Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Emulsifying property,antioxidant activity,and bitterness of soybean protein isolate hydrolysate obtained by Corolase PP under high hydrostatic pressure

Enzymatic hydrolysis of proteins can enhance their emulsifying properties and antioxidant activities.However,the problem related to the hydrolysis of proteins was the generation of the bitter taste.Recently,high hydrostatic pressure(HHP)treatment has attracted much interest and has been used in several studies on protein modification.Hence,the study aimed to investigate the effects of enzymatic hydrolysis by Corolase PP under different pressure treatments(0.1,100,200,and 300 MPa for 1-5 h at 50℃)on the emulsifying property,antioxidant activity,and bitterness of soybean protein isolate hydrolysate(SPIH).As observed,the hydrolysate obtained at 200 MPa for 4 h had the highest emulsifying activity index(47.49 m^(2)/g)and emulsifying stability index(92.98%),and it had higher antioxidant activities(44.77%DPPH free radical scavenging activity,31.12%superoxide anion radical scavenging activity,and 61.50%copper ion chelating activity).At the same time,the enhancement of emulsion stability was related to the increase of zeta potential and the decrease of mean particle size.In addition,the hydrolysate obtained at 200 MPa for 4 h had a lower bitterness value and showed better palatability.This study has a broad application prospect in developing food ingredients and healthy foods.

First-principles study of structural and electronic properties of multiferroic oxide Mn_(3)TeO_(6) under high pressure

Mn_(3)TeO_(6)(MTO) has been experimentally found to adopt a P2_(1)/In structure under high pressure,which exhibits a significantly smaller band gap compared to the atmospheric R3 phase.In this study,we systematically investigate the magnetism,structural phase transition,and electronic properties of MTO under high pressure through first-principles calculations.Both R3 and P2_(1)/n phases of MTO are antiferromagnetic at zero temperature.The R3 phase transforms to the P2_(1)/n phase at 7.5 8 GPa,accompanied by a considerable volume collapse of about 6.47%.Employing the accurate method that combines DFT+U/and GW,the calculated band gap of R3 phase at zero pressure is very close to the experimental values,while that of the P2_(1)/n phase is significantly overestimated.The main reason for this difference is that the experimental study incorrectly used the Kubelka-Munk plot for the indirect band gap to obtain the band gap of the P2_(1)/n phase instead of the Kubelka-Munk plot for the direct band gap.Furthermore,our study reveals that the transition from the R3 phase to the P2_(1)/n phase is accompanied by a slight reduction in the band gap.

Stability and melting behavior of boron phosphide under high pressure

Boron phosphide(BP)has gained significant research attention due to its unique photoelectric and mechanical properties.In this work,we investigated the stability of BP under high pressure using x-ray diffraction and scanning electron microscope.The phase diagram of BP was explored in both B-rich and P-rich environments,revealing crucial insight into its behavior at 5.0 GPa.Additionally,we measured the melting curve of BP from 8.0 GPa to 15.0 GPa.Our findings indicate that the stability of BP under high pressure is improved within B-rich and P-rich environments.Furthermore,we report a remarkable observation of melting curve frustration at 10.0 GPa.This study will enhance our understanding of stability of BP under high pressure,shedding light on its potential application in semiconductor,thermal,and light-transmitting devices.

Ultrafast dynamics in photo-excited Mott insulator Sr_(3)Ir_(2)O_7 at high pressure

High-pressure ultrafast dynamics,as a new crossed research direction,are sensitive to subtle non-equilibrium state changes that might be unresolved by equilibrium states measurements,providing crucial information for studying delicate phase transitions caused by complex interactions in Mott insulators.With time-resolved transient reflectivity measurements,we identified the new phases in the spin–orbit Mott insulator Sr_(3)Ir_(2)O_7 at 300 K that was previously unidentified using conventional approaches such as x-ray diffraction.Significant pressure-dependent variation of the amplitude and lifetime obtained by fitting the reflectivity?R/R reveal the changes of electronic structure caused by lattice distortions,and reflect the critical phenomena of phase transitions.Our findings demonstrate the importance of ultrafast nonequilibrium dynamics under extreme conditions for understanding the phase transition of Mott insulators.

Effect of slow shot speed on externally solidified crystal,porosity and tensile property in a newly developed high-pressure die-cast Al-Si alloy

The effect of slow shot speed on externally solidified crystal(ESC),porosity and tensile property in a newly developed high-pressure die-cast Al-Si alloy was investigated by optical microscopy(OM),scanning electron microscopy(SEM)and laboratory computed tomography(CT).Results showed that the newly developed AlSi9MnMoV alloy exhibited improved mechanical properties when compared to the AlSi10MnMg alloy.The AlSi9MnMoV alloy,which was designed with trace multicomponent additions,displays a notable grain refining effect in comparison to the AlSi10MnMg alloy.Refining elements Ti,Zr,V,Nb,B promote heterogeneous nucleation and reduce the grain size of primaryα-Al.At a lower slow shot speed,the large ESCs are easier to form and gather,developing into the dendrite net and net-shrinkage.With an increase in slow shot speed,the size and number of ESCs and porosities significantly reduce.In addition,the distribution of ESCs is more dispersed and the net-shrinkage disappears.The tensile property is greatly improved by adopting a higher slow shot speed.The ultimate tensile strength is enhanced from 260.31 MPa to 290.31 MPa(increased by 11.52%),and the elongation is enhanced from 3.72%to 6.34%(increased by 70.52%).

High-pressure study on calcium azide(Ca(N_(3))_(2)):Bending of azide ions stabilizes the structure

The high-pressure structure and elastic properties of calcium azide(Ca(N_(3))_(2))were investigated using in-situ highpressure x-ray diffraction and Raman scattering up to 54 GPa and 19 GPa,respectively.The compressibility of Ca(N_(3))_(2)changed as the pressure increased,and no phase transition occurred within the pressure from ambient pressure up to 54 GPa.The measured zero-pressure bulk modulus of Ca(N_(3))_(2)is higher than that of other alkali metal azides,due to differences in the ionic character of their metal-azide bonds.Using CASTEP,all vibration modes of Ca(N_(3))_(2)were accurately identified in the vibrational spectrum at ambient pressure.In the high-pressure vibration study,several external modes(ext.)and internal bending modes(ν_(2))of azide anions(N_(3)^(-))softened up to~7 GPa and then hardened beyond that pressure.This evidence is consistent with the variation observed in the F_(E)–f_(E)data analyzed from the XRD result,where the slope of the curve changes at 7.1 GPa.The main behaviors under pressure are the alternating compression,rotation,and bending of N_(3)^(-)ions.The bending behavior makes the structure of Ca(N_(3))_(2)more stable under pressure.

Analysis of the Flow Field and Impact Force in High-Pressure Water Descaling

This study aims to improve the performances of the high-pressure water descaling technology used in steel hot rolling processes.In particular,a 2050 mm hot rolling line is considered,and the problem is investigated by means of a fluid–structure interaction(FSI)method by which the descaling effect produced by rolling coils with different section sizes is examined.Assuming a flat fan-shaped nozzle at the entrance of the R1R2 roughing mill,the outflow field characteristics and the velocity distribution curve on the strike line(at a target distance of 30–120 mm)are determined.It is found that the velocity in the center region of the water jet with different target distances is higher than that in the boundary region.As the target distance increases,the velocity of the water jet in the central region decreases.Through comparison with experimental results,it is shown that the simulation model can accurately predict the impact position of the high-pressure water on the impact plate,thereby providing a computational scheme that can be used to optimize the nozzle space layout and improve the slabs’descent effect for different rolling specifications.

Single-cell RNA sequencing analysis of the retina under acute high intraocular pressure

High intraocular pressure causes retinal ganglion cell injury in primary and secondary glaucoma diseases,yet the molecular landscape characteristics of retinal cells under high intraocular pressure remain unknown.Rat models of acute hypertension ocular pressure were established by injection of cross-linked hyaluronic acid hydrogel(Healaflow■).Single-cell RNA sequencing was then used to describe the cellular composition and molecular profile of the retina following high intraocular pressure.Our results identified a total of 12 cell types,namely retinal pigment epithelial cells,rod-photoreceptor cells,bipolar cells,Müller cells,microglia,cone-photoreceptor cells,retinal ganglion cells,endothelial cells,retinal progenitor cells,oligodendrocytes,pericytes,and fibroblasts.The single-cell RNA sequencing analysis of the retina under acute high intraocular pressure revealed obvious changes in the proportions of various retinal cells,with ganglion cells decreased by 23%.Hematoxylin and eosin staining and TUNEL staining confirmed the damage to retinal ganglion cells under high intraocular pressure.We extracted data from retinal ganglion cells and analyzed the retinal ganglion cell cluster with the most distinct expression.We found upregulation of the B3gat2 gene,which is associated with neuronal migration and adhesion,and downregulation of the Tsc22d gene,which participates in inhibition of inflammation.This study is the first to reveal molecular changes and intercellular interactions in the retina under high intraocular pressure.These data contribute to understanding of the molecular mechanism of retinal injury induced by high intraocular pressure and will benefit the development of novel therapies.

Determination of critical state line(CSL)for silty-sandy iron ore tailings subjected to low-high confining pressures

The disposal of filtered tailings in high dry stacks can induce particle breakage,changing the material's behaviour during the structure's lifetime.The grading changes influence material properties at the critical state,and this is not mature for intermediate artificial soils(tailings)in a broad range of confining pressures.In this paper,it aims to describe the behaviour of iron ore tailings in a spectrum of confining pressures broader than the reported in previous studies.A series of consolidated drained(CD)triaxial tests was carried out with confining pressures ranging from 0.075 MPa to 120 MPa.These results show that the amount of breakage plays an essential role in the response of iron ore tailings.The existence of curved critical state line(CSL)in both specific volume(ν)-logarithm of mean effective stress(p′)and deviatoric stress(q)-mean effective stress(p′)planes,and different responses in the deviatoric stress-axial strain-volumetric strain curves were verified.An inverse S-shaped equation was proposed to represent the silty-sandy tailings'behaviour up to high pressures onν-lnp′plane.The proposed equation provides a basis for enhancing constitutive models and considers the evolution of the grading up to severe loading conditions.The adjustment considered three regions with different responses associated with particle breakage at different pressure levels.

Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.

An ultrafast spectroscopy system for studying dynamic properties of superconductors under high pressure and low temperature conditions

An ultrafast pump-probe spectroscopy system combined with a cryogenic diamond anvil cell(DAC) instrument is developed to investigate the photo-excitation dynamic properties of condensed materials under low temperature and high pressure(LTHP) conditions.The ultrafast dynamics study is performed on Bi_(2)Sr_(2)CaCu_(2)O_(8+δ)(Bi-2212) thin film under LTHP conditions.The superconducting(SC) phase transition has been observed by analyzing the ultrafast dynamics of Bi-2212 as a function of pressure and temperature.Our results suggest that the pump-probe spectroscopy system combined with a cryogenic DAC instrument is an effective method to study the physical mechanism of condensed matter physics at extreme conditions,especially for the SC phase transition.

Development of Energy-storing High Pressure Spray Cooling System

The greenhouse has been increasingly used in the breeding industry. However, the high temperature inside the greenhouse in summer has not been effectively addressed. The spray cooling system sprays tiny droplets into the air. Thus the water molecules will be vaporized, absorbing heat and reducing ambient temperature. It is the only cooling method that can be used to cool the uneasily-sealed flexible greenhouse. We developed an energy-storing high pressure spray cooling system. The ordinary water pump is used as the source of high-pressure water. The partial kinetic energy is stored in the energy-storing tubes. When the water pump is stopped, the energy produced by releasing the compressed air can still be used to maintain the spray. And thus the use-cost and systematic wear would be reduced. The cooling system only requires 1 kilowatt hour of power per day. It has been widely used in summer to cool the breeding sheds. After a recent continuous improvement, its functions have been extended to disinfection, removing dust, humidifying and immunizing animals. In addition, it can also be used for the cooling and humidifying of squares, venues and streets in summer. The energy-storing high pressure spray cooling system has a broad application prospect.

BLOCKING EFFECT OF HIGH PRESSURE SYSTEM ON THE FORMATION OF EXTRA-INTENSE HEAVY RAIN

Commonly the centre of an intense heavy rain occurs in a very limited area,but for the three extra- intense heavy rains of the present study,63-8 in North China,75-8 in central China and 77-8 in the desert region of Inner Mongolia,which all appeared under the environments of“Western Low and Eastern Blocking” (EB)pattern.From this study,the following effects of the EB are found:(1)It affects the precipitation systems staggering in a local place and/or changes the trajectories of low votices and urges them into the same raining areas intermittently.(2)It transports water vapour into raining areas.The air flows by the west side of EB produce strong cyclonic vorticity behind EB frequently,which transports water vapour and forms mesoscale precipitation systems more favourably than the low level jets.(3)Air flows behind EB con- jugate with adequate topographic relief,which enhances the precipitation and makes the raining areas over- lapped.So that extra-intense heavy rains could occur in higher latitudes of semi-aird areas,and occasionally even in the desert region of North China. Such extra-intense heavy rains could not be explained by static local humidity and temperature only. This is also a principal discrimination between the prolonged extra-intense heavy rain and the short-range convective precipitation and/or the common precipitation.

Rock mass response for lined rock caverns subjected to high internal gas pressure

The storage of hydrogen gas in underground lined rock caverns(LRCs)enables the implementation of the first fossil-free steelmaking process to meet the large demand for crude steel.Predicting the response of rock mass is important to ensure that gas leakage due to rupture of the steel lining does not occur.Analytical and numerical models can be used to estimate the rock mass response to high internal pressure;however,the fitness of these models under different in situ stress conditions and cavern shapes has not been studied.In this paper,the suitability of analytical and numerical models to estimate the maximum cavern wall tangential strain under high internal pressure is studied.The analytical model is derived in detail and finite element(FE)models considering both two-dimensional(2D)and three-dimensional(3D)geometries are presented.These models are verified with field measurements from the LRC in Skallen,southwestern Sweden.The analytical model is inexpensive to implement and gives good results for isotropic in situ stress conditions and large cavern heights.For the case of anisotropic horizontal in situ stresses,as the conditions in Skallen,the 3D FE model is the best approach.

Boosting C–C coupling to multicarbon products via high-pressure CO electroreduction

Electrochemical CO reduction reaction(CORR) provides a promising approach for producing valuable multicarbon products(C_(2+)), while the low solubility of CO in aqueous solution and high energy barrier of C–C coupling as well as the competing hydrogen evolution reaction(HER) largely limit the efficiency for C_(2+)production in CORR. Here we report an overturn on the Faradaic efficiency of CORR from being HER-dominant to C_(2+)formation-dominant over a wide potential window, accompanied by a significant activity enhancement over a Moss-like Cu catalyst via pressuring CO. With the CO pressure rising from 1 to 40 atm, the C_(2+)Faradaic efficiency and partial current density remarkably increase from 22.8%and 18.9 mA cm^(-2)to 89.7% and 116.7 mA cm^(-2), respectively. Experimental and theoretical investigations reveal that high pressure-induced high CO coverage on metallic Cu surface weakens the Cu–C bond via reducing electron transfer from Cu to adsorbed CO and restrains hydrogen adsorption, which significantly facilitates the C–C coupling while suppressing HER on the predominant Cu(111) surface, thereby boosting the CO electroreduction to C_(2+)activity.

Various admixtures to mitigate the long-term strength retrogression of Portland cement cured under high pressure and high temperature conditions

In order to investigate the problem of long-term strength retrogression in oil well cement systems exposed to high pressure and high temperature(HPHT)curing conditions,various influencing factors,including cement sources,particle sizes of silica flour,and additions of silica fume,alumina,colloidal iron oxide and nano-graphene,were investigated.To simulate the environment of cementing geothermal wells and deep wells,cement slurries were directly cured at 50 MPa and 200?C.Mineral compositions(as determined by X-ray diffraction Rietveld refinement),water permeability,compressive strength and Young’s modulus were used to evaluate the qualities of the set cement.Short-term curing(2e30 d)test results indicated that the adoption of 6 m m ultrafine crystalline silica played the most important role in stabilizing the mechanical properties of oil well cement systems,while the addition of silica fume had a detrimental effect on strength stability.Long-term curing(2e180 d)test results indicated that nano-graphene could stabilize the Young’s modulus of oil well cement systems.However,none of the ad-mixtures studied here can completely prevent the strength retrogression phenomenon due to their inability to stop the conversion of amorphous to crystalline phases.

Strengthening pelletization of manganese ore fines containing high combined water by high pressure roll grinding and optimized temperature elevation system

Pelletization is one of useful processes for the agglomeration of iron ore or concentrates. However, manganese ore fines are mainly agglomerated by sintering due to its high combined water which adversely affects the roasting performance of pellets. In this work, high pressure roll grinding(HPRG) process and optimization of temperature elevation system were investigated to improve the strength of fired manganese ore pellets. It is shown that the manganese ore possesses good ballability after being pretreated by HPRG twice, and good green balls were produced under the conditions of blending 2.0% bentonite in the feed, balling for 7 min at 16.00% moisture. High quality roasted pellets with the compressive strength of 2711 N per pellet were manufactured through preheating at 1050 °C for 10 min and firing at 1335 °C for 15 min by controlling the cracks formation. The fired manganese pellets keep the strength by the solid interconnection of recrystallized pyrolusite grains and the binding of manganite liquid phase which filled the pores and clearance among minerals. The product pellets contain high Mn grade and low impurities, and can be used to smelt ferromanganese, which provides a possible way to use imported manganese ore fines containing high combined water to produce high value ferromanganese.

High-pressure and high-temperature sintering of pure cubic silicon carbide:A study on stress-strain and densification

Silicon carbide(SiC)is a high-performance structural ceramic material with excellent comprehensive properties,and is unmatched by metals and other structural materials.In this paper,raw SiC powder with an average grain size of 5μm was sintered by an isothermal-compression process at 5.0 GPa and 1500?C;the maximum hardness of the sintered samples was31.3 GPa.Subsequently,scanning electron microscopy was used to observe the microscopic morphology of the recovered SiC samples treated in a temperature and extended pressure range of 0-1500?C and 0-16.0 GPa,respectively.Defects and plastic deformation in the SiC grains were further analyzed by transmission electron microscopy.Further,high-pressure in situ synchrotron radiation x-ray diffraction was used to study the intergranular stress distribution and yield strength under non-hydrostatic compression.This study provides a new viewpoint for the sintering of pure phase micron-sized SiC particles.