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Assessing intersectional gender analysis in Nepal’s health management information system: a case study on tuberculosis for inclusive health systems

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贫困所致传染病(英文) 2024年第2期13卷 52-62页

作者： parajuli Ayuska Kakchapati Sampurna Arjyal Abriti Joshi Deepak Kharel Chandani del Barrio Mariam Otmani Baral Sushil C HERD International Saibu Awas Cr-Marga Bhaisepati Lalitpur Nepal UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) World Health Organization Geneva Switzerland

Background Tuberculosis (TB) remains a major public health problem in Nepal, high in settings marked by prevalent gender and social inequities. Various social stratifiers intersect, either privileging or oppressing individuals based on their characteristics and contexts, thereby increasing risks, vulnerabilities and marganilisation associated with TB. This study aimed to assess the inclusiveness of gender and other social stratifiers in key health related national policies and the Health Management Information System (HMIS) of National Tuberculosis Programme (NTP) by conducting an intersectional analysis of TB cases recorded via *** A desk review of key policies and the NTP’s HMIS was conducted. Retrospective intersectional analysis utilized two secondary data sources: annual NTP report (2017–2021) and records of 628 TB cases via HMIS 6.5 from two TB centres (2017/18–2018/19). Chi-square test and multi-variate analysis was used to assess the association between social stratifers and types of TB, registration category and treatment *** Gender, social inclusion and concept of intersectionality are incorporated into various health policies and strategies but lack effective implementation. NTP has initiated the collection of age, sex, ethnicity and location data since 2014/15 through the HMIS. However, only age and sex disaggregated data are routinely reported, leaving recorded social stratifiers of TB patients static without analysis and dissemination. Furthermore, findings from the intersectional analysis using TB secondary data, showed that male more than 25 years exhibited higher odds [adjusted odds ratio (aOR) = 4.95, 95% confidence interval (CI): 1.60–19.06,P = 0.01)] of successful outcome compared to male TB patients less than 25 years. Similarly, sex was significantly associated with types of TB (P < 0.05) whereas both age (P < 0.05) and sex (P < 0.05) were significantly associated with patient registration category (old/new cases).Conclusio

关键词： Tuberculosis Intersectional gender analysis Gender and social inequities Social determinant Health Management Information System National Tuberculosis Programme Social inclusion Gender

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Outcome of patients with traumatic cranial nerve palsy admitted to a university hospital in Nepal

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中华神经外科杂志(英文) 2024年第2期10卷 1-7页

作者： Kumari Khusbu Gautam Naveen parajuli Monika Singh Shreejana Pradhananga Amit Sedai Gopal Shilpakar Sushil Sharma Mohan Raj Maharajgunj Medical Campus Institute of Medicine Tribhuvan University Maharajgunj Kathmandu Nepal Department of Research Institute of Medicine Maharajgunj Kathmandu Nepal Department of Neurosurgery Tribhuvan University Teaching Hospital Maharajgunj Kathmandu Nepal

Background Cranial nerve palsy (CNP) is a common complication of traumatic brain injury (TBI). Despite a high incidence of TBI in Nepal (382 per 100,000), literature on the specific management and outcome of CNP is lacking. This study aimed to examine the outcomes of TBI patients involving single versus multiple *** A retrospective chart review of 170 consecutive TBI patients admitted to the tertiary neurosurgical center in Nepal between April 2020 and April 2022 was conducted. Demographic, clinical, and etiological characteristics; imaging findings; and management strategies were recorded, compared, and analyzed using descriptive statistics. The Glasgow Outcome Scale Extended (GOSE) was used to measure the outcomes in two groups of patients (single and multiple CNP) at 3 *** Out of 250 eligible patients, 80 were excluded and CNP was noted in 29 (17.1%) of the remaining 170. The median age was 34.9 years, and falls (60.6%) were the most common cause of trauma. TBI severity was categorized based on GCS: mild (82.4%), moderate (15.9%), and severe (1.8%). Cranial nerve involvement was seen in 29 (17.05%) patients: single cranial nerve involvement in 26 (89.65%) and multiple nerve involvement in 3 (10.34%). The most common isolated cranial nerve involved was the oculomotor nerve (37.9%). CT findings revealed a maximum of skull fractures with no significant association between CNP and CT *** CNP is a common consequence of TBI with the most common etiology being falls followed by RTA. Single CNP was more common than multiple CNP with no significant difference in the outcome in the 3-month GOSE score. Further research is needed to determine the burden of traumatic CNP and establish specific management guidelines for different types of CNP.

关键词： Cranial nerve palsy Nepal Outcome Traumatic brain injury

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Pattern of Acute Parasitic Diarrhea in Children Under Five Years of Age in Kathmandu, Nepal

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Open Journal of Medical Microbiology 2012年第3期2卷 95-100页

作者： Shamshul Ansari Jeevan Bahadur Sherchand keshab parajuli Bharat Mani Paudyal Ram Prasad Adhikari Shovita Shrestha Shyam Kumar Mishra Rajan Kumar Dahal Sarmila Tandukar Rama Khadka Ranju Shreshta Soma Kanta Baral Bharat Mani Pokhrel Department of Microbiology Institute of Medicine Tribhuvan University Teaching Hospital (TUTH) Kathmandum Nepal Public Health Research Laboratory Institute of Medicine Tribhuvan University Teaching Hospital (TUTH) Kathmandu Nepal

Diarrheal diseases are major problem of developing countries. Though precise data on childhood mortality associated with diarrheal diseases in Nepal is not available, it has been estimated that approximately 25% of child death are associated with diarrheal disease, particularly acute diarrhea. The purpose of this study was to assess the incidence of parasitic pathogens causing acute diarrhea in children under 5 years of age. A total of 525 children with acute diarrhea in a children’s hospital of Kathmandu, Nepal were enrolled between April 2011 and September 2011. The higher prevalence of diarrhea was in the age group of less than 2 years. Out of total 525 enrolled cases, protozoal parasites were found in 10.7% (56/525) of cases and helminthic parasites were found in 1.3% (7/525) of cases. Highest prevalence of 60.3% (38/63) of parasitic infection was found in the age group of 6 - 24 months followed by 7.9% (5/63) in the age group of less than 6 months. Of the total enrolled cases E. histolytica were 6.7% (35/525) followed by Giardial lamblia 3.4% (18/525) and the least frequency was due to A. lumbricoides constituting 0.6% (3/525). The aim of this study was to know the parasitic agents causing acute diarrhea in children.

关键词： Parasitic Diarrhea Protozoa Helminthes TUTH Nepal

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Long-term follow-up of kidney transplant recipients admitted to a tertiary care transplant center with SARS-CoV-2

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World Journal of Virology 2024年第2期13卷 87-95页

作者： Emily E Zona Mina L Gibes Asha S Jain Jeannina A Smith Jacqueline M Garonzik-Wang Didier A Mandelbrot Sandesh parajuli Division of Nephrology Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWI 53705United States Department of Infectious Disease University of Wisconsin Hospital and ClinicsMadisonWI 53705United States Department of Surgery University of WisconsinMadisonWI 53705United States Department of Medicine University of Wisconsin School of Medicine and Public HealthMadisonWI 53705United States Department of Medicine University of Wisconsin School of Medicine and Public HealthUniversity of Wisconsin MadisonMadisonWI 53705United States

BACKGROUND Kidney transplant recipients(KTR)are at risk of severe coronavirus disease 2019(COVID-19)disease and mortality after severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)*** predicted that hospitalization for COVID-19 and subsequent admission to the intensive care unit(ICU)would yield worse outcomes in *** was stratified by ICU *** of interest included risk factors for ICU admission and mortality,length of stay(LOS),respiratory symptoms at admission,all-cause graft failure at the last follow-up,and death related to *** 96 KTRs were hospitalized for SARS-COV-2 infection.21(22%)required ICU *** ICU group had longer hospital LOS(21.8 vs 8.6 days,P<0.001)and were more likely to experience graft failure(81%vs 31%,P<0.001).Of those admitted to the ICU,76%had death at last-follow up,and 71%had death related to *** factors for ICU admission included male sex(aHR:3.11,95%CI:1.04-9.34;P=0.04).Risk factors for all-cause mortality and COVID-19-related mortality included ICU admission and advanced age at SARS-CoV-2 *** was highest within a month of COVID-19 diagnosis,with the ICU group having increased risk of all-cause(aHR:11.2,95%CI:5.11-24.5;P<0.001)and COVID-19-related mortality(aHR:27.2,95%CI:8.69-84.9;P<0.001).CONCLUSION ICU admission conferred an increased risk of mortality,graft failure,and longer ***-fifth of those hospit-alized died of COVID-19,reflecting the impact of COVID-19-related morbidity and mortality among KTRs.

关键词： Kidney transplants SARS-CoV-2 Intensive care unit admission Outcomes Graft failure

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Urban heat mitigation by green and blue infrastructure:Drivers,effectiveness,and future needs

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The Innovation 2024年第2期5卷 145-166页

作者： Prashant Kumar Sisay E.Debele Soheila Khalili Christos H.Halios Jeetendra Sahani Nasrin Aghamohammadi Maria de Fatima Andrade Maria Athanassiadou Kamaldeep Bhui Nerea Calvillo Shi-Jie Cao Frederic Coulon Jill L.Edmondson David Fletcher Edmilson Dias de Freitas Hai Guo Matthew C.Hort Madhusudan Katti Thomas Rodding Kjeldsen Steffen Lehmann Giuliano Maselli Locosselli Shelagh K.Malham Lidia Morawska Rajan parajuli Christopher D.F.Rogers Runming Yao Fang Wang Jannis Wenk Laurence Jones Global Centre for Clean Air Research(GCARE) School of SustainabilityCivil and Environmental EngineeringFaculty of Engineering and Physical SciencesUniversity of SurreyGuildford GU27XHUK Institute for Sustainability University of SurreyGuildford GU27XHSurreyUK School of Built Environment University of ReadingWhiteknightsReading RG66BUUK School Design and the Built Environment Curtin University Sustainability Policy InstituteKent StBentley 6102Western Australia Harry Butler Institute Murdoch UniversityMurdoch 6150Western Australia Atmospheric Sciences Department Institute of AstronomyGeophysics and Atmospheric SciencesUniversity of Sao PauloSao Paulo 05508-090Brazil Met Office FitzRoy RoadExeter EX13PBUK Department of Psychiatry and Nuffield Department of Primary Care Health Sciences Wadham CollegeUniversity of OxfordOxfordUK Centre for Interdisciplinary Methodologies University of WarwickWarwickUK School of Architecture Southeast University2 SipailouNanjing 210096China Cranfield University School of WaterEnvironment and EnergyCranfield MK430ALUK Plants PhotosynthesisSoil ClusterSchool of BiosciencesUniversity of SheffieldSheffield S102TNUK UK Centre for Ecology&Hydrology Environment Centre WalesDeiniol RoadBangor LL572UWUK Air Quality Studies Department of Civil and Environmental EngineeringThe Hong Kong Polytechnic UniversityHong KongChina Department of Forestry and Environmental Resources Faculty Excellence Program for Leadership in Public ScienceNorth Carolina State UniversityChancellorRaleighNC 27695USA Departments of Architecture&Civil Engineering and Chemical EngineeringUniversity of BathBath BA27AYUK School of Architecture University of NevadaLas VegasNV 89154USA Department of Tropical Ecosystems Functioning Center of Nuclear Energy in AgricultureUniversity of São PauloPiracicaba 13416-000Sao PauloBrazil School of Ocean Sciences Bangor UniversityMenai BridgeAnglesey LL595 ABUK International Laboratory for Air Quality and Health Science and Engine

The combination of urbanization and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate ***,the risk of urban overheating can be mitigated by urban green-blue-grey infrastructure(GBGI),such as parks,wetlands,and engineered greening,which have the potential to effectively reduce summer air *** many reviews,the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are *** systematic literature review synthesizes the evidence base for heat mitigation and related co-benefits,identifies knowledge gaps,and proposes recommendations for their implementation to maximize their *** screening 27,486 papers,202 were reviewed,based on 51 GBGI types categorized under 10 main *** GBGI(green walls,parks,street trees)have been well researched for their urban cooling ***,several other GBGI have received negligible(zoological garden,golf course,estuary)or minimal(private garden,allotment)*** most efficient air cooling was observed in botanical gardens(5.0±3.5℃),wetlands(4.9±3.2℃),green walls(4.1±4.2℃),street trees(3.8±3.1℃),and vegetated balconies(3.8±2.7℃).Under changing climate conditions(2070–2100)with consideration of RCP8.5,there is a shift in climate subtypes,either within the same climate zone(e.g.,Dfa to Dfb and Cfb to Cfa)or across other climate zones(e.g.,Dfb[continental warm-summer humid]to BSk[dry,cold semi-arid]and Cwa[temperate]to Am[tropical]).These shifts may result in lower efficiency for the current GBGI in the *** the importance of multiple services,it is crucial to balance their functionality,cooling performance,and other related co-benefits when planning for the future *** global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritizing effective interventions to reduce the risk of urban overheating,fi

关键词： estuary walls extreme

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Synergistic effects of zeolitic imidazolate frameworks(ZIFs)with different transition metals on intumescent flame-retarded polypropylene composites:A comparative study

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Journal of Materials Science & Technology 2023年第24期155卷 102-110页

作者： Yufeng Quan Ruiqing Shen Christian Schweizer Pradeep parajuli Zhuoran Zhang Waruna Kulatilaka Qingsheng Wang Artie McFerrin Department of Chemical Engineering Texas A&M University College Station TX 77843-3122 USA J. Mike Walker ’66 Department of Mechanical Engineering Texas A&M University College Station TX 77843-3123 USA

The use of intumescent flame retardants(IFRs)is considered an environmentally friendly and cost-effective strategy to suppress potential fire hazards from synthetic ***,some conventional IFRs are neither efficient in developing a thermally stable char layer nor reducing the release of toxic byproducts during polymer *** this work,we aim to discuss the effects of zeolitic imidazolate frameworks(ZIFs)on synergistically improving the flame retardancy behaviors in polypropylene(PP)composites,including thermal degradation(evolved gas analysis),free radical reactions in the gaseous phase(in-situ chemiluminescent image analysis),and carbonaceous structure in the condensed phase(micro-morphology and composition analysis).It is found that the transition metals in ZIFs can catalytically accelerate the crosslinking reaction at a lower initial temperature and decrease the amount of hydrocarbon volatiles in the gaseous *** ignited,the embedded ZIFs can firstly bridge adjacent phosphorus chains in the polymer matrix to expand crosslinking degrees and then they are anchored in the developed N-doped phospho-carbonaceous networks after *** a result,more compact char residue structures are observed in the condensed phase for ZIF-reinforced *** example,by replacing 2 wt%of IFR with ZIF-67,the peak heat release rate,peak smoke production rate,and peak CO production rate are reduced by 69%,80%,and 72%,respectively,when compared to the conventional *** results indicate an excellent solution to resolve inherent fire hazards associated with IFRs in polymers and achieve necessary efficiency for industrial *** also provides a new strategy for determining flammability characteristics and combustion mechanisms of polymer composites using in-situ chemiluminescence analysis.

关键词： Polymer flammability Intumescent flame retardants Zeolitic imidazolate frameworks Thermal degradation Free radical analysis Flame retardant mechanism

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Mode-localized accelerometer in the nonlinear Duffing regime with 75 ng bias instability and 95 ng/√Hz noise floor

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Microsystems & Nanoengineering 2022年第1期8卷 237-247页

作者： Hemin Zhang Milind Pandit Guillermo Sobreviela Madan parajuli Dongyang Chen Jiangkun Sun Chun Zhao Ashwin A.Seshia The Nanoscience Centre University of CambridgeCambridge CB30FFUK Silicon Microgravity Ltd. Cambridge Innovation ParkCambridge CB259PBUK MOE Key Laboratory of Fundamental Physical Quantities Measurement and Hubei Key Laboratory of Gravitation and Quantum Physics PGMF and School of PhysicsHuazhong University of Science and Technology430074 WuhanChina

Mode-localized sensors have attracted attention because of their high parametric sensitivity and first-order common-mode rejection to temperature *** high-fidelity detection of resonator amplitude is critical to determining the resolution of mode-localized sensors where the measured amplitude ratio in a system of coupled resonators represents the output *** at specific bifurcation points in a nonlinear regime can potentially improve the amplitude bias stability;however,the amplitude ratio scale factor to the input measurand in a nonlinear regime has not been fully *** paper theoretically and experimentally elucidates the operation of mode-localized sensors with respect to stiffness perturbations(or an external acceleration field)in a nonlinear Duffing *** operation of a mode-localized accelerometer is optimized with the benefit of the insights gained from theoretical analysis with operation in the nonlinear regime close to the top critical bifurcation *** phase portraits of the amplitudes of the two resonators under different drive forces are recorded to support the experimentally observed improvements for velocity random *** temperature control to suppress the phase and amplitude variations induced by the temperature drift,1/f noise at the operation frequency is significantly reduced.A prototype accelerometer device demonstrates a noise floor of 95 ng/√Hz and a bias instability of 75 ng,establishing a new benchmark for accelerometers employing vibration mode localization as a sensing paradigm.A mode-localized accelerometer is first employed to record microseismic noise in a university laboratory environment.

关键词： nonlinear bifurcation gained

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Conductive ionic liquid/chitosan hydrogels for neuronal cell differentiation

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Engineered Regeneration 2022年第1期3卷 1-12页

作者： Wenwu Wang Likun Chang Yichun Shao Dan Yu Jayanti parajuli Chao Xu Guoliang Ying Ali K.Yetisen Yixia Yin Nan Jiang State Key Laboratory of Advanced Technology for Materials Synthesis and Processing Wuhan University of TechnologyWuhan430070China College of Life Science and Technology Huazhong University of Science and Technology Wuhan 430074 China West China School of Basic Medical Sciences&Forensic Medicine Sichuan UniversityChengdu 610041China Department of Chemical Engineering Imperial College LondonLondon SW72AZUK

To regulate cell behaviors and promote nerve function recovery,three-dimensional(3D)conductive hydrogel can transmit intercellular electrical signals,and effectively provide the cell survival ***,produc-ing hydrogels with simultaneous high conductivity,favorable biocompatibility,and tissue-matching properties remains a challenge for spinal cord injury(SCI)***,a conductive,multifunctional,and biocompati-ble VPImBF4 ionic liquid(IL)with photosensitive chitosan-based hydrogel(pCM@IL)is *** pCM@IL hydrogel exhibits a 3D microporous structure that could maintain cell viability and improve cell ***-tic modulus,conductivity,and biodegradability of the pCM@IL hydrogels are investigated with tissue-matching mechanical *** pCM@IL conductive hydrogels synergistically enhance neuronal cell proliferation and promote neuronal cells differentiation via upregulates synapse gene(Tubulin𝛽3,GAP43,Synaptophysin)***,in vivo studies of the pCM@IL conductive hydrogels as implants demonstrate low-inflammation and neovascularize promotion and appropriate biodegradable *** developed pCM@IL conductive hydrogel is a promising therapeutic scaffold biomaterial for SCI repair.

关键词： Ionic liquid Chitosan conductive hydrogels Neural differentiation Spinal cord injury

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Evaluating avoidance distance and fleeing speed of broilers exposed to aerial systems

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International Journal of Agricultural and Biological Engineering 2020年第6期13卷 34-40页

作者： Pratik parajuli Yang Zhao Tom Tabler Department of Agricultural and Biological Engineering Mississippi State UniversityMississippi StateMississippiUSA Department of Animal Science The University of TennesseeKnoxvilleTennesseeUSA Department of Poultry Science Mississippi State UniversityMississippi StateMississippiUSA

Intensive labor chores for broiler production could be reduced by using automated ***,broilers’response toward automated systems remains *** experiments were conducted to determine the avoidance distance(AD)and the fleeing speed(FS)of 4-8 weeks old broilers toward two aerial systems,a rail with a dummy arm and a drone,operated at different speeds(0.2-1.2 m/s),and heights(0.3-1.8 m)in a commercial broiler *** broiler AD to a human assessor was also determined for *** show that the overall mean and standard error(SE)of broiler AD were 63±3 cm for the assessor,58±1 cm for the rail,and 85±1 cm for the *** bird age increased from week 4 to week 8,broiler AD reduced significantly from 82 to 45 cm for the rail but showed no significant change for the *** the operational speed increased,broiler AD significantly increased from 54 cm(0.2 m/s)to 62 cm(0.4 m/s)for the rail,and from 81 cm(0.4 m/s)to 89 cm(1.2 m/s)for the *** the operational height increased,broiler AD increased from 54 cm(0.3 m)to 57 cm(1.5 m)for the rail and 81 cm(1.2 m)to 88 cm(1.8 m)for the *** mean and SE of broiler FS were 0.21±0.01 m/s for the rail and 0.65±0.01 m/s for the *** bird age increased from week 4 to week 8,the mean broiler FS decreased from 0.47 to 0.07 m/s for the rail and from 0.84 to 0.16 m/s for the *** operational speed from 0.2 to 0.4 m/s for the rail and from 0.4 to 1.2 m/s for the drone significantly increased the mean FS from 0.18 to 0.24 m/s and from 0.52 to 0.78 m/s,*** the height of the rail from 0.3 to 1.5 m decreased the broiler FS from 0.27 to 0.16 m/***,increasing drone height from 1.2 to 1.8 m retained a similar *** outcomes of this study can help to better understand the interaction of broilers with aerial systems and provide insights into the optimization of robotic operational strategies while maintaining good broiler welfare production.

关键词： aerial automated system avoidance distance broiler drone fleeing speed

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Adverse effects of personal protection equipment among health workers during COVID-19

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Life Research 2022年第2期5卷 51-52页

作者： Bibek Raj parajuli Jyotishna Dev College of Medical Sciences BharatpurChitwanNepal University of Science and Technology Bangladesh

Personal Protective Equipment(PPE)has become a protective measure for healthcare workers during COVID *** workers are front liners to fight against COVID *** workers developed many adverse effects while working using ***,ocular,psychological were some of the common adverse effects reported by the healthcare *** measures help to reduce them to some *** use of PPE and related pros and cons are well-established,with the benefits outweighing minor adverse events also associated with it.

关键词： protective equipment covid healthcare worker doctors depression

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