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Amphiphilic Janus silica particles, tunable with oleophobic-oleophilic properties and low fluorine content (8 wt % F), exhibited prominent foamability for a variety of aromatic alcohols at low particle concentrations (<1 wt %) compared to randomly functionalized silica particles. When selectively loaded with Pd nanoparticles on the oleophilic hemisphere, the particles displayed more than a 2-fold increase in catalytic activity for the aerobic oxidation of benzyl alcohol compared to nonfoam bulk catalysis under ambient O2 pressure. The particles were conveniently recycled with high foamability and catalytic activity maintained for at least five consecutive runs.
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Paediatric sleep diagnostics is performed using complex multichannel tests in specialised centres, limiting access and availability and resulting in delayed diagnosis and management. Such investigations are often challenging due to patient size (prematurity), tolerability, and compliance with "gold standard" equipment. Children with sensory/behavioural issues, at increased risk of sleep disordered breathing (SDB), often find standard diagnostic equipment difficult.SDB can have implications for a child both in terms of physical health and neurocognitive development. Potential sequelae of untreated SDB includes failure to thrive, cardiopulmonary disease, impaired learning and behavioural issues. Prompt and accurate diagnosis of SDB is important to facilitate early intervention and improve outcomes.The current gold-standard diagnostic test for SDB is polysomnography (PSG), which is expensive, requiring the interpretation of a highly specialised physiologist. PSG is not feasible in low-income countries or outwith specialist sleep centres. During the coronavirus disease 2019 pandemic, efforts were made to improve remote monitoring and diagnostics in paediatric sleep medicine, resulting in a paradigm shift in SDB technology with a focus on automated diagnosis harnessing artificial intelligence (AI). AI enables interrogation of large datasets, setting the scene for an era of "sleep-omics", characterising the endotypic and phenotypic bedrock of SDB by drawing on genetic, lifestyle and demographic information. The National Institute for Health and Care Excellence recently announced a programme for the development of automated home-testing devices for SDB. Scorer-independent scalable diagnostic approaches for paediatric SDB have potential to improve diagnostic accuracy, accessibility and patient tolerability; reduce health inequalities; and yield downstream economic and environmental benefits.
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COVID-19 , Polisomnografía , Síndromes de la Apnea del Sueño , Sueño , Humanos , Niño , Síndromes de la Apnea del Sueño/diagnóstico , Síndromes de la Apnea del Sueño/terapia , Síndromes de la Apnea del Sueño/fisiopatología , COVID-19/diagnóstico , COVID-19/epidemiología , Preescolar , Valor Predictivo de las Pruebas , Inteligencia Artificial , Lactante , Pronóstico , Adolescente , SARS-CoV-2 , Factores de RiesgoRESUMEN
A detailed comparison of the capabilities of electron microscopy and nano-infrared (IR) microscopy for imaging microbial nanostructures has been carried out for the first time. The surface sensitivity, chemical specificity, and non-destructive nature of spectroscopic mapping is shown to offer significant advantages over transmission electron microscopy (TEM) for the study of biological samples. As well as yielding important topographical information, the distribution of amides, lipids, and carbohydrates across cross-sections of bacterial (Escherichia coli, Staphylococcus aureus) and fungal (Candida albicans) cells was demonstrated using PiFM. The unique information derived from this new mode of spectroscopic mapping of the surface chemistry and biology of microbial cell walls and membranes, may provide new insights into fungal/bacterial cell function as well as having potential use in determining mechanisms of antimicrobial resistance, especially those targeting the cell wall.
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Nanoestructuras , Microscopía de Fuerza Atómica , Nanoestructuras/química , Microscopía Electrónica de Transmisión , Candida albicans , Escherichia coli , Pruebas de Sensibilidad Microbiana , Antibacterianos/farmacologíaRESUMEN
BACKGROUND: In 2021, a survey was conducted as part of the regional program of the United Nations Population Fund (UNFPA) Regional Office for Eastern Europe and Central Asia (EECA) to assess the policies and practices relating to HPV vaccination and cervical cancer screening in the 17 countries and territories included in this region. Since then, very substantial progress has been made with HPV vaccination across the region so another survey was conducted establish the current situation. METHODS: A 10 question survey covering the policies, plans and practices for HPV vaccination was prepared. As cervical cancer prevention is a priority for the UNFPA, its offices in the 17 countries and territories included in this study are well placed to identify the people who can provide authoritative data for this survey. Working with the UNFPA offices, the questionnaires were sent to these national experts in May 2023, with data collected until 30 June 2023. All countries and territories returned completed questionnaires. RESULTS: In the period from 30 June 2021 to 30 June 2023, the number of countries and territories that have implemented or are implementing HPV vaccination programs has doubled. As of 30 June 2021, only 6 of 17 countries and territories had implemented national HPV vaccination programmes, and by 30 June 2023, another 6 could be added to this list. Of the 4 countries with sub-optimal vaccination coverage rates in 2021, none showed substantial improvement over the 2-year period. CONCLUSIONS: The implementation of HPV vaccination programs across the region is progressing very rapidly with ≈70% of the countries and territories implementing or having implemented national programs. However, greater attention needs to be given to ensuring that both the old and the new programs will achieve high coverage rates.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/diagnóstico , Detección Precoz del Cáncer , Asia/epidemiología , Políticas , Vacunación , Vacunas contra Papillomavirus/uso terapéuticoRESUMEN
The Declaration of Alma-Ata in 1978 and the subsequent Declaration of Astana in 2018 highlight the important role of primary health care in delivering 'health for all' and supporting progress towards universal health coverage. Alongside these key declarations, the United Nations' Sustainable Development Goals (SDGs) establish an ambitious framework aimed at promoting sustainable development worldwide by addressing poverty, inequality, climate change, health and other global challenges by 2030. There has been progress in respect of many SDGs since their launch in 2015. Nevertheless, many challenges remain, and there will need to be a significant increase in effort if the 2030 targets are to be met in full. Primary health care in Malaysia has evolved in line with broader, global developments. Nonetheless, there are opportunities for the country's primary care physicians to do more to support efforts to achieve the SDGs, including those that extend beyond the health sector as conventionally defined. This paper outlines a number of areas where primary care physicians, fulfilling roles as clinicians, community members, managers of their practices and influential members of society, can contribute to promoting sustainable development in line with the SDG agenda.
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Groundwater salinization is a problem affecting access to water in many world regions. Though desalination by conventional reverse osmosis (RO) can upgrade groundwater quality for drinking, its disadvantages include unmanaged brine discharge and accelerated groundwater depletion. Here, we propose a new approach combining RO, forward osmosis (FO), and halophyte cultivation, in which FO optimally adjusts the concentration of the RO reject brine for irrigation of Salicornia or Sarcocornia. The FO also re-uses wastewater, thus, reducing groundwater extraction and the wastewater effluent volume. To suit different groundwater salinities in the range 1-8 g/L, three practical designs are proposed and analyzed. Results include specific groundwater consumption (SGC), specific energy consumption (SEC), wastewater volume reduction, peak RO pressure, permeate water quality, efficiency of water resource utilization, and halophyte yield. Compared to conventional brackish water RO, the results show superior performance in almost all aspects. For example, SGC is reduced from 1.25 to 0.9 m3 per m3 of drinking water output and SEC is reduced from 0.79 to 0.70 kW h/m3 by a FO-RO-FO system treating groundwater of salinity 8 g/L. This system can produce 1.1 m3 of high-quality drinking water and up to 4.9 kg of edible halophyte per m3 of groundwater withdrawn.
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Agua Potable , Agua Subterránea , Purificación del Agua , Aguas Residuales , Plantas Tolerantes a la Sal , Purificación del Agua/métodos , Membranas ArtificialesRESUMEN
Despite the recent rise of RNA-seq datasets combining single-cell (sc) resolution with 4-thiouridine (4sU) labelling, analytical methods exploiting their power to dissect transcriptional bursting are lacking. Here, we present a mathematical model and Bayesian inference implementation to facilitate genome-wide joint parameter estimation and confidence quantification (R package: burstMCMC). We demonstrate that, unlike conventional scRNA-seq, 4sU scRNA-seq resolves temporal parameters and furthermore boosts inference of dimensionless parameters via a synergy between single-cell resolution and 4sU labelling. We apply our method to published 4sU scRNA-seq data and linked with ChIP-seq data, we uncover previously obscured associations between different parameters and histone modifications.
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Secuenciación de Inmunoprecipitación de Cromatina , Tiouridina , Teorema de Bayes , RNA-Seq , Coloración y EtiquetadoRESUMEN
BACKGROUND: To assess readiness to achieve the WHO Global Strategy targets for HPV vaccination and cervical screening and to guide capacity building, the current status of these services in 18 Eastern European and Central Asian countries, territories and entities (CTEs) was evaluated. METHODS: In order to assess the current status of HPV vaccination and cervical cancer screening in these 18 CTEs, a 30 question survey tool was developed, covering: national policies, strategies and plans for cervical cancer prevention; status of cancer registration; status of HPV vaccination; and current practices for cervical cancer screening and treatment of precancerous lesions. As cervical cancer prevention comes within the mandate of the United Nations Fund for Population Development (UNFPA), the UNFPA offices in the 18 CTEs have regular contact with national experts who are directly involved in cervical cancer prevention actions and are well placed to provide the data required for this survey. Working through the UNFPA offices, the questionnaires were sent to these national experts in April 2021, with data collected from April to July 2021. All CTEs returned completed questionnaires. RESULTS: Only Armenia, Georgia, Moldova, North Macedonia, Turkmenistan and Uzbekistan have implemented national HPV vaccination programmes, with only the last 2 of these reaching the WHO target of 90% of girls fully vaccinated by age 15, while rates in the other 4 range from 8%-40%. Cervical screening is available in all CTEs but only Belarus and Turkmenistan have reached the WHO target of 70% of women screened once by age 35 and again by age 45, while rates elsewhere range from 2%-66%. Only Albania and Turkey follow the WHO recommendation to use a high-performance screening test, while the majority use cervical cytology as the main screening test and Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan use visual inspection. No CTEs currently operate systems to coordinate, monitor and quality assure (QA) the entire cervical screening process. CONCLUSIONS: Cervical cancer prevention services in this region are very limited. Achieving the WHO Global Strategy targets by 2030 will require substantial investments in capacity building by international development organisations.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Adolescente , Adulto , Persona de Mediana Edad , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Detección Precoz del Cáncer , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/epidemiología , Europa Oriental/epidemiología , Tamizaje Masivo , Políticas , Asia/epidemiología , Vacunación , Vacunas contra Papillomavirus/uso terapéuticoRESUMEN
BACKGROUND: As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life. OBJECTIVE: Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting. METHODS: Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered. CONCLUSION: This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER: CRD42019140056.
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Síndrome de Down , Calidad de Vida , Adulto , Humanos , Ejercicio FísicoRESUMEN
InP quantum dots (QDs) are attracting significant interest as a potentially less toxic alternative to Cd-based QDs in many research areas. Although InP-based core/shell QDs with excellent photoluminescence properties have been reported so far, sophisticated interface treatment to eliminate defects is often necessary. Herein, using aminophosphine as a seeding source of phosphorus, we find that H2S can be efficiently generated from the reaction between a thiol and an alkylamine at high temperatures. Apart from general comprehension that H2S acts as a S precursor, it is revealed that with core etching by H2S, the interface between InP and ZnS can be reconstructed with S2- incorporation. Such a transition layer can reduce inherent defects at the interface, resulting in significant photoluminescence (PL) enhancement. Meanwhile, the size of the InP core could be further controlled by H2S etching, which offers a feasible process to obtain wide band gap InP-based QDs with blue emission.
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We investigate the effect of chlorides on the photocatalytic degradation of phenol by titania polymorphs (anatase and rutile). We demonstrate how solubilised chlorides can affect the hydroxyl radical formation on both polymorphs with an overall effect on their photodegradative activity. Initially, the photocatalytic activity of anatase and rutile for phenol degradation is investigated in both standard water and brines. With anatase, a significant reduction of the phenol conversion rate is observed (from a pseudo-first-order rate constant k = 5.3 × 10-3 min-1 to k = 3.5 × 10-3 min-1). In contrast, the presence of solubilised chlorides results in enhancement of rutile activity under the same reaction conditions (from 2.3 × 10-3 min-1 to 4.8 × 10-3 min-1). Periodic DFT methods are extensively employed and we show that after the generation of charge separation in the modelled titania systems, adsorbed chlorides are the preferential site for partial hole localisation, although small energy differences are computed between partially localised hole densities over adsorbed chloride or hydroxyl. Moreover, chlorides can reduce or inhibit the ability of r-TiO2 (110) and a-TiO2 (101) systems to localise polarons in the slab structure. These results indicate that both mechanisms - hole scavenging and the inhibition of hole localisation - can be the origin of the effect of chlorides on photocatalytic activity of both titania polymorphs. These results provide fundamental insight into the photocatalytic properties of titania polymorphs and elucidate the effect of adsorbed anions over radical formation and oxidative decomposition of organic pollutants.
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Siwa Oasis is of great historical, environmental, and scientific importance, as it contains unique archeological and geological features. Groundwater is the main source of freshwater in that oasis. The carbonate aquifer groundwater, used for irrigation, was sampled to evaluate factors controlling quality changes spatially and temporally by applying hydrochemical and statistical analyses. The salinity of the aquifer varied spatially from 1367 to 8645 mg/l based on one hydrogeological condition, with the highest TDS (> 5432.5 mg/l, 25% of samples) at the central part of the study area. Temporally, the salinity changed slightly from 3754.3 mg/l (in 2014) to 4222.4 mg/l (in 2020). The cession of illegal wells, pumping control, and excavation of formed salts have a noticeable impact on salinity (mediate the increase in salinity) and ions. However, about 61% of the studied samples can be considered unsuitable for irrigation owing to salinity and can harm plant yield. The heavy metals studied (Fe, Mn, Cu, Pb), except Cd, were within the permissible limit for irrigation water. Finally, it is proposed to construct desalination stations to enhance water quality for irrigation in the study area and set up many companies for salt extraction.
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Agua Subterránea , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Agua Subterránea/análisis , Calidad del Agua , Pozos de Agua , Salinidad , Contaminantes Químicos del Agua/análisisRESUMEN
Electroplating generates high volumes of rinse water that is contaminated with heavy metals. This study presents an approach for direct metal recovery and recycling from simulated rinse water, made up of an electroplating electrolyte used in industry, using reverse osmosis (RO). To simulate the real industrial application, the process was examined at various permeate fluxes, ranging from 3.75 to 30 L·m−2·h−1 and hydraulic pressures up to 80 bar. Although permeance decreased significantly with increasing water recovery, rejections of up to 93.8% for boric acid, >99.9% for chromium and 99.6% for sulfate were observed. The final RO retentate contained 8.40 g/L chromium and was directly used in Hull cell electroplating tests. It was possible to deposit cold-hued chromium layers under a wide range of relevant current densities, demonstrating the reusability of the concentrate of the rinsing water obtained by RO.
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Severe shortages of skilled health workforce remain a major barrier to universal health coverage in low income countries including Liberia where nurses and midwives form more than 50% of the health workforce. According to the 2018 Service Availability and Readiness Assessment (SARA) report, Liberia has 10.7 core healthcare workers per 10,000 people, far below the WHO benchmark of 23/10,000 people. High quality training for nurses and midwives is one of the most important strategies to addressing these health workforce shortages. Since 2015, William V.S Tubman University (TU) faculty and Partners in Health (PIH) have partnered in nursing and midwifery education to address nursing and midwifery workforce shortages in Southeast Liberia. In our collaboration we have sought to not only increase the quantity of graduate nurses and midwives but also improve the quality of the training to ensure they are equipped to serve the population. TU strives to produce highly competent generic nurses who will excel in their clinical practice and future specialized training. By applying the theory of deliberate practice, learners are allowed to practice and self-evaluate repeatedly until they attain proficiency. Simulation training was adopted early in the training of nurses and midwives at TU to ensure students are well-prepared for real-life patient care. TU also established a preceptorship program to ensure that students receive skilled mentorship during clinical rotations. Internship for graduating senior Nursing/Midwifery students, where they focus on enhancing psychomotor and assessment skills, professional communication, safety and organization, medication administration and documentation, ensures successful integration into clinical practice after graduation. This progression of the student nurse or midwife from the exposure in the skills lab during pre-clinical modules, to individual preceptorship during clinical rotations to a structured internship experience with an intensive pre-internship "boot camp" have been the major innovations that have helped our partnership flourish. The foundation of these interventions is strong and sustained investment in nursing and midwifery faculty both at the university and the health facilities.
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Partería , Estudiantes de Enfermería , Femenino , Fuerza Laboral en Salud , Humanos , Liberia , Preceptoría , EmbarazoRESUMEN
Due to the alarming speed of global warming, greenhouse gas removal from atmosphere will be absolutely necessary in the coming decades. Methane is the second most harmful greenhouse gas in the atmosphere. There is an emerging technology proposed to incorporating photocatalysis with solar updraft Towers (SUT) to remove methane from the air at a planetary scale. In this study, we present a deep analysis by calculating the potential of methane removal in relation to the dimensions and configuration of SUT using different photocatalysts. The analysis shows that the methane removal rate increases with the SUT dimensions and can be enhanced by changing the configuration design. More importantly, the low methane removal rate on conventional TiO2 photocatalyst can be significantly improved to, for example, 42.5% on a more effective Ag-doped ZnO photocatalyst in a 200 MW SUT while the photocatalytic reaction is the rate limiting step. The factors that may further affect the removal of methane, such as more efficient photocatalysts, night operation and reaction zone are discussed as possible solutions to further improve the system.