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Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement.

The results of the development and research of laser Doppler flowmetry for the diagnosis of microvascular hemodynamics with a differential analysis of the rhythmic component are presented.

Solid-state structures of para-sulfonatocalix[6]arene with dimethylammonium and bis-6-aminohexylammonium cations are mainly based on hydrogen bond interactions. In the two complexes the calixarene molecule adopts a chair conformation with small varieties in geometry influenced by the number and types of intra- and intermolecular interactions developed by polar substituents. A stepped layer topology is induced by this chair conformation in the two complexes. Structural motifs present in the two systems generate channels, which in the first complex include dimethylformamide solvent molecules, while in the second case they include water molecules. [ABSTRACT FROM AUTHOR]

The robustness of calix[4]arene dihydroxyphosphonic acid and its ubiquitous dimeric motif offers perspectives for predefined solid-state complexation with small molecules. In the current article, we describe the complex of calix[4]arene dihydroxyphosphonic acid with three different forms of bipyridyl ligand:  2,2‘-bipyridine, 4,4‘-bipyridine, and 1,2-bipyridylethane. A number of resemblances and differences in the interactions between the components in the complexes are pointed out. All the complexes are based on layers of calixarene dimers alternated with layers of bipyridyl molecules. While the complex with 2,2‘-bipyridine is encaged by a dense network of hydrogen bonds, the complexes with 4,4‘-bipyridine and 1,2-bipyridylethane generate an extended 1-D ladder network. All of the complexes present π−π interactions between the bipyridyl moieties and the calix[4]arene dihydroxyphosphonic acid. [ABSTRACT FROM AUTHOR]

Deltaic environments are often densely populated with high socio-economic values, and thus are hotspots of climatic, environmental and anthropogenic change. Large scale engineered structures, such as dike systems, have played an important role in shaping both environmental and socio-economic conditions in deltas, with such interventions more likely where there is a high population and a wealthy economy. Engineered interventions interact with the morphological evolution of the delta, reducing or removing sedimentation and accelerating subsidence, increasing the consequences of flooding and necessitating further adaptation. They also encourage further development, reinforcing this feedback. Thus, in these cases, the deltaic landscape and associated livelihoods can be considered to be the result of a coevolution process between natural delta processes and human engineered interventions. This paper explores this hypothesis. It analyses the history of large scale engineering interventions and their implications in five representative, large, populated deltas across the globe (Ganges-Brahmaputra-Meghna, Yangtze, Rhine-Meuse-Scheldt, Mekong and Nile). The results demonstrate coevolution has occurred and indicate that the response type and the management approach of these engineered structures have significant implications for future delta development. To understand and manage unintended consequences and the development of lock-in trajectories in deltas, a systematic understanding of delta development, including these coevolution processes is essential.

The solid state structures of the complexes between antiseptic chlorhexidine and three anionic calix[4]arene derivatives are described. Each of the three calixarenes shows typical self-organisation in the solid-state that will further impose a specific complexation of the active molecule in the co-crystal. [ABSTRACT FROM AUTHOR]

Measurement(s) social distancing feasibility • physical distancing feasibility Technology Type(s) geospatial analysis Sample Characteristic - Environment urban areas Sample Characteristic - Location Sub-Saharan Africa

Objectives:. To understand the impact that video telehealth has on outpatient visit volume and reimbursement as a method of maintaining care. Background:. As the coronavirus disease 2019 (COVID-19) spread across the United States starting in 2020, it caused numerous areas of medicine and healthcare to reexamine how we provide care to patients across all disciplines. One method clinicians used to rapidly adapt to these transformed settings was video telehealth, which was previously rarely used. Methods:. This retrospective review examined outpatient volume and reimbursement data of a large, academic department of surgery. The study reviewed data during 2 time periods: pre-COVID-19 (February 1, 2020, to March 15, 2020) and COVID-19 (March 16, 2020, to April 30, 2020). Results:. During the period of February 1 to April 30, 13,193 outpatient visits were analyzed. The pre-COVID-19 group contained 9041 (68.5%) visits, whereas the COVID-19 group contained 4152 (31.4%) visits. All divisions noted a drop in visit volume from pre-COVID-19 compared with COVID-19. There was rapid adoption of video telehealth during COVID-19, which made up most patient visits during that time (61.3%). We also found that video telehealth led to significant reimbursements while also allowing patients in numerous states to receive care. Conclusions:. Previously, video telehealth was used by clinicians in a small portion of outpatient visits. However, safety concerns surrounding COVID-19 forced multiple changes to the way care is provided. Although outpatient volume at our center was less than that before the pandemic, video telehealth was rapidly adopted by providers and allowed for safe and effective outpatient care to patients in a high number of states while still being reimbursed at a high rate.

The senile plaque is a hallmark lesion of Alzheimer disease (AD). We compared, without a priori, the lipidome of the senile plaques and of the adjacent plaque-free neuropil. The analysis by liquid chromatography coupled with electrospray ionization mass spectrometry revealed that laser microdissected senile plaques were enriched in saturated ceramides Cer(d18:1/18:0) and Cer(d18:1/20:0) by 33 and 78% respectively with respect to the surrounding neuropil. This accumulation of ceramides was not explained by their affinity for Aβ deposits: no interaction between ceramide-liposomes and Aβ fibrils was observed in vitro by surface plasmon resonance and fluorescent ceramide-liposomes showed no affinity for the senile plaques in AD brain tissue. Accumulation of ceramides could be, at least partially, the result of a local production by acid and neutral sphingomyelinases that we found to be present in the corona of the senile plaques.

The solid-state structure of the tri-potassium calix[4]arene dihydroxyphosphonate salt is presented. In this structure, two potassium cations bridge between layers of dimeric calixarene diphosphonate units and two other potassium cations bridge along the face of the layers. The ubiquitous dimeric association of the calixarenes shows the highest interdigitation value so far observed. As expected, the cations are solvated and are complexed exo with respect to calixarene crown. The octahedral coordination sphere of the potassium cations is formed by two phosphonate groups of the calixarenes and four water molecules. Electrostatic forces represent the major element of interaction in the solid-state system.