Experiences and ways PLWHA deal with their lives

The issue of HIV and AIDS and people living with HIV and AIDS is very sensitive which needs great attention. The population of infected individuals seems not to seek help and health services due to their illness. The barriers which prevent this population experience the meaning of social construction of their illness. The main objective of this study is to understand the day-to-day lives and the ways PLWHA deals with their lives. Qualitative method and participatory action research were used to gather information. The study found out that PLWHA have much to fight for in the complex and frightening areas of HIV research and treatment. Though there have been lacking scientific skills, all PLWHA can bring unique experiences and perspectives to an open discussion. The study concluded that facing the challenges of working with HIV and AIDS–individuals; consider the participatory research approach because it can reach out to individuals, groups and organizations.It was recommended that the ultimate goals of AIDS treatment and research activism are to accelerate scientific research knowledge that contributes towards cure, and to win an early widespread access to treatment for everyone infected with HIV. Developing a well-designed research can help PLWHA learn how to ask themselves different questions and ask if the medical and research establishments will address their concerns. Keywords: Health Services;, seeking behavior; persons living with HIV

Design and Development of Beans (Phaseolus Vulgaris) Shelling Machine

The design and construction of a beans shelling machine, using locally available materials is presented. A detailed design of the various machine components was done, and the appropriate engineering materials were selected for various parts of the machine. A working drawing, detailing the machine components was done for the shop floor fabrication of the machine. The results of the performance evaluation carried out, showed that a shelling efficiency of 81.3% was obtained. The machine has a capacity of 100kg/hr of unshelled beans and a production cost of forty-one thousand, one hundred and fifty naira (N41,150). Keywords: Beans, Shelling Machine, Efficiency, Vibration

Refractory lympho-epithelial carcinoma of the nasopharynx: a case report illustrating a protracted clinical course

Nasopharyngeal carcinoma is an uncommon cancer in North America. Its clinical course is typified by locally advanced disease at diagnosis and has a high propensity for both regional and distant spread. It is, therefore, typically treated with a combination of radiation and chemotherapy. This report describes our 10-year clinical and radiological findings in a 48-year-old Vietnamese male patient with locally-advanced T4N1M0 lympho-epithelial carcinoma of the nasopharynx. Despite a long remission period after his initial course of aggressive chemoradiation, his tumor recurred locally after 4 years. Thereafter, throughout a period of over 10 years, he has been treated with multiple courses of re-irradiation and three different trials of chemotherapy. He was ultimately provided with over 30 months of progression-free tumor control with the epidermal growth factor receptor (EGFR)-inhibitor cetuximab. This case illustrates the commonly protracted course of this disease and its responsiveness to multiple treatment modalities

Arctic Ocean Microbial Community Structure before and after the 2007 Record Sea Ice Minimum

Increasing global temperatures are having a profound impact in the Arctic, including the dramatic loss of multiyear sea ice in 2007 that has continued to the present. The majority of life in the Arctic is microbial and the consequences of climate-mediated changes on microbial marine food webs, which are responsible for biogeochemical cycling and support higher trophic levels, are unknown. We examined microbial communities over time by using high-throughput sequencing of microbial DNA collected between 2003 and 2010 from the subsurface chlorophyll maximum (SCM) layer of the Beaufort Sea (Canadian Arctic). We found that overall this layer has freshened and concentrations of nitrate, the limiting nutrient for photosynthetic production in Arctic seas, have decreased. We compared microbial communities from before and after the record September 2007 sea ice minimum and detected significant differences in communities from all three domains of life. In particular, there were significant changes in species composition of Eukarya, with ciliates becoming more common and heterotrophic marine stramenopiles (MASTs) accounting for a smaller proportion of sequences retrieved after 2007. Within the Archaea, Marine Group I Thaumarchaeota, which earlier represented up to 60% of the Archaea sequences in this layer, have declined to <10%. Bacterial communities overall were less diverse after 2007, with a significant decrease of the Bacteroidetes. These significant shifts suggest that the microbial food webs are sensitive to physical oceanographic changes such as those occurring in the Canadian Arctic over the past decade

Terrestrial organic carbon storage in a British moorland

Accurate estimates for the size of terrestrial organic carbon (C) stores are needed to determine their importance in regulating atmospheric CO2 concentrations. The C stored in vegetation and soil components of a British moorland was evaluated in order to: (i) investigate the importance of these ecosystems for C storage and (ii) test the accuracy of the United Kingdom's terrestrial C inventory. The area of vegetation and soil types was determined using existing digitized maps and a Geographical Information System (GIS). The importance of evaluating C storage using 2D area projections, as opposed to true surface areas, was investigated and found to be largely insignificant. Vegetation C storage was estimated from published results of productivity studies at the site supplemented by field sampling to evaluate soil C storage. Vegetation was found to be much less important for C storage than soil, with peat soils, particularly Blanket bog, containing the greatest amounts of C. Whilst the total amount of C in vegetation was similar to the UK national C inventory's estimate for the same area, the national inventory estimate for soil C was over three times higher than the value derived in the current study. Because the UK's C inventory can be considered relatively accurate compared to many others, the results imply that current estimates for soil C storage, at national and global scales, should be treated with caution

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

There are a number of potential physical advantages to performing orotracheal intubation in an upright position. The objective of this study was to measure the success of intubation of a simulated patient in an upright versus supine position by novice intubators after brief training. This was a cross-over design study in which learners (medical students, physician assistant students, and paramedic students) intubated mannequins in both a supine (head of the bed at 0°) and upright (head of bed elevated at 45°) position. The primary outcome of interest was successful intubation of the trachea. Secondary outcomes included log time to intubation, Cormack–Lehane view obtained, Percent of Glottic Opening score, provider assessment of difficulty, and overall provider satisfaction with the position. There were a total of 126 participants: 34 medical students, 84 physician assistant students, and 8 paramedic students. Successful tracheal intubation was achieved in 114 supine attempts (90.5 %) and 123 upright attempts (97.6 %; P = 0.283). Upright positioning was associated with significantly faster log time to intubation, higher likelihood of achieving Grade I Cormack–Lehane view, higher Percent of Glottic Opening score, lower perceived difficulty, and higher provider satisfaction. A subset of 74 participants had no previous intubation training or experience. For these providers, there was a non-significant trend toward improved intubation success with upright positioning vs supine positioning (98.6 % vs. 87.8 %, P = 0.283). For all secondary outcomes in this group, upright positioning significantly outperformed supine positioning

Feasibility of upright patient positioning and intubation success rates at two academic emergency departments

Objectives Endotracheal intubation is most commonly taught and performed in the supine position. Recent literature suggests that elevating the patient's head to a more upright position may decrease peri-intubation complications. However, there is little data on the feasibility of upright intubation in the emergency department. The goal of this study was to measure the success rate of emergency medicine residents performing intubation in supine and non-supine, including upright positions. Methods This was a prospective observational study. Residents performing intubation recorded the angle of the head of the bed. The number of attempts required for successful intubation was recorded by faculty and espiratory therapists. The primary outcome of first past success was calculated with respect to three groups: 0–10° (supine), 11–44° (inclined), and ≥ 45° (upright); first past success was also analyzed in 5 degree angle increments. Results A total of 231 intubations performed by 58 residents were analyzed. First pass success was 65.8% for the supine group, 77.9% for the inclined group, and 85.6% for the upright group (p = 0.024). For every 5 degree increase in angle, there was increased likelihood of first pass success (AOR = 1.11; 95% CI = 1.01–1.22, p = 0.043). Conclusions In our study emergency medicine residents had a high rate of success intubating in the upright position. While this does not demonstrate causation, it correlates with recent literature challenging the traditional supine approach to intubation and indicates that further investigation into optimal positioning during emergency department intubations is warranted

Residual Type 1 Immunity in Patients Genetically Deficient for Interleukin 12 Receptor β1 (IL-12Rβ1): Evidence for an IL-12Rβ1–Independent Pathway of IL-12 Responsiveness in Human T Cells

Genetic lack of interleukin 12 receptor β1 (IL-12Rβ1) surface expression predisposes to severe infections by poorly pathogenic mycobacteria or Salmonella and causes strongly decreased, but not completely abrogated, interferon (IFN)-γ production. To study IL-12Rβ1–independent residual IFN-γ production, we have generated mycobacterium–specific T cell clones (TCCs) from IL-12Rβ1–deficient individuals. All TCCs displayed a T helper type 1 phenotype and the majority responded to IL-12 by increased IFN-γ production and proliferative responses upon activation. This response to IL-12 could be further augmented by exogenous IL-18. IL-12Rβ2 was found to be normally expressed in the absence of IL-12Rβ1, and could be upregulated by IFN-α. Expression of IL-12Rβ2 alone, however, was insufficient to induce signal transducer and activator of transcription (Stat)4 activation in response to IL-12, whereas IFN-α/IFN-αR ligation resulted in Stat4 activation in both control and IL-12Rβ1–deficient cells. IL-12 failed to upregulate cell surface expression of IL-18R, integrin α6, and IL-12Rβ2 on IL-12Rβ1–deficient cells, whereas this was normal on control cells. IL-12–induced IFN-γ production in IL-12Rβ1–deficient T cells could be inhibited by the p38 mitogen-activated protein kinase (MAP) kinase inhibitor SB203580 and the MAP kinase kinase (MEK) 1/2 inhibitor U0126, suggesting involvement of MAP kinases in this alternative, Stat4-independent, IL-12 signaling pathway

PERANCANGAN ALAT PENGUPAS SABUT KELAPA MENGGUNAKAN METODE VDI 2221

The increasing demand for coconut productin in Sungai Kupah Village, Kuburaya Regency has&nbsp;resulted in workers needing a tool that can complete work more quickly and effiently. The tools&nbsp;used today stil use wedges where their use takes a long tie because the process in the process&nbsp;relies on human power. In additin, with non-ergonomic work positins, workers can also experience&nbsp;several work-related diseases such as back pain and back pain. The objecties of this research are (1)&nbsp;Designing an ergonomic coconut peeler according to consumer needs (2) Testig the performance of&nbsp;the tool (3) Testig worker fatiue before and aftr using the tool (4) Testig the level of consumer&nbsp;satifactin. The solutin used in this study is the VDI 2221, CVL method approach, measuring tool&nbsp; performance and analyzing the level of satifactin. The results obtained in this study are (1) produce a tool design according to consumer needs and have paid attntin to ergonomic aspects (2) The design of this tool produces a fairly fast stripping tie of 143 peeling fruit/hour when compared to tools using a wedge, namely 92 peeling fruit/hour (3) Worker fatiue test aftr using this tool showed 14.42 % of coconut owners, 11.20 % of worker 1 and 10.48 % of worker 2. This test resulted in CVL below 30% where workers did not experience fatiue. (4) Respondents feel comfortable with the designed tool as evidenced by the results of the 4.8 Linkert scale. Meanwhile, for ease of operatin, the result is 4.3, which means that respondents fid it easy to operate the designed tool. The conclusion in this study is that the currently designed tools are quite effctie, ergonomic and able to reduce the level of worker fatiue.Meningkatnya permintaan produksi kelapa di Desa Sungai Kupah Kabupaten Kuburaya&nbsp;mengakibatkan pekerja membutuhkan sebuah alat yang dapat menyelesaikan pekerjaan lebih&nbsp;cepat dan efiien. Alat yang digunakan saat ini masih menggunakan baji dimana penggunaannya&nbsp;membutuhkan waktu yang lama karena proses dalam pengerjaannya bertumpu pada tenaga&nbsp;manusia. Selain itu, dengan posisi pekerjaan yang tiak ergonomis, pekerja juga dapat mengalami&nbsp;beberapa penyakit akibat kerja sepert nyeri punggung dan sakit pinggang. Adapun tujuan&nbsp;penelitin ini yaitu (1)Merancang alat pengupas kelapa yang ergonomis sesuai dengan kebutuhan&nbsp;konsumen (2) Melakukan pengujian terhadap kinerja alat (3) Menguji kelelahan perkerja sebelum&nbsp;dan sesudah menggunakan alat (4) Menguji tigkat Kepuasan konsumen. Adapun solusi yang&nbsp;digunakan dalam penelitin ini yaitu dengan pendekatan metode VDI 2221, CVL, pengukuran&nbsp;kinerja alat dan analisis tigkat kepuasan. Hasil yang di dapatkan dalam penelitin ini yaitu (1)&nbsp;menghasilkan rancangan alat sesuai dengan kebutuhan konsumen dan telah memperhatikan&nbsp;aspek ergonomis (2) Rancangan alat ini menghasilkan waktu pengupasan yang cukup cepat yaitu&nbsp;143 pengupasan buah/jam jika dibandingkan dengan alat sebelumnya menggunakan baji yaitu 92&nbsp;pengupasan buah/jam (3) Uji kelelahan pekerja setelah menggunakan alat ini menunjukkan hasil&nbsp;yang cukup baik yaitu diperoleh hasil CVL. 14.42 % pemilik kelapa, 11.20% pekerja 1 dan 10.48 %&nbsp;pekerja 2. Pengujian ini menghasilkan CVL dibawah 30% dimana pekerja tiak mengalami&nbsp;kelelahan. (4) Responden merasa nyaman dengan alat yang dirancang yang dibuktian dengan&nbsp;hasil skala linkert 4.8. Sedangkan untuk kemudahan dalam pengoperasian didapatkan hasil 4.3&nbsp;artiya responden merasa mudah dalam mengoperasikan alat yang dirancang. Adapun kesimpulan&nbsp;dalam penelitin ini yaitu alat yang dirancang saat ini cukup efekti, ergonomis dan mampu&nbsp;mengurangi tigkat kelelahan pekerja

Recent Results from Epitaxial Growth on Step Free 4H-SiC Mesas

This paper updates recent progress made in growth, characterization, and understanding of high quality homoepitaxial and heteroepitaxial films grown on step-free 4H-SiC mesas. First, we report initial achievement of step-free 4H-SiC surfaces with carbon-face surface polarity. Next, we will describe further observations of how step-free 4H-SiC thin lateral cantilever evolution is significantly impacted by crystal faceting behavior that imposes non-uniform film thickness on cantilever undersides. Finally, recent investigations of in-plane lattice constant mismatch strain relief mechanisms observed for heteroepitaxial growth of 3C-SiC as well as 2H-AlN/GaN heterofilms on step-free 4H-SiC mesas will be reviewed. In both cases, the complete elimination of atomic heterointerface steps on the mesa structure enables uniquely well-ordered misfit dislocation arrays to form near the heterointerfaces with remarkable lack of dislocations threading vertically into the heteroepilayers. In the case of 3C-SiC heterofilms, it has been proposed that dislocation half-loops nucleate at mesa edges and glide laterally along the step-free 3C/4H interfaces. In contrast, 3C-SiC and 2H-AlN/GaN heterofilms grown on 4H-SiC mesas with steps exhibit highly disordered interface misfit dislocation structure coupled with 100X greater density of dislocations threading through the thickness of the heteroepilayers. These results indicate that the presence of steps at the heteroepitaxial interface (i.e., on the initial heteroepitaxial nucleation surface) plays a highly important role in the defect structure, quality, and relaxation mechanisms of single-crystal heteroepitaxial films