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Approximately three-quarters of participants (76.5%) agreed that thalassemia screening should be compulsory for the individual and the majority of students and 92.7% recognized the importance of thalassemia screening for both partners. Approximately three-quarters (75.9%) of participants disagreed that fetuses with thalassemia should be aborted. More than half of the participants disagreed that thalassemia carriers and patients should be prevented from marrying each other. Generally, older respondents (final year students), respondents who had dealt with thalassemia patients, and respondents with relatives with thalassemia had more comprehensive knowledge of thalassemia. Campaigns focusing on college and university students should be regarded as an essential element of the thalassemia prevention strategy for contemporary UAE society.Asymptomatic carriage of methicillin-resistant Staphylococci (MRS) may allow for the unseen dissemination of antibiotic-resistant strains through the population. This study investigates the prevalence and epidemiological risk factors that contribute to the spread of MRS in a university setting in Amman, Jordan. A cross-sectional questionnaire-based study was performed in December 2019. Five hundred and four students enrolled in the study and provided skin and nasal swabs. Swabs were then processed to isolate MRS on Mannitol Salt Agar (MSA) + 4 µg/ml oxacillin. Isolates were tested for their antibiotic susceptibility using the disc diffusion assay. Epidemiological risk assessment was performed using the Chi-square test and univariate and multivariant analysis. The percentage carriage of MRS in the 504 students was 40.4%. The carriage rate of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) from the skin and nasal areas was 13.5% and 26.9%, respectively. The percentage of male carriers was significantly higher than females, and the only identified epidemiological risk factor related to the carriage was attendance at a fitness club. All MRS isolates were resistant to oxacillin (100%), cefoxitin (45.5%), erythromycin (35.2%), gentamycin (10.2%), ciprofloxacin (12.7%), nitrofurantoin (12.2%), linezolid (7.8%), amikacin (1.47%), and Vancomycin (0.49%). 42% of MRS expressed a multiple antibiotic resistance (MAR) index above 0.2. Three isolates expressed a MAR index of 0.8. MRS has been exhibited to be present in an otherwise healthy population of students, which may then act as a reservoir for MAR strains.The increase in depression during the COVID-19 pandemic underscores the importance of systematic approaches to identify individuals with mental health concerns. Primary care is often underutilized for depression screening, and it is not clear how practices can successfully increase screening rates. This study describes a quality improvement initiative to increase depression screening in five Family Medicine clinics. The initiative included four Plan-Do-Study-Act cycles that resulted in implementing a standardized workflow for depression screening, collaborative efforts with health information technology to prompt providers to perform screening via the medical record, delivering educational materials for providers and clinic staff and conducting follow-up education. Between September 2020 and April 2021 there were 23,745 clinic encounters with adult patients that were analyzed to determine whether patients were up-to-date on depression screening following their visit. PHA-665752 research buy A multi-level logistic regression model was constructed to determine the changes in likelihood of a patient being up-to-date on screening over the study period, while controlling for patient demographics and comorbidities. The average proportion of up-to-date patients increased from 61.03% in September 2020 to 82.33% in April 2021. Patients aged 65+ and patients with comorbidities were more likely to be up-to-date on screening; patients with telemedicine visits had lower odds of being up-to-date on depression screening. Overall, this paper describes a feasible, effective intervention to increase depression screening in a primary care setting. Additionally, we discuss lessons learned and recommendations to inform the design of future interventions.This study explored racial and ethnic differences in perception of work environment, safe work practices, general health status, experience of work-related injury or illness and subsequent symptom reporting and health care seeking behaviors among cleaning workers. This study analyzed cross-sectional data obtained from 183 cleaning workers employed in a university hospital or a health sciences campus in Northern California. The sample included 120 Asians (65.6%), 37 Hispanics (20.2%), and 27 other ethnicities (14.2%); 85.7% were foreign-born. Asian workers perceived lower job control and supervisor support and higher job strain than other workers. The odds of perceiving general health as excellent or very good were lower among Asians compared to Hispanics and Others. Asians who experienced chemical-related symptoms were less likely than Hispanics and others to report the symptoms to their supervisor or seek healthcare. Our study findings indicated racial/ethnic differences in perceptions of work and general health, seeking healthcare, and reporting behaviors among cleaning workers. Asian workers, specifically, may need special attention to improve their experiences of work environments and health in the workplace.

Selective internal radiation therapy (SIRT) requires a good liver registration of multi-modality images to obtain precise dose prediction and measurement. This study investigated the feasibility of liver registration of CT and MR images, guided by segmentation of the liver and its landmarks. The influence of the resulting lesion registration on dose estimation was evaluated.

The liver segmentation was done with a convolutional neural network (CNN), and the landmarks were segmented manually. Our image-based registration software and its liver-segmentation-guided extension (CNN-guided) were tuned and evaluated with 49 CT and 26 MR images from 20 SIRT patients. Each liver registration was evaluated by the root mean square distance (RMSD) of mean surface distance between manually delineated liver contours and mass center distance between manually delineated landmarks (lesions, clips, etc.). The root mean square of RMSDs (RRMSD) was used to evaluate all liver registrations. The CNN-guided registration was furts the feasibility of applying the CNN&LM- or CNN-guided registration to volume-level dose prediction. The CNN&LM- and CNN-guided registrations for CTs can be applied to voxel-level dose prediction according to their small V70 change for most lesions. The CNN-guided MR to CT registration still needs to incorporate landmark guidance for smaller change of voxel-level dose estimation.In this paper, a novel ANN flood forecasting model is proposed. The ANN model is combined with traditional hydrological concepts and methods, taking the initial Antecedent Precipitation Index (API), rainfall, upstream inflow and initial flow at the forecast river section as input of model, and flood flow forecast of the next time steps as output of the model. The distributed rainfall is realized as the input of the model. The simulation is processed by dividing the watershed into several rainfall-runoff processing units. Two hidden layers are used in the ANN, and the topology of ANN is optimized by connecting the hidden layer neurons only with the input which has physical conceptual causes. The topological structure of the proposed ANN model and its information transmission process are more consistent with the physical conception of rainfall-runoff, and the weight parameters of the model are reduced. The arithmetic moving-average algorithm is added to the output of the model to simulate the pondage action of the watershed. Satisfactory results have been achieved in the Mozitan and Xianghongdian reservoirs in the upper reaches of Pi river in Huaihe Basin, and the Fengman reservoir in the upper reach of Second Songhua river in Songhua basin in China.Breed type and environmental factors such as breeding season may have a significant impact on neonatal morphometrics. We followed a total of 236 elective cesarean sections in Belgian Blue (BB) cows, from which neonatal calves were morphometrically assessed (in cm) within the first 72 h of delivery using a strictly standardized protocol. The effect of the season of birth on each calf measurement was analyzed using mixed linear regression models, including the farm of origin as a random effect. Calves born in spring had a longer diagonal length (69.7 ± 1.24; P = 0.05) than those born in autumn (66.9 ± 1.16). The tibial length of calves born in spring (35.8 ± 0.48) was longer (P 0.08). Based on the results of this study, it can be concluded that the birth season influences the morphometrics of neonatal BB calves, with a tendency for spring to be associated with the largest body size. The latter is important to avoid dystocia when BB cattle are crossed with other breeds.Engagement in lifelong HIV care is critical for both patient and public health, yet there are limited resources to invest in improving HIV outcomes. We systematically reviewed evidence on the cost-effectiveness of retention and re-engagement interventions. We searched five databases for peer-reviewed studies published between 2010 and 2020. We assessed reporting and methods quality, extracted data on target populations, interventions, and cost-effectiveness, and evaluated overall strength of evidence. Eleven studies met inclusion criteria, and eight had moderate-high quality. Cost-effectiveness estimates ranged from cost-saving to over $1,000,000/quality-adjusted life year (QALY) gained. Of the 73 cost-effectiveness ratios reported, 64% were  less then  $100,000/QALY gained. Interventions were more likely to be cost-effective when targeted to high-risk groups, implemented in locations where baseline retention levels were low, and when used in combination with other high-impact HIV interventions (such as prevention). Overall, existing evidence is moderately strong that retention and/or re-engagement interventions can be cost-effective in high-income countries.While there is strong evidence that the experience of intimate partner violence (IPV) shapes PrEP use among heterosexual women, evidence for similar relationships among gay, bisexual and other men who have sex with men (GBMSM) is scant. In this paper we analyze baseline data from a large randomized controlled trial (RCT) of an HIV prevention intervention for GBMSM recruited from three cities (Atlanta, Detroit and New York City) to examine how the recent experience of IPV shapes their rankings of PrEP delivery options. Men were asked to rank from 1 to 8 PrEP taken by daily pill, event-based pill, injection, anal suppository (before sex), suppository (after sex), gel (penile or rectal) (before sex), and gel (after sex) and condoms. The analysis sample is 694 HIV-negative, sexually active GBMSM. Analysis considers an ordinal outcome measuring participant's ranked preferences for their future use of eight HIV prevention options. Men who experienced physical IPV preferred PrEP in pill form, while men who experienced partners monitoring their behaviors (monitoring IPV) preferred PrEP by injection.