Effects of air sac compliances on flow in the parabronchi: Computational fluid dynamics using an anatomically simplified model of an avian respiratory system

Air flow in an avian lung was studied numerically to determine the effects of air sac compliance on flow in the parabronchi. In this preliminary study, the geometry of the avian respiratory system was simplified to capture the characteristics of respiratory flow. The pressure fluctuation within air sacs caused by inflation and deflation was expressed by a lumped parameter model. The results demonstrate that the flow direction in the parabronchi varied, depending upon the compliance of the air sacs. A unidirectional flow in the parabronchi was achieved for compliances where pressure fluctuations in all air sacs were in phase. Air sac compliance significantly affected the pressures in the anterior and posterior air sacs and thus the pressure difference over the parabronchi that drove the flow in the parabronchi. These results address the importance of air sac compliance in the avian respiratory system and suggest that the compliance of air sacs would be optimized to accomplish unidirectional flow in the parabronchi.

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Anisotropic time-dependent behaviors of shale under direct shearing and associated empirical creep models

Understanding the anisotropic creep behaviors of shale under direct shearing is a challenging issue.In this context,we conducted shear-creep and steady-creep tests on shale with five bedding orientations (i.e.0°,30°,45°,60°,and 90°),under multiple levels of direct shearing for the first time.The results show that the anisotropic creep of shale exhibits a significant stress-dependent behavior.Under a low shear stress,the creep compliance of shale increases linearly with the logarithm of time at all bedding orientations,and the increase depends on the bedding orientation and creep time.Under high shear stress conditions,the creep compliance of shale is minimal when the bedding orientation is 0°,and the steady-creep rate of shale increases significantly with increasing bedding orientations of 30°,45°,60°,and 90°.The stress-strain values corresponding to the inception of the accelerated creep stage show an increasing and then decreasing trend with the bedding orientation.A semilogarithmic model that could reflect the stress dependence of the steady-creep rate while considering the hardening and damage process is proposed.The model minimizes the deviation of the calculated steady-state creep rate from the observed value and reveals the behavior of the bedding orientation's influence on the steady-creep rate.The applicability of the five classical empirical creep models is quantitatively evaluated.It shows that the logarithmic model can well explain the experimental creep strain and creep rate,and it can accurately predict long-term shear creep deformation.Based on an improved logarithmic model,the variations in creep parameters with shear stress and bedding orientations are discussed.With abovementioned findings,a mathematical method for constructing an anisotropic shear creep model of shale is proposed,which can characterize the nonlinear dependence of the anisotropic shear creep behavior of shale on the bedding orientation.

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Enhancing AI System Privacy:An Automatic Tool for Achieving GDPR Compliance in NoSQL Databases

The EU’s Artificial Intelligence Act(AI Act)imposes requirements for the privacy compliance of AI systems.AI systems must comply with privacy laws such as the GDPR when providing services.These laws provide users with the right to issue a Data Subject Access Request(DSAR).Responding to such requests requires database administrators to identify information related to an individual accurately.However,manual compliance poses significant challenges and is error-prone.Database administrators need to write queries through time-consuming labor.The demand for large amounts of data by AI systems has driven the development of NoSQL databases.Due to the flexible schema of NoSQL databases,identifying personal information becomes even more challenging.This paper develops an automated tool to identify personal information that can help organizations respond to DSAR.Our tool employs a combination of various technologies,including schema extraction of NoSQL databases and relationship identification from query logs.We describe the algorithm used by our tool,detailing how it discovers and extracts implicit relationships from NoSQL databases and generates relationship graphs to help developers accurately identify personal data.We evaluate our tool on three datasets,covering different database designs,achieving an F1 score of 0.77 to 1.Experimental results demonstrate that our tool successfully identifies information relevant to the data subject.Our tool reduces manual effort and simplifies GDPR compliance,showing practical application value in enhancing the privacy performance of NOSQL databases and AI systems.

Performance and Safety Improvement of Induction Motors based on Testing and Evaluation Standards

The induction motor,which converts electrical energy into mechanical energy,has been recognized as the cornerstone of industrialization.The rotor of an induction motor can be either a squirrel cage rotor or a wound-type rotor,both existing as magnetless topologies.Three-phase squirrel cage induction motors are frequently utilized in industrial drives because they are dependable,have high starting torque,are selfstarting and affordable.Single-phase induction motors,on the other hand,are commonly used for small loads such as domestic appliances in form of modest fans,pumps and electric power tools.In South Africa,there have been reports of fires and explosions resulting in live and property loss because of induction motors that have not been thoroughly tested or are incorrectly labelled in terms of ratings,electrical safety and performance.The goal of this study is targeted at preventing end-user injuries and failures caused by non-compliant induction motors,by evaluating locally manufactured/imported induction motors based on tests and evaluation from standards(IEC and SANS).The study is conducted using experimental procedures at the Explosion Prevention Technology and Rotating Machines(EPT and RM)laboratory,South African Bureau of Standards(SABS),South Africa.The main finding from the study shows differences in the nameplate characteristics of various induction motors which could have detrimental effects such as production and operational downtime in their end-use industries,at later stages.

Value of improved nursing measures and enhanced nursing management to reduce the occurrence of adverse events in pediatric infusion

BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to infusion by nursing staff,may cause adverse infusion events.AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion.METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management:65 patients in the control group received conventional nursing and nursing management interventions,while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management.The occurrence of adverse events,compliance of children,satisfaction of children’s families,and complaints regarding the transfusion treatment were recorded in both groups.RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08%and 1.54%,respectively,which were significantly lower than 12.31%and 13.85%in the control group(P<0.05),while repeated punctures and medication addition errors in the observation group were 3.08%and 0.00%,respectively,which were lower than 9.23%and 3.08%in the control group,but there was no significant difference(P>0.05).The compliance rate of children in the observation group was 98.46%(64/65),which was significantly higher than 87.69%(57/65)in the control group,and the satisfaction rate of children’s families was 96.92%(63/65),which was significantly higher than 86.15%(56/65)in the control group(P<0.05).The observation group did not receive any complaints from the child’s family,whereas the control group received four complaints,two of which were due to the crying of the child caused by repeated punctures,one due to the poor attitude of the nurse,and one due to medication addition errors,with a cumulative complaint rate of 6.15%.The cumulative complaint rate of the observation group was significantly lower than that of the control group(P<0.05).CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients,improve children’s compliance and satisfaction of their families,and reduce family complaints.

Changes and Adjustments:The Rule of Law Response to Medical Institution Data Compliance

Medical institution data compliance is an exogenous product of the digital society,serving as a crucial means to maintain and balance the relationship between data protection and data sharing,as well as individual interests and public interests.The implementation of the Healthy China Initiative greatly benefits from its practical significance.In practice,data from medical institutions takes varied forms,including personally identifiable data collected before diagnosis and treatment,clinical medical data generated during diagnosis and treatment,medical data collected in public health management,and potential medical data generated in daily life.In the new journey of comprehensively promoting the Chinese path to modernization,it is necessary to clarify the shift from an individual-oriented to a societal-oriented value system,highlighting the reinforcing role of the trust concept.Guided by the principle of minimizing data utilization,the focus is on the new developments and changes in medical institution data in the postpandemic era.This involves a series of measures such as fulfilling the obligation of notification and consent,specifying the scope of data collection and usage,strengthening the standardized use of relevant technical measures,and establishing a sound legal responsibility system for data compliance.Through these measures,a flexible and efficient medical institution data compliance system can be constructed.

Value of combining targeted emergency nursing with psychological nursing in children with febrile convulsions

BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clinical practice,but their value and impact on the management of pediatric febrile convulsions are unclear.AIM To determine the impact of targeted emergency nursing combined with psychological nursing on satisfaction in children with febrile convulsions.METHODS Data from 111 children with febrile convulsions who received treatment at Nantong Maternal and Child Health Care Hospital between June 2021 and October 2022 were analyzed.The control group consisted of 44 children who received conventional nursing care and the research group consisted of 67 children who received targeted emergency and psychological nursing.The time to fever resolution,time to resolution of convulsions,length of hospital stays,Pittsburgh Sleep Quality Index,patient compliance,nursing satisfaction of the parents,occurrence of complications during the nursing process,and parental anxiety and depression were compared between the control and research groups.Parental anxiety and depression were assessed using the Hamilton Rating Scale for Depression(HAMD)and the Hamilton Rating Scale for Anxiety(HAMA).RESULTS The fever resolution,convulsion disappearance,and hospitalization times were longer in the control group compared with the research group(P<0.0001).The time to falling asleep,sleep time,sleep quality,sleep disturbance,sleep efficiency,and daytime status scores were significantly better in the research group compared with the control group(P<0.0001).The HAMD and HAMA scores for parents of children in the research group were lower than the scores in the control group after nursing(P<0.05).Compliance with treatment of children in the research group was higher than in the control group(P<0.05).Parental satisfaction with nursing in the research group was higher than in the control group(P<0.05).The total complication rate of children in the control group was higher than in the research group(P<0.05).CONCLUSION Combining psychological nursing with targeted emergency nursing improved the satisfaction of children’s families and compliance with treatment and promoted early recovery of clinical symptoms and improvement of sleep quality.

Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery

BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.METHODS One hundred and sixteen preschool-aged children were selected and assigned to the drug(n=37),intervention(n=40),and control(n=39)groups.All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation.The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments.The control group received no intervention.The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery(T0),before leaving the preoperative preparation room(T1),when entering the operating room(T2),and at anesthesia induction(T3).Compliance during anesthesia induction(T3)was evaluated using the Induction Compliance Checklist(ICC).Changes in mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were also recorded at each time point.RESULTS The anxiety scores of the three groups increased variously at T1 and T2.At T3,both the drug and intervention groups had similar anxiety scores,both of which were lower than those in the control group.At T1 and T2,MAP,HR,and RR of the three groups increased.The drug and control groups had significantly higher MAP and RR than the intervention group at T2.At T3,the MAP,HR,and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group.Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction(T3),both of which were higher than those of the control group.CONCLUSION Combining static cartoons with dynamic virtual environments as effective as medication,specifically midazolam,in reducing preoperative anxiety and fear in preschool-aged children.This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

Does enhanced recovery after surgery programs improve clinical outcomes in liver cancer surgery?

Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects.

Cosmetic or Dietary Vegetable Oils Sampled in the Cameroonian Market May Not Expose Consumers to Lipid Oxidation Products Generating Oxidative Stress and Inflammation

Vegetable oils are a source of energy, essential fatty acids, antioxidants and fat-soluble vitamins useful for human health care and development. These oils also contribute to organoleptic quality of their products’ derivatives. However, their chemical and physical properties can be modified by the mode of their extraction, storage and distribution. These modifications might negatively affect the nutritional quality of the oils. The goals of this study were to: sample different vegetable oils for cosmetic or dietary use marketed in Cameroon, and verify purity and oxidation states of each kind of oil through determination of its acidity, iodine, peroxide, saponification, refractive indexes and the conformity of the labeling. The carotene content, the level of polar components and specific absorbance were also determined. As the result, six oils namely palm, palm kernel, coconut, black cumin, peanut and shea butter were collected. Apart from labeling, chemicals and physicals parameters analyzed were generally in accordance with the Cameroonian and Codex Alimentarius standard. This study suggests that vegetable oils sampled in the Cameroonian market may not expose consumers to lipid oxidation products generating pathological oxidative stress and inflammation. However, efforts in application of existing standard need to be done as far as labeling are concerned.

Effect of continuous nursing on treatment compliance and side effect management of coronary heart disease

BACKGROUND There are relatively few studies on continuing care of coronary heart disease(CHD),and its research value needs to be further clarified.AIM To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD.METHODS This is a retrospective study with patients from January 2021 to 2023.The study was divided into two groups with 30 participants in each group.Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS)were used to assess patients'anxiety and depression,and medical coping questionnaire was used to assess patients'coping styles.The pelvic floor dysfunction questionnaire(PFDI-20)was used to assess the status of pelvic floor function,including bladder symptoms,intestinal symptoms,and pelvic symptoms.RESULTS SAS score decreased from 57.33±3.01before treatment to 41.33±3.42 after treatment,SDS score decreased from 50.40±1.45 to 39.47±1.57.The decrease of these two indexes was statistically significant(P<0.05).PFDI-20 scores decreased from the mean 16.83±1.72 before treatment to 10.47±1.3the mean after treatment,which was statistically significant(P<0.05).CONCLUSION The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients'treatment compliance,reducing anxiety and depression levels,and improving coping styles and pelvic floor functional status.

Effects of intensive psychological intervention on treatment compliance,psychological status,and quality of life of patients with epilepsy

BACKGROUND Epilepsy is a nervous system disease characterized by recurrent attacks,a long disease course,and an unfavorable prognosis.It is associated with an enduring therapeutic process,and finding a cure has been difficult.Patients with epilepsy are predisposed to adverse moods,such as resistance,anxiety,nervousness,and anxiety,which compromise treatment compliance and overall efficacy.AIM To explored the influence of intensive psychological intervention on treatment compliance,psychological status,and quality of life(QOL)of patients with epilepsy.METHODS The clinical data of 105 patients with epilepsy admitted between December 2019 and July 2023 were retrospectively analyzed,including those of 50 patients who underwent routine intervention(control group)and 55 who underwent intensive psychological intervention(research group).Treatment compliance,psychological status based on the Self-Rating Anxiety Scale(SAS)and Depression Scale Self-Rating Depression Scale(SDS)scores,hope level assessed using the Herth Hope Scale(HHS),psychological resilience evaluated using the Psychological Resilience Scale,and QOL determined using the QOL in Epilepsy-31 Inventory(QOLIE-31)were comparatively analyzed.RESULTS Treatment compliance in the research group was 85.5%,which is significantly better than the 68.0%of the control group.No notable intergroup differences in preinterventional SAS and SDS scores were identified(P>0.05);however,after the intervention,the SAS and SDS scores decreased significantly in the two groups,especially in the research group(P<0.05).The two groups also exhibited no significant differences in preinterventional HHS,Connor-Davidson Resilience Scale(CD-RISC),and QOLIE-31 scores(P>0.05).After 6 months of intervention,the research group showed evidently higher HHS,CD-RISC,tenacity,optimism,strength,and QOLIE-31 scores(P<0.05).CONCLUSION Intensive psychological intervention enhances treatment compliance,psychological status,and QOL of patients with epilepsy.

Challenges with non-descriptive compliance labeling of end-stage renal disease patients in accessibility for renal transplantation

Non-descriptive and convenient labels are uninformative and unfairly project blame onto patients.The language clinicians use in the Electronic Medical Record,research,and clinical settings shapes biases and subsequent behaviors of all providers involved in the enterprise of transplantation.Terminology such as noncompliant and nonadherent serve as a reason for waitlist inactivation and limit access to life-saving transplantation.These labels fail to capture all the circum-stances surrounding a patient’s inability to follow their care regimen,trivialize social determinants of health variables,and bring unsubstantiated subjectivity into decisions regarding organ allocation.Furthermore,insufficient Medicare coverage has forced patients to ration or stop taking medication,leading to allograft failure and their subsequent diagnosis of noncompliant.We argue that perpetuating non-descriptive language adds little substantive information,in-creases subjectivity to the organ allocation process,and plays a major role in reduced access to transplantation.For patients with existing barriers to care,such as racial/ethnic minorities,these effects may be even more drastic.Transplant committees must ensure thorough documentation to correctly encapsulate the entirety of a patient’s position and give voice to an already vulnerable population.

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.

The Impact and Intervention of Handheld Tai Chi Water-Resistance Fitness Ball on Middle-Aged and Elderly Patients with Parkinson’s Disease

Through the use of a survey and statistical methods, this study explores the effects and interventions of handheld Tai Chi water resistance fitness balls on the elderly with Parkinson’s disease. Firstly, a questionnaire on exercise compliance for patients with Parkinson’s disease was developed, and its reliability and validity were tested. Then, a survey was conducted to investigate the current status of exercise compliance among Parkinson’s disease patients, including general information, scoring status, and single and multiple factor analyses of influencing factors [1]. The results of the study show that through qualitative research, the dimensions and item pools of the questionnaire were initially constructed, and the reliability analysis of the questionnaire was conducted through Delphi expert consultation, with favorable results in terms of its reliability and validity [2]. Regarding the current status of exercise compliance among Parkinson’s disease patients, the study found that the level of exercise compliance needs improvement, and there are significant differences in exercise compliance levels among patients under different circumstances. Finally, the research results were discussed and conclusions were drawn. The innovation of this study lies in the development of a questionnaire on exercise compliance for patients with Parkinson’s disease and the preliminary qualitative research and Delphi expert consultation conducted on it, providing new ideas and methods for the study of exercise compliance. However, the study also has limitations as it did not examine the effects of other interventions on Parkinson’s disease, so further research should be conducted [3].

A Qualitative Look at Decreasing Barriers to Receiving Uninterrupted Care for People Living with HIV in Rural Southern Georgia

Early linkage to antiretroviral therapy (ART) after HIV diagnosis extends life. Low socioeconomic populations with HIV face regional concerns that inhibit early treatment. Barriers include religious-based stigma, lack of local treatment facilities, fear of discovery and purposeful secrecy fostering increased HIV transmission and decreased ART adherence. This ethnographic qualitative study employed semi-structured interviews with 10 health care providers (HCP) and 10 people living with HIV (PLWH) to discover methods to streamline care and increase medication adherence. Clients perceive enhanced care when they are active participants in treatment. HCPs reported positive health outcomes when there was active multidisciplinary communication. Obstacles included a lack of consistent medication assistance programs, homelessness, and limited access to specialized services. There is a need for further investigation on how to provide individualized, holistic treatment to a population of patients with extremely limited federal funding in a geographic region where religious stigma surrounding HIV is widespread.

Conformity Assessment of Lead Aprons Used in Conventional Radiology: A Multi-Centre Survey in Togo

Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.

Blockchain-Based System for Secure and Efficient Cross-Border Remittances: A Potential Alternative to SWIFT

This paper proposes a blockchain-based system as a secure, efficient, and cost-effective alternative to SWIFT for cross-border remittances. The current SWIFT system faces challenges, including slow settlement times, high transaction costs, and vulnerability to fraud. Leveraging blockchain technology’s decentralized, transparent, and immutable nature, the proposed system aims to address these limitations. Key features include modular architecture, implementation of microservices, and advanced cryptographic protocols. The system incorporates Proof of Stake consensus with BLS signatures, smart contract execution with dynamic pricing, and a decentralized oracle network for currency conversion. A sophisticated risk-based authentication system utilizes Bayesian networks and machine learning for enhanced security. Mathematical models are presented for critical components, including transaction validation, currency conversion, and regulatory compliance. Simulations demonstrate potential improvements in transaction speed and costs. However, challenges such as regulatory hurdles, user adoption, scalability, and integration with legacy systems must be addressed. The paper provides a comparative analysis between the proposed blockchain system and SWIFT, highlighting advantages in transaction speed, costs, and security. Mitigation strategies are proposed for key challenges. Recommendations are made for further research into scaling solutions, regulatory frameworks, and user-centric designs. The adoption of blockchain-based remittances could significantly impact the financial sector, potentially disrupting traditional models and promoting financial inclusion in underserved markets. However, successful implementation will require collaboration between blockchain innovators, financial institutions, and regulators to create an enabling environment for this transformative system.