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Nowadays, the number of scientifc publications existing in the form of electronic text is constantly growing. As a result, the tasks related to the text processing of scientifc articles become especially actual. This paper is dedicated to the task of extracting semantic relations between entities from the texts of scientifc articles in Russian, where we consider scientifc terms as entities. Relation extraction can be useful in some specialized areas, such as searching and question-answering systems, as well as in the compilation of ontologies. In our work, we have created a corpus of scientifc texts consisting of 136 abstracts of scientifc articles in Russian, in which 353 relations of the following types were highlighted: USAGE, ISA, TOOL, SYNONYMS, PART_OF, CAUSE. This corpus was used to train the machine learning models. In addition, we have implemented the automatic semantic relation extraction algorithm and tested it on the already existing corpus RuSERRC. The neural network model BERT was used to implement the algorithm. We’ve done a number of experiments using vectors derived from different language models, as well as two neural network architectures. The developed tool and the annotated corpus are publicly available and can be useful for other researchers.

Background: Coronavirus, or SARS-CoV2, is one of the main pathogens that attack the human respiratory system. The coronavirus disease caused by SARS COV2 represents the causative agent of a potentially fatal disease of global public health concern. West Sumatra is in the top 10 provinces that contributed the most COVID-19 cases in Indonesia. 1st According to the official website of the Health Padang City Service on September 22, 2020, 2385 confirmed COVID-19 people, 1426 people recovered from COVID-19, and 53 people died. The high incidence of positive cases of Covid-19 in Padang is due to a lack of public knowledge and adherence to government-mandated health practices. Dental care places have a risk of COVID-19 infection due to aerosols generated during procedures, handling of sharp objects, and the proximity of dentists to patients. Dentistry students must have an awareness of deep knowledge, a better understanding, and must be updated with the practice of adapting to identify possible COVID-19 infections. Objective: The aim is to increase awareness about COVID-19 among undergraduate dentistry students at the Baiturrahmah Faculty of Dentistry, Padang. Methods: This type of research is called descriptive research. The target population of this study was undergraduate dentistry students in 2017, 2018, and 2019, with a sample of 175 people. This research was conducted online in the city of Padang using Google Forms Media for distributing questionnaires. When the research was carried out in September 2020. Results: The results showed that as many as 99.4% of respondents had good knowledge awareness about COVID-19, 0.6% awareness of bad knowledge, 97.7% of respondents got the first information about COVID-19 through the media, 56% of respondents got the latest Covid information via the internet, only 11.4% of respondents are taking Covid-19 courses, and 5.1% are still taking courses until now. The method of data analysis in this study used the SPSS program with univariate and bivariate analysis. The processed data is presented in table form. Conclusion: Students have awareness about COVID-19.

Pada Desember 2019, virus Coronavirus Disease 2019 (COVID-19) menyebar di Wuhan, China. WHO menyatakan epidemi itu sebagai kondisi yang sangat mengkhawatirkan kesehatan masyarakat internasional pada 1 Januari 2020, menyatakan bahwa itu akan mempengaruhi 2.725.920 orang pada 24 April 2020, yang mengakibatkan 191.061 kematian. Unit UKGS ialah cabang dari usaha kesehatan sekolah atau UKS yang menjadi bagian terikat dengan pelayanan kesehatan gigi dan mulut yang dilakukan oleh Puskesmas. UKGS menggunakan Sekolah Dasar sebagai sarana kegiatan pelayanan kesehatan gigi dan mulut. Namun tidak dapat dipungkiri bahwa pandemic Covid-19 sangat berpengaruh besar terhadap efektivitas UKGS mengingat virus korona yang rentan menyerang petugas yang melalui kontaminasi dari mulut pasien. Tujuan : untuk mengetahui efektivitas usaha kesehatan gigi sekolah (ukgs) di masa pandemi? Metode: Dalam penelitian ini menggunakan metode review dalam bentuk scooping review beberapa artikel.Hasil : Praktik UKGS dapat berjalan efektif jika diiringi dengan strategi inovatif seperti dengan meningkatkan proses promosi dan aksesibel bagi orang tua siswa. Kata Kunci : Efektivitas, UKGS, Covid-19

This paper describes NEREL-BIO -- an annotation scheme and corpus of PubMed abstracts in Russian and smaller number of abstracts in English. NEREL-BIO extends the general domain dataset NEREL by introducing domain-specific entity types. NEREL-BIO annotation scheme covers both general and biomedical domains making it suitable for domain transfer experiments. NEREL-BIO provides annotation for nested named entities as an extension of the scheme employed for NEREL. Nested named entities may cross entity boundaries to connect to shorter entities nested within longer entities, making them harder to detect. NEREL-BIO contains annotations for 700+ Russian and 100+ English abstracts. All English PubMed annotations have corresponding Russian counterparts. Thus, NEREL-BIO comprises the following specific features: annotation of nested named entities, it can be used as a benchmark for cross-domain (NEREL -> NEREL-BIO) and cross-language (English -> Russian) transfer. We experiment with both transformer-based sequence models and machine reading comprehension (MRC) models and report their results. The dataset is freely available at https://github.com/nerel-ds/NEREL-BIO., Submitted to Bioinformatics (Publisher: Oxford University Press)

We address the named entity omission - the drawback of many current abstractive text summarizers. We suggest a custom pretraining objective to enhance the model's attention on the named entities in a text. At first, the named entity recognition model RoBERTa is trained to determine named entities in the text. After that, this model is used to mask named entities in the text and the BART model is trained to reconstruct them. Next, the BART model is fine-tuned on the summarization task. Our experiments showed that this pretraining approach improves named entity inclusion precision and recall metrics., Comment: https://aclanthology.org/2022.sdp-1.17/

Introduction. The paper submits the analysis of existing design solutions of flow dividers used to synchronize hydraulic drives of working bodies of technological and mobile machines. The market demands for multithreaded throttle flow dividers without valves with the controlled division ratio, such as multi-axle vehicle chassis, are identified. The objective of the work was to analyze the possibility and rationale for developing a throttle four-way flow divider without valves with sensing elements of the Venturi tube type. The solution should provide the synchronicity of movement (rotation) of more than three working bodies of technological and mobile machines.Materials and Methods. A patent search for the designs of hydraulic flow dividers is carried out, and systems that require the division of the hydraulic fluid flow into more than two executive bodies are considered. An upgrade option, which allows dividing the flow into four branches, is proposed for the design of a three-channel throttle flow divider without valves.Results. The urgency of developing a multithreaded throttle flow divider without valves for application in industrial and mobile machines is validated. Two types of four-flow dividers are considered, their weaknesses are indicated. It is noted that the development of a multithreaded throttle flow divider based on the designs created in 1989 and 1991 will reduce the number of hydraulic pumps and get rid of the series connection of double-flow dividers. In this way, it is possible to reduce pressure losses in the hydraulic system and implement adaptive control of hydraulic motors of multi-motor mobile machines. The possibility to obtain a divider/combiner into four flows by adding an outlet chamber connected to the membrane chamber through a channel entering the Venturi nozzle on the basis of a three-flow throttle divider is shown. The principle of operation of such equipment is described.Discussion and Conclusions. The principles of construction of throttle flow dividers without valves are considered. An upgrade option is proposed to increase the number of division channels from three to four. However, to validate the operability of this design, a numerical analysis of the various modes of operation of the divider is required — calculation of the reduced volumetric stiffness of its working cavities. The information obtained can be used to modernize the hydraulic units of technological and mobile machines, increase their reliability, manufacturability, and efficiency. The issues that need to be solved in further research are identified.

Acute urinary retention is a common clinical presentation in emergency departments in the UK and is responsible for over 30 000 hospital admissions annually. Awareness of the latest advice and guidelines regarding its presentation, investigation and management is paramount to improve patient outcomes and reduce morbidity. Immediate management of acute urinary retention relies on timely bladder decompression by catheterisation. Knowledge of the routes and types of catheterisation, including the associated risks, complications and contraindications, is essential to allow rapid and early intervention, thus preventing further complications. Differences in the presentation of patients with acute urinary retention reflect varying aetiologies, the knowledge of which determines long-term management and prognosis.

Nowadays, there is a growing interest in solving NLP tasks using external knowledge storage, for example, in information retrieval, question-answering systems, dialogue systems, etc. Thus it is important to establish relations between entities in the processed text and a knowledge base. This article is devoted to entity linking, where Wikidata is used as an external knowledge base. We consider scientific terms in Russian as entities. Traditional entity linking system has three stages: entity recognition, candidates (from knowledge base) generation, and candidate ranking. Our system takes raw text with the defined terms in it as input. To generate candidates we use string match between terms in the input text and entities from Wikidata. The candidate ranking stage is the most complicated one because it requires semantic information. Several experiments for the candidate ranking stage with different models were conducted, including the approach based on cosine similarity, classical machine learning algorithms, and neural networks. Also, we extended the RUSERRC dataset, adding manually annotated data for model training. The results showed that the approach based on cosine similarity leads to better results compared to others and doesn’t require manually annotated data. The dataset and system are open-sourced and available for other researchers.

Background Cystic fibrosis (CF) is one of the most common autosomal recessive diseases. Factors contributing to disease exacerbations and survival rate of CF patients are type of mutation in the CFTR gene, poor nutritional status, lung failure, and infection development by Pseudomonas aeruginosa. The study aimed to evaluate the relationship between the severity of mutation, nutritional status, lung function, and Pseudomonas aeruginosa prevalence and survival rate in adult patients with cystic fibrosis. Methods A study of 124 (68 ♀ and 56 ♂) adults with CF aged 18–51 years were evaluated for (a) type of mutation in the CFTR gene, (b) nutritional status (BMI), (c) lung function (FEV1%), and (d) Pseudomonas aeruginosa prevalence. For statistical calculations, Kaplan-Meier analysis of survival, chi-squared test for multiple samples, and logistic regression were used. Results The type of mutation (χ2 = 12.73, df = 3, p = 0.005), FEV1% (χ2 = 15.20, df = 2, p = 0.0005), Pseudomonas aeruginosa prevalence (χ2 = 11.48, df = 3, p = 0.009), and BMI (χ2 = 31.08, df = 4, p < 0.000) significantly differentiated the probability of survival of patients with CF. The shortest life expectancy was observed in patients with a severe type of mutation on both alleles, FEV1% < 40, subjects in whom Pseudomonas culture was extensively drug-resistant or pandrug-resistant, and patients whose BMI was lower than 18.5 kg/m2. The period from 30 to 40 years of age was the most critical in CF adults’ lifespan. The risk of adults with CF death doubled with Pseudomonas aeruginosa prevalence (OR = 2.06, 95% CI 1.29; 2.28) and eightfold when the bacteria acquired antibiotic resistance (OR = 8.11, 95% CI 1.67; 38.15). Conclusions All factors included in the study were significantly related to the survival rate of patients with cystic fibrosis.

BackgroundTimely and appropriate health care during pregnancy and childbirth are the pillars of better maternal health outcomes. However, factors such as poverty and low education levels, long distances to a health facility, and high costs of health services may present barriers to timely access and utilisation of maternal health services. Despite antenatal care (ANC), delivery and postnatal care being free at the point of use in Burundi, utilisation of these services remains low: between 2011 and 2017, only 49% of pregnant women attended at least four ANC visits. This study explores the socio-economic determinants that affect utilisation of maternal health services in Burundi.MethodsWe use data from the 2016–2017 Burundi Demographic and Health Survey (DHS) collected from 8941 women who reported a live birth in the five years that preceded the survey. We use multivariate regression analysis to explore which individual-, household-, and community-level factors determine the likelihood that women will seek ANC services from a trained health professional, the number of ANC visits they make, and the choice of assisted childbirth.ResultsOccupation, marital status, and wealth increase the likelihood that women will seek ANC services from a trained health professional. The likelihood that a woman consults a trained health professional for ANC services is 18 times and 16 times more for married women and women living in partnership, respectively. More educated women and those who currently live a union or partnership attend more ANC visits than non-educated women and women not in union. At higher birth orders, women tend to not attend ANC visits. The more ANC visits attended, and the wealthier women are; the more likely they are to have assisted childbirth. Women who complete four or more ANC visits are 14 times more likely to have an assisted childbirth.ConclusionsIn Burundi, utilisation of maternal health services is low and is mainly driven by legal union and wealth status. To improve equitable access to maternal health services for vulnerable population groups such as those with lower wealth status and unmarried women, the government should consider certain demand stimulating policy packages targeted at these groups.

Bu tezin amacı üç boyutludur. İlki, bireyin varlığı, kişiliği, kimliği ve öz benliğini neyin oluşturduğu ve onların nasıl şekillendiğini incelemektir. Bu çerçevede filozofların ve psikologların konuyla ilişkili çeşitli görüşlerine yer verilmiştir. İkincisi, Abraham Maslow'un kendini gerçekleştirme teorisini, yirminci yüzyılın sonlarında yaşamış eşsiz İngiliz yazar Penelope Fitzgerald'ın (1916-2000) hayatına uygulamaktır. Üçüncüsü, kendini gerçekleştirmiş bir birey olmak için nelerin gerektiği, Fitzgerald'ın kendini gerçekleştirme sürecine hangi faktörler ve kişilik özelliklerinin katkıda bulunduğunu ortaya koymaktır. Zira Henry David Thoreau dışında, erkek ya da kadın hiçbir yazarın kendini gerçekleştirmiş bir kişilik olarak kabul edilmediği göz önüne alındığında, Fitzgerald'ın hayatının analiz edilmesi daha çok önem kazanmaktadır. Fitzgerald'ın hayatı, kendini gerçekleştirme sürecinde insanın cesareti ve iradesinin son derece kritik bir role sahip olduğunu iddia eden Maslow'u tamamen haklı çıkarmaktadır. Tezde, öncelikle nitel, açıklayıcı ve deskriptif araştırma yöntemleri kullanılmıştır. Ayrıca felsefi, psikolojik ve edebi alanları da içine alan geniş kapsamlı metin analizinden faydalanılarak, disiplinler arası çalışmalara katkıda bulunmak hedeflenmiştir. Yazarın öz benliğini ve yaratıcılık sürecini keşfetmesine odaklanan bu çalışma, kapsam olarak edebiyat psikolojisi alanına girmektedir. Tezde, biyografik ve tarihsel yaklaşımların yanı sıra, Fitzgerald'ın öz benliğini doğumundan ölümüne kadar birbiriyle bağlantılı ele alan bütüncül bir bakış benimsenmiştir. Kendini gerçekleştirme teorisinin bütün bileşenlerini Fitzgerald'ın yaşamının istisnasız bir şekilde karşıladığı anlaşılmıştır. Çalışmanın kendini gerçekleştirme teorisinin ilk kez bir yazarın yaşamı ve edebi kariyerine uygulanması ve bu manada Türkiye'de yapılan ilk çalışma olması açısından önemli olduğu söylenebilir. Anahtar Kelimeler: Penelope Fitzgerald, Abraham Maslow, Kendini Gerçekleştirme Teorisi, Edebi Biyografi, Biyografizm., The purpose of the present dissertation is threefold. First, to examine what makes one's entity, how personality, identities and selves come to shape. In this frame, multiple perspectives of philosophers and psychologists were presented. Second, to apply Maslow's famous theory of self-actualization to the life of the unique English writer of late twentieth-century Penelope Fitzgerald (1916-2000). Third, what it takes to become a self-actualized person, what factors and personality traits contribute to the author's self-actualized process. Given that except for Henry David Thoreau, no other writer, male or female, has been considered a self-actualized personality, Penelope Fitzgerald's life gains much more significance. Fitzgerald's life fully justifies Maslow's claim that human courage and willpower are of utmost importance in the process of self-actualization. Employing qualitative, descriptive and explorative research methods as well as textual analysis with a wide range of text-based materials ranging from philosophical, psychological to literary studies, the study aims to contribute to interdisciplinary studies. The exploration of the self of the writer as well as her creative process makes this a study of psychology of literature. With the employment of humanistic psychology, the dissertation adopts biographical and historical approaches as well as a holistic approach considering Penelope Fitzgerald's self as a whole interconnected entity from birth to death. The dissertation is the first of its kind in two ways. Firstly, the application of self-actualization theory to the author's life and career is carried out for the first time. Secondly, it is the first study in Turkey to examine Penelope Fitzgerald's life and career employing the theory in question. Keywords: Penelope Fitzgerald, Abraham Maslow, Self-actualization theory, Literary biography, Biographism., Tez (Doktora-PhD), Süleyman Demirel Üniversitesi, Sosyal Bilimler Enstitüsü, Batı Dilleri ve Edebiyatları Anabilim Dalı, 2021., Kaynakça var.

Purpose: An ageing population has led to many people aged 80 and over requiring urological surgery. There are concerns that operating on octogenarians may be fraught with higher morbidity and mortality risk. Therefore, the purpose was to study postoperative outcomes in people aged 80 years and over undergoing elective urological surgery. Materials and methods: We retrospectively reviewed the 30-day readmissions and deaths in patients aged 80 years and over who had elective urological surgery over a seven and half year period from February 2011 to July 2018 in a district general hospital. Surgeries were stratified into minor, intermediate and major. Our data did not include supra-major surgeries like radical cystectomy as these are done in tertiary centres. We used logistic regression to examine factors associated with readmissions and death. Results: A total of 1239 patients had 2201 operations. The median age was 84.1 years. Procedures on the bladder were the most common, followed by prostate surgery. A 17.9% of operations resulted in an adverse outcome (death or readmission attributable to surgery) within 30 days. There were 21 deaths, equating to 1% of all surgeries undertaken. There was a significant difference in both readmissions and deaths by American Society of Anaesthesiologists (ASA) grade. The median time to readmission from surgery was 18 (IQR 13–23) days. The highest number of readmissions occurred in the third week after surgery. A 94% of the readmissions were for a minor complication (grade I Clavien Dindo), with haematuria and urinary retention being most common. Conclusions: This study informs hospitals, surgeons, patient advocacy groups and insurance, that the morbidity and mortality risks of non-supra major elective urological surgery in patients aged 80 and over are not disproportionately high.

Background Papua New Guinea (PNG) has one of the highest burdens of HIV and syphilis in pregnancy in the Asia-Pacific region. Timely and effective diagnosis can alleviate the burden of HIV and syphilis and improve maternal and newborn health. Supply-side factors related to implementation and scale up remain problematic, yet few studies have considered their impact on antenatal testing and treatment for HIV and syphilis. This study explores health service availability and readiness for antenatal HIV and/or syphilis testing and treatment in PNG. Methods Using data from two sources, we demonstrate health service availability and readiness. Service availability is measured at a province level as the average of three indicators: infrastructure, workforce, and antenatal clinic utilization. The readiness score comprises 28 equally weighted indicators across four domains; and is estimated for 73 health facilities. Bivariate and multivariate robust linear regressions explore associations between health facility readiness and the proportion of antenatal clinic attendees tested and treated for HIV and/or syphilis. Results Most provinces had fewer than one health facility per 10 000 population. On average, health worker density was 11 health workers per 10 000 population per province, and approximately 22% of pregnant women attended four or more antenatal clinics. Most health facilities had a composite readiness score between 51% and 75%, with urban health facilities faring better than rural ones. The multivariate regression analysis, when controlling for managing authority, catchment population, the number of clinicians employed, health facility type and residence (urban/rural) indicated a weak positive relationship between health facility readiness and the proportion of antenatal clinic attendees tested and treated for HIV and/or syphilis. Conclusion This study adds to the limited evidence base for the Asia-Pacific region. There is a need to improve antenatal testing and treatment coverage for HIV and syphilis and reduce healthcare inequalities faced by rural and urban communities. Shortages of skilled health workers, tests, and medicines impede the provision of quality antenatal care. Improving service availability and health facility readiness are key to ensuring the effective provision of antenatal care interventions.

Due to the growth of the number of scientific publications, the tasks related to scientific article processing become more actual. Such texts have a special structure, lexical and semantic content that should be taken into account while processing. Using information from knowledge bases can significantly improve the quality of text processing systems. This paper is dedicated to the entity linking task for scientific articles in Russian, where we consider scientific terms as entities. During our work, we annotated a corpus with scientific texts, where each term was linked with an entity from a knowledge base. Also, we implemented an algorithm for entity linking and evaluated it on the corpus. The algorithm consists of two stages: candidate generation for an input term and ranking this set of candidates to choose the best match. We used string matching of an input term and an entity in a knowledge base to generate a set of candidates. To rank the candidates and choose the most relevant entity for a term, information about the number of links to other entities within the knowledge base and to other sites is used. We analyzed the obtained results and proposed possible ways to improve the quality of the algorithm, for example, using information about the context and a knowledge base structure. The annotated corpus is publicly available and can be useful for other researchers.

We propose a method for scientific terms extraction from the texts in Russian based on weakly supervised learning. This approach doesn't require a large amount of hand-labeled data. To implement this method we collected a list of terms in a semi-automatic way and then annotated texts of scientific articles with these terms. These texts we used to train a model. Then we used predictions of this model on another part of the text collection to extend the train set. The second model was trained on both text collections: annotated with a dictionary and by a second model. Obtained results showed that giving additional data, annotated even in an automatic way, improves the quality of scientific terms extraction.

BACKGROUND: Globally, nearly half of all deaths among children under the age of 5 years can be attributed to malaria, diarrhoea, and pneumonia. A significant proportion of these deaths occur in sub-Saharan Africa. Despite several programmes implemented in sub-Saharan Africa, the burden of these illnesses remains persistently high. To mobilise resources for such programmes it is necessary to evaluate their costs, costs-effectiveness, and affordability. This study aimed to estimate the provider costs of treating malaria, diarrhoea, and pneumonia among children under the age of 5 years in routine settings at the health facility level in rural Uganda and Mozambique. METHODS: Service and cost data was collected from health facilities in midwestern Uganda and Inhambane province, Mozambique from private and public health facilities. Financial and economic costs of providing care for childhood illnesses were investigated from the provider perspective by combining a top-down and bottom-up approach to estimate unit costs and annual total costs for different types of visits for these illnesses. All costs were collected in Ugandan shillings and Mozambican meticais. Costs are presented in 2021 US dollars. RESULTS: In Uganda, the highest number of outpatient visits were for children with uncomplicated malaria and of inpatient admissions were for respiratory infections, including pneumonia. The highest unit cost for outpatient visits was for pneumonia (and other respiratory infections) and ranged from $0.5 to 2.3, while the highest unit cost for inpatient admissions was for malaria ($19.6). In Mozambique, the highest numbers of outpatient and inpatient admissions visits were for malaria. The highest unit costs were for malaria too, ranging from $2.5 to 4.2 for outpatient visits and $3.8 for inpatient admissions. The greatest contributors to costs in both countries were drugs and diagnostics, followed by staff. CONCLUSIONS: The findings highlighted the intensive resource use in the treatment of malaria and pneumonia for outpatient and inpatient cases, particularly at higher level health facilities. Timely treatment to prevent severe complications associated with these illnesses can also avoid high costs to health providers, and households. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT01972321.

This systematic review aimed to identify factors significantly associated with the occurrence of epilepsy in autistic individuals and to consider the impact of study quality on findings. Electronic databases were systematically searched on October 2nd, 2020 and records retrieved were limited to those published from 2000 onwards. Study quality was categorised as ‘good’, ‘moderate’ or ‘weak’. Fifty-three studies were included and in studies where the prevalence of epilepsy was reported (n = 257,892), 18,254 (7%) had co-occurring epilepsy. Intellectual disability/cognitive impairment was the most commonly reported risk factor associated with occurrence of epilepsy in autistic individuals. The evidence supporting other, potentially relevant factors was weak and inconsistent and requires further evaluation. Only 9/53 studies were considered ‘good’ quality.

BackgroundThe majority of post-neonatal deaths in children under 5 are due to malaria, diarrhoea and pneumonia (MDP). The WHO recommends integrated community case management (iCCM) of these conditions using community-based health workers. However iCCM programmes have suffered from poor implementation and mixed outcomes. We designed and evaluated a technology-based intervention ‘inSCALE’ (Innovations At Scale For Lasting Effects) to support iCCM programmes and increase appropriate treatment and other outcomes for children with MDP.MethodsThis superiority cluster randomised controlled trial allocated all 12 districts in Inhambane Province in Mozambique to receive iCCM only (control) or iCCM plus the inSCALE technology intervention. The key components of the intervention consisted of a digital application on smartphones and tablets providing clinical decision support algorithms, stock tracking, automatic personalised messaging, free calls, and solar chargers for iCCM-trained community health workers and primary care facility supervising staff in intervention districts. Population surveys were conducted at baseline and after 18 months in all districts to assess the impact of the intervention on the coverage of appropriate treatment for malaria, diarrhoea and pneumonia in children 2-59months of age, on prevalence of cases of these conditions, and on a range of secondary household and health worker level outcomes. All statistical models accounted for the clustered study design and variables used to constrain the randomisation. A meta-analysis of the estimated pooled impact of the technology intervention was conducted including results from a sister trial (inSCALE-Uganda).FindingsThe study included 2740 eligible children in control arm districts and 2863 children in intervention districts. The prevalence of cases of MDP decreased from 53.5% (1467) to 43.7% (1251) in the control and intervention arms respectively (risk ratio 0.82, 95% CI 0.78-0.87, pInterpretationThe inSCALE intervention led to a reduction in prevalence of MDP and an improvement in appropriate treatment when delivered at scale in Mozambique. The programme will be rolled out by the ministry of health to the entire national CHW and primary care network in 2022. This study highlights the potential value of a technology intervention aimed at strengthening iCCM systems to address the largest causes of childhood morbidity and mortality in sub-Saharan Africa.Author SummaryThe inSCALE cluster-randomised trial in Mozambique was part of a $10million project funded by the Bill and Melinda Gates Foundation to design and test innovative primary care interventions to improve health outcomes for children with malaria, diarrhoea and pneumonia (MDP), which together are the largest killers of children aged We designed a technology-based intervention delivered using cheap smartphones. This intervention was based on mHealth principles and included basic AI to guide correct diagnosis and treatment of MDP, provided personalised feedback to health workers, and alerts to supervising health facilities on stock outs and data tracking. The study was implemented within the entire province of Inhambane, and districts were randomly assigned to the intervention or to continue with standard care (control). Compared to control districts, we observed significant reductions in the prevalences of MDP in children under 5 years (reductions of 20% for malaria, 34% for pneumonia, and 45% for diarrhoea) and an increase in appropriate treatment of any cases of MDP by 26% (of all cases MDP) and 40% (of all children) in the intervention districts.As a result of this trial, the government of Mozambique incorporated the inSCALE intervention into its policy for child health services, and is in the process of scaling up the programme to all 8000+ community health workers across the country (2022).

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Antibiotic resistance (ABR) has been identified as a critical threat to global health at the highest policy fora. A leading cause of ABR is the inappropriate use of antibiotics by both patients and healthcare providers. Although countries around the world have committed to developing and implementing national action plans to tackle ABR, there is a considerable gap in evidence about effective behaviour change interventions addressing inappropriate use of antibiotics in low- and middle-income countries (LMICs), where ABR is growing at an alarming rate. We conducted a systematic review to synthesize evidence about the effectiveness and cost-effectiveness of behaviour change interventions to reduce inappropriate use of antibiotics in LMICs. Three databases were searched using a set of predefined search terms and exclusion criteria. The search identified 43 relevant articles. A narrative synthesis of results was conducted using the Behaviour Change Wheel framework to categorize intervention components. The majority of the reviewed studies were set in lower-middle-income or low-income countries located in Sub-Saharan Africa or East Asia and the Pacific. Twenty-four articles evaluated multi-faceted interventions over a period of 12 months or less. Despite the widespread use of antibiotics in the community, interventions were primarily implemented in public health facilities, targeting health professionals such as doctors, nurses, and other allied medical staff. Although education for providers was the most widely used strategy for influencing antibiotic use, it was shown to be most effective when used in conjunction with training or other enabling and supportive measures to nudge behaviour. Six articles included an evaluation of costs of interventions and found a reduction in costs in inpatient and outpatient settings, and one article found a training and guidelines implementation-based intervention to be highly cost-effective. However, the small number of articles conducting an economic evaluation highlights the need for such analyses to be conducted more frequently to support priority setting in resource-constrained environments.

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Background: Pharmacists have been at the frontline of the COVID-19 response in Indonesia, providing medicines, advice, and referral services often in areas with limited healthcare access. This study aimed to explore their knowledge, attitudes, and practices during the pandemic, so that we can be better prepared for future emergencies. Methods: A cross-sectional online survey of community pharmacists and pharmacy technicians in Indonesia was conducted between July and August 2020. The dataset was analysed descriptively, and logistic regression was used to explore willingness to participate in COVID-19 interventions. Findings: 4716 respondents participated in the survey. Two-thirds (66·7%) reported knowing only "a little" about COVID-19 and around a quarter (26·6%) said they had not received any COVID-19 guidelines. Almost all were concerned about being infected (97·2%) and regularly took steps to protect themselves and their clients (87·2%). Stock-outs of Personal Protective Equipment (PPE) and other products (32·3%) was the main reason for not taking any precautions. Around a third (37·7%) mentioned having dispensed antibiotics to clients suspected of having COVID-19. To support COVID-19 response efforts, most respondents were willing to provide verbal advice to clients (97·8%), distribute leaflets to clients (97·7%), and participate in surveillance activities (88·8%). Older respondents, those identifying as male, and those working in smaller outlets were more willing to provide information leaflets. Those working in smaller outlets were also more willing to engage in outbreak surveillance. Interpretation: Drug retail outlets continue to operate at the frontline of disease outbreaks and pandemics around the world. These providers have an important role to play by helping to reduce the burden on facilities and providing advice and treatment. To fulfil this role, drug retail outlets require regular access to accurate guidelines and steady supplies of PPE. Calls for drug retail outlet staff to plat in response efforts including the provision of information to clients and surveillance could ease escalating pressures on the health system during future outbreaks. Funding: This study was funded by a grant from the Department of Foreign Affairs and Trade, Australia, under the Stronger Health Systems for Health Security Scheme.

The Nurture Early for Optimal Nutrition (NEON) study is a multiphase project that aims to optimize feeding, care and dental hygiene practices in South Asian childrenlt;2 years in East London, United Kingdom. The multiphase project uses a participatory learning and action (PLA) approach facilitated by a multilingual community facilitator. In this paper, we elaborate on the process and results of the Intervention Development Phase in the context of the wider NEON programme.Qualitative community-based participatory intervention codevelopment and adaptation.Community centres in East London and online (Zoom) meetings and workshops.In total, 32 participants registered to participate in the Intervention Development Phase. Four Intervention Development workshops were held, attended by 25, 17, 20 and 20 participants, respectively.Collaboratively, a culturally sensitive NEON intervention package was developed consisting of (1) PLA group facilitator manual, (2) picture cards detailing recommended and nonrecommended feeding, care and dental hygiene practices with facilitators/barriers to uptake as well as solutions to address these, (3) healthy infant cultural recipes, (4) participatory Community Asset Maps and (5) list of resources and services supporting infant feeding, care and dental hygiene practices.The Intervention Development Phase of the NEON programme demonstrates the value of a collaborative approach between researchers, community facilitators and the target population when developing public health interventions. We recommend that interventions to promote infant feeding, care and dental hygiene practices should be codeveloped with communities. Recognizing and taking into account both social and cultural norms may be of particular value for infants from ethnically diverse communities to develop interventions that are both effective in and accepted by these communities.Considerable efforts were placed on Patient/Participant and Public Involvement and Engagement. Five community facilitators were identified, each of which represented one ethnic/language group: (i) Bangladeshi/Bengali and Sylheti, (ii) Pakistani/Urdu, (iii) Indian/Gujrati, (iv) Indian/Punjabi and (v) Sri Lankan/Tamil. The community facilitators were engaged in every step of the study, from the initial drafting of the protocol and study design to the Intervention Development and refinement of the NEON toolkit, as well as the publication and dissemination of the study findings. More specifically, their role in the Intervention Development Phase of the NEON programme was to: 1. Support the development of the study protocol, information sheets and ethics application. 2. Ensure any documents intended for community members are clear, appropriate and sensitively worded. 3. Develop strategies to troubleshoot any logistical challenges of project delivery, for example, recruitment shortfalls. 4. Contribute to the writing of academic papers, in particular reviewing and revising drafts. 5. Develop plain language summaries and assist in dissemination activities, for example, updates on relevant websites. 6. Contribute to the development of the NEON intervention toolkit and recruitment of the community members. 7. Attend and contribute to Intervention Development workshops, ensuring the participant's voices were the focus of the discussion and workshop outcomes.

The role of regulatory T cells (Tregs), damage-associated molecular patterns (DAMPs), and myeloid-derived suppressor cells (MDSCs) in the mechanism of innate and adaptive immune responses in chronic obstructive pulmonary disease (COPD) is not well understood.Evaluating the presence of Tregs in the bronchoalveolar lavage fluid (BALF) and peripheral blood in patients with COPD, and assessment of the relationship between Tregs, MDSCs, and DAMPs as factors activating innate and adaptive immune responses. Description of the association between immune and clinical parameters in COPD.Thirty-one patients with COPD were enrolled. Clinical parameters (forced expiratory volume in one second [FEV1], forced vital capacity, total lung capacity [TLC], diffusion capacity of carbon monoxide, and B-BMI, O-obstruction, D-dyspnea, E-exercise [BODE]) were assessed. Tregs and MDSCs were investigated in the BALF and blood using monoclonal antibodies directly conjugated with fluorochromes in flow cytometry. The levels of defensin (DEF2), galectin-1 (Gal-1), galectin-3 (Gal-3), galectin-9 (Gal-9), heat shock protein-27 (HSP27), and surfactant protein A were assessed via sandwich enzyme-linked immunosorbent assay.The percentage of Tregs was significantly higher in the blood than in the BALF, in contrast to the mean fluorescence intensity of forkhead box P3 (FoxP3). Significant associations were observed between Tregs and HSP27 (r = 0.39), Gal-1 (r = 0.55), Gal-9 (r = -0.46), and MDSCs (r = -0.50), and between FoxP3 and Gal-1 (r = -0.42), Gal-3 (r = -0.39), and MDSCs (r = -0.43). Tregs and clinical parameters, including FEV1%pred (r = 0.39), residual volume (RV)%pred (r = -0.56), TLC%pred (r = -0.55), RV/TLC (r = -0.50), arterial oxygen saturation (r = -0.38), and arterial oxygen pressure (r = -0.39) were significantly correlated. FoxP3 was significantly interlinked with RV/TLC (r = -0.52), arterial oxygen pressure (r = 0.42), and BODE index (r = -0.57).The interaction between innate and adaptive immune responses in patients with COPD was confirmed. The expression of Tregs in BALF may have prognostic value in patients with COPD. The conversion of immune responses to clinical parameters appears to be associated with disease severity.

The results of an experimental wind-tunnel investigation of the plate surface heating in the strong viscous-inviscid interaction regime are presented. It is shown that In the presence of a wedge mounted in the vicinity of the trailing edge of the plate the temperature distribution over the plate surface ahead of the wedge considerably changes up to the leading edge, as compared with the case of flow past the same plate in the absence of the wedge. The boundary layer flow is not steady, since during the run the surface temperature grows continuously, the temperature distribution itself along the plate surface being variable. It is established that in an unsteady boundary layer the upwind propagation of pressure disturbances produced by a thin wedge is fundamentally different in nature from the disturbance propagation in the case of flow past a plate with a constant surface temperature.

We investigated the conditions for forming the single-frequency monopulse operation mode of the transversally diode pumped Yb,Er-phosphate glass laser with a passive Q-switch based on the Co2+:MgAl2O4 crystal. It was shown experimentally that the spectral selectivity that ensures the stable single-frequency operation for the Yb,Er-laser is achieved in the intracavity Fabry–Perot interferometer in the form of the totally reflecting mirror and nearest end surface of an active element with plane-parallel faces, as well as the polarization interference filter (PIF, Lyot filter). Meanwhile, the PIF created by an active element with thermally induced anisotropy and a polarizer in the form of a passive Q-switch plate, oriented at Brewster’s angle to the resonator axis, acts as a preliminary spectral selector. The maximum energy of the formed output laser pulses was 6 mJ with a duration of 20.2 ns, a repetition rate of 1 Hz, and a single-frequency lasing spectrum width of 41 MHz.

CARMIL2 is required for CD28-mediated co-stimulation of NF-κB signaling in T cells and its deficiency has been associated with primary immunodeficiency and, recently, very early onset inflammatory bowel disease (IBD). Here we describe the identification of novel biallelic CARMIL2 variants in three patients presenting with pediatric-onset IBD and in one with autoimmune polyendocrine syndrome (APS). None manifested overt clinical signs of immunodeficiency before their diagnosis. The first patient presented with very early onset IBD. His brother was found homozygous for the same CARMIL2 null variant and diagnosed with APS. Two other IBD patients were found homozygous for a nonsense and a missense CARMIL2 variant, respectively, and they both experienced a complicated postoperative course marked by severe infections. Immunostaining of bowel biopsies showed reduced CARMIL2 expression in all the three patients with IBD. Western blot and immunofluorescence of transfected cells revealed an altered expression pattern of the missense variant. Our work expands the genotypic and phenotypic spectrum of CARMIL2 deficiency, which can present with either IBD or APS, aside from classic immunodeficiency manifestations. CARMIL2 should be included in the diagnostic work-up of patients with suspected monogenic IBD.

Introduction: Fournier’s gangrene is a necrotizing infection of the external genitalia, perineal or perianal regions and is mainly seen in males. Its main risk factors include diabetes, chronic alcoholism, HIV and other immune-compromised states. Fournier’s gangrene has an aggressive course associated with a mortality rate of 20%−30%, making early diagnosis and management very important. The Fournier Gangrene Severity Index (FGSI) has been traditionally used to predict the severity and prognosis. More recently, simplified FGSI (sFGSI) has been proposed and is helpful. However, timely diagnosis, supportive medical management and complete surgical debridement are still the cornerstones of treatment. These must be complemented with early and timely re-look debridements and appropriate reconstruction to cover soft tissue defects. This literature review aims to look at recent relevant research regards risk factors and prognostic features of Fournier’s gangrene. Methods: A search was conducted on Google Scholar and PubMed databases for all articles related to Fournier’s Gangrene. These included clinical reviews, case reports, case series and retrospective studies. Reports or studies which were not published in English were not reviewed. Various reconstructive techniques to cover the defects have also been revisited. Results: Broad-spectrum antibiotics and urgent surgical debridement are the core management principles of Fournier’s gangrene. Repeat debridement after 24 h is also recommended. Adjunctive therapies such as hyperbaric oxygen and vacuum-assisted closure are supported in most aspects of recent literature. Expectedly, there is a lack of randomised controlled studies in such emergency surgical conditions, which limits the widespread use of newer therapies to patients unresponsive to conventional management. Conclusion: Fournier’s gangrene is a urological emergency with a high mortality rate. The aggressive nature of the infection necessitates early recognition and immediate surgical intervention. Negative pressure dressing and occasional hyperbaric oxygen as adjuncts should be used more routinely, especially if there is a delayed response to conventional treatment or in severe infections.

This article studies the kinetics of structure formation of a composite powder material containing solid lubricants such as graphite, talc and zinc stearate. For the experiments were prepared charge containing powders, wt.%: Cu – 4-18; Sn – 1-2.0; C – 1.5-2.5; talc – 2.0-3.5; zinc stearate – 0.5, Fe – the rest. Mixing of powders was carried out in a Y-shaped mixer, pressing of charges was carried out on a hydraulic press at pressures of 400-1000 MPa, and sintering of compacts – in a conveyor furnace in a protective gas (endothermic gas) in the temperature range 850-1150°C. There is no pearlite in the microstructure of iron-bronze sintered at 850°C. This is due to the adsorption capacity of talc on the surface of iron particles, which prevents the diffusion of carbon into the iron crystal lattice. An increase in the sintering temperature to 1000°C leads to the formation of pearlite in the structure of iron-bronze, while pearlite prevails over ferrite. This indicates the partial burnout of talc from the surface of the iron particles and the open paths of carbon diffusion. At a sintering temperature of 1150°C, a pearlite structure and a network of light inclusions are formed in the microstructure of iron-bronze samples. The study of the chemical composition of light inclusions with a micro-X-ray spectral analyzer showed that these inclusions contain solid solutions of variable compositions either Fe-Cu-Sn, Cu-Fe-Sn or Cu-Sn-Fe. To confirm these assumptions, X-ray phase analysis was performed. The diffraction patterns of these samples are reflections of Fe and Cu. The absence of diffraction effects characteristic of Sn is due to its solubility in the Cu lattice. This is due to the low melting point of Sn (232°С) and its ionic radius, which allows the isomorphic substitution of Cu and Fe ions with Sn ions (their difference is no more than 15%), В данной статье изучены кинетика структурообразования композиционного порошкового материала, содержащего твердые смазочные материалы типа графита, талька и стеарата цинка. Для проведения экспериментов были приготовлены шихты, содержащие порошки, масс.%: Сu – 4-18; Sn – 1-2,0; C – 1,5-2,5; тальк – 2,0-3,5; стеарат цинка – 0,5, Fe – остальное. Смешивание порошков осуществлялось в Y-образном смесителе, прессование шихт проводили на гидравлическом прессе под давлением 400-1000 МПа, а спекание прессовок – в конвейерной печи в среде защитного газа (эндотермический газ) в интервале температур 850-1150°С. В микроструктуре спеченной при 850°С железо-бронзы перлит отсутствует. Это связано с адсорбирующей способностью талька на поверхности железных частиц, что препятствует диффузии углерода в кристаллическую решетку железа. Повышение температуры спекания до 1000°С приводит к образованию в структуре железо-бронзы перлита, при этом перлит преобладает над ферритом. Это свидетельствует о частичном выгорании талька с поверхности железных частиц и открытом пути диффузии углерода. При температуре спекания 1150°С в микроструктуре образцов железо-бронзы образуется перлитная структура и сетка светлых включений. Изучение химического состава светлых включений в микрорентгеноспектральном анализаторе показало, что в этих включениях имеются твердые растворы переменных составов: либо Fe-Cu-Sn, Cu-Fe-Sn, либо Cu-Sn-Fe. Для подтверждения этих предположений был проведен фазовый рентгеноструктурный анализ. Дифрактограммы этих образцов являются рефлексами Fe и Cu. Отсутствие дифракционных эффектов, характерных для Sn, связано с его растворимостью в решетке Cu. Это связано с низкой температурой плавления Sn (232°С) и его ионным радиусом, который позволяет изоморфно замещать ионы Cu и Fe ионами Sn (их разность составляет не более 15%), У даній статті вивчено кінетику структуроутворення композиційного порошкового матеріалу, що містить тверді мастильні матеріали типу графіту, тальку і стеарата цинку. Для проведення експериментів були приготовлені шихти, що містять порошки, мас.%: Сu – 4-18; Sn – 1-2,0; C – 1,5-2,5; тальк – 2,0-3,5; стеарат цинку – 0,5, Fe – інше. Змішування порошків здійснювалося в Y-подібному змішувачі, пресування шихти проводили на гідравлічному пресі під тиском 400-1000 МПа, а спікання прессовок – у конвеєрній печі в середовищі захисного газу (ендотермічний газ) в інтервалі температур 850-1150°С. У мікроструктурі спеченої при 850°С залізо-бронзи перліт відсутній. Це пов’язано з адсорбуючою здатністю тальку на поверхні залізних часток, що перешкоджає дифузії вуглецю в кристалічну решітку заліза. Підвищення температури спікання до 1000°С призводить до утворення в структурі залізо-бронзи перліту, при цьому перліт переважає над ферритом. Це пов’язано з частковим вигоранням тальку з поверхні залізних часток і відкритим шляхом дифузії вуглецю. При температурі спікання 1150°С в мікроструктурі зразків залізо-бронзи утворюється перлитная структура і сітка світлих включень. Вивчення хімічного складу світлих включень у мікрорентгенспектральному аналізаторі показало, що в цих включеннях є тверді розчини змінних складів: або Fe-Cu-Sn, Cu-Fe-Sn, або Cu-Sn-Fe. Для підтвердження цих припущень був проведений фазовий рентгеноструктурний аналіз. Дифрактограми цих зразків є рефлексами Fe і Cu. Відсутність дифракційних ефектів, характерних для Sn, пов’язано з його розчинністю в решітці Cu. Це пов’язано з низькою температурою плавлення Sn (232°С) і його іонним радіусом, який дозволяє ізоморфно заміщати іони Cu і Fe іонами Sn (їх різниця складає не більше 15%)

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ObjectivesGiven high maternal and child mortality rates, we assessed the impact of conditional cash transfers (CCTs) to retain women in the continuum of care (antenatal care (ANC), delivery at facility, postnatal care (PNC) and child immunisation).DesignWe conducted an unblinded 1:1 cluster-randomised controlled trial.Setting48 health facilities in Siaya County, Kenya were randomised. The trial ran from May 2017 to December 2019.Participants2922 women were recruited to the control and 2522 to the intervention arm.InterventionsAn electronic system recorded attendance and triggered payments to the participant’s mobile for the intervention arm (US$4.5), and phone credit for the control arm (US$0.5). Eligibility criteria were resident in the catchment area and access to a mobile phone.Primary outcomesPrimary outcomes were any ANC, delivery, any PNC between 4 and 12 months after delivery, childhood immunisation and referral attendance to other facilities for ANC or PNC. Given problems with the electronic system, primary outcomes were obtained from maternal clinic books if participants brought them to data extraction meetings (1257 (50%) of intervention and 1053 (36%) control arm participants). Attendance at referrals to other facilities is not reported because of limited data.ResultsWe found a significantly higher proportion of appointments attended for ANC (67% vs 60%, adjusted OR (aOR) 1.90; 95% CI 1.36 to 2.66) and child immunisation (88% vs 85%; aOR 1.74; 95% CI 1.10 to 2.77) in intervention than control arm. No intervention effect was seen considering delivery at the facility (90% vs 92%; aOR 0.58; 95% CI 0.25 to 1.33) and any PNC attendance (82% vs 81%; aOR 1.25; 95% CI 0.74 to 2.10) separately. The pooled OR across all attendance types was 1.64 (1.28 to 2.10).ConclusionsDemand-side financing incentives, such as CCTs, can improve attendance for appointments. However, attention needs to be paid to the technology, the barriers that remain for delivery at facility and PNC visits and encouraging women to attend ANC visits within the recommended WHO timeframe.Trial registrationNCT03021070.