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Many low- and middle-income countries and international organisations have invested resources to strengthen primary health care (PHC). This study aimed to identify the challenges and unmet needs in the current PHC by assessing the experiences and perceptions of healthcare workers in three townships (Htan Ta Pin, Hmawbi, and Taikkyi) in Yangon, Myanmar.
The study was conducted among healthcare professionals and community leaders in three townships. Adopting a mixed-method approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (FGDs) were conducted online for qualitative data.
Enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5 ratings) while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28) and the impact of the intervention (4.7). The FGDs revealed that while specific infrastructures and equipment were reported insufficient and necessary, the need for financial support has been the recurrent theme throughout the discussions.
Utilising the World Health Organisation’s six building block frameworks, our findings suggest that a long-term targeted financial investment in the PHC system is critical in Myanmar through increasing healthcare expenditure per capita.
The efficiency of halide perovskite solar cells has progressed rapidly through a series of major breakthroughs. Currently, a certified efficiency of 25.2% has been achieved for a solar cell using a polycrystalline thin film. This is the result of having reached 75% of the Shockley–Queisser limit for single-junction solar cells. However, for further improvements, new breakthrough technologies are required. This article reviews the impact of previous breakthrough technologies on the efficiency of halide perovskite solar cells, based on certified efficiencies. We clarify the current status of halide perovskite solar cells and introduce photon recycling as the next technological innovation for higher efficiencies. Photon recycling keeps the photon concentration inside the light-harvesting layer high, and consequently, leads to open-circuit voltages close to the theoretical value. Although photon recycling has not yet been implemented in real halide perovskite solar cells, three key technologies for implementing it are examined.
This study aimed to investigate associations among spirituality, coping strategies, quality of life (QOL), and the effects of depression and anxiety thereon in cancer patients.
In total, 237 cancer patients referred to a psycho-oncology clinic at a university hospital in Korea were enrolled. After identifying predictors of patient QOL in a stepwise regression model, we developed a hypothetical path model wherein interpersonal coping was considered as a mediating variable between spirituality (meaning/peace) and QOL and wherein depression and anxiety affected each of these three variables.
The direct effect of spirituality (meaning/peace) on QOL was 36.7%. In an indirect model, interpersonal coping significantly mediated the relationship between spirituality (meaning/peace) and QOL. Depression exerted the largest negative effect on spirituality (meaning/peace), interpersonal coping, and QOL. Anxiety had negative effects on spirituality (meaning/peace) and QOL, but a positive effect on interpersonal coping.
Significance of results
Interpersonal coping strategies work as a partial mediator of the relationship between meaning/peace subscales of spirituality and QOL. Effective management of depression may help in achieving better outcomes associated therewith. Greater attention and efforts to improve social connectedness and meaning of life in spiritual well-being may improve the QOL of cancer patients.
Diet may play an important role in breast cancer recurrence or survival, and therefore assessment of long-term diet among breast cancer survivors is important in breast cancer survivorship research. Given that the diet of breast cancer survivors may differ from that of the general population, the use of a FFQ specific to this group may be needed. The objective of this study was to develop a FFQ for breast cancer survivors, the most commonly used tool to measure long-term dietary patterns in nutritional epidemiological studies. We collected information on the foods and amounts of foods consumed using 3-d dietary records from a total of 192 women who had been diagnosed with stage I–III breast cancers and had undergone breast cancer surgery at least 6 months before the baseline study. A total of 1254 foods and dishes consumed were re-grouped by the similarity of the main ingredients and/or serving units, and several dishes commonly consumed among the Korean population were added. After we performed contribution analyses and variability analyses to detect between-person variation for selected nutrients, we listed a total of 123 foods and dishes for the FFQ specific to breast cancer survivors. Our breast cancer survivor-specific FFQ can be used to estimate long-term dietary intake and to examine its association with breast cancer prognosis in epidemiological studies of breast cancer in Korea.
We demonstrate here the design, synthesis and characterization of two new chlorinated polymers, P(NDI2HD–T2Cl2) and P(NDI2OD–T2Cl2) based on N,N′-difunctionalized naphthalene diimide (NDI) and 3,3′-dichloro-2,2′-bithiophene (T2Cl2) moieties. Our results indicate that organic thin-film transistors (OTFTs) based on these new chlorinated polymers exhibit electron mobilities approaching 0.1 cm2V−1s−1 (Ion:Ioff ~ 106–107), with far less ambipolarity due to their lower highest occupied molecular orbital energies, and they are more stable under deleterious high-humidity conditions (RH ~ 60%) and upon submersion in water, compared with those fabricated with the parent non-chlorinated polymers. In addition, OTFTs fabricated with the new chlorinated polymers exhibit excellent operational stabilities with <3% degradations upon bias-stress test.
Feasibility of multiwavelength Raman spectroscopy was studied as a potential
in-line monitoring technique for grain size distribution in channel poly-Si used
in three dimensional stacked NAND (3D NAND) Flash memory devices. Various
channel poly-Si materials in 3D-NAND Flash memory devices, converted from
chemical vapor deposition (CVD) grown a-Si, were characterized using
non-contact, multiwavelength Raman spectroscopy and high resolution
cross-sectional transmission electron microscopy (HRXTEM). The Raman
characterization results were compared with HRXTEM images. The correlation
between the grain size distribution characterized by multiwavelength Raman
spectroscopy and “on current” (ION) of 3D NAND
Flash memory devices was investigated. Good correlation between these techniques
was seen. Multiwavelength Raman spectroscopy is very promising as a
non-destructive in-line monitoring technique for grain size distribution in
channel poly-Si used in 3D NAND Flash memory devices.
There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.
We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.
Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.
Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
Borna disease virus (BDV) predominantly infects horses and sheep, causing a broad range of behavioural disorders. It is controversial whether BDV infects humans and causes psychiatric disorders.
We searched for BDV-derived nucleic acids in blood of race horses and jockeys riding the horses.
We assayed for the BDV genome in RNA extracted from peripheral blood mononuclear cells (PBMC) of 39 race horses and 48 jockeys. Two polymerase chain reaction protocols [one-tube reverse transcription–polymerase chain reaction (RT-PCR) and two-step RT-PCR] were used to assay BDV p24 and p40 transcripts.
The p24 and p40 viral nucleic acid sequences were not detected in the PBMC RNAs from any of the race horses or jockeys.
These data do not support an epidemiological association between BDV infection, race horses and humans.
Oligonol was orally administered at 10 or 20 mg/kg body weight per d for 8 weeks to db/db mice with type 2 diabetes, and its effects were compared with those of the vehicle in db/db and m/m (misty, non-diabetic) mice. Serum and renal biochemical factors, protein expressions related to lipid metabolism and inflammation, and advanced glycation endproducts were measured. There were significant reductions in the serum lipid concentration, reactive oxygen species (ROS) and lipid peroxidation, as well as improvements in renal function parameters. In addition, oligonol treatment significantly decreased ROS levels and lipid peroxidation in the kidney. In particular, the renal lipid contents such as TAG and total cholesterol were significantly reduced in the oligonol-administered groups through the up-regulation of PPARα and down-regulation of sterol regulatory element-binding protein-1 in db/db mice. Moreover, oligonol inhibited non-fluorescent AGE formation and their receptor expression, suggesting that it could effectively inhibit AGE development caused by oxidative stress and/or dyslipidaemia in the kidney of db/db mice. Furthermore, augmented expressions of NF-κBp65, cyclo-oxygenase-2 and inducible NO synthase were down-regulated to the levels of m/m mice in the group given oligonol at 20 mg/kg. This means that oligonol would act as a regulator in the inflammatory response of type 2 diabetes. The present results suggest that oligonol could have renoprotective effects against abnormal lipid metabolism and ROS-related AGE formation in type 2 diabetes.
Thin ruthenium films were deposited using chemical vapor deposition from the single-source precursor tricarbonyl(1,3-cyclohexadiene)Ru(0) onto silicon, silicon dioxide and c-plane sapphire substrates in the absence of a carrier gas by thermolysis. Growth rate, resistivity, purity, crystallinity and microstructure were determined. Tricarbonyl(1,3-cyclohexadiene)Ru(0) gave metallic ruthenium films with near bulk resistivities (11-21μΩ-cm), high growth rates (up to 20 nm/min), and nearly featureless microstructures. Nucleation was rapid on all substrates tested. These results suggest that tricarbonyl(1,3-cyclohexadiene)Ru(0) is an excellent, practical precursor to use for practical applications that require depositing thin ruthenium films.
The transformation of Au thin films grown on sapphire (0001) substrates into nano crystals during thermal annealing was investigated by in situ synchrotron x-ray scattering and ex situ atomic force microscopy (AFM). By monitoring the Au(111) Bragg reflection and the low Q reflectivity and comparing them with ex situ AFM images, we found that polygonal-shape holes were nucleated and grow initially. As the holes grow larger and contact each other, their boundary turns into Au nano crystals. The Au nano crystals have a well-defined (111) flat top surface and facets in the in-plane direction.
The structural and the optical properties of 10-period In0.15Ga0.85N/GaN multiple quantum wells (MQWs) have been investigated using HRXRD (high-resolution X-ray diffraction) and PL (photoluminescence). For the samples, the barrier thickness was kept constant, 7.5 nm and the well thicknesses were varied, 1.5, 3.0, 4.5, and 6.0 nm. For the structural characterization, an ω/2θ-scan and an ω-scan for GaN (00 2) reflection and a reciprocal space mapping (RSM) around the GaN (10 5) lattice point were employed. The average strain for the MQWs increased as the well thickness increased. The MQW with a 6.0 nm well thickness experienced lattice relaxation and the crystallinity of the sample was poor compared to that of the other samples. MQWs with well thicknesses of 1.5, 3.0 and 4.5 nm, however, maintained lattice coherency with the GaN epilayers underneath, and the critical well thickness for lattice relaxation of the MQWs used in the study was 6.0 nm. The PL spectra showed that the relative emission intensity of the sample with a 6.0 nm well thickness was lower than for the others, a fact consistent with the X-ray results. The emission intensity, therefore, is considered to be affected by defects due to lattice relaxation of the epilayer.
The melting of the semicrystalline poly(ethylene oxide)(PEO)/ poly(ε -caprolactone) (PCL) multiblock copolymer was investigated by small and wide angle x-ray scattering. The two-stage melting was found in which the PEO block and the PCL block melt independently. The crystalline PEO Bragg peaks disappear at 30.5 °C while the block spacing increases due to the chain relaxation. The PEO crystalline domain size decreases continuously in proportion to the amount of the crystalline part. Above 40 °C, the PCL lamellae domains started to melt and the integrated intensity of the PCL Bragg peak decreases with increasing temperature. In the case of the PCL, however, the crystal domain size decreases only slightly. This indicates that the number of the PCL crystalline domains decreases during the melting.
Effect of host polymers on energy transfer in phosphorescent dye doped polymer light emitting devices has been investigated. Poly (N-vinylcarbazol) [PVK] and poly (9,9'-di-n-hexyl-2,7-fluorene-alt-1,4(2,5dinhexyloxy) phenylene) [PFHP] were examined as the host materials for the phosphorescent dyes fac tris(2-phenypyridine) irdium(III) [Ir(ppy)3] and 2,3,7,8,12,13,17,18-octaethyl-21H,23H-porphyrin platinum(II) [PtOEP]. The host and guest materials have the large spectrum overlap between the emission of the hosts and absorption of the guests. When the guests were doped in PVK, the singlet-singlet and triplet-triplet energy transfer took place efficiently. On the contrary, the energy transfer did not take place from φ-conjugated polymer PFHP to the guests, even though common requirements for Förster and Dexter energy transfer were fulfilled. Host aggregation in PFHP based phosphorescent dye doped light emitting devices can play an undesired role obstructing efficient energy transfer.
We have fabricated phosphorescent light emitting devices using mixed ligand bisorthometalated Ir(III) complexes, chlorobis-(2-phenylpyridinato-N,C2')pyridineiridium(III) [Ir(Cl)(ppy)2(py)] and chlorobis-(2-phenylpyridinato-N,C2')triphenylphosphine iridium(III) [Ir(Cl)(ppy)2P(Ph)3] chlorobis-(2-phenylpyridinato-N,C2')tri-n-butylphosphine iridium(III) [Ir(Cl)(ppy)2P(n-Bu)3], where ppy is the orthometalating ligand. These complexes vary in their HOMO (highest occupied molecular orbital), LUMO (lowest unoccupied molecular orbital) and emissive states in accordance with the φ-accepting abilities of the non-orthometalating ligands. The lifetimes and EL spectrum of the devices were studied and compared.
The highly strained interfacial structure and reaction of Co on Si(111) in the initial growth stage was studied by in-situ surface x-ray scattering. Co was deposited on Si(111) – (7×7) reconstruction by electron beam evaporation in ultra high vacuum. Our study reveals that the interfacial layer, formed by the reaction of Co with Si in the initial growth stage at room temperature, is a silicide layer with stoichiometry of Co2Si. The interfacial silicide layer is a commensurate phase of pseudohexagonal Co2Si, which shows a significant local atomic displacements imposed by Si substrate. The intensity oscillations at the anti-Bragg position with Co coverage show that a layer-by-layer consumption of silicon substrate occurs for the first 15 monolayers (ML) of Co deposited.