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.

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。

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.

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.

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.

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.

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.

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.

Ustekinumab versus adalimumab for induction and maintenance therapy in biologic-naive patients with moderately to severely active Crohn's disease:a multicentre,randomised,double-blind,parallel-group,phase 3b trial

Background:Active-comparator trials are important to inform patient and physician choice.We aimed to evaluate the efficacy and safety of monotherapy with either ustekinumab or adalimumab in biologic-naive patients with moderately to severely active Crohn's disease.

Development of ZZC-1 ultrasonic testing system for centre bores of turbine rotors

General Great importance is being attached in the electric power in-dustry to the inspection of rotor shafts. This is because defects areusually concentrated at the central part of large forgings for makingrotors, some remnants of them may still remain after the centre borehas been drilled. Some rotors even have quite a number of defects atlocations rather remote from the centre bore. Working conditions for steam turbine rotors are very ex-

The Application of Layered Progressive Teaching Method in Nursing Teaching of Health Management Centre

Objective:To explore the clinical effect of the layered progressive teaching method in the process of nursing teaching in the health management centre.Methods:100 nursing students in the health management centre of our hospital were randomly divided into two groups from April 2018 to April 2019,in which students of the control group were treated with routine teaching,while those of the experimental group were treated with layered progressive teaching.Then,the teaching effect of the two groups was compared and analysed.Results:The assessment results of nursing students in the two groups were compared,in which the theoretical knowledge scores and practical operation scores of nursing students in the experimental group were(94.34±2.33)and(90.45±2.20)respectively.By contrast,the score of students in the control group was lower and the difference between the two groups was not significant(P<0.50).The teaching effect of students in the experimental group is more significant.Conclusion:During the process of nursing teaching in the Health Management Centre,the progressive teaching method showed a significant clinical effect and could effectively enhance students’scores.Therefore,it is positively significant for clinical development.

Hypersphere World-Universe Model: Centre of Our Galaxy

In 1937, Paul Dirac proposed: the Large Number Hypothesis and the Hypothesis of the variable gravitational “constant”;and later added the notion of continuous creation of Matter in the World. The developed Hypersphere World-Universe Model (WUM) follows these ideas, albeit introducing a different mechanism of matter creation. In this paper, we show that WUM is a natural continuation of Classical Physics, and it can already serve as a basis for a New Cosmology proposed by Paul Dirac. In 2013, WUM predicted the values of the following Cosmological parameters: gravitational, concentration of intergalactic plasma, and the minimum energy of photons, which were experimentally confirmed in 2015-2018. “The Discovery of a Supermassive Compact Object at the Centre of Our Galaxy” (Nobel Prize in Physics 2020) made by Prof. R. Genzel and A. Ghez is a confirmation of one of the most important predictions of WUM in 2013: “Macroobjects of the World have cores made up of the discussed DM particles. Other particles, including DM and baryonic matter, form shells surrounding the cores”.

ANALYSIS OF LOCATION CONDITIONS OF FINANCIAL CENTRES IN CHINA

First of all, the necessity of establishing financial centres is expounded. The establishment of financial centres has a lot of benefits to the world economic development, China’s economy and the occupied cities. The location conditions of financial centres may be summarized as follows: the location of trade centre, the factors of geographical position, the circumstances of finance, etc.. We consider that the first batch of financial centres in China should be established in the eastern cities of China. So 9 eastern cities in China are chosen as the spare financial centres. According to the location conditions of financial centres, 12 indices are chosen and the method of synthetic weighted average is used to find the best locations of financial centres. The conclusions are that the grade A financial centres should be in Shanghai and the grade B should be in Tianjin and Guangzhou.

Long-primed germinal centres with enduring affinity maturation and clonal migration

Germinal centres are the engines of antibody evolution. Here, using human immunodeficiency virus (HIV) Env protein immunogen priming in rhesus monkeys followed by a long period without further immunization, we demonstrate germinal centre B (BGC) cells that last for at least 6 months. A 186-fold increase in BGC cells was present by week 10 compared with conventional immunization. Single-cell transcriptional profiling showed that both light- and dark-zone germinal centre states were sustained. Antibody somatic hypermutation of BGC cells continued to accumulate throughout the 29-week priming period, with evidence of selective pressure. Env-binding BGC cells were still 49-fold above baseline at 29 weeks, which suggests that they could remain active for even longer periods of time. High titres of HIV-neutralizing antibodies were generated after a single booster immunization. Fully glycosylated HIV trimer protein is a complex antigen, posing considerable immunodominance challenges for B cells1,2. Memory B cells generated under these long priming conditions had higher levels of antibody somatic hypermutation, and both memory B cells and antibodies were more likely to recognize non-immunodominant epitopes. Numerous BGC cell lineage phylogenies spanning more than the 6-month germinal centre period were identified, demonstrating continuous germinal centre activity and selection for at least 191 days with no further antigen exposure. A long-prime, slow-delivery (12 days) immunization approach holds promise for difficult vaccine targets and suggests that patience can have great value for tuning of germinal centres to maximize antibody responses.

Dynamic Automated Infrastructure for Efficient Cloud Data Centre

We propose a dynamic automated infrastructure model for the cloud data centre which is aimed as an efficient service stipulation for the enormous number of users.The data center and cloud computing technologies have been at the moment rendering attention to major research and development efforts by companies,governments,and academic and other research institutions.In that,the difficult task is to facilitate the infrastructure to construct the information available to application-driven services and make business-smart decisions.On the other hand,the challenges that remain are the provision of dynamic infrastructure for applications and information anywhere.Further,developing technologies to handle private cloud computing infrastructure and operations in a completely automated and secure way has been critical.As a result,the focus of this article is on service and infrastructure life cycle management.We also show how cloud users interact with the cloud,how they request services from the cloud,how they select cloud strategies to deliver the desired service,and how they analyze their cloud consumption.