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Healthcare Worker-Related Factors Contributing to Tuberculosis Treatment Non-Adherence among patients in Kisumu East Sub-County

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Journal of Tuberculosis Research 2024年第1期12卷 13-33页

作者： Marlyn Ochieng Jackline Nyaberi Susan Mambo charles Wafula Department of Environmental Health and Disease Control School of Public Health Jomo Kenyatta University of Agriculture and Technology (JKUAT) Nairobi Kenya European and Developing Countries Clinical Trials partnership (EDCTp) Strengthening Capacity for Epidemics Preparedness and Response in Sub-Saharan Africa (SCEPRESSA) Nairobi Kenya Great Lakes University of Kisumu (GLUK) Kisumu Kenya

Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patie

关键词： Tuberculosis Treatment Adherence Human Resources for Health

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In-situ study of the microstructure evolution during tension of a Mg-Y-Zn-Al alloy processed by rapidly solidified ribbon consolidation technique

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Journal of Magnesium and Alloys 2024年第5期12卷 2024-2040页

作者： Jeno Gubicza Kristián Máthis péter Nagy péter Jenei Zoltán Hegedus Andrea Farkas Jozef Vesely Shin-ichi Inoue Daria Drozdenko Yoshihito Kawamura Department of Materials physics Faculty of ScienceEotvos Loránd UniversityPázmány P.sétány 1/ABudapest H-1117Hungary Department of physics of Materials Faculty of Mathematics and PhysicsCharles UniversityKe Karlovu 512116 Praha 2Czech Republic Deutsches Elektronen-Synchrotron DESY Notkestr.85Hamburg 22603Germany Magnesium Research Center Kumamoto University2-39-1 KurokamiChuo-kuKumamoto 860-8555Japan

Mg-Y-Zn-Al alloys processed by rapidly solidified ribbon consolidation(RSRC)technique exhibit an exceptional mechanical performance indicating promising application *** material has a bimodal microstructure consisting of fine recrystallized and coarse non-recrystallized grains with solute-rich stacking faults forming cluster arranged layers(CALs)and nanoplates(CANaps),or complete long period stacking ordered(LpSO)*** order to reveal the deformation mechanisms,in-situ synchrotron X-ray diffraction line profile analysis was employed for a detailed study of the dislocation arrangement created during tension in Mg-0.9%Zn-2.05%Y-0.15%Al(at%)*** uncovering the effect of the initial microstructure on the mechanical performance,additional samples were obtained by annealing of the as-consolidated specimen at 300 and 400℃ for 2 *** heat treatment at 300℃ had no significant effect on the initial microstructure,its evolution during tension and,thus,the overall deformation behavior under tensile *** the other hand,annealing at 400℃ resulted in a significant increase of the recrystallized grains fraction and a decrease of the dislocation density,leading to only minor degradation of the mechanical *** maximum dislocation density at the failure of the samples corresponding to the plastic strain of 10-25% was estimated to be about 16-20×10^(14)m^(-2).The diffraction profile analysis indicated that most dislocations formed during tension were of non-basal and pyramidal types,what was also in agreement with the Schmid factor values revealed independently from orientation *** was also shown that the dislocation-induced Taylor hardening was much lower below the plastic strain of 3% than above this value,which was explained by a model of the interaction between prismatic dislocations and CANaps/LpSO plates.

关键词： Mg-Zn-Y-Al alloy Long period stacking ordered(LpSO)phase Cluster arranged nanoplates(CANaps) Annealing Tension Dislocation density Hardening

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CDC7 inhibition impairs neuroendocrine transformation in lung and prostate tumors through MYC degradation

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Signal Transduction and Targeted Therapy 2024年第8期9卷 3519-3532页

作者： Alvaro Quintanal-Villalonga Kenta Kawasaki Esther Redin Fathema Uddin Swanand Rakhade Vidushi Durani Amin Sabet Moniquetta Shafer Wouter R.Karthaus Samir Zaidi Yingqian A.Zhan parvathy Manoj Harsha Sridhar Dennis Kinyua Hong Zhong Barbara p.Mello Metamia Ciampricotti Umesh K.Bhanot Irina Linkov Juan Qiu Radhika A.patel Colm Morrsey Sanjoy Mehta Jesse Barnes Michael C.Haffner Nichlas D.Socci Richard p.Koche Elisa de Stanchina Sonia Molina-pinelo Sohrab Salehi Helena A.Yu Joseph M.Chan charles M.Rudin Department of Medicine Thoracic Oncology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNYUSA Cancer Biology and Genetics program Sloan Kettering InstituteMemorial Sloan Kettering Cancer CenterNew YorkNYUSA Vagelos College of physicians and Surgeons Columbia UniversityNew YorkNYUSA Weill Cornell Graduate School of Medical Sciences Weill Cornell MedicineNew YorkNYUA Human Oncology and pathogenesis program Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Center for Epigenetics Research Memorial Sloan Kettering Cancer CenterNew YorkNYUSA pathology Core Facilty Department of Pathology and Laboratory MedicineMSKCCNew YorkNYUSA Antitumor Assessment Core Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Divisionsof Human Biology and Clinical Research Fred Hutchinon Cancer CenterSeattleWAUSA Deparmentof Urology University of WashingtonSeattleWAUSA Gene Editing&Screening Core Facility Memorial Sloan Kettering Cancer Center New YorkNYUSA Department of Laboratory Medicine and pathology University of WashingtonSeattleWAUSA Bioinfomatics CoreFacility Memorial Soan Kettering Cancer CenterNew YorkNYUSA Institute of Biomedicine of Seille(Bis) HURCSCUniversidad de SevillaSevilleSpain Computational Oncology Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNYUSA Well Cornell Medical College New York NYUSA present address:Swiss Institute for Experimental Cancer Research(ISREC) School of Life SciencesEPFLLausanneSwitzerland

Neuroendocrine(NE)transformation is a mechanism of resistance to targeted therapy in lung and prostate adenocarcinomas leading to poor *** to date,even if patients at high risk of transformation can be identified by the occurrence of Tumor protein p53(Tp53)and Retinoblastoma Transcriptional Corepressor 1(RB1)mutations in their tumors,no therapeutic strategies are available to prevent or delay histological *** of the cell cycle kinase Cell Division Cycle 7(CDC7)occurred in tumors during the initial steps of NE transformation,already after Tp53/RB1 co-inactivation,leading to induced sensitivity to the CDC7 inhibitor ***7 inhibition suppressed NE transdifferentiation and extended response to targeted therapy in in vivo models of NE transformation by inducing the proteasome-mediated degradation of the MYC proto-Oncogen(MYC),implicated in stemness and histological *** overexpression of a degradation-resistant MYC isoform reestablished the NE transformation phenotype observed on targeted therapy,even in the presence of ***7 inhibition also markedly extended response to standard cytotoxics(cisplatin,irinotecan)in lung and prostate small cell carcinoma *** results nominate CDC7 inhibition as a therapeutic strategy to constrain lineage plasticity,as well as to effectively treat NE tumors de novo or after *** simurosertib clinical efficacy trials are ongoing,this concept could be readily translated for patients at risk oftransformation.

关键词： tumors markedly transformation

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The siphonic energy transfer between hot solar wind and cold martian ionosphere through open magnetic flux rope

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Fundamental Research 2024年第4期4卷 882-889页

作者： Xiaojun Xu Lou-Chuang Lee Qi Xu Qing Chang Jing Wang Ming Wang Shaosui Xu Christian Mosti charles J.Farrugia Xing Wang Yudong Ye Zilu Zhou Lei Luo peishan He Shaoguan Cheng State Key Laboratory of Lunar and planetary Sciences Macao University of Science and TechnologyMacao 999078China CNSA Macao Center for Space Exploration and Science Macao 999078China Institute of Earth Science Academia SinicaTaipei 115029China Institute of Space Science and Applied Technology Harbin Institute of TechnologyShenzhen 518000China planetary Environmental and Astrobiological Research Laboratory(pEARL) School of Atmospheric SciencesSun Yat-sen UniversityZhuhai 519000China Nanjing University of Information Science and Technology Nanjing 210000China Space ScienceLaboratory Universityof CaliforniaBerkeleyCA94320USA Space Research Institute Austrian Academy of SciencesGraz 8010Austria University of New Hampshire NH 03824USA

A mechanism for energy transfer from the solar wind to the Martian ionosphere through open magnetic flux rope is proposed based on the observations by Mars Atmosphere and Volatile EvolutioN(MAVEN).The satellite was located in the dayside magnetosheath at an altitude of about 70o km above the northern *** between the hot solar wind protons and the cold heavy ions/neutrals in the subsolar region can cool the protons and heat the heavy *** a result,the magnetosheath protons are siphoned into the ionosphere due to the thermal pressure gradient of protons and the heated heavy ions escape along the open magnetic field *** direct collisions in the lower-altitude region were not detected,this physical process is demonstrated by MAVEN measurements of enhanced proton density,decreased proton temperature and oppositely directed motions of hot and cool protons within the flux rope,which are very different from the observational features of the flux transfer events near the Earth's *** mechanism could universally exist in many contexts where a collisionless plasma region is connected to a collisional plasma *** reconstructing the magnetic geometry and the cross-section of the flux rope using the Grad-Shafranov technique,the ion loss rates are quantitatively estimated to be on the order of 1023 s-l,which is much higher than previously estimated.

关键词： Mars Flux rope Solarwind Ionosphere Ion loss

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Electroencephalography studies of hypoxic ischemia in fetal and neonatal animal models

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Neural Regeneration Research 2020年第5期15卷 828-837页

作者： Hamid Abbasi charles p.Unsworth Department of Engineering Science the University of Auckland

Alongside clinical achievements,experiments conducted on animal models (including primate or non-primate) have been effective in the understanding of various pathophysiological aspects of perinatal hypoxic/ ischemic encephalopathy (HIE).Due to the reasonably fair degree of flexibility with experiments,most of the research around HIE in the literature has been largely concerned with the neurodevelopmental outcome or how the frequency and duration of HI seizures could relate to the severity of perinatal brain injury,following HI *** survey concentrates on how EEG experimental studies using asphyxiated animal models (in rodents,piglets,sheep and non-human primate monkeys) provide a unique opportunity to examine from the exact time of HI event to help gain insights into HIE where human studies become difficult.

关键词： animal models automatic detection clinical EEG fetal HIE hypoxic-ischemic encephalopathy neonatal non-human primates review seizure

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Applications of advanced signal processing and machine learning in the neonatal hypoxic-ischemic electroencephalography

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Neural Regeneration Research 2020年第2期15卷 222-231页

作者： Hamid Abbasi charles p.Unsworth Department of Engineering Science The University of Auckland

perinatal hypoxic-ischemic-encephalopathy significantly contributes to neonatal death and life-long disability such as cerebral palsy. Advances in signal processing and machine learning have provided the research community with an opportunity to develop automated real-time identification techniques to detect the signs of hypoxic-ischemic-encephalopathy in larger electroencephalography/amplitude-integrated electroencephalography data sets more easily. This review details the recent achievements, performed by a number of prominent research groups across the world, in the automatic identification and classification of hypoxic-ischemic epileptiform neonatal seizures using advanced signal processing and machine learning techniques. This review also addresses the clinical challenges that current automated techniques face in order to be fully utilized by clinicians, and highlights the importance of upgrading the current clinical bedside sampling frequencies to higher sampling rates in order to provide better hypoxic-ischemic biomarker detection frameworks. Additionally, the article highlights that current clinical automated epileptiform detection strategies for human neonates have been only concerned with seizure detection after the therapeutic latent phase of injury. Whereas recent animal studies have demonstrated that the latent phase of opportunity is critically important for early diagnosis of hypoxic-ischemic-encephalopathy electroencephalography biomarkers and although difficult, detection strategies could utilize biomarkers in the latent phase to also predict the onset of future seizures.

关键词： advanced signal processing aEEG automatic detection classification clinical EEG fetal HIE hypoxic-ischemic encephalopathy machine learning neonatal seizure real-time identification review

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Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

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World Journal of Orthopedics 2024年第8期15卷 754-763页

作者： Mahad M Hassan Aliya G Feroe Brenton W Douglass Andrew E Jimenez Benjamin Kuhns charles F Mitchell Robert L parisien Daniel A Maranho Eduardo N Novais Young-Jo Kim Ata M Kiapour Department of Orthopedic Surgery University of MinnesotaMinneapolisMN 55454United States Department of Orthopedic Surgery TRIA Orthopaedic CenterBloomingtonMN 55122United States Department of Orthopedic Surgery Boston Children’s HospitalBostonMA 02115United States Department of Orthopedic Surgery Mayo ClinicRochesterMN 55901United States Department of Orthopaedics and Rehabilitation Yale School of MedicineNew HavenCT 06510United States Department of Orthopedic Surgery American Hip Institute Research FoundationDes PlainesIL 60018United States Department of Orthopedic Surgery Mount SinaiNew YorkNY 10029United States Department of Biomechanics Medicineand Rehabilitation of the Locomotor SystemRibeirao Preto Medical SchoolUniversity of São PauloRibeirao Preto 14048-900São PauloBrazil

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular *** To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric *** hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both *** Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip *** femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head *** In both sexes,the residual volume increased by age(ppite significantly smaller femoral head size in older ages(>13 years)in females,there were no sex-differences in residual volume and aspherity *** were no age-related changes in mean diameter difference in both sexes(p=0.07)with no significant sex-differences across different age groups(p=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(p=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(p>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(p=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age *** 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

关键词： Hip Femoral head Sphericity Skeletal growth Sex differences

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Machine learning-guided accelerated discovery of structure-property correlations in lean magnesium alloys for biomedical applications

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Journal of Magnesium and Alloys 2024年第6期12卷 2267-2283页

作者： Sreenivas Raguraman Maitreyee Sharma priyadarshini Tram Nguyen Ryan McGovern Andrew Kim Adam J.Griebel paulette Clancy Timothy p.Weihs Department of Materials Science and Engineering Johns Hopkins University3400 N Charles StBaltimore21218MDU.S.A Hopkins Extreme Materials Institute Johns Hopkins University3400 N Charles StBaltimore21218MDU.S.A Department of Chemical and Biomolecular Engineering Johns Hopkins University3400 N Charles StBaltimore21218MDU.S.A Translational Tissue Engineering Center Johns Hopkins School of Medicine400 N BroadwayBaltimore21231MDU.S.A Department of Biomedical Engineering Johns Hopkins University3400 N Charles StBaltimore21218MDU.S.A Research and Development Fort Wayne Metals Research ProductsLLC9609 Ardmore AveFort Wayne46809INU.S.A Department of Mechanical Engineering Johns Hopkins University3400 N Charles StBaltimore21218MDU.S.A

Magnesium alloys are emerging as promising alternatives to traditional orthopedic implant materials thanks to their biodegradability,biocompatibility,and impressive mechanical ***,their rapid in-vivo degradation presents challenges,notably in upholding mechanical integrity over *** study investigates the impact of high-temperature thermal processing on the mechanical and degradation attributes of a lean Mg-Zn-Ca-Mn alloy,*** rapid,cost-efficient characterization methods like X-ray diffraction and optical microscopy,we swiftly examine microstructural changes post-thermal *** pearson correlation coefficient analysis,we unveil the relationship between microstructural properties and critical targets(properties):hardness and corrosion ***,leveraging the least absolute shrinkage and selection operator(LASSO),we pinpoint the dominant microstructural factors among closely correlated *** findings underscore the significant role of grain size refinement in strengthening and the predominance of the ternary Ca_(2)Mg_(6)Zn_(3)phase in corrosion *** suggests that achieving an optimal blend of strength and corrosion resistance is attainable through fine grains and reduced concentration of ternary *** thorough investigation furnishes valuable insights into the intricate interplay of processing,structure,and properties in magnesium alloys,thereby advancing the development of superior biodegradable implant materials.

关键词： Magnesium alloys Machine learning Corrosion Mechanical properties Rapid characterization

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Usefulness of the Surgical Apgar Score to predict the Occurrence of Major Complications in the Early post-Operative period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

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Open Journal of Anesthesiology 2024年第3期14卷 51-65页

作者： charles Emmanuel Toussaint Binam Bikoi Francis Ateba Ndongo Serge Vivier Nga Nomo Édouard Léa Mekoui Ze Fidèle Binam Department of Anesthesia and Intensive Care University of Ebolowa Ebolowa Cameroon Yaounde Mother and Child Center Chantal Biya Foundation University of Garoua Garoua Cameroon Department of Anesthesia and Intensive Care Catholic University of Central Africa Yaounde Cameroon

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the “Laquintinie” Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at p Results: Of the 88 patients studied, the SAS was 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 - 0.2) and p = 000. Conclusion: The study found a specific and powerful link between the SAS score plications in the early postoperative period, in favor of its relevance in predicting them.

关键词： Early postoperative Complications Major Surgeries Surgical Apgar Score

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Beginning algebra :a text/workbook /charles p. McKeague. 7th ed.

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2007年

作者： charles p. McKeague.

来源：畅想之星图书光盘版（南... 评论

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