Purpose The aim of this paper is to present and validate a framework for assessing healthcare facilities in low-resource settings to collect evidence and inform policies on the harmonisation, regulation and contextualised design of medical devices. Methods A literature review and focus groups with several experts of medical device design, clinical engineering, health technology assessment and management, allowed the creation of a protocol, comprising two parts: a semi-structured interview and electrical safety measures. Results Three hospitals were assessed in Benin and three in Uganda. All the health centres resulted to be facing typical challenges for low-resource settings, including the lack of funding, expertise, a well-established maintenance program, spare parts and consumables, and unreliable power supplies. Conclusion As there is a paucity of information regarding low-resource settings, the proposed framework can be used by clinical or biomedical engineers to assess and thereby propose actions for improving the conditions of healthcare settings.

Abstract. In this paper we evaluate characteristics of three optical particulate matter sensors/sizers (OPS): high-end spectrometer 11-D (Grimm, Germany), low-cost sensor OPC-N2 (Alphasense, United Kingdom) and in-house developed MAQS (Mobile Air Quality System), which is based on another low-cost sensor – PMS5003 (Plantower, China), under realistic conditions of strong and mild urban pollution. Results were compared against a reference gravimetric system, based on a Gemini (Dadolab, Italy), 2.3 m3 h−1 air sampler, with two channels (simultaneously measuring PM2.5 and PM10 concentrations). The measurements were performed in Sarajevo, the capital of Bosnia-Herzegovina, from December 2019 until May 2020. This interval is divided into period 1 – strong pollution – and period 2 – mild pollution. The city of Sarajevo is one of the most polluted cities in Europe in terms of particulate matter: the average concentration of PM2.5 during the period 1 was 83 µg m−3, with daily average values exceeding 500 µg m−3. During period 2, the average concentration of PM2.5 was 20 µg m−3. These conditions represent a good opportunity to test optical devices against the reference instrument in a wide range of ambient particulate matter (PM) concentrations. The effect of an in-house developed diffusion dryer for 11-D is discussed as well. In order to analyse the mass distribution of particles, a scanning mobility particle sizer (SMPS), which together with the 11-D spectrometer gives the full spectrum from nanoparticles of diameter 10 nm to coarse particles of diameter 35 µm, was used. All tested devices showed excellent correlation with the reference instrument in period 1, with R2 values between 0.90 and 0.99 for daily average PM concentrations. However, in period 2, where the range of concentrations was much narrower, R2 values decreased significantly, to values from 0.28 to 0.92. We have also included results of a 13.5-month long-term comparison of our MAQS sensor with a nearby beta attenuation monitor (BAM) 1020 (Met One Instruments, USA) operated by the United States Environmental Protection Agency (US EPA), which showed similar correlation and no observable change in performance over time.

Flour-based confectionary is the most popular confectionary and have an important position in food technology in general. Those products present the most often consumed confectionary products and their growth in EU market has been increasing per capita consumption [1] owing to their sweet taste and nice aroma and flavor, easy accessibility–ready to use and well-established habits [2], lower production costs, convenience and long shelf life [3].

Estimation of unmeasured variables is a crucial objective in a broad range of applications. However, the estimation process turns into a challenging problem when the underlying model is nonlinear and even more so when additionally it exhibits multiple time scales. The existing results on estimation for systems with two time scales apply to a limited class of nonlinear plants and observers. We focus on analyzing nonlinear observers designed for the slow state variables of nonlinear singularly perturbed systems. Moreover, we consider the presence of bounded measurement noise in the system. We generalize current results by considering broader classes of plants and estimators to cover reduced‐order, full‐order, and higher‐order observers. First, we show that the singularly perturbed system has bounded solutions under an appropriate set of assumptions on the corresponding boundary layer and reduced systems. We then exploit this property to prove that, under reasonable assumptions, the error dynamics of the observer designed for the reduced system are semiglobally input‐to‐state practically stable when the observer is implemented on the original plant. We also conclude ℒ2 stability results when the measurement noise belongs to ℒ2∩ℒ∞ . In the absence of measurement noise, we state results on semiglobal practical asymptotical stability for the error dynamics. We illustrate the generality of our main results through three classes of systems with corresponding observers and one numerical example.

In medium-size, spiny striatal neurons of the direct pathway, dopamine D1- and adenosine A1-receptors are co-expressed and are mutually antagonistic. Recently, a mutation in the gene encoding the A1-receptor (A1R-G279S7.44) was identified in an Iranian family: two affected off-springs suffered from early onset L-DOPA-responsive Parkinson's disease. The link between the mutation and the phenotype is unclear. Here, we explored the functional consequence of the G279S substitution on the activity of the A1-receptor after heterologous expression in HEK293 cells. The mutation did not affect surface expression and ligand binding, but changed the susceptibility to heat denaturation: the thermodynamic stability of A1R-G279S7.44was enhanced by about 2 and 8 K when compared to wildtype A1-receptorand A1R-Y288A7.53 (a folding-deficient variant used as a reference), respectively. In contrast, the kinetic stability was reduced indicating a lower energy barrier for conformational transitions in A1R-G279S7.44(73 {plus minus} 23 kJ/mol) than in wildtype A1R(135 {plus minus} 4 kJ/mol) or in A1R-Y288A7.53 (184 {plus minus} 24 kJ/mol). Consistent with this lower energy barrier, A1R-G279S7.44was more effective in promoting guanine nucleotide-exchange than wildtype A1R. We detected similar levels of complexes formed between D1-receptors and wildtype A1R or A1R-G279S7.44by co-immunoprecipitation and bioluminescence resonance energy transfer (BRET). However, lower concentrations of agonist were required for half-maximum inhibition of dopamine-induced cAMP accumulation in cells co-expressing D1-receptor and A1R-G279S7.44than in those co-expressing wildtype A1R. These observations predict enhanced inhibition of dopa-minergic signaling by A1R-G279S7.44 in vivo consistent with a pathogenic role in Parkinson's disease. Significance Statement Parkinson's diseaseis caused by a loss of dopaminergic input from the substantia nigrato the caudate nucleus and the putamen. Activation of the adenosine A1-receptor antagonizes respon-ses elicited by dopamine D1-receptors. We show that this activity is more pronounced in a mutant version of the adenosine A1-receptor (A1R-G279S7.44), which was identified in individuals suffering from early onset Parkinson's disease.

Nanosheet heterostructures offer emergent optical/electronic properties. These could be achieved using selective materials binding peptides, but lack of understanding of selectivity impedes advancement. Here we examine peptides with affinity for graphene or h-BN using quantitative experiments and molecular simulation to identify traits for design of 2D nanosheet selective peptides.

Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. Methods: A total of 1,084 women were initially recruited from Pittsburgh, PA to participate in the Epidemiologic Study of HEalth Risk in Women (ESTHER) study and completed a baseline survey between 2003 and 2006. In 2015 or 2016, N = 483 women, 270 of whom were lesbian, completed a follow-up survey. Participants completed a questionnaire at both baseline and follow-up and completed a clinic visit for the baseline study to provide biometric data. Results: At baseline, lesbian participants reported higher rates of obesity (p = 0.03), depression (p = 0.02), and smoking (p = 0.04). Lesbian participants had elevated measured C-reactive protein levels (p = 0.05). By the time of the follow-up survey 10 years later, lesbian women continued to have higher rates of smoking (p = 0.04), but the disparity in depression (p = 0.53) and obesity (p = 0.24) rates had resolved. We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.

Background Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting up to 20% of pre-menopausal women. The most recent international guidelines set lifestyle management as the cornerstone of the PCOS treatment. Still, there is a paucity of data on the implementation of lifestyle management in clinical practice. This cross-sectional study aimed to explore physicians-reported practices in PCOS lifestyle management in the Sarajevo Canton, Bosnia and Herzegovina (BiH). The profession of dietetics is not legally recognized in BiH. Nutritional interventions in health promotion and disease treatment are provided by medical professionals. Methods Data were collected by a paper-based questionnaire distributed during March-May 2018 in the Public Institution Health Centre of Sarajevo Canton. Results Forty-six physicians (response rate of 80.7%) completed the questionnaire. An initial treatment plan based solely on lifestyle measures (diet + physical activity), as recommended by current guidelines was reported by 34.8% of physicians. Although dietary interventions were rated as highly relevant in PCOS management by the vast majority of physicians, only one-half reported recording patients' adherence and 45.7% of physicians were unsure of the effectiveness of the lifestyle interventions in their patients. Conclusion PCOS lifestyle management in the study setting is sub-optimal. Additional education on effective PCOS lifestyle management strategies would be beneficial, especially for physicians with less than 15 years in practice. Possible obstacles to better physicians' engagement in PCOS lifestyle management should be further investigated.

Voice over Internet Protocol (VoIP) is characterized by the growth of session control signalling, which is based on the Session Initiation Protocol (SIP). The growing amount of SIP signalling may cause an overload of VoIP session control infrastructure and quality of service degradation. To reduce the effect of overload conditions, we studied the impact of SIP message differentiation on the quality of VoIP session control procedures. We proposed an algorithm for SIP message prioritization and tested it with Kamailio SIP server under different conditions. Summarizing our research findings, the proposed algorithm improves the performance metrics related to VoIP session control procedures.

The number of obese and overweight people around the world rapidly grows and takes on epidemic proportions. The aim of this research is to determine the influence of body weight on quality of life and to investigate our patients' consciousness about their body weight and its impact on their quality of life.Methods : The cross-sectional study was conducted by interviewing 1067 respondents, using the WHOQOL-BREF questionnaire.Results : Out of 1067 patients, 684 were females. 65.5 % of patients had BMI ≥25 kg/m 2 . 21.7% of 699 patients who had BMI ≥25 kg/m 2 think that their increased body weight doesn’t affect their health, 27.9 % of respondents think that their overweight is unrelated to physical activity, 41.8 % of respondents have no problems purchasing the clothes due to their weight and 31.6 % of respondents with BMI ≥25 kg/m 2 think that it doesn’t affect their quality of life.Conclusion : Quality of life is significantly better in respondents with BMI <25 kg/m 2 . The alarming result is that slightly less than half of respondents think that overweight doesn’t affect their health and don’t understand the seriousness of the problem.

Von Willebrand factor (VWF) plays a major role in arterial thrombosis. Antiplatelet drugs induce only a moderate relative risk reduction after atherothrombosis, and their inhibitory effects are compromised under high shear rates when VWF levels are increased. Therefore, we investigated the ex vivo effects of a third-generation anti-VWF aptamer (BT200) before/after stimulated VWF release. We studied the concentration-effect curves BT200 had on VWF activity, platelet plug formation under high shear rates (PFA), and ristocetin-induced platelet aggregation (Multiplate) before and after desmopressin or endotoxin infusions in healthy volunteers. VWF levels increased > 2.5-fold after desmopressin or endotoxin infusion (p < 0.001) and both agents elevated circulating VWF activity. At baseline, 0.51 µg/ml BT200 reduced VWF activity to 20% of normal, but 2.5-fold higher BT200 levels were required after desmopressin administration (p < 0.001). Similarly, twofold higher BT200 concentrations were needed after endotoxin infusion compared to baseline (p < 0.011). BT200 levels of 0.49 µg/ml prolonged collagen-ADP closure times to > 300 s at baseline, whereas 1.35 µg/ml BT200 were needed 2 h after desmopressin infusion. Similarly, twofold higher BT200 concentrations were necessary to inhibit ristocetin induced aggregation after desmopressin infusion compared to baseline (p < 0.001). Both stimuli elevated plasma VWF levels in a manner representative of thrombotic or pro-inflammatory conditions such as arterial thrombosis. Even under these conditions, BT200 potently inhibited VWF activity and VWF-dependent platelet function, but higher BT200 concentrations were required for comparable effects relative to the unstimulated state.

A “ No vel Th understorm A lert S ystem” (NOTHAS) has been developed and extensively tested for forecast and warnings of mid-latitude and tropical convective events. The design of the system showed some potential advantages compared to earlier alert systems, mainly in reducing uncertainties in predictions by taking the given maximum hourly local-scale signal. It represents a dynamic tool which allows the use of the probability concept of multivariate distribution and integrating it into general function by taking all convective parameters. It utilizes the latest developed microphysical parameterization scheme using a scale and aerosol awareness convective scheme and the sharpest criteria for mid-latitude storms. NOTHAS shows consistency and some kind of flexibility in post-processing applications, regardless of different parameterizations used in the ensemble or deterministic forecasts. The scientific verification shows a high level of accuracy in all significant scores which indicates that severe weather outlooks produced by NOTHAS for several hours ahead are in good alignment with observed thunderstorm activity. This novel tool shows a good performance which has sufficient merit for further additional testing and system evaluation of different severe mid-latitude and tropical storms, tropical cyclones and other severe weather cases across regions.