Comparison of Multi Criteria Decision Making Method (WP, SAW & TOPSIS) for best supplier selection.

Purpose: This study aims to find the best method among the methods that have often been used in the selection of suppliers among the methods to be compared is the MCDM (WP, SAW &TOPSIS) method.Design/methodology/approach: Selecting the right supplier will significantly reduce the cost of purchasing materials and improve the competitiveness of the company. In Rouydel's research for supplier selection using 6 criteria that will be an assessment of supplier selection including: Quality, Price / cost, standardization, Service, Flexibility, On time delivery [8].Findings/result: The results of this study are that the three WP, SAW and TOPSIS methods can be used in supplier selection, of the three methods almost all are equal in the ranking so it can be concluded that the three WP, SAW and TOPSIS methods are the right methods in the decision making of the best supplier selection.Originality/value/state of the art: The selection of the best suppliers in Indonesia rarely pays attention to the Flexibility factor when this factor is needed in the selection of suppliers, and on average only based on price, shipping, quality criteria

Factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic

"Introduction: Sanitary control mechanisms differ greatly from country to country. Therefore, it is important to know citizens' perception of different realities. We aimed to determine the factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic. Methods: This is an analytical cross-sectional study. We asked about six perceptions in regard to different situations experienced by inhabitants of 12 Latin American countries during the pandemic. Frequencies according to country were described and associations vs. other important variables were obtained. Results: Out of 8,489 participants, 68% stated that there were moments of collective hysteria. Honduras was the country that most perceived inadequate control mechanisms established by the government. Multivariate analysis showed that there were statistically significant differences among many of the countries according to the six evaluated items. The higher the level of education, the greater the perception of poor control in five of the aspects. Additionally, men had a lower perception of inadequate control. The older the age, the lower the perception of inadequate control regarding whether there was collective hysteria and shortages of basic essentials. Those with COVID-19 had a lower perception of medicine shortages. Conclusion: The population of multiple realities in Latin America have perceived a bad management of the pandemic. Citizens' perception is an important indicator of the performance of each government during the COVID-19 pandemic. This study may provide valuable information on the relationship between the effectiveness of government sanitary control and people's mental health, which ultimately helps to create objective prevention programs against post-traumatic stress disorder, depression, fear of contagion, and collective hysteria. In addition, governments could use this information to design effective mitigation plans for future unavoidable pandemic events based on the six criteria discussed here.

The Importance of Clinical Examination under General Anesthesia: Improving Parametrial Assessment in Cervical Cancer Patients

Background: Parametrial tumor involvement is an important prognostic factor in cervical cancer and is used to guide management. Here, we investigate the diagnostic value of clinical examination under general anesthesia (EUA) and magnetic resonance imaging (MRI) in determining parametrial tumor spread. Methods: Post-operative pathological findings of 400 patients with primary cervical cancer were compared to the respective MRI data and the results from EUA. The gynecological oncologist had access to the MR images during clinical assessment (augmented EUA, aEUA). Results: Pathologically proven parametrial tumor invasion was present in 165 (41%) patients. aEUA exhibited a higher accuracy than MRI alone (83% vs. 76%; McNemar’s odds ratio [OR] = 2.0, 95%CI 1.25–3.27, p = 0.003). Although accuracy was not affected by tumor size in aEUA, MRI was associated with a lower accuracy in tumors ≥2.5 cm (OR for a correct diagnosis compared to smaller tumors 0.22, p < 0.001). There was also a decrease in specificity when evaluating parametrial invasion by MRI in tumors ≥2.5 cm in diameter (p < 0.0001) compared to smaller tumors (< 2.5 cm). Body mass index had no influence on performance of either method. Conclusions: aEUA has the potential to increase the diagnostic accuracy of MRI in determining parametrial tumor involvement in cervical cancer patients

First M87 Event Horizon Telescope Results. IV. Imaging the Central Supermassive Black Hole

We present the first Event Horizon Telescope (EHT) images of M87, using observations from April 2017 at 1.3 mm wavelength. These images show a prominent ring with a diameter of similar to 40 mu as, consistent with the size and shape of the lensed photon orbit encircling the "shadow" of a supermassive black hole. The ring is persistent across four observing nights and shows enhanced brightness in the south. To assess the reliability of these results, we implemented a two-stage imaging procedure. In the first stage, four teams, each blind to the others' work, produced images of M87 using both an established method (CLEAN) and a newer technique (regularized maximum likelihood). This stage allowed us to avoid shared human bias and to assess common features among independent reconstructions. In the second stage, we reconstructed synthetic data from a large survey of imaging parameters and then compared the results with the corresponding ground truth images. This stage allowed us to select parameters objectively to use when reconstructing images of M87. Across all tests in both stages, the ring diameter and asymmetry remained stable, insensitive to the choice of imaging technique. We describe the EHT imaging procedures, the primary image features in M87, and the dependence of these features on imaging assumptions.Academy of Finland [274477, 284495, 312496]; European Commission Framework Programme Horizon 2020 Research and Innovation action [731016]; Black Hole Initiative at Harvard University through John Templeton Foundation [60477]; Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT, Chile) [PIA ACT172033, Fondecyt 1171506, BASAL AFB-170002, ALMA-conicyt 31140007]; Consejo Nacional de Ciencia y Tecnologia (CONACYT, Mexico) [104497, 275201, 279006, 281692]; Direccion General de Asuntos del Personal Academico-Universidad Nacional Autonoma de Mexico (DGAPA-UNAM) [IN112417]; European Research Council Synergy Grant "BlackHoleCam: Imaging the Event Horizon of Black Holes" [610058]; Generalitat Valenciana postdoctoral grant [APOSTD/2018/177]; Gordon and Betty Moore Foundation [GBMF 947, GBMF-3561, GBMF-5278]; Japanese Government (Monbukagakusho: MEXT) Scholarship; Japan Society for the Promotion of Science (JSPS) [JP17J08829]; JSPS Overseas Research Fellowships; Key Research Program of Frontier Sciences, Chinese Academy of Sciences (CAS) [QYZDJ-SSW-SLH057, QYZDJ-SSW-SYS008]; Leverhulme Trust Early Career Research Fellowship; MEXT/JSPS KAKENHI [18KK0090, JP18K13594, JP18K03656, JP18H03721, 18K03709, 18H01245, 25120007]; MIT International Science and Technology Initiatives (MISTI) Funds; Ministry of Science and Technology (MOST) of Taiwan [105-2112-M-001-025-MY3, 106-2112-M-001-011, 106-2119-M-001-027, 107-2119-M-001-017, 107-2119-M-001-020, 107-2119-M-110-005]; National Aeronautics and Space Administration (NASA) [80NSSC17K0649]; National Key Research and Development Program of China [2016YFA0400704, 2016YFA0400702]; National Science Foundation (NSF) [AST-0096454, AST-0352953, AST-0521233, AST-0705062, AST-0905844, AST-0922984, AST-1126433, AST-1140030, DGE-1144085]; Natural Science Foundation of China [11573051, 11633006, 11650110427, 10625314, 11721303, 11725312, 11873028, 11873073, U1531245, 11473010]; Natural Sciences and Engineering Research Council of Canada (NSERC); National Research Foundation of Korea [2015-R1D1A1A01056807, NRF-2015H1A2A1033752, NRF-2015H1D3A1066561]; Netherlands Organization for Scientific Research (NWO) VICI award [639.043.513]; Spinoza Prize [SPI 78-409]; Swedish Research Council [2017-00648]; Government of Canada through the Department of Innovation, Science and Economic Development Canada; Province of Ontario through the Ministry of Economic Development, Job Creation and Trade; Russian Science Foundation [17-12-01029]; Spanish Ministerio de Economia y Competitividad [AYA2015-63939-C2-1-P, AYA2016-80889-P]; US Department of Energy (USDOE) through the Los Alamos National Laboratory [89233218CNA000001]; Italian Ministero dell'Istruzione Universita e Ricerca through the grant Progetti Premiali 2012-iALMA [CUP C52I13000140001]; ALMA North America Development Fund; NSF [DBI-0735191, DBI-1265383, DBI-1743442, ACI-1548562]; Smithsonian Institution; Academia Sinica; National Key R&D Program of China [2017YFA0402700]; Science and Technologies Facility Council (UK); CNRS (Centre National de la Recherche Scientifique, France); MPG (Max-Planck-Gesellschaft, Germany); State of Arizona; NSF Physics Frontier Center award [PHY-0114422]; Kavli Foundation; National Science Foundation [PLR-1248097]; NSF Physics Frontier Center [PHY-1125897]; KREONET (Korea Research Environment Open NETwork); Jansky Fellowship program of the National Radio Astronomy Observatory (NRAO); South African Radio Astronomy Observatory (SARAO), which is a facility of the National Research Foundation (NRF), an agency of the Department of Science and Technology (DST) of South Africa; State Agency for Research of the Spanish MCIU through the "Center of Excellence Severo Ochoa" award [SEV-2017-0709]; Compute Ontario; Calcul Quebec; Compute Canada; IGN (Instituto Geografico Nacional, Spain); NSF; GBMF [GBMF-947]; CyVerse; [Chandra TM6-17006X]; [MM07B]; [AST-1207704]; [AST-1207730]; [AST-1207752]; [MRI-1228509]; [OPP-1248097]; [AST-1310896]; [AST-1312651]; [AST-1337663]; [AST-1440254]; [AST-1555365]; [AST-1715061]; [AST-1614868]; [AST-1615796]; [AST-1716327]; [OISE-1743747]; [AST-1816420]This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Multimodal prehabilitation for major surgery in elderly patients to lower complications: protocol of a randomised, prospective, multicentre, multidisciplinary trial (PREHABIL Trial).

INTRODUCTION The global volume of surgery is growing and the population ageing, and economic pressure is rising. Major surgery is associated with relevant morbidity and mortality. Postoperative reduction in physiological and functional capacity is especially marked in the elderly, multimorbid patient with low fitness level, sarcopenia and malnutrition. Interventions aiming to optimise the patient prior to surgery (prehabilitation) may reduce postoperative complications and consequently reduce health costs. METHODS AND ANALYSIS This is a multicentre, multidisciplinary, prospective, 2-arm parallel-group, randomised, controlled trial with blinded outcome assessment. Primary outcome is the Comprehensive Complications Index at 30 days. Within 3 years, we aim to include 2×233 patients with a proven fitness deficit undergoing major surgery to be randomised using a computer-generated random numbers and a minimisation technique. The study intervention consists of a structured, multimodal, multidisciplinary prehabilitation programme over 2-4 weeks addressing deficits in physical fitness and nutrition, diabetes control, correction of anaemia and smoking cessation versus standard of care. ETHICS AND DISSEMINATION The PREHABIL trial has been approved by the responsible ethics committee (Kantonale Ethikkomission Bern, project ID 2020-01690). All participants provide written informed consent prior to participation. Participant recruitment began in February 2022 (10 and 8 patients analysed at time of submission), with anticipated completion in 2025. Publication of the results in peer-reviewed scientific journals are expected in late 2025. TRIAL REGISTRATION NUMBER NCT04461301

First M87 Event Horizon Telescope Results. VI. The Shadow and Mass of the Central Black Hole

We present measurements of the properties of the central radio source in M87 using Event Horizon Telescope data obtained during the 2017 campaign. We develop and fit geometric crescent models (asymmetric rings with interior brightness depressions) using two independent sampling algorithms that consider distinct representations of the visibility data. We show that the crescent family of models is statistically preferred over other comparably complex geometric models that we explore. We calibrate the geometric model parameters using general relativistic magnetohydrodynamic (GRMHD) models of the emission region and estimate physical properties of the source. We further fit images generated from GRMHD models directly to the data. We compare the derived emission region and black hole parameters from these analyses with those recovered from reconstructed images. There is a remarkable consistency among all methods and data sets. We find that >50% of the total flux at arcsecond scales comes from near the horizon, and that the emission is dramatically suppressed interior to this region by a factor >10, providing direct evidence of the predicted shadow of a black hole. Across all methods, we measure a crescent diameter of 42 +/- 3 mu as and constrain its fractional width to be <0.5. Associating the crescent feature with the emission surrounding the black hole shadow, we infer an angular gravitational radius of GM/Dc(2) = 3.8 +/- 0.4 mu as. Folding in a distance measurement of 16.8(-0.7)(+0.8) gives a black hole mass of M = 6.5. 0.2 vertical bar(stat) +/- 0.7 vertical bar(sys) x 10(9) M-circle dot. This measurement from lensed emission near the event horizon is consistent with the presence of a central Kerr black hole, as predicted by the general theory of relativity.Academy of Finland [274477, 284495, 312496]; European Commission Framework Programme Horizon 2020 Research and Innovation action [731016]; Black Hole Initiative at Harvard University through John Templeton Foundation [60477]; Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT, Chile) [PIA ACT172033, Fondecyt 1171506, BASAL AFB-170002, ALMA-conicyt 31140007]; Consejo Nacional de Ciencia y Tecnologia (CONACYT, Mexico) [104497, 275201, 279006, 281692]; Direccion General de Asuntos del Personal Academico-Universidad Nacional Autonoma de Mexico (DGAPA-UNAM) [IN112417]; European Research Council Synergy Grant "BlackHoleCam: Imaging the Event Horizon of Black Holes" [610058]; Generalitat Valenciana postdoctoral grant [APOSTD/2018/177]; Gordon and Betty Moore Foundation [GBMF 947, GBMF-3561, GBMF-5278]; Japanese Government (Monbukagakusho: MEXT) Scholarship; Japan Society for the Promotion of Science (JSPS) [JP17J08829]; JSPS Overseas Research Fellowships; Key Research Program of Frontier Sciences, Chinese Academy of Sciences (CAS) [QYZDJ-SSW-SLH057, QYZDJ-SSW-SYS008]; Leverhulme Trust Early Career Research Fellowship; MEXT/JSPS KAKENHI [18KK0090, JP18K13594, JP18K03656, JP18H03721, 18K03709, 18H01245, 25120007]; MIT International Science and Technology Initiatives (MISTI) Funds; Ministry of Science and Technology (MOST) of Taiwan [105-2112-M-001-025-MY3, 106-2112-M-001-011, 106-2119-M-001-027, 107-2119-M-001-017, 107-2119-M-001-020, 107-2119-M-110-005]; National Aeronautics and Space Administration (NASA) [80NSSC17K0649]; National Key Research and Development Program of China [2016YFA0400704, 2016YFA0400702]; National Science Foundation (NSF) [AST-0096454, AST-0352953, AST-0521233, AST-0705062, AST-0905844, AST-0922984, AST-1126433, AST-1140030, DGE-1144085, AST-1207704, AST-1207730, AST-1207752, MRI-1228509]; Natural Science Foundation of China [11573051, 11633006, 11650110427, 10625314, 11721303, 11725312, 11873028, 11873073, U1531245, 11473010]; Natural Sciences and Engineering Research Council of Canada (NSERC); National Research Foundation of Korea [2015-R1D1A1A01056807, NRF-2015H1A2A1033752, NRF-2015H1D3A1066561]; Netherlands Organization for Scientific Research (NWO) VICI award [639.043.513]; Spinoza Prize [SPI 78-409]; Swedish Research Council [2017-00648]; Government of Canada through the Department of Innovation, Science and Economic Development Canada; Province of Ontario through the Ministry of Economic Development, Job Creation and Trade; Russian Science Foundation [17-12-01029]; Spanish Ministerio de Economia y Competitividad [AYA2015-63939-C2-1-P, AYA2016-80889-P]; US Department of Energy (USDOE) through the Los Alamos National Laboratory [89233218CNA000001]; Italian Ministero dell'Istruzione Universita e Ricerca through the grant Progetti Premiali 2012-iALMA [CUP C52I13000140001]; ALMA North America Development Fund; NSF [DBI-0735191, DBI-1265383, DBI-1743442, ACI-1548562]; Smithsonian Institution; Academia Sinica; National Key R&D Program of China [2017YFA0402700]; Science and Technologies Facility Council (UK); CNRS (Centre National de la Recherche Scientifique, France); MPG (Max-Planck-Gesellschaft, Germany); IGN (Instituto Geografico Nacional, Spain); State of Arizona; NSF Physics Frontier Center award [PHY-0114422]; Kavli Foundation; National Science Foundation [PLR-1248097]; NSF Physics Frontier Center [PHY-1125897]; South African Radio Astronomy Observatory (SARAO), which is a facility of the National Research Foundation (NRF), an agency of the Department of Science and Technology (DST) of South Africa; Compute Ontario; Calcul Quebec; Compute Canada; NSF; GBMF [GBMF-947]; CyVerse; [OPP-1248097]; [AST-1310896]; [AST-1312651]; [AST-1337663]; [AST-1440254]; [AST-1555365]; [AST-1715061]; [AST-1614868]; [AST-1615796]; [AST-1716327]; [OISE-1743747]; [AST-1816420]This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Human Coronavirus NL63 Open Reading Frame 3 encodes a virion-incorporated N-glycosylated membrane protein

Background: Human pathogenic coronavirus NL63 (hCoV-NL63) is a group 1 (alpha) coronavirus commonly associated with respiratory tract infections. In addition to known non-structural and structural proteins all coronaviruses have one or more accessory proteins whose functions are mostly unknown. Our study focuses on hCoV-NL63 open reading frame 3 (ORF 3) which is a highly conserved accessory protein among coronaviruses. Results: In-silico analysis of the 225 amino acid sequence of hCoV-NL63 ORF 3 predicted a triple membranespanning protein. Expression in infected CaCo-2 and LLC-MK2 cells was confirmed by immunofluorescence and Western blot analysis. The protein was detected within the endoplasmatic reticulum/Golgi intermediate compartment (ERGIC) where coronavirus assembly and budding takes place. Subcellular localization studies using recombinant ORF 3 protein transfected in Huh-7 cells revealed occurrence in ERGIC, Golgi- and lysosomal compartments. By fluorescence microscopy of differently tagged envelope (E), membrane (M) and nucleocapsid (N) proteins it was shown that ORF 3 protein colocalizes extensively with E and M within the ERGIC. Using N-terminally FLAG-tagged ORF 3 protein and an antiserum specific to the C-terminus we verified the proposed topology of an extracellular N-terminus and a cytosolic C-terminus. By in-vitro translation analysis and subsequent endoglycosidase H digestion we showed that ORF 3 protein is N-glycosylated at the N-terminus. Analysis of purified viral particles revealed that ORF 3 protein is incorporated into virions and is therefore an additional structural protein. Conclusions: This study is the first extensive expression analysis of a group 1 hCoV-ORF 3 protein. We give evidence that ORF 3 protein is a structural N-glycosylated and virion-incorporated protein.Web of Scienc

First M87 Event Horizon Telescope Results. V. Physical Origin of the Asymmetric Ring

The Event Horizon Telescope (EHT) has mapped the central compact radio source of the elliptical galaxy M87 at 1.3 mm with unprecedented angular resolution. Here we consider the physical implications of the asymmetric ring seen in the 2017 EHT data. To this end, we construct a large library of models based on general relativistic magnetohydrodynamic (GRMHD) simulations and synthetic images produced by general relativistic ray tracing. We compare the observed visibilities with this library and confirm that the asymmetric ring is consistent with earlier predictions of strong gravitational lensing of synchrotron emission from a hot plasma orbiting near the black hole event horizon. The ring radius and ring asymmetry depend on black hole mass and spin, respectively, and both are therefore expected to be stable when observed in future EHT campaigns. Overall, the observed image is consistent with expectations for the shadow of a spinning Kerr black hole as predicted by general relativity. If the black hole spin and M87's large scale jet are aligned, then the black hole spin vector is pointed away from Earth. Models in our library of non-spinning black holes are inconsistent with the observations as they do not produce sufficiently powerful jets. At the same time, in those models that produce a sufficiently powerful jet, the latter is powered by extraction of black hole spin energy through mechanisms akin to the Blandford-Znajek process. We briefly consider alternatives to a black hole for the central compact object. Analysis of existing EHT polarization data and data taken simultaneously at other wavelengths will soon enable new tests of the GRMHD models, as will future EHT campaigns at 230 and 345 GHz.Academy of Finland [274477, 284495, 312496]; European Commission Framework Programme Horizon 2020 Research and Innovation action [731016]; Black Hole Initiative at Harvard University through John Templeton Foundation [60477]; Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT, Chile) [PIA ACT172033, Fondecyt 1171506, BASAL AFB-170002, ALMA-conicyt 31140007]; Consejo Nacional de Ciencia y Tecnologica (CONACYT, Mexico) [104497, 275201, 279006, 281692]; Direccion General de Asuntos del Personal Academico-Universidad Nacional Autonoma de Mexico (DGAPA-UNAM) [IN112417]; European Research Council Synergy Grant "BlackHoleCam: Imaging the Event Horizon of Black Holes" [610058]; Generalitat Valenciana postdoctoral grant [APOSTD/2018/177]; Gordon and Betty Moore Foundation [GBMF-947, GBMF-3561, GBMF-5278]; Japanese Government (Monbukagakusho: MEXT) Scholarship; Japan Society for the Promotion of Science (JSPS) [JP17J08829]; JSPS Overseas Research Fellowships; Key Research Program of Frontier Sciences, Chinese Academy of Sciences (CAS) [QYZDJ-SSW-SLH057, QYZDJ-SSW-SYS008]; Leverhulme Trust Early Career Research Fellowship; MEXT/JSPS KAKENHI [18KK0090, JP18K13594, JP18K03656, JP18H03721, 18K03709, 18H01245, 25120007]; MIT International Science and Technology Initiatives (MISTI) Funds; Ministry of Science and Technology (MOST) of Taiwan [105-2112-M-001-025-MY3, 106-2112-M-001-011, 106-2119-M-001-027, 107-2119-M-0 01-017, 107-2119-M-001-020, 107-2119-M-110-005]; National Aeronautics and Space Administration (NASA) [80NSSC17K0649]; National Key Research and Development Program of China [2016YFA0400704, 2016YFA0400702]; National Science Foundation (NSF) [AST-0096454, AST-0352953, AST-0521233, AST-0705062, AST-0905844, AST-0922984, AST-1126433, AST-1140030, DGE-1144085, AST-1207704, AST-1207730, AST-1207752, MRI-1228509, OPP-1248097]; Natural Science Foundation of China [11573051, 11633006, 11650110427, 10625314, 11721303, 11725312, 11873028, 11873073, U1531245, 11473010]; Natural Sciences and Engineering Research Council of Canada (NSERC); National Research Foundation of Korea [NRF-2015H1A2A1033752, 2015-R1D1A1A01056807, NRF-2015H1D3A1066561]; Netherlands Organization for Scientific Research (NWO) VICI award [639.043.513]; Spinoza Prize [SPI 78-409]; Swedish Research Council [2017-00648]; Government of Canada through the Department of Innovation, Science and Economic Development Canada; Province of Ontario through the Ministry of Economic Development, Job Creation and Trade; Russian Science Foundation [17-12-01029]; Spanish Ministerio de Economia y Competitividad [AYA2015-63939-C2-1-P, AYA2016-80889-P]; US Department of Energy (USDOE) through the Los Alamos National Laboratory [89233218CNA000001]; Italian Ministero dell'Istruzione Universita e Ricerca through the grant Progetti Premiali 2012-iALMA [CUP C52I13000140001]; ALMA North America Development Fund; Sprows Family VURF Fellowship; NSERC Discovery Grant; NINS program of Promoting Research by Networking among Institutions [01421701]; NSF [ACI-1548562, DBI-0735191, DBI-1265383, DBI-1743442]; Compute Ontario; Calcul Quebec; Compute Canada; Smithsonian Institution; Academia Sinica; National Key R&D Program of China [2017YFA0402700]; Science and Technologies Facility Council (UK); CNRS (Centre National de la Recherche Scientifique, France); MPG (Max-Planck-Gesellschaft, Germany); IGN (Instituto Geografico Nacional, Spain); State of Arizona; NSF; NSF Physics Frontier Center award [PHY-0114422]; Kavli Foundation; GBMF [GBMF-947]; National Science Foundation [PLR-1248097]; NSF Physics Frontier Center grant [PHY-1125897]; South African Radio Astronomy Observatory (SARAO), which is a facility of the National Research Foundation (NRF), an agency of the Department of Science and Technology (DST) of South Africa; CyVerse; [Chandra TM6-17006X]; [DD7-18089X]; [AST-1310896]; [AST-1312651]; [AST-1337663]; [AST-1440254]; [AST-1555365]; [AST-1715061]; [AST-1615796]; [AST-1716327]; [OISE-1743747]; [AST-1816420]; [AST-1614868]This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

(De)Constructing ‘Therapeutic Itineraries’ of Hypertension Care: A Qualitative Study in the Philippines

Hypertension, a major risk factor for non-communicable diseases, remains poorly controlled in many countries. In the Philippines, it is still one of the leading causes of preventable deaths despite the accessibility and availability of essential technologies and medicine to detect and treat hypertension. This paper characterizes the ‘therapeutic itineraries’ of people with hypertension from poor communities in rural and urban settings in the Philippines. We employ longitudinal qualitative methodology comprised of repeat interviews and digital diaries using mobile phones from 40 recruited participants in 12 months. Our findings demonstrate that therapeutic itineraries, rather than being organized according to categories that stem from the structure of the health system (i.e., diagnosis, treatment, follow-up, adherence), diverge from clinical pathways. Therapeutic itineraries begin at a stage we label as ‘pre-diagnosis’ (PD). Following this, itineraries diverge according to two possible entry points into the healthcare system: via incidental diagnosis (ID) whereby participants were diagnosed with hypertension without deliberately seeking care for hypertension-related symptoms and symptom-driven diagnosis (SD) whereby their diagnosis was obtained during a clinical encounter specifically prompted by hypertension-related symptoms. Participants whose itineraries follow the SD route typically oscillated between periods of regular and intermittent medical treatment, while participants who were diagnosed incidentally (ID) typically opted for self-care As we follow our participants\u27 therapeutic itineraries, we explore the confluence of factors informing their care journey, namely, their conceptions of hypertension, their social relationships, as well the choices and trade-offs they make. We conclude with policy implications from our findings, chief of which is our proposition that models of care based on mere access and availability of clinical interventions fail to reflect the complexity of people\u27s lay understanding and their lived experiences of hypertension and are thus ultimately unhelpful in improving its control

Occurrence of non-toxic bioemulsifiers during polyhydroxyalkanoate production by Pseudomonas strains valorizing crude glycerol by-product

While screening for polyhydroxyalkanoate (PHA) producing strains, using glycerol rich byproduct as carbon source, it was observed that extracellular polymers were also secreted into the culture broth. The scope of this study was to characterize both intracellular and extracellular polymers, produced by Pseudomonas putida NRRL B 14875 and Pseudomonas chlororaphis DSM 50083, mostly focusing on those novel extracellular polymers. It was found that they fall into the class of bioemulsifiers (BE), as they showed excellent emulsion stability against different hydrocarbons/oils at various pH conditions, temperature and salinity concentrations. Cytotoxicity tests revealed that BE produced by P. chlororaphis inhibited the growth of highly pigmented human melanoma cells (MNT-1) by 50% at concentrations between 150-200 μg/mL, while no effect was observed on normal skin primary keratinocytes and melanocytes. This is the first study reporting mcl-PHA production by P. putida NRRL B-14785 and bioemulsifier production from both P. putida and P. chlororaphis strains