized.

When choosing a core set of outcome measures with standard definitions, there are additional issues to consider. First, the time point for reporting outcome measures should be clinically meaningful and feasible \[[@ref47]\]. Second, a detailed description of the measure should be provided, such as calculation method or definitions. Third, a clear explanation on the target population for each outcome measure can be useful. For example, some outcome measures may be more appropriate for MDR-TB patients rather than TB patients on their first-line therapy course. Finally, long-term outcome measures should be considered to establish fundamental evidence for TB mHealth interventions. The long-term outcomes can be related to physical, psychosocial, or mental health. Despite its importance, our review showed that only 2 out of 27 studies reported long-term health outcomes; Mohammed et al, reported self-reported psychological and physical health measures \[[@ref22]\] and Hunchangsith et al, reported DALYs averted \[[@ref46]\].

Another issue to consider is related to evidence for cost. As this study suggested, insufficient evidence exists in terms of cost-effectiveness or cost of mHealth interventions for TB management. Those previous studies that have evaluated the cost-effectiveness or cost of mHealth interventions only considered SMS as mHealth channels and did not consider or evaluate other mHealth channels and technologies. However, other mHealth channels and technologies such as mobile apps or global positioning system are now available for TB patients \[[@ref48]\]. Therefore, future studies need to assess the cost-effectiveness of such channels and technologies for improving TB management in LMICs.

This study has some limitations. First, the database used for identifying relevant studies is limited to the 3 most frequently cited sources, namely MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews. Grey literature or other sources of information can supplement our findings. To complement this limitation, we attempted to identify additional related studies from relevant systematic reviews searched from our study. Second, the effectiveness of the mHealth interventions for TB was not quantitatively evaluated because of the heterogeneity of the outcomes reported.

Despite these limitations, this study provides an overview of the currently reported outcome measures for mHealth interventions intended to improve TB management in the context of LMICs. The results from this review can be used as a starting point for discussion to adopt standardized definitions within different categories of outcome measures for future mHealth interventions for TB management in LMICs.

Conclusions
-----------

This systematic review of mHealth studies for TB suggests that substantial variability exists with regard to the definitions of outcome measures across studies. Our review highlights that a standardized method for measuring the different outcomes is warranted to improve comparability of outcome measures across studies for a more rigorous and reliable evaluation of the effectiveness of mHealth interventions for TB. In doing so, the coordination among researchers and the development of a core set of outcome measures based on standardized methods would be necessary. Our study provides useful information for researchers to better assess the effectiveness of mHealth interventions for TB. In addition, the study provides insights into the possibility of developing a core set of outcome measures by intervention type and study design based on a standardized or coordinated set of methods.

ShL was involved in the conceptualization of the study and drafted the manuscript. ShL, YL, and SmL developed the search strategy, collected data, and reviewed the identified studies. SMSI critically reviewed the manuscript. SYK critically reviewed the manuscript and interpreted the findings. All authors reviewed and approved the final version of the manuscript. This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (\#21B20151213037).

Conflicts of Interest: None declared.

Search strategy.

Definitions of TB treatment outcome by the WHO \[[@ref17]\].

Risk of bias assessment.

DALY

:   disability-adjusted life years

DOT

:   directly observed treatment

IPT

:   isoniazid preventive therapy

IVR

:   interactive voice response

LMICs

:   low- and middle-income countries

MDR-TB

:   multidrug resistant-TB

mHealth

:   mobile health

RCT

:   randomized controlled trial

SMS

:   short message service

TB

:   tuberculosis

WHO

:   World Health Organization


Efficient use of patient-derived organoids as a preclinical model for gynecologic tumors.
The relevance of patient-derived cancer cells has been recently increasing, particularly in terms of drug discovery and precision medicine. Whereas Matrigel-based organoid culture is a promising technique that enables infinite proliferation of cells from many types of organs in a physiological condition, its validity in gynecologic tumors remains to be established. To address this issue, we aimed at developing an efficient method for organoid culture of both ovarian and endometrial tumors. We conducted 3D culture of 21 gynecologic tumors following our original and modified protocol for Matrigel bilayer organoid culture. We investigated whether propagated organoids retained various features of the original tumors by histopathological examination and targeted genome sequencing. We customized the protocol we previously optimized for murine normal and cancer tissues, so as to circumvent the digestion-resistant nature inherent to gynecologic tumors. Indeed, this modified protocol improved the success rate from 45 to 90%, for robust propagation of organoids from tumors with various stages and subtypes. Finally, 14 patient-derived organoids were established. The recovered organoids were enriched for cancer cells that retained many aspects of the original tumors, including histological features, mutation profiles, and intra-tumoral heterogeneity. A subset of the expanded organoids could develop xenografts in immunodeficient mice, potentially paving the way to drug screening in vivo. Drug response assay in vitro for paclitaxel and cisplatin was feasible using organoid-derived spheroids. We showed that patient-derived organoids closely resembled the original gynecologic tumors, and thereby would serve as a promising resource for preclinical studies.


Q:

Why can't I create a database in a 107GB dbspace I created for my instance?

11.70.FC6 Developer Edition on Windows 7 Pro 64-bit:

Downloaded via IIUG link and installed it.
I created a custom DSS instance named "server" with a 128GB dbspace named "datadbs".
Install wizard created a Windows user "informix".
I connected to instance "server", logging in as "informix".
Executed an SQL script "CREATE DATABASE voters IN datadbs NLSCASE INSENSITIVE;"
This failed (see first image), then tried creating the db via dbaccess menu.
In dbaccess, dbspaces options did not show "datadbs", only root, phys, log & sbs dbs',
but when I do a dir of the dbspaces it shows "datadbs" with 107GB (see second image).
I set the following values in "onconfig.server" (see third image), but still no dice!

A:

Since the datadbs file is not anywhere near 128 MiB, I wonder if you were successful in adding that dbspace.  One might be forgiven for thinking that in fact you were unsuccessful since the database server doesn't think it exists.
Use 'oncheck' or 'onstat' (or both) to check whether the dbspace exists and is intact.  If not, arrange to drop it, or simply remove the datadbs file and try again with the onspaces command.


BOCHAROV RUCHEI, Russia (Reuters) - Russia increased economic pressure on Ukraine on Saturday by drawing a link between disbursement of the next tranche of its $15 billion aid package to Kiev with repayment of a hefty gas bill owed to Russian firms.

The linkage, made in comments by Russia’s finance minister, came as the Kremlin confirmed President Vladimir Putin had held private talks with Ukraine’s leader Viktor Yanukovich in Sochi on Friday before the opening of the Winter Olympics.

No details of the leaders’ talks were disclosed.

Moscow agreed on credits and cheaper gas for Kiev in December to help it meet huge debt payments, gaining the edge over the European Union in a tug-of-war for influence in Ukraine, a former Soviet republic of 46 million people.

Ukraine, whose ailing economy and hryvnia currency have been further battered by months of anti-government protests, sorely needs the next tranche of Russian loans, worth $2 billion.

Russian Finance Minister Anton Siluanov said Russia would follow through on its loan commitment, but also pointedly highlighted Ukraine’s outstanding gas debt of $2.7 billion.

“We will fulfil what we have promised to Ukraine, but we would like the Ukrainian side to comply with the obligations that it has committed to,” Siluanov told reporters at Putin’s Black Sea residence of Bocharov Ruchei.

The gas debt was due for repayment in late January, but Ukraine has not paid up, he added.

CRISIS

“We did not link the (aid) tranches with the transactions between Naftogaz and Gazprom, but they both are state entities. We always agree that our (obligations) between the states and (state) companies should be complied with,” Siluanov said.

Moscow has used gas before as a tool to exert pressure on countries such as Ukraine which are heavily dependent on Russian gas imports.

Ukraine’s political crisis blew up last November when Yanukovich turned his back on a trade pact with the European Union in favour of closer economic ties with Russia, the country’s Soviet-era overlord.

But despite the aid package agreed with Moscow, Yanukovich’s position has become much weaker in the face of sustained and sometimes violent street protests.

Last week, his pro-Russian prime minister quit in an abortive attempt to defuse the protests. Moscow has accused the Western-backed opposition leaders in Kiev of fomenting the unrest in order to topple a democratically elected president.

The political crisis has also badly strained relations between Russia and Western powers, with both sides accusing the other of interfering in Ukraine’s affairs.

Siluanov expressed uncertainty over who to speak to in Kiev, with parliament yet to decide on a new prime minister.

“We would also like to have more understanding of who among our (Ukrainian) colleagues we should be talking to,” he said.

While the details of Friday’s meeting between Putin and Yanukovich are unclear, a similar tete-a-tete between the two leaders late last year is thought to have led to Yanukovich’s last-minute decision to spurn the trade deal with the EU.

The Sochi meeting is likely to have placed the ball firmly in Yanukovich’s court. It follows talks on Wednesday in Kiev between the Ukrainian leader and the EU’s foreign policy chief.

Catherine Ashton told him the EU was ready to help Ukraine in many ways, both financially and with expertise, to improve its long-term economic development.


Shah and Anchor Kutchhi Engineering College organized the 6th edition of SAKEC MUN in association with Maharashtra United Nations Association (MUNA) and United Nations Information Center for India and Bhutan (UNIC) on the 21st and 22nd of March, 2015..

Maharashtra United Nations Association (MUNA) joined hands with Rotaract District Organization, R.I.D. 3140, Rotary Club of Bombay Pier and Rotaract club of SIES Sion (West) to host and organize the Model United Nations Assembly at Amulakh Amichand Bhimji Vividhlakshi Vidyalaya at Matunga on 8th February ,2015 from 9:30 am to 6.00 pm..

The Maharashtra United Nations Association, member of the Indian Federation of UN Associations, collaborated with the United Nations Information Centre for India and Bhutan (UNIC) and the Indo Arab Society in Mumbai, to host the observance of the International Day of Solidarity with the Palestinian People.

Maharashtra United Nations Association observed the World Health Day 2014 in association with Saifee Hospital, Indian Federation of United Nations Association and United Nations Information Centre (UNIC) for India and Bhutan on Moday the 7th April at 5:30 pm.

Street play training, tailoring lessons, skills training workshops, senior citizens’ outings, road traffic camp for children, NGO fairs for youth, celebrating different United Nations Days – these are just some of the activities of the Young Women’s Christian Association (YWCA).

The Indian federation of United Nations Associations (IFUNA), New Delhi, Maharashtra United Nations Association (MUNA) and United Nations Information centre (UNIC) for India and Bhutan joined hands to celebrate the UN Day 2013 at Mumbai.

Maharashtra United Nations Association (MUNA) in association with Rotract Club of Mumbai Shivaji Park (RC-MSP) organized the Model United Nations Assembly, a zealous event at Amulakh Amichand Bhimji Vividhlakshi Vidyalaya, from 9:30 am to 4:30 pm on Sunday 25th August 2013. The resolution being debated at the Model UN Assembly was “Protecting Human Rights in the Syrian Conflict”.

Maharashtra United Nations Association (MUNA) in collaboration with Indian Federation of United Nations Associations (IFUNA), New Delhi, United Nations Information Centre (UNIC) for India and Bhutan, New Delhi and Kohinoor Hospital, ‘de-stresses’ on ‘Prevention of Hypertension’ on World Health Day 2013 at Mumbai.

Organised by The Maharashtra United Nations Association (MUNA), The Simon Wiesenthal Centre, an NGO at the United Nations, Israel Consulate in Mumbai, and St. Xavier’s College encouraged by The United Nations Information Centre (UNIC) for India and Bhutan, New Delhi

Maharashtra United Nations Youth Association (MUNYA) Under the guidance of MUNA in association with Rotract Club of Mumbai Shivaji Park (RC-MSP) organized the Model United Nations Assembly, an ardent event at Amulakh Amichand Bhimji Vividhlakshi Vidyalaya, at Matunga Mumbai

An extremely innovative, informative and interesting event was organized by The MUNA in collaboration with the Indian Coastal Guard (Ministry of Defence – Govt. of India) to celebrate and observe World Environment Day aboard the Coast Guard ships


OOIDA petition for reconsideration of final medical examiner integration rule

By Jami Jones, managing editor

A recent final rule that rolled out a new medical history form and requires medical examiners to transmit the results of DOT physicals within 24 hours of the exam has drawn fire from the Owner-Operator Independent Drivers Association.

OOIDA filed a petition for reconsideration with the Federal Motor Carrier Safety Administration in late May.

The petition requests that the agency reconsider the final rule and calls for the agency to withdraw the final rule and to proceed with a notice and comment period.

On April 23, FMCSA published a final rule that adopted new standards for issuing medical certificates and amended the reporting requirements of the results of DOT physicals.

In the final rule, the agency expanded the medical history criteria and incorporated those criteria into the regulations. A new medical form included in the final rule now has 32 health conditions listed under the medical history portion of the rule. Of those conditions, 13 are new to the form.

New conditions to the form include high cholesterol; chronic cough, shortness of breath or other breathing problems; unexplained weight loss; bone, muscle, joint or nerve problems; blood clots or bleeding problems; chronic infection or other chronic diseases; problems staying awake; loud snoring; sleep apnea; have you ever had a sleep test; have you ever spent a night in the hospital; have you ever been treated for a mental health problem; and have you ever had a broken bone.

OOIDA’s petition states that the final rule does not contain any definition of the listed conditions, nor any guidelines for determining the degree to which any sign of the listed condition reaches a level serious enough to warrant reporting.

“More significantly, FMCSA has not provided any connection between the numerous conditions required to be reported and any risk to highway safety,” the petition states.

The agency also modified the duration of the history to be reported from five years to lifetime. The form now states: “Do you have or have you ever had ...”

“Those plain words can only mean ‘even in your whole life.’ Aside from the obvious problem of a 50-year-old remembering conditions from his teenage years or earlier, what possible relevance would teen acne (a chronic skin disease) or a broken arm at age 5 have on a driver’s ability to operate his vehicle,” the petition states.

“The complete failure of FMCSA to develop any record in support of the changes adopted renders the rule ‘arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law,’” the petition states.

OOIDA also takes aim at FMCSA’s attempt to regulate sleep apnea through the final rule.

Congress previously passed legislation that was signed into law preventing FMCSA from implementing any sleep apnea requirements without going through the rulemaking process.

OOIDA’s petition contends that although FMCSA has added sleep apnea to the health history reporting requirements, the agency failed to develop any record regarding standards for sleep apnea or the need to include sleep apnea as reportable, as a disqualifying condition.

“The final rule is invalid regarding its attempt to regulate sleep disorders for the agency’s failure to act in accordance with the statutory mandate that it address sleep disorders only through formal notice and comment rulemaking. FMCSA has not done so. For this reason alone, FMCSA’s final rule is invalid,” OOIDA’s petition states.

The petition also tackles the new reporting requirement on medical examiners to transmit the results of DOT physicals to the agency within 24 hours of the exam. The requirement, according to the OOIDA petition deprives drivers of the right to challenge a denial of certification.

As written, the final rule mandates that drivers, even with a valid medical card, who fail their DOT physical are immediately deemed not physically fit to drive and their driving privileges are revoked.

So in a scenario where a driver goes in for a physical a couple of months before his or her current card expires, the driver would not have that additional two months to try to rectify the denial of medical certification. LL


SPRINGFIELD — A new plan to raise the state’s minimum wage to $15 an hour is expected to be introduced in the Illinois Senate as early as next week.

Sen. Kimberly Lightford, D-Maywood, said that while negotiations are continuing with business interests and others with a stake in the minimum wage, she expects to introduce something “early next week.”

“We’re still working on (details),” she said. “We’re very committed to keeping everyone at the table, providing an opportunity to express how a minimum wage increase will work with their entity.”

The last increase in the state’s minimum wage went into effect in 2010 when it was increased to $8.25 an hour. It was the last of a series of increases approved in 2006. The federal minimum wage continues to be $7.25 an hour.

Lightford said the plan would be to get the Illinois minimum wage to $15 an hour and to phase it in over several years. Just how long of a phase-in is still being discussed, she said.

“We all know that to get from $8.25 to $15 an hour it can’t be a significant jump,” she said. “It has to be over a period of time to allow business to adjust.”

In 2017, Illinois lawmakers approved legislation to raise the minimum wage to $15 an hour. However, then-Gov. Bruce Rauner vetoed the bill saying it would result in job losses at the low end of the wage scale and hurt the people the minimum wage is supposed to help.

Gov. JB Pritzker supports raising the minimum wage to $15 an hour. Pritzker senior adviser Nikki Budzinski testified in favor of the increase at a Senate Labor Committee hearing Wednesday.

Business interests offered different views of the increase. The National Federation of Independent Business, which represents smaller employers, said something less than a $15-an-hour rate and a minimum wage that varied across the state would be preferable.

“As it stands now, it is a job killer and a business killer,” said Mark Grant, NFIB state director.

Lightford, though, said businesses have said the same thing for years about increasing the minimum wage, and there’s been no documentation of ill effects.

“There’s been no data that told me businesses shut down because of the minimum wage,” she said.

Rob Karr, president and CEO of the Illinois Retail Merchants Association, also endorsed the idea of different rates for different areas of the state. Both Oregon and New York have adopted that idea where a higher minimum wage is in effect for large urban areas and an lower rate is set for less populated parts of those states.

“The suburbs and downstate simply don’t enjoy the same (economic activity) as the city of Chicago,” Karr said.

Lightford said the idea of a regional minimum wage will be considered, but said there are potentially legal issues that would prevent Illinois from doing that. She also questioned if it is fair to pay workers in some portions of the state a lower minimum wage than in other areas.

Concerns about the effect of a minimum wage increase weren’t limited to the business community. Chris Boyster of the Illinois Collaboration on Youth said more than 12,000 people are employed by the organization’s member agencies. Many of them are working at or near minimum wage, he said.

“These human service organizations will not be able to accommodate an increase in the minimum wage without increased financial support from the state,” he said. “Providers want to pay their workforce better. They just need the means to do so.”

The Illinois Association of Park Districts also said increasing the minimum wage would put pressure on park districts that employ teens as life guards, camp counselors and other jobs that pay the minimum wage. Likewise, the state’s nursing homes that serve large numbers of Medicaid patients would be squeezed between paying higher wages with stagnant Medicaid reimbursements, said Pat Comstock of the Health Care Council of Illinois.

Twenty-six states and the District of Columbia have a higher minimum wage than Illinois.


2018 U.S. Open Cup Final

The 2018 Lamar Hunt U.S. Open Cup Final was played on September 26, 2018, at BBVA Compass Stadium in Houston, Texas. The match determined the winner of the 2018 U.S. Open Cup, a tournament open to amateur and professional soccer teams affiliated with the United States Soccer Federation. It was the 105th edition of the oldest competition in United States soccer. This edition of the final was contested between Houston Dynamo and the Philadelphia Union, both of Major League Soccer.

The match was broadcast in English on ESPN2 and in Spanish on Univision Deportes, making it the fourth straight time the cup final was aired on one of the ESPN networks.

Houston Dynamo won the match 3–0 for their first U.S. Open Cup title.

Match

Details

References

Category:2018 U.S. Open Cup
Category:U.S. Open Cup Finals
U.S. Open Cup Final 2018
U.S. Open Cup Final 2018


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119
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Latest Episode

Fish Markets - Follow Hawai’i Chef Ed Kenney to a fish market in Funibashi, Japan, located on the banks of Tokyo Bay. After a brief tour, we meet up with the owners of a local Izakaya (Japanese pub) for a memorable experience. It’s memory Ed takes back home to Hawai’i while visiting the local fish market in Honolulu.

About Family Ingredients

Get an introduction to interesting people and riveting stories linked by a family recipe, starting from a base in Hawaii to locations such as Japan and Puerto Rico. Find the rich and sometimes surprising connections to a treasured family dish.


CNN host Don Lemon and conservative commentator Ben Ferguson got into a heated debate on Wednesday night over NFL players kneeling during the national anthem in protest of racial injustice in the United States.

Lemon opened up the segment by playing a clip from Fox News host Sean Hannity's interview with President Donald Trump earlier that night. Trump said the NFL should have suspended former San Francisco 49ers quarterback Colin Kaepernick for one game after he kneeled during the national anthem last season, two games for the second time, and the full season if he kneeled a third time.

Liberal CNN commentator Van Jones pushed back against Trump's comments and said no athlete disrespects the military.

"We have been trying to get this point made over and over again; they are not protesting the flag. They are not protesting the anthem. No athlete has ever said one bad thing about a soldier. They are concerned about the neighborhoods they left behind where there is still so much injustice and poverty," Jones said.

Ferguson disagreed and said people are not going to have a consensus about the proper way to protest or handle racial injustice because of their "flat-out disrespect" to the American flag, prompting Lemon to say nobody saw it as a protest of the flag, or being disrespectful toward the flag until Trump "made it into an issue."

Ferguson disagreed and said the protest had also become much more about protesting Trump than anything else.

"A lot of the players also didn't protest until they started to protest Donald Trump. You had whole teams stay in the lock room. You had whole teams that had never come out before," Ferguson said.

Lemon followed up by asking Ferguson why he and others are "forcing patriotism" on Americans, prompting Ferguson to say no one is forcing patriotism on anyone, but as the president, Trump has an obligation to protect and defend the honor and integrity of the flag and anthem. He then emphasized that no one is arguing against people having the right to protest.

As the exchange progressed, it grew increasingly heated, with the two often talking over one another. One topic they disagreed on was what behavior is appropriate when when watching a football game and the national anthem is being played.

"I am in a bar almost every weekend during football season having wings and beer and everybody is chugging beers, and I look around and all these people who are screaming about people not standing," Lemon said.

Ferguson countered Lemon's argument by saying that is different when people are at the game and that the players need to stand to "honor America." Lemon responded by saying that each game consists of two American teams and that it's not as if "we’re playing some international country."

Ferguson said his comments are why so many Americans disagree with him, citing his "arrogance" and the "lack of respect" for the American flag.

NFL Commissioner Roger Goodell sent an email to all NFL executives on Tuesday, praising them for their willingness to engage in dialogue, but said their anthem protests were becoming barriers to conversation.

"Like many of our fans, we believe that everyone should stand for the National Anthem," Goodell wrote. "It is an important moment in our game. We want to honor our flag and our country, and our fans expect that of us."

The NFL sent out a message the next day clarifying that Goodell was not "demanding" all players stand, but that the topic would be addressed at the league's upcoming owners meeting.

Cameron CawthorneEmail Cameron | Full Bio | RSSCameron Cawthorne is a Media Analyst for the Washington Free Beacon. He graduated from the University of Virginia in 2013. Prior to joining Free Beacon, Cameron was a Legislative Assistant in the Virginia General Assembly and a War Room Analyst at America Rising.


Q:

Trouble in retrieving contact information

I want to get the contact name from a number i had tried retrieving it through a query But i am not getting the result..It is returning the number itself.....I had  already saved that number to the contacts.
The code i tried is...
public class MainActivity extends Activity {

@Override
protected void onCreate(Bundle savedInstanceState) {
    super.onCreate(savedInstanceState);
    setContentView(R.layout.activity_main);

    String x = getContactNameFromNumber("+918281306132");
    System.out.println(x);
}
private String getContactNameFromNumber(String number) {
    // define the columns I want the query to return

    System.out.println("Entering into getContactNameFromNumber");
    String[] projection = new String[] {
            Contacts.Phones.DISPLAY_NAME,
            Contacts.Phones.NUMBER };

    // encode the phone number and build the filter URI
    Uri contactUri = Uri.withAppendedPath(Contacts.Phones.CONTENT_FILTER_URL, Uri.encode(number));

    // query time
    Cursor c = getContentResolver().query(contactUri, projection, null,
            null, null);

    // if the query returns 1 or more results
    // return the first result
    if (c.moveToFirst()) {
        String name = c.getString(c
                .getColumnIndex(Contacts.Phones.DISPLAY_NAME));
        return name;
    }

    // return the original number if no match was found
    return number;
}

}
I also added a read phone state permission too. Somebody please help me to retrieve the contact name.

A:

You can try my snippet :
public static String findContactByNumber(String phoneNumber,
        ContentResolver cr) {

    Uri lookupUri = Uri.withAppendedPath(PhoneLookup.CONTENT_FILTER_URI,
            Uri.encode(phoneNumber));

    String[] phoneNoProjections = { PhoneLookup._ID,
            PhoneLookup.DISPLAY_NAME };

    Cursor cursor = cr.query(lookupUri, phoneNoProjections, null, null,
            null);

    try {

        if (cursor.moveToFirst()) {

            return cursor.getString(1); //1 is the display name index. 0 is id.

        }

    } finally {

        if (cursor != null)

            cursor.close();

    }

    return null;

}


So . . . I saw the rheumatologist yesterday and he said he is confused . . . basically my blood work indicates SLE, Sjogrens and other connective tissue disorders, but no positive ANA (have never had a positive ANA) . . . he said that he has never really seen my combination of blood work results, has never seen positive cytoplasmic staining without a positive ANA . . . good news is, its not fibro or CFS . . . bad news is he can't nail down anything definitive right now . . . He ordered all new bloodwork again . . . just had that done 2 months ago!

He started me on plaquenil - i have always been pretty resistant to start on meds as long as i could cope, but its been really hard lately . . . so achey, so tired - bone crushing fatigue, nausea every single stinking morning . . . i decided i had to do something . . . sick & tired of being sick & tired.

He said that if my latest issues are lupus related, the plaquenil will help. If it isn't, the plaquenil won't help and we are back to square one. He said all we can do at this point is approach it through a "diagnosis via treatment" method . . . I feel like i'm on "House"!!

Anyway . . . hoping the plaquenil helps . . . hoping something helps.

AnneAlienWife

There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.

I have the opposite problem....no indicators in the bloodwork other than a high positive ANA, but all the symptoms of a variety of AI problems. Lupus seems the most likely. Liver enzymes are occasionally high - and CRP, and white count is occasionally low - usually during a flare. Never had the AI markers run while in an acute flare - always wonder if something would show then. Anyway - have been on Plaquenil 6 mos. - treatment witnout firm diagnosis. I feel it has helped somewhat. Having fibro complicates the results. Will see what rheumie says next week at my 6 mos. visit.

I really feel ya on the "sick and tired of being sick and tired feeling"! I waited too long to try medication. Even if it doesn't help you siginificantly - you have another answer of sorts and you're one step further along in the process. I hope the Plaquenil provides you with relief though, and you start feeling better soon!

The rheumy said that if it were Fibro or CFS, I would have predictable pain trigger points at certain locations . . . when he was "testing" the pain trigger points, it actually felt good (he could have kept at it for a while and saved me the money of going to see my massage therapist)! Also, CFS and Fibro are not considered autoimmune disorders and I have ai markers in my bloodwork along with chronically elevated liver enzymes, low potassium levels, low rdw levels . . .

I suppose that it really doesn't mean that I couldn't have CFS, but he doesn't seem to think that CFS is my issue . . . really got no answers yet as to what really IS my problem, but at this point I really don't have much of a choice but to do the plaquenil thing and see if it works . . . I should have bloodwork results back next week and a follow up with the rheumy in July . . . hopefully by then the plaquenil will have had some results!

Good luck with your rheumy visit next week! let us know how it goes?

AnneAlienWife

There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.

Anne It's good he put you on plaquenil you might start feeling better, it takes about 6 months to start kicking in, hope you can get your answers soon. Take Care. DebbieAsthma,Lupus,H.B.P.,Dermatomyostis,Gastrparsis,Acid Reflux

I hope the plaquenil helps . . . but it does take months to fully build in the system. Some patients feel relief quickly and others don't. It often takes a combination of meds to quiet things down if you are in a flare. Most of us aren't aware that it is working until we go off of it (because we think it isn't working) and then find out that it was actually doing a lot.

Have you gone for your baseline eye exam??? I hope the plaquenil helps you LOTS.

Keep us posted.

Blessings!

In His Grip

AlwaysRosie "We can't control the waves, but we can learn how to surf!!"

I have the baseline eye exam scheduled, although not until the end of june - the opthalmologist was booked until then. The nurse seemed to think that it would be ok to wait that long.

I am hoping the plaquenil works . . . i was on fairly high doses of chloraquine (same family as plaquenil) last year when i went to china (prophylactic for malaria since we were going to some pretty remote areas with less than desireable sanitation in the factories) . . . and, while it gave me the most bizarre dreams, i remember that my skin issues were practically cleared up by the time i got back after 3 1/2 weeks - i contributed it to the fact that it rained the entire time i was there and that the humidity was good for my skin . . . i dunno . . . maybe it wasnt the humidity? we will see . . .

Thanks for the replies :)

AnneAlienWife

There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.

LOL. The humidity wasn't what did it, I live in very high humidity and that doesn't help my skin in the slightest! It was the malaria treatment that helped you out -- chloroquine is often used if/when plaquenil is not tolerated.

I found the dreams went away after a few weeks, so I hope you feel better soon,


Definition

Multimedia

Dry mouth, or xerostomia (zeer-o-STOE-me-uh), refers to any condition in which your mouth is unusually dry. Most often, dry mouth is the result of a decrease in saliva produced by the glands in your mouth (salivary glands), and it's frequently a side effect of medication. Less often, dry mouth may be caused by a condition that directly affects the salivary glands.

Dry mouth is a common problem. It can range from being merely a nuisance to something that has a major impact on your general health and the health of your teeth, as well as your appetite and enjoyment of food.

Saliva helps prevent tooth decay by neutralizing acids produced by bacteria, limiting bacterial growth and washing away food particles. Saliva also enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

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<?php
/**
 * Copyright since 2007 PrestaShop SA and Contributors
 * PrestaShop is an International Registered Trademark & Property of PrestaShop SA
 *
 * NOTICE OF LICENSE
 *
 * This source file is subject to the Open Software License (OSL 3.0)
 * that is bundled with this package in the file LICENSE.md.
 * It is also available through the world-wide-web at this URL:
 * https://opensource.org/licenses/OSL-3.0
 * If you did not receive a copy of the license and are unable to
 * obtain it through the world-wide-web, please send an email
 * to license@prestashop.com so we can send you a copy immediately.
 *
 * DISCLAIMER
 *
 * Do not edit or add to this file if you wish to upgrade PrestaShop to newer
 * versions in the future. If you wish to customize PrestaShop for your
 * needs please refer to https://devdocs.prestashop.com/ for more information.
 *
 * @author    PrestaShop SA and Contributors <contact@prestashop.com>
 * @copyright Since 2007 PrestaShop SA and Contributors
 * @license   https://opensource.org/licenses/OSL-3.0 Open Software License (OSL 3.0)
 */

namespace PrestaShop\PrestaShop\Core\Domain\Category\Command;

use PrestaShop\PrestaShop\Core\Domain\Category\Exception\CategoryConstraintException;

/**
 * Class AddCategoryCommand adds new category.
 */
class AddCategoryCommand
{
    /**
     * @var string[]
     */
    private $localizedNames;

    /**
     * @var int
     */
    private $parentCategoryId;

    /**
     * @var string[]
     */
    private $localizedLinkRewrites;

    /**
     * @var string[]
     */
    private $localizedDescriptions;

    /**
     * @var bool
     */
    private $isActive;

    /**
     * @var string[]
     */
    private $localizedMetaTitles;

    /**
     * @var string[]
     */
    private $localizedMetaDescriptions;

    /**
     * @var string[]
     */
    private $localizedMetaKeywords;

    /**
     * @var int[]
     */
    private $associatedGroupIds;

    /**
     * @var int[]
     */
    private $associatedShopIds;

    /**
     * @param string[] $localizedNames
     * @param string[] $localizedLinkRewrites
     * @param bool $isActive
     * @param int $parentCategoryId
     *
     * @throws CategoryConstraintException
     */
    public function __construct(array $localizedNames, array $localizedLinkRewrites, $isActive, $parentCategoryId)
    {
        $this
            ->setLocalizedNames($localizedNames)
            ->setLocalizedLinkRewrites($localizedLinkRewrites)
            ->setIsActive($isActive)
            ->setParentCategoryId($parentCategoryId);
    }

    /**
     * @return int
     */
    public function getParentCategoryId()
    {
        return $this->parentCategoryId;
    }

    /**
     * @param int $parentCategoryId
     *
     * @return self
     *
     * @throws CategoryConstraintException
     */
    public function setParentCategoryId($parentCategoryId)
    {
        if (!is_int($parentCategoryId) || 0 >= $parentCategoryId) {
            throw new CategoryConstraintException(sprintf('Invalid Category parent id %s supplied', var_export($parentCategoryId, true)), CategoryConstraintException::INVALID_PARENT_ID);
        }

        $this->parentCategoryId = $parentCategoryId;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedNames()
    {
        return $this->localizedNames;
    }

    /**
     * @param string[] $localizedNames
     *
     * @return $this
     *
     * @throws CategoryConstraintException
     */
    public function setLocalizedNames(array $localizedNames)
    {
        if (empty($localizedNames)) {
            throw new CategoryConstraintException('Category name cannot be empty', CategoryConstraintException::EMPTY_NAME);
        }

        $this->localizedNames = $localizedNames;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedLinkRewrites()
    {
        return $this->localizedLinkRewrites;
    }

    /**
     * @param string[] $localizedLinkRewrites
     *
     * @return $this
     *
     * @throws CategoryConstraintException
     */
    public function setLocalizedLinkRewrites(array $localizedLinkRewrites)
    {
        if (empty($localizedLinkRewrites)) {
            throw new CategoryConstraintException('Category link rewrite cannot be empty', CategoryConstraintException::EMPTY_LINK_REWRITE);
        }

        $this->localizedLinkRewrites = $localizedLinkRewrites;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedDescriptions()
    {
        return $this->localizedDescriptions;
    }

    /**
     * @param string[] $localizedDescriptions
     *
     * @return $this
     */
    public function setLocalizedDescriptions(array $localizedDescriptions)
    {
        $this->localizedDescriptions = $localizedDescriptions;

        return $this;
    }

    /**
     * @return bool
     */
    public function isActive()
    {
        return $this->isActive;
    }

    /**
     * @param bool $isActive
     *
     * @return $this
     *
     * @throws CategoryConstraintException
     */
    public function setIsActive($isActive)
    {
        if (!is_bool($isActive)) {
            throw new CategoryConstraintException('Invalid Category status supplied', CategoryConstraintException::INVALID_STATUS);
        }

        $this->isActive = $isActive;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedMetaTitles()
    {
        return $this->localizedMetaTitles;
    }

    /**
     * @param string[] $localizedMetaTitles
     *
     * @return $this
     */
    public function setLocalizedMetaTitles(array $localizedMetaTitles)
    {
        $this->localizedMetaTitles = $localizedMetaTitles;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedMetaDescriptions()
    {
        return $this->localizedMetaDescriptions;
    }

    /**
     * @param string[] $localizedMetaDescriptions
     *
     * @return $this
     */
    public function setLocalizedMetaDescriptions(array $localizedMetaDescriptions)
    {
        $this->localizedMetaDescriptions = $localizedMetaDescriptions;

        return $this;
    }

    /**
     * @return string[]
     */
    public function getLocalizedMetaKeywords()
    {
        return $this->localizedMetaKeywords;
    }

    /**
     * @param string[] $localizedMetaKeywords
     *
     * @return $this
     */
    public function setLocalizedMetaKeywords(array $localizedMetaKeywords)
    {
        $this->localizedMetaKeywords = $localizedMetaKeywords;

        return $this;
    }

    /**
     * @return int[]
     */
    public function getAssociatedGroupIds()
    {
        return $this->associatedGroupIds;
    }

    /**
     * @param int[] $associatedGroupIds
     *
     * @return $this
     */
    public function setAssociatedGroupIds(array $associatedGroupIds)
    {
        $this->associatedGroupIds = $associatedGroupIds;

        return $this;
    }

    /**
     * @return int[]
     */
    public function getAssociatedShopIds()
    {
        return $this->associatedShopIds;
    }

    /**
     * @param int[] $associatedShopIds
     *
     * @return $this
     */
    public function setAssociatedShopIds(array $associatedShopIds)
    {
        $this->associatedShopIds = $associatedShopIds;

        return $this;
    }
}