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Abstract Shared sanitation facilities have replaced open defecation in many areas, improving sanitation access. Although a broad body of literature has been published regarding the importance of shared sanitation services, it is still unclear how to assess their quality. The objective of this review was to synthesize evidence on the use of shared sanitation facilities in informal settlements and identify indicators for assessing their quality. We conducted a systematic review of relevant studies and a total of 248 studies were included in the final analysis. Findings include a proposed list of indicators for evaluating the quality of shared sanitation such as the number of people sharing facilities, cleanliness, privacy, facility location, accessibility, and safety, and a tool for distinguishing between sanitation facilities that are improved shared, basic shared and unimproved shared. We recommend incorporating the proposed indicators in primary data collection, and routine national and global sanitation monitoring.

Objective: The objective of this study was to identify the factors associated with the outcome of the 2023 diphtheria outbreak in Jigawa State, Nigeria. Methods: A descriptive cross-sectional study was conducted amongst all line-listed diphtheria cases reported from Jigawa State, Nigeria, using the 2023 Integrated Disease and Surveillance Response line list of cases that met the World Health Organization case definition of diphtheria. A total of 245 line-listed cases from January 2023 to December 2023 met the criteria for inclusion in the study. Data were analysed using IBM SPSS version 22.0 with a P value set at ≤5%. Binary logistic regression was used to identify the independent predictors of the outcome of the 2023 outbreak. Results: The maximum age of the line-listed cases was 39 years, and the minimum was 1 year with a median of 8 (interquartile range = 5–8) years. More than two-thirds (68.2%) of the cases were ≥5 years of age. More than one-third of the cases (39.6%) were from the northeast senatorial zone of the state. Out of the total 245 cases, 14 died of the disease representing a case fatality rate of 6%, and an attack rate of 3.4 per 100,000 populations. The majority of the cases (95.5%) had fever, cough (81.2%), pharyngitis (86.9%), tonsillitis (96.7%) and laryngitis (82.0%). More diphtheria-related mortalities were recorded amongst cases

The Ebola Data Platform (EDP) was developed to strengthen knowledge and capacity across health, research, and humanitarian communities to reduce the impact of Ebola through responsible data use. This collaborative initiative was established by West African governments, NGOs, academic organisations, and intra-governmental health organisations directly involved in the 2013–2016 West African Ebola outbreak. The platform was established to provide a centralised, standardised dataset of individual patient data collected during the outbreak for the purpose of research to improve Ebola treatment and control, and includes over 13,600 patient records of individuals infected and treated from 22 different Ebola treatment centres across Guinea, Sierra Leone, Liberia, and Nigeria. Patient data are available from treatment centre triage and admission, inpatient clinical observations, and outcomes, with outpatient follow-up available for some datasets. Data include signs and symptoms, pre-existing comorbidities, vital signs, laboratory testing, treatments, complications, dates of admission and discharge, mortality, viral strains, and other data. This publication describes characteristics of the EDP dataset, its architecture, methods for data access and tools for utilising the dataset.

Access to adequate and secure sanitation to prevent and reduce disease occurrence and improve people's health has been a longstanding global concern. Toilet standardization is immensely important for the promotion of sanitation in China. At present, China has more than 200 toilet-related standards, including national, industrial, provincial, association, and enterprise standards. In addition, there are many existing problems with the standard system, such as standards lagging, standards deficiency, and cross-repetition of standards content. This study analyzed the toilet standards utilizing a six-dimensional structure of the standardized system engineering methodology. A framework for the toilet standard system, which consists of six components, is proposed: basic general standard, public toilet standard, household toilet standard, toilet hardware standard, environmental health and safety standard, and toilet accessory standard and standard toilet peripherals. Additionally, the study suggests approaches for improving standardization including cultivating and developing association and enterprise standards, establishing a standardization technical committee, strengthening standard publicizing and implementation, and linkages with international standards. HIGHLIGHTS A six-level framework of the toilet standard system in China is presented and elaborated.; Problems and potential barriers for toilet standardization in China are analyzed.; We suggest establishing a technical standardization committee, standardization organization coordination mechanism, etc. to promote toilet standardization.; This study provides insights that will guide the formation of effective policies and strategies to enhance sanitation in China.;

Abstract Background Infertility is a major health issue worldwide, yet very few examples of interventions addressing infertility in the Global South have been documented to date. In The Gambia, West Africa, infertility is recognised as a burden and the health authorities have included it in several health policies and the new National Reproductive Health Strategy however, a detailed operationalisation plan for fertility care has not yet been established. Here, we aim to understand and document the factors that influence the implementation of fertility care in The Gambia. Methods We conducted 46 semi-structured interviews with policymakers, implementers, and health practitioners in both the public and private sectors from July to November 2021. The interviews were transcribed, anonymised and analysed with NVivo Pro version 1.6.1. The analysis was initially inductive, with themes arising from the coding categorised according to the WHO health systems building blocks framework. Results This study identified several barriers to a successful implementation of fertility care in The Gambia, including (i) a lack of routinely collected infertility data; (ii) an absence of financial protection mechanisms for patients, and/or a specific budget for infertility; (iii) limited cooperation between the public and private sectors in the provision of fertility care; and (iv) gaps in fertility care training among health practitioners. Conversely, enablers included: (i) strong national infertility leadership; and (ii) the integration of infertility care within public reproductive health services. Conclusion The Gambian health system is not yet in the position to support a comprehensive fertility care package in its public health facilities. Several aspects of the implementation of fertility care must be considered in operationalising the health strategy including the systematic collection of infertility data, fertility awareness, and the provision of specialised fertility care training. Furthermore, a stronger partnership between the public and private sectors must be developed. Given the increasing availability of assisted reproductive technologies in the sub-Saharan Africa region, and the tendency to locate these technologies in the private sector, further research is needed to understand and identify the processes underlying the implementation of fertility care and to foster better integration with the existing health system.

Green synthesis of silica nanoparticles (SiO2-NPs) from agricultural residues is a promising avenue for cementitious materials application. However, very few studies are dedicated to reviewing the influence mechanisms underlying the green synthesis methods and the mechanisms governing their effectiveness in property enhancement in cementitious materials. Our review established that the influence mechanisms of green synthesis of SiO2-NPs include fracturing, polymerization, solubilization, and oxidoreductase. The highest silica purity of over 99 % was mainly reported in chemical sol-gel synthesis, meanwhile, the biggest surface area was reported with mechanical milling of up to 1441 m2/g from rice straw ash. SiO2-NPs were found to enhance the cementitious matrix mainly through nucleation seeding and pozzolanicity. Our review critically discusses other influence mechanisms of the hydration kinetics and interfacial transition zone, pore structure, and matrix densification optimization. SiO2-NPs were reported to enhance the early compressive strength of cementitious materials, sulfate attack resistance, and chloride permeability by up to 100.6 %, 79 %, and 86.2 % respectively. Optimum dosages based on compressed strength improvement varied mainly between 1.0 % and 4.0 %. Existing research seems not to address how the synthesis influencing parameters, such as pH, gelation time, temperature, and milling parameters could be optimized, hence an avenue for future research.

Abstract The integration of digital technologies holds significant promise in enhancing accessibility to disease diagnosis and treatment at point-of-care (POC) settings. Effective implementation of such interventions necessitates comprehensive stakeholder engagements. This study presents the outcomes of a workshop conducted with key stakeholders, aiming to discern barriers and enablers in implementing digital-connected POC diagnostic models in South Africa. The workshop, a component of the 2022 REASSURED Diagnostics symposium, employed the nominal group technique (NGT) and comprised two phases: Phase 1 focused on identifying barriers, while Phase 2 centered on enablers for the implementation of digital-linked POC diagnostic models. Stakeholders identified limited connectivity, restricted offline functionality, and challenges related to load shedding or rolling electricity blackouts as primary barriers. Conversely, ease of use, subsidies provided by the National Health Insurance, and 24-h assistance emerged as crucial enablers for the implementation of digital-linked POC diagnostic models. The NGT workshop proved to be an effective platform for elucidating key barriers and enablers in implementing digital-linked POC diagnostic models. Subsequent research endeavors should concentrate on identifying optimal strategies for implementing these advanced diagnostic models in underserved populations.

Planning frameworks, usually in the form of master plans, provide the direction for investment priorities necessary to achieve development objectives in many sub-Saharan African countries. Traditionally, master plans were developed using engineering methodologies with little stakeholder participation. There is little understanding of how master plans for sanitation infrastructure and services can be collaboratively designed. Through the application of a case study from Freetown, Sierra Leone, the paper proposes a framework for shifting infrastructure planning from conventional models to participatory, evidence-based methods. Findings highlight that the commitment of government and funding institutions created a sense of urgency and importance around sanitation issues and unlocked opportunities for increased financing and a better enabling policy and regulatory environment. Active engagement of the community and evidence-based decision-making ensured that the master plan aligned with the specific needs, preferences, and aspirations of all stakeholders. It was however challenging to use the principles of citywide inclusive sanitation (CWIS) for participatory planning because the implementing agencies and stakeholders lacked adequate capacity to do so. These findings hold significant implications for decision-makers, sanitation planners, and municipal authorities engaged in the development of sanitation master plans. HIGHLIGHTS It is rare for sanitation master plans to be participatory and to involve a diverse range of stakeholders.; By using inclusive sanitation principles and a participatory framework, we developed a new city sanitation master plan for Freetown.; Stakeholders’ needs, preferences, and aspirations were reflected in the master plan through peer-to-peer learning and consensus-building activities.;

Maseve Mine is located in the western limb of the Bushveld Complex, recognized as the largest layered igneous intrusion in the world. The study shows results from surface (SP1, SP2, and SP3) and tunnel (T3a, T3b, and TP4b) reflection seismic profiles, totaling 4150 m. Tunnel seismic data were acquired using a seismic landstreamer and spiked geophones with 5 m receiver and shot spacing, as well as a sledgehammer for shots due to space constraints and safety. The profiles, 10–50 m above mineral deposits, crossed major geological structures. Surface seismic profiles used cabled systems and wireless sensors with 5 m and 10 m receiver spacing, respectively, and a 500 kg drop hammer as a source with 10 m shot spacing. Despite high noise levels from mine infrastructure and power cables, a careful processing workflow enhanced target reflections. Interpretation was constrained using borehole data, geological models, and 2D/3D seismic modeling. The processed data exhibit gently dipping reflections associated with faults and dykes, imaging the target mineralization (Merensky Reef and Upper Group 2) and a possible extension. Tunnel seismic experiments demonstrated the application of seismic methods using in-mine infrastructure, while surface experiments proved efficient, illustrating small-scale seismic surveys’ capability to image the subsurface, adding value in active mining environments for exploration with cost-effective seismic equipment.

Background: A global move towards inclusivity has made inclusive education (IE) a necessity. The education of the learner with hearing loss (HL) in an IE setting remains challenging and scarcely researched. Despite government’s clear position on IE, the extent to which the recommendations in the Education White Paper 6 (2001) (EWP6) are implemented, and the educator’s related experiences, remains limited, which inspired this study. Aim: To explore the educators’ experiences of teaching learners with HL and the extent to which their current teaching practices incorporate the inclusive education model (IEM) and the EWP6. Setting: Public primary schools, practicing IE in KwaZulu-Natal (KZN), South Africa. Method: An explorative descriptive, qualitative approach within a phenomenology design was utilised. An interview schedule guided the semi-structured interviews, conducted with six purposively sampled educators. Post thematic analysis, data were organised within four organising themes, adopted from the IEM. Results: The experienced practical implementation of IE comprised the adaptation of curriculum, teaching practices and assessment procedures to accommodate learners with HL. Educators experienced support from relevant stakeholders and policies. Facilitators included the availability of some resources and the learner’s access to an appropriate school. Challenges included insufficient guidance from policies and guidelines. Conclusion: Educators experience difficulties in practically implementing IE with learners with HL. They incorporate the EWP6 and the IEM to a limited extent. Contribution: The study contributed to the limited information regarding the experiences of educators in an IE context, with learners with HL, at least within the studied or similar context.

Abstract Anomaly detection within the context of healthcare billing requires a method or algorithm which is flexible to the practicalities and requirements of manual case review, the volumes and associated effort of which can determine whether anomalous output is ultimately actioned or not. In this paper, we apply a modified version of a previously introduced anomaly detection algorithm to address this very issue by enacting refined targeting capability based on the identification of sub-extreme anomalies. By balancing the anomaly identification process with appropriate threshold setting tailored to each sample health provider discipline, it is shown that final candidate volumes are controlled with greater accuracy and sensitivity. A comparison with standard local outlier factor (LOF) scores is included for benchmark purposes.

IntroductionIn the Global South, (in)fertility care is scarcely recognized as a priority, yet the government of The Gambia has recently included it as one of the key priorities in its reproductive health strategic plan. This inclusion appears to be the result of years of engagement between policy actors, academic researchers, and activists in the field of reproductive health and specifically of infertility. However, the operationalization of the strategic plan may be hampered by multiple factors. The research aims to identify and analyze challenges that may impede the effective implementation of the strategic plan, thereby providing policy action points and practical guidance into the operationalization of (in)fertility care in the context of The Gambia's health system.MethodsThis is a mixed-methods study with data from a survey and semi-structured interviews collected between 2020 and 2021 in The Gambia that were separately published. In this paper, we present the triangulation of quantitative and qualitative data using a convergence coding matrix to identify relevant policy action points.ResultsSix fertility care policy action points, driven by data, arose from the triangulation and interpretation process, specifically: (i) establishing and maintaining political commitment and national priority for fertility care; (ii) creating awareness and increasing the involvement of men in SRH and fertility; (iii) ensuring data-driven health policymaking; (iv) offering and regulating affordable IVF alternatives; (v) improving knowledge of and means for fertility care provision; and (vi) enhancing the collaboration among stakeholders and building links with the private healthcare sector.ConclusionThis study found the implementation of the fertility care-related activities in the reproductive health strategic plan may face challenges that require careful mitigation through a holistic approach. Such an approach conceptualizes infertility not just as a biomedical issue but as a broader one that incorporates educational and socio-emotional aspects, including male and (not only) female involvement in sexual and reproductive health. Moreover, it is supported by a comprehensive health management information system that includes capturing data on the demand for, and access to, infertility services in The Gambia health system.

Retention on antiretroviral therapy (ART) during the early treatment period is one of the most serious challenges facing HIV programs, but the timing and patterns of early disengagement from care remain poorly understood. We describe patterns of engagement in HIV care during the first year after treatment initiation. We analysed retrospective datasets of routinely collected electronic medical register (EMR) data for ≥18-year-old clients who initiated ART at public sector clinics in South Africa after 01/01/2018 and had ≥14 months of potential follow-up. Using scheduled visit dates, we characterized engagement in care as continuous (no treatment interruption), cyclical (at least one visit >28 days late with a return visit observed) or disengaged (visit not attended and no evidence of return). We report 6- and 12-month patterns of retention in care and viral suppression. Among 35,830 participants (65% female, median age 33), in months 0-6, 59% were continuously in care, 14% had engaged cyclically, 11% had transferred to another facility, 1% had died, and 16% had disengaged from care at the initiating facility. Among disengagers in the first 6 months, 58% did not return after their initiation visit. By 12 months after initiation, the overall proportion disengaged was 23%, 45% were classified as continuously engaged in months 7-12, and only 38% of the cohort had maintained continuous engagement at both the 6- and 12-month endpoints. Participants who were cyclically engaged in months 0-6 were nearly twice as likely to disengage in months 7-12 as were continuous engagers in months 0-6 (relative risk 1.76, 95% CI:1.61-1.91) and were more likely to have an unsuppressed viral load by 12 months on ART (RR = 1.28; 95% CI1.13-1.44). The needs of continuous and cyclical engagers and those disengaging at different timepoints may vary and require different interventions or models of care.

E-Objection is one of the services of the Directorate of Taxes that can be used by taxpayers in submitting tax objection letters. E-Objection is an adoption policy that is an alternative to the previous program, namely the manual submission of objection letters. E-Objection can be accessed via E-Filling. This research is motivated by the lack of exploration of the introduction of E-Objection to taxpayers that there are still many who submit objection letters manually. Based on the data submitted by the Directorate General of Taxes (Direktorat Jenderal Pajak/DJP) and previous research in 2021 based on 2020 data, data on submitting objection letters online (E-Objectionareis still very minimal so that are problems in analyzing the effectiveness of E-Objection. Therefore, this study was conductedtoo to analyze the effectiveness of E-Objection from 2020 to 2021 at KPP Pratama Cibitung, but because the data of taxpayers who submitted objection letters by E-Objection was confidential, it was hindered from interviewing informants who had accessed E-Objection besides that because E-Objection data could not be accessed from KPP Pratama, so in this study using two research objects, namely KPP Pratama Cibitung and Kanwil DJP II. So that the purpose of this study can determine the effectiveness of E-Objection as an alternative to the previous system. Based on E-Objection data in the West Java DJP Regional Office II in 2020 there were 109 data and in 2021 there were 115 data so it could be known that there was an increase, but based on the percentage of effectiveness criteria, the percentage of e-objection effectiveness in the DJP of the West Java Regional Office II in 2020 was 8.93% and in 2021 it was 9.75% so that it can be concluded that the analysis of the effectiveness of E-Objection in KPP Pratama Cibitung during the Covid-19 pandemic (2020-2021) was ineffective.

This study aimed to compare the degree of epigenetic modifications between a TB-HIV co-infected cohort and uninfected subjects. Formalin-fixed paraffin-embedded (FFPE) tissues were retrieved from 45 TB-HIV co-infected and 45 control individuals. Real-time PCR was applied to compare the level of expression of genes involved in epigenetic regulation. The protein multiplex assay was used to assess the degree of protein modification. DNA sequencing was used to determine the evolutionary relationships between the infecting HIV and Mtb strains. Our results indicated a significant increase in the expression of the five candidate genes in the patients with TB-HIV relative to the control cohort. A sharp increase in the degree of histone methylation, acetylation and phosphorylation was observed in TB-HIV co-infected patients. The phylogenetic analysis classified the strains into three distinct HIV clusters and five Mtb clusters. The disparities in the expression profiles of our candidate genes between the TB-HIV cohort and non-TB-HIV group highlights the important role played by various TB and HIV strains in regulating the host gene expression landscape.

The study sought to examine business incubators as catalyst for entrepreneurial process development in Oyo and Ekiti States. The high rate of entrepreneurial failure rate in developing countries is motivation for this investigation to explore the relationship between business incubators and entrepreneurial process development in the target states. The population is made up of three hundred and forty-six (346) respondents made-up of technology incubators and staff of entrepreneurial start-ups and the sample of 186 was drawn from graduated residence incubates and technology incubator employees using Taro Yamane sample size calculation formula. The sampling approach employed was multistage sampling procedure through the use of purposive, stratified and simple random sampling technique to pick out respondents. Simple linear and correlation coefficient were used to test the hypotheses. The results confirmed that the impact of business incubators is a right predictor for entrepreneurial process development in Oyo and Ekiti States. The study concluded that business incubators are catalysts and essential tools for promoting entrepreneurial process development in Oyo and Ekiti states in South West Nigeria. The study recommends that authorities should intensify effort in equipping all TIC facilities in the country for better results and for incubates to seize the opportunity to increase their overall performance through the support services provided to them through business incubators

The proximate composition and mineral contents of eggs from quail (Coturnix japonica) turkey (Meleagris gallopavo) commercial chicken (Gallus domesticus), local chicken (Gallus domesticus) guinea fowl, (Numida meleagris) and duck (Cairina moschata) obtained in Minna, Nigeria were studied. Standard laboratory procedures were used in determining the nutrients and mineral compositions of the egg samples. The local chicken eggs had significantly higher crude fat (11.73 ± 0.18%), ash (1.38 ± 0.01%), zinc (3.23 ± 0.11 mg/100 g), and manganese (0.44 ± 0.01 mg/100 g) contents, it also showed the lowest phosphorus (120.00 ± 3.50 mg/100 g, iron (19.70 ± 0.60 mg/100 g) and vitamin A concentration (1.62 ± 0.59 × 103 μg/L). Quail egg had the highest (p < 0.05) vitamin A (4.16 ± 0.16 × 103 μg/L) and protein (13.49 ± 0.33%) contents. The moisture content was significantly higher in guinea fowl eggs (80.28 ± 0.41%) than in others. The outcome of this study indicated that some eggs which are seemingly underutilised may provide an enormous supply of nutrients needed for adequate human nutrition and health. Hence, if properly exploited they may substantially improve the quality of diet.

Despite clear evidence of the adverse health impacts of unsafe child feces disposal (CFD), there is little evidence of the effectiveness of interventions targeting the improvement of unsafe CFD practices in the Asia-Pacific region. A systematic review of the literature was conducted to identify and evaluate the quality of both behavior change and hardware interventions targeting the improvement of CFD practices in this region. A total of 695 articles were screened, and 15 studies were included. The combined hardware and behavior change interventions reported the highest rates of safe CFD (SCFD) post-intervention; however, these interventions were of lower quality. Four interventions focused specifically on improving SCFD practices, while the remaining seven studies evaluated the impacts of large-scale interventions, such as India's MANTRA and Total Sanitation Campaign programs, on unsafe CFD practices. Large-scale programs and hardware interventions are important for providing communities with the infrastructure necessary to improve unsafe CFD practices, but such interventions may be improved by the addition of a behavioral change component. With little evidence available on the effectiveness of behavioral interventions on reducing unsafe CFD in the Asia-Pacific region, future work should focus on how behavior change models combined with hardware interventions impact unsafe CFD. HIGHLIGHTS The Asia-Pacific region has high rates of unsafe child feces disposal (CFD).; There is little evidence on the effectiveness of sanitation interventions targeting the improvement of unsafe CFD practices.; Hardware interventions may be improved by the addition of a behavioral change component.; Future work should focus on how behavior change models combined with hardware interventions address unsafe CFD practices.;

This article aims to analyze the assistance provided by the Canada Fund for Local Initiatives to the Jakarta Feminist in the 2017-2021 period as one of the proofs that Canada's Feminist International Assistance Policy has so far been running smoothly. In addition, this article also aims to correct the misunderstandings of foreign policy observers regarding FIAP as a feminist foreign policy. FIAP has so far only used elements of Liberal Feminism as a lens of observation to focus on their foreign aid agenda to achieve a safe, inclusive, and prosperous world development. Therefore, this article argues that FIAP does contain elements of Feminism but focuses more on assisting non-profit organizations in developing countries, one of which is Indonesia. By using a descriptive qualitative research method that processes primary and secondary data from personal interviews and literature review, this article finds that CFLI, under the auspices of FIAP, has been successful in assisting the Jakarta Feminist in 2017-2021 and has also managed to reveal that FIAP is not a feminist foreign policy. FIAP oversees several foreign aid programs initiated by Canada for developing countries, one of which is CFLI.

Iran possesses about 241 species of reptiles, which 55 species of them (22.8%) are endemic to Iran. Agamidae is the important family of reptile in Iran with 22 species, which is poor in terms of chromosomal studies. In this paper, karyological survey was made for four species of the family Agamidae by bone marrow cell preparations. Karyotype of male and female of Laudakia caucasia (2n=34) was consisted of 6 pairs macro and 11pairs of microchromosomrs. Karyotype of Laudakia nupta nupta (2n=36) was including of 6 pairs of macro and 12 pairs of microchromosomes. Karyotype of Phrynocephalus scutellatus (2n=46) was consisted of 22 macro and 24 microchromosomes, which is reported here for the first time. Also, new cytotype of Traplus agilis agilis (2n=49) is reported here for the first time. Karyotype of this species was consisted of 21 large acrocentric and 28 microchromosomes, which one of the acrocentric chromosomes may be a sex chromosome.

Abstract Background Infertility is a long-standing reproductive health issue, which affects both men and women worldwide and it is especially problematic in the Global South. In sub-Saharan Africa, understanding the current availability of diagnostic and treatment services for infertility is important because this could guide health systems to improve access to fertility care for all. Yet, few studies have explicitly started from a health system perspective to grasp the availability and integration of infertility services in sub-Saharan Africa. This quantitative study, the first in The Gambia, West Africa, examines the availability of infertility services in public and private facilities as part of a wider endeavour to improve fertility care policy and practice in the country. Methods A cross-sectional survey using Qualtrics was administered to 38 health facilities. The survey was carried out between March and August 2021 and involved closed-ended questions. Data analysis consisted of descriptive statistics and t-tests performed using SPSS version 26. Results A total of 25 facilities (66%) offered infertility services, of which 13 (52%) were public and 12 (47%) private. Although the availability of screening tests was similar between health institutions, most diagnostic and treatment services were available only in the private sector. Treatment services included: (i) ovarian stimulation (n = 16, 42%); (ii) reversal of tubal ligation and/or blockage (tuboplasty) (n = 4, 11%); and (iii) intrauterine insemination (n = 3, 8%). Assisted reproductive technologies such as IVF and ICSI were not available in public or private sectors. The Gambian health management information system lacked a dedicated space to capture data on infertility. Reported barriers to integration of infertility services in existing reproductive health services included a lack of specialised training, an absence of national guidance on infertility management, and a shortage of appropriate equipment, supplies, and medication. Conclusions The availability of infertility services in The Gambia follows a trajectory that is similar to other SSA countries in which services are mostly obtainable through the private sector. Yet, access to private care is expensive and geographically restricted, which exacerbates inequalities in accessing fertility care for all. Improving the provision of infertility services in the public sector requires systematically capturing data on infertility and investing in the provision of a full-range fertility care package.

Familial Mediterranean fever is a rare autosomal recessive autoinflammatory disorder prevalent in Middle Eastern populations, characterized by episodic abdominal pain. This case report presents a 34-year-old Egyptian man with severe lower abdominal pain, chest discomfort, and joint pain, along with a positive family history of familial Mediterranean fever but had no previous personal history of this condition. Blood work revealed leukocytosis with neutrophilia and elevated C-reactive protein and erythrocyte sedimentation rate. The patient received intravenous fluids, antiemetics, and analgesics before further evaluation. Diagnosis of familial Mediterranean fever relies on clinical symptoms, ethnic origin, and family history, supported by specific criteria. Typical familial Mediterranean fever attacks involve serositis-induced pain, recurrent episodes, short-duration fever (12 h to 3 days), and arthritis. Familial Mediterranean fever may mimic other acute abdominal conditions, warranting consideration, particularly in individuals from Mediterranean regions. Genetic testing is valuable in confirming familial Mediterranean fever diagnosis.

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host's immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well as Coronavirus Disease 2019 (COVID-19) and human papillomavirus (HPV). Studies typically describe how STHs can affect the immune system and promote increased susceptibility, survival, and persistence of the infection in the host by causing a TH2-dominated immune response. The co-infection of STH with other diseases has important implications for the development of treatment and control strategies. Eliminating parasites from a human host can be more challenging because the TH2-dominated immune response induced by STH infection can suppress the TH1 immune response required to control other infections, resulting in an increased pathogen load and more severe disease. Preventive chemotherapy and treatment are currently the most common approaches used for the control of STH infections, but these approaches alone may not be adequate to achieve elimination goals. Based on the conclusions drawn from this review, integrated approaches that combine drug administration with water, sanitation and hygiene (WASH) interventions, hygiene education, community engagement, and vaccines are most likely to succeed in interrupting the transmission of STH co-infections. Gaining a better understanding of the behavior and relevance of STH co-infections in the context of elimination efforts is an important intermediate step toward reducing the associated burden of disease.

Background The UK Medicines Health products Regulation Agency instructs that valproate prescriptions should be restricted in women of childbearing age to those consenting to the Pregnancy Prevention Programme (PPP). We assessed the compliance and barriers to the valproate PPP.Methods We retrospectively audited NHS Grampian’s compliance with PPP guidelines among women of childbearing potential prescribed valproate between October 2017 and March 2018. Additionally, we prospectively reviewed new valproate prescriptions from February 2019 to March 2022 and compared this with our retrospective data to assess the effectiveness of our identification process using descriptive statistics.Results We identified 351 women retrospectively and 80 women prospectively. Epilepsy, migraine and psychiatry were the main indications. There was a decline in valproate use over the years, particularly for epilepsy. Initially, only 132 (37.6%) met the PPP requirement, and eventually, 81 (23%) stopped the medication. Despite efforts, 38 (10.8%) had contact with secondary care but still did not meet PPP and 100 (28.5%) had no documentation or referral to secondary care. Patients not meeting PPP lacked capacity, most commonly with severe learning difficulties. Women treated for psychiatric purposes were less likely to meet PPP than other indications.Conclusions A significant proportion of women continue valproate treatment without meeting the PPP requirement. This is linked to their indication for prescription and their comorbidities. Collaborative input from relevant specialities and primary care is required to fully achieve PPP if a national valproate database is to be established.

Different fecal sludge (FS) emptying practices have been documented worldwide, but little is known about how the type of on-site sanitation system (OSS) and other factors associated with emptying and transport influence how OSSs are emptied, nor about how FS is released to the environment during emptying. This systematic literature review assessed our current knowledge on OSS fecal sludge management practices and their impacts on pathogen releases into the environment including (i) the prevalence and frequency of emptying, (ii) the types of OSS emptying practices, (iii) other factors influencing these practices, and (iv) the return pathways into the environment during emptying and transport. The analysis included 58 peer-reviewed studies examining emptying in low- and middle-income countries in Asia published between 2001 and May 2021. Mechanical emptying was the most discussed emptying method (n=39), followed by manual emptying (n=22). The most discussed emptying factor was cost (n=19), followed by OSS accessibility (n=17). Discussion on FS releases was focused on deliberate disposal into the environment, with little on unintentional spills and leaks. Remaining gaps in the literature include the quantity, pathogenicity, and fate of FS spills during emptying, the effect of OSS type on emptying, and the effectiveness of emptying interventions. More research is needed on emptying to fully understand its impact on public health and how best to facilitate safe fecal sludge management.

Meteorological time series, such as rainfall data, show spatiotemporal characteristics and are often faced with the problem of containing missing values. Discarding missing values or modeling data with missing values causes negative impacts on the accuracy of the final predictions. Hence, accurately estimating missing values by considering the spatiotemporal variations in data has become a crucial step in eco-hydrological modeling. The multi-layer perceptron (MLP) is a promising tool for modeling temporal variation, while spatial kriging (SK) is a promising tool for capturing spatial variations. Therefore, in this study, we propose a novel hybrid approach combining the multi-layer perceptron method and spatial kriging to impute missing values in rainfall data. The proposed approach was tested using spatiotemporal data collected from a set of nearby rainfall gauging stations in the Ratnapura area, Sri Lanka. Missing values are present in collected rainfall data consecutively for a considerably longer period. This pattern has scattered among stations discontinuously over five years. The proposed hybrid model captures the temporal variability and spatial variability of the rainfall data through MLP and SK, respectively. It integrates predictions obtained through both MLP and SK with a novel optimal weight allocation method. The performance of the model was compared with individual approaches, MLP, SK, and spatiotemporal kriging. The results indicate that the novel hybrid approach outperforms spatiotemporal kriging and the other two pure approaches.

Mechanochemical and solvent-based complexes of Mn(II) with cefixime and cefuroxime were synthesized and characterized by melting point and conductivity measurements, elemental analysis, FTIR spectral studies, and electronic spectral analysis. The Mn(II) complexes with cefixime and cefuroxime synthesized mechanochemically were both ash colored, while Mn(II) cefixime and cefuroxime complexes synthesized through solvent-based method were milky and ash respectively. The molar conductivity values (14.9 – 16.6 Scm2mol-1) indicate non-electrolytic nature of the complexes. The FTIR revealed that the ligands were coordinated to the Mn(II) ion through the carboxylate ions (C=O). A six coordinate octahedral geometry has been proposed for the complexes. The result of the antibacterial assay of the synthesized complexes of Mn(II) with cefuroxime generally showed better activity against Staphylococcus aureus, Streptococcus pyogenes and Methicillin-resistant Staphylococcus aureus (MRSA) than the free ligand cefuroxime. Similarly, the Mn(II) complex of cefuroxime synthesized by mechanochemical method shows higher activity against the aforementioned organisms as compared to the solution-based complex which might be as a result of solvent effect.

In the developing world, matching the education and training of Valuation Surveyors with the needs of the industry is increasingly becoming challenging. This is largely due to globalisation, commercialisation, and advancements in information and communications technology, among others. In Uganda, while curricula are reviewed at least every after five years, the technologies and the market requirements continue to evolve, affecting the skills and knowledge passed on to graduates at universities and other tertiary institutions. This paper evaluates the education and training of Valuation Surveyors in Uganda, through a stakeholder survey, to determine the gaps in training and suggest ways on how to fill the gaps and consequently improve the valuation surveying curriculum. A questionnaire designed to capture both quantitative and qualitative data was administered to valuation practitioners and students. Over 49% of the respondents suggested the need for constant review of curriculum and adoption of a more practical approach to learning, as one of the major ways of bridging the gap between the education system and the changing industry. The findings of the study can be used by stakeholders in the education sector, to identify and prioritise the training needs of valuation students in different institutions for quality improvement purposes.

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage. Reasons for households’ continued OD practice include financial constraints, lack of water supply, governmental mistrust, cultural beliefs, and personal preference. Community incentives and penalties have been used to encourage proper sanitation practices with varying success. Overarching strategies and approaches that have worked well across study districts to reduce OD include high involvement of district leadership and innovative behavior-change and local community mobilization campaigns.

Water supply systems form one of the most fundamental components of building services. In many communities, especially in developing countries like Uganda, most households use the indirect cold water supply system, particularly because of the intermittent water supply problems. However, research has linked the main component of this system, particularly water storage tanks, to the contamination of water. There is a paucity of research regarding which features of these tanks contribute to water contamination. This study investigated the effects of storage tank features and cleaning practices on water quality. The results revealed that the treated water received by households became significantly (α = 0.05) contaminated with faecal coliforms (p = 0.001), total coliforms (p < 0.001), and heterotrophic bacteria (p < 0.001) while in storage tanks. Furthermore, Fe and Mn significantly increased in stored water (with p = 0.001, and p = 0.023, respectively) while residual free chlorine significantly reduced (p < 0.001). The study revealed that tank type, tank connectors, and tank age significantly affect water quality. The study concluded that tank cleaning does not guarantee improvement in the quality of stored water. Further research is recommended to determine the best tank cleaning methods and optimal cleaning frequency. HIGHLIGHTS Water storage tanks caused significant contamination of stored water.; 60% of households did not clean their water storage tanks.; Improper tank cleaning methods and tools led to contamination of stored water.; Tank cleaning does not guarantee improvement in water quality.; Stored water quality was most affected by tank material.;

Abstract Background The B-cell prolymphocytic leukemia (B-PLL) diagnosis is challenging due to the superposition with mature B-cell leukemia and/or lymphoma. Objective An insight case study of trisomy 5 with complex karyotype abnormalities in B-cell prolymphocytic leukemia. Subject and methods A 72-year-old man was referred to the Hematology Department, Qilu Hospital, Shandong University, because of persistent fever (10 days) and lymphocytosis. A detailed diagnostic methods including complete blood count, bone marrow aspiration, flow cytometry, conventional karyotype analysis, fluorescence in situ hybridization (FISH), quantitative real-time polymerase chain reaction (qRT-PCR), next-generation sequencing technology (NGS) used to detect 41 kinds of mutant genes related to hematological malignancies were conducted and reasonable therapeutic regimens including emergent leukapheresis accompanied by basification of urine and hydrotherapy, followed by a regimen of cyclophosphamide and dexamethasone. Results Subject white blood cell count was 143.43 × 109/L, and 56% prolymphocytes. He did not show lymphadenopathy but splenomegaly. Immunophenotyping of prolymphocytes was CD5(+low), CD10(−), CD11c(−), CD19(+), CD20(+), cCD22(+), CD23(−), cCD79a(+), CD79b(+), FMC7(±), CD43(−), CD3(−), CD56(−), CD103(−), HLA-DR(+), and Lambda(+). R-banding and FISH revealed that leukemia cells carried extra chromosome 5. Considering the rare occurrence of trisomy 5 found in prolymphocytic leukemia, especially in Asians, with rapid disease progression. We know that median survival of B-PLL is three years after diagnosis, while survival time of this patient was only 1 month. Conclusion This study could provide the firsthand materials for precision, medicine and mechanism research in cytogenetics and molecular biology. It inferred that trisomy 5 might be a poor prognosis indicator, providing directions for clinical practice in the foreseeable future.

Globally, about 2.7 billion people depend on onsite sanitation systems (OSS) (e.g., septic tanks) for their sanitation needs. Although onsite sanitation systems help in providing primary treatment for domestic wastewater, they don’t effectively remove nutrients, pathogens, and other inorganic contaminants. Previous studies have posited that the use of post treatment systems which incorporate biochar leads to improved contaminant removal efficiency. However, the mechanism through which contaminants are removed and factors potentially affecting the removal are still understudied. To fill this knowledge gaps, this review discusses factors which affect efficiency of biochar in removing contaminants found in onsite domestic wastewater, modifications applied to improve the efficiency of biochar in removing contaminants, mechanisms through which different contaminants are removed and constraints in the use of biochar for onsite wastewater treatment. It was noted that the removal of contaminants involves a combination of mechanisms which include adsorption, filtration, biodegradation, ion exchange, pore entrapment. The combination of these mechanisms is brought about by the synergy between the properties of biochar and microbes trapped in the biofilm on the surface of the biochar. Future areas of research such as the modification of biochar, use of biochar in the removal of antibiotic resistant genes (ARGs), application of wet carbonization methods and resistance of biochar to physical disintegration are also discussed. This study provides useful information that can be applied in the use of biochar for the treatment of wastewater and guide future design of treatment systems for optimized treatment performance.

There is conflicting evidence regarding whether athletes have better visio-spatial skills than non-athletes. This gap may result from athletes' superiority in only some visio-spatial abilities (VSS), rather than all areas of vision. The aim of this study was to determine whether there is a significant difference in the visio-spatial intelligence between female netball players (n = 40) and non-athletes (n = 40) when comparing six visual skills (accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness, hand-eye coordination, and visual memory). Following an optometric evaluation, the participants were assessed in six distinct established tests, including the hart near far rock, saccadic eye movement, evasion, accumulator, ball wall toss tests, and flash memory, to evaluate the VSS components of non-athletes and premier league netball players. For five of the six tests, there was a statistically significant (p ≤ 0.05) difference between netball players and non-athletes. Conversely, there is no concrete evidence that netball players have better visual memory than non-athletes (p = 0.277). When compared to non-athletes, netball players have significantly improved accommodation facility (p

The emptying and transport of faecal sludge (FS) is a fundamental aspect of the sanitation service chain and is mostly carried out by private operators who usually face a lot of challenges. Our review assessed how influencing factors and challenges FS emptiers face are linked and in turn how they act as barriers to improvement initiatives. We conducted a systematic review of peer-reviewed journals on FS emptying in sub-Saharan Africa, South and Southeast Asia published between January 2002 and December 2021. Amongst the 37 journals reviewed, accessibility was mostly documented (n = 18) as a factor which affected choice of emptying method, followed by cost (n = 14), quality of service (n = 13) and then sludge thickness (n = 8). We grouped the types of challenges identified from the publications into five categories of financial, technical and institutional (n = 14, each), followed by health (n = 12) and then social challenges (n = 8). Discussions on initiatives (n = 13) used to improve the emptying business were limited to Cost/affordability of sanitation services and access to finance by FS emptiers, which were noted to be the major barriers to effective implementation of these strategies. This review identified the need for sensitizing the public on FS emptying, financial modelling of manual emptying business and a need to study the relationship between perceptions and emptying behavior of users.

Introduction: Faecal sludge management (FSM) in urban areas of low-and middle-income countries (LMICs) is not properly implemented due to inaccessibility of sanitation facilities and high faecal sludge (FS) emptying costs, amongst others. Unlike in solid waste and fresh human excreta, use of black soldier fly larvae (BSFL) in treatment of FS from pit latrines - which are the most common sanitation facilities in urban areas of LMICs - has not yet been explored. Moreover, the optimal conditions for efficient FS degradation, such as moisture content, feeding rate and larval density are not yet well known. Against this backdrop, the overarching aim of this study was to determine the effectiveness of BSFL in treating FS under different conditions of moisture content, feeding rate and larval density. Also, the quality of residue left after treatment was assessed.Methods: FS samples were collected from lined and unlined pit latrines in Bwaise I parish in Kampala, Uganda and experiments were set up to feed 10-day old larvae.Results and Discussion: The optimum feeding rate, larval density and moisture content were found to be 50 mg/larvae/day, 1.33 larvae/cm2 and 60%, respectively. The reduction efficiency at optimum conditions were 72% and 66% for FS from lined and unlined pit latrines, respectively. It was further noted that BSFL can feed on FS from pit latrines without dewatering it, hence there is no need for a dewatering unit. The properties of the residue left after treatment were within the allowable limit for use as compost except for helminth egg concentration. Thus, in informal urban settlements, BSFL can be applied for effective treatment of FS from pit latrines while generating good quality residue thereby providing an additional value chain in FSM.

The study proposes an ensemble spatiotemporal methodology for short-term rainfall forecasting using several data mining techniques. Initially, Spatial Kriging and CNN methods were employed to generate two spatial predictor variables. The three days prior values of these two predictors and of other selected weather-related variables were fed into six cost-sensitive classification models, SVM, Naïve Bayes, MLP, LSTM, Logistic Regression, and Random Forest, to forecast rainfall occurrence. The outperformed models, SVM, Logistic Regression, Random Forest, and LSTM, were extracted to apply Synthetic Minority Oversampling Technique to further address the class imbalance problem. The Random Forest method showed the highest test accuracy of 0.87 and the highest precision, recall and an F1-score of 0.88.

Cities emit the majority of greenhouse gas emissions globally and are increasingly committing to aggressive mitigation actions. Cities are also experiencing poor—and in some cases worsening—air quality, contributing to large disease burdens for adults and children. Integrated planning frameworks can help cities leverage and prioritize measures that achieve climate, air quality, and health benefits simultaneously. We developed and applied an integrated climate action planning process that includes air quality, utilizing Pathways-AQ, a new assessment tool, in six pilot cities: Accra, Ghana; Addis Ababa, Ethiopia; Buenos Aires, Argentina; the metropolitan area of Guadalajara, Mexico; Johannesburg, South Africa; and Lima, Peru. Implementing the “ambitious” greenhouse gas reduction scenarios in these cities' climate action plans would reduce in-city contributions to fine particulate matter (PM2.5) concentrations and would avoid 230–1,040 annual premature deaths per city, by 2050. This new integrated climate action planning process revealed the importance of (i) geographic scales of analysis, (ii) data integration across climate and air quality, (iii) local civic engagement, and (iv) nuanced health messaging. Rapidly scaling up and applying this integrated approach can broaden the group of municipal stakeholders involved in climate-related planning goals, potentially leading to greater ambition by integrating climate, air pollution, and health objectives.

Adolescents in the current development. requires peers to facilitate adolescents in determining future orientation after graduating from high school.The purpose of this study was to determine how much influence peers have on the future orientation of class XI science students in one of the public high schools in Manado city. Respondents in this study were 134 students of class XI science. In this study using a quantitative approach with correlation analysis techniques that are processed using SPSS 21.0 for windows. The data collection technique used an instrument in the form of a questionnaire with a system using a Likert scale model. Results based on data analysis, the influence of peers on future orientation by looking at the ANOVA test value is fcount = 9.920 > ftable = 3.84. From the results, if fcount>ftable, the hypothesis Ha in this study is accepted. The influence of peers on future orientation can be seen from the R2 value of 0.070. This means that peers have an influence of 7% on the future orientation of class XI science students

Poor management of organic waste is a key environmental and public health issue as it contributes to environmental contamination and the spread of diseases. Anaerobic digestion (AD) presents an efficient method for organic waste management while generating energy and nutrient-rich digestate. However, the AD process is limited by key factors, which include process inefficiencies from substrate-induced instability, poor quality digestate, and poor management of effluent and emissions. Lately, there has been more interest in the use of biochar for improving anaerobic digestion. Biochar can improve methane production by speeding up the methanogenesis stage, protecting microorganisms from toxic shocks, and reducing inhibition from ammonia and volatile fatty acids. It can be applied for in situ cleanup of biogas to remove carbon dioxide. Applying biochar in AD is undergoing intensive research and development; however, there are still unresolved factors and challenges, such as the influence of feedstock source and pyrolysis on the performance of biochar when it is added to the AD process. In light of these considerations, this review sheds more light on various potential uses of biochar to complement or improve the AD process. This review also considers the mechanisms through which biochar enhances methane production rate, biochar’s influence on the resulting digestate, and areas for future research.

Abstract Background Household water storage remains a necessity in many communities worldwide, especially in the developing countries. Water storage often using tanks/vessels is envisaged to be a source of water contamination, along with related user practices. Several studies have investigated this phenomenon, albeit in isolation. This study aimed at developing a systematic review, focusing on the impacts of water storage tank/vessel features and user practices on water quality. Methods Database searches for relevant peer-reviewed papers and grey literature were done. A systematic criterion was set for the selection of publications and after scrutinizing 1106 records, 24 were selected. These were further subjected to a quality appraisal, and data was extracted from them to complete the review. Results and discussion Microbiological and physicochemical parameters were the basis for measuring water quality in storage tanks or vessels. Water storage tank/vessel material and retention time had the highest effect on stored water quality along with age, colour, design, and location. Water storage tank/vessel cleaning and hygiene practices like tank/vessel covering were the user practices most investigated by researchers in the literature reviewed and they were seen to have an impact on stored water quality. Conclusions There is evidence in the literature that storage tanks/vessels, and user practices affect water quality. Little is known about the optimal tank/vessel cleaning frequency to ensure safe drinking water quality. More research is required to conclusively determine the best matrix of tank/vessel features and user practices to ensure good water quality.

This paper centers around an experimental investigation into the effectiveness of an innovative hybrid control approach based on an intelligent active force control (IAFC) strategy to stabilize a twin-rotor helicopter model and improve its ability to reject external disturbances efficiently. The intelligent algorithm was based on an iterative learning (IL) method integrated into the main control loop to estimate control parameters automatically while on-line. A mechatronic test rig with the IAFC-based control algorithm was incorporated into a Quanser Aero twin-rotor model in a laboratory setting as a verification platform to evaluate the applicability and efficacy of the proposed control algorithm via a practical real-time implementation. The hybrid IAFC-based control design was rigorously examined to test its feasibility and durability in countering various forms of external disturbances while executing the trajectory tracking tasks. Notably, the efficiency of the IAFC-based control unit was mainly studied and compared with other control plans under different operating conditions for benchmarking. The experimental results show the ability of the controller based on the IAFC strategy to effectively improve the disturbance rejection capability compared to the other control schemes considered in the study. About 27% improvement of the system performance in terms of lowering the root mean square error (RMSE) was observed compared to the other control systems counterparts.

This study proposes the design and development of an in-pipe mini crawler (or robot) capable of performing its various tasks with the ability to reject undesired disturbances resulting from friction and viscosity, as it was modeled, simulated, and experimented using an iterative learning algorithm (ILA)-based active force control (AFC) strategy. The crawler motion was executed based on a rapid and successive push-pull action plus friction that causes the crawler to move in an earthworm-like manner using a linear voice-coil actuator (VCA). A novel self-adjusted mechanism was designed to ensure that the crawler remained concentric in the pipe as it slides along the inner surface of the pipe. A novel control strategy was also proposed consisting of the AFC-based controller cascaded with a proportional-integral-derivative (PID) controller to control the crawler movement and expel off the applied perturbations. An intelligent PD-type ILA was employed to automatically tune the AFC while online. For the validation part, a prototype was designed, developed, and later experimented with using the proposed technique for a given set of conditions. The system integration employed a hardware-in-the-loop (HIL) test configuration utilizing LabVIEW. Experimental results are in good agreement with the simulation counterpart, thereby indicating the practicality and feasibility of the control system in performing accurate and robust trajectory tracking. This shall serve as a good basis for designing more challenging tasks related to miniature crawling mechanism in-pipe applications.

Chronic kidney disease (CKD) and stroke share many common risk factors, and the presence of CKD confers added risk factors for stroke. With increasing interest and understanding of the close relationship between the kidney and the brain, this study aims to assess the prevalence and impact of renal dysfunction on outcomes acute stroke patients. This is a prospective hospital-based study carried out in the neurology unit of University of Maiduguri Teaching Hospital, Maiduguri, northeastern Nigeria. The study population consisted of adult patients (>18 years) admitted in the medical wards with a diagnosis of acute stroke. Sociodemographic variables and biochemical parameters were obtained from each patient. Patients’ functional status assessment by modified Rankin scale, Barthel index, and National Institutes of Health Stroke Scale score were obtained at admission and discharge. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease equation. Patients who have estimated GFR (eGFR) 60 mL/min. Out of a total of 501 patients admitted during the study period, 448 patients had complete data and were recruited, out of which 275 (61.4%) were male and 173 (38.6%) were female. Their ages ranged from 38 to 89 years, with a mean age ± standard deviation of 53.85 ± 18.13 years. The mean eGFR of the study population was 66.55 ± 30.49 mL/min. Two hundred and twenty-five (50.2%) had renal dysfunction with GFR

Abstract The Barremian-Cenozoic depositional sequences in the northern Orange Basin, SW, South Africa, were investigated using the principles of seismic stratigraphy to understand the interplay of tectonics and sedimentary processes in the distribution of potential hydrocarbon reservoirs. A seismic stratigraphic workflow (seismic sequence, seismic facies and lithofacies analysis) was completed by utilising three seismic lines (L1, L2 and L3) tied to Wireline data (gamma, checkshots and sonic) in two exploration wells (A1 and A2). Seven depositional sequences were mapped followed by the creation of lithofacies log interpreted from the gamma-ray log (GR) by setting maximum GR value at 60 API for Sandstone, 60–100 API for Siltstone and above 100 API for Shale. Six seismic facies units are recognised based on internal geometry and configurations of the seismic reflectors; Tangential-Oblique (SF1), Hummocky (SF2), Wavy-Parallel (SF3), Chaotic (SF4), Sub-parallel/parallel (SF5) and Divergent (SF6). SF4 is dominant within the Barremian-Aptian sequence and expressed in an incised valley fill, suggesting mass transport deposition accompanied by strong hydrodynamic conditions. Evidence of sedimentary basins progradation is seen within the Late-Albian-Turonian sequences, because of the occurrences of SF2, SF6 and SF 4 facies. SF5 facies is prominent in the Maastrichtian/Campanian sequence, indicating that the deposition of sediments may have been accompanied by uniform margin subsidence after the Late-Cretaceous uplift of the Africa margin. The occurrence of SF1 and SF4 facies within the Cenozoic sequence indicates terrigenous pro-deltaic deposits and mass transport deposits, respectively. Further results from seismic-lithofacies modelling reveal that sand deposits of Barremian-Aptian (SF4 facies unit) and Albian sequences (SF2 and SF6 facies units) are potential stratigraphic reservoirs in this part of the basin.

Objectives: In this study, we examined the impact of epigenetic modifications on host gene functioning by assessing the expression of seven candidate genes in three separate groups including healthy, multidrug-resistant (MDR) TB-HIV co-infected and HIV-1 positive individuals. Methods: Ten patients with MDR TB and HIV-1 co-infection on TB and HIV therapy and a cohort comprised of 10 newly diagnosed individuals with HIV-1 infection were recruited from the TB and HIV clinics at the Charlotte Maxeke Johannesburg Academic Hospital. Notably, the HIV-1 positive individuals were not placed on antiretroviral therapy (ART) at the time of recruitment and blood collection. A third group consisting of 10 healthy participants without MDR TB or HIV infection was recruited from the University of the Witwatersrand. Blood samples collected from all three cohorts were employed for extraction of plasma, total RNA and genomic DNA. Results: Our data indicated that the expression of DNA methyltransferase 1 (DNMT1) and Ten-eleven translocation methylcytosine dioxygenase 1 (TET1) genes was significantly increased in HIV-1 positive patients and was lowest in MDR TB-HIV co-infected patients. By contrast, histone acetyltransferase (HAT), histone deacetylase (HDAC), protein tyrosine kinase (PtkA) and protein tyrosine phosphatase (PtpA) mRNA expression levels were substantially enhanced in HIV-1 infected and were lowest in healthy individuals. Conversely, Dicer expression levels were comparable among all three study groups. Conclusion: Promising preliminary data emanating from this investigation may potentially be used for generation of novel vaccines and therapeutic compounds capable of neutralising MDR TB-HIV and HIV-1 infection.

Abstract Background Evidence-based healthcare (EBHC) principles are essential knowledge for patient and consumer (“consumer”) engagement as research and research implementation stakeholders. The aim of this study was to assess whether participation in a free, self-paced online course affects confidence in explaining EBHC topics. The course comprises six modules and evaluations which together take about 6 h to complete. Methods Consumers United for Evidence-based Healthcare (CUE) designed, tested and implemented a free, online course for consumers, Understanding Evidence-based Healthcare: A Foundation for Action (“Understanding EBHC”). The course is offered through the Johns Hopkins Bloomberg School of Public Health. Participants rated their confidence in explaining EBHC topics on a scale of 1 (lowest) to 5 (highest), using an online evaluation provided before accessing the course (“Before”) and after (“After”) completing all six course modules. We analyzed data from those who registered for the course from May 31, 2007 to December 31, 2018 (n = 15,606), and among those persons, the 11,522 who completed the “Before” evaluation and 4899 who completed the “After” evaluation. Our primary outcome was the overall mean of within-person change (“overall mean change”) in self-reported confidence levels on EBHC-related topics between “Before” and “After” evaluations among course completers. Our secondary outcomes were the mean within-person change for each of the 11 topics (mean change by topic). Results From May 31, 2007 to December 31, 2018, 15,606 individuals registered for the course: 11,522 completed the “Before” evaluation, and 4899 of these completed the “After” evaluation (i.e., completed the course). The overall mean change in self-reported confidence levels (ranging from 1 to 5) from the “Before” to “After” evaluation was 1.27 (95% CI, 1.24–1.30). The mean change by topic ranged from 1.00 (95% CI, 0.96–1.03) to 1.90 (95% CI, 1.87–1.94). Conclusion Those who seek to involve consumer stakeholders can offer Understanding EBHC as a step toward meaningful consumer engagement. Future research should focus on long-term impact assessment of online course such as ours to understand whether confidence is retained post-course and applied appropriately.

Though wearable electronics remain an attractive technology for bioelectronics, fabrication methods that precisely print biocompatible materials for electronics are needed. Here, the authors report an additive manufacturing process that yields all-printed nanomaterial-based wireless electronics.

A drought is a phenomenon of shortages in water supply in an area for a long time. Drought usually occurs in areas that have little rain for a long time or in areas with low precipitation. Drought have negative impacts on many sectors such as agriculture, plantations, water resources and environment. This paper describes the results of a research that aims to analyze data to get the level of drought during four yearly periods, and predict the likelihood of drought to occur in the future. The level of drought was analyzed using the Inverse Distance Weighted (IDW) method and the Standardized Precipitation Index (SPI). Least square time series was utilized to forecast the level of drought in the near future. Data consists of drought data collected from electronic news, rainfall data from BMKG, and anual Landsat-8 satellite imagery. All data are for Western Southeast Mallucas in the range of 2015-2018. Analysis using IDW and SPI methods produce similar interpretation for year 2015, i.e. mild dryness, and fro year 2018, i.e. no drought. However, the two methods show discrepancy in analysis of data for 2016 and 2017. The use of least square time series to forecast drought in 2019 gives SPI value of 0.03 which intepretes as normal weather (no drought) that is consistent with the result of field observation.