bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ Attitudes Towards Their Job in Outpatient HIV Facilities in Namibia: A Qualitative Descriptive Study
Authors: Adynski Gillian I , Leeman Jennifer , Adynski Harry , Ledford Alasia , McQuide Pamela , Bock Ria , Tjituka Francina , Jones Cheryl
Published: May 2021

Background
Nurse attitudes such as job satisfaction and burnout affect nurses’ ability to do their job well. Positive nurse attitudes have been associated with better patient outcomes, while negative job attitudes have been associated with increased nurse turnover and negative patient outcomes. The Job Demand Resource Model theorized that job attitude mediates the relationship between a job’s demands and resources and organizational outcomes. In Namibia’s outlying located hospitals, health centers and clinics, nurses are key prescribers and managers of antiretroviral therapy. It is vital to understand nurses’ job attitudes, factors that contribute to nurses’ job attitudes and how nurses perceive the impact of their job attitudes, in order to best understand how policy makers can empower nurses to do their jobs well. This paper seeks to examine: 1) factors that contribute to nurses’ job attitudes, and 2) how nurses’ job attitudes affect their ability to do their jobs well.
Methods
This study is a qualitative descriptive study of 18 semi-structured interviews with nurses working in outlying located hospitals, health centers, and clinics in northern Namibia. Interviews were analyzed using directed content analysis, with codes derived from the Job Demand Resource Model.
Results
Job factors that influence job attitudes included support from coworkers, workload, access to material resources, access to information, and patient rapport. Personal resilience factors included spirituality and emotional awareness. Patient outcomes were reported to shape nurses’ job attitudes by increasing the drive to learn more at work, improve patients’ satisfaction, decrease mistakes, decrease peer conflicts, increase the drive to coach patients on medication adherence, increase focus while at work, and decrease missed nursing care.
Conclusions
This study’s finding support the importance of investing in factors that promote positive nurse attitudes such as making investments when feasible in human resources (improving support form coworkers), providing material resources, facilitating positive patient relations, and supporting nurses by providing opportunities to increase their knowledge. This study also highlights the importance of nurse resilience against negative job attitudes, coming from intrinsic factors amongst nurses helping them to deal with stress at work.
Effect of Droplet Transition on the Dynamic Behavior of the Keyhole during 6061 Aluminum Alloy Laser-MIG Hybrid Welding
Authors: Li Yue , Zhao Yanqiu , Zhou Xudong , Zhan Xiaohong
Published: May 2021

The simulation method in laser-MIG hybrid welding, which involves two heat sources and multiple welding parameters, is beneficial to reveal the complex physical phenomena and dynamic behavior of molten pool keyhole during welding process. In this investigation, laser-MIG hybrid welding for 6-mm-thick 6061 aluminum alloy was performed under different heat input by the high-power disc laser, MIG welding system and KUKA Robot. The high-speed camera system was used to observe the droplet transition phenomenon in the welding process. Besides, a thermal-fluid coupling model was established to simulate the temperature field and flow field, which were changed by the droplet transfer during laser-MIG hybrid welding. The experimental and simulated results showed that the droplet transition behavior affected the formation of the keyhole. The keyhole was the smallest when the droplet contacted the molten pool. In addition, the droplet transition brought external momentum and energy to the molten pool, which was conducive to the increase of the flow rate of the molten pool.
Investigation of the Factors Affecting Quality of Life in Patients with Mild to Moderate Alzheimer's Disease: A Cross-Sectional Study from Turkey
Authors: Felekoğlu Elvan , ÖZALEVLİ Sevgi , YAKUT Hazal , AKTAN Rıdvan , YENER Görsev
Published: May 2021

Background

Like other chronic diseases with limited medical treatment, the most important goal of Alzheimer’s disease rehabilitation is to provide a better quality of life. The purpose of this study was to investigate the factors affecting the quality of life of the patients with Alzheimer's Disease (according to parts of the Quality of Life in Alzheimer’ Disease Questionnaire: patient, proxy and total score).
Methods

In this cross-sectional study, 73 home-dwelling patients with Alzheimer's Disease and their caregivers were recruited. Cognition, depression and Quality of Life in Alzheimer’ Disease -self rating were asked to the patient. The caregiver was asked about patient’s sociodemographic information, sleepiness, activities of daily living and Quality of Life in Alzheimer’ Disease -proxy rating.
Results

The Quality of Life in Alzheimer’ Disease -self rating were higher than the Quality of Life in Alzheimer’ Disease -proxy rating. Cognition (p = 0.02), sleepiness (p < 0.01) and depression (p = 0.03) were correlated with the Quality of Life in Alzheimer’ Disease -self rating, while the independence level of the patient in activities of daily living was correlated to the Quality of Life in Alzheimer’ Disease -proxy rating (p < 0.05). Predicting quality of life according to linear regression analysis those were statistically significant in respectively; depression is for Quality of Life in Alzheimer’ Disease, depression and cognition were for Quality of Life in Alzheimer’ Disease -self rating and instrumental activities of daily living was for QoL-AD-PR (p < 0.01).
Conclusion

While subjective situations such as psychology is important for the patients with Alzheimer's Disease, objective conditions such as the independence of the patient’s in daily life activities are important for the caregiver. While evaluating the quality of life, both the evaluations of the patients with Alzheimer's Disease and the caregiver should be applied, because different things are prioritized by them and priorities of both should be taken into account when planning the treatment program.
Potential Diagnostic and Therapeutic Targets for Hepatocellular Carcinoma Based on Exosome-Derived Competitive Endogenous RNA Network
Authors: Tian Yuan , Yang Dongliang , Wang Tieshan , Bu He , Wu JinBao , Zhang Wei , Jian Shengbo , Zhang Li
Published: May 2021

Background: Hepatocellular carcinoma (HCC) is one of the most malignant tumors in the world. The pathogenesis of HCC is complex and closely related to chronic uncontrollable inflammation. As a bridge between inflammation and cancer, circulating exosomes play a vital role in early tumorigenesis, metastasis, and immune escape. Studies have shown that exosomes containing specific RNAs may be potential diagnostic and therapeutic targets for HCC. Purpose The current research investigated key circRNA through exosome-derived competitive endogenous RNA network based on the ExoRBase database. Methods: The circRNA, lncRNA, and mRNA expression profiles of human blood samples were downloaded from the ExoRBase database. At the standard of P<0.05 and log FC>0, differentially expressed genes (DEGs) were further identified between normal human and HCC patients. The co-expressed pairs of DEGs were predicted by TargetScan, miRcode, and StarBase databases. The ceRNA network was constructed by Cytoscape software. Subsequently, target genes corresponding to circRNA in the ceRNA network were annotated and analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG). The potential transcription factors were screened by FunRich database. Results: At the criterion of P<0.05 and log FC>0, 13 differentially expressed circRNAs(DECs) were identified with 9 up-regulated and 4 down-regulated. The co-expressed differentially expressed miRNAs-mRNAs (DEMis-DEMs) (620 pairs), differentially expressed miRNAs- LncRNAs (DEMis-DElncRNA) (684 pairs) and DEMis-DECs (53 pairs) were finally predicted to construct the ceRNA network. The GO analysis indicated that target genes in the ceRNA network were mainly enriched in the molecular function of protein serine/threonine kinase activity. KEGG pathway analysis suggested target genes were enriched in two pathways of MAPK and central carbon metabolism. Conclusion: The study provides a valuable reference for HCC through the ceRNA network in exosomes. Besides, hsa_circ_0000284 may be potential diagnostic markers of HCC.
The Whole Genome Sequence of a Novel Chrysovirus From Beauveria Bassiana Vuillemin, an Entomopathogenic Fungus
Authors: Li Le , Kang Qin , Zhang Song-Bai , Hai Du , Lu Yang , Sui Li , Li Qiyun , Zhang Zheng-kun
Published: May 2021

Beauveria bassiana, an entomopathogenic fungus, has a wide host range and is used for arthropod pest control worldwide. Here, we report the discovery and characterization of a novel double-stranded RNA (dsRNA) mycovirus Beauveria bassiana chrysovirus 2 (BbCV2), isolated from the B. bassiana from China. The genome of the virus was determined by metagenomic sequencing, RT-PCR, and RACE cloning comprises four dsRNA segments that are 3441bp, 2779bp, 2925bp, and 2688bp long, respectively, each of them contains a single ORF, the first one (ORF1) encoding a 1115-amino-acid-long protein (122.65 kDa) with a conserved RNA-dependent RNA polymerase (RdRp) motif, its sequences showed the highest identity of only 16.13% to that of the Beauveria bassiana chrysovirus 1. The second ORF (ORF-2) encoding a 807-amino-acid-long coat protein (CP) (88.77 kDa). The virus constitutes a new member of the chrysoviridea family from B. bassiana.
The Role of Nanoliposomal Irinotecan Plus Fluorouracil and Folinic Acid as Second-Line Treatment Option in Patients With Metastatic Pancreatic Ductal Adenocarcinoma
Authors: Park Se Jun , Kim Hyunho , Shin Kabsoo , Hong Tae Ho , Suh Ja Hee , Lee MyungAh
Published: May 2021

BackgroundAccording to the NAPOLI-1 trial, nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) showed improved overall survival compared to fluorouracil alone for patients with metastatic pancreatic cancer who previously treated gemcitabine-based therapy. In that trial, Asian patients had frequent dose modification due to hematological toxicity. There has been limited information on the clinical benefit and toxicity of this regimen in a real-world setting. Herein, we assessed real-world experience of nal-IRI plus 5-FU/LV in patients with advanced pancreatic cancer after gemcitabine failure.MethodsWe conducted a single institution retrospective analysis of response, survival and safety in patients who had been treated with nal-IRI with 5-FU/LV. Patients with metastatic pancreatic ductal adenocarcinoma previously treated with gemcitabine-based therapy received nal-IRI (80mg/m2) with 5-FU/LV every 2 weeks. ResultsFifty-one patients received nal-IRI plus 5-FU/LV between January 2015 and December 2020. The median age was 67 years, and males were 58.8%. A total of 40 (78.4%) and 11 (21.6%) patients had received one and two lines of prior chemotherapy before enrollment, respectively. Median progression-free survival was 2.8 months (95% confidence interval [CI] 1.8-3.7) and median overall survival was 7.0 months (95% CI 6.0-7.9). Chemotherapy doses were reduced or delayed in 33 (64.7%) patients during the first 6 weeks and median relative dose intensity was 0.87. Thirty-six (70.6%) patients experienced any grade 3 or 4 adverse events. Most common grade 3 or 4 adverse event was neutropenia (58.8%) and most non-hematologic adverse events were under grade 2. Since the start of first-line chemotherapy, median overall survival was 16.3 months (95% CI 14.1-18.4).ConclusionsNal-IRI plus 5-FU/LV seems to be effective, with manageable toxicities, after gemcitabine-based treatment in patients with metastatic pancreatic ductal adenocarcinoma. Trial registration Retrospectively registered
Drug-Induced Liver Injury Associated with Lopinavir- Ritonavir in Patients with COVID-19: A Disproportionality Analysis of U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) Data
Authors: Tang Huilin , Zhou Liyuan , Li Xiaotong , Kinlaw Alan C , Yang Jeff Y , Moon Andrew M , Barnes Edward L , Wang Tiansheng
Published: May 2021

Background
Liver injury has been documented independently in novel coronavirus disease 2019 (COVID-19) patients and patients treated with lopinavir-ritonavir.
Objective
to investigate the drug-induced liver injury associated with lopinavir-ritonavir among the patients with COVID-19.
Methods
We conducted a disproportionality analysis of US Food and Drug Administration Adverse Event Reporting System (FAERS) between 2020Q1 and 2020Q3 to evaluate the association between lopinavir-ritonavir and risk of drug-induced liver injury (or severe drug-induced liver injury) and calculated their reporting odds ratios (RORs) with 95% confidence intervals (CIs).
Results
A total of 1,754 reports of drug-induced liver injury in patients with COVID-19. The ROR for drug-induced liver injury was 1.4 (95% CI, 1.1–1.7), 3.6 (95% CI, 2.7–4.7), and 0.8 (95% CI, 0.7-1.0) when comparing lopinavir-ritonavir with all other drugs, hydroxychloroquine/chloroquine only, and remdesivir, respectively. For severe drug-induced liver injury, RORs for lopinavir-ritonavir provided evidence of an association compared with all other drugs (ROR, 4.9; 95% CI, 3.7–6.5), compared with hydroxychloroquine/chloroquine only (ROR, 4.3; 95% CI, 3.0-6.2), and compared with remdesivir (ROR, 10.4; 95% CI, 7.2–15.0).
Conclusions
In the FAERS, we observed a disproportional signal for severe drug-induced liver injury associated with lopinavir-ritonavir in patients with COVID-19.
Purinergic P2X7 receptor antagonist ameliorates intestinal inflammation in postoperative ileus
Authors: Kimura Hitomi , Yamazaki Takako , Mihara Taiki , Kaji Noriyuki , Hori Masatoshi
Published: May 2021

Postoperative ileus (POI) is gastrointestinal motility dysfunction after abdominal surgery caused by mechanical stress to intestine. It occurs nausea and vomiting, and lead to lower QOL during hospitalization for patients. It is regarded as a problem because it costs medical expenses due to long hospitalization. The intestinal inflammation caused by macrophage and neutrophil is thought to be important of the mechanism of POI. In tissue injury or inflammation, adenosine triphosphate (ATP) is released from injured cell. Purinergic P2X7 receptor (P2X7R) is expressed on inflammatory cells and ATP induces the secretion of inflammatory mediators through P2X7R. P2X7R antagonist is thought to be important in the first step of inflammation, and it is confirmed that P2X7R antagonist showed anti-inflammatory effects in chemically-induced colitis models. Therefore, we hypothesized that P2X7R has important function in POI and examined the effect of P2X7R antagonist in mouse POI model. As a result, P2X7R antagonist A438079 ameliorated macrophage and neutrophil infiltration in POI. The impairment of intestinal transit was improved by P2X7R antagonist. It tended to ameliorate the increase of IL-6, IL-1β and TNF-α mRNA expression in intestinal muscularis caused by POI. P2X7R expressed on both infiltrated and resident macrophages in the inflamed ileal muscle layer. In conclusion, P2X7R antagonist showed the anti-inflammatory effect through P2X7R on macrophages, and it may be the target to treat POI.
Per-Covid-19: A Benchmark Database For Covid-19 Percentage Prediction From CT-scans
Authors: Bougourzi Fares , Distante Cosimo , Abdelkrim Ouafi , Dornaika Fadi , Hadid Abdenour , Taleb-Ahmed Abdelmalik
Published: May 2021

Covid-19 infection recognition is very important step in the fighting against the new pandemic Covid-19. In fact, many methods have been used to recognize the Covid-19 infection including Reverse transcription polymerase chain reaction (RT-PCR), X-ray scan and CT-scan. In addition to the recognition of the Covid-19 infection, CT-scans can provide more important information about the evolution of this disease and its severity. With the extensive number of Covid-19 infections, estimating the Covid-19 percentage can help the intensive care to free up the resuscitation beds for the critical cases and follow other protocol for less severity cases. In this paper, we propose Covid-19 percentage estimation database. Moreover, we evaluate the performance of three Covolutional Neural Network (CNN) architectures which are ResneXt-50, Densenet-161 and Inception-v3. For the three CNN architectures, we use two loss functions which are MSE and Dynamic Huber. In addition, two pretrained scenarios are investigated (ImageNet pretrained models and X-ray pretrained models). The evaluated approaches achieved promising results, where Inception-v3 with using Dynamic Huber loss function and X-ray pretrained model achieved the best performance.
Consideration of Trade-offs Regarding COVID-19 Containment Measures in the United States
Authors: Rebeira Mayvis , Nauenberg Eric
Published: May 2021

Background: The economic stimulus package in the United States, which totalled $2.48 trillion, was designed to soften the economic impact of sweeping containment measures including shelter-in-place orders that were put in place to control the COVID-19 pandemic.Methods: In healthcare, interventions are rarely justified simply in terms of the number of lives saved but also in terms of a myriad of other trade-off factors including value-for-money or cost-effectiveness. Cost-effectiveness analysis was therefore conducted as the cost per life-year gained (Cost/LYG) from the containment measures adopted based on several different projections of the baseline number of deaths in the absence of any containment measures. Reductions in premature mortality due to the shutdown (i.e. the difference between years of life lost relative to life expectancy under the shutdown and no shutdown scenarios) were used to calculate changes in health status. Given that men and women have different life expectancies, the analysis calculates premature mortality for men and women by age bracket. Results: The results showed seven different scenarios that reflect different death projections. It showed that as the projected number of deaths increases, the cost-effectiveness of the containment measures becomes more favourable i.e. providing better value-for money for US taxpayers. Cost-effectiveness ranged from $180,874 per life-year-gained for the high-end projection to $4,258,780 per life-year gained for the low-end death projection estimate.Conclusion: Incremental costs per life-year gained related to the economic shutdown can span a wide range depending on the baseline number of deaths in the absence of any containment measures. The results show that in the US, under no scenario for life-years gained does the stimulus package compare favourably to other healthcare interventions that have had favourable cost-effectiveness profiles. However, when comparing value-of-statistical-life-year (VSLY) threshold measures used in other sectors, it is plausible that the U.S. stimulus package could be viewed more favourably from a cost-effectiveness perspective. Given the wide-ranging impacts that COVID-19 has had on American life, it would seem that the comparison should be made to experiences in multiple sectors and on this basis, it appears that the shutdown is likely to represent good value-for-money.
Performance Analysis of Double Gate Dielectric Modulation In Schottky FET As Biomolecule Sensor
Authors: Kumar Prasahanth
Published: May 2021

In this article, a charge-plasma (CP)-based double gate schottky barrier FET structure has been investigated using dielectric controlled biomolecule sensor. The use of Hafnium as a charge plasma at the source side encourages an n+ charge plasma in an un-doped silicon region, which expressively decreases the Schottky barrier thickness. The oxide below the Metal gate M1 and M2 is etched out to create nanogap openings for biomolecule finding. Here, the existence of molecules is categorized by the modification in oxide material inside the nanogap and the related charge densities, hence, to controls the tunneling thickness at the Metal-source-silicon channel interface, also with the help of plasma charges in an intrinsic-Si film. This paper is mainly focused on the fundamental physics of the proposed structure and approximations of their relative sensitivity detecting enactment. The sensing enactment has been assessed for charged biomolecules and charge-neutral biomolecules by widespread device simulation, and the special properties of the biomolecule. The proposed device improves its control over the tunneling region and this has been used for the sensing, ensuing to larger on-state drain current (Ids) sensitivity for biomolecule. Hence, the gate voltage is recognised as the active design parameters for efficient reduction. Moreover, the sensing of the SB FET-based biosensor threshold voltage (Vth), abnormality in the on-current (Ion), and Ion/Ioff ratio has been shown. Also, the charge-plasma (CP)-based double gate schottky barrier FET simulations calibrated with experimental results. Hence, the relative change in Ion using charge-plasma (CP)-based double gate schottky barrier FET biosensor maintain improved detecting ability for biomolecule recognition.
Microbial Risk Assessment of Vegetables Irrigated with Akaki River Water in Addis Ababa.
Authors: Mengesha Sisay Derso , Asfaw Yosef Beyene , Kidane Abel Weldetinsae , Teklu Kirubel Tesfaye , Serte Melaku Gizaw , Kenea Moa Abate , Dinssa Daniel Abera , Woldegabriel Mesay Getachew , Alemayehu Tsigereda Assefa , Girmay Aderajew Mekonnen
Published: May 2021

Background: Consumption of vegetable plays important role in human health. Above 60% of Addis Ababa, vegetable demand is covered by smallholder farmers who grow various vegetables by using the Akaki River as their main water source for irrigation. However, applying faecally contaminated water for irrigation could expose fresh vegetable consumers to many health problems. Therefore, this study aimed to evaluate the microbial contamination of irrigation water and freshly produced vegetables. The study assessed the quality of Akaki river water and vegetables. Fresh vegetables including Ethiopian Kale, Lettuce, Cabbage, and Spinach were collected from 14 farmlands, irrigated with Akaki River water, in the dry and wet seasons. Using standard methods, analysis of E.coli, Non-E.coli, Total coliform, fecal coliform, and Total Aerobic Plate Count were done among the Akaki River water and vegetables. Result: The finding of the study indicated that all fresh vegetables were contaminated with total coliforms, fecal coliforms, and Total aerobic in the dry and wet seasons. The overall mean count of E. coli and Non-E. Coli from water samples were 2.09 and >3.48 log10 CFU 10 mL−1. The mean count of TC, FC, and TAC on sampled vegetables were 3.22, 1.37, and 4.72 in the dry season, and 3.87, 2.57, and 5.09 log10 CFU per gram in the wet season, respectively.Conclusion: The Akaki River has been contaminated with non-E. Coli & E. coli coliforms and did not meet the WHO guideline criteria for safe irrigation. The microbial contamination of vegetables was found high and exceeded the HACCPTQM and ICMSF limit values for safe consumption. This calls for farmers and the consumer has to insist on properly processed/stored/sliced fresh vegetables needs to be aware.
Impact of COVID-19 Policy Measures on Food Security Among Urban Residents in Blantyre City, Malawi
Authors: Dzimbiri Mastano , Mwanjawala Patrick , Chilanga Emmanuel , Munthali George N.
Published: May 2021

Background

Malawi, a vulnerable country in Sub Saharan Africa (SSA) is at the helm of experiencing food insecurity amidst COVID-19 as the vast majority survives on the hand-to-mouth economy. However, knowledge about how COVID-19 policy measures lead to food insecurity among the urban residents in Malawi is scanty. Understanding this link is crucial for designing the interventions that can help reduce the risk of being food insecure while containing further spread of the virus. Using Bronfenbrenner’s ecological theory as a conceptual framework, we explore the impact of COVID-19 policy measures on food security experienced by Blantyre residents in Malawi. We interviewed fifteen participants composed of private secondary school teachers and informal workers to understand their experiences of food insecurity linked to COVID-19 policy measures in place by the Malawi government.
Results

Our results show that participants face difficulties to access adequate food and have also changed their eating habits by skipping meals in some days due to loss of jobs, underpayment as well as business disruption.
Conclusion

Based on the findings, we argue that the COVID-19 policies have aggravated severe challenges among urban residents to access adequate food rendering them food insecure. To ensure sustained livelihood, we suggest the Malawi government should design immediate interventions such as relief fund packages targeting the urban poor to rescue them from facing acute food shortages while containing the pandemic.
Saline and Alkaline Stresses Alter Soil Properties And Composition And Structure of Gene-Based Nitrifier And Denitrifier Communities In A Calcareous Desert Soil
Authors: Guo Jiaxin , Zhou Yongxue , Guo Huijuan , Min Wei
Published: May 2021

Background: Saline and alkaline stresses damages the health of soil systems. Meanwhile, Little is known about how saline or alkaline stress affects soil nitrifier and denitrifier communities. Therefore, we compared the responses of gene-based nitrifier and denitrifier communities to chloride (CS), sulfate (SS), and alkaline (AS) stresses with those in a no-stress control (CK) in pots with a calcareous desert soil. Results: Compared with CK, saline and alkaline stress decreased potential nitrification rate (PNR) and NO3-N; increased pH, salinity, water content, and NH4-N; and decreased copy numbers of amoA-AOA and amoA-AOB genes but increased those of denitrifier nirS and nosZ genes. Copies of nirK increased in SS and AS but decreased in CS. There were more copies of amoA-AOB than of amoA-AOA and of nirS than of nirK or nosZ. Compared with CK, SS and AS decreased operational taxonomic units (OTUs) of amoA-AOB but increased those of nirS and nosZ, whereas CS decreased nirK OTUs but increased those of nosZ. The numbers of OTUs and amoA-AOB genes were greater than those of amoA-AOA. There were positive linear relations between PNR and amoA-AOA and amoA-AOB copies. Compared with CK, the Chao 1 index of amoA-AOA and amoA-AOB decreased in AS, that of nirK increased in CS and SS, but that of nirS and nosZ increased in all treatments.The Shannon index of amoA-AOB decreased but that of nirS increased in CS and SS, whereas the index of nirK decreased in all treatments. Saline and alkaline stress greatly affected the structure of nitrifier and denitrifier communities and decreased potential biomarkers of nirS-type; however, AS increased those of nirK- and nosZ-type, and SS decreased those of nosZ-type. Soil water content, pH, and salinity were important in shaping amoA-AOA and denitrifier communities, whereas soil water and pH were important to amoA-AOB communities. Conclusion: These results indicate that the nitrifier and denitrifier communities respond to saline and alkaline stresses conditions. Communities of amoA-AOA and amoA-AOB contribute to nitrification in alluvial gray desert soil, and those of nirS are more important in denitrification than those of nirK or nosZ.
Comparison of an Improved Self-consistent Lower Bound Theory with Lehmann’s Method for Low-lying Eigenvalues
Authors: Ronto Miklos , Pollak Eli , Martinazzo Rocco
Published: May 2021

Ritz eigenvalues only provide upper bounds for the energy levels, while obtaining lower bounds requires at least the calculation of the variances associated with these eigenvalues. The well-known Weinstein and Temple lower bounds based on the eigenvalues and variances converge very slowly and their quality is considerably worse than that of the Ritz upper bounds. Lehmann presented a method that in principle optimizes Temple’s lower bounds with significantly improved results. We have recently formulated a Self-Consistent Lower Bound Theory (SCLBT), which improves upon Temple’s results. In this paper we further improve the SCLBT and compare its quality with Lehmann’s theory. The Lánczos algorithm for constructing the Hamiltonian matrix simplifies Lehmann’s theory and is essential for the SCLBT. Using two lattice Hamiltonians, we compared the improved SCLBT with its previous implementation as well as with Lehmann’s lower bound theory. The novel SCLBT exhibits a significant improvement over the previous version. Both Lehmann’s theory and the SCLBT provide significantly better lower bounds than those obtained from Weinstein’s and Temple’s methods. Compared to each other, the Lehmann and SCLBT theories exhibit similar performance in terms of the quality and convergence of the lower bounds. By increasing the number of states included in the calculations, the lower bounds are tighter and their quality becomes comparable with that of the Ritz upper bounds. Both methods are suitable for providing lower bounds for low-lying excited states as well. Compared to Lehmann’s theory, one of the advantages of the SCLBT method is that it does not necessarily require the Weinstein lower bound for its initial input, but Ritz eigenvalue estimates can also be used. Especially owing to this property the SCLBT method sometimes exhibits improved convergence compared to that of Lehmann’s lower bounds.
A Multicomponent Intervention to Improve Blood Pressure Management in Chronic Kidney Disease: A Protocol for a Pragmatic Clinical Trial
Authors: Kilgallon John L. , Gannon Michael , Burns Zoe , McMahon Gearoid , Dykes Patricia , Linder Jeffrey A. , Bates David W. , Waikar Sushrut , Lipsitz Stuart , Baer Heather J. , Samal Lipika
Published: May 2021

BackgroundChronic kidney disease is common, leads to end stage renal disease, and is a major risk factor for cardiovascular disease. Although both chronic kidney disease and hypertension, the main risk factor for disease progression, are not difficult to diagnose, both often go unrecognized by primary care providers. It has yet to be determined whether a multicomponent intervention that leverages electronic health records and behavioral economic principles can improve diagnosis, treatment, and control of hypertension in chronic kidney disease. MethodsThe aim of this pragmatic, cluster-randomized controlled trial is to evaluate a clinical decision support system based in behavioral economic and user-centered design principles that will: 1) synthesize existing laboratory tests, medication orders, and vital sign data; 2) increase recognition of chronic kidney disease, 3) increase recognition of uncontrolled hypertension in chronic kidney disease patients, and 4) deliver evidence-based chronic kidney disease and hypertension management recommendations. The intervention has been designed and piloted. The primary endpoint is the change in mean systolic blood pressure between baseline and 6 months compared across arms. We will use an effectiveness-implementation hybrid trial type 2 design and the RE-AIM framework to guide evaluation of process and outcome measures. Patients with two prior eGFR 16-59 mL/min/1.73m2 separated by 90 days or two prior UACR >30mg/g, one SBP >140 mmHg within the 2 years preceding the enrollment visit, and SBP >140 mmHg at enrollment will be included; patients with a most recent eGFR ≤ 20 or 2 previous eGFRs within 2 years separated by at least 90 days ≤ 15 will be excluded. Rao-Scott chi-square tests and GEE z-tests will be used. We calculated that 497 evaluable patients per arm and an average of 6 patients per provider would provide over 80% power to detect an average 3 mmHg SBP decrease in the intervention arm. Discussionhe proposed study, if successful, would be the first to improve hypertension in chronic kidney disease patients through a multicomponent intervention that incorporates clinical decision support and behavioral methods. Trial RegistrationClinicalTrials.gov identifier: NCT03679247. Registered September 20, 2018, https://clinicaltrials.gov/ct2/show/NCT03679247?term=Samal&draw=2&rank=1.
Scaling-up Shared Decision Making in Multidisciplinary Osteoarthritis Care Teams: A Qualitative Study Using the Consolidated Framework for Implementation Research With Three Demonstration Sites
Authors: Trevena Lyndal , Mac Olivia , Muscat Danielle M , Bakhit Mina , Shepherd Heather L , Dimopoulos-Bick Tara , Osten Regina , Hoffmann Tammy , Thompson Rachel
Published: May 2021

BackgroundDespite the development of theory-driven frameworks to guide implementation strategies, their application thus far has largely been limited to evaluating effectiveness within specific contexts. This study describes the use of these frameworks to inform a scale-up strategy for shared decision making (SDM) implementation across a state-wide government-funded health program. MethodsTailored SDM strategies were implemented in three multidisciplinary osteoarthritis care teams over a 3-6 month period during 2019-20 in New South Wales, Australia. Staff interviews occurred across 3 timepoints based on the Organisational Readiness for Change Scale, the Theoretical Domains Framework and the Preparation for Decision-Making (PreP-DM) Scales. Patient interviews based on the PreP-DM were also completed. A hybrid inductive-deductive thematic analysis was followed by mapping the results to the Consolidated Framework for Implementation Research (CFIR) and the OMERACT core domains for SDM. Finally, a ranked list of Expert Recommendations for Implementing Change (ERIC) was derived using a published tool.Results47 interviews were conducted with 18 staff along with 20 interviews with patients. We identified 39 themes for SDM implementation across the five CFIR domains: 1) Interventions need to be flexible to align with different clinical workflows and busy clinics; 2) Outer Settings such as senior managers should formally endorse SDM and clinical protocols and standards need to better align with an SDM approach; 3) Inner Setting teams need early engagement, role clarification and communities of practice in SDM; 4) Individuals are strongly motivated by better patient outcomes and need SDM training and support; and 5) Processes such as patient-reported measures and feedback along with adequate resourcing were key. Recommended strategies therefore focussed on Stakeholder Engagement, Evaluative and Iterative Strategies, Education and Training and Adaptation/Tailoring to the Context. Skills in the identification of decision points, values clarification and deliberation were particularly challenging for staff.Conclusions﻿Theory-driven scale-up strategies can be developed using qualitative research within demonstration sites. By combining the CFIR and TDF frameworks and prior mapping to the ERIC strategies, health system and program planners can obtain a relevant and evidence-informed roadmap for implementation across complex health systems.
Obstructive Sleep Apnea and Associated Factors Among Hypertensive Patients Attending a Tertiary Cardiac Center in Tanzania: a Comparative Cross-sectional Study
Authors: Pallangyo Pedro , Mgopa Lucy R. , Mkojera Zabella , Komba Makrina , Millinga Jalack , Misidai Nsajigwa , Swai Happiness J. , Mayala Henry , Bhalia Smita , Wibonela Salma , Janabi Mohamed
Published: May 2021

Background: There is mounting evidence for a reciprocal yet bidirectional association between sleep-disordered breathing and hypertension. Obstructive sleep apnea (OSA), a common cause of systemic hypertension is an independent risk factor for hypertension-related cardiovascular morbidity and mortality. In this comparative hospital-based cross-sectional study, we sought to explore the burden of obstructive sleep apnea and its associated risk factors among hypertensive patients attending Jakaya Kikwete Cardiac Institute.Methodology: A total of 1974 individuals (i.e. 1289 hypertensive and 685 normotensives) were consecutively enrolled in this study. The Berlin questionnaire and Epworth Sleepiness Scale were utilized in the assessment of OSA and excessive daytime sleepiness (EDS) respectively. Logistic regression analyses were employed in the determination of associated factors for OSA. Results: The mean age was 53.4 years and females constituted the large majority (60.4%) of participants. About three quarters (74.1%) of participants had excess body weight, 11.6% had diabetes, 8.0% had asthma and 18.6% had history of recurrent nasal congestion. Positive family history of snoring was reported by 43.1% of participants and 36.9% had a personal history of snoring. Persons with hypertension displayed a higher frequency (42.1%) of OSA compared to their normotensive counterparts (11.8%), p<0.001. Multivariate logistic regression analyses revealed hypertension (OR 5.1, 95% CI 3.2-8.2, p<0.001), diabetes mellitus (OR 2.2, 95% CI 1.3-3.5, p<0.01), chronic nasal congestion (OR 1.6, 95% CI 1.1-2.5, p = 0.01), obesity (OR 2.4, 95% CI 1.8-3.3, p<0.001), increased neck circumference (OR 2.7, 95% CI 1.2-6.4, p = 0.02), family history of snoring (OR 5.5, 95% CI 4.0-7.5, p<0.001), and working >8hrs/24hr (OR 0.6, 95% CI 0.4-1.0, p = 0.03) to have an independent association for OSA. Furthermore, participants with hypertension displayed superior odds for OSA compared to their normotensive counterparts across all subgroup analyses. Conclusion: OSA is considerably common among hypertensives in a tertiary health care setting in Tanzania. Positive family history of snoring was the strongest associated factor; however, excess body weight proved to be the strongest modifiable risk factor. In view of its pervasiveness, OSA should be an integral part of the medical evaluation in hypertensive individuals.
Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures
Authors: Kim Chul-Ho , Kim Jung Jae , Kim Ji Wan
Published: May 2021

Background: This study aimed to compare the clinical outcomes and complications between two minimally invasive surgical techniques: percutaneous transiliac plate fixation and iliosacral (IS) screw fixation for the treatment of Tile C-type pelvic bone fractures.Materials and Methods: We retrospectively reviewed the data of 77 consecutive patients with Tile C pelvic ring injuries who underwent either percutaneous transiliac plate fixation or IS screw fixation in a single academic center between November 2007 and January 2018. Posterior plating was indicated for those with sacral dysmorphism or bilateral sacral fractures, including spinopelvic dissociation. We recorded patients’ demographics, surgery-related data, and postoperative surgical outcomes and compared the incidence of complications and revision surgery rates between the two groups.Results: Overall, 14 patients were included in the plate group, while 63 were included in the IS screw fixation group. No significant differences were observed in the patients’ demographics between the two groups except for a longer interval from injury to surgery (13.5 days vs. 5.4 days, P = 0.001). Both groups acquired fracture union in all cases. There was one case of infection requiring surgical debridement in the plating group. Notably, nerve injury (n = 3) and implant loosening (n = 5) occurred in the IS screw group, but the difference was not significant.Conclusions: Both percutaneous posterior transiliac plating and IS screw fixation in patients with Tile C-type pelvic bone fractures showed good results. We recommend IS screw fixation as the primary treatment and propose posterior plating as treatment for sacral dysmorphism and bilateral sacral alar fractures in patients with spinopelvic dissociation.
Short Term Clinical Results of Single Injection Autologous BMAC (Bone Marrow Aspirate Concentrate) As A Therapeutic Option/Tool in Knee Osteoarthritis
Authors: Subramanyam Krishna , Poornima Subhadra , Kumar Satish , Hasan Qurratulain
Published: May 2021

Background: Knee Osteoarthritis (KOA) is a common degenerative joint disease characterized by loss of articular cartilage, osteophyte formation, resulting in disability and affecting the quality of life. There is no treatment as on today to reverse the progression of KOA. The present available treatments for KOA are palliative. Therefore, there is a need for an alternative treatment modality in the treatment of KOA during the early grades, which should help in not only giving a symptomatic relief but also downturn the disease process. Bone marrow aspirate concentrate (BMAC) has gained a considerable importance change in the management/treatment of KOA in the recent times due to its potential advantages of disease modifying and regeneration capacities. The latest studies on usage of Autologous BMAC injection in KOA showed promising and encouraging results in terms of decrease in the pain, improved knee range of movement, daily activities of living and thus improved expectations for good quality lives. The current study aimed to assess the role of single injection- autologous BMAC as a therapeutic option in the treatment of KOA and evaluate the functional and clinical outcome of KL grade II&III patients.Methods: One Hundred and thirty-two patients with KOA (KL grade II&III) were included in the study as per the inclusion criteria. Autologous Bone marrow aspiration was done and the separation was done using density gradient centrifugation and final aspirate was injected into the knee joint. Results: The clinical outcomes of the patients were evaluated at different time points both objectively [Visual Analogue Scale (VAS) & WOMAC (Western Ontario Mac Master Universities Score)] and subjectively (radiographs & MRI) and the follow up was done for a period of one year. At the end of the study period, BMAC therapy showed promising results with encouraging clinical outcome.Conclusion:BMAC therapy has more potential with satisfactory, efficient and durable results in KOA. BMAC/mononuclear cells with enriched stem cell therapy can be an alternative therapy as an early intervention option for knee osteoarthritis.
Socio-economic and Household Determinants of Malaria in Adults Aged 45 and Above: Analysis of Longitudinal Ageing Survey in India (2017-2018)
Authors: Mohan Indumathi , Kodali Naveen Kumar , Chellappan Savitha , Karuppusamy Balasubramani , Behera Sujit Kumar , Natarajan Gopalan , Nina Praveen Balabaskaran
Published: May 2021

BackgroundEven though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016-30) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid in India’s malaria elimination efforts.MethodsThe data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017-2019) survey comprising 70671 respondents ≥45 years across all the States and Union Territories were used for analysis.Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables.ResultsThe major socio-economic variables that increase the likelihood of malaria are caste (Schedule Tribes), rural residence and low education levels.The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5-2.1). Respondents withhigh school education (6-12 grade) (AOR: 0.7; 95% CI: 0.6-0.8) and college education (AOR: 0.5; 95% CI: 0.4-0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling.ConclusionsIn addition to vector and parasite control strategies, improving literacy and housing conditions, especially in tribal dominated regions will greatly aid in India’s malaria elimination efforts.
Not a Problem at All or Excluded by Oneself, Doctors and the Law? Healthcare Workers’ Perspectives on Access to HIV-Related Healthcare Among Same-Sex Attracted Men in Tanzania
Authors: Mwijage Alexander Ishungisa , Mizinduko Mucho Michael , Likindikoki Samuel Lazarus , Meyrowitsch Dan Dan Wolf , Mmbaga Elia John , Leshabari Melkizedeck Thomas , Moen Kåre
Published: May 2021

Background: Same-sex attracted men in Tanzania are disproportionately affected by HIV. Drawing on qualitative research, the present study explores healthcare providers’ perspectives on access to HIV-related healthcare services among same-sex attracted men. Methods: A qualitative study was carried out among healthcare workers in in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Fieldwork entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. Twenty-four interviews and six focus group discussions were conducted.Results: This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for SSAM. One held that access to healthcare was not a major problem at all, another that some SSAM did not utilize healthcare services although they were available, a third that some healthcare workers prevented SSAM from gaining access to healthcare and a fourth that healthcare for gender and sexual minority persons was made difficult by structural barriers. Conclusion: Although these are four rather different takes on the prevailing circumstances with respect to healthcare access for SSAM, we suggest that they may all be ‘true’ in the sense that they grasp and highlight different aspects of the same realities.
Organosilane-Functionalized Graphene Oxide Hybrid Material: Efficient Adsorbent For Heavy Metal Ions In Drinking Water
Authors: KARABÖRK Muharrem , Muhammed Ban Abdullelah , TÜMER Mehmet , URUŞ SERHAN
Published: May 2021

Organosilane-functionalized and chemically activated graphene-supported Schiff base ligand were synthesized and characterized with XRD, SEM, EDX, TEM, UV.-Vis., FT-IR and TG/DTA techniques. In the synthesis process, graphene oxide was firstly obtained with Hummer’ s method and reacted with 3-(trimethoxysilyl)propylamine. The last, the amine-activated and organosilane containing GO was reacted with 3,5-di-tert-butylsalicylaldehyde resulting the hybrid material (M) having azomethine group. The material (M) was used as an adsorbent in order to remove the cobalt(II) and zinc(II) ions in drinking water and standard solutions. The adsorption capacity of the material (M) to cobalt(II) and zinc(II) ions was investigated by batch method. Moreover, the effect of pH, contact time, temperature, and concentration on the adsorption capacity of the material was also investigated. The enrichment factors were calculated as 441 and 675 for zinc(II) and cobalt(II), respectively. The recovery performance of the material was determined in 98.65-101.75% and 98.55-104.0% range for zinc(II) and cobalt(II) ions, respectively.