State-level scope of practice regulations for nurse practitioners impact work environments: Six state investigation.

Nurse practitioner (NP) scope of practice (SOP) policies are different across the United States. Little is known about their impact on NP work environment in healthcare organizations. We investigated the association between SOP policies and organizational-level work environment of NPs. Through a cross-sectional survey design, data were collected from 1244 NPs in six states with variable SOP regulations (Arizona, New Jersey, Washington, Pennsylvania, Texas, and California) in 2018-2019. Arizona and Washington had full SOP-NPs had full authority to deliver care. New Jersey and Pennsylvania had reduced SOP with physician collaboration requirement; California and Texas had restricted SOP with physician supervision requirement. NPs completed mail or online surveys containing the Nurse Practitioner Primary Care Organizational Climate Questionnaire, which has these subscales: NP-Administration Relations (NP-AR), NP-Physician Relations (NP-PR), Independent Practice and Support (IPS), and Professional Visibility (PV). Regression models assessed the relationship between state-level SOP and practice-level NP work environment. NP-AR scores were higher in full SOP states compared to reduced (ß = 0.22, p < 0.01) and restricted (ß = 0.15, p < 0.01) SOP states. Similarly, IPS scores were higher in full SOP states. The PV scores were also higher in full SOP states compared to reduced (ß = 0.16, p < 0.001) and restricted (ß = 0.12, p < 0.05) SOP states. There was no relationship between SOP and NP-PR score. State-level policies affect NP work environment. In states with more favorable policies, NPs have better relationships with administration and report more role visibility and support. Efforts should be made to remove unnecessary SOP restrictions.

Nurse-led HIV services and quality of care at health facilities in Kenya, 2014-2016.

OBJECTIVE: To develop a novel measure to characterize human immunodeficiency virus (HIV) programme quality at health facilities in Kenya and explore its associations with patient- and facility-level characteristics. METHODS: We developed a composite indicator to measure quality of HIV care, comprising: assessment of eligibility for antiretroviral therapy (ART); initiation of ART; and retention on ART or in care, if ineligible for ART, for 12 months. We applied the comprehensive retention indicator to routinely collected clinical data from 13 331 patients enrolled in HIV care and treatment at 63 health facilities in the Eastern and Nyanza regions of Kenya from 1 January 2014 to 31 March 2016. We explored the association between facility- and patient-level characteristics and the primary outcome: appropriate staging and management of HIV, and retention in care over 12 months. FINDINGS: Of the enrolled patients, 8404 (63%) achieved comprehensive retention 12 months after enrolment in care. In univariate analyses, patients at facilities where nurses delivered HIV treatment services (including eligibility assessment, initiation and follow up of ART) had significantly higher comprehensive retention rates at 12 months. In multivariate analyses, after adjusting for both facility- and patient-level characteristics, patients at facilities where nurses initiated ART had significantly higher comprehensive retention in care at 12 months (relative risk, RR: 1.22; 95% confidence interval, CI: 1.00-1.48). CONCLUSION: Nurse-led HIV services were significantly associated with quality of care, confirming the central role of nurses in the achievement of global health goals, and the need for further investment in nursing education, training and mentoring.

Ultra rapid direct heating synthesis of ZnO nanorods with improved light trapping from stacked photoanodes for high efficiency photocatalytic water splitting.

An ultra rapid growth method for vertically aligned ZnO nanorod (NR) thin films on metal meshes was developed using a direct heating synthesis technique. A typical NR growth rate of 10 µm h-1 was achieved. The effects of the applied heating power and growth duration on the morphologies of ZnO nanostructures were examined. High density surface defects were formed on the ZnO NRs, which is responsible for slow charge recombination and high efficiency in the photoelectrochemical (PEC) water splitting process. The light absorption for a photoanode was significantly improved by light trapping using a 3D stacked metal mesh photoanode structure. With the internal reflection between the stacked photoanodes, the final light leakage is minimised. The light absorption in the stacked photoanode is improved without restricting the charge transportation. In comparison with a single mesh photoanode and a chemical bath deposition grown flat photoanode, the PEC water splitting efficiency from the stacked photoanode was increased by a factor of 2.6 and 6.1 respectively.

Influence of different parameters on the corneal asphericity (Q value) assessed with progress in biomedical optics and imaging - A review.

The corneal eye diseases such as Keratoconus cause weakening of the cornea, with this disease the cornea can change in shape. This condition affects between 1 in 3,000 to 1 in 10,000 people. The main reason for the development of such conditions is unknown and can have significant impacts. Over the last decade, with advancements in computerized corneal topography assessments, researchers have increasingly expressed interest in corneal topography for research as well as clinical activities. Up till now, several aspheric numerical models have been developed as well as proposed to define the complex shape of the cornea. A commonly used term for characterizing the asphericity in an eye is the Q value, a common indicator of the aspherical degree of the cornea. It is one of the critical parameters in the mathematical description model of the cornea as it represents the cornea's shape and the eye's characteristics. Due to the utmost importance of this Q value of the cornea, a couple of studies have attempted to explore this parameter and its distribution, merely in terms of its influence on the human eye's optical properties. The corneal Q value is an important factor that needs to be determined to treat for any refractive errors as corneal degeneration are disease that can lead to potential problems with the structure of the cornea. This study aims to highlight the need to understand Q value of the cornea as this can essentially assist with personalising corneal refractive surgeries and implantation of intraocular lenses. Therefore, the relevance of corneal Q value must be studied in association with different patients, especially ones who have been diagnosed with cataracts, brain tumours, or even COVID-19. To address this issue, this paper first carries out a literature review on the optics of the cornea, the relevance of corneal Q value in ophthalmic practice and studies corneal degenerations and its causes. Thereafter, a detailed review of several noteworthy relevant research studies examining the Q value of the cornea is performed. To do so, an elaborate database is created, which presents a list of different research works examined in this study and provides key evidence derived from these studies. This includes listing details on the age, gender, ethnicity of the eyes assessed, the control variables, the technology used in the study, and even more. The database also delivers important findings and conclusions noted in each study assessed. Next, this paper analyses and discusses the magnitude of corneal Q value in various scenarios and the influence of different parameters on corneal Q value. To design visual optical products as well as to enhance the understanding of the optical properties of an eye, future studies could consider the database and work presented in this study as useful references. In addition, the work can be used to make informed decisions in clinical practice for designing visual optical products as well as to enhance the understanding of the optical properties of an Eye.

0,1,2,3D nanostructures, types of bulk nanostructured materials, and drug nanocrystals: An overview.

Functional materials are required to meet the needs of society, such as environmental protection, energy storage and conversion, integrated product production, biological and medical processing. bulk nanostructured materials are a research concept that combines nanotechnology with other research fields such as supramolecular chemistry, materials science, and life science to develop logically functional materials from nanodevices. In this review article, nanostructures are synthetized by different methods based on the types and nature of the nanomaterials. In a broad sense "top-down" and "bottom-up" are the two foremost methods to synthesize nanomaterials. In top-down method bulk materials have been reduced to nanomaterials, and in case of bottom-up method, the nanomaterials are synthesized from elementary level. The different methods which are being used to synthesize nanomaterials are chemical vapor deposition method, thermal decomposition, hydrothermal synthesis, solvothermal method, pulsed laser ablation, templating method, combustion method, microwave synthesis, gas phase method, and conventional Sol-Gel method. We also briefly discuss the various physical and chemical methods for producing nanomaterials. We then discuss the applications of functional materials in many areas such as energy storage, supercapacitors, sensors, wastewater treatment, and other biological applications such as drug delivery and drug nanocrystals. Finally, future challenges in materials nanoarchitecture and concepts for further development of functional nanomaterials are briefly discussed.

Healthcare Workers' Perception and Compliance on Personal Protective Equipment Use in Critical Care Units of a Tertiary Care Hospital in Bahrain.

Introduction Contact precautions or the use of personal protective equipment (PPE), specifically gowns and gloves, has become a common practice in intensive care units (ICUs) as part of robust infection prevention and control efforts. Hence, a positive attitude toward PPE used among healthcare workers (HCWs) is critical to prevent healthcare-associated infections (HAIs). Aim This study aimed to determine the perception and compliance of HCWs working at critical care units regarding PPE used at government hospitals (GHs) in Bahrain. Subject and methods A cross-sectional study was conducted among HCWs working in critical units at GHs, Bahrain. A self-administered questionnaire consisting of three sections was sent to the targeted HCWs. The questionnaire consisted of socio-demographic characteristics (i.e., age, gender, job category, etc.), previous participation in PPE training, and a 15-item questionnaire to assess the perception and compliance of HCWs regarding PPE use. Results Among the 119 HCWs enrolled, 73.1% were females, and 48.7% were between 31 and 40 years old. The results of this study suggested that although 95.8% of participants received education about PPE use, only 48.7% had a good perception of PPE, and an even smaller percentage (12.6%) demonstrated good compliance. A positive, highly statistically significant correlation was found between perception and compliance scores (p<0.001). Increased perception and compliance scores were associated with increasing age, non-Bahrainis, and years of experience. Interestingly, doctors were more likely to demonstrate lower perception and compliance scores toward PPE use. Conclusion The perception of HCWs regarding PPE use was adequate, but their actual adherence was unsatisfactory. However, doctors' perceptions and compliance with PPE use were significantly lower than other HCWs. Further larger studies are required to establish the level of perception and compliance among HCWs in our region.

Protocol for UAV fault diagnosis using signal processing and machine learning.

Unmanned aerial vehicles (UAVs) require fault diagnosis for safe operation. Here, we present a protocol for UAV fault diagnosis using signal processing and artificial intelligence. We describe steps for collecting vibration-based signal data, preprocessing, and feature extraction using a 3-axis accelerometer or similar sensors. We then detail the application of machine learning techniques, including deep neural networks, support vector machine, k-nearest neighbor, and other algorithms, for classifying faults. This protocol is applicable to various UAV models for accurate fault detection. For complete details on the use and execution of this protocol, please refer to Al-Haddad et al.,1,2,3,4 Shandookh et al.5.

Global nutritional challenges of reformulated food: A review.

Food reformulation, the process of redesigning processed food products to make them healthier, is considered a crucial step in the fight against noncommunicable diseases. The reasons for reformulating food vary, with a common focus on reducing the levels of harmful substances, such as fats, sugars, and salts. Although this topic is broad, this review aims to shed light on the current challenges faced in the reformulation of food and to explore different approaches that can be taken to overcome these challenges. The review highlights the perception of consumer risk, the reasons for reformulating food, and the challenges involved. The review also emphasizes the importance of fortifying artisanal food processing and modifying microbial fermentation in order to meet the nutrient requirements of people in developing countries. The literature suggests that while the traditional reductionist approach remains relevant and yields quicker results, the food matrix approach, which involves engineering food microstructure, is a more complex process that may take longer to implement in developing economies. The findings of the review indicate that food reformulation policies are more likely to succeed if the private sector collaborates with or responds to the government regulatory process, and further research is conducted to establish newly developed reformulation concepts from different countries. In conclusion, food reformulation holds great promise in reducing the burden of noncommunicable diseases and improving the health of people around the world.

Environmental impact of fouling for crude oil flow in preheat pipes according to oil blends.

Crude oil fouling is a complex process caused by multiple mechanisms. This study examined fouling's environmental impact on a distillation unit's heating tubes and heat exchangers, proposing optimal pollution levels to reduce emissions and achieve sustainability goals. The study evaluated five crude oil blends in terms of API, sulphur, salt content, and other physical properties. Contaminated water was analyzed through biological and chemical means, while CO2, NOx, and SOx emissions were calculated from actual fuel and power consumption. Solid and sludge sediments were observed throughout all plate heat exchangers, consisting primarily of iron hydroxides and manganese oxides. Rationalizing energy use reduced the burden on the environment and fuel consumption by 7 %, with a 2 % reduction in energy needed to refine crude oil feeding units when fouling is removed after maintenance. By optimizing pollution levels and reducing energy consumption, the environmental impact of fouling can be mitigated.

Evaluation of Bronchiolitis in the Pediatric Population in the United States of America and Canada: A Ten-Year Review.

Bronchiolitis is a well-known viral infection among the pediatric population, significantly impacting hospitalization rates. The COVID-19 pandemic profoundly affected respiratory viral infections, including bronchiolitis, as various mitigation measures were implemented. In this study, we analyzed bronchiolitis cases during the pandemic and post-pandemic period, aiming to identify changes in management guidelines and their incidence and management over the last 10 years. Moreover, we explored the relationship between bronchiolitis and COVID-19, a virus that gained rapid notoriety worldwide. By analyzing data from pediatric populations in Canada and the USA, we sought to understand the role of varying seasons in the peak periods of bronchiolitis infections. The comprehensive review's results will provide valuable insights into bronchiolitis dynamics within the context of the COVID-19 pandemic. Our aim is to better comprehend the interplay between bronchiolitis, COVID-19, and seasonal variations, ultimately contributing to a deeper understanding of this respiratory viral infection and informing future management strategies. Furthermore, these findings can assist healthcare professionals in preparing for and responding to potential fluctuations in bronchiolitis cases in the post-pandemic era.

A Rare Case of Hypomyelinating Leukodystrophy and Its Management: A Case Report and Literature Review.

A subset of hereditary white matter disorders called hypomyelinating leukodystrophies (HLD) is characterized primarily by the absence of myelin deposition. Although the clinical presentation can be mild and the development of symptoms can occur in adolescence or adulthood, the majority of severe cases present during infancy and early childhood with significant neurological impairments. The clinical features vary from muscle stiffness to seizures and developmental delay. The detailed myelination process can be seen with magnetic resonance imaging (MRI), and many patients are diagnosed using MRI pattern recognition and next-generation sequencing (NGS) in most cases. Here, we report a case of an infant suffering from the hypomyelinating leukodystrophy-13 (HLD-13) variant, whose next-generation sequencing revealed a pathogenic homozygous variant.

A Comparative Clinical and Laboratory Study of Adolescent and Adult Acne in Iraqi Women.

Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units associated with long-term sequelae and complications. Currently, acne in women is classified into adolescent and post-adolescent forms. However, comparative studies evaluating the clinical and laboratory parameters across various age groups in women with acne are lacking. The aim of the study is to compare the clinical and laboratory characteristics of different groups of women with acne vulgaris. Patients and methods Over 3 years (2018-2021), a cross-sectional study was carried out on 340 women with acne consulting the Dermatology and Venereology Outpatient Clinic, Basrah Teaching Hospital, Basrah, Iraq. Eligible patients were carefully evaluated and fully examined, emphasizing on signs of hyperandrogenism and scoring of acne severity. Hormonal assays of serum total testosterone (TST), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular stimulating hormone (FSH), and serum prolactin (PRL) were done. Pelvic ultrasonography was performed to identify any pelvic pathology. The patients were classified according to their age of onset. Clinical and laboratory data were compared among groups. Results Three groups were recognized: 160 patients (47%) with adolescent acne (AA) (mean age SD: 17.2±1.6 years), 80 (23.5%) with early adult-onset acne (EA) (mean age SD: 21.4±1.2 years), and 100 (29.4%) with post-adolescent acne (PA) (mean age SD: 28.7±2.9 years), which were further sub-grouped into late-onset acne (40 cases, 11.7%), and persistent acne (60 cases, 17.6%). The mean body mass index was normal in the AA group and overweight in the EA and PA groups. Moderate obesity was more frequent in PA (24%, p=0.03). While 78.5% of AA was mild to moderate acne, 77.5% of EA was moderate to moderately severe, and 72% of PA was moderately severe to severe. Clinical and biochemical markers of hyperandrogenism were seen in all groups, however, they were more frequent in PA and EA groups than in the AA group (p<005). Conclusion Clinical and biochemical hyperandrogenism were present in a significant proportion of women with acne; their prevalence was higher in post-adolescent acne than in adolescent acne. Acne that began between the ages of 20 and 25 was classified as "early adult-onset acne," and showed variable features of hyperandrogenism. A complete evaluation, regardless of age, for every female with acne, including a hormonal analysis and pelvic ultrasound examination to detect hormonal imbalances as early therapy, can help to prevent and reduce the risk of consequences.

Novel NARC-G1 garlic: comparative allicin quantification with morpho-biochemical & genetic profiling.

Garlic (Allium sativum) is an important cash food crop, and the biotechnology industry has considerable interest in the plant because of its medicinal importance. These medicinal properties are attributed to organosulphur compounds as the accumulation of these compounds varies according to genotype, locality, light quality, and cultivation practices. In this study, we compared a newly developed garlic variety NARC-G1 by National Agricultural Research Centre (NARC), Islamabad, Pakistan with three different garlic cultivars and highlighted the distinctive attributes like phenotypic characteristics, the content of allicin, elemental profile, and gene polymorphism. Phenotypic analysis showed NARC-G1 has significantly higher bulb weight (66.36g ± 18.58), single clove weight (5.87g ± 1.041), and clove width (17.41mm ± 0.95) which directly correlates to the size of the garlic. The analytical analysis showed the highest allicin content (4.82 ± 0.001) in NARC-G1. Genotyping of the alliinase in all four cultivars showed indels in the gene resulting in distinguishable changes in organosulphur compounds' profile. NARC-G1 is unique from other garlic cultivars and could be the best choice for mass production with proper cultivation and irrigation management. Moreover, for Pakistan NARC-G1 could be a potential contender to earn the industrial benefits with inland cultivation instead of importing garlic alleviating the economic burden.

The safety of nanomaterials in food production and packaging.

Nanotechnology involves developing, characterising, and applying structures ranging in size from 1 to 100 nm. As a key advanced technology, it has contributed to a substantial impact across engineering, medicine, agriculture and food. With regards to their application in food, nanomaterials posses the ability to lead the quantitative and qualitative development of high-quality, healthier, and safer foods by outperforming traditional food processing technologies for increasing shelf life and preventing contaminations. Although rapid progress has been made in nanotechnology in food products, the toxicity of nanoparticles and nanomaterials is not very well known. As a result, nanomaterials are potentially toxic, therefore, considering the constantly increasing employment in food science, they need to be further characterised, and their use must be better regulated. We may face a crisis of nanotoxicity if the molecular mechanisms by which nanoparticles and nanomaterials interact with food and within living organisms is not fully understood. Food safety can be guaranteed only if we are thoroughly aware of nanomaterial properties and potential toxicity. Therefore, it is urgently necessary to have in the food sector a regulatory system capable of managing nanofood risks and nanotechnology, considering the health effects of food processing techniques based on nanotechnology. This present review discusses the impact and role nanotechnology play in food science. The specific application of Nanomaterials in food science, their advantages and disadvantages, the potential risk for human health and the analysis to detect nanocomponents are also highlighted.

Property development during the COVID-19 pandemic: challenges and outlook in Malaysia.

Through administrative research and media records, this paper aims to examine and highlight the effects of the COVID-19 pandemic on Malaysian workers, property development, construction sites, and the national economy. The development of real estate and the construction industry can significantly impact socio-economic growth and infrastructure development. Adequate building and infrastructure construction can ensure national economic stability, job creation, community cohesion, and higher living standards. Since the COVID-19 pandemic began in 2019, many countries, including Malaysia, have reported an increased number of virus cases. According to the Ministry of Health, 9316 cases and 314 COVID-19 clusters were discovered in Malaysia, with a 38.55-48.06% prevalence for factories, a 12.55-15.29% prevalence for community spreading, an 8.6-11.56% prevalence for construction sites, a 5.53-7.96% prevalence for educational sites, and a 7.01% prevalence for shopping areas. Several governments-imposed lockdowns, movement, and proximity restrictions during the pandemic due to the high infection rates at property development sites. However, due to inactivity in various sectors such as the construction industry, these measures have significantly impacted the national economy. As a result, the pandemic has had an impact on workers, production costs, and project completion timelines, resulting in operational issues and policy concerns. Overall, the records reviewed revealed that the COVID-19 pandemic has significantly impacted real estate development, the housing market, and the construction industry. As a result, sustained and targeted policies are required to support Malaysia's construction industry's socio-economic growth and infrastructure development.

Online Health (Mis)Information: The Role of Medical Students.

The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students' awareness of regulations for dispersion of health-related information on social media and physicians' online self-promotional activities. A cross-sectional study was conducted among undergraduate medical students from the 3 largest administrative regions of Saudi Arabia: Central, Western, and Eastern regions. Data was collected between February-July 2020 via online distribution of a self-administered questionnaire. Results showed that: (a) a total of 730 medical students participated; (b) about half of respondents were unsure or unaware of guidelines of both, online posting of medical information and physicians' online self-promotional activities (343/47% and 385/52.7%, respectively); (c) 610 (83.6%) students supported that healthcare providers report accounts sharing unreliable health information. Physicians' online promotional activities, and posting about successful cases, might shift physicians' focus from patient care to becoming more popular online. Care should be taken not to breach essential professional and ethical principles, such as protecting the confidentiality and privacy of patients. Raising awareness among patients and physicians, current and future ones, of the regulations governing these online health related interactions is imperative.

Impact of Adverse Childhood Experiences on Resilience and School Success in Individuals With Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder.

Adolescents with emotional and behavioral disorders face known academic challenges and poor life outcomes. It was imperative to explore and find if the new diagnostic criterion for diagnosing autism profoundly affects educational outcomes and resilience in individuals diagnosed with co-occurring autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The literature is robust on the impact of adverse childhood experiences (ACEs) on educational outcomes and resilience in adolescents with no history of disability. Still, there remains a dearth of literature explaining, with no ambiguity, the complex relationships between ACEs and resilience, school engagement, and success in individuals with co-occurring ASD and ADHD. This study reviews the existing scholarships on the topic. The significance of this review is that it informs healthcare providers, rehabilitation counselors, and educators about the need for early identification of individuals with ASD and ADHD with a background in ACEs. This will enable interventions early enough to ensure they are more resilient and can obtain improved success in school-related and outside-school activities and eventually improved quality of life.

Propolis efficacy on SARS-COV viruses: a review on antimicrobial activities and molecular simulations.

This current study review provides a brief review of a natural bee product known as propolis and its relevance toward combating SARS-CoV viruses. Propolis has been utilized in medicinal products for centuries due to its excellent biological properties. These include anti-oxidant, immunomodulatory, anti-inflammatory, anti-viral, anti-fungal, and bactericidal activities. Furthermore, studies on molecular simulations show that flavonoids in propolis may reduce viral replication. While further research is needed to validate this theory, it has been observed that COVID-19 patients receiving propolis show earlier viral clearance, enhanced symptom recovery, quicker discharge from hospitals, and a reduced mortality rate relative to other patients. As a result, it appears that propolis could probably be useful in the treatment of SARS-CoV-2-infected patients. Therefore, this review sought to explore the natural properties of propolis and further evaluated past studies that investigated propolis as an alternative product for the treatment of COVID-19 symptoms. In addition, the review also highlights the possible mode of propolis action as well as molecular simulations of propolis compounds that may interact with the SARS-CoV-2 virus. The activity of propolis compounds in decreasing the impact of COVID-19-related comorbidities, the possible roles of such compounds as COVID-19 vaccine adjuvants, and the use of nutraceuticals in COVID-19 treatment, instead of pharmaceuticals, has also been discussed.