The effect of CLOSER-computer-based exercise program in older adults with a history of falls: A pilot study.

CLOSER is a computer-based exercise program that aims to improve older adults' health, fitness and social lives. This pilot study aimed to examine the effect of CLOSER, the first computer-based exercise program developed for older adults on a national scale, on those with a history of falls. Forty-eight older adults (71.33 ± 7.47) with a history of falling at least once in the last year were included in the study. Older adults performed CLOSER exercises for (balance maintenance, neck rotation, rhythmic walking, knee flexion and trunk rotation) 2 sessions per week for eight weeks. All individuals were evaluated at baseline and the end of the eighth week. The primary outcome measures were the 30-s Chair-Stand Test (p = 0.002), the Berg Balance Scale (p = 0.002), the Falls Efficacy Scale International (p = 0.003), the Timed Up and Go Test (p = 0.008) and the motivation level (p = 0.007) statistically significant improvements were observed. The results show that a CLOSER-computer-based exercise program effectively increases balance and reduces the risk and fear of falling. In the future, CLOSER could significantly contribute to the healthcare system as an alternative aid for home-based exercise.

Hagenia abyssinica-Biomediated Synthesis of a Magnetic Fe3O4/NiO Nanoadsorbent for Adsorption of Lead from Wastewater.

Magnetic nanocomposite adsorbents are cost-effective, environmentally friendly, easy to use, and highly efficient at removing metals from large volumes of wastewater in a short time by using an external magnetic field. In this study, an Fe3O4/NiO composite nanoadsorbent was prepared by varying the mass percent ratios of NiO (50, 40, 30, 20%), which are denoted Fe3O4/50%NiO, Fe3O4/40%NiO, Fe3O4/30%NiO, and Fe3O4/20%NiO, respectively, using Hagenia abyssinica plant extract as the template/capping agent and a simple mechanical grinding technique. The nanocomposites were characterized using an X-ray diffractometer (XRD), scanning electron microscopy (SEM), Fourier transform infrared (FT-IR) spectroscopy, nitrogen adsorption, and ζ-potential measurements. The adsorption performance of the nanoadsorbent was assessed for the removal of lead (Pb2+) ions from aqueous solutions. Among the composite adsorbents, Fe3O4/50%NiO demonstrated the best Pb(II) removal efficiency (96.65%) from aqueous solutions within 80 min at pH 8, at a 100 mg/L lead concentration and 0.09 g of adsorbent dose. However, with the same parameter, only 62.8% of Pb(II) was removed using Fe3O4 nanoparticles (NPs). The adsorptive performance indicated that the optimum amount of porous material (NiO) in the preparation of the Fe3O4/NiO composite nanoadsorbent, with the aid of H. abyssinica plant extract, enhances the removal of toxic heavy metals from aqueous solutions. Multiple isotherm and kinetic models were used to analyze the equilibrium data. Adsorption isotherm and kinetic studies were found to follow the Freundlich isotherm and pseudo-second-order kinetics, respectively.

Annealing Effect on Mechanical and Tribological Behaviors of Nanoscale Mechanics of Zr60Cu25Al5Ag5Ni5 Thin-Layer Metallic Glasses for Engineering Materials Applications.

A new and unique alloy formulation design strategy has been developed in order to fabricate thin-layered metallic glasses (TLMGs) with superior fracture resistance and low coefficient of friction (COF) during the nanoscratching test. Due to the outstanding properties, TFMG could be applied for different uses, such as for surface coating, biomedical, bioimprinting, electronic devices, spacecraft, and railway, all of which need surface fracture resistance. The fabricated Zr-based metallic glass was prepared from Zr, Al, Cu, Ni, and Ag above 99.9 Wt % in purity by arch melting techniques. TFMGs were coated on silicon wafer by sputtering the vapor deposition method from bulk metallic glass then annealed below glass transition temperature Tg ∼ 450 °C for 10, 30, and 60 min. Nanoindentation and nanoscratch tests were used to investigate nanomechanical and nanotribological properties, and atomic force microscopy (AFM) was used to examine the surface morphology and microstructures of TLMG. The nanoindentation data indicated that the average hardness of metallic glasses increased from 9.75 (as-cast MG) to 13.4 GPa (annealed for 60 min). Coefficients of friction for the cast sample, annealed for unannealed, 10, 30, and 60 min, were 0.062, 0.049, 0.039, and 0.03, respectively, as well as the wear depths were 201.56, 148.43, 37.32, and 25.27 nm, respectively. These studies show that the coefficient of friction and wear rate decreases when the annealing time increases as a result of atomic reordering and structural relaxation that occurred at longer annealing times. Furthermore, continuous wear process, wear depth, wear track volume, and contact area decrease with increasing annealing time. This study can be used to design protocols to prepare novel TLMGs, which have outstanding mechanical and tribological properties for engineering materials applications.

Healable supramolecular micelle/nano-encapsulated metal composite phase change material for thermal energy storage.

Phase change materials (PCMs) have emerged as promising materials for latent heat storage due to their characteristic solid-liquid phase transition behavior during the melting and cooling process. Among them, organic phase change materials are commonly used in latent heat storage. Herein, new phase change self-assembled micelles (PCSM) demonstrated thermal-based phase transition properties. Silver nanoparticles were employed as an additive to improve the thermal properties of the shape-stabilized composite PCSM. The surface morphology and microstructure, general thermal properties and heat adsorption and release behaviors of the samples were characterized with the aid of TEM, SEM, OM, DSC, TGA and DLS techniques. The DSC curve showed that the latent heat adsorption and temperature, heat capacity and thermal reliability of the composite PCSM improved upon the addition of Ag NPs. The TGA curves demonstrated that the presence of Ag NPs increased the onset decomposition temperature and the peak weight loss temperature. PCSM demonstrated low thermal conductivity, whereas the composite PCSM showed better thermal conductivity. This study provides new insight into the promising preparation of healable composite PCMs and their application in thermal energy storage.

Incidence of Diabetic Foot Ulcer and Its Predictors Among Diabetes Mellitus Patients at Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia: A Retrospective Follow-Up Study.

AIM: The incidence of a diabetic foot ulcer (DFU) is increasing over the previous decade with an increasing prevalence of diabetes mellitus (DM). Despite the increasing incidence of DFU, there is limited information about the problem in Ethiopia. Hence, this study aimed to investigate the incidence of DFU and its predictors among newly diagnosed DM patients who were on follow-up at Felege Hiwot Referral Hospital. METHODS: Institution-based retrospective follow-up study was conducted at Felege Hiwot Referral Hospital among newly diagnosed DM patients from January 1, 2009, to December 31, 2018. A simple random sampling method was used to select 401 study participants from a total of 723 eligible population. Data was entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. The incidence rate was estimated using person-years of observation and Nelson-Aalen cumulative hazard function, showing the cumulative probability of diabetic foot ulcer, was done. The best model (Gompertz) was selected using the AIC and log-likelihood method. Hazard ratio (HR) with its 95% confidence interval was computed and variables having a p-value less than 0.05 in the multivariable model were considered to be significantly associated with DFU. RESULTS: A total of 387 patients were followed retrospectively for a median follow-up time of 95 months. Out of all, 66 (17.05%) patients developed DFU with an incidence rate of 4 cases per 100 person-years of observation. Diabetic nephropathy (adjusted hazard ratio (AHR) = 2.37, 95% CI: 1.33-54.24), diabetic retinopathy (AHR = 5.56, 95% CI: 2.64-11.74), and increased body mass index (AHR = 1.13, 95% CI: 1.01-1.27) were found to increase the hazard of DFU. CONCLUSION: The incidence of DFU was relatively high. Diabetic nephropathy, diabetic retinopathy, and body mass index were its significant predictors. Therefore, close monitoring of patients with co-morbidities and increased body mass index should be considered to reduce DFU.

Correction to: High burden of undernutrition among primary school-aged children and its determinant factors in Ethiopia; a systematic review and meta-analysis.

An amendment to this paper has been published and can be accessed via the original article.

High burden of undernutrition among primary school-aged children and its determinant factors in Ethiopia; a systematic review and meta-analysis.

BACKGROUND: Undernutrition remains a major public health concern affecting both children and adolescents in Ethiopia. However, little attention has been given to the undernutrition of primary school-aged children, with their exclusion within national surveys. Therefore, this systematic review and meta-analysis was conducted to determine pooled estimate and determinant factors of undernutrition among primary school-aged children (6 to 15 years of age) in Ethiopia. METHOD: We systematically retrieved available articles on the prevalence of undernutrition in primary school-aged children in Ethiopia by using a number of computerized databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Science Direct between September 1 and November 25, 2019. Two authors independently extracted relevant data using a standardized data extraction form. Heterogeneity among included studies was assessed with the Cochrane Q test statistics and Higgins I2 tests. The pooled estimates and determinant factors of school-aged undernutrition were assessed with random-effects model using Stata/se Version 14. RESULT: We have retrieved 30 eligible articles with pooled sample size of 16,642 primary school- aged children to determine the prevalence of undernutrition in Ethiopia. Hence, the pooled prevalence of stunting, underweight, and wasting were found to be 21.3% (95% CI: 17.0, 25.5), 18.2% (95% CI: 14.4, 22.0) and 17.7% (95% CI, 13.5, 21.8) respectively. Heterogeneity was assessed by doing subgroup analysis for study province/region. Thus, the highest prevalence of stunting was 27.6% (95% CI, 20.7, 34.5) and underweight 22.7% (95% CI, 19.2, 26.3) in Amhara Region while, in the instance of wasting, it was 19.3%(95% CI: 5.1, 33.4) in Southern Nations, Nationalities and People's Region. Maternal educational status (OR = 1.91, 95% CI: 1.33, 2.73), age of school-aged child (OR = 0.56, 95% CI: 0.44, 0.72) and sex of school-aged child (OR = 0.73, 95% CI: 0.62, 0.85) were found to be significantly associated with stunting. Maternal educational status (OR = 0.6, 95% CI: 0.36, 0.9) and age of school-aged child (OR = 2.74, 95% CI: 1.81, 4.14) were associated with thinness/wasting. Parasitic infection (OR = 2.02, 95% CI: 1.10, 3.73) were associated with underweight of school age children. CONCLUSION: The prevalence of stunting and underweight among primary school-aged children are moderately high while acute undernutrition (wasting) is more critical than under-five national average as reported in the 2016 Ethiopian Demography and Health Survey. Therefore, this finding warrants the need to design a school-aged children nutrition survey and expand school feeding programs to improve the nutritional status of primary school-aged children in the country. In addition, emphasis should be given to female school-aged children in the early school years, creating awareness for those mothers who lack formal education, and preventing and treating/deworming parasitic infection. Moreover, researchers must conduct research in province/regions which have not yet studied school aged children's nutritional status to date.

Dual stimuli-responsive supramolecular boron nitride with tunable physical properties for controlled drug delivery.

The new concept of modifying and tailoring the properties of existing two-dimensional (2D) nanomaterials by invoking the assembly of supramolecular networks upon association with a adenine-functionalized macromer (A-PPG) has significant potential to facilitate the development of highly water-dispersible few-layered 2D nanosheets. In this study, we propose that water-soluble A-PPG directly self-assembles into a long-period stacking-ordered lamellar structure over the surface of hexagonal boron nitride (BN) in aqueous solution, due to the efficient non-covalent interactions between A-PPG and BN nanosheets. The layer number of BN nanosheets can be easily tuned by altering the mass ratio of the A-PPG and BN blend, and the resulting exfoliated nanosheets also exhibit excellent temperature/pH-responsive behavior, biocompatibility and extremely high drug-loading capacity (up to 36.2%), features that are highly desirable yet exceedingly rare in traditional 2D nanomaterials. Importantly, in vitro drug release studies showed the drug-loaded nanosheets function as a stable nanocarrier with excellent stability and drug entrapment under normal physiological conditions. Increasing the environmental temperature to 40 °C or decreasing the pH to 5.5 triggered rapid release of the encapsulated drug from the drug-loaded nanosheets, suggesting this newly developed material has potential as a novel multi-responsive 2D nanocarrier to safely deliver drugs and effectively facilitate controlled drug release under specific microenvironmental conditions. This study provides new insight towards the promising application of this system in controlled release drug delivery systems.

Comparison of the use of antibiotic-loaded calcium sulphate and wound irrigation-suction in the treatment of lower limb chronic osteomyelitis.

AIMS: We sought to compare the efficacy of antibiotic-loaded calcium sulphate with wound irrigation-suction in patients with lower limb chronic osteomyelitis. PATIENTS AND METHODS: Adult patients with lower limb chronic osteomyelitis treated at our hospital by means of segmental bone resection, antibiotic-loaded calcium sulphate implantation or wound irrigation-suction, followed by bone transport with external fixator from January 2011 to July 2015 were retrospectively evaluated. The clinical presentation, laboratory results, complications, docking obstruction, infection recurrence were compared. RESULTS: There were totally 74 patients met the inclusion criteria. Docking obstruction rate and infection recurrence were higher in the irrigation group with significant difference. The success rate of the first operation was 90.74% in the calcium sulphate group compared with 45% in the irrigation group. Postoperaton leakage of the incision happened more in the calcium sulphate group, but it wasn't a risk factor for docking obstruction and infection recurrence. Patients in the calcium sulphate group had shorter hospital stay and systemic antibiotic treatment, also with less external fixator index. CONCLUSIONS: The findings of our study suggest that antibiotic-loaded calcium sulphate implantation for lower chronic limb osteomyelitis was a more successful method than wound irrigation-suction, it greatly decreased infection recurrence and docking obstruction. Postoperative leakage after implantation didn't worsen patient's outcome.

Audio-Recorded Discharge Instructions for Limited English Proficient Parents: A Pilot Study.

BACKGROUND: Parents with limited English proficiency (LEP) demonstrate lower comprehension of discharge instructions. A study was conducted to (1) determine the feasibility of providing a greeting card with language-specific, audio-recorded discharge instructions to LEP parents; (2) describe use of and satisfaction with the cards; and (3) evaluate card effect on instruction comfort with home care and comprehension. METHODS: LEP parents of children undergoing day surgery from April to September 2016 were eligible. Participants were randomized to usual discharge instructions, or usual instructions plus a three-minute card with language-specific audio instructions that could be replayed repeatedly. Parents were surveyed by telephone two to seven days postdischarge to assess card use and satisfaction, comfort with home care, and discharge instruction recall (medications, home care, follow-up, and return precautions). Parent-reported instructions were compared to instructions in the medical record; concordance was determined by two blinded reviewers. Due to difficulty achieving recruitment goals, analysis focused on feasibility and acceptability. RESULTS: Of 83 parents enrolled, 66 (79.5%) completed the follow-up survey. Most had not completed high school (61.0%) and spoke Spanish (89.2%). Parents reported high satisfaction with the card (4.5/5 for ease of use, helpfulness, and understandability). Ninety-four percent shared the card with others, and 45.2% reported listening > 5 times. Besides reviewing the care instructions generally, parents reported using the card to review medications and engage others in the child's care. CONCLUSION: Providing language-concordant, audio-recorded discharge instructions was feasible, and parents reported high satisfaction with and frequent use of the cards with multiple caregivers.

Dynamic tungsten diselenide nanomaterials: supramolecular assembly-induced structural transition over exfoliated two-dimensional nanosheets.

A simple and effective method for direct exfoliation of tungsten diselenide (WSe2) into few-layered nanosheets has been successfully developed by employing a low molecular weight adenine-functionalized supramolecular polymer (A-PPG). In this study, we discover A-PPG can self-assemble into a long-range, ordered lamellar microstructure on the surface of WSe2 due to the efficient non-covalent interactions between A-PPG and WSe2. Morphological and light scattering studies confirmed the dynamic self-assembly behavior of A-PPG has the capacity to efficiently manipulate the transition between contractile and extended lamellar microstructures on the surface of metallic 1T-phase and semiconducting 2H-phase WSe2 nanosheets, respectively. The extent of WSe2 exfoliation can be easily controlled by systematically adjusting the amount of A-PPG in the composites, to obtain nanocomposites with the desired functional characteristics. In addition, the resulting composites possess unique liquid-solid phase transition behavior and excellent thermoreversible properties, revealing the self-assembled lamellar structure of A-PPG functions as a critical factor to manipulate and tailor the physical properties of exfoliated WSe2. This newly developed method of producing exfoliated WSe2 provides a useful conceptual and potential framework for developing WSe2-based multifunctional nanocomposites to extend their application in solution-processed semiconductor devices.

East African Perceptions of Barriers/Facilitators for Pediatric Clinical Research Participation and Development of the Inclusive Research Model.

PURPOSE: This study sought to gain a greater understanding of perceptions related to barriers/facilitators for pediatric (ages 0-17) clinical research participation among East African immigrant community members. DESIGN AND METHODS: Community leader interviews (n = 6) and focus groups with lay members (n = 16) from the three largest East African communities in the Seattle area (Eritrean, Ethiopian and Somali) were conducted. Discussions were semi-structured based on existing barrier/facilitator research and analyzed using directed content analysis to identify major themes. RESULTS: Analysis revealed two novel barrier sub-themes: inadequate interpretation and translation of information even when services were available and a lack of adequate vocabulary in preferred languages. Participants also confirmed previously identified logistical barriers/facilitators (lack of knowledge regarding clinical research; time, cost, transportation, and child care challenges; providing incentives) and psychosocial barriers/facilitators (mistrust of research; cultural and/or religious differences; connecting benefits to the community; involving religious/community leaders or organizations and including community members on the research team; transparency in the research process; presenting results to the community) for clinical research participation among underrepresented groups. CONCLUSION: Perceptions of barriers/facilitators for pediatric clinical research participation among East African immigrants identified two novel sub-themes and confirmed those previously described by other underrepresented communities. PRACTICE IMPLICATIONS: To facilitate more inclusive research participation, researchers, nurses and other health care providers might consider ensuring adequate time for discussion of the research study and process, engaging the community in the research process, employing lay reviews of translated materials and/or oral consent processes, and other strategies outlined in the Inclusive Research Model.