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This study aimed to investigate the shallow groundwater status around the Sheba Leather Tannery area, Wikro, North Ethiopia, through geophysical and hydrochemical methods. Seventeen Vertical Electrical Soundings (VESs) acquisitions, 4 upstream and 13 downstream, of the leather tannery area were conducted. Using the data, four geoelectric profiles were generated. The aquifers' geoelectrical layers, depth, and lateral extent were delineated. The VES curves depicted three to four resistivity layers. These alternating layers of low, moderate, and high resistivity values, traced at different VES points, were attributed to the formations' composition and the groundwater quality status. Besides the geophysical survey, 32 water samples were collected from the area. Parameters such as electrical conductivity (EC), total dissolved solids (TDSs), pH, major ions, and heavy metals were analyzed. Moreover, PHREEQC was used to determine the groundwater mineral saturation indices where most minerals, except halite, were found supersaturated. The quality status for drinking purposes was also evaluated using the water quality index (WQI), and the water was classified as good (56.3%), poor (37.5%), and very poor (6.2%). The sodium adsorption ratio (SAR) and the percentage of sodium (Na+%) were calculated, and the results indicated that the water is suitable for direct use in irrigation. [ABSTRACT FROM AUTHOR]

Real-world data on treatment outcomes or the quality of large-scale chronic hepatitis B (CHB) treatment programs in sub-Saharan Africa (SSA) is extremely difficult to obtain. In this study, we aimed to provide data on the prevalence and incidence of mortality, loss to follow-up (LFTU), and their associated factors in patients with CHB in three treatment centres in Eritrea. Additional information includes baseline clinical profiles of CHB patients initiated on nucleos(t)ide analogue (NUCs) along with a comparison of treatment with Tenofovir disoproxil fumarate (TDF) vs. TDF + Lamuvudine (LAM) using specific biochemical, haematological and virologic parameters. A multicenter retrospective cohort study was conducted on CHB patients in Asmara, Eritrea (2018–2021). Demographic, clinical, and laboratory information was collected from medical records using a structured checklist. Relevant parametric and nonparametric statistics were employed to explore treatment outcomes and to evaluate differences between groups. Where appropriate, Kaplan-Meier (KM) curves and univariate and multivariate Cox regression models were implemented. A two-sided p-value < 0.05 was considered significant. A total of 413 patients with HBV (median age (IQR) at diagnosis: 39 (IQR: 28–50 years; females: 118(28.6%); followed for a total of 22,921 person days) were studied. HBV/HIV co-infection was observed in 15(3.6%) and baseline ALT and AST were elevated in 99(31.2%) and 101(32.8%), respectively. The Fibrosis-4 (FIB-4) index estimates suggested that cirrhosis was highly likely in 33 (14%) patients with 49 (20.8%) patients in the indeterminate FIB-4 score category. During the follow-up period, 4.6% (95% CI: 2.5–6.6%) died, while 23.9% (95% CI: 19.8–28%) were LTFU. In the adjusted Cox proportional hazards model, LTFU were independently associated with baseline serum HBV DNA (IU/mL) (aHR = 1.3, 95% CI 1.04–1.7; p-value = 0.02); Not initiated on NUC (aHR = 3.9, 95% CI: 1.1–13.7, p-value = 0.02); and FIB-4 Score (aHR = 1.05, 95% CI: 1-1.1; p-value = 0.01). Of the 413 patients enrolled in the study, 98 cases (23.73%) were initiated on treatment. In the head-to-head comparison of the results in TDF and TDF + LAM after 12 weeks of treatment, VR was observed in 14(45.2%) vs. 17(54.8%), respectively, translating into an overall VR of 60.7% (95% CI 46.9–74.6). Furthermore, VR in TDF vs. TDF + LAM were similar, 14(45.2%) vs. 17(54.4%) respectively, p-value = 0.3). This study uncovered multiple systems- and patient-centered gaps in the three HBV treatment programs in Asmara, Eritrea. These include late presentation, high incidence of LTFU, inconsistencies in routine data, and poor data management. Interventions should target improvements in laboratory infrastructure, adherence to patient monitoring guidelines, HBV literacy, better tracking of patients, and documentation of patient's information. [ABSTRACT FROM AUTHOR]

An integrated care pathway to manage small and nutritionally at‐risk infants under 6 months (u6m) and their mothers (MAMI Care Pathway) is consistent with 2023 WHO malnutrition guidelines and is being tested in a randomised controlled trial (RCT) in Ethiopia. To optimise trial implementation, we investigated contextual fit with key local stakeholders. We used scenario‐based interviews with 17 health workers and four district managers to explore perceived feasibility. Eighteen policymakers were also surveyed to explore policy coherence, demand, acceptability, evidence needs, opportunities and risks. The Bowen feasibility framework and an access to health care framework were adapted and applied. Health workers perceived the MAMI Care Pathway as feasible to implement with support to access services and provide care. The approach is acceptable, given consistency with national policies, local protocols and potential to improve routine care quality. Demand for more comprehensive, preventive and person‐centred outpatient care was driven by concerns about unmet, hidden and costly care burden for health services and families. Inpatient care only for severe wasting treatment is inaccessible and unacceptable. Support for routine and expanded components, especially maternal mental health, is needed for successful implementation. Wider contextual factors may affect implementation fidelity and strength. Policymakers cautiously welcomed the approach, which resonates with national commitments, policies and plans but need evidence on how it can work within varied, complex contexts without further system overstretch. A responsive, pragmatic randomised controlled trial will generate the most useful evidence for policymakers. Findings have informed trial preparation and implementation, including a realist evaluation to contextualise outcomes. Key messages: The MAMI Care Pathway integrated approach is perceived as acceptable, needed and possible to implement during a randomised control trial in outpatient clinics in Ethiopia.Contextualised inputs (training, staffing, space and supplies) will be needed to strengthen implementation of existing activities and for new components.Breastfeeding counselling skills and maternal care provision, especially maternal mental health, are varied and often limited in routine services.National policymakers need trial implementation evidence to contextualise RCT outcomes for policy development. [ABSTRACT FROM AUTHOR]

Background: There is widespread enthusiasm for scaling interventions to strengthen health systems. However, little is known about the scalability of such interventions in Africa. In this study, we seek to assess the scalability of interventions for improving the functionality of health systems in Africa, as a key to large-scale implementation strategy of interventions with potential for impact. Methods: The study will deploy a multi-pronged approach, grounded in an integrated knowledge translation (iKT) approach. First, a multidisciplinary steering committee will be established, involving key female and male stakeholders in all stages of our study from its inception and as equal members of the research team for overseeing the project. Second, as part of the RAND/University of California, Los Angeles (UCLA) Appropriateness Method, evidence from a published systematic review will be used to develop the African Scalability Assessment Framework (AFROSAF), a series of multiple attributes for assessing the ability to scale a health system intervention in Africa. Third, the content of the AFROSAF will be validated using Delphi survey (within a deliberative dialogue) following the Lavis' framework for knowledge transfer and a conceptual framework developed by Boyko et al. a multi-stakeholder consensus exercise with experts from Africa will be convened. The Likert scaled scalability attributes developed will be rated and descriptive statistics and hierarchical cluster analysis will be used to synthesize the data. Finally, document analyses will be conducted to rate to which extent each intervention has data that meet criteria responding to the essential components of scalability using the AFROSAF. We will conduct an analysis to score and rank each intervention for scalability. Discussion: This project proposes an approach aiming to catalyse the scale of interventions for effective functionality of health systems in Africa. The process will yield a scalability assessment tool for Africa and inventory scalable interventions. The findings will help African countries and policymakers understand the parameters to use and assess health system interventions for scaling. [ABSTRACT FROM AUTHOR]

Background: Childhood is a period marked by dynamic growth. Evidence of the association between childhood linear growth and school achievement comes mostly from cross-sectional data. We assessed associations between birth length, childhood linear growth velocities, and stunting with school achievement. Methods: Newborns were recruited into the Ethiopian infant Anthropometry and Body Composition (iABC) birth cohort and followed from birth to 10 years. Velocities from 0 to 6 years were computed using linear spline mixed effect modelling. Stunting (height-for-age < -2 z-scores) was assessed at the ages of 1, 2, 4, 5, and 6 years. School achievement was measured by having a high (≥ 80%) combined high math, English, and science (MES) score and being at appropriate grade-for-age. Logistic regression models assessed associations between birth length, linear growth velocities and stunting with school achievement. Results: Children's mean age was 9.8 years (standard deviation, SD 1.0, range 7–12 years). A 1 SD greater birth length increased the odds of achieving a high MES combined score by 1.42 (95% CI: 0.99, 2.03). A 1 SD increase in linear growth velocity from 6 to 24 months increased the odds of being in the appropriate grade-for-age by 1.66 (95% CI: 1.14, 2.43). Stunting at ages 4 and 6 years was associated with lower odds of achieving a high MES combined score: 0.43 (95% CI: 0.20, 0.93) and 0.31 (95% CI: 0.11, 0.89), respectively. Faster post-natal linear growth was not associated with school achievement. Conclusion: Greater birth length and higher growth velocity from 6 to 24 months were associated with higher school achievement and being in the appropriate grade-for-age, respectively. Children who experienced growth failure were less likely to achieve a high MES score. Interventions aimed at improving school achievement should address maternal and fetal nutrition and health, and monitor post-natal growth. [ABSTRACT FROM AUTHOR]

The plaques associated with Alzheimer's disease are formed as a result of the aggregation of Aβ peptides, which vary in length from 38 to 43 amino acids. The 1-40 peptide is the most abundant, while the 1-42 peptide appears to be the most destructive to neurons and/or glial cells in a variety of assays. We have demonstrated that aggregated Aβ, a state prior to plaque formation, will activate the plasma bradykinin-forming pathway when tested in vitro. Aggregation is zinc-dependent, optimal at 25–50 µM, and the rate of aggregation is paralleled by the rate of activation of the bradykinin-forming pathway as assessed by plasma kallikrein formation. The aggregation of Aβ 1-38, 1-40, and 1-42 is optimal after incubation for 3 days, 3 h, and under 1 min, respectively. The cascade is initiated by the autoactivation of factor XII upon binding to aggregated Aβ; then, prekallikrein is converted to kallikrein, which cleaves high-molecular-weight kininogen (HK) to release bradykinin. Studies by a variety of other researchers have demonstrated the presence of each "activation-step" in either the plasma or spinal fluid of patients with Alzheimer's disease, including activated factor XII, kallikrein, and bradykinin itself. There is also evidence that activation is more prominent as dementia worsens. We now have medications that can block each step of the bradykinin-forming pathway as currently employed for the therapy of hereditary angioedema. Given the current state of therapy for Alzheimer's disease, which includes monoclonal antibodies that retard the rate of progression by 30% at most and have significant side effects, it seems imperative to explore prophylaxis using one of the long-acting agents that target plasma kallikrein or factor XIIa. There is a long-acting bradykinin antagonist in development, and techniques to target kallikrein mRNA to lower levels or knock out the prekallikrein gene are being developed. [ABSTRACT FROM AUTHOR]

Hemosuccus pancreaticus is a rare but potentially fatal cause of upper gastrointestinal (GI) bleeding. It is defined as bleeding from the pancreatic duct with blood draining into the duodenum through the ampulla of Vater. In patients with pancreatitis, peri-pancreatic blood vessels may be inflamed by pancreatic enzymes and form a pseudoaneurysm which can rupture and bleed into the pancreatic duct. We report a case of a 43-year-old man who presented with episodic upper GI bleeding of unclear etiology over 9 months without a clear documented history of pancreatitis. The etiology remained elusive even after multiple upper and lower endoscopies. Computed tomography angiography of the abdomen and pelvis during an acute episode detected a pseudoaneurysm of the gastroduodenal artery (GDA) with contrast extravasation into the dilated pancreatic duct. The pseudoaneurysm was treated with coil embolization, resulting in a persisting resolution of the patient's symptoms. Clinicians should consider abdominal angiography when diagnosing obscure GI bleeding. [ABSTRACT FROM AUTHOR]

Background: In patients with bicuspid aortic valve (BAV), 4D flow MRI can quantify regions exposed to abnormal aortic hemodynamics, including high wall shear stress (WSS), a known stimulus for arterial wall dysfunction. However, the long‐term multiscan reproducibility of 4D flow MRI‐derived hemodynamic parameters is unknown. Purpose: To investigate the long‐term stability of 4D flow MRI‐derived peak velocity, WSS, and WSS‐derived heatmaps in patients with BAV undergoing multiyear surveillance imaging. Study Type: Retrospective. Population: 20 BAV patients (mean age 48.4 ± 13.9 years; 14 males) with five 4D flow MRI scans, with intervals of at least 6 months between scans, and 125 controls (mean age: 50.7 ± 15.8 years; 67 males). Field Strength/Sequence: 1.5 and 3.0T, prospectively ECG and respiratory navigator‐gated aortic 4D flow MRI. Assessment: Automated AI‐based 4D flow analysis pipelines were used for data preprocessing, aorta 3D segmentation, and quantification of ascending aorta (AAo) peak velocity, peak systolic WSS, and heatmap‐derived relative area of elevated WSS compared to WSS ranges in age and sex‐matched normative control populations. Growth rate was derived from the maximum AAo diameters measured on the first and fifth MRI scans. Statistical Tests: One‐way repeated measures analysis of variance. P < 0.05 indicated significance. Results: One hundred 4D flow MRI exams (five per patient) were analyzed. The mean total follow‐up duration was 5.5 ± 1.1 years, and the average growth rate was 0.3 ± 0.2 mm/year. Peak velocity, peak systolic WSS, and relative area of elevated WSS did not change significantly over the follow‐up period (P = 0.64, P = 0.69, and P = 0.35, respectively). The patterns and areas of elevated WSS demonstrated good reproducibility on semiquantitative assessment. Conclusion: 4D flow MRI‐derived peak velocity, WSS, and WSS‐derived heatmaps showed good multiyear and multiscan stability in BAV patients with low aortic growth rates. These findings underscore the reliability of these metrics in monitoring BAV patients for potential risk of dilation. Level of Evidence: 3 Technical Efficacy: Stage 1 [ABSTRACT FROM AUTHOR]

Eritrea does not have one official language and there is experience in using multiple languages in official government communications, education, media and the legal system. Since Eritrean independence in May 1991, Eritrean laws have been promulgated in a mix of Arabic, English and Tigrinya: some are issued in these three languages; some are issued in Arabic and Tigrinya or Tigrinya and English; and the rest are issued in English or Tigrinya only. Given the continuation of some pre-independence laws, laws written in Amharic and Italian are also applicable. There is also a plan to translate four basic laws (called Codes), circulated in 2015 in Arabic, Tigrinya and English, into the remaining seven Eritrean languages and making them operational. The Eritrean legal system which gives equal weight to laws prepared in, or translated into, multiple languages has created, and will continue to create, a difficult atmosphere of linguistic discrepancy with prejudicial consequences on rights and duties of people and on the expectation for consistency, predictability and uniformity of judgments. This article presents the experiences in Eritrean courts in relation to discrepancies in legal texts issued in different languages and suggests possible solutions. [ABSTRACT FROM AUTHOR]

Many municipalities around the world place their production wells in shallow alluvial aquifers that are adjacent to streams. Pumping these wells then induces the infiltration of surface water into the aquifer, allowing the greater extraction of water without significantly depleting the aquifer. However, induced infiltration poses a risk of introducing contamination from surface water into groundwater systems. The goal of this study was to quantify the amount of induced infiltration due to municipal pumping at the Four Mile Creek well field in Oxford, Ohio, using stable isotopes of water oxygen (δ18O) and deuterium (δ2H). In areas of municipal pumping, we sampled water from the production wells, Four Mile Creek, and from monitoring wells that we hypothesized to be both influenced and not influenced by induced infiltration. Samples were collected over 10 months in 2012 and over 12 months in 2021. In 2012, surface water δ18O values ranged from −3.89 to −8.04‰, and δ2H ranged from −26.55 to −55.65‰ at sampling sites. PW1 δ18O values ranged from −4.71 to −7.39‰ with a mean of −6.61 and −32.01 to −47.86‰ with a mean of −42.74‰ for δ2H. PW2 δ18O values ranged from −5.74 to −7.34‰, with a mean of −6.45‰, and δ2H ranged from −36.29 to −47.82‰ with a mean of −42.43‰. PW3 had lower values of both δ18O and δ2H, ranging from −6.36 to −8.02‰ and −47.7 to −40.35‰, and with means of −7.08 and −45.11, respectively. In 2021/2022, surface water δ18O values ranged from −5.32 to −7.93‰, and the δ2H ranged from −36.14 to −50.56‰. PW1 δ18O values ranged from −6.15 to −7.54‰ with a mean of −7.13‰, and δ2H ranged from −43.52 to −49.01‰ with a mean of −45.99‰. PW2 δ18O values ranged from −5.72 to −7.34‰, with a mean of −6.70‰, and δ2H ranged from −36.69 to −46.14‰, with a mean of −43.61‰. Using the time averaged values of δ18O of groundwater, production wells and surface water, the percentages of surface water resulting from induced infiltration in 2012 were 57%, 59% and 15% at the three wells, respectively, while in 2021, PW1 had 35% and PW2 91%. The amount of induced infiltration was apparently related to the pumping rates of the production wells, the length of time of pumping and the distance between Four Mile Creek and production wells. Our results indicate that stable isotopes of water provide a reliable method of quantifying groundwater/surface water interaction in alluvial aquifers. [ABSTRACT FROM AUTHOR]

Peer-to-Peer systems are still in the early stages of development when it comes to the processing of credit and the appraisal of the risk associated with it. In this study, we used a hybrid convolutional neural network with logistic regression, a gradient-boosting decision tree, and a k-nearest neighbor to predict the credit risk in a P2P lending club. The lending clubs publicly available P2P loan data was used to train the model. In order to address the issue of data imbalance within the dataset, specifically between the non-defaulter and defaulter classes, the synthetic minority oversampling technique sampling approach is utilized. We developed the architecture of our hybrid model by removing the fully connected layer with the soft-max, which is the final layer of the fully connected CNN model and replaced by LR, GBDT, and k-NN algorithms. The experimental results show that the hybrid CNN-kNN model outperforms the CNN-GBDT and CNN-LR models based on the performance metrics accuracy, recall, F1-score, and area under the curve for both all input and important features. This shows that hybrid machine learning models effectively identify and categorize credit risk in peer-to-peer lending clubs, hence assisting in financial loss prevention. [ABSTRACT FROM AUTHOR]

The influence of breed type (purebred vs. crossbred), sex (short-scrotum ram vs. ewe lamb), and supplementation (pasture-only vs. pasture plus 2% soy hull) on carcass and meat quality of landrace hair (Barbados Blackbelly; BB and St. Croix; SX) and wool (Dorset; DO) × hair sheep lambs was evaluated. Forty-eight, mixed sex 5-mo old purebred hair (body weight (BW) = 17.9 ± 1.95 kg) and crossbred (wool × hair) sheep lambs (BW = 21.7 ± 2.56 kg) rationally grazed predominantly tall fescue pasture during summer with or without soy hull supplementation at 2% of BW. At the end of a 90-d grazing trial, lambs were harvested using the USDA standard procedures and their carcasses were evaluated. After 24 h chilling storge (2°C), longissimus muscle (LM) pH was measured, and carcasses were fabricated into primal cuts. Loin chops and fat depots were collected to analyse meat quality parameters. Supplementation rather than crossbreeding had more significant effect on carcass quality under the conditions of this experiment. Regardless of breed type, soy hull supplementation improved colour, lipid oxidation stability and texture properties of fresh lamb, whereas pasture-only lambs had healthier fatty acid profiles compared with those from supplemented lambs. [ABSTRACT FROM AUTHOR]

The Hawzien-Ger’alta area is home to several remarkable Medieval rock-hewn churches that hold great religious, historical, and geoheritage significance. These churches are currently facing a range of detrimental issues. These include the deterioration of architectural features and decorative elements, fading, peeling, obscuring and concealing of paintings, weakening and collapse of the churches’ structural integrity, and spalling and pitting in the pillars, walls, and roofs. To assess these challenges, a comprehensive investigation of the geological and geotechnical properties of the rock mass from which the churches are carved has been conducted using the Rock Mass Rating (RMR) and rock mass stability (Q) techniques. The findings of this investigation reveal that the churches are carved from weak to medium-strength rock masses. These geotechnical properties imply significant challenges on the long-term stability of the Hawzien-Ger’alta rock-hewn churches and their preservation. These challenges arise from both inherent geotechnical problems (weathering and material loss, discontinuities, groundwater seepage, and surface water infiltration) and human-induced factors (such as improper restoration works). To tackle these challenges, several measures need to be implemented. These include raising public awareness and providing education on the importance of proper restoration, and some urgent technical measures in some of the churches, such as reinforcement to enhance structural stability, and effective water management systems to mitigate water-related degradation. There is also an urgent need to set up preservation guidelines to enhance restoration efforts and foster collaborative partnerships to strengthen conservation initiatives. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection is one of the most common health problems worldwide and is associated with high mortality and heavy economic burdens. The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg) and associated risk factors among pregnant women attending antenatal clinics at Adigrat General Hospital in Northern Ethiopia. Methods: An institutional-based cross-sectional study was conducted from January to March 2024 among 385 pregnant women. Participants were selected through a systematic random sampling method. Socio-demographic and associated factor data were collected using a structured questionnaire, and 5 mL blood samples were collected. The data were subsequently entered into EPI Info and analyzed using SPSS version 25. Descriptive statistics were computed. Bivariate and multivariate regression analyses were employed to measure associations, and values < 0.05 were considered to indicate statistical significance. Results: The overall seroprevalence of HBsAg among the 385 study subjects enrolled was 10.4% (n = 40). HBsAg was common in all age groups. The prevalence of infection was greater in those who had a history of multiple sexual partners (22.7%), early piercing (13.4%), or abortion (27.6%), as was the history of delivery (26.3%) and genital mutilation (35.7%). According to multivariate logistic regression, patients were unmarried (AOR 8.57; 95% CI 3.20 - 22.93), illiterate (AOR 12.06; 95% CI 3.07 - 47.33), had a history of ear piercing (AOR 5.66; 95% CI 1.65 - 19.45), a history of abortion (AOR 8.16; 95% CI 3.18 - 20.95), a history of home delivery (AOR 6.69; 95% CI 1.26 - 35.53), and a history of genital mutilation (AOR 9.77; 95% CI 2.64 - 36.18) for acquiring HBV infection compared to their counterparts. Conclusions: The results showed that HBV was highly prevalent in our study area. Being unmarried, having a low educational level, having an ear piercing, having an abortion, having a home delivery, and having genital mutilation were significantly associated with HBV infection. Therefore, these findings suggest that health education programs should be provided to the community to increase awareness among mothers. [ABSTRACT FROM AUTHOR]

Background: Stunting remains a considerable public health problem globally, and sex differences in prevalence have been documented. While many risk factors for stunting have been identified, few studies examine how these factors may contribute to sex differences. We test whether: (1) boys and girls are differentially exposed to stunting risk factors, (2) boys and girls respond differently to similar exposures, and (3) these associations are sensitive to the growth measures used. Methods: Data comes from 7486 Zambian infants, aged 0–23 months, participating in the SUN (Scaling Up Nutrition) 2.0 Program baseline survey. Surveys and dietary recalls were collected from primary caregivers, and anthropometry was collected for caregivers and children. Stunting was defined as height-for-age z-score (HAZ) <-2. Descriptive statistics and adjusted multilevel logistic regression models controlling for age and province were used to identify sex differences in exposures and risk factors for stunting, respectively. Interaction terms between exposure and infant sex were added to test for sex differences in response. Sensitivity testing with alternate measures of infant size, including height-for-age difference (HAD), was conducted. Results: Boys were more likely to be stunted than girls (34.5% vs. 25.7%, respectively). Numerous maternal, care giving, diet, and household characteristics were associated with the risk of stunting, but few sex differences were seen in exposure to these factors. Only one risk factor—maternal marital status—showed evidence of moderation by sex at the p < 0.05 level, while a limited number of risk factors did so at the p < 0.10 level. At all ages, boys were longer than girls, and there were no sex-specific differences in the patterns of HAZ or HAD with age. Results were robust to alternate specifications. Conclusions: Our results show that Zambian boys have lower mean HAZ scores than girls and a greater prevalence of stunting throughout the first two years We do not find strong evidence that infant feeding practices, environmental exposures, or care giving differ consistently between boys and girls or that boys and girls respond differently to these exposures. Our results instead indicate that further investigation of prenatal factors and/or measurement issues is needed. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a major public health challenge in Ethiopia. TB treatment outcomes were suboptimal compared to the expected target of the national TB control Program. The provision of standard anti-TB treatment is the primary component of the directly observed treatment, short-course strategy. The aim of this study was to assess the TB treatment outcomes and the determinants of an unfavorable treatment outcome. The study used a cross-sectional study design at baseline and record review to identify treatment outcomes. A total of 1,161 TB patients were recruited from eight randomly selected districts and one town administration in the Jimma Zone, Ethiopia. Treatment outcomes were grouped into favorable and unfavorable. Of the total participants, 86.9% had a favorable treatment outcome, and 5.7% an unfavorable treatment outcome. The rest were transferred out and not recorded cases. Women were more likely to experience an unfavorable treatment outcome [adjusted odds ratio (AOR) = 1.96, 95% CI 1.06, 3.64]. Patients who were perceived to not be stigmatized were less likely to have an unfavorable treatment outcome (AOR = 0.32, 95% CI 0.15, 0.73). Patients who had a monthly income of > 3,500 Ethiopian birr were less likely to have an unfavorable outcome than patients who did not have a regular income (AOR = 0.04, 95% CI 0.01, 0.45). The observed treatment success rate is lower than the World Health Organization’s target of successfully treating > 90% of detected TB cases. It is imperative to ensure that information, education and communication/behavior change communication strategies consider the needs of women and patients with perceived TB stigma. Furthermore, designing locally acceptable and affordable interventions may help to address the financial challenges of TB treatment adherence. [ABSTRACT FROM AUTHOR]

Highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b viruses were first detected in St. John's, Canada in late 2021. To investigate the patterns of avian influenza virus (AIV) infection and immune responses subsequent to the arrival of H5N1, we sampled the wild urban duck population in this area for a period of 16 months after the start of the outbreak and compared these findings to those from archived samples. Antibody seroprevalence was relatively stable before the outbreak (2011–2014) at 27.6% and 3.9% for anti-AIV (i.e., NP) and H5-specific antibodies, respectively. During the winter of 2022, AIV-NP and H5-specific antibody seroprevalence both reached 100%, signifying a population-wide infection event, which was observed again in late February 2023 following a second H5N1 incursion from Eurasia. As expected, population-level immunity waned over time, with ducks seropositive for anti-AIV-NP antibodies for approximately twice as long as for H5-specific antibodies, with the population seronegative to the latter after approximately six months. We observed a clear relationship of increasing antibody levels with decreasing viral RNA loads that allowed for interpretation of the course of infection and immune response in infected individuals and applied these findings to two cases of resampled ducks to infer infection history. Our study highlights the value of applying both AIV surveillance and seroprevalence monitoring to provide a better understanding of AIV dynamics in wild populations, which may be crucial following the global dissemination of clade 2.3.4.4b H5Nx subtypes to assess the threats they pose to both wild and domestic animals, and to humans. [ABSTRACT FROM AUTHOR]

We developed and applied a new calibration method to make more accurate measurements with our multi-color ellipsometric mapping tool made from cheap parts. Ellipsometry is an optical technique that measures the relative change in the polarization state of the measurement beam induced by reflection from or transmission through a sample. During conventional ellipsometric measurement, the data collection is relatively slow and measures one spot at a time, so mapping needs a long time compared with our new optical mapping equipment made by an ordinary color LED monitor and a polarization-sensitive camera. The angle of incidence and the incident polarization state is varied point by point, so a special optical calibration method is needed. Three SiO2 samples with different thicknesses were used for the point-by-point determination of the angle of incidence and rho (ρ) corrections. After the calibration, another SiO2 sample was measured and analyzed using the calibrated corrections; further, this sample was independently measured using a conventional spectroscopic ellipsometer. The difference between the two measured thickness maps is less than 1 nm. Our optical mapping tool made from cheap parts is faster and covers wider area samples relative to conventional ellipsometers, and these correction enhancements further demonstrate its performance. [ABSTRACT FROM AUTHOR]

The article discusses the ARISE-NUTRINT initiative, which aims to improve adolescent and youth health through nutrition fluency in Sub-Saharan Africa. The initiative focuses on addressing the high rates of undernutrition and diet-related obesity in this population, as well as the increased risk of non-communicable diseases. The ARISE-NUTRINT consortium includes partners from Europe, North America, and Sub-Saharan Africa, and will conduct research and interventions in seven countries. The initiative aims to generate evidence on the effectiveness and implementation of community-based interventions and policies to promote healthy diets among adolescents, with the goal of informing decision-making, policy adoption, and practice in reducing the burden of non-communicable diseases. [Extracted from the article]

Objective: The lung is a target organ of diabetes mellitus (DM) via glycation of pulmonary elastin and collagen. In addition, hyperglycemia facilitates hypercapnic respiratory failure, which is instead mitigated by low‐carbohydrate high‐lipid (LC‐HL) nutrition. We sought to determine the association between diabetes and severe respiratory failure (SRF, i.e., need of reintubation\tracheostomy) after open aortic arch replacement (AAR). Methods: Machine learning algorithms were evaluated for precision and recall (F2 score) and for clinical applicability to predict SRF. Conditional regression evaluated independent predictors of SRF after 1:2 propensity‐score matching. Results: Information on diabetic status was available in 1275 patients undergoing AAR (1997–2023). Although support vector machine presented the highest F2 score (F2 = 0.337), conditional inference trees provided the most clinically applicable algorithm: diabetes was the best predictor of SRF, which occurred in 20/150 diabetics (13.3%) vs. 40/1125 nondiabetics (3.6%) (p < 0.01). In diabetics, left ventricular ejection fraction (LVEF) was the next best predictor of SRF, which occurred in 8/20 diabetics with LVEF ≤ 30% (40%) vs. 12/130 diabetics with LVEF >30% (9.2%) (p = 0.02). In nondiabetics, chronic obstructive pulmonary disease (COPD) was the next best predictor of respiratory failure, which occurred in 14/177 nondiabetics with COPD (7.9%) vs. 26/948 nondiabetics without COPD (2.7%) (p = 0.01). In the matched sample, diabetes was independently able to predict SRF (OR 2.20, 95% CI 1.10 | 4.42). Conclusions: DM was the best predictor of SRF after AAR. Strict glycemic control and LC‐HL nutrition should be evaluated as measures to reduce postoperative SRF in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Depression is a common mental disorder that affects 3.8% of the general population and 24% of healthcare workers globally. Healthcare professionals are more susceptible to depression because they face higher amounts of professional stress in their jobs and academic lives. However, there is limited knowledge regarding health professionals' level of depression in Ethiopia. This study aimed to assess the prevalence of depression and associated factors among health professionals, at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: We conducted an institution-based cross-sectional study among 439 randomly selected healthcare workers using interviewer-administered patient health questionnaire-9 from April to May 2023. Ordinal logistic regression was performed to identify predictors of depression. Reported p-values < 0.05 or a 95% Confidence Interval of Odds Ratio excluding one was considered statistically significant. Result: The overall prevalence of depression among healthcare workers was 21.9% (95%CI: 18%, 27.76%). There were reports of mild (35%), moderate (13%) and severe (9%) depression, respectively. Marital status of being single (AOR = 7.78, 95%CI: 1.123, 49.01), history of childhood abuse (AOR = 2.57, 95%CI:1.49, 4.42), history of suicidal attempt (AOR = 2.66, 95%CI:1.25,5.67), having a history of stressful life event (AOR = 1.527, 95%CI: 1.02,2.3), back pain over the past 30 days (AOR = 2, 95%CI: 1.30,3.11), working for more than 8 hours (AOR = 3.03, 95%CI: 1.12,8.24), and having experience of 5–10 year (AOR = 4, 95%CI: 1.05,15.27) and 10–15 years (AOR = 4.24, 95%CI: 1.08,16.58) and poor social support (AOR = 2.09, 95%CI: 1.09,3.99) were statistically associated with increased level of depression. Conclusion: Healthcare professionals' higher rate of depression was due to the higher workload, childhood abuse, history of stressful life, back pain, and poor social support. Thus, the hospital should give special attention to early screening and treatment for depression for those healthcare workers who have a high workload, childhood abuse, back pain, a history of stressful life and poor social support. Similarly, the Ministry of Health should also design strategies to screen, detect and treat depression among healthcare workers. [ABSTRACT FROM AUTHOR]

Background: Anti-seizure medications (ASMs) are the primary therapeutic mode to control seizures in patients with epilepsy. Adherence to the medications is critical to achieving the goals of epilepsy therapy. However, the cost of the medications and the interrupted availability of ASMs contribute to non-adherence to epilepsy treatment. Therefore, this study aimed to assess ASM adherence and its association with self-reported medication availability and affordability. Objective: To assess whether self-reported availability and affordability of Anti-seizure medications affect medication adherence among Epileptic Patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia, from January 13, 2023 to March 23, 2023. Methods: A hospital-based analytical cross-sectional study was conducted among 357 epileptic patients using the Consecutive sampling method in Eka Kotebe General Hospital, Addis Ababa, Ethiopia. ASM adherence was measured using a self-report 3items questionnaire focusing on medication use patterns of patients from their last visit to the current visit. Statistical packages for Social Sciences 26.0 version statistical software cleaned, coded and analyzed the collected data. Binary logistic regression was fitted, and P-values less than 0.05 were considered to have statistical significance. Result: The prevalence of ASM adherence was 55.2% with 95% CI (50.1%; 60.2%). About two-thirds (61.3%) of patients in this study had limited access to the ASMs or could not afford the medications. Self-reported availability of ASMs (AOR = 2.01, 95% CI = 1.01, 3.98) was significantly associated with ASM adherence. Self-reported affordability of ASMs was associated with ASM adherence in the Bivariate logistic regression analysis; however, when adjusted for other covariates in the multivariable logistic regression, no significant association was observed (p = 0.674). Conclusion and recommendation: Only about half of the epileptic patients adhered to ASMs at Eka Kotebe General Hospital. Self-reported availability of ASMs was an essential factor. Improving access to ASMs is critical to improving adherence and management of epilepsy. [ABSTRACT FROM AUTHOR]

Drought is a recurring natural hazard impacting agriculture, water resources, and various socioeconomic sectors. This study evaluated the performances of multiple meteorological and hydrological drought index estimation methods in the Tekeze River basin, northwestern Ethiopia. Monthly rainfall and temperature data from 15 meteorological stations with varying record lengths (28–59 years) and streamflow data from nine functional stations (1991–2018) were used to compute hydrometeorological drought indices. Standardized precipitation index (SPI), standardized precipitation evapotranspiration index (SPEI), reconnaissance drought index (RDI), rainfall anomaly index (RAI), decile index (DI), and streamflow drought index (SDI) were calculated using DrinC software, R programming, and empirical formulas at 1, 3, 6, and 12‐month timescales. Results from the analysis revealed a basin‐wide prevalence of mild drought, with SPI indicating severity and negative values over longer timescales. The RDI analyses showed lower drought severity but also decreased its frequency over longer timescales. The DI calculation using basin station averages indicated 48.4%, 10.7%, and 8.0% incidence rates for severe, moderate, and mild droughts, respectively. RAI had generally lower positive and negative values compared to SPI. SPEI‐1 analysis classified almost all stations as experiencing mild drought. Conversely, SDI6 analysis at a 6‐month timescale revealed diverse impacts, with the Tekeze River basin experiencing sustained severe drought (SDI6 < −2.0) for three consecutive years (2004–2006). Spearman's rank correlation coefficients of the indices were positive, with RAI showing particularly strong and statistically significant positive correlations with other indices. This study provides valuable insights for policymakers, researchers, and water resource managers in the Tekeze River basin, aiding in the development of effective drought mitigation and preparedness strategies. [ABSTRACT FROM AUTHOR]

Erdafitinib, an oral pan‐FGFR inhibitor, is used in locally advanced or metastatic urothelial carcinoma for adults with FGFR3 genetic alterations and whose disease progressed following prior systemic therapy. This drug‐drug interaction substudy evaluated the effect of erdafitinib on the pharmacokinetics of midazolam (cytochrome P450 3A4 substrate), and metformin (organic cation transporter 2 substrate). Twenty‐five patients with advanced solid tumors harboring FGFR gene alterations received pretreatment with single doses of midazolam and metformin, followed by a daily dose of erdafitinib. Drug‐drug interaction assessments were performed at erdafitinib steady state following coadministration of single doses of midazolam and metformin, respectively. Geometric mean ratios for maximum plasma concentration and area under the plasma concentration‐time curve (AUC) from time 0 to the last measurable concentration, and AUC from time 0 to infinity were estimated using linear mixed‐effects models (90% confidence interval within 80%‐125% indicated no interaction). The 90% confidence intervals of geometric mean ratios for maximum plasma concentration, AUC from time 0 to the last measurable concentration, and AUC from time 0 to infinity of midazolam (86.3%, 88.5%, and 82.1%), 1‐OH midazolam (99.8%, 97.4%, and 101.5%), and metformin (108.7%, 119.0%, and 113.9%) were either contained or slightly outside the 80%‐125% interval and not considered clinically meaningful. Adverse events were consistent with the known erdafitinib safety profile; no new safety signals emerged. Thus, repeated dosing of erdafitinib had no clinically meaningful effect on the pharmacokinetics of midazolam or metformin. [ABSTRACT FROM AUTHOR]

BACKGROUND: Emerging literature suggests that fine particulate matter [with aerodynamic diameter ≤2.5 µm (PM2.5)] air pollution and its components are linked to various neurodevelopmental outcomes. However, few studies have evaluated how PM2.5 component mixtures from distinct sources relate to cognitive outcomes in children. OBJECTIVES: This cross-sectional study investigated how ambient concentrations of PM2.5 component mixtures relate to neurocognitive performance in 9- to 10-year-old children, as well as explored potential source-specific effects of these associations, across the US. METHODS: Using spatiotemporal hybrid models, annual concentrations of 15 chemical components of PM2.5 were estimated based on the residential address of child participants from the Adolescent Brain Cognitive Development (ABCD) Study. General cognitive ability, executive function, and learning/memory scores were derived from the NIH Toolbox. We applied positive matrix factorization to identify six major PM2.5 sources based on the 15 components, which included crustal, ammonium sulfate, biomass burning, traffic, ammonium nitrate, and industrial/residual fuel burning. We then utilized weighted quantile sum (WQS) and linear regression models to investigate associations between PM2.5 components’ mixture, their potential sources, and children’s cognitive scores. RESULTS: Mixture modeling revealed associations between cumulative exposure and worse cognitive performance across all three outcome domains, including shared overlap in detrimental effects driven by ammonium nitrates, silicon, and calcium. Using the identified six sources of exposure, source-specific negative associations were identified between ammonium nitrates and learning & memory, traffic and executive function, and crustal and industrial mixtures and general cognitive ability. Unexpected positive associations were also seen between traffic and general ability as well as biomass burning and executive function. DISCUSSION: This work suggests nuanced associations between outdoor PM2.5 exposure and childhood cognitive performance, including important differences in cognition related both to individual chemicals as well as to specific sources of these exposures. [ABSTRACT FROM AUTHOR]

University-Industry Linkage (UIL) is the interaction of academic or research universities and industries of different sectors for complementary benefits. This paper presents the results of a study conducted to understand the present status and challenges of UIL in the Regional State of Tigray, Ethiopia. Using convergent parallel mixed research design, the study addressed two research questions: (1) what is the status of UIL in the Regional State of Tigray, Ethiopia? (2) what are the UIL challenges facing universities and industries in the Regional State of Tigray, Ethiopia? Respondents were recruited from two universities and eight industries of different business areas including service, manufacturing, finance and energy. A survey questionnaire and interview protocols were developed by adapting items used in previous studies and distributed to a sample size of 1350. The findings show that there are occasional collaborations between the universities and industries in the Region mostly focusing on internship and training. Although communications and meetings are conducted between the universities and industries to create UIL opportunities in Tigray, signed collaboration agreements remain mostly on the shelf mainly due to lack of due attention and commitment from both sides in taking the step forward. Therefore, awareness creation measures and sound policy framework and guidelines should be in place for effective and practical collaborations to exist and get realized. [ABSTRACT FROM AUTHOR]

Background: The severity of infectious disease outcomes is dependent on the virulence factors of the pathogen and the host immune response. CARD8 is a major regulator of the innate immune proinflammatory response and has been suggested to modulate the host response to common inflammatory diseases. In the present study, the C10X genetic polymorphism in the CARD8 gene was investigated in relation to bacterial meningitis. Methods: A total of 400 clinically suspected meningitis patients hospitalized at the University of Gondar Hospital were enrolled in the study. Cerebrospinal fluid (CSF) and blood samples were collected for laboratory investigations. The collected CSF was cultured, and all the results obtained from the culture were confirmed using direct RT‒PCR. Genotyping of whole-blood samples was performed using a TaqMan assay. The results were compared with apparently healthy controls and with PCR-negative meningitis suspected patients. Results: Of the included patients, 57% were men and the most common clinical signs and symptoms were fever (81%), headache (80%), neck stiffness (76%), nausea (68%), and vomiting (67%). Microbiology culture identified 7 patients with bacterial meningitis caused by Neisseria meningitidis (n = 4) and Streptococcus pneumoniae (n = 3). The RT-PCR revealed 39 positive samples for N. meningitidis (n = 10) and S. pneumoniae (n = 29). A total of 332 whole-blood samples were genotyped with the following results: 151 (45.5%) C10X heterozygotes, 59 (17.7%) C10X homozygotes and 122 (36.7%) wild genotypes. The polymorphic gene carriers among laboratory confirmed, clinically diagnosed meningitis and healthy controls were 23(46%), 246(40%), and 1526(39%), respectively with OR = 1.27 (0.7–2.3) and OR = 1.34 (0.76–2.4). The presence of the C10X polymorphism in the CARD8 gene was more prevalent in suspected meningitis patients than in healthy controls (OR 1.2; 1.00-1.5). Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease. The presence of viable or active bacterial infection was found to be associated with the presence of heterozygous C10X carriers. Conclusions: A greater proportion of C10X in the CARD8 gene in confirmed bacterial meningitis patients and clinically diagnosed meningitis patients than in healthy controls. Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease than heterozygote gene carriers and healthy controls. [ABSTRACT FROM AUTHOR]

Background: Sepsis is the 3rd leading cause of neonatal mortality in Ethiopia contributing to 16% of neonatal death. In a hospital study, neonatal sepsis was the leading diagnosis at admission and the second leading cause of neonatal death at the neonatal intensive care unit. Among other factors repeated vaginal examination during labor is known to contribute to sepsis in low-income settings. However, there is limited evidence in the Ethiopian setting. Objective: The objective of this study was to examine the association between early-onset neonatal sepsis and repeated vaginal examinations. Methods: The study was conducted at Gandhi Memorial Hospital, a public maternity and newborn care hospital. We followed 672 mother-newborn pairs by phone until 7 days of age to detect clinical sepsis. Data were analyzed using SPSS version 20 software. Adjusted odds ratio risk (AOR) with a corresponding 95% confidence interval (CI) was used to show the strength of associations and variables with p-value < 0.05 were considered to be statistically significant. Results: The incidence of early-onset neonatal sepsis was found to be 20.83% (95% CI 17.60, 24.00). Having a frequent vaginal examination (four or more times) during labor and delivery, prolonged rupture of membranes, induced labor and gestational age < 37 weeks were strongly associated with the development of early-onset neonatal sepsis, (AOR 2. 69;95 CI: 1.08, 6.70) AOR 5.12(95% CI 1.31, 20.00), AOR of 5.24 (95% CI 1.72, AOR4.34 (95% CI 1.20, 15.68), 16.00), respectively. Conclusion: Frequent digital vaginal examination prolonged rupture of membranes, induced labor and gestational age < 37 weeks significantly increases the risk of early onset neonatal sepsis. We also recommend further study using neonatal blood culture to better diagnose early onset neonatal sepsis objectively. [ABSTRACT FROM AUTHOR]

Background: HIV/AIDS has left a profound impact, leading to significant mortality, morbidity, economic strain, and disability on a global scale. The introduction of antiretroviral therapy (ART) has played a pivotal role in mitigating the economic burden of HIV and enhancing overall productivity. However, the emergence of virological failure presents a critical contemporary challenge within global health, reflecting the complexity of effectively managing HIV treatment outcomes in the 21st century. Methods: An institutional based, cross-sectional study was conducted. Data were collected using a pretested, structured checklist. Data were edited and cleaned using Microsoft Excel 2016 and analyzed using SPSS version 25. Baseline demographic and clinical data were summarized using descriptive statistics. Multiple logistic regression analysis was run to identify association between dependent and independent variables, by computing odds ratio and 95% confidence interval. A p-value < 0.05 was considered significant. Results: The study delved into the health profile of 117 individuals who were receiving treatment with a third-line antiretroviral therapy (ART) regimen. The findings revealed that the median age of the participants stood at 44 (IQR = ± 17) years and male accounted 53%. The median duration of after HIV diagnosis was found to be 14.25 (± IQR = 5.71) years. Overall virological suppression after third line ART was 76.9% at 6 months. Following adjustment with multiple variable logistic regression, good adherence to medication showed statistical significance in achieving virologic suppression (AOR = 8.48(95% CI: 2.3–30.8), p = 0.001). In contrast, the absence of a change in the second line regimen (AOR = 3.0(95% CI: 0.36–24.8), p = 0.31) and receiving second-line medication for less than three years (AOR = 1.07(95% CI: 0.39–2.95), p = 0.89), and baseline viral load above 100,000 (AOR = 1.74(0.64–2.95), p = 0.27) shows statistically non-significant association with virologic suppression. Clinical trial number: Not applicable. Conclusion: This multicenter study provides strong evidence on virological suppression following the use of third-line antiretroviral therapy drugs in Ethiopia. The results of the study indicate rate of Virological suppression after starting third-line ART drugs is significantly linked to good adherence. [ABSTRACT FROM AUTHOR]

Current poultry vaccines against influenza A viruses target the globular head region of the hemagglutinin (HA1), providing limited protection against antigenically divergent strains. Experimental subunit vaccines based on the conserved ectodomain of the matrix protein 2 (M2e) induce cross-reactive antibody responses, but fail to fully prevent virus shedding after low pathogenic avian influenza (LPAI) virus challenge, and are ineffective against highly pathogenic avian influenza (HPAI) viruses. This study assessed the benefits of combining nanoparticles bearing three tandem M2e repeats (NR-3M2e nanorings or NF-3M2e nanofilaments) with an HA1 subunit vaccine in protecting chickens against a heterologous HPAI H5N1 virus challenge. Chickens vaccinated with the combined formulations developed M2e and HA1-specific antibodies, were fully protected from clinical disease and mortality, and showed no histopathological lesions or virus shedding, unlike those given only HA1, NR-3M2e, or NF-3M2e. Thus, the combined vaccine formulations provided complete cross-protection against HPAI H5N1 virus, and prevented environmental virus shedding, crucial for controlling avian influenza outbreaks. [ABSTRACT FROM AUTHOR]

Barley (Hordeum vulgare L.) is a major grain crop farmed in Ethiopia throughout the long rainy season (Meher) and the short rainy season (Belg) of the year. Barley genotypes were subjected to multi‐environment experiments in six different settings to identify stable genotypes and estimate the impact of genotype × environment interaction (GEI) on grain production. In each area, the field experiment was conducted from mid‐July to January during the primary cropping season of 2021. Three replications of a randomized complete block design were used to set up the trials. According to the additive main effects and multiplicative interaction (AMMI) study, genotype (18.19%), GEI (22.98%), and environment (58.83%) all had an impact on the major treatment sum of squares. The more variance attributed to the environments is a sign of environmental diversity. Given that the two interaction principal component analysis (IPCAs) accounted for 76.94% of the interaction sum of squares, they were sufficient for cross‐validation of the grain yield variance explained by GEI. In contrast to the GGE biplot approaches, which indicated genotypes G12, G3, and G9 as stable and high‐yielding genotypes throughout the environments, the AMMI stability value identified genotypes G3, G12, and G9 as high yielding with stable performance across environments. In general, the GGE biplot and AMMI analysis models demonstrated that genotypes G12, G3, and G9 were stable and yielded well, making G3 acceptable for cultivation in a wider range of environments and G12 and G9 suitable for release. Core Ideas: The environment explained the greatest portion of the variation in grain yield in this study (58.83%), followed by the GEI (22.98%) and genotype (18.19%).Environment Bule is more effective at discriminating genotypes and is representative of the test environments.additive main effects and multiplicative interaction (AMMI) and GGE biplot models identified high yielding and stable genotypes.GGE biplot and AMMI models demonstrated that genotypes G12, G3, and G9 were stable and high yielding.G3 acceptable for cultivation in a wider range of environments and G12 and G9 suitable for release. [ABSTRACT FROM AUTHOR]

The landscape of oncology drug development has witnessed remarkable advancements over the last few decades, significantly improving clinical outcomes and quality of life for patients with cancer. Project Optimus, introduced by the U.S. Food and Drug Administration, stands as a groundbreaking endeavor to reform dose selection of oncology drugs, presenting both opportunities and challenges for the field. To address complex dose optimization challenges, an Oncology Dose Optimization IQ Working Group was created to characterize current practices, provide recommendations for improvement, develop a clinical toolkit, and engage Health Authorities. Historically, dose selection for cytotoxic chemotherapeutics has focused on the maximum tolerated dose, a paradigm that is less relevant for targeted therapies and new treatment modalities. A survey conducted by this group gathered insights from member companies regarding industry practices in oncology dose optimization. Given oncology drug development is a complex effort with multidimensional optimization and high failure rates due to lack of clinically relevant efficacy, this Working Group advocates for a case‐by‐case approach to inform the timing, specific quantitative targets, and strategies for dose optimization, depending on factors such as disease characteristics, patient population, mechanism of action, including associated resistance mechanisms, and therapeutic index. This white paper highlights the evolving nature of oncology dose optimization, the impact of Project Optimus, and the need for a tailored and evidence‐based approach to optimize oncology drug dosing regimens effectively. [ABSTRACT FROM AUTHOR]

Highland bamboo has been traditionally used in building construction, wall partitioning, ceiling, doors, windows, and roofs and has contributed in people's livelihoods. This paper focuses on pinpointing bamboo value chain, its opportunities, and challenges. Site selection and observation, review of existing knowledge, key informant interview and market assessment in the value chain, stakeholders' consultation workshop, processors workspace visit, and group discussion were performed. We found that highland bamboo is a raw material, semi-processed and processed product and sold at different locations passing through different routes based on the request and demand of the customers in the value chain. We identified different bamboo landraces in the studied areas. However, there are knowledge gaps by processors on the use of the different races for different purposes. Traders buy bamboo culms based on their sizes by giving different grades. The price of the product varied from product to product depending on the quality of bamboo raw material/culm used and the time (man-days) required to make the finished product. Local processors' capacity to produce well-finished products is affected due to lack of important machineries and tools. Therefore, introducing and promoting modern processing tools and machines through credit support systems are crucial to make processors more competitive in the value chain. Moreover, the study identified major challenges faced by bamboo growers, culm traders, and processors that have effects on bamboo value chain development. Therefore, it is important to work towards alleviating/minimizing the major challenges in the bamboo value chain considering all actors to strive towards improving the value chain. [ABSTRACT FROM AUTHOR]

Acetic acid, a substance with numerous uses as a bulk chemical, may be produced novelty by Aspergillus terreus. With the newfound understanding of Aspergillus species catabolism of glucose, fermentation techniques for the generation of secondary metabolites like acetic acid in the Ethiopian north Gondar zone can be developed with glucose feeding and pH feedback management. Previous works done on extracting organic acids including acetic acid from filamentous fungi in Ethiopia and at the global level are scanty. Therefore, this study aimed to produce acetic acid from A. terreus isolated from agricultural soils in the north Gondar zone of Ethiopia using barely straw as a substrate. In the current study, Aspergillus isolates were obtained in the samples taken from three different locations. The isolates were screened for acetic acid production. The optimum temperature and pH for the maximum production of acetic acid by the selected isolate were also undertaken. The potential isolates were further cultured using barley straw as a local substrate. Preliminary identification of the selected isolates was based on morphological methods. Molecular characterization (amplification and sequencing of the two intergenic spacers, ITS1 and ITS2, and the intervening 5.8S gene of the ribosomal RNA) was carried out to confirm the identity of the Aspergillus isolates. When the isolates were screened for the production of acetic acid, an isolate from low land (isolate LL2) had the highest yield (72.5 ± 1.65 g/l) on basal screening media. The optimum temperature and pH for the maximum production of acetic acid by this isolate were 30°C and pH 5.0. A sequence similarity of 98.5% to A. terreus isolate LL2 (KIA) was obtained by comparing the Aspergillus isolate to a reference sequence in the GenBank using the BLAST algorithm. It can be concluded from this study that A. terreus isolated from agricultural soil in the north Gondar zone of Ethiopia could produce more acetic acid using barely straw as a substrate. [ABSTRACT FROM AUTHOR]

Background: Antenatal balanced energy and protein (BEP) supplements have well-documented benefits for pregnancy outcomes. However, considerable practical gaps remain in the effective and cost-effective delivery of antenatal BEP supplements at scale in low- and middle-income countries. Methods: A randomized effectiveness study will be conducted in two sub-cities of Addis Ababa, Ethiopia, to evaluate the effectiveness, cost-effectiveness, and implementation of different targeting strategies of antenatal BEP supplements. Pregnant women aged 18 to 49, with a gestational age of 24 weeks or less, and attending antenatal visits in one of the nine study health facilities are eligible for enrollment. In six of the health facilities, participants will be randomized to one of three study arms: control (Arm 1), targeted BEP provision based on baseline nutritional status (Arm 2), and targeted BEP supplementation based on baseline nutritional status and monthly gestational weight gain (GWG) monitoring (Arm 3). In the remaining three facilities, participants will be assigned to universal BEP provision (Arm 4). Participants in Arms 2 and 3 will receive BEP supplements if they have undernutrition at enrollment, as defined by a baseline body mass index less than 18.5 kg/m2 or mid-upper arm circumference less than 23 cm. In Arm 3, in addition to targeting based on baseline undernutrition, regular weight measurements will be used to identify insufficient GWG and inform the initiation of additional BEP supplements. Participants in Arm 4 will receive BEP supplements until the end of pregnancy, regardless of baseline nutritional status or GWG. All participants will receive standard antenatal care, including iron and folic acid supplementation. A total of 5400 pregnant women will be enrolled, with 1350 participants in each arm. Participants will be followed up monthly during their visits to the antenatal facilities until delivery. Maternal and infant health status will be evaluated within 72 h after delivery and at 6 weeks postpartum. The effectiveness and cost-effectiveness of the different BEP targeting strategies in preventing adverse pregnancy outcomes will be compared across arms. Qualitative data will be analyzed to assess the feasibility, acceptability, and implementation of different supplementation strategies. Discussion: This study will inform global recommendations and operational guidelines for the effective and cost-effective delivery of antenatal BEP supplements. The targeted approaches have the potential for broader scale-up in Ethiopia and other low-resource settings with a high burden of undernutrition among pregnant women. Trial registration: ClinicalTrials.gov registration number: NCT06125860. Registered November 9, 2023. [ABSTRACT FROM AUTHOR]

Background: Despite improvements in food access and nutrition security over the last few decades, malnutrition remains a major public health problem. One of the significant contributors to these problems is affordability of nutritious food. This study aimed to examine the association between perceived food affordability and pre-school children's diet diversity in Addis Ababa, Ethiopia. Methods: Cross-sectional data from 2017 to 18 were used for the analysis. A 24-hour dietary recall assessment was done to assess children's dietary diversity (DD). We used a modified operational definition of affordability indicator called perceived affordability of dietary diversity (afford-DD) to evaluate the impact of the food environment in terms of affordability at the household level. A sample (n 4,898) of children aged 6–59 months representative of households in Addis Ababa was randomly selected using a multistage sampling procedure including all districts in the city. Mixed-effects linear regression models were used to assess the association between children's DD and afford-DD. Results: The survey revealed that the mean (standard deviation [SD]) of children's DD was 3.9 [± 1.4] while the mean [SD] of afford-DD was 4.6 [± 2.1]. Overall, 59.8% of children met the minimum dietary diversity (≥ 4 food groups). White roots and tubers were the most commonly consumed food groups regardless of their affordability. Considerable variations were observed between households that reported the food item affordable and not affordable in consumption of Vitamin A rich vegetables and fruits, meat and fish, egg, and dairy. The children's DD was positively associated with afford-DD after adjusting for maternal education, household wealth status and other relevant confounding. Higher maternal education modified the association between affordability and children's diet diversity. Conclusions: This study suggests higher perceived food affordability was associated with better diet diversity in children. A higher level of maternal education had the potential to mitigate affordability challenges in meeting the children's dietary diversity needs. Our study emphasizes the need for inclusive food programs and nutrition interventions addressing social differences, intensifying efforts to make nutrient-rich diets affordable for the less privileged, and highlights the potential benefits of targeting maternal education in addressing child dietary diversity. [ABSTRACT FROM AUTHOR]

Background. COVID-19 has reduced the capacity for delivering essential health services due to lockdown restrictions. Telehealth is an effective alternative option to improve healthcare access. However, there remain implementation challenges to patient adoption in resource-limited settings such as Ethiopia. Therefore, the purpose of this study was to assess patient satisfaction following the implementation of telehealth in ambulatory settings during the COVID-19 pandemic. Methods. A cross-sectional study was conducted at Ayder Comprehensive Specialized Hospital in the Tigray region of Northern Ethiopia. Patients who used the telehealth service were invited to participate in a patient satisfaction survey. All statistical analyses were performed using STATA Version 14.1. Result. A total of 149 patients have participated in the survey. Out of the total participants, 129 (86.6%) found that telehealth is easy to understand and overall satisfaction for telehealth was 87.9%. About two-thirds of the patients (97, 65.1%) reported that the telehealth visit is just as good as a traditional visit. The vast majority of participants (148, 98.6%) stated that they would definitely or probably use telehealth again and would recommend it to others. The majority of respondents (137, 91.9%) followed the recommendations provided. Conclusion. Patients have a high level of satisfaction with the use of telehealth during the COVID-19 pandemic. About two-thirds of patients said the telehealth visit was just as good as a traditional visit. The majority of patients followed the recommendations given to them by the healthcare providers and stated that they would definitely or probably use telehealth in the future and would recommend it to others. This high level of patient satisfaction with telehealth implementation suggests that the service could be considered in low-income countries as well. [ABSTRACT FROM AUTHOR]

Uptake of the COVID-19 vaccine among pregnant persons is lower than the general population. This scoping review explored pregnant people's attitudes towards the COVID-19 vaccine, reasons for vaccine hesitancy, and whether attitudes about COVID-19 vaccines differ by country of origin. A scoping review was conducted across PubMed, Embase, CINHAL, and Scopus. Inclusion criteria were articles published in English from 2019–2022 focused on attitudes towards COVID-19 vaccination among pregnant persons. Data analysis was done via the 5Cs framework for vaccine hesitancy: Constraints, Complacency, Calculation, Confidence, and Collective Responsibility. 44 articles were extracted. A lack of confidence in vaccine safety was the most prevalent theme of hesitancy among pregnant persons. This was largely driven by a lack of access to information about the vaccine as well as mistrust of the vaccine and medical professionals. Meanwhile, vaccine acceptance was mostly driven by a desire to protect themselves and their loved ones. Overall, COVID-19 vaccine hesitancy among pregnant persons continues to be high. Vaccine hesitancy is primarily driven by fear of the unknown side effects of the vaccine on pregnant persons and their fetuses along with a lack of information and medical mistrust. Some differences can be seen between high income and low- and middle-income countries regarding vaccine hesitancy, showing that a single solution cannot be applied to all who are vaccine hesitant. General strategies, however, can be utilized to reduce vaccine hesitancy, including advocating for inclusion of pregnant persons in clinical trials and incorporating consistent COVID-19 vaccine counseling during prenatal appointments. [ABSTRACT FROM AUTHOR]

Accurate estimation of infiltration rates is crucial for effective irrigation system design and evaluation by optimizing irrigation scheduling, preventing soil erosion, and enhancing water use efficiency. This study evaluates and compares selected infiltration models for estimating water infiltration rates in the Shillanat-iv irrigation scheme in northern Ethiopia. Soil samples were collected to determine textural classes using hydrometer soil texture analysis and the United States Department of Agriculture (USDA) textural triangle. The soil textural map of the study was created using the inverse distance weight interpolation technique in ArcGIS version 10.4. Infiltration rates were measured using the double-ring infiltrometer for five soil textures: clay loam, loam, sandy clay loam, clay, and sandy loam. Six infiltration models (Kostiakov, Modified Kostiakov, Revised Modified Kostiakov, Philip, Horton, and Novel) were employed and evaluated using statistical parameters. Model calibration and validation were conducted using data from 38 points within the study area. The parameter values of the infiltration models were optimized using SPSS statistical software using least-squares errors. The results showed that, Revised Modified Kostiakov, Modified Kostiakov, and Novel infiltration models demonstrated superior capability in estimating infiltration rates for clay loam, loam, and sandy loam soil textures, respectively. Horton's model outperformed other models in estimating infiltration rates for both sandy clay loam and clay soil textures. The appropriately fitted infiltration models can be utilized in designing the irrigation system to estimate the infiltration rate of soil textures within the selected irrigation scheme and at similar sites with comparable soil textures. [ABSTRACT FROM AUTHOR]

Barley is one of Ethiopia's most important cereal crops, ranking fifth in total cereal production, after maize, wheat, teff, and sorghum. Based on its intended use, it is divided into two types: food barley and malt barley. This study investigated the factors that affect farmers' decisions to adopt malt barley technology. The research was conducted in eight major malt barley‐growing districts in the central highlands of Ethiopia. Data were collected from both primary and secondary sources. A structured questionnaire was used to obtain quantitative data from 400 sample farmers. Key informant interviews and focus group discussions were conducted to triangulate and substantiate the quantitative data. Secondary data were also used to supplement the primary data. The data were analyzed using descriptive statistics and econometric models. A logistic regression model was employed to analyze quantitative data. The findings revealed that educational level of the household head, family size of the household, access to input, experience, and access to demanded variety all have a positive and significant impact on malt barley technology adoption. However, the age of the household head, income from off‐farm activities, and distance to the market have a negative and significant impact on farmers' decisions to use malt barley technology. Up to 2021, about 30 malt barley varieties were released or registered by the Ministry of Agriculture for production nationwide, while only six to seven varieties were adopted by the sampled farmer households. As a result, we concluded that strong government support and clear policy direction are required to encourage farmers and other stakeholders to invest more to enhance adoption of improved varieties across malt barley growing areas. [ABSTRACT FROM AUTHOR]

Climate change threatens African countries' economic development and affects agriculture and food security. Ethiopia is especially vulnerable to the negative effects of climate change because its economy is dependent on climate-sensitive livelihoods that have limited potential for adaptation. Emerging evidence indicates that climate-smart agriculture (CSA) can help smallholder farmers adapt to climate change and increase agricultural productivity, thereby enhancing household income and food security. In the study area, different CSA practices have been adopted to mitigate the negative effects of climate change and improve agricultural productivity, income, and food security. Therefore, this study examines the impact of CSA practices on household income and food security in southern Ethiopia. A total of 385 households were selected using multistage sampling. Primary and secondary data were used, and propensity score matching with different types of matching algorithms, such as nearest neighbor, kernel, and radius matching, was employed to quantify the conditional impacts of CSA intervention on farm income and food security. In comparison with non adopters farmers that have adopted CSA practices had a higher food consumption score between 6.27 and 8.15, which was statistically significant at the 1% level. Overall, 34.55% of interviewed households had acceptable food consumption scores, 44.68% had borderline, and 20.77% had poor food consumption scores. Furthermore, households that adopted CSA practices had a 20.30% higher average annual farm income per hectare than non-adopters. The study suggests that effective extension services, accurate climate information, and sound policy support are required to promote and scale up CSA measures in the study area to improve farmers' adaptive capacity, farm income, and food security. [ABSTRACT FROM AUTHOR]