Implementing HbA1c monitoring in sub-Saharan Africa: Lessons learnt from a pilot project in Mozambique.

Aims: We aimed to evaluate lesson learnt from a pilot project in Mozambique focused on point-of-care (POC) HbA1c testing for diabetes management in primary health care facilities. Methods: Over a three-year period, several health centers were equipped with POC HbA1c testing machines. The evaluation involved 12 months of data collection, interviews with patients and staff, and regular supervision visits. Results: The project screened over 22,000 individuals and provided HbA1c testing to 2362 diabetes patients. Among the analyzed results, 65.7 % had HbA1c levels below 7 %, 10.9 % between 7 % and 8.5 %, and 23.4 % above 8.5 %. POC testing showed advantages such as reduced costs and improved workload management. Conclusions: Limited access to HbA1c testing remains a challenge in African countries. The pilot project demonstrated the feasibility of POC HbA1c testing and highlighted the need for increased efforts to make it more widely available, leading to improved diabetes management and patient outcomes.

Culture, heritage looting, and tourism: A text mining review approach.

Tourism scholars have been devoted to exploring the significance of cultural heritage in generating economic, environmental, and social values. However, limited efforts were found to verify potential threats that demolish these values such as looting issue in the global heritage tourism industry. Therefore, this study has reviewed extant publications to demonstrate the potential emerged textual clusters discussed by previous studies. It also summarized the network distribution of articles journals and authors' affiliations to capture the mobility and diversity with a focus on the business and tourism management field. Hence, the core clusters discovered were related to heritage destruction, public access, world heritage, human rights, cultural heritage preservation, and protection of cultural heritage in the event. The results have established theoretical insights and research agendas for future tourism studies, while it determined critical drawbacks in employing technology tools including virtual reality, augmented reality, and artificial intelligence for cultural heritage preservation/protection.

Use numbers not words! Communicating hotels' cleaning programs for COVID-19 from the brand perspective.

After hotels in many countries were forced to close in government-imposed lockdowns during the COVID-19 pandemic, there is an inherent need to communicate how they deal with the coronavirus to motivate guests to visit. However, lack of knowledge about how to persuasively communicate about hotels' cleaning programs for COVID-19 can challenge the industry's survival. We investigated how hotels that position their brand as a particular personality (sincere vs. exciting) could benefit from different communication styles (inclusion of numerical vs. verbal quantifiers) when presenting their COVID-19 cleaning procedures. Study 1 explored tourists' central attitudinal responses toward hotels' cleaning programs. Study 2 demonstrated that sincere hotel brands would benefit from using numerical and verbal quantifiers to communicate their cleaning policies, whereas exciting hotel brands would benefit only from numerical quantifiers. Our results invite hotel managers to use their brand personality positioning to influence tourists' attitudes and intentions in a pandemic context.

Smart Speaker Recommendations: Impact of Gender Congruence and Amount of Information on Users' Engagement and Choice.

The relevance of smart speakers is steadily increasing, allowing users perform several daily tasks. From a commercial perspective, smart speakers also provide recommendations of products and services that may influence the consumer decision-making process. However, previous studies have mainly focused on the adoption of smart speakers, but there is a lack of proper guidelines that help design the way these devices should offer their consumption recommendations. Based on a stimulus-organism-response approach, we analyze how two features of smart speakers' recommendations (the gender congruence between the customer and the speaker, and the length of the message) influence on the effectiveness of such recommendations (i.e., visiting intentions) through its impact on user engagement and attitude. Data was collected from a sample of undergrad students in Spain using an experiment design that focused on a restaurant recommendation, and analyzed using partial least squares. On the one hand, our results suggests that gender congruence generates user engagement with the smart speaker. On the other hand, message length is positively related to attitudes towards the restaurant, at a declining rate. In addition, while better attitudes lead to higher visiting intentions, the influence of engagement on visiting intentions is partially mediated via attitudes. Thus, our findings contribute to understand the antecedents of users' engagement with smart speakers, as well as its impact on the customers' willingness to follow smart speakers' recommendations, constituting a base to analyze the impact of artificial intelligence solutions aimed to smooth the transitions of a customer through the stages of purchase process.

A Rare Case of Cecal Bascule in a Child With Normal Neurodevelopment.

Cecal volvulus is a rare cause of bowel obstruction in adults and an extremely rare presentation in children. One form known as a cecal bascule has only previously been reported in children with neurodevelopmental issues or with severe chronic constipation. We present the case of a 10-year-old boy who presented with an acute history of left lower quadrant abdominal pain, who upon investigation was found to have a cecal bascule.

Normas de manejo da diabetes Mellitus e Hiperatenção arterial 1 edição / Guidelines for the Management of Diabetes Mellitus and Arterial Hypertension 1 edition

Em Moçambique, as doenças crónicas constituem importante causa de morbilidade, de mortalidade precoce e de incapacidade física, particularmente em pessoas em idade produtiva. Este facto contribui significativamente para a redução da produtividade e por conseguinte com impacto no desenvolvimento do país. Com o intuito de garantir medidas de prevenção, diagnóstico e tratamento precoces da Diabetes Mellitus e da Hipertensão Arterial nas unidades sanitárias, são elaboradas as presentes normas de tratamento destas doenças crónicas. Estas normas são dirigidas aos trabalhadores de saúde envolvidos no diagnóstico e tratamento da Diabetes e da Hipertensão em todas as unidades sanitárias e poderão ser de utilidade para médicos, estudantes dos cursos de Medicina, Técnicos e Agentes de Medicina. Sendo a DM e a HTA doenças crónicas e considerando o seu impacto na saúde global, todos os clínicos devem assumir uma postura de responsabilidade, cumprindo e fazendo cumprir rigorosamente estas normas para benefício da comunidade e da saúde pública no nosso País. Como qualquer documento normativo, as presentes normas não são um documento acabado, esperando-se por isso a contribuição de todos que as utilizem para a sua progressiva melhoria

Characterization of RanBPM molecular determinants that control its subcellular localization.

RanBPM/RanBP9 is a ubiquitous, nucleocytoplasmic protein that is part of an evolutionary conserved E3 ubiquitin ligase complex whose function and targets in mammals are still unknown. RanBPM itself has been implicated in various cellular processes that involve both nuclear and cytoplasmic functions. However, to date, little is known about how RanBPM subcellular localization is regulated. We have conducted a systematic analysis of RanBPM regions that control its subcellular localization using RanBPM shRNA cells to examine ectopic RanBPM mutant subcellular localization without interference from the endogenously expressed protein. We show that several domains and motifs regulate RanBPM nuclear and cytoplasmic localization. In particular, RanBPM comprises two motifs that can confer nuclear localization, one proline/glutamine-rich motif in the extreme N-terminus which has a dominant effect on RanBPM localization, and a second motif in the C-terminus which minimally contributes to RanBPM nuclear targeting. We also identified a nuclear export signal (NES) which mutation prevented RanBPM accumulation in the cytoplasm. Likewise, deletion of the central RanBPM conserved domains (SPRY and LisH/CTLH) resulted in the relocalization of RanBPM to the nucleus, suggesting that RanBPM cytoplasmic localization is also conferred by protein-protein interactions that promote its cytoplasmic retention. Indeed we found that in the cytoplasm, RanBPM partially colocalizes with microtubules and associates with α-tubulin. Finally, in the nucleus, a significant fraction of RanBPM is associated with chromatin. Altogether, these analyses reveal that RanBPM subcellular localization results from the combined effects of several elements that either confer direct transport through the nucleocytoplasmic transport machinery or regulate it indirectly, likely through interactions with other proteins and by intramolecular folding.

Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: a study within the Drug Resource Enhancement Against AIDS and Malnutrition Program.

BACKGROUND: The administration of antiretroviral therapy to lactating women could represent a possible strategy to reduce postnatal HIV transmission. In this study, we assessed the effect of antiretroviral treatment on breast milk viral load and determined plasma and breast milk drug concentrations in pregnant women receiving highly active antiretroviral therapy (HAART). METHODS: We studied 40 women receiving zidovudine, lamivudine, and nevirapine from 28 weeks of gestation to 1 month postpartum (group A) and 40 untreated pregnant women (group B). Blood and breast milk samples were collected at delivery and 7 days postpartum. RESULTS: Women in group A had received a median of 85 days of therapy before delivery. Median breast milk concentrations of nevirapine, lamivudine, and zidovudine were 0.6, 1.8, and 1.1 times, respectively, those in maternal plasma. HIV RNA levels in breast milk were significantly lower in group A than in group B (median of 2.3 vs. 3.4 log at delivery and 1.9 vs. 3.6 log at day 7; P < 0.001 for both comparisons). CONCLUSIONS: Antiretroviral drugs administered during the last trimester of pregnancy and after delivery reach levels similar to or higher than plasma concentrations in breast milk and can significantly reduce HIV RNA levels. Our data support the potential role of maternal HAART prophylaxis in reducing the risk of breast-feeding-associated transmission.

A sexualidade do ostomizado na visäo do parceiro: parte II / The ostomate's sexuality from his partner's view: part II

A condiçäo de ostomizado implica em mudanças no seu estilo de vida, daí a importância do processo reabilitatório ser implementado já na fase diagnóstica, visando o paciente como centro desse processo e como agente participante, incluindo neste contexto sua família, principalmente seu parceiro. O presente trabalho objetiva verificar o significado da sexualidade para o parceiro do ostomizado e verificar as mudanças e suas causas ocorridas na sexualidade do ostomizado, após a operaçäo de ostomia, na visäo do parceiro. Foram entrevistados 43 parceiros de portadores de estomas urinários e intestinais, sendo 21 mulheres e 22 homens, com idade média de 56 anos. Os resultados com relaçäo ao significado de sexualidade mostram igual porcentagem para as categorias relaçäo afetiva e ato sexual, correspondendo a 68,8 por cento das 61 respostas obtidas (34,4 por cento para cada uma); 70,5 por cento das 34 respostas para as mudanças ocorridas referem-se à ausência e diminuiçäo de relacionamento sexual e 62,1 das 37 respostas para as causas dessas mudanças relacionam-se às condiçöes psicológicas. Assim, podemos considerar que o parceiro do ostomizado pode estar hipertrofiando a afetividade para suprir a ausência de relacionamento sexual, constituindo um mecanismo compensatório para os distúrbios de auto-imagem e imagem corporal que afetam a sexualidade do ostomizado

Qualidade de vida sob a ótica de pessoas que apresentam lesäo medular / Life quality under the people's optics that they present lesion medualar

Diante da vivência em tratar de indivíduos que apresentam lesäo medular nos deparamos com a problemática envolvida no cotidiano dessas pessoas após uma situaçäo de trauma súbito e inesperado.Com a intençäo de prestar cuidados efetivos a estas pessoas nos preocupamos, neste estudo, em identificar a situaçäo pela qual elas estäo passando, se houve mudanças e quais foram elas, tanto em nível psíquico como físico e social. Para tanto, optou-se pela realizaçäo de uma entrevista individual semi-estruturada, utilizando-se o recurso da gravaçäo, o instrumento de coleta de dados consta de dados de identificaçäo e dados a respeito da vida do entrevistado. O discurso livre com gravaçäo e posterior transcriçäo caracteriza um estudo de caso de natureza, sobretudo exploratória...

A sexualidade do ostomizado na visäo do parceiro: parte I / The ostomate's sexuality from his partner's view: part I

A condiçäo de ostomizado implica em mudança no seu estilo de vida, daí a importância do processo reabilitatório ser implementado já na fase diagnóstica, visando o paciente como centro desse processo e como agente participante, incluindo neste contexto sua família, principalmente seu parceiro. O presente trabalho objetiva verificar o significado da sexualidade para o parceiro ostomizado e verificar as mudanças e suas causas ocorridas na sexualidade do ostomizado, após a operaçäo de ostomia, na visäo do parceiro. Foram entrevistados 43 parceiros de portadores de estomas urinários e intestináis, sendo 21 mulheres e 22 homens, com idade média de 56 anos. Os resultados com relaçäo ao significado de sexualidade mostram igual porcentagem para as categorias relaçäo afetiva e ato sexual, correspondendo a 68,8 por cento das 61 respostas obtidas (34,4 por cento para cada uma); 70,5 por cento das 34 respostas para as mudanças ocorridas referem-se à ausência e diminuiçäo de relacionamento sexual e 62,1 por cento das 37 respostas para as causas dessas mudanças, relacionam-se às condiçöes psicológicas. Assim podemos considerar que o parceiro do ostomizado pode estar hipertrofiando a afetividade para suprir a ausência de relacionamento sexual, constituindo um mecanismo compensatório para os distúrbios de auto-imagem e imagem corporal que afetam a sexualidade do ostomizado