Neurocognitive Profile of People Living with Human Immunodeficiency Virus Initiating Treatment in Kinshasa in the Dolutegravir Era, Democratic Republic of Congo

Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .

Tumor initiating cells in pancreatic cancer: A critical view

Emerging evidence points to the existence of pan-creatic cancer stem cells (CSC) as the culprit in the initiation, maintenance, metastasis, and treatment resistance of pancreatic cancer. The existence of such a cell population would have an important im-pact on the design of novel therapies against this devastating disease. However, no in vivo validation or rebuttal of the pancreatic CSC hypothesis exists. Major backlashes in the discussion on CSC are firstly, the confusion between the terms CSC and cell of origin of pancreatic ductal adenocarcinoma (PDAC), secondly the ambiguity of the cell of origin itself and thirdly, the fact that the CSC hypothesis is based on cell sorting and xenografting experiments; the latter of which often precludes solid conclusions because of the lack of a natural microenvironment and differences in drug delivery. Nonetheless, recent studies in other cancers partially support the CSC hypothesis by demonstrating a link between epithelial-to-mesenchymal transdifferentiation/transition (EMT) and CSC properties. Such a link is again open to dispute as EMT is a reversible process which is highly dependent on major oncogenic pathways in PDAC [e.g. K-Ras, transforming growth factor-β (TGF-β)] rather than on presumed cancer stem cell pathways. Hence, the available evidence does not robustly support the CSC concept in PDAC and a thorough validation of this hypothesis in well-defined genetically engineered mouse models of pancreatic cancer is required.

Numerical simulation of the delay arming process of initiating explosive brakes

The delay arming process of initiating explosive （ IE ） brakes for fuse is complex and hard to be verified. A numerical simulation model of IE brakes was established based on the arbitrary La- grange-Euler method. The model included the structure, the air filed, etc. The simulation boundary conditions were defined, including the contacts, blasting parameters of the explosive and the fluid- solid coupling interface. The simulation results show that the shear pin of the chosen IE can be cut off. When the piston needs to move 0.8 cm, the time set to the delay arming of the IE brakes model is about 40μS. The maximum displacement of the piston is 1. 17 cm. The model provides basis for parameters design and further improvement of IE brakes.

Safety control for powder compaction of initiating explosive device

Powder compaction is one of the most crucial processes in initiating explosive device manufacturing. The quality of powder compaction may influence the performances of product directly. Traditional powder compaction mainly makes use of manual gravitational spiral loading machine or lever loading machine. Potential accident by the strike in powder compaction of initiating explosive device could risk life, property and the environment. To prevent this risk, automatic control system and control strategy can be used to guarantee no strike in pressing process. The scope of this paper is to analyze and review the control strategy for powder compact and discuss the experimental results for the application of the proposed strategy.

Tumor heterogeneity of gastric cancer: From the perspective of tumor-initiating cell

Gastric cancer(GC) remains one of the most common and malignant types of cancer due to its rapid progression, distant metastasis, and resistance to conventional chemotherapy, although efforts have been made to understand the underlying mechanism of this resistance and to improve clinical outcome. It is well recognized that tumor heterogeneity, a fundamental feature of malignancy, plays an essential role in the cancer development and chemoresistance. The model of tumor-initiating cell(TIC) has been proposed to explain the genetic, histological, and phenotypical heterogeneity of GC. TIC accounts for a minor subpopulation of tumor cells with key characteristics including high tumorigenicity, maintenance of self-renewal potential, giving rise to both tumorigenic and non-tumorigenic cancer cells, and resistance to chemotherapy. Regarding tumor-initiating cell of GC(GATIC), substantial studies have been performed to(1) identify the putative specific cell markers for purification and functional validation of GATICs;(2) trace the origin of GATICs; and(3) decode the regulatory mechanism of GATICs. Furthermore, recent studies demonstrate the plasticity of GATIC and the interaction between GATIC and its surrounding factors(TIC niche or tumor microenvironment). All these investigations pave the way for the development of GATIC-targeted therapy, which is in the phase of preclinical studies and clinical trials. Here, we interpret the heterogeneity of GC from the perspectives of TIC by reviewing the above-mentioned fundamental and clinical studies of GATICs. Problems encountered during the GATIC investigations and the potential solutions are also discussed.

Application of equivalent information method to high reliability assessment of initiating explosive devices

The amount of information required for reliability assessment of success/failure products is defined and the formula of equivalent information method is deduced. Based on the formula, a method for assessing reliability of initiating explosive devices with small sample size is established. Compared with the assessment method for devices with large sample size, the new method is correct and feasible and can be used to assess the reliability of initiating explosive devices with high reliability requirements.

A New Safety Electric Initiating System

Based on the analysis of weakness on the safety of traditional electric detonators, a BJ-l safety electric detonator initiatingsystem and its corresponding safe examination technique were successfully developed. By leading false foot wires and taking advantageof the transmitting frequency band of Mo-Zn ferrite, detonators in this new system can completely impede the direct induction of outsidecrosstalk that may cause casual firing in the ordinary as well as eleclromagnetic ones. Possible causality by lightning was discussed. Results are presented, of its safety tests on resistance to direct and alternating current, electrostatic, and crosstalk induced by damp leakagein saturated salty water.

Preliminary discussion on the ignition mechanism of exploding foil initiators igniting boron potassium nitrate

Exploding foil initiator(EFI)is a kind of advanced device for initiating explosives,but its function is unstable when it comes to directly igniting pyrotechnics.To solve the problem,this research aims to reveal the ignition mechanism of EFIs directly igniting pyrotechnics.An oscilloscope,a photon Doppler velocimetry,and a plasma spectrum measurement system were employed to obtain information of electric characteristics,impact pressure,and plasma temperature.The results of the electric characteristics and the impact pressure were inconsistent with ignition results.The only thing that the ignition success tests had in common was that their plasma all had a relatively long period of high-temperature duration(HTD).It eventually concludes that the ignition mechanism in this research is the microconvection heat transfer rather than the shock initiation,which differs from that of exploding foil initiators detonating explosives.Furthermore,the methods for evaluating the ignition success of semiconductor bridge initiators are not entirely applicable to the tests mentioned in this paper.The HTD is the critical parameter for judging the ignition success,and it is influenced by two factors:the late time discharge and the energy of the electric explosion.The longer time of the late time discharge and the more energy of the electric explosion,the easier it is to expand the HTD,which improves the probability of the ignition success.

Barriers that practitioners face when initiating insulin therapy in general practice settings and how they can be overcome

AIM To explore primary care physicians' perspectives on possible barriers to the use of insulin.METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight electronic databases were searched(between January 1, 1994 and August 31, 2014) for relevant studies. A search for grey literature and a review of the references in the retrieved studies were also conducted. Studies that focused on healthcare providers' perspectives on possible barriers to insulin initiation with type 2 diabetic patients were included, as well as articles suggesting solutions for these barriers. Review articles and studies that only considered patients' perspectives were excluded. RESULTS A total of 19 studies met the inclusion criteria and were therefore included in this study: 10 of these studies used qualitative methods, 8 used quantitative methods and 1 used mixed methods. Studies included a range of different health care settings. The findings are reported under four broad categories: The perceptions of primary care physicians about the barriers to initiate insulin therapy for type 2 diabetes patients, how primary care physicians assess patients prior to initiating insulin, professional roles and possible solutions to overcome these barriers. The barriers described were many and covered doctor, patient, system and technological aspects. Interventions that focused on doctor training and support, or IT-based decision support were few, and did not result in significant improvement. CONCLUSION Primary care physicians' known delay in insulin initiation is multifactorial. Published reports of attempts to find solutions for these barriers were limited in number.

Hysteresis characteristics of the initiating and extinguishing boundaries in a nanosecond pulsed DBD

The dielectric barrier discharge(DBD)is presently used in many fields,in eluding plasma medicine,surface modification,and ozone synthesis;the influe nee of airflow on the DBD is a widely investigated topic.In this work,a hysteresis characteristic on the initiating and extinguishing boundaries is observed in a nanosecond pulsed DBD,which is sensitive to the variation in the airflow velocities and pulse repetition frequencies(PRFs).It is found that,at a certain airflow velocity,the initiating PRF is higher than the extinguishing PRF.This differenee between the initiating PRF and the extinguishing PRF leads to a hysteresis phenomenon on the initiating and extinguishing boun daries.When the airflow velocity is in creased,both the initiating and extinguishing PRFs are increased and the differenee between the initiating PRF and the extinguishing PRF also increased.The hysteresis width between the initiating and extinguishing boundaries is enhanced.To explain these results,the physical processes involved with the seed particles and the mechanisms of forming discharge channels are discussed.

Risk assessment of oil and gas investment environment in countries along the Belt and Road Initiative

With the implementation of the Belt and Road Initiative, China is deepening its cooperation in oil and gas resources with countries along the Initiative. In order to better mitigate risks and enhance the safety of investments, it is of significant importance to research the oil and gas investment environment in these countries for China's overseas investment macro-layout. This paper proposes an indicator system including 27 indicators from 6 dimensions. On this basis, game theory models combined with global entropy method and analytic hierarchy process are applied to determine the combined weights, and the TOPSIS-GRA model is utilized to assess the risks of oil and gas investment in 76 countries along the Initiative from 2014 to 2021. Finally, the GM(1,1) model is employed to predict risk values for 2022-2025. In conclusion, oil and gas resources and political factors have the greatest impact on investment environment risk, and 12 countries with greater investment potential are selected through cluster analysis in conjunction with the predicted results. The research findings may provide scientific decisionmaking recommendations for the Chinese government and oil enterprises to strengthen oil and gas investment cooperation with countries along the Belt and Road Initiative.

Nonlinearity of initiating and extinguishing boundaries of DBDs with airflows

Various applications of volume dielectric barrier discharges(DBDs)with airflows have attracted significant attention such as in the fields of plasma medicine,surface modification,ozone synthesis,etc.In this work,the nonlinearity characteristics of DBDs in initiating and extinguishing boundaries with airflows are experimentally investigated.It is found that the difference between initiating pulse repetition frequencies(PRFs)and extinguishing PRFs is affected by the addition of airflows.A hysteresis region is produced between these two PRFs.A topological rule of Thom's classification theorem is proposed to investigate the hysteresis phenomenon of discharges with airflows.It is concluded that the discharge state is dependent on the operation route.The discharge state would transit from initiating to extinguishing,or in the opposite direction,while passing along a specific operation route.Based on the topological method,two nonlinear laws of discharge structure transition under the typical operation routes are predicted and verified in the discharge experiments.

Influence of initial check, information exchange, final accuracy check, reaction information nursing on the psychology of elderly with lung cancer

BACKGROUND As one of the fatal diseases with high incidence,lung cancer has seriously endangered public health and safety.Elderly patients usually have poor self-care and are more likely to show a series of psychological problems.AIM To investigate the effectiveness of the initial check,information exchange,final accuracy check,reaction(IIFAR)information care model on the mental health status of elderly patients with lung cancer.METHODS This study is a single-centre study.We randomly recruited 60 elderly patients with lung cancer who attended our hospital from January 2021 to January 2022.These elderly patients with lung cancer were randomly divided into two groups,with the control group taking the conventional propaganda and education and the observation group taking the IIFAR information care model based on the conventional care protocol.The differences in psychological distress,anxiety and depression,life quality,fatigue,and the locus of control in psychology were compared between these two groups,and the causes of psychological distress were analyzed.RESULTS After the intervention,Distress Thermometer,Hospital Anxiety and Depression Scale(HADS)for anxiety and the HADS for depression,Revised Piper’s Fatigue Scale,and Chance Health Locus of Control scores were lower in the observation group compared to the pre-intervention period in the same group and were significantly lower in the observation group compared to those of the control group(P<0.05).After the intervention,Quality of Life Questionnaire Core 30(QLQ-C30),Internal Health Locus of Control,and Powerful Others Health Locus of Control scores were significantly higher in the observation and the control groups compared to the pre-intervention period in their same group,and QLQ-C30 scores were significantly higher in the observation group compared to those of the control group(P<0.05).CONCLUSION The IIFAR information care model can help elderly patients with lung cancer by reducing their anxiety and depression,psychological distress,and fatigue,improving their tendencies on the locus of control in psychology,and enhancing their life qualities.

Murine models based on acute myeloid leukemia-initiating stem cells xenografting

Acute myeloid leukemia(AML) is an aggressive malignant disease defined by abnormal expansion of myeloid blasts. Despite recent advances in understanding AML pathogenesis and identifying their molecular subtypes based on somatic mutations, AML is still characterized by poor outcomes, with a 5-year survival rate of only 30%-40%, the majority of the patients dying due to AML relapse. Leukemia stem cells(LSC) are considered to be at the root of chemotherapeutic resistance and AML relapse. Although numerous studies have tried to better characterize LSCs in terms of surface and molecular markers, a specific marker of LSC has not been found, and still the most universally accepted phenotypic signature remains the surface antigens CD34+CD38- that is shared with normal hematopoietic stem cells. Animal models provides the means to investigate the factors responsible for leukemic transformation, the intrinsic differences between secondary post-myeloproliferative neoplasm AML and de novo AML, especially the signaling pathways involved in inflammation and hematopoiesis. However, AML proved to be one of the hematological malignancies that is difficult to engraft even in the most immunodeficient mice strains, and numerous ongoing attempts are focused to develop "humanized mice" that can support the engraftment of LSC. This present review is aiming to in-troduce the field of AML pathogenesis and the concept of LSC, to present the current knowledge on leukemic blasts surface markers and recent attempts to develop best AML animal models.

Planning in England:Inhibiting or Initiating Development

Conceived as countering market outcomes,British planning focuses on the development and design of land use and the built environment,with a close relationship with the economy.The public and politicians in the UK often associate planning with rigorous regulations that prevent economic growth,and many stakeholders complain about the restrictions that planning puts on their autonomous activities.To explore this,this essay focuses on the definition and the nature of ‘inhibit’,‘regulate’,‘guide’ and ‘initiate’ features through the plan-making process and management in England,finding out a more proactive role for planning as guiding and initiating development.

Numerical simulation for the initial state of avalanche in polydisperse particle systems

Numerical simulation is employed to investigate the initial state of avalanche in polydisperse particle systems.Nucleation and propagation processes are illustrated for pentadisperse and triadisperse particle systems,respectively.In these processes,particles involved in the avalanche grow slowly in the early stage and explosively in the later stage,which is clearly different from the continuous and steady growth trend in the monodisperse system.By examining the avalanche propagation,the number growth of particles involved in the avalanche and the slope of the number growth,the initial state can be divided into three stages:T1(nucleation stage),T2(propagation stage),T3(overall avalanche stage).We focus on the characteristics of the avalanche in the T2 stage,and find that propagation distances increase almost linearly in both axial and radial directions in polydisperse systems.We also consider the distribution characteristics of the average coordination number and average velocity for the moving particles.The results support that the polydisperse particle systems are more stable in the T2 stage.

Effects of Initial Defects on Effective Elastic Modulus of Concrete with Mesostructure

An exquisite mesostructure model was presented to predict the effective elastic modulus of concrete,in which concrete is realized as a four-phase composite material consisting of coarse aggregates,mortar matrix,interfacial transition zone(ITZ),and initial defects.With the three-dimensional(3D)finite element(FE)simulation,the highly heterogeneous composite elastic behavior of concrete was modeled,and the predicted results were compared with theoretical estimations for validation.Monte Carlo(MC)simulations were performed with the proposed mesostructure model to investigate the various factors of initial defects influencing the elastic modulus of concrete,such as the shape and concentration(pore volume fraction or crack density)of microspores and microcracks.It is found that the effective elastic modulus of concrete decreases with the increase of initial defects concentration,while the distribution and shape characteristics also exert certain influences due to the stress concentration caused by irregular inclusion shape.

Actors of Psychoactive Drug Initiation among Adolescents in Yaoundé-Cameroon

Introduction: Actors of psychoactive drug initiation refer to those who introduce others to psychoactive drug use (initiators) and those who are introduced to psychoactive drugs (users). By identifying their features, better prevention and intervention programs can be developed to reduce psychoactive drug use among adolescents. This article describes the role of actors of psychoactive drug initiation among teenagers in secondary schools in Yaoundé (Cameroon). Methodology: A cross sectional study was carried out in twelve secondary schools in Yaoundé from October 2022 to May 2023. Adolescents from Form four to upper sixth, who assented to participate in the study and received parental consent were included. Data were collected in a structured self-reported questionnaire and analyzed using SPSS 23. Quantitative variables were expressed using means, standard deviations, median and interquartile ranges depending on the distribution of data. Qualitative variables were expressed in the form of frequency and percentages. Results: Drug use was more prevalent among male adolescents (55.3%) from nuclear families (91.4%) who received relatively high pocket money. The main sources of drug exposure were non-family members (49.7%), especially friends outside school. The most frequent place of initiation was snack bars (33.1%). Conclusion: The study revealed the importance of the family, friends and leisure places in the initiation process of drug use in teenagers. Based on these results, parents and school authorities should work together to create a safe and supportive environment that fosters communication, education to prevent drug abuse among adolescents in Yaoundé.

Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.

UNEP welcomes China to international decarbonization initiative

An official with the United Nations Environment Programme has welcomed China’s participation in an international initiative that aims to decarbonize the building sector,saying it offers the opportunity for China to share its valuable experiences and insight on promoting green buildings.Jonathan Duwyn,program officer of UNEP’s buildings and construction cities unit,made the remarks in a recent interview with China Daily,following the launch of the Buildings Breakthrough on Dec.6at COP28United Nations climate change conference in Dubai,the United Arab Emirates.