Overall adherence in hemodialysis patients and associated factors: A cross-sectional study from Morocco.

INTRODUCTION: Hemodialysis patients' adherence to hemodialysis sessions, medication, diet and, fluid restriction is an essential condition to ensure effective treatment. Therefore, this study aimed to assess the overall adherence of hemodialysis patients in the Marrakech-Safi region of Morocco. METHODS: A quantitative cross-sectional study of hemodialysis patients at the Safi, Youssoufia and Ibn Tofail public hemodialysis centers was conducted in the last trimester of 2023 using a questionnaire (ESRD-AQ), which was completed by analyzing patient records and interviewing patients during the hemodialysis session. RESULTS: A total of 199 patients were included in this study. Women accounted for 53.3% of patients, 73.9% were under 65 years, 55.8% had been on hemodialysis for more than 5 years, and 62.8% had an Inter-dialytic-weight (IDW) ≥ 2.5 kg. Mean scores for adherence to hemodialysis, medication, diet and fluid restriction were 534.92 ± 98.71 out of 600, 113.32 ± 50.86 out of 200, 75.38 ± 42.00 out of 200 and 52.51 ± 53.59 out of 200, respectively. Regarding overall adherence, 24.1% had low adherence, 63.8% had moderate adherence, and 12.1% had good adherence, with a mean score of 793.99 ± 151.28 out of 1200. Our results showed that male gender (p = 0.010, ORa = 5.61), young age (p = 0.004, ORa = 8.48), and short duration on hemodialysis (p = 0.001, ORa = 23.91) were risk factors for low overall adherence. CONCLUSION: Our results justify the increased need for educational programs aimed at improving the overall adherence of hemodialysis patients.

Crystal structure of the tetra-aqua-bis-(thio-cyanato-κN)cobalt(II)-caffeine-water (1/2/4) co-crystal.

In the structure of the title compound [systematic name: tetra-aqua-bis-(thio-cyanato-κN)cobalt(II)-1,3,7-trimethyl-1,2,3,6-tetra-hydro-7H-purine-2,6-dione-water (1/2/4)], [Co(NCS)2(H2O)4]·2C8H10N4O2·4H2O, the cobalt(II) cation lies on an inversion centre and is coordinated in a slightly distorted octa-hedral geometry by the oxygen atoms of four water mol-ecules and two N atoms of two trans-arranged thio-cyanate anions. In the crystal, the complex mol-ecules inter-act with the caffeine mol-ecules through O-H⋯N, O-H⋯O and C-H⋯S hydrogen bonds and π-π inter-actions [centroid-to-centroid distance = 3.4715 (5) Å], forming layers parallel to the ab plane, which are further connected into a three-dimensional network by O-H⋯O and O-H⋯S hydrogen bonds involving the non-coordinating water mol-ecules.

Virulence Diversity of the Common Bean Rust Pathogen Within and Among Individual Bean Fields and Development of Sampling Strategies.

There is a dearth of information on pathogen variation within an individual field. In this study, virulence diversity of Uromyces appendiculatus, cause of bean rust, within individual fields was investigated. From six bean fields in the United States, Honduras, Dominican Republic, and South Africa, 380 U. appendiculatus isolates were differentiated into 65 virulence phenotypes on bean lines containing Andean- and Middle American-derived rust resistance genes. Race variation among bean rust isolates from different geographic regions was found, and virulence phenotypes found in fields from tropical and subtropical regions were more virulent and diverse than those found in fields from temperate regions. The variance components between fields was greater than the variance within a field based on mean disease score on 12 differentials but the variance components within a field were greater than the variances between fields based on number of virulence phenotypes. This is the first report that multiple site samples are needed to represent the fungal virulence diversity in a diseased field. In developing sampling plans, the entire cost of sampling one field is higher than the cost of taking more samples; therefore, to estimate virulence diversity variation, we recommend selecting fewer fields and collecting more samples per field.