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The flow of information between markets is important to guide investors and policymakers in the effective allocation of assets and proactive market regulation, respectively. This study examines the impact of information flow from global financial market stress on the African stock markets using the daily US financial stress index (USFSI) and other advanced economies' financial stress index (OAEFSI) to proxy the global financial stress index. To understand the information flow dynamics across various investment horizons, the ensemble empirical mode decomposition (EEMD)-based transfer entropy is employed. Our findings reveal that African equity markets are highly risky for information flow from global financial market stress. However, we identify diversification prospects based on market conditions for Ghana and Egypt in the short term and Tanzania, Cote D'Ivoire, and Egypt in the medium term. Empirical results also show that the information flow from global financial stress to African stock markets depends on time scales, economic relations, and the state of global financial markets. The findings are important for investors, portfolio managers, practitioners, and policymakers., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018-2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events., Main Text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks., Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now., (© 2022. The Author(s).)

Background: Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing mitral valve replacement (MVR) surgery. We aimed to investigate the incidence of PPM of the mitral position in our center and analyze the possible predictors of PPM as well as its effect on short-term outcomes., Methods: We retrospectively examined all consecutive patients with isolated or concomitant MVR at our center from 2013 to 2015. PPM was defined as an indexed effective orifice area (iEOA) of ≤1.2 cm2/m2. After inclusion and exclusion, a total of 1067 patients were analyzed. The baseline information were collected and compared between the two groups. Multivariate logistic regression analysis was conducted to determine the preoperative predictors of PPM as well as the effect of PPM on early mortality., Results: A total of 1067 patients were included in the study. PPM was detected in 15.9% of the patients while 12 patients (1.12%) met the criteria for severe PPM. Patients with PPM compared to the non-PPM patients had higher age, larger body surface area and were more likely to be male and obese. Logistic regression analysis showed that higher age, larger BSA, bioprosthesis and smaller left ventricle end-diastolic diameter were predictors of PPM. There were no significant differences between the PPM and non-PPM groups regarding post-operative complications. Logistic regression analysis showed that PPM was not a risk factor of short-term mortality (P = 0.654). Also, there were no significant differences regarding short-/mid-term heart function between the PPM and non PPM groups (P = 0.902)., Conclusions: Our results demonstrated that higher age, bioprosthesis, larger BSA and smaller left ventricle size were associated with mitral PPM. However, PPM was not associated with poorer early outcomes after MVR surgery. In eastern of China, the prevalence of mitral valve stenosis is high; therefore, whether the standard PPM criteria are suitable for patients of this district needs to be further verified.

Background: Conventional methods of preparing magnetoliposomes are complicated and inefficient. A novel approach for magnetoliposomes preparation was investigated in the study reported here., Methods: FeCl3/FeCl2 solutions were hydrated with lipid films to obtain liposome-encapsulated iron ions by ultrasonic dispersion. Non-encapsulated iron ions were removed by dialysis. NH3·H2O was added to the system to adjust the pH to a critical value. Four different systems were prepared. Each was incubated at a different temperature for a different length of time to facilitate the permeation of NH3·H2O into the inner phase of the liposomes and the in situ formation of magnetic iron-oxide cores in the liposomes. Single-factor analysis and orthogonal-design experiments were applied to determinate the effects of alkalization pH, temperature, duration, and initial Fe concentration on encapsulation efficiency and drug loading., Results: The magnetoliposomes prepared by in situ precipitation had an average particle size of 168±14 nm, zeta potential of -26.2±1.9 mV and polydispersity index of 0.23±0.06. The iron-oxide cores were confirmed as Fe3O4 by X-ray diffraction and demonstrated a superparamagnetic response. Encapsulation efficiency ranged from 3% to 22%, while drug loading ranged from 0.2 to 1.58 mol Fe/mol lipid. The optimal conditions for in situ precipitation were found to be an alkalization pH of 12, temperature of 60°C, time of 60 minutes, and initial Fe concentration of 100 mM Fe(3+) + 50 mM Fe(2+)., Conclusion: In situ precipitation could be a simple and efficient approach for the preparation of iron-oxide magnetoliposomes.

The objective of this study is to determine the impact of group psychological therapy (GPT) on the mental health of obstetric fistula patients. It was a comparative pre and post intervention design. All patients had GPT prior to surgery and mental health assessment conducted before and after surgical repair. There was a significant reduction in proportion of those with severe mental health status after surgery. Specifically, the proportion of those with depression score of 4 and above reduced from 71.7% to 43.4%, and those with score of less than 4 increased from 28.3 to 56.6 percent. There was a significant reduction in those with very low self-esteem from 65.0% to 18.3%. Suicidal ideation reduced generally; severe (15.0 to 0%), moderate (16.7 to 5.0%) and mild (25.0 to 21.7%) and those without increased (43.3 to 73.3%). In conclusion, GPT is a useful adjunct to OF care as it improves their overall mental health status.