Research attitudes, practice and literacy among Kenyan palliative care healthcare professionals: an observational, crosssectional online survey

Background: While research is needed to advocate for implementation of global agendas to strengthen palliative care, healthcare professionals’ research literacy must improve to bridge the gap between evidence and practice. A resurgent focus on North-South power disparities, means attention should also focus on understanding low- and middle-income countries’ local agency to implement palliative care research agendas. Methods: An observational, cross-sectional online survey among Kenyan palliative healthcare professionals currently working at any of the palliative and hospice care organizations operational during January – December 2019, using descriptive statistics. Results: Among the 93 survey respondents, participants were mainly nurses (50.54%; n=47). Regarding research attitudes: all agreed/strongly agreed research was important for their professional work. Over nine-tenths (91.21%; n=83) reported having the skills to conduct research, and 91.30% (n=84) wanted to conduct research in their clinical work. 90% (90.21%; n=83) reported supervisory support to conduct research. A comparable proportion (90.22%; n=83) would undertake research if they could find funding. Regarding research practice: over two-thirds (70.65%; n=65) reported ever having had a mentor who encouraged them to do research, while approximately half (50.59%; n=43) reported reading evidence-based journal articles about once per month and attending monthly in-house meetings on palliative care (56.79%; n=46). Regarding research literacy: while over two-fifths of respondents described their current research literacy level as ‘none’ or ‘beginner’ (44.56%; n=41), a comparable proportion described it as ‘intermediate’ (45.65%; n=42), with 9 (9.78%) stating it was ‘advanced’. Conclusion: The majority of palliative healthcare professionals report having interest, skills and support at work to conduct palliative care research, with a low-to-medium level of research literacy. The current study explored palliative care staff attitudes to, experience in, and literacy with the research process, which is necessary to creating a dialogue on implementing research findings. This study also adds to the global empowerment agenda, addressing inequities in research opportunities and local capacity to own and undertake palliative care research

Collision avoidance system with obstacles and humans to collaborative robots arms based on RGB-D data

The collaboration between humans and machines, where humans can share the same work environment without safety equipment due to the collision avoidance characteristic is one of the research topics for the Industry 4.0. This work proposes a system that acquires the space of the environment through an RGB-Depth sensor, verifies the free spaces in the created Point Cloud and executes the trajectory of the collaborative manipulator avoiding collisions. It is demonstrated a simulated environment before the system in real situations, in which the movements of pick-and-place tasks are defined, diverting from virtual obstacles with the RGB-Depth sensor. It is possible to apply this system in real situations with obstacles and humans, due to the results obtained in the simulation. The basic structure of the system is supported by the ROS software, in particular, the Movelt! and Rviz. These tools serve both for simulations and for real applications. The obtained results allow to validate the system using the algorithms PRM and RRT, chosen for being commonly used in the field of robot path planning.This work has been partially funded by Junta de Castilla y León and FEDER funds, under Research Grant No. LE028P17 and by "Ministerio de Ciencia, Innovación y Universidades" of the Kingdom of Spain through grant RTI2018-100683- B-I00.info:eu-repo/semantics/publishedVersio

ZnO/CeO₂ Nanocomposites:Metal-Organic Framework-Mediated Synthesis, Characterization, and Estimation of Cellular Toxicity toward Liver Cancer Cells

The Zinc-doped cerium oxide nanocomposite (ZnO/CeO2 NC) was synthesized using a metal-organic framework as a precursor through the combustion method. It was characterized by powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FTIR), field emission electron microscopy (FESEM), energy dispersive analysis (EDX), transmission electron microscopy (TEM), dynamic light scattering (DLS), and ξ-potential. The PXRD demonstrated the successful synthesis of ZnO/CeO2 NC with a crystallite size of 31.9 nm. FESEM and TEM images displayed hexagonal and spherical morphologies, and the solid-phase size was 65.03 ± 30.86 nm for ZnO/CeO2 NCs. DLS, TEM, and FESEM showed that the NCs have a high tendency for agglomeration/aggregation in both aqueous media and solid phase. The anticancer attributes of ZnO/CeO2 NC were investigated against Liver cancer cells (HepG2), which showed inhibition of cancer cell growth on a concentration-dependent gradient. The cell toxicity effects of ZnO/CeO2 nanocomposites were also studied toward NIH-3T3, in which the data displayed the lower toxicity of NC compared to the HepG2 cell line

Giant viable hydatid cyst of the lung: a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Bouveret's syndrome as an unusual cause of gastric outlet obstruction: a case report

An 83 year old caucasian gentleman presented with vomiting and left sided abdominal pain. A subsequent upper GI endoscopy demonstrated a large smooth mass impacted within the duodenum. A cholecysto-duodenal fistula was discovered at laparotomy, with a large gallstone impacted in the duodenum. A diagnosis of Bouveret's syndrome was made. The management of this rare cause of gastric outlet obstruction is discussed

An unusually large myofibroblastoma in a male breast: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myofibroblastoma of the breast is a rare benign stromal tumour seen predominantly in men. The gross appearance is that of a well-circumscribed nodule, characteristically small, seldom exceeding 3 cm. We present a case of an unusually large myofibroblastoma, which mimicked a malignant breast tumour.</p> <p>Case presentation</p> <p>A 65-year-old man presented with a rapid enlargement of the right breast over 6 weeks. Examination revealed a firm 15 cm hemispherical lump occupying the whole of the right breast with peau d'orange appearance of the overlying skin and distortion of the nipple. The clinical and radiological features suggested the possibility of sarcoma of the breast. However, a guided Tru-Cut biopsy was inconclusive. A mastectomy was performed to remove the tumour, which weighed more than 2 kg. Histopathology and immunocytochemistry revealed a mixed classical and collagenised type of myofibroblastoma. The patient is well with no evidence of recurrence 5 years after the mastectomy.</p> <p>Conclusion</p> <p>This unexpected presentation of an unusually large myofibroblastoma in a male breast is the largest reported to date. Myofibroblastomas can mimic malignant neoplasms and the clinical significance of this entity lies primarily in its recognition as a distinctive benign neoplasm.</p

Design and testing of hydrophobic core/hydrophilic shell nano/micro particles for drug-eluting stent coating

In this study, we designed a novel drug-eluting coating for vascular implants consisting of a core coating of the anti-proliferative drug docetaxel (DTX) and a shell coating of the platelet glycoprotein IIb/IIIa receptor monoclonal antibody SZ-21. The core/shell structure was sprayed onto the surface of 316L stainless steel stents using a coaxial electrospray process with the aim of creating a coating that exhibited a differential release of the two drugs. The prepared stents displayed a uniform coating consisting of nano/micro particles. In vitro drug release experiments were performed, and we demonstrated that a biphasic mathematical model was capable of capturing the data, indicating that the release of the two drugs conformed to a diffusion-controlled release system. We demonstrated that our coating was capable of inhibiting the adhesion and activation of platelets, as well as the proliferation and migration of smooth muscle cells (SMCs), indicating its good biocompatibility and anti-proliferation qualities. In an in vivo porcine coronary artery model, the SZ-21/DTX drug-loaded hydrophobic core/hydrophilic shell particle coating stents were observed to promote re-endothelialization and inhibit neointimal hyperplasia. This core/shell particle-coated stent may serve as part of a new strategy for the differential release of different functional drugs to sequentially target thrombosis and in-stent restenosis during the vascular repair process and ensure rapid re-endothelialization in the field of cardiovascular disease

Surgical Management of Inguinal Hernias at Bugando Medical Centre in Northwestern Tanzania: Our Experiences in a Resource-Limited Setting.

Inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. There is paucity of published data on surgical management of inguinal hernias in our environment. This study is intended to describe our own experiences in the surgical management of inguinal hernias and compare our results with that reported in literature. A descriptive prospective study was conducted at Bugando Medical Centre in northwestern Tanzania. Ethical approval to conduct the study was obtained from relevant authorities before the commencement of the study. Statistical data analysis was done using SPSS software version 17.0. A total of 452 patients with inguinal hernias were enrolled in the study. The median age of patients was 36 years (range 3 months to 78 years). Males outnumbered females by a ratio of 36.7:1. This gender deference was statistically significant (P=0.003). Most patients (44.7%) presented late (more than five years of onset of hernia). Inguinoscrotal hernia (66.8%) was the commonest presentation. At presentation, 208 (46.0%) patients had reducible hernia, 110 (24.3%) had irreducible hernia, 84 (18.6%) and 50(11.1%) patients had obstructed and strangulated hernias respectively. The majority of patients (53.1%) had right sided inguinal hernia with a right-to-left ratio of 2.1: 1. Ninety-two (20.4%) patients had bilateral inguinal hernias. 296 (65.5%) patients had indirect hernia, 102 (22.6%) had direct hernia and 54 (11.9%) had both indirect and direct types (pantaloon hernia). All patients in this study underwent open herniorrhaphy. The majority of patients (61.5%) underwent elective herniorrhaphy under spinal anaesthesia (69.2%). Local anaesthesia was used in only 1.1% of cases. Bowel resection was required in 15.9% of patients. Modified Bassini's repair (79.9%) was the most common technique of posterior wall repair of the inguinal canal. Lichtenstein mesh repair was used in only one (0.2%) patient. Complication rate was 12.4% and it was significantly higher in emergency herniorrhaphy than in elective herniorrhaphy (P=0.002). The median length of hospital stay was 8 days and it was significantly longer in patients with advanced age, delayed admission, concomitant medical illness, high ASA class, the need for bowel resection and in those with surgical repair performed under general anesthesia (P<0.001). Mortality rate was 9.7%. Longer duration of symptoms, late hospitalization, coexisting disease, high ASA class, delayed operation, the need for bowel resection and presence of complications were found to be predictors of mortality (P<0.001). Inguinal hernias continue to be a source of morbidity and mortality in our centre. Early presentation and elective repair of inguinal hernias is pivotal in order to eliminate the morbidity and mortality associated with this very common problem

Geotechnical Parameters of Landslide-Prone Laflamme Sea Deposits, Canada: Uncertainties and Correlations

Due to inherent variability arising from unpredictable geological depositional and post-depositional processes, the geotechnical parameters of Laflamme sea clay deposits remain highly uncertain. This study aims to develop and apply a methodology to assess the uncertainties of geotechnical parameters using statistical distributions for a landslide-prone Saguenay Lac-Saint-Jean (SLSJ) region. We used the measured physical and mechanical parameters of Laflamme Sea clays of various locations in the SLSJ region to characterize the geotechnical parameters in a representative manner. Goodness-of-fit tests assign each physical and mechanical parameter a distribution function for their descriptive analysis. We found that the quality of these tests is significantly influenced by outliers. The detected outliers in the dataset considerably impact the distribution type and the uncertainties of the specific geotechnical parameter. Subsequently, appropriate distribution functions for each parameter were assigned after treating the outliers. The derived coefficient of variability values for the SLSJ region were significantly high in comparison to the literature with cone penetration test data being only the exception. Finally, the results indicated that the uncertainties of geotechnical parameters of the Saguenay-Lac-Saint-Jean region marine clays are high as compared to Scandinavian clays and are relatively comparable to other eastern Canadian clays

Comparison of Real-time PCR to ELISA for the detection of human cytomegalovirus infection in renal transplant patients in the Sudan

<p>Abstract</p> <p>Background</p> <p>This study was carried out to detect human cytomegalovirus (HCMV) IgG and IgM antibodies using an Enzyme-linked immunosorbent assay (ELISA) in renal transplant patients in Khartoum state, Sudan and to improve the diagnosis of HCMV through the introduction of Real-time Polymerase Chain Reaction (PCR) testing. A total of 98 plasma samples were collected randomly from renal transplant patients at Ibin Sina Hospital and Salma Centre for Transplantation and Haemodialysis during the period from August to September 2006.</p> <p>Results</p> <p>Among the 98 renal transplant patients, 65 were males and 33 females. The results revealed that HCMV IgG was present in all patients' plasma 98/98 (100%), while only 6/98 (6.1%) had IgM antibodies in their plasma. HCMV DNA viral loads were detected in 32 patients 32/98 (32.7%) using Real-time PCR.</p> <p>Conclusions</p> <p>The HCMV IgG results indicate a high prevalence of past HCMV infection in all tested groups, while the finding of IgM may reflect a recent infection or reactivation. HCMV detection by real-time PCR in the present study indicated a high prevalence among renal transplant patients in Khartoum. In conclusion, the prevalence of HCMV in Khartoum State was documented through detection of HCMV-specific antibodies. Further study using various diagnostic methods should be considered to determine the prevalence of HCMV disease at the national level.</p