Daughertyvincent4705

An electron mobility of ∼29 500 cm2/(V s) is measured, which is the highest value reported for free-standing 2D InSb nanostructures in literature. We envision the use of 2D InSb NFs for fabrication of advanced quantum devices.Sequential infiltration synthesis (SIS) into poly(styrene)-block-maltoheptaose (PS-b-MH) block copolymer using vapors of trimethyl aluminum and water was used to prepare nanostructured surface layers. Prior to the infiltration, the PS-b-MH had been self-assembled into 12 nm pattern periodicity. Scanning electron microscopy indicated that horizontal alumina-like cylinders of 4.9 nm diameter were formed after eight infiltration cycles, while vertical cylinders were 1.3 nm larger. Using homopolymer hydroxyl-terminated poly(styrene) (PS-OH) and MH films, specular neutron reflectometry revealed a preferential reaction of precursors in the MH compared to PS-OH. The infiltration depth into the maltoheptaose homopolymer film was found to be 2.0 nm after the first couple of cycles. It reached 2.5 nm after eight infiltration cycles, and the alumina incorporation within this infiltrated layer corresponded to 23 vol % Al2O3. The alumina-like material, resulting from PS-b-MH infiltration, was used as an etch mask to transfer the sub-10 nm pattern into the underlying silicon substrate, to an aspect ratio of approximately 21. These results demonstrate the potential of exploiting SIS into carbohydrate-based polymers for nanofabrication and high pattern density applications, such as transistor devices.We studied how GC death in glaucoma related to the intraocular pressure (IOP), eyeball volume (VS) and elasticity (volumetric KS and tensile ES), and eyeball volume-pressure relation. Glaucomatous GC loss was studied in DBA/2J (D2) mice with wild-type mice as controls. GCs were retrogradely identified and observed with a confocal microscope. The elasticity calculation was also done on published data from patients treated by a gas bubble injection in the vitreous cavity. The GC population in D2 mice (1.5- to 14-month-old) was negatively correlated with following factors VS (p = 0.0003), age (p = 0.0026) and IOP (but p = 0.0966). As indicated by average values, adult D2 mice (≥6 months) suffered significant GC loss, low KS and ES, and universal expansion of VS with normal IOP. KS and ES in the patients were also lower upon prolonged eyeball expansion compared to acute expansion. Based on the results and presumptions of a closed and continuous eyeball space (thereby ΔVS ≈ ΔVW, ΔVW-the change in the aqueous humor amount), we deduced equations on the ocular volume-pressure relationship ΔIOP = KS*ΔVW/VS or ΔIOP = (2/3)*[1/(1-ν)]*(H/R)*ES*ΔVW/VS (ν, Poisson's ratio taken as 0.5; R, the curvature radius; and H, the shell thickness). Under normal atmospheric pressure, IOP of 10~50 mmHg contributed only 1.2~6.6% of the pressure opposing the retina and eyeball shell. We conclude 1) A disturbance of ocular volume-pressure homeostasis, mediated primarily by low KS and ES, expanded VS, and large ΔVW, is correlated with GC death in glaucoma and 2) D2 mice with GC loss and normal IOP may serve as animal models for human normal-tension glaucoma.

The thalamus is the hub of the brain and has a significant role in various brain activities.

This study explored racial differences in the association between parental education and thalamus volume among American children.

Using data from the Adolescent Brain Cognitive Development (ABCD), we analyzed the structural Magnetic Resonance Imaging (sMRI) data of 11141 9-10 years old children. The main outcome was the left thalamus volume. The independent variable was parental education. Age, sex, ethnicity, family marital status, and intracranial volume were the covariates. Race was the moderator. To analyze the data, we used mixed-effects regression models.

In race-stratified models, high parental education was associated with smaller thalamus volume in White but not Black children. In the pooled sample, significant interactions were found between race and parental education suggesting that the effect of parental education on left thalamus volume is significantly smaller for Blacks and mixed/other race children than White children. We did not find similar findings for the right thalamus volume.

The effect of parental education on children's left thalamus volume seems to be weaker for Black and other/mixed-race children than their White counterparts. This finding is in support of Minorites' Diminished Returns (MDRs) that suggest due to social stratification and racism, economic resources have weaker-than-expected effects for minority than majority populations.

The effect of parental education on children's left thalamus volume seems to be weaker for Black and other/mixed-race children than their White counterparts. This finding is in support of Minorites' Diminished Returns (MDRs) that suggest due to social stratification and racism, economic resources have weaker-than-expected effects for minority than majority populations.Health disclosure at work is complicated for people with invisible chronic conditions. Due to the lack of visible symptoms, invisible conditions affect the work life of people in ways that are not obvious to others. This study examines how people disclose and conceal their conditions in the workplace and opens the design space for this topic. In the first phase, we analyzed posts on two subreddit forums, r/migraine and r/fibromyalgia, and found a range of strategies that individuals use to disclose or conceal their conditions. In the second phase, we created five technological design concepts based on these strategies that were shown to eight people with migraines or fibromyalgia in semi-structured interviews. Based on these phases, we contribute understandings of disclosure and concealment of invisible conditions in the workplace for future research, such as potential areas for intervention ranging from individual to societal level efforts, as well as the potential and limitations of relying on empathy from others.Research into companion robots for older adults, including those who are socially isolated and lonely, continues to grow. Although some insight into older adults' preferences for various robotic types and functionality is emerging, we lack research examining how these robots fulfil or challenge a range of values and aspirations individuals have in later life. This study examines the attitudes and perspectives of 16 older adults (aged 65+) living independently but alone in their own homes, who were interviewed and shown videos depicting three distinctive companion robots a talking assistant; a roving toylike vehicle; and a robotic dog. This approach illuminated values, preferences, and needs amongst older people that are vital for understanding the potential of companion robots. In comparing the robots, participants expressed concerns about the impact of different companion robots on their abilities and skills, their sense of autonomy and control over their lives, and the maintenance of several kinds of dignity. These results inform user-centered design and use of companion robots for older people living alone and independently.

To perform a geospatial and temporal trend analysis for coronavirus disease-2019 (COVID-19) in a Midwest community to identify and characterize hotspots for COVID-19.

We conducted a population-based longitudinal surveillance assessing the semi-monthly geospatial trends of the prevalence of test confirmed COVID-19 cases in Olmsted County, Minnesota, from March 11, 2020, to October 31, 2020. As urban areas accounted for 84% of population and 86% of all COVID-19 cases in Olmsted County, MN, we determined hotspots for COVID-19 in urban areas of Olmsted County (Rochester and other small cities), MN during the study period by using kernel density analysis with a half-mile bandwidth.

As of October 31, 2020, a total of 37,141 subjects (30%) were tested at least once of whom 2,433 (6.6%) tested positive. Testing rates among race groups were similar 29% (African American), 30% (Hispanic), 25% (Asian), and 31% (White). Ten urban hotspots accounted for 590 cases at 220 addresses (2.68 case/address), compared to 1,843 cases at 1,292 addresses in areas outside hotspots (1.43 case/address). Overall, 12% of population residing in hotspot areas accounted for 24% of all COVID-19 cases. Hotspots were concentrated in neighborhoods with low-income apartments and mobile home communities. People living in hotspots tended to be minorities and from lower socioeconomic background.

Geographic and residential risk factors might significantly account for overall burden of COVID-19 and its associated racial/ethnic and socioeconomic disparities. Results could geospatially guide community outreach efforts (e.g., testing/tracing, and vaccine roll out) for populations at risk for COVID-19.

Geographic and residential risk factors might significantly account for overall burden of COVID-19 and its associated racial/ethnic and socioeconomic disparities. Results could geospatially guide community outreach efforts (e.g., testing/tracing, and vaccine roll out) for populations at risk for COVID-19.Reactivation or reinfection cases of SARS-CoV-2 are known but there is scarce evidence about reactivation in immunocompromised patients. Here, we report the case of a 61-year-old male undergoing a conditioning regimen with fludarabine, cyclophosphamide, and 2-Gy total body irradiation in preparation of a haplo-identical allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia (AML). He received the first dose of a COVID-19 vaccine 6 weeks prior allo-HSCT and was hospitalized a month prior because of a COVID-19 bilateral pneumonia. On discharge, he showed two negative SARS-CoV-2 nasopharyngeal PCR swabs as well as a high SARS-CoV-2 antibody titer. On admission for allo-HSCT, he tested negative for SARS-CoV-2 again. Conditioning with fludarabine, cyclophosphamide, and 2-Gy total body irradiation was started and the patient developed lymphopenia. During his hospital stay, he tested positive for SARS-CoV-2 in a PCR test twice but remained asymptomatic. The conditioning regimen was continued as planned. Later during his stay, the patient showed undetectable SARS-CoV-2 load four times. This case documents possible reactivation of SARS-CoV-2 and raises questions about reactivation risks among recipients of stem cell transplants and other immunocompromised patients.As more and more studies have shown that venovenous extracorporeal membrane oxygenation (VV-ECMO) improves oxygenation and prognosis of critical patients, VV-ECMO has been frequently used in critical patients for severe acute respiratory distress syndrome (ARDS). Prone positioning (PP) is a postural therapy for ARDS, which permits for better ventilation/perfusion ratio (V/Q) matching, improvement of hypoxemia. Some articles revealed that performing PP during ECMO for refractory respiratory failure is feasible; however, the results obtained were controversial. Therefore, we performed a systematic review to further assess the effects of PP during ECMO for refractory respiratory failure. Six studies with 465 subjects were enrolled. Four articles examined changes of PaO2/FiO2 ratio after PP during VV-ECMO; PaO2/FiO2 ratio improved from 18.5 to 62 mmHg. Our analysis inferred that the PP-ECMO group did not have a significant advantage in survival at discharge (odds risk 1.42, 95% confidence interval 0.92-2.18; p = 0.11) compared with the ECMO group. We found that the PP-ECMO group had a significantly longer duration than the ECMO group (MD 5.37, 95% CI 4.19-6.54, I2 = 67%, P less then .00001). ICU length of stay in the PP-ECMO group was significantly longer than the ECMO group (MD 7.29, 95% CI 4.06-10.52, I2 = 64%, P less then .00001). No unplanned extubation of ECMO was recorded. In conclusion, our review found that performing PP during ECMO for refractory respiratory failure is safe and PP can improve the PaO2/FiO2 ratio, which is in line with the length of PP performed.

Women with hormone receptor-positive, early-stage breast cancer who adhere to adjuvant endocrine therapy (AET) reduce the risk of cancer recurrence and mortality. AET, however, is associated with adverse symptoms that often result in poor adherence. We applied participatory action research (PAR) principles to conduct focus groups and interviews to refine and enhance a web-enabled app intervention that facilitates patient-provider communication about AET-related symptoms and other barriers to adherence.

We conducted four focus groups with women with early-stage breast cancer on AET (N=28), stratified by race (Black and White) and length of time on AET (<6 months and >6 months), to determine preferences and refine the app-based intervention. A fifth mixed-race focus group was convened (N=6) to refine THRIVE app content using high-fidelity mock-ups and to develop new, tailored feedback messages. We also conducted interviews with oncology nurses (N=5) who participated in the THRIVE randomized controlledrs and adherence to participatory design by incorporating patient-requested app features, app aesthetics, and message content. The app has the potential to improve AET adherence and quality of life among breast cancer survivors and reduce disparities in mortality rates for Black women by facilitating communication with healthcare providers.

THRIVE app content reflects researchers' partnership with a racially diverse sample of breast cancer survivors and healthcare providers and adherence to participatory design by incorporating patient-requested app features, app aesthetics, and message content. The app has the potential to improve AET adherence and quality of life among breast cancer survivors and reduce disparities in mortality rates for Black women by facilitating communication with healthcare providers.Autophagy is a critical cellular process by which biomolecules and cellular organelles are degraded in an orderly manner inside lysosomes. This process is particularly important in neurons these post-mitotic cells cannot divide or be easily replaced and are therefore especially sensitive to the accumulation of toxic proteins and damaged organelles. Dysregulation of neuronal autophagy is well documented in a range of neurodegenerative diseases. However, growing evidence indicates that autophagy also critically contributes to neurodevelopmental cellular processes, including neurogenesis, maintenance of neural stem cell homeostasis, differentiation, metabolic reprogramming, and synaptic remodelling. These findings implicate autophagy in neurodevelopmental disorders. In this review we discuss the current understanding of the role of autophagy in neurodevelopment and neurodevelopmental disorders, as well as currently available tools and techniques that can be used to further investigate this association.Eukaryotic cells release the phylogenetically ancient protein acyl coenzyme A binding protein (ACBP, which in humans is encoded by the gene DBI, diazepam binding inhibitor) upon nutrient deprivation. Accordingly, mice that are starved for one to two days and humans that undergo voluntary fasting for one to three weeks manifest an increase in the plasma concentration of ACBP/DBI. Paradoxically, ACBP/DBI levels also increase in obese mice and humans. Since ACBP/DBI stimulates appetite, this latter finding may explain why obesity constitutes a self-perpetuating state. Here, we present a theoretical framework to embed these findings in the mechanisms of weight control, as well as a bioinformatics analysis showing that, irrespective of the human cell or tissue type, one single isoform of ACBP/DBI (ACBP1) is preponderant (~90% of all DBI transcripts, with the sole exception of the testis, where it is ~70%). Based on our knowledge, we conclude that ACBP1 is subjected to a biphasic transcriptional and post-transcriptional regulation, explaining why obesity and fasting both are associated with increased circulating ACBP1 protein levels.Acute respiratory distress syndrome is a refractory respiratory syndrome with a high prevalence in the Intensive Care Unit. Though much improvement has been achieved over the last 50 decades, the disease continues to be under-recognized and under-treated, and its mortality remains high. Since the first report, the radiologic examination has been an essential part in evaluating this disease. Chest X-ray radiography and computed tomography are conventional imaging techniques in routine clinical practice. Other image modalities, including lung ultrasound, electrical impedance tomography, positron emission tomography, have demonstrated their respective advantages over recent years but have not yet been broadly applied in clinical practice. Among these modalities, computed tomography and its quantitative analysis have shown an irreplaceable power in diagnosis, intervention evaluation and prognostic prediction. In this review, we briefly introduced the basics of acute respiratory distress syndrome and summarized imaging advances. In addition, we focused on the computed tomography modality and highlighted the value of its quantitative assessment.

Injuries are a public health concern accounting for 2.78 million fatalities globally. Welders are exposec to a broad range of injuries (e.g. cuts, burns, eye injuries, skin irritations, and musculoskeletal disorders) and yet, there is paucity of information on context specific determinants to inform injury prevention and control. This study determined the factors associated with occupational injuries among welders in Uganda.

A cross-sectional study was conducted among welders in Wakiso District, Uganda. Pretested and translated questionnaires were used to collect data from 327 randomly selected respondents using face to face interviews. 2 parishes were purposively selected, and 20 metal workshops were systematically selected in each parish. Descriptive statistics and adjusted odds ratios were computed.

A high prevalence 287 (87.8%) of self-reported occupational injuries was found among welding workers with cuts/burns 242 (84.3%) and eye injuries 180 (62.7%) reported as the most sustained injuries. Occupational injuries were associated with being a causal labourer with informal training (AOR 4.70 (2.03-10.84)) and working for longer hours (AOR 2.63 (1.26-5.51)). Those with more work experience were less likely to be involved in occupational injuries (AOR 0.30 (0.11-0.84)).

The prevalence of occupational injuries among small-scale welding workers was high and this was associated with learning their trade at work and working for longer hours. Mitigation measures that focus on safety at workplace, advocating for capacity training, and enforcement of workplace regulations should be instituted.

The prevalence of occupational injuries among small-scale welding workers was high and this was associated with learning their trade at work and working for longer hours. Mitigation measures that focus on safety at workplace, advocating for capacity training, and enforcement of workplace regulations should be instituted.

Schistosomiasis remains a major public health problem in Kenya. Environmental factors are critical in creating a medium for growth and spread of schistosomiasis vectors. The study investigated the environmental factors influencing prevention and control of schistosomiasis infection in Mwea West Sub County, Kirinyaga County-Kenya.

A multi stage sampling was used to identify four hundred and sixty-five (465) household. Analytical descriptive cross-sectional design that utilised quantitative data collection method was used. Data was collected using a pretested structured questionnaire and analysed using Chi square tests or Fisher's exact tests where applicable.

Study results indicated a significant association

between household level of education, members being affected by floods during the rainy season and schistosomiasis infection. The result further indicates level of significance (

) in the association between sources of water in a household and schistosomiasis infection. No level of significance whaviours for diagnosis and treatment of schistosomiasis as a way of reducing the spread of infection.

Dengue is a viral disease transmitted by female Aedes mosquitoes which are commonly found in tropical and subtropical areas. There is a dramatic increase in annual incidence rate of dengue attributed to urbanisation, poor environmental management as well as increased people mobility. Outbreak of dengue have been reported in Tanzania in recent years with Dar es salaam being the most affected region. Dengue is associated with haematological derangements and itindicates the severity of the disease. These changes have not been well elucidated in Tanzanian patients. The aim of this study was to determine these derangements among dengue patients admitted at Kairuki hospital in Dar es salaam, and compare these changes with non-dengue febrile patients.

A retrospective cross sectional study was conducted among patients who were suspected to have dengue; tested for dengue IgM and their Complete Blood Count were tested during the index illness. This information was obtained from Kairuki hospital laboratory database. combined with these haematological changes may be used by clinicians as a guide to order confirmatory test for suspected dengue cases.

Patients with dengue had significantly low total white blood cell and lymphocyte count compared to non-dengue febrile patients. Lymphopenia is a significant haematological predictor for dengue positive results. Case defining signs and symptoms combined with these haematological changes may be used by clinicians as a guide to order confirmatory test for suspected dengue cases.

Initiating breastfeeding during the first hour after birth and continuing breastfeeding exclusively for 6 months prevents childhood infections such as diarrhoea. Exclusive breastfeeding (EBF) for the first 6 months of life of the baby is recognised globally as the best and the most effective intervention to ensure the survival of babies. The aim of this study was to determine the prevalence of EBF and its predictors among mothers of 0 to 6 months infants from pastoralists and hunters' community in Manyara region-Tanzania.

This was a community-based analytical cross-sectional study that involved 342 mothers of 0 to 6 months infants who were randomly selected through 4 stage multistage sampling technique. Data was collected using an interviewer-administered questionnaire. Collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20. Binary Logistic Regression analysis was used to establish factors associated with EBF practices.

The prevalence of EBF among postnatal women frois highly recommended to come up with strategies that will improve knowledge on EBF and practice of EBF.

Majority of mothers from pastoralists' and hunters' societies were not practising EBF. Predictors of EBF practice were; the age of infants, maternal age, level of education of the mother and knowledge on exclusive breastfeeding. Poor EBF practice was mainly contributed to low level of knowledge about the EBF. The low level of knowledge could have been contributed by poor access to maternal services. Nature of living (lack of permanent settlement) of the study population could have contributed to low access to maternal services. An innovative interventional study is highly recommended to come up with strategies that will improve knowledge on EBF and practice of EBF.

Globally in 2017, Burundi was the 9

country with the highest population growth rate of 3.2% and a fertility rate of 5.5 children per woman. This probably suggested low uptake of Modern Contraceptive methods (MCM) in the country. Our analysis investigated factors associated with low uptake of MCM among women of reproductive age in Burundi.

Cross sectional data of non-pregnant women aged 15-49 years was extracted from the Burundi Demographic and Health Survey (2016-2017). We analysed the data at univariate, bivariate and multivariate levels to assess factors influencing MCM uptake among these women using Epi-Info 7.2.2.6.

Of the 9,945 women, 2,372 (23.8%) were using MCM. Ngozi province had the highest prevalence of MCM users [284/691(37.7%)]. The most used MCM among respondents was injectable contraceptive (48.3%). As respondent's age increases, the odds of using MCM decreases; 20-24 years (aOR=0.9, 95% CI [0.6-1.2]), 30-34 years (aOR=0.8, 95% CI [0.5-1.0]), 35-39 years (aOR=0.7, 95% CI [0.5-0.9]), 40-4ation is recommended.

Diabetes Mellitus (DM) is a worldwide public health problem and its prevalence has been rising rapidly in low and middle income countries (LMICs) including Tanzania. According to WHO report 2015, DM is ranked number six as a leading cause of death worldwide. Strong evidence suggests that DM may be associated with Tuberculosis (TB) and could affect TB treatment outcomes. Tanzania is among the 22 countries that have a high burden of TB and currently facing increased epidemic of DM. The increasing diabetes prevalence may be a threat to TB control and counteract strategies to end TB by 2030 as proposed by WHO.

To determine proportion of TB patients who are co-infected with DM in Moshi municipal council, Kilimanjaro Tanzania.

This study was a hospital based cross-sectional study conducted in April to July 2018 at 4 health facilities; Mawenzi Regional Referral hospital, St. Joseph District Designated hospital, Pasua Health center and Majengo Health centre in Moshi municipal. The study included adults aged 18 years and above attending either of the 4 health facilities for TB care. The study included newly diagnosed and those who were on TB treatment. Interviews were conducted followed by blood glucose testing. Data was entered and analysed using SPSS.

A total of 153 TB patients were enrolled, their mean age was 42.5 (±14.75) years and 46 (30.1%) were females. The prevalence of DM among TB patients in this study was 9.2%. Factors associated with TB-DM comorbidity were age (OR 4.43, 95% CI 1.18-16.55), HIV status (OR 3.88, 95% CI 1.06-14.11), and family history of DM (OR 6.50, 95% CI 0.67-25.56).

One in ten patients with TB had confirmed DM. There is a need for future studies to assess if DM influences TB treatment and outcomes in this setting.

One in ten patients with TB had confirmed DM. There is a need for future studies to assess if DM influences TB treatment and outcomes in this setting.

Bacterial vaginosis (BV) is one of the most common genital tract infections in pregnancy associated with an increased risk of pregnancy losses, maternal and perinatal morbidity and mortality. Different social behavioural and obstetric factors can contribute to the development of BV. Determining the predictors of BV could be the best way of identifying women at high risk of developing the disease.

This was a cross-sectional study conducted between December 2017 and February 2018 to determine the prevalence and predictors of BV among pregnant women attending antenatal Clinic (ANC) at Muhimbili National Hospital (MNH), Tanzania. Participants were recruited using systematic random sampling. For each consented participant, a pretested questionnaire was filled, a pelvic examination was done and a sample was collected. BV was diagnosed using Nugent's score. Data was analysed using Statistical Package for Social Scientists (SPSS) version 23.0. Bivariate and multivariate logistic regression analysis was done to deless than 30 years, primary education level and below, vaginal douching, HIV infection, STI, more than one lifetime sexual partners and early age of sexual debut were found to be significant predictors of BV. The high prevalence of BV in our population should necessitate policy makers to include screening and treatment of BV in the future policy of antenatal care package, as BV is associated with significant maternal and neonatal morbidity and mortality. Women should also be educated on harmful effects of certain behavioural practices such as vaginal douching that predispose to BV. In addition symptoms of BV such as abnormal vaginal discharge during pregnancy are inconsistent, under reported and often overlooked. Therefore, a high-risk approach can be used for screening and treatment of asymptomatic women.

Hypertension remains a public-health challenge globally. Its prevention, early detection, proper and adequate treatment and control should be given high consideration to prevent occurrence of cardiovascular disease and stroke. This study is guided by the Health Belief Model (HBM) to investigate the influence of treatment compliance using HBM constructs among elderly hypertensive patients in 3 regional hospitals in Dar es Salaam, Tanzania.

An analytical cross-sectional study was conducted in 3 region hospitals in Dar es Salaam from April to May 2012. The study included patients who were on antihypertensive medications. Simple Random Sampling was used to enrol the study participants. Data was collected using structured questionnaire. Data was analysed using SPSS version 20. Linear Multiple Regression analysis was performed to identify variables which are strongest predictor of treatment compliance among variables of the Health belief Model.

A total of 135 participants were enrolled of whom 56% were compliant to hypertensive treatment. Multivariate analysis indicated significant model fit for the data (F=11.19 and

<

). The amount of variance in treatment compliance that was explained by the predictors was 30.3% (R

=0.303) with perceived barrier being the strongest predictor of treatment compliance (β=-0.477;

<

). Other predictor variables were not statistically associated with treatment compliance.

The study showed that 56% of study participants had hypertensive treatment compliance and perceived barrier to treatment was the strongest predictor. Innovative strategy on improving patients' perception of barrier to treatment is recommended in order to improve treatment compliance.

The study showed that 56% of study participants had hypertensive treatment compliance and perceived barrier to treatment was the strongest predictor. Innovative strategy on improving patients' perception of barrier to treatment is recommended in order to improve treatment compliance.

Pregnancy Induced Hypertension (PIH) is a common burden during pregnancy usually associoted with adverse maternal and paternal outcomes. The uric acid serum level was identified as an important biochemical marker which can predict preeclampsia, a type of PIH. This study was conducted to evaluate the effects of serum uric acid levels in association with blood pressure among pregnant women attending Ruhengeri Referral Hospital.

A cross-sectional study was designed and 80 pregnant women in different gestation trimesters participated in the study. Data was collected from September to October 2018. Digital sphygmomanometer was used to test blood pressures for participants. Blood samples were collected in red top tubes and centrifuged to obtain serum for uric acid levels. Using Humastar 80, uric acid levels were measured for each participant. Data was analysed using Statistical Package for Social Sciences (SPSS) version 23.0. Bivariate correlation was used to analyse the relationship between uric acid levels an association of hypertension and hyperuricemia was recorded with a strong correlation between blood pressures and serum uric acid levels. Examination of Uric acid levels among pregnant women should be routinely performed for early identification and management of hypertension.

Healthcare associated infections is a global burden and is one of the main causes of maternal and neonatal morbidity and mortality during the time of labour when admitted to the hospital. Healthcare workers' hands are in most cases the vehicle for transmission of microorganisms from patient to patient. Good hand hygiene practices at the bedside are a simple way of reducing healthcare associated infections. The objective was to assess the impact of a criterion-based audit on infection prevention performance and knowledge during vaginal delivery at a hospital in Tanzania. The quantitative findings were discussed with staff to identify barriers and solutions to quality improvement.

A mixed-method uncontrolled, before and after intervention study by criterion-based audit was performed at the labour ward at Kilimanjaro Christian Medical Centre. Criteria for best practice were established together with key staff based on national and international guidelines. Sixty clean procedures during vaginal birth were obsn and introducing alcohol-based hand rub resulted in improvements on infection prevention performance.

The criterion-based audit process identified substandard care for infection prevention at the labour ward. An intervention of discussing baseline findings and a short training session and introducing alcohol-based hand rub resulted in improvements on infection prevention performance.

The study examined the influence of implementation of employee empowerment on competitive advantage in hospitals within Nairobi. The study looked at the following aspects of employee empowerment; competence, teamwork, motivation, reward and recognition. Employee empowerment is derived from the Total Quality Management (TQM) principles bringing forth competitive advantage that results from high customer satisfaction levels, employee satisfaction and operations efficiency.

A descriptive correlational research design that applied positivism philosophy. Data was collected from both private and public hospitals within Nairobi targeting patients who were admitted in these hospitals for more than three days during the study period and senior employees of the respective hospitals. There were 308 participants, 154 hospital employees and 154 patients from 31 hospitals within Nairobi. After institutional and individual consent was obtained, participants filled a self-administered questionnaire. The collected data was coded into SPSS Version 23 software and the analysis was done using descriptive and inferential statistics.

The findings illustrated that employee empowerment significantly predicted competitive advantage. High responsiveness and good attitude, being reliable, empathy and assuring the patients of their state best enhance patients' and employee satisfaction.

This brings out the importance of realigning the staff inputs towards improving patient experiences, as well as considering employees' performance as individual instead of considering them as teams.

This brings out the importance of realigning the staff inputs towards improving patient experiences, as well as considering employees' performance as individual instead of considering them as teams.

The Corona virus disease, first identified in Wuhan city, Hubei province of China, is a respiratory illness caused by Novel Corona Virus also known as Severe Acute Respiratory Syndrome Corona Virus 2 (SARS Cov.2). The disease is characterised by; dry cough and shortness of breath with difficulty in breathing and at least 2 of the following; fever, chills, muscle pain, headache, sore throat and loss of test and smell. Uganda in general and Mbale in particular has people of diverse culture, religion and ethnic background as well as diverse socio economic activities with various practices. This multi-cultural environment creates differences in perception of information and practices. Most cultures encourage socialisation through social functions like attending weddings, funerals, work places and gatherings and Muslims who have to go for congregation prayers in the mosques 5 times a day among others. This puts such communities at risk of spreading the disease very fast and slow in adapting to control measures.

both political and religious leaders in Health Education Campaigns. Government should provide facemasks and enforce their use. A study to assess the ability of both political and religious leaders in health promotion campaigns should be carried out.There is an unmet need for the treatment of hydrocephalus in Tanzania. Thousands of newborns each year in the region are affected by this condition and access to care remains a challenge. While treatment options like cerebrospinal fluid diversion through ventriculo-peritoneal shunting are within the skill set of general surgeons, the potential complications represent an additional challenge. We present a 10-month-old Tanzanian female who developed bilateral-subdural hematomas after insertion of a ventriculoperitoneal shunt.Many years ago, Aloe Vera was cited to have a lot of therapeutic properties including; anti-microbial, anti-viral, anti-cancer, anti-oxidant, anti-inflammatory, skin protection, wound healing, and regulation of blood glucose and cholesterol. However, Aloe could present some side effects. This review focused on the latest discoveries regarding the therapeutic role of Aloe plant or its compounds on the acquired biological capabilities for tumour growth and progression namely; evading growth suppressor, avoiding immune destruction, enabling replicative immortality, tumour promoting inflammation, activating invasion and metastasis, inducing angiogenesis, genome instability and mutation, resisting cell death, deregulating cellular energetics and sustaining proliferating signalling. It clarified the anti-cancer activities it exerts on different types of cancer and also highlighted some pro-oncogenic pathways that can be disrupted by different compounds of Aloe.

The incidence of paediatric cancers has increased in recent years; however, with advances in the treatment of paediatric cancer, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. Given the high stress levels associated with cancer, it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors.

This study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer.

We performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer (survivors) during follow-up visits at the University Hospital 'Policlinico G Rodolico' of Catania (Italy) and 98 healthy controls among medicine students. We administered the Defence Mechanism Inventory (DMI) to assess defence styles. The Symptom Checklist-90-Revised (SCL-90-R) and the Davidson Trauma Scale (DTS) were administered to assysis, we found how the decreasing of TAS utilization in survivors as the consequence of cancer history, has decreased interpersonal sensitivity, anxiety and GSI score in these subjects compared with controls. Similary, the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale. Unexpectedly, our analysis excluded relationships between cancer history, other defence styles and psycopathological scores as we initially assumed.

Integrating data from mediation and correlation analysis, we found how the decreasing of TAS utilization in survivors as the consequence of cancer history, has decreased interpersonal sensitivity, anxiety and GSI score in these subjects compared with controls. Similary, the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale. Unexpectedly, our analysis excluded relationships between cancer history, other defence styles and psycopathological scores as we initially assumed.The intertidal zone is characterized by persistent, tidally-driven fluctuations in both abiotic (e.g., temperature, oxygen, and salinity) and biotic (e.g., food availability and predation) factors, which make this a physiologically challenging habitat for resident organisms. The relative magnitude and degree of variability of environmental stress differ between intertidal zones, with the most extreme physiological stress often being experienced by organisms in the high intertidal. Given that so many of the constantly shifting parameters in this habitat are primary drivers of metabolic rate (e.g., temperature, [O2], and food availability), we hypothesized that sessile conspecifics residing in different tidal zones would exhibit distinct "metabolic phenotypes," a term we use to collectively describe the organisms' baseline metabolic performance and capacity. To investigate this hypothesis, we collected acorn barnacles (Balanus glandula) from low, mid, and high intertidal positions in San Luis Obispo Bay, CA, anrt metabolism during more prolonged episodes of emersion or during events other than emersion (e.g., coastal hypoxia and predation). There were also no significant differences in CS activity or baseline O2 consumption rates (in air or seawater at 14°C) across tidal heights, which imply that aerobic metabolic capacity may not be as sensitive to tidal position as anaerobic processes. Understanding how individuals occupying different shore heights differ in their metabolic capacity becomes increasingly interesting in the context of global climate change, given that the intertidal zone is predicted to experience even greater extremes in abiotic stress.

This study was undertaken with the following objectives (a) to find out the awareness of warning symptoms and risk factors of stroke, (b) response to acute stroke, and (c) factors associated with awareness, risk factors, and response to acute stroke among community-dwelling adults in Biswanath district of Assam.

Using a cross-sectional design, a community-based study was done among 340 adults (mean age 38 years, men 55%) selected using multistage cluster sampling. Information on sociodemographic variables, stroke warning symptoms, risk factors, and response to acute stroke was collected using an adapted World Health Organization (WHO) STEPs stroke surveillance tool. Bivariate and logistic regression analysis were done to find out the factors associated with stroke warning symptoms, risk factors, and response to acute stroke. A "P" value < .05 was considered for statistical significance.

Awareness of stroke was significantly higher among males (

< .01), better educated (

< .01), government employees (

< .05), high-income group (

< .01), and those who reported receiving information from a professional source (

< .01) compared to their counterparts. Knowledge of at least one stroke risk factor and providing at least one correct response to acute stroke was higher among males, better educated, government employees, higher income groups, and those who received information from professional source compared to their counterparts (

< .05).

Awareness of stroke warning symptoms, risk factors, and response to acute stroke needs to be improved focusing on women, low education groups, those working in the nongovernment sector, and low-income groups by health professionals.

Awareness of stroke warning symptoms, risk factors, and response to acute stroke needs to be improved focusing on women, low education groups, those working in the nongovernment sector, and low-income groups by health professionals.Malnutrition in critical care is highly prevalent and well documented to have adverse implications on morbidity and mortality. During the current COVID-19 pandemic, the evolving literature has been able to identify high risk groups in whom unfavourable outcomes are more common, for example, obesity, premorbid status, male sex, members from the Black, Asian and Minority Ethnic (BAME) community and others. Nutritional status and provision precritical and pericritical phase of COVID-19 illness is gaining traction in the literature assessing how this can influence the clinical course. It is therefore of importance to understand and address the challenges present in critical care nutrition and to identify and mitigate factors contributing to malnutrition specific to this patient group. We report a case of significant disease burden and the associated cachexia and evidence of malnutrition in a young 36-year-old male with Somalian heritage with no pre-existing medical conditions but presenting with severe COVID-19 during the first wave of the pandemic (March 2020). We highlight some key nutritional challenges during the critical phase of illness signposting to some of the management instigated to counter this. These considerations are hoped to provide further insight to help continue to evolve nutritional management when treating patients with COVID-19.

Primary care is the ideal setting to promote weight management, warranting innovative ways to support patients. This systematic review aimed to determine whether providing food to patients in primary care can help to reduce body weight.

Four databases were searched for studies that aimed to elicit weight loss by directly providing foodstuffs and/or supplements to patients in primary care settings. Interventions with adults of any gender or race were included. Interventions that involved other components such as exercise classes or education sessions were excluded. The methodological quality of each study was appraised using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.

Four heterogeneous studies met the eligibility criteria, representing 476 adults. Two studies used meal-replacement products but differed in length and intensity, another study provided green tea and vitamin E supplementation, and the final study provided vouchers for use at a farmers' market hosted at a primary care clinic. Interventions ranged in length from 4 to 13 weeks. Three of the four studies observed weight loss in some form and all studies observed at least one other improvement in a health outcome such as waist circumference, blood pressure or fasting insulin levels.

A small yet notable body of literature supports the concept of providing food to patients in primary care settings to support weight loss. Further, high-quality research is needed on the efficacy and cost-effectiveness of this approach to ultimately inform policy initiatives for primary care.

A small yet notable body of literature supports the concept of providing food to patients in primary care settings to support weight loss. Further, high-quality research is needed on the efficacy and cost-effectiveness of this approach to ultimately inform policy initiatives for primary care.

Reviews on the relationship of low-energy sweeteners (LES) with body weight (BW) have reached widely differing conclusions. To assess possible citation bias, citation analysis was used to quantify the relevant characteristics of cited articles, and explore citation patterns in relation to review conclusions.

A systematic search identified reviews published from January 2010 to March 2020. Different characteristics (for example, type of review or research, journal impact factor, conclusions) were extracted from the reviews and cited articles. Logistic regression was used to estimate likelihood of articles with particular characteristics being cited in reviews. A qualitative network analysis linked reviews sub-grouped by conclusions with the types of articles they cited.

(OR; 95% CI) for likelihood that articles with particular characteristics were cited as evidence in reviews.

From 33 reviews identified, 183 different articles were cited (including other reviews). Narrative reviews were 62% less likelywith the Open Science Framework (https//osf.io/9ghws).

Prior to data analysis, the protocol was registered with the Open Science Framework (https//osf.io/9ghws).

Poor diet is a leading cause of death worldwide. Doctors are well placed to provide dietary advice, yet nutrition remains insufficiently integrated into medical education. Enforcement of curriculum or accreditation requirements such as nutrition requires relevant regulatory frameworks. The aim of this review was to identify nutrition content or requirements for nutrition education in accreditation standards or formal curriculum guidance for medical education internationally.

Non-systematic comparative analysis.

An internet search using the Google Search engine, the WHO Directory of Medical Schools and Foundation for Advancement of International Medical Education and Research Directory of Organizations that Recognise/Accredit Medical Schools was conducted through September 2020 to identify government and organisational reports as well as publications from regulatory and professional bodies relevant to medical education.

Eligible publications included (A) accreditation standards, (B) competency standardof nutrition in medical education has appeared throughout medical education literature for more than five decades, yet without consensus standards there is little likelihood of uniform adoption.

This review is a call to action for the medical profession including government, health agencies and educational and accreditation entities. The inclusion of nutrition in medical education has appeared throughout medical education literature for more than five decades, yet without consensus standards there is little likelihood of uniform adoption.

The majority of Indian women have a poor dietary folate and vitamin B

intake resulting in their chronically low vitamin status, which contributes to anaemia and the high incidence of folate-responsive neural-tube defects (NTDs) in India. Although many countries have successfully deployed centrally-processed folate-fortified flour for prevention of NTDs, inherent logistical problems preclude widespread implementation of this strategy in India. Because tea-the second most common beverage worldwide (after water)-is consumed by most Indians every day, and appeared an ideal vehicle for fortification with folate and vitamin B

, we determined if daily consumption of vitamin-fortified tea for 2 months could benefit young women of childbearing-age in Sangli, India.

Women (average age=20±2 SD) used teabags spiked with therapeutic doses of 1 mg folate plus

0.1 mg vitamin B

(Group-1, n=

)

0.5 mg vitamin B

(Group-2, n=

), or mock-fortified teabags (Group-0, n=

) to prepare a cup of tea every day for 2 utstanding scalable vehicle for fortification with folate and vitamin B

in India, and has potential to help eliminate haematological and neurological complications arising from inadequate dietary consumption or absorption of folate and vitamin B

.

Tea is an outstanding scalable vehicle for fortification with folate and vitamin B12 in India, and has potential to help eliminate haematological and neurological complications arising from inadequate dietary consumption or absorption of folate and vitamin B12.

Smoking has been associated with poorer outcomes in relation to COVID-19. Smokers have higher risk of mortality and have a more severe clinical course. There is paucity of data available on this issue, and a definitive link between smoking and COVID-19 prognosis has yet to be established.

We included 5224 patients with COVID-19 with an available smoking history in a multicentre international registry Health Outcome Predictive Evaluation for COVID-19 (NCT04334291). Patients were included following an in-hospital admission with a COVID-19 diagnosis. We analysed the outcomes of patients with a current or prior history of smoking compared with the non-smoking group. The primary endpoint was all-cause in-hospital death.

Finally, 5224 patients with COVID-19 with available smoking status were analysed. A total of 3983 (67.9%) patients were non-smokers, 934 (15.9%) were former smokers and 307 (5.2%) were active smokers. The median age was 66 years (IQR 52.0-77.0) and 58.6% were male. The most frequent comorbidities were hypertension (48.