Implementation strategy of primary health care in Ovia communities

Primary health care is the essential health service provided at the grassroot level. Over the years the implementation of Primary Health Care (PHC) programmes in Edo state are bedeviled with associated challenges such as limited community participation, great communication gap that limit evaluation processes of PHC programme and slow pace collaboration among stakeholders. These challenges need to be averted through effective and people oriented strategies to ensure the implementation of primary health care. A descriptive research design with a population of the study comprised 1,024 primary health care stakeholders in Edo state. Multi-stage sampling technique was used to select 180 respondents for the study. The study found that intersectoral collaboration involving partnerships with community health agencies such as village health committees and ward health committees significantly influenced the implementation of PHC. Intersectoral collaboration, community mobilization strategy and community feedback mechanism are effective and efficient strategies for improved implementation of PHC programmes. The study recommended among others that National Primary Health Care Development Agency (NPHCDA) and State Primary Health Care Development Agency (SPHCDA) should strengthen partnership with international health organizations such as WHO, UNICEF, GAVI, UNDP and boost confidence and trust of these international organizations

Gauge coupling unification with large extra dimensions

We make a detailed study of the unification of gauge couplings in the MSSM with large extra dimensions. We find some scenarios where unification can be achieved (with the strong coupling constant at the Z mass within one standard deviation of the experimental value) with both the compactification scale and the SUSY breaking scale in the few TeV range. No enlargement of the gauge group or particle content is needed. One particularly interesting scenario is when the SUSY breaking scale is larger than the compactification scale, but both are small enough to be probed at the CERN LHC. Unification in two scales scenarios is also investigated and found to give results within the LHC.Comment: 17 pages, 3 figures, some discussions added, few additional references included. Version to appear in Phys. Rev.

Universal Quantum Computation using Exchange Interactions and Teleportation of Single-Qubit Operations

We show how to construct a universal set of quantum logic gates using control over exchange interactions and single- and two-spin measurements only. Single-spin unitary operations are teleported instead of being executed directly, thus eliminating a major difficulty in the construction of several of the most promising proposals for solid-state quantum computation, such as spin-coupled quantum dots, donor-atom nuclear spins in silicon, and electrons on helium. Contrary to previous proposals dealing with this difficulty, our scheme requires no encoding redundancy. We also discuss an application to superconducting phase qubits.Comment: 4.5 pages, including 2 figure

Comparison of Gadoterate Meglumine and Gadobutrol in the MRI Diagnosis of Primary Brain Tumors: A Double-Blind Randomized Controlled Intraindividual Crossover Study (the REMIND Study)

ABSTRACT BACKGROUNDANDPURPOSE: Effective management of patients with brain tumors depends on accurate detection and characterization of lesions. This study aimed to demonstrate the noninferiority of gadoterate meglumine versus gadobutrol for overall visualization and characterization of primary brain tumors. MATERIALS AND METHODS: This multicenter, double-blind, randomized, controlled intraindividual, crossover, noninferiority study included279patients.Bothcontrastagents(dose=0.1mmol/kgofbodyweight)wereassessedwith2identicalMRIsatatimeintervalof 2–14 days. The primary end point was overall lesion visualization and characterization, scored independently by 3 off-site readers on a 4-point scale, ranging from “poor” to “excellent.” Secondary end points were qualitative assessments (lesion border delineation, internal morphology, degree of contrast enhancement, diagnostic confidence), quantitative measurements (signal intensity), and safety (adverse events). All qualitative assessments were also performed on-site. RESULTS: Forall3readers,imagesofmostpatients(>90%)werescoredgoodorexcellentforoveralllesionvisualizationandcharacterizationwitheithercontrastagent;andthenoninferiorityofgadoteratemeglumineversusgadobutrolwasstatisticallydemonstrated.No significant differences were observed between the 2 contrast agents regarding qualitative end points despite quantitative mean lesion percentageenhancementbeinghigherwithgadobutrol(P81%ofthe patientswithbothcontrastagents.Similarpercentagesofpatientswithadverseeventsrelatedtothecontrastagentswereobservedwith gadoterate meglumine (7.8%) and gadobutrol (7.3%), mainly injection site pain. CONCLUSIONS: Thenoninferiorityofgadoteratemeglumineversusgadobutrolforoverallvisualizationandcharacterizationofprimary brain tumors was demonstrated

6-thioguanine treatment in inflammatory bowel disease: A critical appraisal by a European 6-TG working party

Recently, the suggestion to use 6-thioguanine (6-TG) as an alternative thiopurine in patients with inflammatory bowel disease (IBD) has been discarded due to reports about possible (hepato) toxicity. During meetings arranged in Vienna and Prague in 2004, European experts applying 6-TG further on in IBD patients presented data on safety and efficacy of 6-TG. After thorough evaluation of its risk-benefit ratio, the group consented that 6-TG may still be considered as a rescue drug in stringently defined indications in IBD, albeit restricted to a clinical research setting. As a potential indication for administering 6-TG, we delineated the requirement for maintenance therapy as well as intolerance and/or resistance to aminosalicylates, azathioprine, 6-mercaptopurine, methotrexate and infliximab. Furthermore, indications are preferred in which surgery is thought to be inappropriate. The standard 6-TG dosage should not exceed 25 mg daily. Routine laboratory controls are mandatory in short intervals. Liver biopsies should be performed after 6-12 months, three years and then three-yearly accompanied by gastroduodenoscopy, to monitor for potential hepatotoxicity, including nodular regenerative hyperplasia (NRH) and veno-occlusive disease (VOD). Treatment with 6-TG must be discontinued in case of overt or histologically proven hepatotoxicity. Copyright (c) 2006 S. Karger AG, Basel

Standard Model baryogenesis through four-fermion operators in braneworlds

We study a new baryogenesis scenario in a class of braneworld models with low fundamental scale, which typically have difficulty with baryogenesis. The scenario is characterized by its minimal nature: the field content is that of the Standard Model and all interactions consistent with the gauge symmetry are admitted. Baryon number is violated via a dimension-6 proton decay operator, suppressed today by the mechanism of quark-lepton separation in extra dimensions; we assume that this operator was unsuppressed in the early Universe due to a time-dependent quark-lepton separation. The source of CP violation is the CKM matrix, in combination with the dimension-6 operators. We find that almost independently of cosmology, sufficient baryogenesis is nearly impossible in such a scenario if the fundamental scale is above 100 TeV, as required by an unsuppressed neutron-antineutron oscillation operator. The only exception producing sufficient baryon asymmetry is a scenario involving out-of-equilibrium c quarks interacting with equilibrium b quarks.Comment: 39 pages, 5 figures v2: typos, presentational changes, references and acknowledgments adde

Mechanical vibrations of pendant liquid droplets

A simple optical deflection technique was used to monitor the vibrations of microlitre pendant droplets of deuterium oxide, formamide, and 1,1,2,2-tetrabromoethane. Droplets of different volumes of each liquid were suspended from the end of a microlitre pipette and vibrated using a small puff of nitrogen gas. A laser was passed through the droplets and the scattered light was collected using a photodiode. Vibration of the droplets resulted in the motion of the scattered beam and time-dependent intensity variations were recorded using the photodiode. These time- dependent variations were Fourier transformed and the frequencies and widths of the mechanical droplet resonances were extracted. A simple model of vibrations in pendant/sessile drops was used to relate these parameters to the surface tension, density and viscosity of the liquid droplets. The surface tension values obtained from this method were found to be in good agreement with results obtained using the standard pendant drop technique. Damping of capillary waves on pendant drops was shown to be similar to that observed for deep liquid baths and the kinematic viscosities obtained were in agreement with literature values for all three liquids studied

Integrated plasma proteomic and single-cell immune signaling network signatures demarcate mild, moderate, and severe COVID-19

The biological determinants of the wide spectrum of COVID-19 clinical manifestations are not fully understood. Here, over 1400 plasma proteins and 2600 single-cell immune features comprising cell phenotype, basal signaling activity, and signaling responses to inflammatory ligands were assessed in peripheral blood from patients with mild, moderate, and severe COVID-19, at the time of diagnosis. Using an integrated computational approach to analyze the combined plasma and single-cell proteomic data, we identified and independently validated a multivariate model classifying COVID-19 severity (multi-class AUCtraining = 0.799, p-value = 4.2e-6; multi-class AUCvalidation = 0.773, p-value = 7.7e-6). Features of this high-dimensional model recapitulated recent COVID-19 related observations of immune perturbations, and revealed novel biological signatures of severity, including the mobilization of elements of the renin-angiotensin system and primary hemostasis, as well as dysregulation of JAK/STAT, MAPK/mTOR, and NF-κB immune signaling networks. These results provide a set of early determinants of COVID-19 severity that may point to therapeutic targets for the prevention of COVID-19 progression

Role of genetic testing for inherited prostate cancer risk: Philadelphia prostate cancer consensus conference 2017

Purpose: Guidelines are limited for genetic testing for prostate cancer (PCA). The goal of this conference was to develop an expert consensus-dri

Functional mechanisms underlying pleiotropic risk alleles at the 19p13.1 breast-ovarian cancer susceptibility locus

A locus at 19p13 is associated with breast cancer (BC) and ovarian cancer (OC) risk. Here we analyse 438 SNPs in this region in 46,451 BC and 15,438 OC cases, 15,252 BRCA1 mutation carriers and 73,444 controls and identify 13 candidate causal SNPs associated with serous OC (P=9.2 × 10-20), ER-negative BC (P=1.1 × 10-13), BRCA1-associated BC (P=7.7 × 10-16) and triple negative BC (P-diff=2 × 10-5). Genotype-gene expression associations are identified for candidate target genes ANKLE1 (P=2 × 10-3) and ABHD8 (P<2 × 10-3). Chromosome conformation capture identifies interactions between four candidate SNPs and ABHD8, and luciferase assays indicate six risk alleles increased transactivation of the ADHD8 promoter. Targeted deletion of a region containing risk SNP rs56069439 in a putative enhancer induces ANKLE1 downregulation; and mRNA stability assays indicate functional effects for an ANKLE1 3′-UTR SNP. Altogether, these data suggest that multiple SNPs at 19p13 regulate ABHD8 and perhaps ANKLE1 expression, and indicate common mechanisms underlying breast and ovarian cancer risk