Markerregan3283

Background Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. This study aims to assess the level of glycemic control and factors contributing to uncontrolled glycemia among diabetic patients at the Nekemte Referral Hospital, West Ethiopia. Methods A cross sectional study was conducted on diabetic patients attending the diabetes clinic of Nekemte Referral Hospital. A total of 252 study participants were included in the study. Data were collected by interviewing patients during hospital visits and reviewing respective databases. The association between dependent and independent variables was assessed using bivariable and stepwise multivariable logistic regression. A variable with a p-value 10 years (p = 0.005), poor knowledge about diabetes (p = 0.012), taking insulin (p = 0.004) and taking metformin plus glibenclamide (p less then 0.001). Conclusion A finding of this study revealed that a glycemic control of study participants was poor. Thus greater effort is needed to improve glycemic control. Health care professionals should work on improving the adherence to anti-diabetic medications of diabetic patients and knowledge of diabetic patients on diabetes by providing education to the patients during follow up to improve glycemic control.Dietary electrolyte balance (dEB) is known to affect acid-base status and mineral metabolism, but is rarely considered in diet formulation for pigs. Yet, the use of a wide variety of local feedstuffs in Europe contributes to lowering the dEB and increasing the fibre content. Hence, mineral requirements may be modified and skeletal health affected. Therefore, the effects of a lower dEB and a higher dietary Ca level on acid-base balance and mineral status were assessed in young pigs fed a diversified diet. A total of twenty-four weaned pigs were fed a control moderate-dEB diet (C) or a diversified moderate-dEB (D), low-dEB (D-A) or low-dEB supplemented with Ca (D-CA) diet. Growth performance, venous blood gas and chemistry, urine pH, mineral balance and femur characteristics were determined. With an equivalent dEB compared with the C diet, the D diet caused an acidification of the urine and increased the excretion of P as a result of a higher dietary content of S. Low-grade metabolic acidosis occurred in piglets fed the D-A diet with changes at systemic and urine levels. A higher excretion of ammonia and P in urine was observed and some bone characteristics tended to be negatively affected. Ca supplementation partially counteracted the effects of low-grade acidosis. Urine excretion of P and ammonia was alleviated and bone characteristics improved. In conclusion, a higher Ca supply must be considered in more diversified diets to counteract the risk of evolving towards low-grade metabolic acidosis which can negatively affect bone.Objectives The present study uses the Atlanta Heart Failure Questionnaire as a tool to evaluate and design a tailored education material for ambulatory heart failure patients with preserved ejection fraction, highlighting the strengths and weakness toward the planning of education programs. Methods A total of 450 patients were screened; 112 patients were recruited, and 27-item was used to evaluate the usefulness of this questionnaire. All patients received education by a dedicated medical education about the nature of the disease, risk factors and management including prevention of complications. Descriptive statistics were used for assessing the sample characteristics. Results In the assessment of patient disease knowledge, in a 7-item questionnaire, the most well-understood item was correctly identified in 95% patients, whereas the least-understood item was identified in 1.8% of patients. In the assessment of patient management knowledge, in a 6-item questionnaire, the most well-understood item was correctly identified in 50% of patients and the least-understood item was identified in 10% of patients. In the assessment of patient medication intake knowledge, in a 3-item questionnaire, the most well-understood item was correctly identified in 97.3% of patients and the least-understood item was identified in 26.6% of patients. Conclusion For a disease not fully understood, the study has concluded the usefulness of Atlanta Heart Failure Questionnaire for filling the gaps, setting a base line and follow-up in the process of educating ambulatory heart failure patients with preserved ejection fraction HFPF.Phase and polarization singularities are important degrees of freedom for electromagnetic field manipulation. Detecting these singularities is essential for modern optics, but it is still a challenge, especially in integrated optical systems. In this paper, we propose an on-chip plasmonic spin-Hall nanograting structure that simultaneously detects both the polarization and phase singularities of the incident cylindrical vortex vector beam (CVVB). The nanograting is symmetry-breaking with different periods for the upper and lower parts, which enables the unidirectional excitation of the surface plasmon polariton depending on the topological charge of the incident optical vortex beam. Additionally, spin-Hall meta-slits are integrated onto the grating so that the structure has a chiral response for polarization detection. We demonstrate theoretically and experimentally that the designed structure fully discriminates both the topological charges and polarization states of the incident beam simultaneously. The proposed structure has great potential in compact integrated photonic circuits.Dynamic metasurfaces are endowed with self-adaptive and learning capabilities, enabling an array of important applications ranging from satellite communications to the monitoring of human health and activities.Chromatic dispersion spatially separates white light into colours, producing rainbows and similar effects. Detrimental to imaging but essential to spectroscopy, chromatic dispersion is the result of material properties in refractive optics and is considered an inherent characteristic of diffractive devices such as gratings and flat lenses. Here, we present a fundamental relation connecting an optical system's dispersion to the trajectories light takes through it and show that arbitrary control over dispersion may be achieved by prescribing specific trajectories, even in diffractive systems. Using cascaded metasurfaces (2D arrays of sub-micron scatterers) to direct light along predetermined trajectories, we present an achromatic twisted metalens and experimentally demonstrate beam deflectors with arbitrary dispersion. Ruboxistaurin inhibitor This new insight and design approach usher in a new class of optical systems with wide-ranging applications.