Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Low Level of Cystic Fibrosis Transmembrane Conductance Regulator Is Associated with Human Sperm Autophagy and Vitality

Low sperm motility is one of the main causes of male infertility. Cystic fibrosis transmembrane conductance regulator (CFTR, an anion channel protein) is related to the progressive motility of sperm. CFTR disruptor CFTRinh-172 or forskolin (FSK) in this study were used to treat human sperm separately, and the rates of sperm autophagy and progressive motility, mitochondrial membrane potential (MMP) and ATP concentration, and the expression levels of related factors were detected to explore their relationship. It was showed that sperms treated with CFTRinh-172 or FSK reduced the levels of cAMP, CFTR and PKA, but increased sperm autophagy rate, expression levels of AMPK and LC3B. However, reactive oxygen species content had no significant difference. It was indicated that low level of CFTR performed with cAMP and its downstream effectors such as PKA and AMPK to regulate mitochondrial structure and function, leading to increased autophagy rate and reduced vitality of sperm.

A Low Mach Number IMEX Flux Splitting for the Level Set Ghost Fluid Method

Considering droplet phenomena at low Mach numbers,large differences in the magnitude of the occurring characteristic waves are presented.As acoustic phenomena often play a minor role in such applications,classical explicit schemes which resolve these waves suffer from a very restrictive timestep restriction.In this work,a novel scheme based on a specific level set ghost fluid method and an implicit-explicit(IMEX)flux splitting is proposed to overcome this timestep restriction.A fully implicit narrow band around the sharp phase interface is combined with a splitting of the convective and acoustic phenomena away from the interface.In this part of the domain,the IMEX Runge-Kutta time discretization and the high order discontinuous Galerkin spectral element method are applied to achieve high accuracies in the bulk phases.It is shown that for low Mach numbers a significant gain in computational time can be achieved compared to a fully explicit method.Applica-tions to typical droplet dynamic phenomena validate the proposed method and illustrate its capabilities.

Diagnostic and prognostic implications of non-high-density lipoprotein cholesterol and homocysteine levels for cognitive impairment in thalamic infarction

BACKGROUND Patients with thalamic infarction experience abnormal blockages of multinuc-leated vessels,affecting the body and thereby the thalamus.Most patients with thalamic infarction have an adverse prognosis,which seriously affects their safety.Therefore,it is essential to analyze the independent risk factors that influence the prognosis of patients with thalamic infarction and develop corresponding preventive measures.AIM To explore the effect of non-high-density lipoprotein cholesterol(non-HDL-C)and Homocysteine(Hcy)levels in cognitive impairment in thalamic infarction.METHODS From March 2019 to March 2022,80 patients with thalamic infarction were divided into a group with cognitive impairment[Montreal Cognitive Assessment(MoCA)score<26;35 patients]and a group with normal cognitive function(MoCA score of 26-30;45 patients)according to the MoCA score.In addition,50 healthy people in the same period were selected as the control group.A correlation between the non-HDL-C and Hcy levels and the MoCA score and receiver operating characteristic curve was observed,and the serum non-HDL-C and Hcy levels were analyzed for the diagnosis of cognitive impairment in patients with thalamic infarction.According to the Modified Rankin Scale(MRS)score,80 patients with thalamic infarction were divided into a good prognosis group(MRS score≤2)and a poor prognosis group(MRS score>2).RESULTS The non-HDL-C and Hcy levels were significantly higher in the group with cognitive impairment than in the group with normal cognitive function(P<0.05).There was no significant difference in the non-HDL-C level between the control group and the group with normal cognitive function(P>0.05).The MoCA scores of the group with cognitive impairment were significantly lower than those of the group with normal cognitive function and the control group(P<0.05).There was a significant difference between the control group and the group with normal cognitive function(P<0.05).The non-HDL-C and Hcy levels were correlated with the MoCA score(P<0.05),cognitive impairment[areas under the curve(AUC)=0.709,95%confidence interval(95%CI):0.599-0.816],the non-HDL-C level,and could predict cognitive impairment in patients with thalamic infarction(AUC=0.738,95%CI:0.618-0.859).Hcy combined with non-HDL-C levels can predict cognitive impairment in patients with thalamic infarction(AUC=0.769,95%CI:0.721-0.895).RESULTS There were 50 patients in the good prognosis group and 30 patients in the poor prognosis group.Compared with the good prognosis group,in the poor prognosis group,the National Institutes of Health Stroke Scale(NIHSS)score,non-HDL-C level,Hcy level,large-area cerebral infarction,atrial fibrillation,and activated partial prothrombin time were statistically significant(P<0.05).The non-HDL-C level,the Hcy level,the NIHSS score,extensive cerebral serum,and atrial fibrillation may all be independent risk factors for poor prognosis in patients with thalamic infarction(P<0.05).CONCLUSION Non-HDL-C and Hcy levels are positively correlated with cognitive impairment in patients with thalamic infarction.Non-HDL-C and Hcy levels can be used in the diagnosis of cognitive impairment in patients with thalamic infarction,and the combined detection effect is better.The main factors affecting the prognosis of patients with thalamic infarction are the non-HDL-C level,the Hcy level,the NIHSS score,large-area cerebral infarction,and atrial fibrillation.Clinically,corresponding preventive measures can be formulated based on the above factors to prevent poor prognosis and reduce mortality.

Effective Dose Screening of Low Level Red Light in Different Cell Indexes

The low level red light irradiation dose that produced positive response on different cell indexes was selected through experiments.In fibroblast detection model,the low level red light irradiation dose that had positive response to the four indicators of mitochondrial membrane potential,ATP release,cell migration and collagen synthesis was screened.The experimental results showed that low level red light with a irradiation dose of 2 J/cm^(2) had a positive response to the above four indexes in fibroblast.The test model on fibroblast was later transferred to dermal papilla cells for further experimental verification.The results showed that low level red light with a irradiation dose of 2 J/cm^(2) also had a positive response to the four indicators of dermal papilla cells,namely,mitochondrial membrane potential,ATP release,cell proliferation rate and collagen synthesis.It is proved that the low level red light with a irradiation dose of 2 J/cm^(2) could improve the mitochondrial function,cell migration and collagen synthesis of fibroblast and dermal papilla cell,thus providing energy for cell activities,improving cell repair ability and cell anti-aging ability.

Theory and Practice of High-Level Sprint Training Based on Accurate Sectional Timing

There is an obvious gap in sprint level at home and abroad,and there are different opinions on the reasons.According to the analysis,physical energy and its distribution in each segment are the main factors restricting the sprint performance in China.Different from middle and long-distance running,we must rely on accurate sectional timing technology to master the law of speed-physical energy change in the process of sprint.Each stage is an integral part of the whole dash process,and each part restricts each other.Each stage has a relative best achievement.Simply pursuing the optimal state of segment is not only not helpful to the final result,but also counterproductive.

Predictive Value of Serum pgRNA on HBeAg Clearance in Patients with Chronic Hepatitis B with Low HBeAg Levels Treated with Pegylated Interferon

Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon therapy.Methods:Twenty chronic hepatitis B patients with HBeAg positive and quantitative<50S/CO were selected for this study.The subjects underwent pegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after treatment.The patients were then divided into groups based on whether their HbeAg turned negative.The predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive group.Results:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after treatment.Conclusion:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.

A Strategy for Magnifying Vibration in High-Energy Orbits of a Bistable Oscillator at Low Excitation Levels

This work focuses on how to maintain a high-energy orbit motion of a bistable oscillator when subjected to a low level excitation. An elastic magnifier （EM） positioned between the base and the bistable oscillator is used to magnify the base vibration displacement to significantly enhance the output characteristics of the bistable oscillator. The dimensionless electromechanical equations of the bistable oscillator with an EM are derived, and the effects of the mass and stiffness ratios between the EM and the bistable oscillator on the output displacement are studied. It is shown that the jump phenomenon occurs at a lower excitation level with increasing the mass and stiffness ratios. With the comparison of the displacement trajectories and the phase portraits obtained from experiments, it is vMidated that the bistable oscillator with an EM can effectively oscillate in a high-energy orbit and can generate a superior output vibration at a low excitation level as compared with the bistable oscillator without an EM.

Health concerns of veterans with high-level lower extremity amputations

Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire(SF-36) that assessed their ability to perform activities of daily living(ADL), instrumental activities of daily living(IADL) and life satisfaction(SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs.Results: The means of the Physical Component Summary(PCS), Mental Component Summary(MCS), SWLS, ADL and IADL were 48.58±29.6, 33.33±22.0, 19.30±7.7, 48.10±10.5 and 5.08±1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders;among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma(49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study.The Canadian-type of prosthesis was uncomfortable and not useful(27%) and excessively heavy(10%) according to the amputees.Conclusions: Understanding veterans’ characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.

Low power and high speed explicit-pulsed double-edge triggered level converting flip-flop

Variable supply voltage-clustered voltage scaling （VS-CVS） scheme can be very effective in reducing power consumption of CMOS circuits without degrading system performance. Level converting flip-flops （LCFFs） are key elements in the CVS scheme. In this paper, a new explicit-pulsed double-edge triggered level converting flip-flop （nEP-DET-LCFF） is proposed, which employs double-edge triggering technique, dynamic structure, explicit pulse generator, conditional discharge technique and proper arrangement of stacked nMOS transistors to efficiently perform latching and level converting functions simultaneously. The proposed nEP-DET-LCFF combines merits of both conventional explicit-LCFFs and implicit-LCFFs. Simulation shows the proposed nEP-DET-LCFF has improvement of 19.2% -46% in delay, and 19.4% - 52.9% in power-delay product （PDP） as compared with the published LCFFs.

Simulation of Quantum Noise in the Low-Light-Level Imaging System

A mathematical model of quantum noise having much effect on the low light imaging system is set up. To simulate the quantum noise, the random numbers obeying noise distribution must be formed and are weighted on the basis of the model created. Three uniform random sequences are built by the linear congruential method, of which two are used to form integer number and decimal fraction parts of the new random sequence respectively and the third to shuffle the new sequence. And then a Gauss sequence is formed out of uniform distribution by a function transforming method. It actualizes the simulation in real time of quantum noise in the low light imaging system, where video flow is extracted in real time, the noise summed up and played back side by side with the original video signs by a simulation software.

Effects of Nitrogen Level and High Temperature Stress on Yield, SPAD Value and Soluble Sugar Content of Early Rice Ganxin 203

This study aimed to investigate the combined effects of nitrogen level （high and ordinary） and high temperature stress （37 ℃, 4 d） at the late panicle ini- tiation stage on yield, SPAD value and soluble sugar content of Ganxin 203, an early rice cultivar. The results showed that under both high and ordinary nitrogen levels, high temperature stress reduced the seed-setting rate, yield per stem, SPAD value and soluble sugar content of Ganxin 203; under both high and ordinary tem- peratures, high nitrogen level increased the seed-setting rate, yield per stem and soluble sugar content of Ganxin 203; the seed-setting rate, yield per stem and yield per plant of Ganxin 203 under high temperature and high nitrogen level were higher than those under high temperature and ordinary nitrogen level. It suggests that ap- propriate high nitrogen level contributes to weakening the negative effects of high temperature stress on rice yield.

Coral Reef and High Sea Level at Luhuitou, Hainan Island during the Holocene

According to the field survey and ^14C dating at Luhuitou, southern Hainan Island, a subsiding area, the authors conclude the high sea level history recorded by coral reef in the Holocene. At least 4 sea level high-stands can be identified from the distribution of coral reef ages： 7300 - 6000 cal.aBP, 4800 - 4700 cal.aBP, 4300 - 4200 cal.aBP and 3100 - 2900 cal.aBP. The highest sea level occurred around 7300 - 6700 cal.aBP, and biological-morphological zones took their shape during the stage. The later coral reefs developed in ponds, depressions, and developed outwards on both sides of Luhuitou peninsula. The modern coral reefs are developing in out reef flat and reef-front slope. Moreover, the time of high sea levels in the northern South China Sea recorded by coral reefs in the Luhuitou peninsula can link up with that in other parts of South China Sea. That means the high sea levels in the South China Sea during the Holocene, which are relative to the warming climate, have the global background.

Individualized management of pregnant women with high hepatitis B virus DNA levels

Hepatitis B is a major health concern in the Asia-Pacific region, and is endemic in China, Southeast Asia, and Africa. Chronic hepatitis B virus (HBV) infection may cause hepatic cirrhosis and liver cancer. It is estimated that there are more than 350 million chronic HBV carriers worldwide, of whom approximately one quarter will die of chronic hepatitis B-related liver diseases. HBV is transmitted horizontally through blood and blood products or by sexual transmission, and vertically from mother to infant. Perinatal infection is the predominant mode of transmission in countries with a high prevalence of hepatitis B surface antigen (HBsAg) carriage, and perinatal transmission leads to high rates of chronic infection. Therefore, it is important to prevent the mother-to-child transmission (MTCT) of HBV. Research has shown that pregnant women with high HBV DNA levels have an increased risk of MTCT. However, most of the obstetrics guidelines do not make a distinction between pregnant women with high HBV DNA levels and those who are HBsAg positive only. This review addresses the management of pregnant women with high levels of HBV viremia, in terms of antiviral therapy, use of hepatitis B immunoglobulin (HBIG), the combined application of hepatitis B vaccine and HBIG, choice of delivery mode and feeding practices. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Thermal stratification level of low sidewall air supply with air-conditioning system in large space

The thermal stratification level of low sidewall air supply system in large space was defined. Depending on the experiment of low sidewall air supply in summer 2008,the thermal stratification level was studied by simulation. Based on the simulation of experiment condition,the air velocity and vertical temperature distribution in a large space were simulated at different air-outlet velocities,and then the thermal stratification level line was obtained. The simulation results well match with the experimental ones and the average relative error is 3.4%. The thermal stratification level is heightened by increasing the air-outlet velocity with low sidewall air supply mode. It is concluded that when air-outlet velocity is 0.29 m/s,which is the experimental case,a uniform thermal environment in the higher occupied zone and a stable stratification level are formed. When the air-outlet velocity is low,such as 0.05 m/s,the thermal stratification level is too low and the air velocity is too small to meet the human thermal comfort in the occupied zone. So,it would be reasonable that the air-outlet velocity may be designed as 0.31 m/s if the height of the occupied zone is 2 m.

The effects of high temperature level on square Bt protein concen-tration of Bt cotton

Higher boll worm survival rates were detected after high temperature presented during square period in Bt cotton. The objective of this study was to investigate the effects of high temperature level on the Bt efficacy of two different types of Bt cotton cultivars at squaring stage. During the 2011 to 2013 cotton growth seasons, high temperature treatments ranged from 34 to 44°C in climate chambers, and field experiments under high temperature weather with various temperature levels were conducted to investigate the effects of the high temperature level on square Bt protein concentration and nitrogen metabolism. The climate chamber experiments showed that the square insecticidal protein contents reduced after 24 h elevated temperature treatments for both cultivars, whereas significant declines of the square insecticidal protein contents were detected at temperature 〉38°C, and only slightly numerical reductions were observed when temperature below 38°C. Similar high temperature responses were also observed at the two field experimental sites in 2013. Correspondingly, high temperature below 38°C seems have little effect on the square amino acid concentrations, soluble protein contents, glutamic-pyruvic transaminase（GPT） and glutamic-oxalacetic transaminase（GOT） activities as well as protease and peptidase activities; however, when the temperature was above 38°C, reduced soluble protein contents, enhanced amino acid concentrations, decreased GPT and GOT activities, bolstered protease and peptidase activities in square were detected. In general, the higher the temperature is（〉38°C）, the larger the changes for the above compound contents and key enzymes activities of the square protein cycle. The findings indicated that the unstable insect resistance of the square was related to high temperature level during square stage.

High level architecture evolved modular federation object model

To improve the agility, dynamics, composability, reusability, and development efficiency restricted by monolithic federation object model （FOM）, a modular FOM is proposed by high level architecture （HLA） evolved product development group. This paper reviews the state-of-the-art of HLA evolved modular FOM. In particular, related concepts, the overall impact on HLA standards, extension principles, and merging processes are discussed. Also permitted and restricted combinations, and merging rules are provided, and the influence on HLA interface specification is given. The comparison between modular FOM and base object model （BOM） is performed to illustrate the importance of their combination. The applications of modular FOM are summarized. Finally, the significance to facilitate compoable simulation both in academia and practice is presented and future directions are pointed out.

System-on-Chip Design Using High-Level Synthesis Tools

This paper addresses the challenges of System-on-Chip designs using High-Level Synthesis (HLS). HLS tools convert algorithms designed in C into hardware modules. This approach is a practical choice for developing complex applications. Nevertheless, certain hardware considerations are required when writing C applications for HLS tools. Hence, in order to demonstrate the fundamental hardware design concepts, a case studyis presented. Fast Fourier Transform (FFT) implementation in ANSI C is examined in order to explore the important design issues such as concurrency, data recurrences and memory accesses that need to be resolved before generating the hardware using HLS tools. There are additional language constraints that need to be addressed including use of pointers, recursion and floating point types.

Effects of low level laser treatment on the survival of axotomized retinal ganglion cells in adult Hamsters

Injury to axons close to the neuronal bodies in the mammalian central nervous system causes a large proportion of parenting neurons to degenerate. It is known that optic nerve transection close to the eye in rodents leads to a loss of about half of retinal ganglion cells in 1 week and about 90% in 2 weeks. Using low level laser treatment in the present study, we demonstrated that treatment with helium-neon （660 nm） laser with 15 mW power could delay retinal ganglion cell death after optic nerve axotomy in adult hamsters. The effect was most apparent in the ifrst week with a short period of treatment time （5 minutes） in which 65–66% of retinal ganglion cells survived the optic nerve axotomy whereas 45–47% of retinal ganglion cells did so in optic nerve axotomy controls. We also found that single dose and early commencement of laser irradiation were important in protecting retinal ganglion cells following optic nerve axotomy. These ifndings thus convincingly show that appropriate laser treatment may be neuroprotective to retinal gan-glion cells.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study

Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.