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45 mins ago


This module had 25 questions of the Brazilian validated version of the adult reduced PCAT. CONCLUSION We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.Namibia is one of the least densely populated countries in Southern Africa. Namibia's health services are twofold private (serving 18% of the population with medical aid) and public (serving the remaining 82%). This, in part, is due to the country's high income inequality. Access to healthcare is comparably good with 76% of the population living within a 10km radius of a healthcare facility. Yet, Namibia faces many challenges related to the provision of patient-centred primary health care (PHC). The provision of competent generalist doctors and family physicians has the potential to address the current health care challenges and priorities. The inclusion of family physicians in PHC teams will further aid such efforts.BACKGROUND Shortage of nurses in South African hospitals has affected the nurse-patient ratio, thus prompting nurses to be focussed on completing nursing-related duties with less or no caring for the patient. Caring involves having a therapeutic relationship with the patients, and it can be challenging and demanding for final-year student nurses who are still novices in the nursing profession. OBJECTIVES To explore and describe the experiences of caring for patients amongst final-year student nurses in order to develop and provide recommendations to facilitate caring. METHOD A qualitative, descriptive and contextual design was used. Data collection was done through eight in-depth individual interviews. Giorgi's five-step method of data analysis was used, along with an independent coder. Measures to ensure trustworthiness and ethical principles were applied throughout the research. RESULTS Four themes with 12 subthemes emerged from the data therapeutic relationship with patients as an integral part of caring, teamwork - team spirit makes caring easy, continuous caring that promotes quality and safe nursing, as well as satisfaction amongst staff and patients, and various barriers that contributed to lack of caring in the unit. CONCLUSION The majority of student nurses had positive experiences of caring, which included therapeutic relationships between nurses and the patients, teamwork and team spirit that fostered safe and quality nursing care, rendered effortlessly. Barriers to caring were also highlighted as negative experiences.BACKGROUND Nurse leadership is about aligning employees to a vision. This happens with buy-in, motivation and communication. When conducive environments are created by organisations, the motivation of nurse leaders will be enhanced, which will have a positive outcome on the organisation. Highly motivated nurse leaders accomplish more and are more productive. Nurse leadership is an essential source of support, mentorship and role modelling. These attributes tend to be more evident when nurse leaders are motivated. OBJECTIVES The objective of this study was to determine the factors that influence the motivation of nurse leaders. METHOD A quantitative, descriptive design and stratified sampling was used. Participants comprised unit managers (n = 49) from five hospitals in a private hospital group in South Africa. A self-administered questionnaire, namely, the Multidimensional Work Motivation Scale, was used to collect the data. Data were analysed using the IBM SPSS 22.0 program. RESULTS The results indicated that the nurse leaders in this study were intrinsically motivated. Their motivation was influenced by support, relatedness, autonomy and competence. No relationships were found between motivation and age, years in a management position, gender, qualifications and staff-reporting structure. CONCLUSION By implication, to understand what motivates nurse leaders and to keep them motivated, recommendations were proposed to nursing and human resources management. https://www.selleckchem.com/products/cx-5461.html It is expected that the implementation of the recommendations will have a positive influence on patient outcomes, organisational success and the motivation and satisfaction of nurse leaders.BACKGROUND Medication errors may result in patients' harm and even death. The improvement of nursing students' competence in the administration of medication through education and training can contribute to the reduction of medication errors. OBJECTIVES This study aimed at describing the Bachelor of Nursing students' perceptions about clinical learning opportunities and competence in the administration of oral medication. METHOD A quantitative descriptive design was employed. An all-inclusive sample of 176 nursing students registered at a university in the Western Cape, South Africa, in 2014 was considered for the study, of whom 125 students consented to participate and completed the questionnaires. Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis and descriptive statistics were conducted. RESULTS The findings showed that a minority of students did not have opportunities to rotate in all specific types of wards. The findings indicated that a total of 92% (115) and 86.4% (108) of the 125 respondents were placed in medical and surgical wards, respectively, where they more likely had opportunities to practise the administration of oral medication. However, 59.2% (74) did not practise administration of oral medication on a daily basis. Only 19.2% (24) of respondents perceived themselves as competent in the administration of oral medication. CONCLUSION The findings indicated that many students perceived their education and training as not providing sufficient learning opportunities to practise the administration of oral medication, whilst the majority of respondents perceived themselves as competent in some of the aspects related to the administration of oral medication, and very few perceived themselves as competent overall in the administration of oral medication.

2 hrs ago


4%) persons with detectable ARV as having long-term infection. Those with detectable ARV were significantly more likely to be aware of their HIV-positive status (84% vs. 10%) and had higher levels of drug resistance (74% vs. 26%) than those without detectable ARV. RITA2 incidence was lower than RITA1 incidence (range, 0%-30% decrease), resulting in decreased estimated new infections from 390,000 to 341,000 across the 13 countries. Incidence estimates were similar using detectable or self-reported ARV (R2 > 0.995).

Including ARV in RITA2 improved the accuracy of HIV-1 incidence estimates by removing participants with likely long-term HIV infection.
Including ARV in RITA2 improved the accuracy of HIV-1 incidence estimates by removing participants with likely long-term HIV infection.
In the population-based HIV impact assessment surveys, early infant diagnosis (EID) was provided to infants <18 months without a prior diagnosis. For the Namibia population-based HIV impact assessment (NAMPHIA), the GeneXpert platform was assessed for the feasibility of near POC EID testing compared with the standard Roche COBAS AmpliPrep/COBAS TaqMan (CAP/CTM) platform. Quality assurance measures and turnaround time were compared to improve EID results reporting.

NAMPHIA participants were screened for HIV exposure using Determine HIV-1/2 rapid test; samples reactive on Determine received EID testing on the GeneXpert instrument and Xpert HIV-1 Qual assay using whole blood. Results were confirmed at the Namibia Institute of Pathology using dried blood spots on the Roche CAP/CTM platform per national guidelines.

Of the 762 screened infants, 61 (8.0%) were Determine-reactive and considered HIV-exposed. Of the 61 exposed infants, 2 were found to be HIV-infected whereas 59 were negative on both GeneXpert and Roche platforms, achieving 100% concordance. Average turnaround time was 3.4 days for the Xpert HIV-1 Qual assay, and average time from collection to testing was 1.0 days for GeneXpert compared with 10.7 days for Roche. No samples failed using GeneXpert whereas 1 sample failed using Roche and was repeated.

Quality POC EID testing is feasible in a national survey through extensive training and external quality assurance measures. The use of decentralized POC EID for national testing would provide rapid diagnosis and improve TATs which may prevent loss to follow-up, ensure linkage to care, and improve clinical outcomes for infants.
Quality POC EID testing is feasible in a national survey through extensive training and external quality assurance measures. The use of decentralized POC EID for national testing would provide rapid diagnosis and improve TATs which may prevent loss to follow-up, ensure linkage to care, and improve clinical outcomes for infants.
High response rates in surveys are critical to ensuring that findings are unbiased and representative of the target population. Questionnaire length affects response rates, with long interviews associated with partially complete surveys, higher item nonresponse ("don't know" and "refuse" responses), and willingness to participate in future surveys. Our aim is to determine the impact of questionnaire length on blood test participation in population-based HIV surveys.

Data are from population-based HIV impact assessments conducted in Zambia, Eswatini, and Lesotho in 2016-2017. The population-based HIV impact assessments consist of an interview followed by a blood draw. https://www.selleckchem.com/products/bgj398-nvp-bgj398.html Consent for blood draw was obtained before the interview in Eswatini and after the interview in Zambia and Lesotho. Interview length was measured by the survey tablet as the time to complete the survey (interview duration) and the number of questions answered by the participant (questionnaire length). We assessed the effects of questionnaire length and interview duration on blood test participation using logistic regression.

Across all 3 surveys, the median interview duration was 16 minutes and the median number of questions was 77. In adjusted analyses, there was a negative impact of interview duration on blood draw consent for individuals with unknown status in Lesotho and a positive relationship between questionnaire length and blood draw consent in Zambia for those with HIV-negative and unknown status.

Although interview length is an important consideration to reduce respondent burden, a longer questionnaire does not necessarily result in lower consent rates for blood testing.
Although interview length is an important consideration to reduce respondent burden, a longer questionnaire does not necessarily result in lower consent rates for blood testing.
Measurement of mother-to-child HIV transmission through population-based surveys requires large sample sizes because of low HIV prevalence among children. We estimate potential improvements in sampling efficiency resulting from a targeted sample design.

Eight countries in sub-Saharan Africa with completed Population-based HIV Impact Assessment (PHIA) surveys as of 2017.

The PHIA surveys used a geographically stratified 2-stage sample design with households sampled from randomly selected census enumeration areas. Children (0-14 years of age) were eligible for HIV testing within a random subsample of households (usually 50%). Estimates of child HIV prevalence in each country were calculated using jackknife replicate weights. We compared sample sizes and precision achieved using this design with a 2-phase disproportionate sample design applied to strata defined by maternal HIV status and mortality.

HIV prevalence among children ranged from 0.4% (95% confidence interval 0.2 to 0.6) in Tanzania to 2.8% (95% confidence interval 2.2 to 3.4) in Eswatini with achieved relative standard errors between 11% and 21%. The expected precision improved in the targeted design in all countries included in the analysis, with proportionate reductions in mean squared error ranging from 27% in Eswatini to 61% in Tanzania, assuming an equal sample size.

Population-based surveys of adult HIV prevalence that also measure child HIV prevalence should consider targeted sampling of children to reduce required sample size, increase precision, and increase the number of positive children tested. The findings from the PHIA surveys can be used as baseline data for informing future sample designs.
Population-based surveys of adult HIV prevalence that also measure child HIV prevalence should consider targeted sampling of children to reduce required sample size, increase precision, and increase the number of positive children tested. The findings from the PHIA surveys can be used as baseline data for informing future sample designs.

6 hrs ago


Thus, the surviving GCs after Cy exposure had intact AMH-producing ability. In future, an effort to minimize GC death by Cy treatment is required, while maintaining its therapeutic effects.
We determined the predictors of osteonecrosis in a longitudinal lupus cohort, emphasizing the role of maximal prednisone dose and duration.

Data from 2428 patients were included in the analysis based on 224295 person-months of follow-up. We used pooled logistic regression to assess the relationship between risk factors and rates of osteonecrosis. After identifying a set of variables related to osteonecrosis incidence, we fit a final multivariable model to identify the most important risk factors for incident osteonecrosis.

In 18691 person-years of follow up after cohort entry, 122 incident osteonecrosis event were observed. In the multivariable analysis, African-Americans had twice the risk of osteonecrosis compared to Caucasians. Males and smokers had 80% and 50% increased risk of osteonecrosis compared to females and non-smokers, respectively. For every 10 year increase in the age of diagnosis, there was a 20% reduced risk of osteonecrosis. Patients diagnosed after the 1990's had a 50% reduced risk of osteonecrosis compared to those diagnosed before the 1990's. A daily dose of prednisone of 20-39 mg or higher, when administered for more than a month, or a daily prednisone dose of 40 mg or higher, even when administered for one month, significantly increased the risk of osteonecrosis. Use of pulse methylprednisolone or intramuscular triamcinolone was not associated with an increased risk of osteonecrosis.

Oral prednisone at 20-39 mg for more than one month, or 40 mg daily for even one month remained the most important corticosteroid predictor of osteonecrosis.
Oral prednisone at 20-39 mg for more than one month, or 40 mg daily for even one month remained the most important corticosteroid predictor of osteonecrosis.Signal intensity measured in a mass cytometry (CyTOF) channel can often be affected by the neighboring channels due to technological limitations. Such signal artifacts are known as spillover effects and can substantially limit the accuracy of cell population clustering. Current approaches reduce these effects by using additional beads for normalization purposes known as single-stained controls. While effective in compensating for spillover effects, incorporating single-stained controls can be costly and require customized panel design. This is especially evident when executing large-scale immune profiling studies. We present a novel statistical method, named CytoSpill that independently quantifies and compensates the spillover effects in CyTOF data without requiring the use of single-stained controls. Our method utilizes knowledge-guided modeling and statistical techniques, such as finite mixture modeling and sequential quadratic programming, to achieve optimal error correction. We evaluated our method using five publicly available CyTOF datasets obtained from human peripheral blood mononuclear cells (PBMCs), C57BL/6J mouse bone marrow, healthy human bone marrow, chronic lymphocytic leukemia patient, and healthy human cord blood samples. In the PBMCs with known ground truth, our method achieved comparable results to experiments that incorporated single-stained controls. In datasets without ground-truth, our method not only reduced spillover on likely affected markers, but also led to the discovery of potentially novel subpopulations expressing functionally meaningful, cluster-specific markers. CytoSpill (developed in R) will greatly enhance the execution of large-scale cellular profiling of tumor immune microenvironment, development of novel immunotherapy, and the discovery of immune-specific biomarkers. The implementation of our method can be found at https//github.com/KChen-lab/CytoSpill.git.Stereotactic body radiotherapy (SBRT) of lung tumors via the ring-mounted Halcyon Linac, a fast kilovoltage cone beam CT-guided treatment with coplanar geometry, a single energy 6MV flattening filter free (FFF) beam and volumetric modulated arc therapy (VMAT) is a fast, safe, and feasible treatment modality for selected lung cancer patients. Four-dimensional (4D) CT-based treatment plans were generated using advanced AcurosXB algorithm with heterogeneity corrections using an SBRT board and Halcyon couch insert. https://www.selleckchem.com/products/choline-hydroxide.html Halcyon VMAT-SBRT plans with stacked and staggered multileaf collimators produced highly conformal radiosurgical dose distribution to the target, lower intermediate dose spillage, and similar dose to adjacent organs at risks (OARs) compared to SBRT-dedicated highly conformal clinical noncoplanar Truebeam VMAT plans following the RTOG-0813 requirements. Due to low monitor units per fraction and less multileaf collimator (MLC) modulation, the Halcyon VMAT plan can deliver lung SBRT fractions with an overall treatment time of less than 15 min (for 50 Gy in five fractions), significantly improving patient comfort and clinic workflow. Higher pass rates of quality assurance results demonstrate a more accurate treatment delivery on Halcyon. We have implemented Halcyon for lung SBRT treatment in our clinic. We suggest others use Halcyon for lung SBRT treatments using abdominal compression or 4D CT-based treatment planning, thus expanding the access of curative ultra-hypofractionated treatments to other centers with only a Halcyon Linac. Clinical follow-up results for patients treated on Halcyon Linac with lung SBRT is ongoing.
Anaemia, a condition characterized by reduced oxygen-carrying capacity, is a widespread public health problem with major consequences for human health as well as social and economic development. Prompt and accurate diagnosis as well as effective management of iron deficiency anaemia (IDA) is important to prevent the undesired adverse clinical outcomes.

The purpose of the study was to assess the adequacy of IDA diagnosis and management within the Namibian private healthcare system. In this study, we used a quantitative, descriptive research design and data collection methods. The design was also nonexperimental in nature, employing a survey instrument to collect data. In total, 51 questionnaires were administered to private medical practitioners.

The surveyed medical practitioners used different Standard Treatment Guidelines (STGs) in managing IDA cases, with the majority (76.5%) using the Namibia STGs. The other guidelines and their usage rates were as follows World Health Organization guidelines (39.2%), Standard Treatment Guidelines and Essential Medicine List for South Africa (19.

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45 mins ago


This module had 25 questions of the Brazilian validated version of the adult reduced PCAT. CONCLUSION We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.Namibia is one of the least densely populated countries in Southern Africa. Namibia's health services are twofold private (serving 18% of the population with medical aid) and public (serving the remaining 82%). This, in part, is due to the country's high income inequality. Access to healthcare is comparably good with 76% of the population living within a 10km radius of a healthcare facility. Yet, Namibia faces many challenges related to the provision of patient-centred primary health care (PHC). The provision of competent generalist doctors and family physicians has the potential to address the current health care challenges and priorities. The inclusion of family physicians in PHC teams will further aid such efforts.BACKGROUND Shortage of nurses in South African hospitals has affected the nurse-patient ratio, thus prompting nurses to be focussed on completing nursing-related duties with less or no caring for the patient. Caring involves having a therapeutic relationship with the patients, and it can be challenging and demanding for final-year student nurses who are still novices in the nursing profession. OBJECTIVES To explore and describe the experiences of caring for patients amongst final-year student nurses in order to develop and provide recommendations to facilitate caring. METHOD A qualitative, descriptive and contextual design was used. Data collection was done through eight in-depth individual interviews. Giorgi's five-step method of data analysis was used, along with an independent coder. Measures to ensure trustworthiness and ethical principles were applied throughout the research. RESULTS Four themes with 12 subthemes emerged from the data therapeutic relationship with patients as an integral part of caring, teamwork - team spirit makes caring easy, continuous caring that promotes quality and safe nursing, as well as satisfaction amongst staff and patients, and various barriers that contributed to lack of caring in the unit. CONCLUSION The majority of student nurses had positive experiences of caring, which included therapeutic relationships between nurses and the patients, teamwork and team spirit that fostered safe and quality nursing care, rendered effortlessly. Barriers to caring were also highlighted as negative experiences.BACKGROUND Nurse leadership is about aligning employees to a vision. This happens with buy-in, motivation and communication. When conducive environments are created by organisations, the motivation of nurse leaders will be enhanced, which will have a positive outcome on the organisation. Highly motivated nurse leaders accomplish more and are more productive. Nurse leadership is an essential source of support, mentorship and role modelling. These attributes tend to be more evident when nurse leaders are motivated. OBJECTIVES The objective of this study was to determine the factors that influence the motivation of nurse leaders. METHOD A quantitative, descriptive design and stratified sampling was used. Participants comprised unit managers (n = 49) from five hospitals in a private hospital group in South Africa. A self-administered questionnaire, namely, the Multidimensional Work Motivation Scale, was used to collect the data. Data were analysed using the IBM SPSS 22.0 program. RESULTS The results indicated that the nurse leaders in this study were intrinsically motivated. Their motivation was influenced by support, relatedness, autonomy and competence. No relationships were found between motivation and age, years in a management position, gender, qualifications and staff-reporting structure. CONCLUSION By implication, to understand what motivates nurse leaders and to keep them motivated, recommendations were proposed to nursing and human resources management. https://www.selleckchem.com/products/cx-5461.html It is expected that the implementation of the recommendations will have a positive influence on patient outcomes, organisational success and the motivation and satisfaction of nurse leaders.BACKGROUND Medication errors may result in patients' harm and even death. The improvement of nursing students' competence in the administration of medication through education and training can contribute to the reduction of medication errors. OBJECTIVES This study aimed at describing the Bachelor of Nursing students' perceptions about clinical learning opportunities and competence in the administration of oral medication. METHOD A quantitative descriptive design was employed. An all-inclusive sample of 176 nursing students registered at a university in the Western Cape, South Africa, in 2014 was considered for the study, of whom 125 students consented to participate and completed the questionnaires. Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis and descriptive statistics were conducted. RESULTS The findings showed that a minority of students did not have opportunities to rotate in all specific types of wards. The findings indicated that a total of 92% (115) and 86.4% (108) of the 125 respondents were placed in medical and surgical wards, respectively, where they more likely had opportunities to practise the administration of oral medication. However, 59.2% (74) did not practise administration of oral medication on a daily basis. Only 19.2% (24) of respondents perceived themselves as competent in the administration of oral medication. CONCLUSION The findings indicated that many students perceived their education and training as not providing sufficient learning opportunities to practise the administration of oral medication, whilst the majority of respondents perceived themselves as competent in some of the aspects related to the administration of oral medication, and very few perceived themselves as competent overall in the administration of oral medication.

2 hrs ago


4%) persons with detectable ARV as having long-term infection. Those with detectable ARV were significantly more likely to be aware of their HIV-positive status (84% vs. 10%) and had higher levels of drug resistance (74% vs. 26%) than those without detectable ARV. RITA2 incidence was lower than RITA1 incidence (range, 0%-30% decrease), resulting in decreased estimated new infections from 390,000 to 341,000 across the 13 countries. Incidence estimates were similar using detectable or self-reported ARV (R2 > 0.995).

Including ARV in RITA2 improved the accuracy of HIV-1 incidence estimates by removing participants with likely long-term HIV infection.
Including ARV in RITA2 improved the accuracy of HIV-1 incidence estimates by removing participants with likely long-term HIV infection.
In the population-based HIV impact assessment surveys, early infant diagnosis (EID) was provided to infants <18 months without a prior diagnosis. For the Namibia population-based HIV impact assessment (NAMPHIA), the GeneXpert platform was assessed for the feasibility of near POC EID testing compared with the standard Roche COBAS AmpliPrep/COBAS TaqMan (CAP/CTM) platform. Quality assurance measures and turnaround time were compared to improve EID results reporting.

NAMPHIA participants were screened for HIV exposure using Determine HIV-1/2 rapid test; samples reactive on Determine received EID testing on the GeneXpert instrument and Xpert HIV-1 Qual assay using whole blood. Results were confirmed at the Namibia Institute of Pathology using dried blood spots on the Roche CAP/CTM platform per national guidelines.

Of the 762 screened infants, 61 (8.0%) were Determine-reactive and considered HIV-exposed. Of the 61 exposed infants, 2 were found to be HIV-infected whereas 59 were negative on both GeneXpert and Roche platforms, achieving 100% concordance. Average turnaround time was 3.4 days for the Xpert HIV-1 Qual assay, and average time from collection to testing was 1.0 days for GeneXpert compared with 10.7 days for Roche. No samples failed using GeneXpert whereas 1 sample failed using Roche and was repeated.

Quality POC EID testing is feasible in a national survey through extensive training and external quality assurance measures. The use of decentralized POC EID for national testing would provide rapid diagnosis and improve TATs which may prevent loss to follow-up, ensure linkage to care, and improve clinical outcomes for infants.
Quality POC EID testing is feasible in a national survey through extensive training and external quality assurance measures. The use of decentralized POC EID for national testing would provide rapid diagnosis and improve TATs which may prevent loss to follow-up, ensure linkage to care, and improve clinical outcomes for infants.
High response rates in surveys are critical to ensuring that findings are unbiased and representative of the target population. Questionnaire length affects response rates, with long interviews associated with partially complete surveys, higher item nonresponse ("don't know" and "refuse" responses), and willingness to participate in future surveys. Our aim is to determine the impact of questionnaire length on blood test participation in population-based HIV surveys.

Data are from population-based HIV impact assessments conducted in Zambia, Eswatini, and Lesotho in 2016-2017. The population-based HIV impact assessments consist of an interview followed by a blood draw. https://www.selleckchem.com/products/bgj398-nvp-bgj398.html Consent for blood draw was obtained before the interview in Eswatini and after the interview in Zambia and Lesotho. Interview length was measured by the survey tablet as the time to complete the survey (interview duration) and the number of questions answered by the participant (questionnaire length). We assessed the effects of questionnaire length and interview duration on blood test participation using logistic regression.

Across all 3 surveys, the median interview duration was 16 minutes and the median number of questions was 77. In adjusted analyses, there was a negative impact of interview duration on blood draw consent for individuals with unknown status in Lesotho and a positive relationship between questionnaire length and blood draw consent in Zambia for those with HIV-negative and unknown status.

Although interview length is an important consideration to reduce respondent burden, a longer questionnaire does not necessarily result in lower consent rates for blood testing.
Although interview length is an important consideration to reduce respondent burden, a longer questionnaire does not necessarily result in lower consent rates for blood testing.
Measurement of mother-to-child HIV transmission through population-based surveys requires large sample sizes because of low HIV prevalence among children. We estimate potential improvements in sampling efficiency resulting from a targeted sample design.

Eight countries in sub-Saharan Africa with completed Population-based HIV Impact Assessment (PHIA) surveys as of 2017.

The PHIA surveys used a geographically stratified 2-stage sample design with households sampled from randomly selected census enumeration areas. Children (0-14 years of age) were eligible for HIV testing within a random subsample of households (usually 50%). Estimates of child HIV prevalence in each country were calculated using jackknife replicate weights. We compared sample sizes and precision achieved using this design with a 2-phase disproportionate sample design applied to strata defined by maternal HIV status and mortality.

HIV prevalence among children ranged from 0.4% (95% confidence interval 0.2 to 0.6) in Tanzania to 2.8% (95% confidence interval 2.2 to 3.4) in Eswatini with achieved relative standard errors between 11% and 21%. The expected precision improved in the targeted design in all countries included in the analysis, with proportionate reductions in mean squared error ranging from 27% in Eswatini to 61% in Tanzania, assuming an equal sample size.

Population-based surveys of adult HIV prevalence that also measure child HIV prevalence should consider targeted sampling of children to reduce required sample size, increase precision, and increase the number of positive children tested. The findings from the PHIA surveys can be used as baseline data for informing future sample designs.
Population-based surveys of adult HIV prevalence that also measure child HIV prevalence should consider targeted sampling of children to reduce required sample size, increase precision, and increase the number of positive children tested. The findings from the PHIA surveys can be used as baseline data for informing future sample designs.

6 hrs ago


Thus, the surviving GCs after Cy exposure had intact AMH-producing ability. In future, an effort to minimize GC death by Cy treatment is required, while maintaining its therapeutic effects.
We determined the predictors of osteonecrosis in a longitudinal lupus cohort, emphasizing the role of maximal prednisone dose and duration.

Data from 2428 patients were included in the analysis based on 224295 person-months of follow-up. We used pooled logistic regression to assess the relationship between risk factors and rates of osteonecrosis. After identifying a set of variables related to osteonecrosis incidence, we fit a final multivariable model to identify the most important risk factors for incident osteonecrosis.

In 18691 person-years of follow up after cohort entry, 122 incident osteonecrosis event were observed. In the multivariable analysis, African-Americans had twice the risk of osteonecrosis compared to Caucasians. Males and smokers had 80% and 50% increased risk of osteonecrosis compared to females and non-smokers, respectively. For every 10 year increase in the age of diagnosis, there was a 20% reduced risk of osteonecrosis. Patients diagnosed after the 1990's had a 50% reduced risk of osteonecrosis compared to those diagnosed before the 1990's. A daily dose of prednisone of 20-39 mg or higher, when administered for more than a month, or a daily prednisone dose of 40 mg or higher, even when administered for one month, significantly increased the risk of osteonecrosis. Use of pulse methylprednisolone or intramuscular triamcinolone was not associated with an increased risk of osteonecrosis.

Oral prednisone at 20-39 mg for more than one month, or 40 mg daily for even one month remained the most important corticosteroid predictor of osteonecrosis.
Oral prednisone at 20-39 mg for more than one month, or 40 mg daily for even one month remained the most important corticosteroid predictor of osteonecrosis.Signal intensity measured in a mass cytometry (CyTOF) channel can often be affected by the neighboring channels due to technological limitations. Such signal artifacts are known as spillover effects and can substantially limit the accuracy of cell population clustering. Current approaches reduce these effects by using additional beads for normalization purposes known as single-stained controls. While effective in compensating for spillover effects, incorporating single-stained controls can be costly and require customized panel design. This is especially evident when executing large-scale immune profiling studies. We present a novel statistical method, named CytoSpill that independently quantifies and compensates the spillover effects in CyTOF data without requiring the use of single-stained controls. Our method utilizes knowledge-guided modeling and statistical techniques, such as finite mixture modeling and sequential quadratic programming, to achieve optimal error correction. We evaluated our method using five publicly available CyTOF datasets obtained from human peripheral blood mononuclear cells (PBMCs), C57BL/6J mouse bone marrow, healthy human bone marrow, chronic lymphocytic leukemia patient, and healthy human cord blood samples. In the PBMCs with known ground truth, our method achieved comparable results to experiments that incorporated single-stained controls. In datasets without ground-truth, our method not only reduced spillover on likely affected markers, but also led to the discovery of potentially novel subpopulations expressing functionally meaningful, cluster-specific markers. CytoSpill (developed in R) will greatly enhance the execution of large-scale cellular profiling of tumor immune microenvironment, development of novel immunotherapy, and the discovery of immune-specific biomarkers. The implementation of our method can be found at https//github.com/KChen-lab/CytoSpill.git.Stereotactic body radiotherapy (SBRT) of lung tumors via the ring-mounted Halcyon Linac, a fast kilovoltage cone beam CT-guided treatment with coplanar geometry, a single energy 6MV flattening filter free (FFF) beam and volumetric modulated arc therapy (VMAT) is a fast, safe, and feasible treatment modality for selected lung cancer patients. Four-dimensional (4D) CT-based treatment plans were generated using advanced AcurosXB algorithm with heterogeneity corrections using an SBRT board and Halcyon couch insert. https://www.selleckchem.com/products/choline-hydroxide.html Halcyon VMAT-SBRT plans with stacked and staggered multileaf collimators produced highly conformal radiosurgical dose distribution to the target, lower intermediate dose spillage, and similar dose to adjacent organs at risks (OARs) compared to SBRT-dedicated highly conformal clinical noncoplanar Truebeam VMAT plans following the RTOG-0813 requirements. Due to low monitor units per fraction and less multileaf collimator (MLC) modulation, the Halcyon VMAT plan can deliver lung SBRT fractions with an overall treatment time of less than 15 min (for 50 Gy in five fractions), significantly improving patient comfort and clinic workflow. Higher pass rates of quality assurance results demonstrate a more accurate treatment delivery on Halcyon. We have implemented Halcyon for lung SBRT treatment in our clinic. We suggest others use Halcyon for lung SBRT treatments using abdominal compression or 4D CT-based treatment planning, thus expanding the access of curative ultra-hypofractionated treatments to other centers with only a Halcyon Linac. Clinical follow-up results for patients treated on Halcyon Linac with lung SBRT is ongoing.
Anaemia, a condition characterized by reduced oxygen-carrying capacity, is a widespread public health problem with major consequences for human health as well as social and economic development. Prompt and accurate diagnosis as well as effective management of iron deficiency anaemia (IDA) is important to prevent the undesired adverse clinical outcomes.

The purpose of the study was to assess the adequacy of IDA diagnosis and management within the Namibian private healthcare system. In this study, we used a quantitative, descriptive research design and data collection methods. The design was also nonexperimental in nature, employing a survey instrument to collect data. In total, 51 questionnaires were administered to private medical practitioners.

The surveyed medical practitioners used different Standard Treatment Guidelines (STGs) in managing IDA cases, with the majority (76.5%) using the Namibia STGs. The other guidelines and their usage rates were as follows World Health Organization guidelines (39.2%), Standard Treatment Guidelines and Essential Medicine List for South Africa (19.

23 hrs ago


The L-embedded OTU did not influence IFN signaling, the sensitivity to IFN, or IFN induction. Moreover, the attenuation of OTU C40A-mutated L could not be relieved by inactivating the IFN response, but after overexpression of conjugation-competent ISG15 the polymerase activity recovered to wild-type levels. Consequently, ISG15 was used to produce OTU-deficient tc-VLPs, a potential vaccine candidate. Our data thus indicate that in the context of full-length L the OTU domain is important for the regulation of CCHFV polymerase by ISG15.Following the Fukushima Daiichi Nuclear Power Plant accident in March 2011, radionuclides such as iodine-131, cesium-134 and cesium-137 were released into environment. In this study, we collected wild mushrooms from the Kawauchi Village of Fukushima Prefecture, located less than 30 km southwest of the Fukushima nuclear power plant, to evaluate their radiocesium (134Cs+137Cs) concentrations and the risk of internal radiation exposure in local residents. 342 mushroom samples were collected from 2016 to 2019. All samples were analysed for radiocesium content by a high-purity germanium detector. Among 342 mushroom samples, 260 mushroom samples (76%) were detected the radiocesium exceeding the regulatory limit of radiocesium (100 Bq/kg for general foods in Japan). The median of committed effective dose from ingestion of wild mushrooms was in the range of 0.015-0.053 mSv in 2016, 0.0025-0.0087 mSv in 2017, 0.029-0.110 mSv in 2018 and 0.011-0.036 mSv in 2019 based on the assumption that Japanese citizens consumed wild mushrooms for 1 year. https://www.selleckchem.com/products/ad80.html Thus, our study showed that although radiocesium is still detected in mushrooms collected in Kawauchi village even after 5 to 9 years later, the committed effective dose due to consuming mushrooms was lower than 1 mSv per year. Long-term comprehensive follow-up should monitor radiocesium concentrations in wild mushrooms to support the recovery of the community after the nuclear disaster.The identification of sick leave determinants could positively influence decision making to improve worker quality of life and to reduce consequently costs for society. Sick leave is a research topic of interest in economics, psychology, health and social behaviour. The question of choosing an appropriate statistical tool to analyse sick leave data can be challenging. In fact, sick leave data have a complex structure, characterized by two dimensions frequency and duration, and involve numerous features related to individual and environmental factors. We conducted a scoping review to characterize statistical approaches to analyse individual sick leave data in order to synthesise key insights from the extensive literature, as well as to identify gaps in research. We followed the PRISMA methodology for scoping reviews and searched Medline, World of Science, Science Direct, Psycinfo and EconLit for publications using statistical modeling for explaining or predicting sick leave at the individual level. We selected 469 articles from the 5983 retrieved, dated from 1981 to 2019. In total, three types of model were identified univariate outcome modeling using for the most part count models (438 articles), bivariate outcome modeling (14 articles), such as multistate models and structural equation modeling (22 articles). The review shows that there was a lack of evaluation of the models as predictive accuracy was only evaluated in 18 articles and the explanatory accuracy in 43 articles. Further research based on joint models could bring more insights on sick leave spells, considering both their frequency and duration.Over the past decade, pastoralists in Kunene Region, Namibia, have endured recurrent drought and flood events that have culminated in the loss of their primary form of livelihood-pastoralism. Most pastoralists are finding it difficult to sustain their livelihoods, and their communities have fallen into extreme poverty. Ecosystem-based Adaptation (EbA) approaches are increasingly acknowledged as having the potential to enhance the adaptive capacity of vulnerable communities. The first step is to develop an understanding of how affected communities live, their perceptions of and how they respond to climate change and the biophysical impacts of climate change in their communities. This study aims to collect this information in order to explore the use of EbA to help pastoralists adapt to climate change. We examined an isolated pastoral Himba community, to understand their perceptions, experiences and understanding of climate change and its related impacts on their livelihoods. A nested mixed-methods approach usicapacity.To manage coronavirus disease 2019 (COVID-19), a national health authority has implemented a case definition of patients under investigation (PUIs) to guide clinicians' diagnoses. We aimed to determine characteristics among all PUIs and those with and without COVID-19. We retrospectively reviewed clinical characteristics and risk factors for laboratory-confirmed COVID-19 cases among PUIs at a tertiary care center in Bangkok, Thailand, between March 23 and April 7, 2020. Reverse transcription-polymerase chain reaction for SARS-CoV-2 RNA was performed. There were 405 evaluable PUIs; 157 (38.8%) were men, with a mean age ± SD of 36.2 ± 12.6 years. The majority (68.9%) reported no comorbidities. There were 53 (13.1%) confirmed COVID-19 cases. The most common symptoms among those were cough (73.6%), fever (58.5%), sore throat (39.6%), and muscle pain (37.4%). Among these patients, diagnoses were upper respiratory tract infection (69.8%), viral syndrome (15.1%), pneumonia (11.3%), and asymptomatic infection (3.8%). Multivariate analysis identified close contact with an index case (OR, 3.49; 95%CI, 1.49-8.15; P = 0.004), visiting high-risk places (OR, 1.92; 95%CI, 1.03-3.56; P = 0.039), productive cough (OR, 2.03; 95%CI, 1.05-3.92; P = 0.034), and no medical coverage (OR, 3.91; 95%CI, 1.35-11.32; P = 0.012) as independent risk factors for COVID-19 among the PUIs. The majority had favorable outcomes, though one (1.9%) died from severe pneumonia. COVID-19 was identified in 13% of PUIs defined per a national health authority's case definition. History of contact with a COVID-19 patient, visiting a high-risk place, having no medical coverage, and productive cough may identify individuals at risk of COVID-19 in Thailand.

11/03/2024


People classified by a priori definitions as having metabolically healthy obesity have frequently been found to be at increased risk of mortality, compared with individuals with metabolically healthy normal weight, suggesting these definitions may be insufficient.

To systematically derive a new definition of metabolic health (MH) and investigate its association with cardiovascular disease (CVD) mortality and total mortality.

In a cohort study using data from the third National Health and Nutrition Examination Survey (NHANES-III), a representative survey using complex multistage probability sampling, anthropometric factors, biomarkers, and blood pressure (BP) associated with total and CVD mortality among participants with obesity were identified with Cox proportional hazards regression. Area under the receiver operating characteristic was calculated to identify predictive factors for mortality to be used to define MH, cutoff levels were determined by the Youden index, and the findings were validated throed risks.

This newly proposed definition of MH may identify a subgroup of people with obesity without increased risk of mortality and stratify risks in people who are overweight or normal weight.
This newly proposed definition of MH may identify a subgroup of people with obesity without increased risk of mortality and stratify risks in people who are overweight or normal weight.Nasal swabs collected from 40 wild ruminants in Namibia were analyzed by PCR for the presence of lumpy skin disease virus (LSDV) DNA. One sample from an asymptomatic eland (Taurotragus oryx) tested positive, providing the first evidence of the presence of LSDV DNA in an eland.Oil spills represent a continued threat to marine wildlife. Although the public expects, and the State of California, US requires, oiled animals to be rescued for rehabilitation and release, scientists have questioned the welfare and conservation value of capture and rehabilitation of oiled wildlife, based on poor postrelease survival documented in the few available studies. In May 2015, Plains Pipeline 901 spilled >100,000 gallons of oil near Refugio State Beach, California. Many California Brown Pelicans (Pelecanus occidentalis californicus) were oiled; capture and rehabilitation efforts began within 1 d. Ultimately, 65 live birds were captured, including 50 pelicans. Forty-six pelicans survived and were released. Of these, 12 adults (six male, six female) were fitted with solar-powered GPS satellite Platform Terminal Transmitters (PTT) and released in June 2015. In early July, we captured eight adult (three male, four female, one unknown), unoiled pelicans from the Ventura, California area. These control birds were similarly instrumented and released immediately. At 6 mo after release, PTTs from nine of 12 oiled pelicans and six of eight control pelicans were still transmitting; at 1 yr, those numbers decreased to two of 12 and two of eight, respectively. Survival analysis revealed no difference in survival between oiled and control birds. Although our sample size is limited, these data demonstrate that most oiled and rehabilitated pelicans can survive for 6 mo following release, and some individuals can survive over 1 yr.
Visualization is a powerful tool to analyze, understand and present big data. Computational biology, bioinformatics, and molecular modeling require dedicated tools, tailored to very complex, highly multidimensional data. Over the recent years, numerous tools have been developed for online presentation, but new challenges like the COVID-19 pandemic require new libraries which will guarantee fast development of online tools for a better understanding of biomedical data/results.

VisuaLife is a Python library that provides a new approach to visualization in a web browser. It offers 2D and 3D plotting capabilities as well as widgets designed to display the most common biological data types nucleotide or protein sequences, 3D biomolecular structures and multiple sequence alignments. https://www.selleckchem.com/products/PCI-24781.html Components provided by the VisuaLife library can be assembled into a web application to create an analysis tool tailored to provide multi-dimensional analysis of a specific research problem. VisuaLife, to our best knowledge, is the most modern solution that allows one to implement such a client-side interactivity in Python.

The git repository of the library is hosted at BitBucket https//bitbucket.org/dgront/visualife/. PyPI distribution is also provided for MacOS and Linux. While basic examples are provided in the supporting materials, the full documentation is available at ReadTheDocs website https//visualife.readthedocs.io/.
The git repository of the library is hosted at BitBucket https//bitbucket.org/dgront/visualife/. PyPI distribution is also provided for MacOS and Linux. While basic examples are provided in the supporting materials, the full documentation is available at ReadTheDocs website https//visualife.readthedocs.io/.
Healthcare quality assessment is being conducted in many countries. Although improving health equity is one of the major objectives of medical quality assessment, it is not clear whether different socio-economic statuses show the same health outcomes even in the same medical quality hospitals. No study has directly compared the health outcomes of different socio-economic statuses in the same hospitals nationwide.

To determine whether the mortality rate of acute stroke patients differs according to socioeconomic status.

This study was a retrospective, observational study of patients who were subject to acute stroke quality assessment in 2013. A total of 10 399 stroke cases were included in the study. When evaluating the mortality rate, the researchers analysed 10 228 cases, after excluding 171 cases that were measured twice for the same person. The levels of socio-economic status were divided according to the use of medical benefits, either National Health Insurance (NHI) for general population or Medicaomic status in stroke patients in Korea. Efforts to improve equity are needed, including the development and monitoring of equality indicators and developing policies for healthcare equity.