The key areas for PEN implementation included using the PEN approach to restore service delivery and management in primary health care facilities in Region 8, training health workers on PEN implementation and providing required materials and PEN implementation tools. Monitoring visits that included supportive supervision were also conducted in primary health care facilities in six provinces in Region 8. These assessed the use of the PEN protocols, availability of PEN implementation tools and whether the implementation targets for Region 8 had been met.

Disasters complicate the management of noncommunicable diseases (NCDs) by disrupting access to and delivery of health care, including medicines. Following Typhoon Haiyan in the Philippines in November 2013, much of the health infrastructure was destroyed and health service delivery was severely affected. This left many people with NCDs vulnerable as medicines were destroyed or washed away, food was scarce, and access to medicines and drugs and quality health care was difficult.

An ARM-based embedded system design schemes is proposed for the color-blind image processing system. The hardware and software of the embedded color-blind image processing system are designed using ARM core processor. Besides, a simple and convenient interface is implemented. This system supplies a general hardware platform for the applications of color-blind image processing algorithms, so that it may bring convenience for the test and rectification of color blindness.
Algorithms ; Color Vision Defects ; diagnosis ; Equipment Design ; Image Processing, Computer-Assisted ; instrumentation ; methods ; Software

Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Hip ; Humans ; Joints ; Knee ; Mortality ; Prognosis

Anlotinib has strong antiangiogenic effects and leads to vessel normalization.However,the"window period"characteristic in regulating vessel normalization by anlotinib cannot fully explain the long-term survival benefits achieved through combining it with other drugs.In this study,through RNA sequencing(RNA-seq)and label-free quantitative proteomics analysis,we discovered that anlotinib regulated the expression of components of the extracellular matrix(ECM),leading to a significant reduction in ECM stiffness.Our bioinformatic analysis revealed a potential positive relationship between the ECM pathway and gefitinib resistance,poor treatment outcomes for programmed death 1(PD-1)targeting,and unfavourable prognosis following chemotherapy in lung cancer patients.We administered anlotinib in combination with these antitumour drugs and visualized their distribution using fluorescent labelling in various tumour types.Notably,our results demonstrated that anlotinib prolonged the retention time and distribution of antitumour drugs at the tumour site.Moreover,the combination therapy induced notable loosening of the tumour tissue structure.This reduction was associated with decreased interstitial fluid pressure and tumour solid pressure.Additionally,we observed that anlotinib effectively suppressed the Ras homologue family member A(RhoA)/Rho-associated protein kinase(ROCK)signalling pathway.These findings suggest that,in addition to its antiangiogenic and vessel normalization effects,anlotinib can increase the distribution and retention of antitumour drugs in tumours by modulating ECM expression and physical properties through the RhoA/ROCK signalling pathway.These valuable insights contribute to the development of combination therapies aimed at improving tumour targeting in cancer treatment.

OBJECTIVES: With recent advances in nanoparticle manufacturing and applications, potential exposure to nanoparticles in various settings is becoming increasing likely. No investigation has yet been performed to assess whether respiratory tract exposure to cerium oxide (CeO2) nanoparticles is associated with alterations in protein signaling, inflammation, and apoptosis in rat lungs. METHODS: Specific-pathogen-free male Sprague-Dawley rats were instilled with either vehicle (saline) or CeO2 nanoparticles at a dosage of 7.0 mg/kg and euthanized 1, 3, 14, 28, 56, or 90 days after exposure. Lung tissues were collected and evaluated for the expression of proteins associated with inflammation and cellular apoptosis. RESULTS: No change in lung weight was detected over the course of the study; however, cerium accumulation in the lungs, gross histological changes, an increased Bax to Bcl-2 ratio, elevated cleaved caspase-3 protein levels, increased phosphorylation of p38 MAPK, and diminished phosphorylation of ERK-1/2-MAPK were detected after CeO2 instillation (p<0.05). CONCLUSIONS: Taken together, these data suggest that high-dose respiratory exposure to CeO2 nanoparticles is associated with lung inflammation, the activation of signaling protein kinases, and cellular apoptosis, which may be indicative of a long-term localized inflammatory response.
Animals ; Apoptosis/*drug effects ; Caspase 3/metabolism ; Cerium/chemistry ; Inflammation ; Lung/*drug effects/metabolism/pathology ; Male ; Metal Nanoparticles/chemistry/*toxicity ; Mitogen-Activated Protein Kinase 1/metabolism ; Mitogen-Activated Protein Kinase 3/metabolism ; Mitogen-Activated Protein Kinases/*metabolism ; Phosphorylation/drug effects ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction/*drug effects ; bcl-2-Associated X Protein/metabolism ; p38 Mitogen-Activated Protein Kinases/metabolism

No abstract available.
Education, Medical, Continuing ; Social Media

BACKGROUND: Advances in tissue engineering and regenerative medicine over the last three decades have made great progress in the development of diagnostic and therapeutic methodologies for damaged tissues. However, regenerative medicine is still not the first line of treatment for patients due to limited understanding of the tissue regeneration process. Therefore, it is prerequisite to develop molecular imaging strategies combined with appropriate contrast agents to validate the therapeutic progress of damaged tissues. METHODS: The goal of this review is to discuss the progress in the development of near-infrared (NIR) contrast agents and their biomedical applications for labeling cells and scaffolds, as well as monitoring the treatment progress of native tissue in living organisms. We also discuss the design consideration of NIR contrast agents for tissue engineering and regenerative medicine in terms of their physicochemical and optical properties. RESULTS: The use of NIR imaging system and targeted contrast agents can provide high-resolution and high sensitivity imaging to track/monitor the in vivo fate of administered cells, the degradation rate of implanted scaffolds, and the tissue growth and integration of surrounding cells during the therapeutic period. CONCLUSION: NIR fluorescence imaging techniques combined with targeted contrast agents can play a significant role in regenerative medicine by monitoring the therapeutic efficacy of implanted cells and scaffolds which would enhance the development of cell therapies and promote their successful clinical translations.
Contrast Media ; Fluorescence ; Humans ; Molecular Imaging ; Optical Imaging ; Regeneration ; Regenerative Medicine ; Tissue Engineering ; Translations

PURPOSE: To investigate the temperature-based differences of cortical bone ultrashort echo time MRI (UTE-MRI) biomarkers between body and room temperatures. Investigations of ex vivo UTE-MRI techniques were performed mostly at room temperature however, it is noted that the MRI properties of cortical bone may differ in vivo due to the higher temperature which exists as a condition in the live body. MATERIALS AND METHODS: Cortical bone specimens from fourteen donors (63 ± 21 years old, 6 females and 8 males) were scanned on a 3T clinical scanner at body and room temperatures to perform T1, T2*, inversion recovery UTE (IR-UTE) T2* measurements, and two-pool magnetization transfer (MT) modeling. RESULTS: Single-component T2*, IR-T2*, short and long component T2*s from bi-component analysis, and T1 showed significantly higher values while the noted macromolecular fraction (MMF) from MT modeling showed significantly lower values at body temperature, as compared with room temperature. However, it is noted that the short component fraction (Frac1) showed higher values at body temperature. CONCLUSION: This study highlights the need for careful consideration of the temperature effects on MRI measurements, before extending a conclusion from ex vivo studies on cortical bone specimens to clinical in vivo studies. It is noted that the increased relaxation times at higher temperature was most likely due to an increased molecular motion. The T1 increase for the studied human bone specimens was noted as being significantly higher than the previously reported values for bovine cortical bone. The prevailing discipline notes that the increased relaxation times of the bound water likely resulted in a lower signal loss during data acquisition, which led to the incidence of a higher Frac1 at body temperature.
Biomarkers ; Body Temperature ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Relaxation ; Tissue Donors ; Water

INTRODUCTION: Child sexual abuse (CSA) adversely affects a child's growth and well-being. This study aimed to describe the profile of children presenting to a tertiary paediatric emergency department(ED) with CSA. METHODS: Children 0-16 years old presenting to KK Women's and Children's Hospital ED from June 2016 to August 2020 with sexual abuse were retrospectively reviewed. We performed a secondary analysis on girls and stratified them by age <13 and ≥13 years old. RESULTS: There were 790 patients who made 833 visits for CSA. Victims were predominantly girls (747, 94.8%) and perpetrators were predominantly men (763, 96.6%). The abuse first occurred before the age of 13 years in 315 victims (39.9%). For 468 (59.2%), more than one incident occurred before presentation. Compared to girls ≥13 years old, girls <13 years old were more frequently abused by a family member (47.7% versus 8.0%, CONCLUSION The findings highlight common characteristics of CSA cases, and can aid the future identification and protection of vulnerable children. The fact that most children presented after more than one incident suggests the need to more closely monitor and protect potentially at-risk children.
Adolescent ; Child ; Child Abuse ; Child Abuse, Sexual ; Child, Preschool ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Parents ; Retrospective Studies