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Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study

International Journal of Nursing Sciences 2021年第3期8卷 271-278,I0002,I0003页

作者： sein yaw may Naw Clara Ohn Khin Khin Win Win Mar Aye Nandar Han Su Su Maw Community Health Nursing Department University of Nursing-YangonMyanmar

Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in ***:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative *** data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic *** study is registered with ***:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve *** 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career *** problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health *** are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased *** work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to *** only the health system itself but also the population and other geographical factors have contributed to many challenges to ***:Myanmar’s CHNs face many challenges in achieving *** challenges are not confined to the health *** situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare *** study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infras

关键词： Community health nurses Community health services Health personnel Myanmar Primary health care Professional practice Social conditions Universal health coverage

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Tumor lysis syndrome after transarterial chemoembolization of hepatocellular carcinoma: Case reports and literature review

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World Journal of Gastroenterology 2009年第37期15卷 4726-4728页

作者： Pei-Min Hsieh Kao-Chen Hung yaw-Sen Chen Department of General Surgery E-Da Hospital E-Da Road Yan-Chau Kaohsiung 82445 Taiwan China

Tumor lysis syndrome (TLS) is a potentially lethal complication in cancer therapy. It may occur in highly sensitive tumors, especially in childhood cancer and leukemia, whereas, it is rare in the treatment of solid tumors in adults. TLS results from a sudden and rapid release of nuclear and cytoplasmic degradation products of malignant cells. The release of these can lead to severe alterations in the metabolic prof ile. Here, we present two cases of large hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) that resulted in TLS. Although TLS rarely happens in the treatment of adult hepatic tumor, only a few cases have been reported. We should keep in mind that all patients with HCC, particularly those with large and rapidly growing tumors, must be closely watched for evidence of TLS after TACE.

关键词： Hepatocellular carcinoma Therapeutic chemoembolization Tumor lysis syndrome

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Blood and urine biomarkers in prostate cancer:Are we ready for reflex testing in men with an elevated prostate-specific antigen?

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Asian Journal of Urology 2021年第4期8卷 343-353页

作者： Edward K.Chang Adam J.Gadzinski yaw A.Nyame Department of Urology University of Washington Medical CenterSeattleWAUSA Division of Public Health Sciences Fred Hutchinson Cancer Research CenterSeattleWAUSA

Objective:There is no consensus on the role of biomarkers in determining the utility of prostate biopsy in men with elevated prostate-specific antigen(PSA).There are numerous biomarkers such as prostate health index,4Kscore,prostate cancer antigen 3,ExoDX,SelectMDx,and Mi-Prostate Score that may be useful in this decision-making ***,it is unclear whether any of these tests are accurate and cost-effective enough to warrant being a widespread reflex test following an elevated *** goal was to report on the clinical utility of these blood and urine biomarkers in prostate cancer ***:We performed a systematic review of studies published between January 2000 and October 2020 to report the available parameters and cost-effectiveness of the aforementioned diagnostic *** focus on the negative predictive value,the area under the curve,and the decision curve analysis in comparing reflexive tests due to their relevance in evaluating diagnostic screening ***:Overall,the biomarkers are roughly equivalent in predictive *** test has additional clinical utility to the current diagnostic standard of care,but the added benefit is not substantial to justify using the test reflexively after an elevated ***:Our findings suggest these biomarkers should not be used in binary fashion and should be understood in the context of pre-existing risk predictors,patient’s ethnicity,cost of the test,patient life-expectancy,and patient *** are more recent diagnostic tools such as multi-parametric magnetic resonance imaging,polygenic single-nucleotide panels,IsoPSA,and miR Sentinel tests that are promising in the realm of prostate cancer screening and need to be investigated further to be considered a consensus reflexive test in the setting of prostate cancer screening.

关键词： Prostate-specific antigen Reflex testing Prostate cancer Screening

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Warm-Mix Asphalt and Pavement Sustainability: A Review

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Open Journal of Civil Engineering 2016年第2期6卷 84-93页

作者： Kenneth A. Tutu yaw A. Tuffour Department of Civil Engineering Auburn University Auburn AL USA Department of Civil Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana

Within the past two decades or so, the asphalt paving industry has responded positively to increasing global concerns over shrinking natural resource reserves and worsening environmental conditions through the development and deployment of warm-mix asphalt technologies. Such technologies make it possible to produce and place asphalt concrete at reduced temperatures compared to conventional hot-mix methods. Several studies have reported on the potential of warm-mix asphalt with regard to improved pavement performance, efficiency and environmental stewardship. This paper reviews several of those studies in the context of pavement sustainability. Overall, warm-mix asphalt provides substantial sustainability benefits similar to or, in some cases, better than conventional hot-mix asphalt. Sustainability benefits include lower energy use, reduced emissions, and potential for increased reclaimed asphalt pavement usage. Growth in utilization of warm-mix asphalt worldwide may, in the not-too-distant future, make the material the standard for asphalt paving. Regardless, there are concerns over some aspects of warm-mix asphalt such as lower resistance to fatigue cracking, rutting and potential water-susceptibility problems, particularly with mixes prepared with water-based technologies, which require further research to address.

关键词： Warm-Mix Asphalt Pavement Sustainability Lower Energy Use Reduced Emissions

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Reliability Based Multi-Objective Thermodynamic Cycle Optimisation of Turbofan Engines Using Luus-Jaakola Algorithm

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Energy Engineering 2021年第4期118卷 1057-1068页

作者： Vin Cent Tai Yong Chai Tan Nor Faiza Abd Rahman yaw Yoong Sia Chan Chin Wang Lip Huat Saw Centre for Modelling and Simulation Faculty of EngineeringBuilt Environment and Information TechnologySEGi UniversityPetaling JayaSelangor47810Malaysia Mechanical Engineering Department Faculty of EngineeringBuilt Environment and Information TechnologySEGi UniversityPetaling JayaSelangor47810Malaysia Lee Kong Chian Faculty of Engineering and Science Universiti Tunku Abdul RahmanKajangSelangor43200Malaysia

Aircraft engine design is a complicated process,as it involves huge number of *** design process begins with parametric cycle *** is crucial to determine the optimum values of the cycle parameters that would give a robust design in the early phase of engine development,to shorten the design cycle for cost saving and man-hour *** obtain a robust solution,optimisation program is often being executed more than once,especially in Reliability Based Design Optimisations(RBDO)with Monte-Carlo Simulation(MCS)scheme for complex systems which require thousands to millions of optimisation loops to be *** paper presents a fast heuristic technique to optimise the thermodynamic cycle of two-spool separated flow turbofan engines based on energy and probability of failure criteria based on Luus-Jaakola algorithm(LJ).A computer program called Turbo Jet Engine Optimiser v2.0(TJEO-2.0)has been developed to perform the optimisation *** program is made up of inner and outer loops,where LJ is used in the outer loop to determine the design variables while parametric cycle analysis of the engine is done in the inner loop to determine the engine ***-Hypercube-Sampling(LHS)technique is used to sample the design and model variations for uncertainty *** results show that optimisation without reliability criteria may lead to high probability of failure of more than 11%on *** thrust obtained with uncertainty quantification was about 25%higher than the one without uncertainty quantification,at the expense of less than 3%of fuel *** proposed algorithm can solve the turbofan RBDO problem within 3 min.

关键词： Multi-objective design optimisation reliability based design optimisation turbofan engines luus-jaakola algorithm

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Recent advances of cluster of differentiation 74 in cancer

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World Journal of Immunology 2014年第3期4卷 174-184页

作者： Yu-Huei Liu Jung-yaw Lin Department of Medical Genetics and Medical Research China Medical University HospitalTaichung 40402Taiwan Graduate Institute of Integrated Medicine China Medical UniversityTaichung 40402Taiwan Department of Life Science National Taiwan Normal UniversityTaipei 11677Taiwan Institute of Biochemistry and Molecular Biology College of MedicineNational Taiwan UniversityTaipei 11051Taiwan

Cluster of differentiation 74 （CD74） performs multiple roles in B cells, T cells, and antigen-presenting cells within the immune system; it also participates in ma-jor histocompatibility complex class Ⅱ-restricted an-tigen presentation and inflammation. Recently, a role for CD74 in carcinogenesis has been described. CD74 promotes cell proliferation and motility and prevents cell death in a macrophage migration inhibitory factor-dependent manner. Its roles as an accessory signal receptor on the cell surface and the ability to interact with other signaling molecules make CD74 an attrac-tive therapeutic target for the treatment of cancer. This review focuses on the original role of CD74 in the immune system and its emerging tumor-related func-tions. First, the structure of CD74 will be summarized. Second, the current understandings about the expres-sion, cellular localization, molecular mechanisms and signaling pathways of CD74 in immunity and cancer will be reviewed. Third, the examples that suggest CD74 is a promising molecular therapeutic target are reviewed and discussed. Although the safety and ef-fcacy of CD74-targeted strategies are under develop-ment, deeply understanding of the regulation of CD74 will hold promise for the use of CD74 as a therapeutic target and may develop the CD74-targeted therapeutic agents such as neutralized antibody and compounds.

关键词： Cluster of differentiation 74 Invariant chain Immune Infammation Tumorigenesis Cancer metastasis

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Stability Analysis of Bubonic Plague Model with the Causing Pathogen Yersinia pestis in the Environment

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Advances in Infectious Diseases 2016年第3期6卷 120-137页

作者： Rigobert Charles Ngeleja Livingstone Luboobi yaw Nkansah-Gyekye School of Computational and Communication Science and Engineering Nelson Mandela African Institution of Science and Technology Arusha Tanzania Department of Mathematics Makerere University Kampala Uganda

Bubonic plague is a serious bacterial disease, mainly transmitted to human beings and rodents through flea bite. However, the disease may also be transmitted upon the interaction with the infected materials or surfaces in the environment. In this study, a deterministic model for bubonic plague disease with Yersinia pestis in the environment is developed and analyzed. Conditions for existence and stability of the equilibrium points are established. Using Jacobian method disease free equilibrium (DFE) point, E0 was proved to be locally asymptotically stable. The Metzler matrix method was used to prove that the DFE was globally asymptotically stable when R0 0 > 1. Numerical simulations are done to verify the analytical predictions. The results show that bubonic plague can effectively be controlled or even be eradicated if efforts are made to ensure that there are effective and timely control strategies.

关键词： Disease Free Equilibrium Endemic Equilibrium Stability Analysis Bubonic Plague Pathogens in the Environment

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Flavonoids Reduce Lipid Peroxides and Increase Glutathione Levels in Pooled Human Liver Microsomes (HLMs)

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Advances in Biological Chemistry 2021年第6期11卷 283-295页

作者： William yaw Boadi Camille Stevenson Dontrez Johnson Mohamed Adel Mohamed Departments of Biological Sciences Tennessee State University Nashville USA Departments of Chemistry Tennessee State University Nashville USA

The effects of each of the flavonoids;genistein (G), quercetin (Q) and kaempferol (K) at several doses on lipid peroxides (LP) and reduced glutathione (GSH) in pooled human liver microsomes (HLMs) were investigated following the oxidative damage for 4, 6, 18 and 24 hr. HLMs (1 mg/ml) were exposed to each of the above flavonoids at 0, 5, 10, 15, 20 or 25 μM and incubated for the respective times as previously stated. Our hypothesis was that HLMs exposed to the flavonoids for the respective exposure times can decrease LP and increase GSH in HLMs to better cope with the oxidative stress. The results of our studies indicate that each of the flavonoids significantly (p levels observed for Q for the 24-hr. incubation. The findings suggest that the flavonoids modulate oxidative stress in HLMs by decreasing LP and such decreases in LPs may be due to the increasing and or the replenished levels of GSH in the said cells to better cope with the oxidative stress.

关键词： Flavonoids Glutathione (GSH) Human Liver Microsomes (HLMs) Lipid Peroxidation Oxidative Stress

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Teaching Physical Assessment and Disease Screening to Students in the Health Professions: A Focus in Pharmacy Education

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Health 2016年第15期8卷 1713-1725页

作者： Monica Zolezzi Oraib Abdallah Stella Major Diana White yaw Owusu Sowndramalingam Sankaralingam College of Pharmacy Qatar University Doha Qatar Weill Cornell Medicine—Qatar Qatar Foundation Doha Qatar University of Calgary Qatar Doha Qatar

Background: As pharmacists continue to transition into the provision of public health care, physical assessment and disease screening will become part of their everyday practice, in a similar manner that it has been for doctors and nurses. Objective: The aim was to describe the health assessment of undergraduate curricula across three disciplines involved in public health care and to explore the students’ perceived training in a variety of health assessments. Method: Instructors of courses related to health assessment in medicine, nursing, and pharmacy colleges in Qatar were invited to participate in the curriculum review process. Students’ perceived training in a variety of health assessments was assessed using a self-administered survey. Both descriptive and inferential statistics were used to analyze the survey responses. Results: A narrative description for the similarities and differences in the health assessment curricula across the three colleges was provided. Blood pressure, heart rate, and heart sounds were the health assessments that almost all students received training on, although there were differences in where the training was delivered. The health assessments that the students perceived having received least training on were measuring bone mineral density, blood cholesterol and international normalized ratio reported by only 37%, 41% and 44% of students, respectively. Conclusion: The study identified a close alignment between each of the health discipline’s scope of practice and the health assessment content taught in each individual program. It also identified possible curricular gaps towards learning the skills of patient assessment that may need to be addressed.

关键词： Health Assessment Disease Screening Pharmacy Practice Health Professions Education

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Interleukin-10 promoter polymorphisms may predict survival and relapse in non-small-cell lung cancer

Interleukin-10 promoter polymorphisms may predict survival a...

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第六届海峡两岸毒理学研讨会

作者： Wen-Wei Sung yaw-Cheng Wang Tzu-Chin Wu Chih-Yi Chen Huei Lee School of Medicine Chung Shan Medical University Institute of Medicine Chung Shan Medical University Department of Internal Medicine Chung Shan Medical University Hospital Department of Surgery China Medical University Hospital Department of Medical Research Chung Shan Medical University Hospital Division of Environmental Health and Occupational Medicine National Health Research InstitutesTaiwan

＜正＞Purpose:Polymorphisms at-1082A＞G,-819C＞T,and-592G＞A in the IL-10 promoter have been associated with modification of its transcriptional activity. In the case of effects on tumor progression,IL-10 responses are believed to be mediated through tumor immune *** hypothesized that IL-10 haplotypes categorized by these three SNPs may be useful for the prediction of overall survival（OS）and relapse free survival（RFS）in non-small cell lung cancer（NSCLC）patients. Experimental design:We collected normal lung tissues adjacent to resected tumors from 385 NSCLC patients to determine IL-10 haplotypes by direct sequencing and *** the 385 tumors,241 were randomly enrolled to evaluate IL-10 mRNA expression levels by ***-Meier and multivariate Cox regression models were used to assess the prognostic value of IL-10 haplotypes. Results:Among the 241 analyzed lung tumors,a higher IL-10 mRNA expression level was found in haplotype B carriers than in haplotype A carriers. This predicted a poorer outcome for haplotype B carrier *** Cox regression analysis showed that haplotype B carriers had hazard ratios（HRs） of 1.815 and 1.719 for RFS and OS,respectively,compared with haplotype A. Interestingly,among HPV16/18 E6-positive patients,haplotype B carriers had HRs of 3.007 and 3.215 for RFS and OS,respectively,when compared with haplotype A. Conclusion:We suggest that the haplotypes of IL-10 promoter polymorphisms may act as adjacent markers to predict survival and relapse in resectable NSCLC, especially in patients with E6-positive tumors.

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