49,981 results match your criteria integrated approach

System understanding as a scientific foundation in radioactive waste disposal, legacy site and decommissioning programmes.

J Radiol Prot 2021 Apr 20. Epub 2021 Apr 20.


Ongoing national programmes and International forums have in recent decades developed and enhanced methods and strategies in how to address the characterisation of potentially suitable sites for radioactive waste repositories. Siting processes, site selection and site investigation programmes have been conducted for near surface and geological repositories and plans for construction are in progress or have already been implemented. Lessons learned from these national and international programmes are available and results are published. Read More

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Drivers of successful implementation of integrated care for multi-morbidity: Mechanisms identified in 17 case studies from 8 European countries.

Soc Sci Med 2021 Feb 3;277:113728. Epub 2021 Feb 3.

Erasmus School of Health Policy & Management, Erasmus University Rotterdam, The Netherlands, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands; Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands. Electronic address:

This paper provides a deeper understanding of the mechanisms underlying implementation strategies for integrated care. As part of the SELFIE project, 17 integrated care programmes addressing multi-morbidity from eight European countries were selected and studied. Data was extracted from 'thick descriptions' of the 17 programmes and analysed both inductively and deductively using implementation theory. Read More

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February 2021

Development of an integrated, holistic care package for people with lymphoedema for use at the level of the Primary Health Care Unit in Ethiopia.

PLoS Negl Trop Dis 2021 Apr 20;15(4):e0009332. Epub 2021 Apr 20.

Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom.

Background: Neglected Tropical Diseases (NTDs) are a group of several communicable and non-communicable diseases prevalent in tropical and subtropical areas. The co-endemicity of these diseases, the similarity of their clinical signs, and the need to maximize limited financial and human resources suggest the importance of adoptingan integratedapproach to their prevention and treatment.

Aims: This study describes the development of a comprehensive package of physical, mental health and psychosocial care for people with lower-limb lymphoedema caused bypodoconiosis, lymphatic filariasis (LF)or leprosy as part of the EnDPoINT program in Ethiopia. Read More

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A Semi-Supervised Multi-Task Learning Approach for Predicting Short-Term Kidney Disease Evolution.

IEEE J Biomed Health Inform 2021 Apr 20;PP. Epub 2021 Apr 20.

Kidney Disease (KD) may hide complex causes and is associated with a tremendous socio-economic impact. A timely identification and management from the first level of medical care represent the most effective strategy to address the growing global burden sustainably. Clinical practice guidelines suggest utilizing estimated Glomerular Filtration Rate (eGFR) for routine evaluation within a screening purpose. Read More

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Twin Nanopipettes for Real-Time Electrochemical Monitoring of Cytoplasmic Microviscosity at a Single-Cell Level.

Anal Chem 2021 Apr 20. Epub 2021 Apr 20.

State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093, China.

Cytoplasmic microviscosity (CPMV) plays essential roles in governing the diffusion-mediated cellular processes and has been recognized as a reliable indicator of the cellular response of many diseases and malfunctions. Current CPMV studies are exclusively established by probe-assisted optical methods, which nevertheless necessitate the complicated synthesis and delivery of optical probes into cells and thus the issues of biocompatibility and bio-orthogonality. Using twin nanopipettes integrated with a patch-clamp system, a practical electrochemical single-cell measurement is presented, which is capable of real-time and long-term CPMV detection without cell disruption. Read More

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Clinical Trial on Solid Second-Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: Advanced Bioregenerative Surgeries.

Int J Low Extrem Wounds 2021 Apr 20:15347346211003732. Epub 2021 Apr 20.

Vasile GoldisWestern University of Arad, Arad, Romania.

The supposition is that the usage of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcerative osteomyelitis of the diabetic foot allows rehabilitation from this critical illness. In this investigation, the focus was to normalize the use of platelet-rich fibrin (PRF) in patients with osteomyelitis not amputated, to use this second-generation platelet concentrate as a regeneration enabler. The researchers submitted and utilized A-PRF membranes (1300  × 8 min) in 7 patients (all diabetics) with osteomyelitis and cutaneous injury for 6 months. Read More

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Genomic and proteomic profiles of biofilms on microplastics are decoupled from artificial surface properties.

Environ Microbiol 2021 Apr 19. Epub 2021 Apr 19.

University of Greifswald, Institute of Pharmacy, Greifswald, Germany.

Microplastics in marine ecosystems are colonized by diverse prokaryotic and eukaryotic communities. How these communities and their functional profiles are shaped by the artificial surfaces remains broadly unknown. In order to close this knowledge gap, we set up an in situ experiment with pellets of the polyolefin polymer polyethylene (PE), the aromatic hydrocarbon polymer polystyrene (PS), and wooden beads along a coastal to estuarine gradient in the Baltic Sea, Germany. Read More

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An Integrated Approach of the Potential Underlying Molecular Mechanistic Paradigms of SARS-CoV-2-Mediated Coagulopathy.

Indian J Clin Biochem 2021 Apr 15:1-17. Epub 2021 Apr 15.

Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Maharishi Markandeshwar University (MMU), Mullana, Ambala, Haryana, India.

Coronavirus disease 2019 (Covid-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic disease which has affected more than 6.2 million people globally, with numbers mounting considerably daily. However, till date, no specific treatment modalities are available for Covid-19 and also not much information is known about this disease. Read More

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Integrated computer-aided engineering and design for DNA assemblies.

Nat Mater 2021 Apr 19. Epub 2021 Apr 19.

Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA.

Recently, DNA has been used to make nanodevices for a myriad of applications across fields including medicine, nanomanufacturing, synthetic biology, biosensing and biophysics. However, current DNA nanodevices rely primarily on geometric design, and it remains challenging to rationally design functional properties such as force-response or actuation behaviour. Here we report an iterative design pipeline for DNA assemblies that integrates computer-aided engineering based on coarse-grained molecular dynamics with a versatile computer-aided design approach that combines top-down automation with bottom-up control over geometry. Read More

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Behavioral and neuronal representation of numerosity zero in the crow.

J Neurosci 2021 Apr 19. Epub 2021 Apr 19.

Animal Physiology Unit, Institute of Neurobiology, Auf der Morgenstelle 28, University of Tübingen, 72076 Tübingen, Germany

Different species of animals can discriminate numerosity, the countable number of objects in a set. The representations of countable numerosities have been deciphered down to the level of single neurons. However, despite its importance for human number theory, a special numerical quantity, the empty set (numerosity zero), has remained largely unexplored. Read More

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Understanding how biologic and social determinants affect disparities in preterm birth and outcomes of preterm infants in the NICU.

Semin Perinatol 2021 Mar 24:151408. Epub 2021 Mar 24.

Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 1265 Welch Rd, X157, Stanford, CA 94305-5415, USA.

To understand the disparities in spontaneous preterm birth (sPTB) and/or its outcomes, biologic and social determinants as well as healthcare practice (such as those in neonatal intensive care units) should be considered. They have been largely intractable and remain obscure in most cases, despite a myriad of identified risk factors for and causes of sPTB. We still do not know how they might actually affect and lead to the different outcomes at different gestational ages and if they are independent of NICU practices. Read More

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Compound Sophorae Decoction: treating ulcerative colitis by affecting multiple metabolic pathways.

Chin J Nat Med 2021 Apr;19(4):267-283

Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China; Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China. Electronic address:

Ulcerative colitis (UC) is a chronic refractory non-specific intestinal inflammatory disease that is difficult to be cured. The discovery of new ulcerative colitis-related metabolite biomarkers may help further understand UC and facilitate early diagnosis. It may also provide a basis for explaining the mechanism of drug action in the treatment of UC. Read More

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Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study.

Hum Resour Health 2021 Apr 19;19(1):52. Epub 2021 Apr 19.

Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, 1000, Metro Manila, Philippines.

Background: There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice.

Methods: A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Read More

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Awareness, acceptability, and intention to initiate HIV pre-exposure prophylaxis among pregnant women.

AIDS Care 2021 Apr 19:1-13. Epub 2021 Apr 19.

Women's Health Research, MedStar Health Research Institute (MHRI), Washington, DC, USA.

HIV prevention is critically important during pregnancy, however, pre-exposure prophylaxis (PrEP) is underutilized. We conducted a survey of pregnant and non-pregnant women in a high HIV prevalence community in Washington D.C. Read More

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The role and relevance of public private partnerships in English healthcare.

Alison Tonge

Healthc Manage Forum 2021 Apr 20:8404704211004623. Epub 2021 Apr 20.

367000NHS England and NHS Improvement Midlands Birmingham, United Kingdom of Great Britain and Northern Ireland.

Health systems are now organized across England to deliver a more integrated population-based approach, not competing for services, rather collaborating and driving better value for the population from a fixed resource. This approach of health system leadership and collaboration has resulted in governance including a mixed economy of public-private provision but with greater alignment to delivering an agreed set of outcomes and value-based healthcare for the population. This dramatic shift from provider competition to collaboration and integration means a reframing of contracting and partnerships with the independent sector. Read More

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U Lüttge

New Phytol 1987 Aug;106(4):593-629

Institut fuUr Botanik, Technische Hochschule Darmstadt, D-6100 Darmstadt, FRG.

Plants having crassulacean acid metabolism (CAM) tend to occupy habitats where the prevailing environmental stress is scarcity of water. These are semi-arid or arid regions, salinas or epiphytic sites. CAM plants manage the dilemma of desiccation or starvation by nocturnal malic acid accumulation in the vacuoles. Read More

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Challenges in the harmonisation of global integrated assessment models: A comprehensive methodology to reduce model response heterogeneity.

Sci Total Environ 2021 Apr 7;783:146861. Epub 2021 Apr 7.

Basque Centre for Climate Change, Bilbao, Spain.

Harmonisation sets the ground to a solid inter-comparison of integrated assessment models. A clear and transparent harmonisation process promotes a consistent interpretation of the modelling outcomes divergences and, reducing the model variance, is instrumental to the use of integrated assessment models to support policy decision-making. Despite its crucial role for climate economic policies, the definition of a comprehensive harmonisation methodology for integrated assessment modelling remains an open challenge for the scientific community. Read More

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SopD from Salmonella specifically inactivates Rab8.

Biochim Biophys Acta Proteins Proteom 2021 Apr 16:140661. Epub 2021 Apr 16.

Institute of Biochemistry and Signal Transduction, University Medical Centre Hamburg-Eppendorf (UKE), Martinistrasse 52, 20251 Hamburg, Germany; Center for Integrated Protein Science Munich (CIPSM), Department Chemistry, Technical University of Munich, Lichtenbergstrasse 4, 85748 Garching, Germany; Centre for Structural Systems Biology (CSSB), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany. Electronic address:

Salmonella outer protein D (SopD) is secreted into a host during the first stages of the Salmonella infection and contributes to the systemic virulence of the bacterium. SopD2 is a SopD homolog and possesses GTPase activating protein (GAP) activity towards Rab32. Here, we identified Rab-proteins as putative SopD-targets using a yeast two-hybrid approach. Read More

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Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.

Aims And Objectives: To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care.

Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period. Read More

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A Practical Approach to the Evaluation and Diagnosis of Pediatric CNS Tumors.

Pediatr Dev Pathol 2021 Apr 19:10935266211007022. Epub 2021 Apr 19.

Children's Hospital Los Angeles, Department of Pathology and Laboratory Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California.

Tumor classification in neuropathology is a dynamic and complex topic, with many changes emerging in the past 5 years, up to and including the 2021 publication of the 5th edition of the World Health Organization Classification of Tumours of the Central Nervous System (CNS). For pediatric pathologists who will encounter brain tumors with varying frequency, it is important to understand the principles of these classification updates, particularly the inclusion of molecular genetic features and development of a layered, or integrated, diagnosis. This issue of Perspectives in Pediatric Pathology is dedicated to the examination of pediatric brain tumors, and features articles on intraoperative diagnosis and updated information on molecular-based classification for pediatric glial, glioneuronal, ependymal, and embryonal tumors of the CNS. Read More

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Approximate Bayesian inference for joint linear and partially linear modeling of longitudinal zero-inflated count and time to event data.

Stat Methods Med Res 2021 Apr 19:9622802211002868. Epub 2021 Apr 19.

Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran.

Joint modeling of zero-inflated count and time-to-event data is usually performed by applying the shared random effect model. This kind of joint modeling can be considered as a latent Gaussian model. In this paper, the approach of integrated nested Laplace approximation (INLA) is used to perform approximate Bayesian approach for the joint modeling. Read More

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Nanoscale Disorder Generates Subdiffusive Heat Transport in Self-Assembled Nanocrystal Films.

Nano Lett 2021 Apr 19. Epub 2021 Apr 19.

Department of Chemistry, University of California, Berkeley, California 94720, United States.

Investigating the impact of nanoscale heterogeneity on heat transport requires a spatiotemporal probe of temperature on the length and time scales intrinsic to heat navigating nanoscale defects. Here, we use stroboscopic optical scattering microscopy to visualize nanoscale heat transport in disordered films of gold nanocrystals. We find that heat transport appears subdiffusive at the nanoscale. Read More

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Structural and Functional Characterization of SARS-CoV-2 RBD Domains Produced in Mammalian Cells.

Anal Chem 2021 Apr 19. Epub 2021 Apr 19.

Center for Proteomics and Metabolomics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is still ongoing and dramatically influences our life, the need for recombinant viral proteins for diagnostics, vaccine development, and research is very high. The spike (S) protein, and particularly its receptor-binding domain (RBD), mediates the interaction with the angiotensin-converting enzyme 2 (ACE2) receptor on host cells and may be modulated by its structural features. Therefore, well-characterized recombinant RBDs are essential. Read More

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Acinar cell NLRP3 inflammasome and GSDMD activation mediates pyroptosis and systemic inflammation in acute pancreatitis.

Br J Pharmacol 2021 Apr 19. Epub 2021 Apr 19.

Center of Severe Acute Pancreatitis (CASP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

Background And Purpose: Pyroptosis is a lytic form of proinflammatory cell death characterised as caspase-1-dependent with canonical NLRP3 inflammasome-induced gasdermin D (GSDMD) activation. We aimed to investigate the role of acinar pyroptotic cell death in pancreatic injury and systemic inflammation in acute pancreatitis (AP).

Experimental Approach: Pancreatic acinar pyroptotic cell death pathway activation upon pancreatic toxin stimulation in vitro and in vivo were investigated. Read More

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Geochemical characterization and health risk assessment in two diversified environmental settings (Southern Italy).

Environ Geochem Health 2021 Apr 19. Epub 2021 Apr 19.

Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, 81100, Caserta, Italy.

An integrated approach using chemical and microbial indicators has been tested in two different sites of the Campania Plain (Southern Italy) with different land use covering and different hydrogeological features in order: (1) to define the water-rock interaction processes, (2) to differentiate sources of pollution in a detailed way (3) to evaluate the degree of water quality in the studied alluvial aquifer and (4) to identify the most worrying elements for human's health. Groundwater have showed a HCO-Ca signature for both investigated sites, and a progressive enrichment in alkali ions has been highlighted moving from the boundary of the plain toward the coastal areas, due to groundwater interaction with volcanic rocks along the flow path. The application of the Factor Analysis allowed to identify different sources of pollution, which were attributed to (a) leaks in the sewer system for the Agro-Aversano Area and also the spreading of manure as fertilizers in agricultural activities for the Caiazzo Plain. Read More

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Interlayer bonding strength of 3D printed PEEK specimens.

Soft Matter 2021 Apr 19. Epub 2021 Apr 19.

Department of Materials Science and Engineering, Lehigh University, Bethlehem, PA 18015, USA. and Department of Bioengineering, Lehigh University, Bethlehem, PA 18015, USA.

Recent advances in extrusion-based filament 3D printing technology enable the processability of high-performance polymers. Poly(ether ether ketone) (PEEK) is an important group of high-performance polymer that has been widely used in aerospace, automotive, and biomedical applications. The interlayer bonding strength of 3D printed PEEK is crucial for load-bearing applications, yet studies on 3D printed PEEK are sparse due to processing challenges. Read More

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Clarifying the concept of the four-season symphony (I SEA) in nursing practice: A Wilson's approach to concept analysis.

Nurs Forum 2021 Apr 19. Epub 2021 Apr 19.

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Acquired knowledge provides one with intuitive rationality as a means of achieving a goal. Spiritual, ethical and esthetic competencies are also required for acquiring intuitive rationality. Nurses pay less attention to intuitive rationality, think only with their brain rather than observe with their heart and therefore deprive themselves of proper, immediate and comprehensive cognition of their environment. Read More

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A Practical Approach to Hospital Visitation During a Pandemic: Responding With Compassion to Unjustified Restrictions.

Am J Crit Care 2021 Apr 19:e1-e10. Epub 2021 Apr 19.

Daniel Garros is a clinical professor, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, and a member of the Ethics Committee and senior attending physician in the pediatric intensive care unit, Stollery Children's Hospital, Edmonton, Alberta, Canada.

During the COVID-19 pandemic, evidence-based resources have been sought to support decision-making and strategically inform hospitals' policies, procedures, and practices. While greatly emphasizing protection, most guiding documents have neglected to support and protect the psychosocial needs of frontline health care workers and patients and their families during provision of palliative and end-of-life care. Consequently, the stage has been set for increased anxiety, moral distress, and moral injury and extreme moral hazard. Read More

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Climate change/variability and hydrological modelling studies in Zimbabwe: a review of progress and knowledge gaps.

SN Appl Sci 2021 12;3(5):549. Epub 2021 Apr 12.

School of Geography, Archaeology and Environmental Studies, University of Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, South Africa.

This paper reviews developments in climate science and hydrological modelling studies in Zimbabwe over the past 29 years in an effort to expose knowledge gaps within this research domain. We initially give a global and regional overview and then follow a systematic thematic approach in reviewing specifically online published, peer-reviewed journal articles on climate change/variability and hydrological modelling in Zimbabwe. The state and progress towards advanced integrated climate and hydrological modelling research are assessed, tracking benchmarks in the research methodologies (tools and techniques) used therein including geographic information systems and remote sensing. Read More

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