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Considering the Pharmacist-Led Opioid Stewardship Initiative in an Downtown Instructing Healthcare facility.
Vaccine coverage and timeliness are critical metrics for evaluating the performance of immunization programs. Following the introduction of rotavirus vaccine in Bamako, Mali, we conducted two cluster surveys spaced approximately 1 year apart to evaluate these metrics among children 9 to 20 months of age. Using the child's immunization card or the medical record at the center of administration, each selected child's immunization status was determined at 9 and 12 months of age. Deviations from the WHO-recommended immunization schedule were described by the median delay and fraction of children receiving doses outside of recommended age ranges. Overall, 1,002 children were enrolled in the two surveys combined; 80.1% of children born 7 to 12 months after introduction (survey 1) received three doses of pentavalent rotavirus vaccine (ROTA3) by 9 months of age, which increased to 86.1% among children born 17 to 26 months after introduction (survey 2). Concomitantly, coverage with the third dose of diphtheria-pertussis-tetanus-containing vaccine (DPT3) by age 9 months was 86.5% (survey 1) and 88.9% (survey 2); by age 12 months, 61.3% and 72.4% of children, respectively, had received all scheduled immunizations. The median delay in ROTA3 and DPT3 administration were similar at about 3.4 weeks. Within 3 years of introduction, coverage of rotavirus vaccine among Bamako infants achieved coverage similar to DPT3 and is approaching the Global Vaccine Action Plan goal of 90% coverage by 2020. However, timeliness of coverage remains a concern.Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) are arboviruses that can affect maternal and fetal outcome if acquired during pregnancy. This study was done to estimate the positivity of DENV, CHIKV, and ZIKV in febrile pregnant women attending a tertiary care hospital in north India. Symptomatic pregnant women were tested for these viruses by IgM ELISA and/or by Trioplex real-time polymerase chain reaction. Their symptoms and laboratory parameters were recorded and were followed up till delivery to know their immediate delivery outcome. learn more Of 104 women tested, 50 (48.1%) were positive for viral markers. Of these, evidence of infection by DENV, CHIKV, and both was found in 34 (32.7%), 10 (9.6%), and 6 (5.8%), respectively. ZIKV was not detected in any woman. Maximum DENV positivity occurred in the third trimester of pregnancy and in women residing in urban than rural areas. Chills and rigors, arthralgia, retro-orbital pain, anemia, and vaginal bleeding were more commonly associated with DENV positivity. Backache, arthralgia, jaundice, and vaginal bleeding were more common in CHIKV positives but the difference between positives and nonpositives regarding these symptoms was not statistically significant. Dengue infections were associated with more frequent hospitalizations (OR = 8.38, 95% confidence intervals [CI] = 3.29-21.30) and mortality (OR = 19.0, 95% CI = 1.01-357.10). Hence, to conclude, in India wherever possible, all symptomatic pregnant women should be screened for DENV, CHIKV, and ZIKV as part of sentinel surveillance for ZIKV.Occult Hepatitis B Infection (OBI) is a critical risk factor for triggering post-transfusion hepatitis (PTH), cirrhosis, hepatocellular carcinoma, and hepatitis B virus (HBV) reactivation, which β-thalassemia major (BTM) patients are at risk of it due to multiple blood transfusions. This study was aimed at determining the prevalence of OBI among BTM patients from Khuzestan Province, Iran. In this cross-sectional study, 90 thalassemia patients, who have received blood 36 to 552 times, participated referred to the Shafa hospital of Ahvaz city from January 2018 to April 2019. ELISA for determining serological markers (HBsAg, anti-HBc, anti-HBs, and anti-HCV) and real-time PCR for detecting HBV-DNA were performed; Nested PCR was conducted for DNA sequencing and determining the genotype of OBI case. Phylogenetic and statistical analyses were done by R package. Of 90 subjects enrolled in this study; 95.5% (86/90) were HBsAg negative, and the frequency of OBI among them was 1.16% (1/86). The anti-HBs, anti-HBc, and anti-HCV were detected in 80.00%, 7.78%, and 12.2% of patients, respectively. HBV-DNA was assessed at four HBsAg-positive subjects as well, and all of them were negative. The phylogenetic analysis showed that the detected HBV DNA in the OBI case belongs to the genotype D. This research, for the first time, demonstrated that OBI is present among β-thalassemia patients in Iran. Also, further studies are necessary to determine the actual prevalence of OBI among BTM patients in Iran to decisions concerning OBI screening, especially in transfusion centers.Congenital Chagas disease (CCD) has become a global health problem. Historically, the diagnosis of CCD has been carried out using parasitological methods and traditional serological techniques, however, new serological techniques such as chemiluminescent microparticle immunoassays (CMIA) have been developed in the last few years with many advantages compared with traditional serological tests. A total of 75 children born to 72 Latin American Chagas-infected mothers were consecutively enrolled and studied by CMIA and indirect immunofluorescence (IIF) at 0-2, 6, 9, and 12 months of age. At the end of the follow-up, 74 out of 75 children were considered uninfected and one child was diagnosed with CCD. Our study emphasizes the need to carry out serological follow-up on every newborn from a mother with Chagas disease and shows that CMIA assay is a great diagnostic tool as a single serological test at 9 months of age to rule out CCD or to identify possible transmission.This study aims to assess tuberculosis (TB) patients' health-related quality of life (HRQoL) and to determine the relationship between HRQoL and the socioeconomic and health characteristics of patients. A mixed-method approach of explanatory sequential design is used in this study. Data were collected at 11 TB centers and two private clinics in Khyber Pakhtunkhwa, Pakistan. Quantitative data were collected through a standardized questionnaire (SF-36) of RAND organization from 269 pulmonary TB patients. Qualitative data were collected through 20 in-depth interviews, 15 Key Informant interviews, and a focus group discussion. The maximum score of SF-36 is 100, however, different aspects of HRQoL indicated that patients scored lowest in the role limitation physical (10.3) and emotional (11.2) categories, while the highest remained in the mental health (45.3) category. Patients of higher age, being female, low household income, and comorbidity decreased the HRQoL. Qualitative findings show that TB affected the patients' social functioning, vitality, and emotions. Moreover, poverty and low income, people living in Kacha Houses, family support, and the hate from family members and community are related to low HRQoL. In summary, TB has affected the Patients' HRQoL. TB program managers should pay attention to the nonmedication aspects of TB management. Financial support should be extended TB patients. This study calls for the urgent attention of the National Tuberculosis Program and policymakers, for an increased focus on patients' welfare programs.Stereolithography (SL) 3D printing of ceramic materials is a promising forming technology to prepare denture with complex shape in the dental field. But the SL formed parts often have inferior mechanical properties than traditional forming method, and the debinding process is time assuming, limiting the clinical application of the technology. In this paper, a novel fluorapatite (FAp) glass-ceramics samples were fabricated through SL 3D printing based on self-made glass-ceramic powders. The effect of laser power and scanning speed on mechanical properties and tribological properties of FAp glass-ceramics were investigated. Phase compositions and microstructure of specimens were characterized by X-ray diffractometer and scanning electron microscope. The microhardness, flexural strength, elastic modulus and tribological performances of the SL samples were tested and compared with that of traditional dry pressing formed samples. The results showed that with the appropriate laser parameters and a relatively short debinding time, the SL formed glass-ceramics had microhardness, flexural strength, and elastic modulus of 772.05 Hv, 205.97 MPa, and 97.06 GPa, respectively, which exceeded that of traditional formed samples. The results reveal that it is possible to efficiently obtain FAp glass-ceramics with excellent mechanical and tribological performance by SL 3D printing process with appropriate parameters.
External vibration excitation might be key to many novel non-surgical interventions for pathologies in the musculoskeletal system and in other parts of the human organism. Lack of understanding about vibration patterns, their controllability, and reproducibility are three limitations of ongoing research. This study establishes a bovine vibration model and animal model replacements for future research.

We used biological samples (n=5) and one polyurethane sample of the bovine femur. Mechanical resonance was measured experimentally and analysed numerically by finite element method.

The experiments obtained 5 distinct mode shapes for the biological sample set, with standard deviation < 7.5%. Finite element analysis of the biological samples can replicate experimental mode shape deflection. The use of polyurethane changes resonance character but results are also good approximations of the biological samples.

A model of the bovine femur with consistent resonance behaviour is presented with alternatives (polyurethane and finite element analysis) that can serve in reducing the number of necessary biological samples. Future work will be to adapt results to human anatomy. Of clinical interest will be to influence bone pathologies such as post-surgical non-union, or bone functionality as part of haematopoiesis and endocrine secretion.
A model of the bovine femur with consistent resonance behaviour is presented with alternatives (polyurethane and finite element analysis) that can serve in reducing the number of necessary biological samples. Future work will be to adapt results to human anatomy. Of clinical interest will be to influence bone pathologies such as post-surgical non-union, or bone functionality as part of haematopoiesis and endocrine secretion.The present investigation explores the impact of Mg volume fraction (VMg) as a controlling parameter of degradation rate in designing patient-specific cardiovascular stents made of PLA/Mg composites. For the purpose of this research, PLA/Mg composite plates containing 1, 3, 5, and 10% VMg are produced by melt blending and hot press molding. Characterization techniques such as scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and X-ray diffraction (XRD) are employed to study the microstructure of PLA/Mg composites. For in vitro corrosion tests, stent prototypes and composite samples are immersed in baths of simulated body fluid (SBF). According to in vitro corrosion tests, increasing VMg increases the corrosion rate of the composites by accelerating the corrosion of the particles and the crystalline zones surrounding them. In addition, a 2% raise in the Mg content (from 1% to 3%), increases the overall Mg weight loss by more than 4 times. Composite samples and prototype stents containing more than 5% VMg exhibit cracking and brittleness after 7 days of immersion in SBF.
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