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BACKGROUND: Social determinants of health play a fundamental role in a patient's health status. In recent years, health systems across the nation have implemented numerous strategies aimed at identifying and addressing the health-related social needs of the patients they serve. Despite the influx of peer-reviewed research highlighting outcomes of specific health-related social needs interventions, the spectrum of practices utilized by primary care clinics has not been established. OBJECTIVE: To determine the range of ways primary care clinics address health-related social needs after identification and initial contact with a frontline staff person is completed. DESIGN: We conducted 12 semi-structured, in-person interviews with staff from purposively sampled clinics. If the interview included more than one staff person, all participants were interviewed together. PARTICIPANTS: Twenty-one administrative staff and frontline clinic personnel with experience in 24 separate primary care clinics in the Minneapolis-St. Paul, Minnesota metropolitan area. APPROACH: Interviews focused on the range of health-related social needs processes utilized by clinics, including staff titles, referral procedures, and barriers to addressing needs. Interview recordings were transcribed and coded using thematic analysis. KEY RESULTS: Thematic analysis identified variation in four key areas involving how clinics address patients' health-related social needs after identification and initial contact by frontline staff: clinic personnel involved in addressing needs, clinic referral processes, "resource" and "success" definitions, and barriers to accessing community-based supports. CONCLUSIONS: This study describes the large variation in primary care clinic practices to address health-related social needs after they are identified. The results suggest challenges to standardization and real-world application of previously published studies. Our findings also highlight the opportunity for improved relationships between health systems and community-based agencies.
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Instituciones de Atención Ambulatoria , Derivación y Consulta , Humanos , Minnesota/epidemiología , Atención Primaria de Salud , Investigación CualitativaRESUMEN
Recent activities in the oil and gas industry have shown an increasing need for monitoring engagements, such as in shipping, logistics, exploration, drilling, or production. Hence, there is a need to have asset management of these offshore assets (or facilities). Much of the offshore infrastructure is currently approaching or past its operational life expectancy. The study presents an overview on asset management of offshore facilities towards monitoring, safe practices, maintenance, and sustainability. This study outlines the major considerations and the steps to take when evaluating asset life extensions for an aging offshore structure (or asset). The design and construction of offshore structures require some materials that are used to make the structural units, such as offshore platform rigs, ships, and boats. Maintaining existing assets in the field and developing new platforms that are capable of extracting future oil and gas resources are the two key issues facing the offshore sector. This paper also discusses fault diagnosis using sensors in the offshore facilities. The ocean environment is constantly corrosive, and the production activities demand extremely high levels of safety and reliability. Due to the limited space and remote location of most offshore operations, producing cost-effective, efficient, and long-lasting equipment necessitates a high level of competence. This paper presents the guidelines on asset monitoring, sustainable maintenance, and safety practices for offshore structures. In this study, the management of offshore structures were also presented with some discussions on fault monitoring using sensors. It also proposes sustainable asset management approaches as guidelines that are advised, with policy implications.
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Cáusticos , Industrias , Reproducibilidad de los Resultados , NavíosRESUMEN
Exploiting spontaneous polarization of ferroelectric materials to achieve high charge separation efficiency is an intriguing but challenging research topic in solar energy conversion. This work shows that loading high work function RuO2 cocatalyst on BiFeO3 (BFO) nanoparticles enhances the intrinsic ferroelectric polarization by efficient screening of charges to RuO2 via RuO2 /BFO heterojunction. This leads to enhancement of the surface photovoltage of RuO2 /BFO single nanoparticles nearly 3 times, the driving force for charge separation and transfer in photocatalytic reactions. Consequently, efficient photocatalytic water oxidation is achieved with quantum efficiency as high as 5.36 % at 560 nm, the highest activity reported so far for ferroelectric materials. This work demonstrates that, unlike low photocurrent density in film-based ferroelectric devices, high photocatalytic activity could be achieved by regulating the ferroelectric spontaneous polarization using appropriate cocatalyst to enhance driving force for efficient separation and transfer of photogenerated charges in particulate ferroelectric semiconductor materials.
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miR-122 and miR-192 were investigated as indicators of toxic liver injury caused by acetaminophen, but their role in idiosyncratic toxic liver injury remains controversial. So, this work aimed to assess and compare the expressions of miR-122 and miR-192 in two different types of toxic liver injury (intrinsic [acetaminophen] and idiosyncratic [diclofenac]). Forty male adult Wistar albino rats were divided into equal five groups, in which serum liver enzymes; microRNAs (miRNAs) expressions (miR-122 and miR-192) and histopathological findings were studied. The present study showed that (1) miR-122 and miR-192 are good serum biomarkers of toxic liver injury whatever its etiology, as their serum levels exhibited a significantly earlier increase and earlier return to normal baseline levels as compared to serum aminotransferase levels; (2) miR-122 is more specific than miR-192; and (3) both serum levels of miR-122 and miR-192 showed non-significant differences in relation to the type of toxic liver injury.
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Enfermedad Hepática Inducida por Sustancias y Drogas/sangre , MicroARNs/sangre , Acetaminofén/efectos adversos , Acetaminofén/farmacología , Animales , Biomarcadores/sangre , Masculino , Ratas , Ratas WistarRESUMEN
Ramadan is the Islamic holy month of fasting and practiced by all adult Muslims all over the world at the same time simultaneously. Although people who are ill or diabetics with coronary heart disease are exempted from fasting, they still desire to fast and this is a challenge to themselves and the treating physician. We performed a systematic review of the available Medline English literature on the subject from January 1982 to December 2014 so as to help guide physicians in managing these patients. The results revealed that although the metabolic parameters change during Ramadan fasting, but this does not lead to any significant increase in the incidence of acute coronary events. Most adults with stable coronary artery disease can fast without significant complications, but those with unstable disease or recent or pending revascularization procedures should generally refrain from fasting. Regular monitoring by the physician is mandatory along with adjustment of the dosages.
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Structural features like 3D nano-size, ultrathin thickness and amorphous/crystalline interfaces play crucial roles in regulating charge separation and active sites of photocatalysts. However, their co-occurrence in a single catalyst and exploitation in photocatalytic CO2 reduction (PCR) remains challenging. Herein, nano-sized bismuth oxychloride spheres (BiOCl-NS) confining three-layered nanoplates (â¼2.2 nm ultrathin) and an amorphous/crystalline interface are exclusively developed via intrinsic engineering for an enhanced sacrificial-reagent-free PCR system. The results uncover a unique synergism wherein the three-layered nanoplates accelerate electron-hole separation, and the amorphous/crystalline interface exposes electron-localized active sites (Bi-Ovac-Bi). Consequently, BiOCl-NS exhibit efficient CO2 adsorption and activation with the lowering of rate-determining-step energy barriers, leading to remarkable CO production (102.72 µmol g-1 h-1) with high selectivity (>99%), stability (>30 h), and apparent quantum efficiency (0.51%), outperforming conventional counterparts. Our work provides a facile structural engineering approach for boosting PCR and offers distinct synergism for advancing diverse materials.
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ABSTRACTWhile telemedicine has shown promise for diagnosis and treatment, its integration into specialised clinics and mainstream healthcare is slow. A study at Sultan Qaboos University Hospital, Oman, investigated parental perceptions of virtual clinics and telemedicine experiences among parents of children with neurodevelopmental disorders (NDD) conducted from January 2021 to January 2022; the cross-sectional study involved 130 participants. The study revealed that 70% of participants were male, and the mean age of the children was 6.1 ± 0.26 years. Regarding telemedicine awareness, 53% of respondents were informed, yet encountered obstacles such as poor internet service and lack of awareness. Despite challenges, 46% of respondents viewed telemedicine positively. Parents showed significant differences in their perception of virtual interviews based on interview purpose (P = 0.034), clinic type (P < 0.001), internet service quality (P = 0.029), timing conflicts (P = 0.001), lack of technology experience (P = 0.041), and awareness gaps (P = 0.012). Our study identified challenges for parents of children with NDD in utilising telehealth, primarily stemming from limited awareness and internet connectivity issues. To enhance telemedicine quality, we suggest improving internet infrastructure and promoting telemedicine awareness. Further research is needed to optimise telemedicine implementation for both diagnosis and intervention in children with NDD.
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Trastornos del Neurodesarrollo , Padres , Telemedicina , Humanos , Omán , Masculino , Femenino , Padres/psicología , Niño , Estudios Transversales , Centros de Atención Terciaria , Adulto , Preescolar , Encuestas y CuestionariosRESUMEN
This research study is performed on the self-compacting geopolymer concrete (SCGC) combining coal bottom ash (CBA) and metakaolin (MK) as a substitution for GGBFS alone and combined for analysing the fresh properties (slump flow, V-Funnel, and T50 flow), mechanical characteristics (compressive, splitting tensile and flexural strengths) and durability tests (permeability and sulfate attack test). Though, total 195 SCGC samples were made and tested for 28 days. It has been revealed that the consumption of CBA and MK as a substitution for GGBFS alone and combine in the production of SCGC is decreased the workability of SCGC while mechanical characteristics of SCGC are enhanced by utilizing CBA and MK as a substitution for GGBFS alone and combine up to 10%. In addition, the compressive, splitting tensile and flexural strengths were calculated by 59.40 MPa, 5.68 MPa, and 6.12 MPa while using the 5CBA5MK as a substitution for GGBFS in the production of SCGC after 28 days correspondingly. Furthermore, the permeability is decreased by growing the quantity of CBA and MK by the weight of GGBFS alone and jointly in the production of SCGC after 28 days. Besides, the minimum change in length of the SCGC specimen is recorded by 0.062 mm at 7.5MK7.5CBA while the maximum change in length is calculated by 0.11 mm at 10CBA10MK as a substitution for GGBFS at 180 days correspondingly. In addition, the embodied carbon is recorded reduce as the addition of CBA while it is getting higher when the accumulation of MK alone or combined with CBA in SCGC. Besides, response models for prediction were constructed and confirmed using ANOVA at an accuracy rate of 95%. The models' R2 fluctuated from 88 to 99%. It has been observed that the utilization of CBA and MK alone and together up to 10% as substitution for GGBFS in geopolymer concrete provides the best results therefore it is suggested for structural applications.
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We present an extremely rare case of HughesâStovin syndrome, of which we believe <60 cases have been reported in English medical literature. We wish to draw the attention of our fellow cardiologists to consider this when coming across patients with pulmonary artery aneurysm in their clinical practice. Appropriate treatment, if instituted promptly and early in the course of the disease, has the potential to induce remission.
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All-inorganic lead-free halide double perovskites have emerged as rising star photocatalysts to substitute the toxic lead-based hailed perovskites (LHPs) owing to their unique photophysical properties. Nevertheless, their photocatalytic activities toward CO2 reduction are still far from comparable with the LHPs, associated with severe charge recombination and sluggish surface catalytic reaction. Herein, a delicate 0D/2D heterojunction of Cs2AgBiBr6/Bi2WO6 (CABB/BWO) was assembled by in-situ growing cubic CABB nanocrystals on the flat surface of BWO nanosheets via a facile hot-injection method. Density functional theory (DFT) calculations disclose that the work function and Fermi level difference between CABB and BWO give rise to charge redistribution at the interface upon the formation of the heterojunction, creating an internal electric field (IEF). Upon light irradiation, the IEF enables the photogenerated electron transfer from BWO to CABB via direct Z-scheme electron transfer mode with striking spatial charge separation as verified by in-situ X-ray photoelectron (XPS) and electron spin resonance (ESR) spectra. Consequently, the CABB/BWO heterojunction realizes 7-fold higher photocatalytic activity than pristine CABB with significant electron consumption rate of 87.66 µmol g-1h-1 under simulated solar light (AM 1.5G).
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Introduction: Pulmonary hypertension (PH) is characterized by pulmonary vascular remodeling, right heart failure, and reduced survival. PH can be PH without left ventricular (LV) dysfunction - pulmonary arterial hypertension (PAH) - (Dana point Class I) and PH with LV dysfunction - pulmonary venous hypertension (PVH) - (Dana point Class II). Whatever the underlying cardiac disease, the presence of PH in patients with heart failure is associated with poor prognosis. Right ventricular dysfunction by ventricular interdependence can cause LV dysfunction. Objective: We aim to provide a distinction between PAH and PVH by echocardiography. Methods: Retrospective cross-sectional single-center data of 1075 subjects having PH as defined by echocardiography was collected. These were segregated into mild, moderate, and severe categories. The same cohort of PH subjects was also segregated by E/e' derived pulmonary capillary wedge pressure (PCWP) values. Echocardiographic measurements and effort tolerance in Mets were analyzed. Data for 707 normal subjects were taken from an earlier published study on normative echocardiographic measurements of healthy Indians. Results: Our findings show that PAH and PVH can be distinguished using PCWP value >15 mmHg obtained by applying Nagueh's formulaon E/e'. Conclusion: We recommend that PCWP derived from E/e' should be reported with pulmonary artery systolic pressure measurement to distinguish between PAH and PVH.
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This study aimed to systematically assess the impact of clinical and demographic variables on the diagnostic yield of Whole Exome Sequencing (WES) when applied to children with Autism Spectrum Disorder (ASD) from a consanguineous population. Ninety-seven children were included in the analysis, 63% were male and 37% were females. 77.3% had a suspected syndromic aetiology of which 68% had co-existent central nervous system (CNS) clinical features, while 69% had other systems involved. The diagnostic yield of WES in our cohort with ASD was 34%. Children with seizures were more likely to have positive WES results (46% vs. 31%, p = 0.042). Probands with suspected syndromic ASD aetiology showed no significant differential impact on the diagnostic yield of WES.
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Dye-sensitized system holds great potential for the development of visible-light-responsive photocatalysts not only because it can enhance the light absorption and charge separation efficiency of the systems but also because it can tune the band structure of catalysts. Herein, two-dimensional (2D) Fe-MOF nanosheets (Fe-MNS) with a LUMO potential of 0.11 V (vs. RHE) was prepared. Interestingly, it has been found that when the 2D Fe-MNS catalyst was functionalized with visible-light-responsive [Ru(bpy)]32+ as a dye-sensitizer, the electrons from the [Ru(bpy)]32+ can effectively inject into the 2D Fe-MNS, which resulted in a negative shift of the LUMO potential of the 2D Fe-MNS to -0.15 V (vs. RHE). Consequently, the [Ru(bpy)]32+/Fe-MNS catalytic system exhibits a sound photocatalytic CO2-to-CO activity of 1120 µmol g-1h-1 under visible-light-irradiation. The photocatalytic CO production was further ameliorated by regulating the electronic structure of the 2D Fe-MNS by doping Co ions, achieving a remarkable photocatalytic activity of 1637 µmol g-1h-1. This work further supports that the dye-sensitized system is an auspicious strategy worth exploring with different catalysts for the development of visible-light-responsive photocatalytic systems.
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This study aims to detect an association between potential maternal predictors and neonatal anthropometry in Oman. A retrospective cross-sectional study was conducted in Sultan Qaboos University Hospital, Oman, between November 2014 and November 2015. The study included all term healthy Omani neonate-mother pairs. Summary descriptive statistics of neonatal (N) weight (Wt), length (L), head circumference (HC), and potential maternal (M) characteristics were collected. Multiple linear regression analysis was used to assess associations between maternal predictors and neonatal anthropometry. The study cohort identified 2,783 eligible pairs. The data showed that parity, maternal weight (MWt), and height (MHt) explained a significant amount of the variance in birth weight (F-ratio = 115.4, p-value < 0.001, and R 2 adjusted = 0.12). MWt and MHt were significant predictors of length (F-ratio = 65.3, p-value < 0.001, and R 2 adjusted = 0.048). The predictors of HC were MWt, MHt, and parity (F-ratio = 53.1, p-value < 0.001, and R 2 adjusted = 0.57). Primiparous mothers were 2.2 times at greater risk of delivering low birth weight (LBW) newborns. There were no significant differences in anthropometric outcomes between consanguineous and nonconsanguineous groups. Maternal weight and height had significant positive associations with the three newborn anthropometric outcomes. Additionally, primiparity was associated with the increased risk of LBW. Consanguinity was not associated with LBW in term Omani neonates.
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The prevalence of autism in the Arabian Gulf region is on the rise leading to overstretching of the pre-existing intervention services. The World Health Organization Caregiver Skills Training Program is a novel renovation being studied around the globe to overcome the scarcity of resources, improve autistic children's outcome and empower parents with comparable results to therapist-based models. Recently, Oman achieved great success in advocating for autism and initiated the first screening program for autism in the region. This review aims to use a Strength, Weakness, Opportunities and Threats (SWOT) analysis matrix to investigate the potential for using a parent-mediated intervention program as a supplementary approach to the currently used therapist-based intervention model in the country as an example for Gulf region.
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Developing near-infrared responsive (NIR) photocatalysts is very important for the development of solar-driven photocatalytic systems. Metal sulfide semiconductors have been extensively used as visible-light responsive photocatalysts for photocatalytic applications owing to their high chemical variety, narrow bandgap and suitable redox potentials, particularly the benchmark ZnIn2S4. However, their potential as NIR-responsive photocatalysts is yet to be reported. Herein, for the first time demonstrated that upconversion nanoparticles can be delicately coupled with hierarchical ZnIn2S4 nanorods (UCNPs/ZIS) to assemble a NIR-responsive composite photocatalyst, and as such composite is verified by ultraviolet-visible diffuse reflectance spectra and upconversion luminescence spectra. As a result, remarkable photocatalytic CO and CH4 production rates of 1500 and 220 nmol g-1h-1, respectively, were detected for the UCNPs/ZIS composite under NIR-light irradiation (λ ≥ 800 nm), which is rarely reported in the literature. The remarkable photocatalytic activity of the UCNPs/ZIS composite can be understood not only because the heterojunction between UCNPs and ZIS can promote the charge separation efficiency, but also the intimate interaction of UCNPs with hierarchical ZIS nanorods can enhance the energy transfer. This finding may open a new avenue to develop more NIR-responsive photocatalysts for various solar energy conversion applications.
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2,{2}',7,{7}'-Tetrakis(N,N-di-p-methoxyphenylamine)-9,{9}'-spiro-bi-fluorene(spiro-OMeTAD) has often been used as a hole-transporting material (HTM) in mesoscopic perovskite solar cells (PSCs). However, its potential applications are limited due to its poor conductivity of approximately 10-6 to 10-5 cm2 V s-1 in pristine form, and this influences the stability and intrinsic hole conductivity of the device. In this work, a Mn complex [(Mn(Me-tpen)(ClO4)2 -)]2+ is introduced as a p-dopant to improve the properties of spiro-OMeTAD-based PSCs, including the optical, electrical, conductivity, and stability properties. Interestingly, the use of spiro-OMeTAD with an optimum concentration (1.0% w/w) of Mn complex in mesoscopic PSCs achieves a remarkable power conversion efficiency of 17.62% with a high conductivity of 99.05%. Spiro-OMeTAD with Mn complex as a p-dopant under UV-vis spectroscopy shows a different peak at 520 nm, confirming that oxidation occurs upon the addition of the Mn complex. The enhanced efficiency of the PSCs may be attributed to an increase in the optical and electrical properties of the HTM in the spiro-OMeTAD doped Mn complex.
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OBJECTIVES: This study aimed at evaluating advanced parental age as a risk factor for autism spectrum disorder (ASD) in an Omani cohort. METHODS: This case-control study compared 278 ASD cases with 722 gender-matched controls, retrieved from the electronic records of the Developmental Paediatric Clinic, Sultan Qaboos University Hospital, Muscat, Oman, between January 2015 and June 2016. RESULTS: Most ASD cases were male (76.6%) and mostly diagnosed between 3-4 years of age, with more than 50% of the cases originating from Muscat and Batinah governorates. Compared to controls, mothers from the case group had significantly higher educational levels (post-secondary education versus high school/no formal education: odds ratio [OR] = 1.62, 95% confidence interval [CI]: 1.197-2.192). In a multivariate logistic regression, the OR of maternal age as a risk for ASD increased dramatically with advancing age category (using age <25 as reference, OR = 3.39, 6.12, 7.86 and 13.13 for age categories 25-29, 30-34, 35-39 and ≥40 years, respectively). The ORs of advancing paternal age as a risk for ASD were also statistically significant (using age <30 as reference, OR = 2.20, 2.36 and 3.12 for age categories 30-34, 35-39 and 40-44 years, respectively); however, there was a drop in the effect with paternal age ≥45 years (OR = 1.42; 95% CI: 0.64-3.15). CONCLUSION: Both maternal and paternal increased age were associated with a higher risk of ASD; however, the association was more pronounced and more consistent with advanced maternal age compared to paternal age.
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Trastorno del Espectro Autista , Adulto , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/etiología , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Omán/epidemiología , Padres , Edad PaternaRESUMEN
OBJECTIVES: This study aimed to explore the intelligence quotient (IQ) profile among children with autism spectrum disorder (ASD) and identify the most important subscales that predict the IQ. The analysis of an intellectual profile with age and gender differentials and the identification of a battery of subscales of intelligence are important for clinical management of ASD among children and for facilitating placement for remedial and educational services. METHODS: Data were collected through an exploratory study of 100 children aged between three and 13 years, who were referred to the department of child health and development in Sultan Qaboos University Hospital, a tertiary hospital, in Oman between June 2016 and June 2019. RESULTS: Among the 100 participants of this study, 79% were male, resulting in a male-female ratio of 4:1. The mean of full-scale IQ was found to be 68.6 ± 18.1. Furthermore, the mean of nonverbal IQ (73.5 ± 17.5) was significantly higher than that of verbal IQ (65.5 ± 17.6). Finally, more than half (61%) of the children were observed to have had mild to moderate impairment in their IQ levels. CONCLUSIONS: Age and gender showed no significant association with IQ level. The regression analysis identified nonverbal fluid reasoning, nonverbal visual-spatial processing, nonverbal working memory and verbal knowledge as the significant predictors of total IQ. The crucial dimensions of verbal and nonverbal IQ identified in this study can be used to evaluate complicated cases.