Factors Affecting Cotrimoxazole Prophylactic Therapy Compliance in HIV Patients Attending a Care and Treatment Clinic at Bugando Medical Centre in Mwanza, Tanzania

Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine factors that influence compliance with CPT among HIV patients in the Care and Treatment Clinic (CTC) at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: A descriptive cross-sectional study was conducted at the BMC between April 1, 2021, and June 30, 2021. Data were collected using face-to-face interviews and a semi-structured questionnaire. Data are presented in frequency, percentages, and cross-tabulation tables. A P-value of less than 0.05 was considered statistically significant. Results: The prevalence of compliance with CPT by self-reported measurement was 158 (63.7%). Most CPT-compliant participants were more likely to have a spouse who is familiar with CPT, have a family member who is aware of their HIV status, and be aware of the benefits of CPT. The majority of participants who complied with CPT were more likely to have experienced counseling during refill, felt that the length of time spent seeing doctors for treatment was reasonable, and received accurate information from them. Conclusion: Most adult HIV patients attending CTC at BMC were reported to be in compliance with CPT. These findings suggest that improving social support and patient-provider communication may be effective strategies for improving compliance with CPT among HIV patients.

Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.

Extensive Pineapple Production Constraints and Land Suitability in the Centre Region of Cameroon

The low level of productivity observed in pineapple fields in Centre Came-roon must be sustainably reduced in order to increase producers’ income while using the same resources. The identification and control of production constraints are key steps in optimizing the use of limited resources. To this end, the FAO land assessment methodology following the Fuzzy-MCDM pro-tocol was used for the two pineapple production basins in the Centre, namely Awae and Bokito. It was found that the land in Awae Basin is moderately suitable S2sf with constraints imposed by texture, pH and base saturation. In the Bokito Basin, 25% of the land is suitable S1wf and 75% is moderately suitable S2wsf with constraints imposed by soil texture (27%), temporary soil water saturation (99%), pH, base saturation and exchangeable sodium. Constraint correction improves the land index (potential suitability) and re-mains limited by permanent constraints that cannot be corrected. Improve-ment of the technical itinerary through modification of plant densities, selec-tion of improved cultivars and balanced fertilization must be undertaken to optimize pineapple production in Centre Cameroon.

Inclusiveness in City Centre-A Case Study: 30-E-Tir Street in Tehran

City centres in today’s big cities,particularly in metropolises and megalopolises,play a crucial role in revival of human scale in an urban context.Nowadays,a city centre that corresponds to needs of various groups of users,contributes to creating a safe,healthy,vibrant,inclusive and sustainable city.Accordingly,identification of the major and minor groups of users of city centres as well as their likes,dislikes and preferences is a primary step.To this end,this paper investigates the city centre of Tehran and a recently pedestrianised street called 30-E-Tir.With a focus on the three indicators of age,gender and speed,this paper aims to elucidate the existing divergent groups of users of 30-E-Tir and their physical,mental,and spiritual expectations of this street.This 1.3-km street-as a linear path incorporating food&junk food kiosks and the associated small-scale canopies,and flagstone floorscaping-passes through many famous museums of Tehran.These specific features have converted 30-E-Tir Street into a convivial destination point for Tehranians.The existing problems,however,necessitate a detailed investigation of the current situation.The applied methodology for this qualitative-quantitative analysis of the present condition includes the literature review and the related analysis,direct appraisal,photography,and dot-based analysis.

加拿大多伦多Sunnybrook Health Sciences Centre NICU护理对我国的借鉴

通过介绍Sunnybrook Health Sciences Centre NICU的护理管理和工作制度、医院感染预防、病房布局、护理业务培训和对早产儿发育的护理等内容,为我国NICU护理工作开展提供借鉴。提出我国应该加强根据国内外的最新护理进展情况规范NICU护士专科知识教材和培训方法;合理布局NICU,以改善病房环境和预防医院感染;合理安排治疗和护理时间,尽量减少对早产儿的干扰,促进其发育;鼓励父母参与患儿的护理。

Application of face centred cubic TiB powder as conductive filler for electrically conductive adhesives

Face centred cubic（FCC） TiB ceramic powder synthesized by Ti-boronizing method was used as conductive filler to make ceramic electrically conductive adhesives（ECAs） with the polymer matrix.Electrically conductive properties of the ceramic ECAs were studied.The bulk electrical resistivity varied with the powder content of the FCC-TiB in ECAs.The FCC-TiB filled ECAs also showed the percolation behavior that usually occurred for the metal-filled ECAs,the percolation threshold was located at the content of 60%FCC-TiB.A minimum value of 0.1 Ω·cm was obtained at a content of 75%FCC-TiB.In order to check the reliability of mechanical property,tensile test was done to measure the shear strength,and the shear strength dropped with increasing the content of FCC-TiB powders.It is about 12.26 MPa at the content of 70%TiB powders.The Cu filled ECAs were also prepared for comparison.The properties of the oxidation resistance of the two ECAs were evaluated.The results show that the ceramic ECAs have excellent oxidation resistance and better stability compared with the Cu filled ECAs.

Software-Defined Optical Data Centre Networks

Based on the analysis of data centre(DC) traffic pattern, we introduced a holistic software-defined optical DC solution. Architecture-on-Demand based hybrid optical switched(OPS/OCS) data centre network(DCN) fabric is introduced, which is able to realise different inter-and intra-cluster configurations and dynamically support diverse traffic in the DC. The optical DCN is controlled and managed by a software-defined networking(SDN) enabled control plane to achieve high programmability. Moreover, virtual data centre(VDC) composition is developed as an application of such softwaredefined optical DC to create VDC slices for different tenants.

Business Service Centres and Their Current Challenges in Slovak Republic

Globalization of the world economy and the entrance of the information society have a significant impact on the development of business activities of individual firms.Since centralization and outsourcing of business services is a globally growing trend,this industry has enormous potential.Business Service Centres(BSCs)are considered to be a model in the European Union that leads to improved performance and results achieved by the company.Within the framework of EU free trade,up to 70%of European centres state that standardization and process transformation is the first corner in deciding to set up the BSC.The aim of the article is to analyse the market of business service centres in the Slovak Republic and their impact on employment within the EU.The competitive advantage of Slovakia lies above all in economic and political stability,geographic location,skilled workforce and European currency.Thanks to positive business experiences in Slovakia,most investors remain and large numbers of them are expanding their activities,despite the rising cost of work.Based on the use of quantitative methods,we analyse secondary data on business service centres.Higher education graduates are often the main source of workforce for business service centres.

Serve the People or Serve the Consumer? The Dilemma of Patient-Centred Health Care in China

Patient-centred medicine is being adopted as national policies in many countries, encouraged by positive outcomes of the practice at clinical and organisational levels. This study examines the patient-centred health care reform in China, which has adopted the approach as a national policy for two decades but has yet to achieve the intended goals. Focusing on conflicting interpretations of the nature of patients at national, organisational, and individual levels, this article argues that such conflicts lead to clashes between the political agenda of the state, priorities of health organisations, professional choices of individual practitioners, and expectations of patients in the process of implementing, practicing, and receiving patient-centred health care in China. It reveals that the national health authority has intended patient-centredness as a universal, anti-market, people-centred approach, based on the health ideology of serving the people. But hospitals, compelled by financial restraints, have implemented it as a market approach centring on patients as consumers. Medical professionals and patients also possess contradictory views towards whether a patient should be perceived as a consumer. The discordance in the interpretation of the patient identity has caused great confusion in the implementation and provision of patient-centred health care. The study points out that the success of patient-centredness as national policy cannot be assumed on the basis of its success at clinical and organisational levels. More efforts are needed to coordinate the fundamental understanding of patient-centredness by different actors.

Colour Centres and Energy Transfer in BaF_(2-x)Cl_x∶Eu^(2+) Phosphors

The optical absorption spectra of BaF2-x Clx ：Eu^2＋ after ultraviolet （UV） light excitation were investigated. The differences between the absorption spectra after and before excitation （DAS） were observed. The DAS increase at both the high and the low energy side of F band in BaF2-xClx ： Eu^2 ＋ after 245 nm UV light excitation. The bleach effect of UV light and the absorption of electrons in the valence band may account for the former and the formation of Fa centres （association of F（Cl^-） centres）, whose absorption band matches the HeNe laser better, may explain the latter. In the write-in process, the transfer of electrons is via tunneling, In the readout process, the transfer of electrons captured in F（F^-） and Fa centres is more likely via tunneling, and that of F（Cl^- ） centres is more likely via conduction band.

The influence of trapping centres on the photoelectron decay in silver halide

Photoelectron is the foundation of latent image formation, the decay process of photoelectrons is influenced by all kinds of trapping centres in silver halide. By analysing the mechanism of latent image formation it is found that electron trap, hole trap, and one kind of recombination centre where free electron and trapped hole recombine are the main trapping centres in silver halide. Different trapping centres have different influences on the photoelectron behaviour. The effects of all kinds of typical trapping centres on the decay of photoelectrons are systematically investigated by solving the photoelectron decay kinetic equations. The results are in agreement with those obtained in the microwave absorption dielectric spectrum experiment.

菲律宾St. Luke's Medical Centre NICU学习感悟

本文通过介绍菲律宾St.Luke's Medical Centre NICU的护理工作制度、服务理念、培训制度以及病房布局、母乳喂养的落实情况、对早产儿的发展性照顾等方面的情况,旨在为我国规范NICU护士专科知识的培训、优化病房环境、加强发展性护理、鼓励父母参与患儿的护理、加强患儿出院前的指导、提高NICU护理工作水平提供参考。

Nonlinear consensus protocols for multi-agent systems based on centre manifold reduction

Nonlinear consensus protocols for dynamic directed networks of multi-agent systems with fixed and switching topologies are investigated separately in this paper. Based on the centre manifold reduction technique, nonlinear consensus protocols are presented. We prove that a group of agents can reach a β-consensus, the value of which is the group decision value varying from the minimum and the maximum values of the initial states of the agents. Moreover, we derive the conditions to guarantee that all the agents reach a β-consensus on a desired group decision value. Finally, a simulation study concerning the vertical alignment manoeuvere of a team of unmanned air vehicles is performed. Simulation results show that the nonlinear consensus protocols proposed are more effective than the linear protocols for the formation control of the agents and they are an improvement over existing protocols.

Mechanism of fracture in macro- and micro-scales in hollow centre cracked disc specimen

The hollow centre cracked disc(HCCD) specimen is one of the suggested alternative methods for determining the fracture toughness of rock. This work aims to investigate the fracture mechanism in HCCD in macro- and micro-scales using numerical methods, extended finite element method(X-FEM) and particle flow code(PFC) modeling, respectively. In the X-FEM, heaviside and near-tip enrichment functions are employed to consider the presence of the crack in the model. In PFC modeling the movement and interaction of stressed assemblies of rigid spherical particles are modeled using the distinct element method(DEM). A numerical code called MEX-FEM based on XFEM has been developed to simulate the problems involving crack. The models of pure modes I and Ⅱ in macro-scale are simulated in micro-scale. The results show that dimensionless stress intensity factors(YI, YⅡ) for pure modes I and Ⅱ increase by increasing the crack length ratio. The angle at which the pure mode Ⅱ occurs decreases by increasing the crack length ratio. In mixed mode I-Ⅱ, The value of YI decreases by increasing the crack angle, while the value of YⅡ increases to a given crack angle and then it decreases. Moreover, the fracture in micro-scale, unlike the macro-scale, includes a combination of different modes of fracturing.

Energy-Aware Scheduling Scheme Using Workload-Aware Consolidation Technique in Cloud Data Centres

To reduce energy consumption in cloud data centres,in this paper,we propose two algorithms called the Energy-aware Scheduling algorithm using Workload-aware Consolidation Technique(ESWCT) and the Energyaware Live Migration algorithm using Workload-aware Consolidation Technique(ELMWCT).As opposed to traditional energy-aware scheduling algorithms,which often focus on only one-dimensional resource,the two algorithms are based on the fact that multiple resources(such as CPU,memory and network bandwidth)are shared by users concurrently in cloud data centres and heterogeneous workloads have different resource consumption characteristics.Both algorithms investigate the problem of consolidating heterogeneous workloads.They try to execute all Virtual Machines(VMs) with the minimum amount of Physical Machines(PMs),and then power off unused physical servers to reduce power consumption.Simulation results show that both algorithms efficiently utilise the resources in cloud data centres,and the multidimensional resources have good balanced utilizations,which demonstrate their promising energy saving capability.

Clinical characteristics and in-hospital outcomes of patients receiving contemporary intensive cardiac care:retrospective study from a large centre in China

BACKGROUND Few studies from developed countries have quantitatively characterized the clinical characteristics and outcomes of patients receiving contemporary intensive cardiac care.We sought to investigate these data in patients admitted to a Chinese intensive cardiac care unit(ICCU).METHODS We conducted a retrospective study using data from 2,337 consecutive admissions to the ICCU at a large centre in China from June 2016 to May 2017.Data were captured after systematic inspection of individual medical records regarding current demographics,primary diagnosis,comorbidities,illnesses severity,and in-hospital outcomes.RESULTS The mean age was 65.6±14.2 years,and females accounted for 32.0%of patients.The Charlson Comorbidity Index and Oxford Acute Severity of Illness Score were 2.4±1.8 and 22.5±10.4,respectively.The top reason for admission was ST-segment elevation myocardial infarction(32.0%),and nonischaemic heart diseases accounted for 31.2%of all primary diagnoses.Noncardiovascular diseases were prevalent in the ICCU population,including chronic illnesses and acute noncardiovascular critical illnesses(ANCIs);in particular,21.7%of patients were marked by acute respiratory failure(14.6%),acute kidney injury(13.7%),sepsis(4.2%),or gastrointestinal bleeding(3.3%).The median length of stay in the ICCU and hospital were 1.1 days[interquartile range(IQR):0.8–2.6 days]and 6.3 days(IQR:3.8−10.9 days),respectively.The overall incidence of in-hospital death or discharge against medical advice under extremely critical conditions was 7.6%(n=177).Multivariate logistic regression analysis showed that the complexity of chronic illnesses and incident ANCIs were strong independent determinants for in-hospital outcomes.CONCLUSIONS Remarkable patient diversity and breadth of critical illnesses were observed in a Chinese ICCU population.Particularly,noncardiovascular diseases were prevalent and associated with adverse outcomes.Reformation of organization and staffing practices may be considered to adapt to the changed landscape.

Fracture strength of centre surface cracked tensile specimens made of 2219-T87 Al alloy welding

Fracture data of both parent metal and weldment metals from surface cracked tensile plates made of 2219-T87 Al alloy at cryogenic temperatures were correlated using a modified inherent flaw model. Fracture parameters to generate the failure assessment diagram were determined for the material. Fracture analysis was carried out considering the ultimate tensile strength value and the fracture data of aluminium base metal and weldment metal generated from center–surface cracked tensile specimens having different thicknesses. The failure assessment diagram of a material generated from tensile fracture plate configuration can be applied to failure pressure estimation of any cracked component, made of the same material.

THE HAUSDORFF CENTRED MEASURE OF THE SYMMETRY CANTOR SETS

Let 0<A≤1/3 ,K(λ) be the attractor of an iterated function system {ψ1,ψ2} on the line, where 1(x)= AT, ψ1(x) = 1-λ+λx, x∈[0,1]. We call K(λ) the symmetry Cantor sets. In this paper, we obtained the exact Hausdorff Centred measure of K(λ).

Adjuvant atezolizumab after adjuvant chemotherapy in resected stage IB-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial

Methods:IMpower010 was a randomised,multicentre,open-label,phase 3 study done at 227 sites in 22 countries and regions.Eligible patients were 18 years or older with completely resected stage IB(tumours>4 cm)to IIIA NSCLC per the Union Internationale Contre le Cancer and American Joint Committee on Cancer staging system(7th edition).Patients were randomly assigned(1:1)by a permuted-block method(block size of four)to receive adjuvant atezolizumab(1200 mg every 21 days;for 16 cycles or 1 year)or best supportive care(observation and regular scans for disease recurrence)after adjuvant platinum-based chemotherapy(one to four cycles).The primary endpoint,investigator-assessed disease-free survival,was tested hierarchically first in the stage II-IIIA population subgroup whose tumours expressed PD-L1 on 1%or more of tumour cells(SP263),then all patients in the stage II-IIIA population,and finally the intention-to-treat(ITT)population(stage IB-IIIA).Safety was evaluated in all patients who were randomly assigned and received atezolizumab or best supportive care.IMpower010 is registered with ClinicalTrials.gov,NCT02486718(active,not recruiting).

Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial

Background:We aimed to assess efficacy and safety,with a special focus on cardiovascular safety,of the novel dual GIP and GLP-1 receptor agonist tirzepatide versus insulin glargine in adults with type 2 diabetes and high cardiovascular risk inadequately controlled on oral glucose-lowering medications.Methods:This open-label,parallel-group,phase 3 study was done in 187 sites in 14 countries on five continents.Eligible participants,aged 18 years or older,had type 2 diabetes treated with any combination of metformin,sulfonylurea,or sodiumglucose co-transporter-2 inhibitor,a baseline glycated haemoglobin(HbA1c)of 7-5-10-5%(58-91 mmol/mol),body-mass index of 25 kg/m2 or greater,and established cardiovascular disease or a high risk of cardiovascular events.Participants were randomly assigned(1:1:1:3)via an interactive web-response system to subcutaneous injection of either once-per-week tirzepatide(5 mg,10 mg,or 15 mg)or glargine(100 U/mL),titrated to reach fasting blood glucose of less than 100 mg/dL.The primary endpoint was non-inferiority(0-3%non-inferiority boundary)of tirzepatide 10 mg or 15 mg,or both,versus glargine in HbA1c change from baseline to 52 weeks.All participants were treated for at least 52 weeks,with treatment continued for a maximum of 104 weeks or until study completion to collect and adjudicate major adverse cardiovascular events(MACE).Safety measures were assessed over the full study period.This study was registered with ClinicalTrials.gov,NCT03730662.