Background
The most common HIV neurological comorbidity, Distal Symmetrical Peripheral Neuropathy (DSPN), is characterized by severe symptoms and reduced quality of life. Exercise has consistently ...been mentioned as one of the non-pharmacological therapies for the rehabilitation of individuals with HIV, but little is known about an exercise program to recommend to people living with HIV (PLWHIV)-related DSPN. The purpose of this study was to investigate the effectiveness of aerobic (AE) or progressive resisted exercise (PRE) on quality of life (QOL) in a person living with HIV-related DSPN.
Method
A randomized controlled trial was conducted with 136 persons living with HIV-related Neuropathy, including 6 domains of QOL within WHOQOL-BREF, 45 in the AE (used ergometer), 44 in the PRE (used quadriceps bench), and 47 in the control group (CG). The outcome measures (QOL) data were analyzed using the inferential statistic of Friedman for within-group with post hoc analysis of Wilcoxon signed Test. A Kruskal–Wallis test was carried out for between-groups with post hoc analysis of Mann–Whitney to find where significant differences exist.
Results
The results indicated significant differences within experimental groups in all six domains
p
< 0.05. Similarly, the result indicated significant differences within the CG in Physical, level of independence, and Spirituality/Religions domains (
p
= 0.002,
p
= 0.035,
p
= 0.006). However, the results indicated significant differences between experimental groups and CG.
Conclusion
These findings indicated that strength and endurance exercise of moderate intensity have a positive effect on QOL in PLWHIV-related DSPN.
Clinical trial No.
http://apps.who.int/trialsearch/default.aspx
(PACTR201707002173240).
The COVID-19 diagnostic approach is mainly divided into two broad categories, a laboratory-based and chest radiography approach. The last few months have witnessed a rapid increase in the number of ...studies use artificial intelligence (AI) techniques to diagnose COVID-19 with chest computed tomography (CT). In this study, we review the diagnosis of COVID-19 by using chest CT toward AI. We searched ArXiv, MedRxiv, and Google Scholar using the terms “deep learning”, “neural networks”, “COVID-19”, and “chest CT”. At the time of writing (August 24, 2020), there have been nearly 100 studies and 30 studies among them were selected for this review. We categorized the studies based on the classification tasks: COVID-19/normal, COVID-19/non-COVID-19, COVID-19/non-COVID-19 pneumonia, and severity. The sensitivity, specificity, precision, accuracy, area under the curve, and F1 score results were reported as high as 100%, 100%, 99.62, 99.87%, 100%, and 99.5%, respectively. However, the presented results should be carefully compared due to the different degrees of difficulty of different classification tasks.
X-rays are ionizing radiation of very high energy, which are used in the medical imaging field to produce images of diagnostic importance. X-ray-based imaging devices are machines that send ionizing ...radiation to the patient’s body, and obtain an image which can be used to effectively diagnose the patient. These devices serve the same purpose, only that some are the advanced form of the others and are used for specialized radiological exams. These devices have image quality parameters which need to be assessed in order to portray the efficiency, potentiality and negativity of each. The parameters include sensitivity and specificity, radiation dose delivered to the patient, cost of treatment and machine. The parameters are important in that they affect the patient, the hospital management and the radiation worker. Therefore, this paper incorporates these parameters into fuzzy PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluation) multi-criteria decision theory in order to help the decision makers to improve the efficiency of their decision processes, so that they will arrive at the best solution in due course.
Patient safety involves identifying, assessing, and managing patient-related risks and occurrences to improve patient care and reduce patient harm. In Nigeria, there is a lack of studies on patient ...safety culture, especially in the northern part of the country. This study aimed to determine the levels and factors that contribute to nurses' negative perceptions of patient safety culture in public health facilities.
A total of 460 nurses were surveyed across 21 secondary health facilities using the Hospital Survey on Patient Safety Culture, and the response rate was 93.5%. Descriptive statistics and multiple logistic regression were used to analyze the data.
The results showed that 59.8% of the respondents were female, and 42.6% were within the age range of 30-39 years old. Most of them (48.3%) had spent 1-5 years working in the hospital. Three out of 12 composite measures had higher negative responses (staffing-30.5%, non-punitive response to error-42.8%, and frequency of events reported-43.1%). A multiple logistic regression analysis affirmed that all three variables, in addition to organizational learning, were significant associated with overall negative perceptions of patient safety culture, with 3.15, 1.84, 2.26, and 2.39 odds ratios, respectively.
The results revealed that four critical areas of patient safety required improvement; therefore, intervention is recommended to minimize unnecessary patient harm and medical expenses.
: Transcranial direct current stimulation (tDCS) is effective in the management of patients with central post-stroke pain (CPSP) and post-stroke depression (PSD) individually. However, it is not ...known if tDCS delivered via dorsolateral prefrontal cortex (DLPFC) can be used to ameliorate both symptoms.
The purpose of this case report was to share the effectiveness of using tDCS of the DLPFC with short inter-session intervals to reduce central pain and depression in a stroke survivor.
: A 45-year-old patient presented with CPSP and depression following a stroke. The CPSP and depression were diagnosed using the Douleur Neuropathique 4 Questionnaire (DN4Q) and the Beck Depression Index (BDI) respectively. The pain score was 10 on a visual analogue scale (VAS) and it was a hemi-body burning sensation, with a score of 7 on DN4Q, and the depression score was 25 on the BDI. The patient received anodal tDCS to the left DLPFC using two different application protocols. Initially, a stimulation session of 2 milliamperes (mA) intensity for 20 minutes was given every working day for 2 weeks. After 3 weeks, she then received 7 daily sessions of periodic stimulations of 2 mA intensity for 13 minutes each with 20 minutes inter-session intervals for 1 week. The patient was followed up for 6 months post-intervention.
: Immediately following the last session of the initial protocol of stimulation, the BDI score reduced from 25 to 7 and the pain became abolished. However, the symptoms relapsed at 3 weeks post-intervention to the initial BDI score of 25, VAS score of 10 and DN4Q score of 7. Following the application of the second protocol of stimulation, the BDI score improved to 18 at three weeks and later to 7 at six months post-intervention while the pain (both VAS and DN4Q) became completely abolished.
Further research is needed to determine if a series of periodic tDCS with short-intersession intervals applied to the DLPFC may be more effective than a single tDCS with long inter-session intervals, in decreasing pain and inducing long-term improvement in mood in people with stroke.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
In the emerging market economies the influencing power of different strands of ownership structure and ownership concentration on the risk-adjusted returns on assets and equity, dividend yield, ...earnings, and cost-to income ratio of listed deposit money banks has not been thoroughly investigated. The diminutive research and equivocal findings of previous studies on this subject create grounds for further investigation. Therefore, the aim of this study is to investigate the extent to which these three constructs relate in listed deposit money banks an emerging market economy, Nigeria. Panel data multiple regressions were applied to data extracted from the annual reports from 2009 to 2020 to test the six hypotheses. The results indicate that the disaggregated ownership structure and concentrated ownership relate positively and significantly to the bank performance indices, thereby supporting convergence of owners and managers interests which reduces the agency problems and increases the financial performance of firms. The novelty of this study is the introduction of new indices for measuring performance, ownership structure and concentration which are total departure from the usual method in both emerging and developed market economies. Further research can be extended in other economies using the same computational methods.
Plain language summary
Ownership Structure and Bank Performance in Emerging Market Economy
In the emerging market economies the influencing power of different strands of ownership structure and ownership concentration on the risk-adjusted returns on assets and equity, dividend yield, earnings, and cost-to income ratio of listed deposit money banks has not been thoroughly investigated. The diminutive research and equivocal findings of previous studies on this subject create grounds for further investigation. Therefore, the aim of this study is to investigate the extent to which these three constructs relate in listed deposit money banks an emerging market economy, Nigeria. Panel data multiple regressions were applied to data extracted from the annual reports from 2009 to 2020 to test the six hypotheses. The results indicate that the disaggregated ownership structure and concentrated ownership relate positively and significantly to the bank performance indices, thereby supporting convergence of owners and managers interests which reduces the agency problems and increases the financial performance of firms. The novelty of this study is the introduction of new indices for measuring performance, ownership structure and concentration which are total departure from the usual method in both emerging and developed market economies. Further research can be extended in other economies using the same computational methods.
Institutional quality largely influences the ways in which economic agents align their production and operational behaviors towards expanding the share of renewable energy in the total energy mix and ...enhancing environmental performance. This study therefore explores the panel data for the EU-28 countries to assess the dynamic effects of institutional quality, tourism development, financial development, and renewable energy on environmental performance over the period 2002 to 2014. Using a two-step dynamic system generalized method of moments (GMM), the empirical results broadly suggest that institutional quality can be explored to dampen the potential negative effects of tourism and economic growth on environmental performance. In addition, financial development and renewable energy are positively related to environmental performance. This suggests that financial stability and energy consumption transition to renewable energy are necessary requirements to improve environmental performance. The policy implication for this study is that strengthening of institutional quality, financial stability, and adjusting to alternative and clean energy systems are the surest ways to achieve a cleaner and sustainable environment in the EU region.
The cell envelope of mycobacteria, a group of Gram positive bacteria, is composed of a plasma membrane and a Gram-negative-like outer membrane containing mycolic acids. In addition, the surface of ...the mycobacteria is coated with an ill-characterized layer of extractable, non-covalently linked glycans, lipids and proteins, collectively known as the capsule, whose occurrence is a matter of debate. By using plunge freezing cryo-electron microscopy technique, we were able to show that pathogenic mycobacteria produce a thick capsule, only present when the cells were grown under unperturbed conditions and easily removed by mild detergents. This detergent-labile capsule layer contains arabinomannan, alpha-glucan and oligomannosyl-capped glycolipids. Further immunogenic and proteomic analyses revealed that Mycobacterium marinum capsule contains high amounts of proteins that are secreted via the ESX-1 pathway. Finally, cell infection experiments demonstrated the importance of the capsule for binding to cells and dampening of pro-inflammatory cytokine response. Together, these results show a direct visualization of the mycobacterial capsular layer as a labile structure that contains ESX-1-secreted proteins.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of this study is to apply the principle of multi-criteria decision making theories on various types of cancer treatment techniques. Cancer is an abnormal cell that divides in an uncontrolled ...manner, it is a growth (tumor) that starts when alterations in genes make one cell to grow and multiply rapidly. Eventually, these cells may metastasize to other tissues. The primary factors that influence the comprehensive treatment plan of cancer include, but not limited to genetic factors, patient general health condition, explicit characteristic of cancer, and even purpose of the treatment. Other factors which are also essential include treatment duration, cost of treatment, comfortability, side effects and percentage of survival rate. The latter factors play an important role in the course of treatment and are therefore needed in order to evaluate the several treatment procedures. The outcome of the decision-making theories on these treatment procedures will help the concerned parties such as the patients, oncologists, and the hospital management. The most common cancer treatment techniques were evaluated and compared based on certain criteria using Fuzzy PROMETHEE decision-making theory.
Congenital absence of the nasal septum (hyporhynia) is infrequently reported in the literature. We report a rare case in a newborn with multiple congenital anomalies with the aim to highlight its ...rarity and compatibility with life in a resource-limited setting. The case notes of the child were summarised and the relevant literature reviewed to give the report a context. A 2-hour-old term baby boy presented with a history of abnormal facie characterised by a single nostril and noisy breathing. On examination, he had stridulous breathing, bilateral proptosis, sloping of the forehead, depressed nasal bridge absent nasal septum, absence of columella and hypoplastic mid-face, among other dysmorphic features. A diagnosis of hyporhynia in a baby with multiple congenital anomalies was made and managed accordingly. The baby was discharged to continue follow-up. Congenital absence of the nasal septum is rare and could present without respiratory distress and may be compatible with life.
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