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Standard and econometric models are appropriate for causal relationships and interpretations among facets of the economy. But with prediction, they tend to over-fit samples and simplify poorly to new, undetected data. This paper presents a batch gradient algorithm for predicting the rice of land with large datasets. This paper uses a batch gradient descent algorithm to minimize the cost function, iteratively with possible combinations of the number of iterations i=1500 and learning rates, of 0.01, 0.02, 0.03 for the linear regression case and i = 100, 0.3, 0.2, and 0.1 for the multiple regression case. The paper uses Octave-4.0.3(GUI) for implementing 129 samples of the lease bid price of Mekelle City as training sets and feature inputs of two and three for linear regression and multiple regressions. Using = 0.01, the best fitting parameters found by training the dataset are with a cost of J=67.82. The model predicts with an accuracy of 92.6% using LR and 91.15% using MLR for a 315 m2 land size. As the learning rate increases, the fitting parameters increase and decrease respectively with an equal cost but the model’s prediction error increments slowly. With multiple regression, as the learning rate lowers, the model under fits prediction drastically (with an accuracy of 60%) with gradient descent and predicts with an accuracy of 91.5% with ordinary equations. So, prediction with ordinary equations provides the best fit for multiple regressions.

Tadis Brhane Tesfahunegn,1 Negassie Berhe,2 Teklehaymanot Huluf Abraha,1 Solomon Hintsa,3 Goitom Yohanes,1 Kahsay Desta,4 Haileselasie Berhane Alema,5 Elsa Hagos,6 Gebreamlak Gidey,7 Gebreyesus Brhane Teshahunegn8 1Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 2Department of Human Nutrition, College of Health Sciences, Aksum University, Aksum, Ethiopia; 3Department of Epidemiology, College of Health Sciences, Aksum University, Aksum, Ethiopia; 4School of Medicine, College of Health Sciences, Aksum University, Aksum, Ethiopia; 5Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 6Department of Medical Laboratory, College of Health Sciences, Aksum University, Aksum, Ethiopia; 7Department of Midwifery, College of Health Sciences, Aksum University, Aksum, Ethiopia; 8College of Agriculture, Aksum University, Shire, EthiopiaCorrespondence: Haileselasie Berhane Alema Department of Public Health, College of Health Sciences, Aksum University, P.O.Box: 298, Aksum, Ethiopia Tel +251914006933 Email haileselasieb@yahoo.comBackground: Antiretroviral therapy (ART) provision was among the major challenge of treatments. Maintaining the optimal level of adherence among children living with HIV/AIDS is a pivotal step towards achieving treatment success. However, there are limited studies on child’s ART adherence. Therefore, this study aimed to assess the level of adherence to antiretroviral therapy and associated factors among HIV-infected children in health institutions of Adwa, Axum, and Shire towns, Tigray, Northern Ethiopia.Methods: An institutional-based cross-sectional study was conducted among human immunodeficiency virus (HIV)-infected children in between February and April, 2016. A total of 255 children who were taking antiretroviral therapy in the randomly selected three health facilities from Adwa, Axum and Shire towns were included. Data were collected using pretested and structured questionnaires using a face-to-face interview. The collected data were entered into Epi Info version 7 and then exported to SPSS version 21 for analysis. Bivariate and multivariate binary logistic regression models were used to determine the factors associated with adherence to antiretroviral therapy among HIV-infected children.Results: A total of the 255 study participants were included in the study. The level of ART adherence among HIV-positive children was 212 (84.8%). Knowledge of caregivers about ART treatment (AOR = 2.78, 95% CI: 1.18, 6.53), occupational status (AOR = 4.78, 95% CI: 1.26, 18.91), appointment to ART less than two months (AOR = 3.05, 95% CI: 1.21, 7.70) and use of memory aids (AOR = 4.58, 95% CI: 1.73, 12.13) were independently associated with adherence to ART.Conclusion: The level of adherence to antiretroviral therapy was low. Healthcare providers should reinforce adherence intervention and counseling sessions during follow-up and address the proper use of medication reminders to help children take their drugs appropriately.Keywords: HIV, adherence, ART, children, Ethiopia

Natural constraints and the damaged Meli gold mining: forecasting impact on the water resources quality of the Meli area and the surroundings, Tigray Kaleab Adhena Abera 1, Berhane Abrha 2, Tesfamichael Gebreyohannes 2, Abdelwassie Hussien 2 , Miruts Hagos 2, Gebremedhin Berhane 2, and Kristine Walraevens 11 Laboratory for Applied Geology and Hydrogeology, Department of Geology, Ghent University, Belgium (kaleabadhena.abera@ugent.be)2 Department of Geology, School of Earth Science, Mekelle University, Ethiopia Abstract: Meli is the only modern gold mining site in the Tigray region, Northern Ethiopia. Water resources of this area and the surroundings are currently very susceptible to pollution by toxic chemicals than ever before, due to both the natural geological setup of the area and anthropogenic impacts, specifically because of the recent war in northern Ethiopia. The war that was started on November 03, 2020, resulted in the complete destruction of the mining company and tailings dam due to bombing. This potentially could lead to the uncontrolled movement of wastewater from the dam to the environment. The area is characterized by quite complex geology and associated geological structures. In addition to the direct flow of contaminant plumes to downstream areas as surface water, the naturally existing geological fractures, as well as faults, could also act as conduits and increase the infiltration rate of the pollutants to the groundwater resource. In this research, integrated geological, structural, and remote sensing methods were applied. Mapping of geology and geological structures was compiled using both Spot and Landsat satellite images and a physical field survey conducted before the war started. Metavolcanics, metasediments, granite, and sandstone are the identified lithologies in the area. The detailed fracture measurement helps determine the possible flow direction of water and the pollutants. Totally, 110 structural measurements were taken, and the area is affected by a series of Neoproterozoic structures. These include WNW–ESE striking compression, NE –SW striking exfoliation fractures, and variably oriented faults. Moreover, structures such as folds, minor strike-slip faults, and joints were observed. The chemicals used in the gold mining company were evaluated. The Meli area tailing dam contains wastewater with a very high concentration of cyanide, caustic soda, heavy metals, and salts which are very toxic. The possible impact of these pollutants on water resources was forecasted and threat-solving mechanisms were proposed. The result of this research work will serve as a baseline for further pollution impact studies at a larger catchment scale and as an input for groundwater resource pollution modeling works of the Meli area and the surroundings.

Background Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age =0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0.7% (95% UI 0.7-0.9), corresponding to 56.8 million (95% UI 55.2-67.8) infections, on Jan 1, 2020. This number represents a decrease of 6.8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63.6 million (61.8-75.8) infections (0.9% [0.8-1.0] prevalence). By the end of 2020, an estimated 12.9 million (12.5-15.4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. Interpretation At the beginning of 2020, there were an estimated 56.8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. Copyright (C) 2022 Elsevier Ltd. All rights reserved., John C Martin Foundation [2019-G024]; Gilead Sciences [IN-US-987-5808]; AbbVie [4200907861]; ZeShan Foundation [2021-0101-1-CDA-HEP-10]; The Hepatitis Fund; Ministry of Health, Labour and Welfare of Japan [19HC1001], This analysis was funded by a grant from the John C Martin Foundation (2019-G024) through the Polaris Observatory for low-income and middleincome countries. Grants for analyses in high-income countries and territories were provided by Gilead Sciences (IN-US-987-5808) and AbbVie (4200907861). ZeShan Foundation (2021-0101-1-CDA-HEP-10) supported country and regional analyses in Asia and The Hepatitis Fund supported country and regional analyses in Africa. We thank the Epidemiological Research Group on the Burden of Viral Hepatitis and Measures for its Elimination (grant number 19HC1001; led by JT) funded by the Ministry of Health, Labour and Welfare of Japan. We thank the contributors included in the appendix (pp 2-3), who contributed to the country or territory analyses but did not meet authorship requirements.

The use of light-emitting diode (LED) lights in horticulture allows growers to adjust the light spectrum to optimize crop production and quality. However, changes in light quality can also influence plant–arthropod interactions, with possible consequences for pest management. The addition of far-red light has been shown to interfere with plant immunity, thereby increasing plant susceptibility to biotic stress and increasing pest performance. Far-red light also influences plant emission of volatile organic compounds (VOCs) and might thus influence tritrophic interactions with biological control agents. We investigated how far-red light influences the VOC-mediated attraction of the predatory mite Phytoseiulus persimilis to tomato plants infested with Tetranychus urticae, and its ability to control T. urticae populations. RESULTS: Far-red light significantly influences herbivore-induced VOC emissions of tomato plants, characterized by a change in relative abundance of terpenoids, but this did not influence the attraction of P. persimilis to herbivore-induced plants. Supplemental far-red light led to an increased population growth of T. urticae and increased numbers of P. persimilis. This resulted in a stronger suppression of T. urticae populations under supplemental far-red light, to similar T. urticae numbers as in control conditions without supplemental far-red light. CONCLUSION: We conclude that supplemental far-red light can change herbivore-induced VOC emissions but does not interfere with the attraction of the predator P. persimilis. Moreover, far-red light stimulates biological control of spider mites in glasshouse tomatoes due to increased population build-up of the biocontrol agent.

Abraha Hailu,1 Kibreab Gidey,1 Mohamedawel Mohamedniguss Ebrahim,2 Yonas Berhane,1 Teklay Gebrehawaria,1 Tesfay Hailemariam,1 Atakelti Negash,1 Habtamu Mesele,1 Tekleab Desta,1 Haylsh Tsegay,1 Mulubirhan Assefa Alemayohu,3 Alemayehu Bayray3 1Department of Internal Medicine, School of Medicine, Mekelle University - College of Health Sciences, Mekelle, Tigray, Ethiopia; 2Department of Biostatistics, School of Public Health, Mekelle University - College of Health Sciences, Mekelle, Tigray, Ethiopia; 3Department of Epidemiology, School of Public Health, Mekelle University - College of Health Sciences, Mekelle, Tigray, EthiopiaCorrespondence: Abraha Hailu Weldegerima, Department of Internal Medicine, Cardiology Unit, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia, Tel +251-91-141-3363, Email abrahahailu7@gmail.comBackground: Previous works show that noncommunicable diseases (NCDs) are on the rise in developing nations, including Ethiopia, in the background of preexisting communicable diseases (CDs). Data on hospital admission in sub-Saharan Africa are scarce, particularly prospectively collected, and hence this study was done to close the gap in acquiring accurate diagnosis usually faced with retrospective data. We aimed to describe medical admission patterns, their outcomes and determinants at Ayder Comprehensive Specialized Hospital (ACSH) in Tigray, Ethiopia.Methods: Data were collected prospectively from November 1, 2017 to October 31, 2018 for all medical admissions. Sociodemographic profiles, final diagnosis, outcome of hospitalization, and complications were recorded using a data-abstraction checklist. Data were analyzed using SPSS 26.Results: There were 2084 medical admissions over 1 year. Median age was 45 years (IQR 31). A majority (1107, 53.1%) were male. The age-group 25– 34 years had the most admissions (19.0%). NCDs constituted 68.2% of admissions. According to the International Classification of Diseases, patients were admitted most frequently due to disease of the circulatory system (36.7%) followed by infectious or parasitic diseases (24.1%). Of NCDs, cardiovascular diseases contributed to 53.9%, followed by cancers (8.6%). Of CDs, HIV/AIDS contributed to 31.3%, followed by tuberculosis (22.8%). A total of 1375 (66%) were discharged improved, while 311 (14.9%) died. On multivariate analysis, the in-hospital mortality was significantly higher (18.7%) for CDs than NCDs (13.2%, AOR 1.8, 95% CI 1.4– 2.3; P< 0.001). Bed occupancy of ACSH medical wards and ICU was 54%.Conclusion: NCDs were leading causes of medical admissions in ACSH. The presence of CDs and the development of complications were associated with higher risk of death. Attention should be given by policy-makers to curb the higher morbidity from NCDs and mortality from CDs.Keywords: medical admissions, mortality, Ayder, Ethiopia

Lazertinib is a potent, irreversible, brain-penetrant, mutant-selective, and wild type-sparing third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor indicated for advanced non-small cell lung cancer (NSCLC). The study aimed to evaluate the effects of food and race on the pharmacokinetics (PK) of lazertinib from a healthy volunteer trial and PK data from NSCLC patients with EGFR mutation.An open-label, single-dose, two-period, single-sequence crossover study was conducted in healthy subjects with two race groups (non-Asian and Asian). Subjects orally received a single dose of lazertinib 240 mg in fasted and fed state (high-fat meal) in each period separated by a 21-day washout. An open-label, multicenter, phase 1/2 study was conducted in Asian and non-Asian patients with NSCLC. Patients were given oral lazertinib 20-320 mg once daily in fasted state continuously in 21-day cycles. PK parameters were evaluated using non-compartmental analysis.A total of 24 healthy subjects (12 non-Asians and 12 Asians) and 52 NSCLC patients (22 non-Asians and 30 Asians) were evaluated. The change in the overall systemic exposure of lazertinib at fed state was less than 15%. Non-Asians showed 58-76% of the systemic exposure than Asians in healthy subjects. In contrast, there were no significant differences in systemic exposure by race both after single and multiple doses among NSCLC patients.Lazertinib can be taken with or without food considering the comparable systemic exposures related to food. Although effect of race was not consistent across studies, there was no evidence for dose adjustment based on race.

The development of devices that exhibit both superconducting and semiconducting properties is an important endeavor for emerging quantum technologies. We investigate superconducting nanowires fabricated on a silicon-on-insulator (SOI) platform. Aluminum from deposited contact electrodes is found to interdiffuse with Si along the entire length of the nanowire, over micrometer length scales and at temperatures well below the Al-Si eutectic. The phase-transformed material is conformal with the predefined device patterns. The superconducting properties of a transformed mesoscopic ring formed on a SOI platform are investigated. Low-temperature magnetoresistance oscillations, quantized in units of the fluxoid

Skeletal muscle insulin resistance is a major contributor to type-2 diabetes (T2D). Pioglitazone is a potent insulin sensitizer of peripheral tissues by targeting peroxisome proliferator-activated receptor gamma. Pioglitazone has been reported to protect skeletal muscle cells from lipotoxicity by promoting fatty acid mobilization and insulin signaling. However, it is unclear whether pioglitazone increases insulin sensitivity through changes in protein-protein interactions involving protein phosphatase 2A (PP2A). PP2A regulates various cell signaling pathways such as insulin signaling. Interaction of the catalytic subunit of PP2A (PP2Ac) with protein partners is required for PP2A specificity and activity. Little is known about PP2Ac partners in primary human skeletal muscle cells derived from lean insulin-sensitive (Lean) and obese insulin-resistant (OIR) participants. We utilized a proteomics method to identify PP2Ac interaction partners in skeletal muscle cells derived from Lean and OIR participants, with or without insulin and pioglitazone treatments. In this study, 216 PP2Ac interaction partners were identified. Furthermore, 26 PP2Ac partners exhibited significant differences in their interaction with PP2Ac upon insulin treatments between the two groups. Multiple pathways and molecular functions are significantly enriched for these 26 interaction partners, such as nonsense-mediated decay, metabolism of RNA, RNA binding, and protein binding. Interestingly, pioglitazone restored some of these abnormalities. These results provide differential PP2Ac complexes in Lean and OIR in response to insulin/pioglitazone, which may help understand molecular mechanisms underpinning insulin resistance and the insulin-sensitizing effects of pioglitazone treatments, providing multiple targets in various pathways to reverse insulin resistance and prevent and/or manage T2D with less drug side effects.

Aim To determine serological markers and genotypes profiles of HBV isolates in Central Eritrea. Materials & methods A total of 191 HBsAg sero-positive samples were randomly selected for the study from 23,232 screened blood donors from 2015 to 2017. Enzyme-linked immunosorbent assay was used to perform HBV serological markers screening, while genotypes were determined using type-specific primer-based multiplex-nested PCR. Results The median age of infected blood donors was 28.9 ± 10.26 years. Of 191 HBsAg reactive serum samples, 77.5% (148/191) were sero-positive for HBcAb-total, among which 99.3% (147/148) and 0.7% (1/148) were sero-positive for HBsAg and HBsAb, respectively. Interestingly, among 147 HBcAb-total/HBsAg reactive samples, 16 (10.9%) and 131 (77.9%) were sero-positive for HBeAg and HBeAb, respectively. For genotyping, 73 HBV isolates were successfully amplified and genotyped, with 59 (80.8%) had a mono-genotype and 14 (19.2%) had a mixed-genotype infection. Among HBV isolates with mono-genotypes: 39 (53.4%) D; 10 (13.7%) E; 6 (8.2%) A and 4 (5.5%) C. While five mixed-genotypes comprised: 6 (8.2%) C/D; 3 (4.1%) C/D/E; 2 (2.7%) each with genotype A/D and D/E; and 1 (1.4%) genotype B/D. Conclusion HBV genotype D is the predominant genotype, either as a HBV mono- or mixed-genotype infection, among blood donors in Eritrea.

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

Introduction: While a considerable amount of extant scholarship describes the importance of and strategies for improving the postsecondary pathways of Black engineering students, most literature is contextualized within 4-year institutions. Objectives: The purpose of this article is to illuminate Black engineering students’ experiences at community colleges in order to understand ways in which they engage different types of 2-year institutional support. Methods: We draw from data obtained through a series of focus groups and interviews facilitated between fall 2018 and fall 2019 with 13 engineering undergraduates. Results: Findings include evidence of important connections with faculty at 2-year colleges, such as positive engagement with them inside the classroom, as well as during office hours and general advising. In addition, we describe support from academic advisors regarding transfer pathways, as well as from campus staff who helped identify scholarships or other valuable resources on campus. Conclusion: We offer implications and conclusions that highlight the tremendous capacity of community colleges to support and educate future Black engineers. We also discuss the significance of underrepresented students of color working closely with faculty, adding that research to date notes that these interactions often tenuous for underrepresented racial and ethnic minorities. Finally, we discuss ways in which our results can inform the broader landscape of undergraduate engineering education, which—like other STEM fields—has often created unwelcoming and competitive environments that lead to student attrition for students from all demographic backgrounds.

Background/Aims Maternity waiting homes are temporary shelters for pregnant women located near a hospital or health centre and are designed to reduce adverse maternal and perinatal outcomes. However, studies assessing the association between maternity waiting home use and adverse pregnancy outcomes are limited. This study assessed the association between maternity waiting home use and adverse pregnancy outcomes in northwest Ethiopia. Methods A prospective cohort study was conducted among women attending antenatal care in public health facilities in West Gojjam, northwest Ethiopia. Pregnant women (28 weeks or more gestation) were enrolled and followed up until birth. Maternity waiting home use was classified as if a pregnant woman stayed for at least 1 week in a maternity waiting home before birth. Log-binomial regression analysis was used to calculate the effect of maternity waiting homes on adverse pregnancy outcomes and to control the effect of potential confounders. Results A total of 810 women completed follow up and were included in the analysis. The incidence of composite adverse pregnancy outcomes was lower among maternity waiting home users compared to non-users (16.3% vs 24.5%). Maternity waiting home users had a lower risk of perinatal death (P=0.003), low birth weight (P=0.004) and preterm birth (P=0.007) than non-users. There were no significant differences in the risk of prolonged labour and postpartum haemorrhage between maternity waiting home users and non-users. Conclusions Staying in a maternity waiting home was significantly associated with a lower risk of perinatal death, low birth weight and preterm birth, and maternity waiting home users had approximately 50% lower adverse perinatal outcomes than non-users. Therefore, the Amhara Regional Health Bureau, zonal health departments, district health offices and other stakeholders should strengthen the use of maternity waiting homes.

Mekelle is the capital city of Tigray, located in Northern Ethiopia. Water samples collected from 18 springs, spatially covering the study area, were analyzed for their physical properties, and major cation and anion concentrations. Geologically, the study area is characterized by limestone, shale, limestone-shale-marl intercalation, and a dolerite rock unit. The fractured dolerite and fractured limestone are the main water-bearing geological formations. The objective of this research was to determine the groundwater type, from springwater chemistry, and evaluate its quality status for irrigation purposes. The total dissolved solids (TDS), chloride (Cl), and pH range from 330 to 1346 mg/l, 5.76 to 250.6 mg/l, and 7.01 to 8.13 respectively. A piper diagram showed the presence of three groundwater types in this area: calcium magnesium chloride, mixed type, and calcium magnesium bicarbonate hydrochemical facies. The dominant of the three, with about 70 %, was the calcium magnesium bicarbonate type. The sodium adsorption ratio (SAR) and sodium percentage (Na %) were calculated to determine the suitability of the water for irrigation. The SAR and Na % values ranged from 1.71 to 5.36 and 10.69 to 20.54, respectively. As per the international water quality permissible limit for irrigation, both values fall under suitable status. Therefore, based on the outputs of this research, all of the spring waters found in this thematic area can be directly used for irrigation without any prior treatment.&nbsp, The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Mulu Eyasu Weldekiros,1 Mulugeta Tamire,2 Adugnaw Berhane,2 Zenawi Hagos Gufue,3 Ferehiwot Hailemariam Tesfa1 1Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, EthiopiaCorrespondence: Mulu Eyasu Weldekiros, Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia, Email eyasumulu124@gmail.comBackground: In Ethiopia, teenage sexual activity, unintended pregnancy, and unsafe abortions among youth college students have become the most prevalent public health problems. Contraceptive misuse, low use, and a high unmet need for long-acting reversible contraceptives are attributed to the high rate of unintended pregnancy.Objective: To assess the utilization status of long-acting reversible contraceptives and to explore the perceived barriers among youth female college students in Mekelle City, Northern Ethiopia, in 2019.Methods: An institutional-based, concurrent, mixed cross-sectional study with quantitative and qualitative components was conducted among four private and two public colleges in Mekelle City from March 1 to April 30, 2019. A total of 580 female youth college students were included in the quantitative study, and six in-depth and four key informant interviews were conducted for the qualitative study. The quantitative data were analyzed using descriptive statistics, frequency, and percentages. The chi-square test was done to assess the crude association between the outcome variable and independent categorical variables. A p-value of < 0.05 was considered a statistically significant difference. In addition, ATLAS.ti qualitative software version 7.5 was used to code and analyze the qualitative data.Results: With a 93.8% response rate, 544 female youth college students participated, and 177 (32.5%) were sexually active. Seventy-five (42.3%) of students had a history of pregnancy, and of these, 85% of the pregnancies were unplanned. The utilization of long-acting reversible contraceptives among sexually active college students was 7.3%. Qualitatively, the following themes emerged as perceived barriers to the utilization of long-acting reversible contraceptives: knowledge barriers, fear of side effects, misperceptions, health providers’ approach, discrimination, and poor confidentiality.Conclusion: This study revealed low utilization of long-acting reversible contraceptives among college students. The findings indicate that college students are at high risk of unintended pregnancy, unsafe abortion, and complications.Keywords: long-acting reversible contraceptives, youths, college students, utilization status, Mekelle

Influenza A viruses (IAVs) belonging to the goose/Guangdong (Gs/GD)-lineage H5Nx remain a major concern for the global poultry industry, wildlife, and humans. The hemagglutinin (HA) protein is the dominant antigenic epitope carrier within IAV, which in turn triggers substantial immunogenic responses in the infected host. The current study describes the development and validation of a highly sensitive competitive H5 ELISA (cELISA) based on a novel monoclonal antibody developed in mice immunized with inactivated virus H5N1 (A/Turkey/ON/6213/1966). The cELISA is capable of detecting the H5 antibody response to a wider range of H5-subtype viruses belonging to both North American and Eurasia lineages, including the Gs/GD H5Nx from clade 2.3.4.4b that is currently causing the highly pathogenic avian influenza outbreaks in Eurasia, Africa, and Latin and North America. The developed H5 cELISA provides a specific, sensitive, and species-independent serological assay for the rapid detection of H5 antibodies. The assay is more robust and more sensitive than the hemagglutination inhibition assay, which is the “Gold standard”. The assay can be used in serological diagnosis, serosurveillance, and vaccine monitoring of serum samples collected from different species of animals.

Background: Hypertension is a major public health problem in both developing and developed nations because it is highly prevalent and is associated with complications. Numerous environmental and genetic variables are linked to the occurrence of the disease. It may be influenced by the renin- angiotensin-aldosterone system, which preserves bodily homeostasis. The angiotensinogen gene M235T polymorphisms that has an effect on the activity of the renin-angiotensin-aldosterone system are related to the high hypertension risk. The aim of this study was to find out the association between angiotensinogen M235T gene polymorphism and the risk of developing hypertension. Methods: A total of 306 samples - 153 patients with hypertension and 153 age- and sex-matched healthy controls were selected using a simple random sampling technique. Clinical and biochemical variables were measured to assess the associated risk factors. Blood samples from the patients and matched controls were used to isolate deoxyribonucleic acid. The AGT M235T genotypes were identified using polymerase chain reaction and analyzed by agarose gel electrophoresis. Logistic regression with a 95% confidence interval (CI) was employed to assess the risk correlations of AGT gene M235T polymorphisms with hypertension. Results: Our analysis showed that the AGT-TT genotype (odds ratio [OR] = 3.11, 95% CL = 1.67–5.79, P< 0.001) and T allele (OR = 2.18, 95% CL = 1.56–3.04, P< 0.001) are considerably higher in hypertensive patients than in healthy controls. Our study also identified the clinical risk factors for hypertension, such as, total cholesterol, triglycerol, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol levels, which were significantly higher in patients compared to controls (P< 0.001). Conclusion: The AGT M235T genes of the TT genotype and the T allele are associated with an increased risk of hypertension among the Ethiopian patients. A population-based epidemiological study is needed corroborate the association between AGT and HTN&nbsp

Nega Berhane,1 Zemene Chekol,1 Aynias Seid1,2 1Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 2Department of Biology, Faculty of Natural and Computational Science, Debre-Tabor University, Debre-Tabor, EthiopiaCorrespondence: Zemene Chekol, Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, P.O. Box 196, Gondar, Ethiopia, Tel +251935853217, Email zemenechekol12@gmail.comBackground: Breast cancer is one of the most common cancers and the leading cause of death for women worldwide, and the problem is currently getting worse. In Ethiopia, it has become one of the most prevalent cancers, with high rates of morbidity and mortality. The BRCA2 gene variant c.5946delT has been linked to a higher risk of developing breast cancer.Objective: The aim of the present study was to detect the presence of the c.5946delT pathogenic variant in the BRCA2 gene and associated risk factors among breast cancer patients visiting FHRH and UoGCSH.Methods: A cross-sectional study was conducted from September 2021 to October 2022. Peripheral blood samples were collected from 100 patients with breast cancer, and gDNA was extracted using the salting-out method as per the protocol provided in the manufacturer’s instructions. The BRCA2 gene c.5946delT variant was detected using the PCR-RFLP technique. The data were analyzed using SPSS version 23. P≤ 0.05 was considered statistically significant.Results: In this study, we discovered that 2% of breast cancer patients had a c.5946delT pathogenic variant of the BRCA2 gene. In addition, the results suggested that the c.5946delT pathogenic variant and age at diagnosis were significantly correlated. On the other hand, there was no significant association between inhabitance and family history for the c.5946delT variant.Conclusion: We have found out that breast cancer patients in the study area had the BRCA2 gene variant c.5946delT, which suggests that this pathogenic variant is linked to breast cancer. Hence, assessing gene alterations using the PCR technique is one of the most effective early diagnostic strategies for breast cancer that should be used in hospitals in order to lower mortality.Keywords: BRCA2 gene, breast cancer, pathogenic variant, risk factors

Aynias Seid,1,2 Yilak Girma,3 Ayenesh Abebe,3 Eseye Dereb,3 Meseret Kassa,3 Nega Berhane2 1Department of Biology, College of Natural and Computational Science, Debre-Tabor University, Debre-Tabor, Ethiopia; 2Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 3TB Culture Laboratory, University of Gondar Comprehensive Specialized Hospital, Gondar, EthiopiaCorrespondence: Aynias Seid, Email ayniasseid2@gmail.comBackground: Multidrug-resistant tuberculosis (MDR-TB) has continued to be a serious public health threat and significantly challenges global TB control and prevention efforts, where the TB/HIV co-infection epidemic makes the situation much worse. The aim of the study was to determine the determinant factors associated with patterns of MDR-TB among pulmonary TB patients in the Northwest Amhara, Ethiopia.Methods: A hospital-based cross-sectional study was conducted from May 2022 to February 2023 in the Northwest Amhara, Ethiopia. Data on the participants’ socio-demographics and clinical characteristics were obtained using a pre-tested checklist. Phenotypic susceptibility testing to first-line anti-TB drugs was performed on 180 isolates by automated BD BACTEC MGIT 960 system. Logistic regression analysis was performed to determine the association of risk factors with patterns of MDR-TB. A p-value ≤ 0.05 was considered statistically significant.Results: The overall proportion of TB with HIV co-infected cases was 19.8% (50/252). Culture positivity was confirmed in 203/252 (80.6%) of sputum samples. Among 168 isolates, the DST showed that 119 (70.8%) isolates were pan-susceptible to all first-line drugs and prevalence of any resistance to first-line drugs was 49,168 (29.2%). Among the resistant isolates, 28 (16.7%) were any mono-resistance and 12 (7.1%) were determined to be resistant to MDR-TB. TB with a previous TB treatment (aOR = 6.73, 95% CI: 1.78– 25.47, p = 0.005) and HIV co-infected (aOR = 0.252, 95% CI: 0.73– 0.875, p = 0.03) were significantly associated with MDR-TB.Conclusion: Higher prevalence of TB and MDR-TB was examined among TB patients in the study area. In the study, history of previous TB treatment was the strongest risk factor MDR-TB infection followed by TB with HIV co-infected cases. Therefore, there is a need of strengthening TB control and prevention programs to reduce the increase of TB incidence, further emergence and transmission of a public health threat of MDR-TB cases.Keywords: drug resistance, MDR-TB, prevalence, risk factors, TB/HIV co-infection

Introduction: A 6-month course of isoniazid, 300 mg daily, was programmatically introduced in Eritrea in 2014 as tuberculosis preventive therapy in people living with human immunodeficiency virus (PLHIV). The rollout of isoniazid preventive therapy (IPT) in PLHIV was successful in the first 2–3 years. After 2016, rumours based on rare but real incidents of liver injuries following use of IPT spread widely across the country and created concerns amongst healthcare professionals and consumers, that ultimately caused dramatic decline in the rollout of the intervention. Decision makers have been demanding better evidence as previously conducted local studies had inherent methodological limitations. This real-world observational study was conducted to evaluate the risk of liver injury associated with IPT among PLHIV attending Halibet national referral hospital, Asmara, Eritrea. Methods: A prospective cohort study, that consecutively enrolled PLHIV attending Halibet hospital, was conducted between 1 March and 30 October 2021. Those exposed to anti-retroviral therapy (ART) plus IPT were considered as exposed and those taking only ART were considered as unexposed. Both groups were prospectively followed up for 4–5 months with monthly liver function tests (LFTs). A Cox proportional hazard model was used to explore whether there was increased risk of drug-induced liver injury (DILI) associated with IPT. Probability of survival without DILI was also estimated using Kaplan–Meier curves. Results: A total of 552 patients, 284 exposed and 268 unexposed, completed the study, with a mean follow-up time of 3.97 (SD 0.675) months for the exposed and 4.06 (SD 0.675) months for the unexposed. Twelve patients developed drug-induced liver injury (DILI), with a median time-to-onset of 35 days (interquartile range: 26.8, 60 days). All cases were from the exposed group and all except two cases were asymptomatic. The incidence rate of DILI in the exposed group was 10.6 cases per 1000 person–months and zero for the unexposed group (p = 0.002). Conclusion: DILI in PLHIV taking IPT was common; therefore, liver function should be closely monitored to safely administer the product. Despite high levels of deranged liver enzymes, the majority had no symptoms of DILI, emphasising the importance of close laboratory monitoring, especially during the first 3 months of treatment.

Highly pathogenic avian influenza A(H5N1) viruses of clade 2.3.4.4b underwent an explosive geographic expansion in 2021 among wild birds and domestic poultry across Asia, Europe, and Africa. By the end of 2021, 2.3.4.4b viruses were detected in North America, signifying further intercontinental spread. Here we show that the western movement of clade 2.3.4.4b was quickly followed by reassortment with viruses circulating in wild birds in North America, resulting in the acquisition of different combinations of ribonucleoprotein genes. These reassortant A(H5N1) viruses are genotypically and phenotypically diverse, with many causing severe disease with dramatic neurologic involvement in mammals. The proclivity of the current A(H5N1) 2.3.4.4b virus lineage to reassort and target the central nervous system warrants concerted planning to combat the spread and evolution of the virus within the continent and to mitigate the impact of a potential influenza pandemic that could originate from similar A(H5N1) reassortants.

Soil erosion is a process accelerated by natural and anthropogenic disturbances over time and space, leading to land degradation and causing geomorphological change. It is difficult to investigate the spatial and temporal distribution of soil erosion and sedimentation in data-scare areas, in that case, the use of simplified methods to analyze soil erosion and sediment connectivity variations over time and space can help. Sediment connectivity denotes the transfer of sediment from source to sink areas through channel systems of landscape compartments within a watershed. In this study, we aimed to investigate sediment yield (SY) variation over time and space and understand the link between hillslope soil erosion and sediment connectivity to identify hotspot areas in the Rogativa catchment (∼53 km2) in Southeast Spain. The (specific) sediment yield (S)SY was estimated by combining the Revised Universal Soil Loss Equation (RUSLE) model with the sediment delivery ratio (SDR). The SDR was calculated based on the Index of Connectivity (IC). In the channels, 100% delivery was assumed. In the Rogativa catchment, 58 check dams were constructed in 1976/77. Their trapping efficiency, obtained from field observations of sediment retained behind the checkdams in 2003, was included in the SDR estimation of the checkdams. SY was estimated from accumulated hillslope soil erosion in the local stream network while accounting for sedimentation through the SDR. Soil erosion, IC, SDR, and (S)SY were quantified and compared for the years 1956, 1977, 2001, and 2016, for which different land use maps were available. SY model results for the year 2001 were compared with observed SY (in 2003) behind the check dams. Only for about half of the checkdams, model results were comparable. This is investigated further and could be explained by complex sediment dynamics within the channels and between checkdams (i.e. one check dam retaining part of the sediment, the next downstream checkdam as well, etc) – these dynamics are not included in the RUSLE-SDR model. The RUSLE-generated soil erosion and sediment connectivity signatures (IC, SDR, and (S) SY) showed higher values in the channels and croplands than in hillslopes and decreased over time due to significant changes in land use and construction of check dams in the catchment. Moreover, the combined proportion of erosion-connectivity patterns showed about 7% of the area adjacent to some of the streams was found both highly erodible and highly connected, which indicates an adverse erosion-prone part. It is possible to apply this method to understand SY amount and distribution and identify hotspot locations in drainage systems with limited field data in data-scarce semi-arid areas like the Rogativa catchment. However, more field observations to validate the models to identify hotspot locations and investigate river network systems rather than focusing only on hillslopes, which could help to know where to intervene in the catchment.Keywords: Soil erosion-RUSLE, Sediment connectivity, Sediment delivery ratio, Sediment yield, hotspot location

Breast cancers are categorized into subtypes with distinctive therapeutic vulnerabilities based on expression of clinically targetable receptors and other genes that mimic cell types of the normal gland. Here, we tested the role of the plasma membrane-integral glycoprotein Mcam in breast cancer cell state control and tumorigenicity using a murine tumor cell line (Py230), that exhibits lineage and tumor subtype plasticity. Mcam knockdown (KD) Py230 cells exhibit increased mesenchymal morphology, migration, Src/Fak/Mapk/Paxillin adhesion complex signaling and Pi3K/Akt, Stat3 and Stat5a activation. They also show a transcriptional switch from a hormone-sensing/luminal progenitor state toward alveolar and basal cell states. Reminiscent of archival human breast cancers and patient derived organoid expression data associated with endocrine resistant disease, Mcam KD Py230 cells were refractory to growth inhibition by tamoxifenin vitro. Endocrine resistance and cell state change resulting from Mcam KD were reversed by inhibition of Stat3 or the upstream activating kinase Ck2. Finally, while Mcam KD cells exhibited more aggressive phenotypesin vitro, they showed reduced tumorigenicity and lacked Sox10+/neural crest cell state acquisitionin vivo. Our studies uncover breast cancer cell state plasticity dependent on Mcam, Ck2, and Stat3 with implications for progression, evasion of targeted therapies and combination therapy design.

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

Stalled ribosomes are rescued by pathways that recycle the ribosome and target the nascent polypeptide for degradation. InE. coli, these pathways are triggered by ribosome collisions through recruitment of SmrB, a nuclease that cleaves the mRNA. InB. subtilis, the related protein MutS2 was recently implicated in ribosome rescue. Here we show that MutS2 is recruited to collisions by its SMR and KOW domains and reveal the interaction of these domains with collided ribosomes by cryo-EM. Using a combination ofin vivoandin vitroapproaches, we show that MutS2 uses its ABC ATPase activity to split ribosomes, targeting the nascent peptide for degradation by the ribosome quality control pathway. Notably, we see no evidence of mRNA cleavage by MutS2, nor does it promote ribosome rescue by tmRNA as SmrB cleavage does inE. coli. These findings clarify the biochemical and cellular roles of MutS2 in ribosome rescue inB. subtilisand raise questions about how these pathways function differently in various bacteria.

This manuscript is the preprint version of a conference paper that is accepted for presentation and publication, International Conference on Future Energy Solutions (FES2023) to be held in Vaasa, Finland, 12-14, June 2023.

PURPOSE Nonmetastatic cervical cancer is curable and can be treated with radiotherapy (RT). A delay in receiving treatment because of long waiting times results in upstaging of the disease stage and negatively affects the treatment outcomes. However, real-world evidence that progression occurs while waiting for treatment is scarce in low-income countries. We evaluated the impact of long waiting times for RT in patients with cervical cancer at a referral center in Ethiopia. METHODS A longitudinal study was conducted from January 5, 2019, to May 30, 2020, to address the objectives of this study. Patients with pathologically diagnosed cervical cancer with stage IIB to stage IVA were included in the study. We used Kaplan-Meier analysis to assess overall survival with time. Multivariate Cox regression analysis, using the backward likelihood ratio selection method, was used to fit the final model. RESULTS The median waiting time for radical RT after diagnosis was 477 days. Waiting for more than 51 days for RT results in disease progression. Of the 115 patients included in this study, 59 (51.3%) died during the study period. A delay in waiting (adjusted hazard ratio, 3; 95% CI, 1.7 to 4.9) was significantly associated with disease progression and decreased survival. CONCLUSION Waiting time to receive RT is very long. Urgent action is required to significantly reduce waiting times and improve the survival of patients with cervical cancer.

Background Traditional medicines have been widely used in treating many microbial, inflammatory and other types of diseases states in Eritrea, where complimentary remedies are required to the modern health care system. Methodology The current research project focusses on three Eritrean medicinal plants; Commiphora africana, Cucumis pustulatus and Vernonia schimperi, which are traditionally used in management of different diseases. The hidden potential of the three plants for their anti-microbial activity was assessed with the employment of zone of inhibition. The plants were extracted by cold extraction using three solvents arranged in their increasing polarity starting with Petroleum ether, methanol and distilled water. The in vitro anti-microbial activity was performed by agar well diffusion method. Result Percentage yield was calculated for each plant extract. The cold methanol extracts of these plants exhibited the maximum yield while the minimum yield was obtained with petroleum ether. The gram-positive bacteria Staphylococcus aureus was the most susceptible, while the gram-negative bacteria, Escherichia coli was moderately susceptible. Desirable result has shown against Candida albicans with the methanol extracts of both Commiphora africana and Cucumis pustulatus. The most active antibacterial activity was obtained from the plant Commiphora africana. As a standard anti-biotic, Ciprofloxacin and Fluconazole were taken as positive control for the bacterial and fungal medias respectively and distilled water as a negative control. Conclusion Commiphora africana and Cucumis pustulatus have shown the highest activities. Based on the outcomes these plants have compelling anti-fungal and anti-bacterial property. However further in-vivo studies, advanced phytochemical screenings, toxicity tests are recommended.

We isolated a novel reassortant influenza A(H10N7) virus from a harbor seal in British Columbia, Canada, that died from bronchointerstitial pneumonia. The virus had unique genome constellations involving lineages from North America and Eurasia and polymerase basic 2 segment D701N mutation, associated with adaptation to mammals.

Microsurgical free tissue transfer is the gold standard for reconstruction of significant soft tissue and bony defects following cancer resection and trauma. Many reconstructive units in low-income and middle-income countries (LMICs) do not yet have access to the resources or training required to perform microsurgical procedures. Long-term international collaborations have been formed with annual reconstructive programmes conducting microsurgery.To critically analyze outcomes of microsurgical free tissue transfer performed on international reconstructive collaborations in LMICs.PRISMA-compliant systematic review and meta-analysis of outcomes for free tissue transfer performed during international collaborations in LMICs using an inverse variance model. The study protocol was published prospectively and registered with PROSPERO (ID: CRD42021225613).Seven studies, included 290 flaps on 284 patients. The most common sites requiring reconstruction were Head and neck (53% (n = 153)) and lower limb (7.9% (n = 23)) were lower limb reconstruction. The most common free flaps were radial forearm (22%; n = 64) and anterolateral thigh (18%; n = 51). Total Flap Failure rate was 3.8% (n = 13; 95% confidence interval (CI) = 1.9-6.3%) Overall complication rate was 38% (95% CI =27-48%), with 19% of flaps requiring emergency return to theatre (95% CI =14-26%). Flap salvage was successful in 52% of take-backs (95% CI =15% - 88%).Free flaps performed during international surgical collaborations in LMICs have comparable failure rates to those performed in higher-income settings. However, there are higher complication and take-back rates. This should be taken into account when planning international collaborations. These results should help preoperative counselling and the consent process.

It was noted that the overall stability of foam concrete mixtures made by single-stage technology depends significantly on the measure of distribution of the dispersed gas phase involved in the mixing. The effect of the gas phase structure on the foam concrete mixture was evaluated by the value of the current consumed by the concrete mixer. The results of the experimental studies have shown the relevance of the scientific justification of mass transfer phenomena, that occur during mixing of raw materials in an industrial turbulent mixer. It was found that the process of dispersion of large-sized gas inclusions formed in the foam concrete mixture in the initial period of high-speed mixing is characterized by achieving the maximum power consumption at the mixer shaft. Then there is a slight decrease in energy consumption, in which there is an additional distribution of the dispersed gas phase, sufficient to attain stability of the foam concrete mixture.

Background. Pregnancy complications are the major health problems among women in developing countries. Globally, around 295,000 women die from pregnancy-related causes annually and 86% of these maternal deaths happen in developing countries. Objective. To assess knowledge of obstetric danger signs among reproductive-age women living in southeastern zone of Tigray Region, Ethiopia, 2021. Methods. A community-based quantitative cross-sectional survey was undertaken in southeastern zone of Tigray. A multistage random sampling technique was implemented to select total participants of 410 reproductive-age women. Two districts were randomly selected, and from those districts, 12 kebeles were selected randomly, and the calculated sample size (410) was proportionally allocated to each selected kebel. The data were collected by using face-to-face interview with a structured questionnaire from January 20 to February 20/2021 after ensuring that all requirements of ethical considerations were fulfilled. The collected data were entered into EpiData version 4.2 and then exported to SPSS version 20 for analysis. Descriptive statistics with frequency, percentage, table and graph, and cross-tabulation were used for presentation of result. Bivariable and multivariable analyses were used to examine the association. Odds ratios with 95% confidence interval and P value < 0.05 were used to determine the statistical association. Result. Four hundred ten reproductive-age women participated in the study making a response rate of 100%. Leakage of fluid per vagina was the most commonly mentioned obstetric danger signs (61%). Overall, one hundred seventy-two (42%) had good knowledge on obstetric danger sign. Educational status of the mother (AOR ( 95 % CI = 2.7 (1.189-6.24))), site of delivery (AOR ( 95 % CI = 2.2 (1.6-3.432))), and having history of an ANC follow-up (AOR ( 95 % CI = 2.4 (1.13-5.6))) were found to be independent predictors of knowledge of women about the obstetric danger sign. Conclusion and Recommendation. Educational status of the mother site of delivery and having history of an ANC follow-up were independently associated with knowledge of women about obstetric danger signs. Thus, provision of the Information, Education and Communication targeting women, family, and the general community on obstetric danger signs and associated factors was recommended.

Antipsychotic medications demonstrate a variable range of efficacy and side effects in patients with mental illness. Research has attempted to identify biomarkers associated with antipsychotic effects in various populations. Research designs utilizing healthy volunteers may have the added benefit of measuring the effect of antipsychotics on a given biomarker (s) independent of the varied environmental and clinical factors that often accompany patient populations. The aim of this systematic review and meta-analysis was to synthesize the current evidence of hormonal, inflammatory, and metabolic biomarker studies of antipsychotic treatment in study designs using healthy volunteers. The systematic review was performed according to established guidelines and a random effects meta-analysis of biomarkers appearing in at least three studies was performed while biomarkers in two or less studies were qualitatively summarized. A total of 28 studies including 28 biomarkers were identified. Meta-analyses were carried out for 14 biomarkers, showing significant effects within six biomarkers (cortisol, C-peptide, free fatty acids, leptin, thyroid-stimulating hormone, and prolactin). Many of these effects were associated with olanzapine, the most used antipsychotic amongst the trials, observed on sub-analyses. When combining biomarkers into categories, some additional effects were observed, for example, when grouping inflammatory biomarkers. These findings suggest that antipsychotics exert potentially strong effects on several biomarkers of interest independent of psychiatric disease which could be used to spur future investigations, however, replication work is needed for many biomarkers included in this review.

Michael Assefa Berhane,1 Ketemaw Zewdu Demilew,2 Abel Sinshaw Assem2 1Department of Ophthalmology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Ketemaw Zewdu Demilew, Department of Optometry, College of Medicine and Health Sciences, University of Gondar, PO Box 196, Gondar, Ethiopia, Tel +251-918150629, Email zewdukt@gmail.comPurpose: The purpose of this study was to assess the prevalence and associated factors of myopia among medical students at the University of Gondar College of Medicine and Health Sciences, Northwest Ethiopia.Patients and Methods: Institution-based cross-sectional study was conducted at the University of Gondar College of Medicine and Health Sciences from June 20 to August 15, 2021. A simple random sampling technique with proportional allocation was used to select 492 students. Interviewer-administered questionnaire, Snellen acuity chart, pinhole, retinoscope and direct ophthalmoscope were used to collect the data. The data were entered to EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics were summarized by measures of central tendency. Variables with p-value ≤ 0.2 in bivariable regression were entered into a multivariable logistic regression model. Adjusted odds ratio with 95% confidence interval was used and variables with p-values < 0.05 were considered as statistically significant.Results: A total of 492 respondents participated giving a response rate of 98.3%. The prevalence of myopia was found to be 16.7% (95% CI = 12.8– 19.4%). Urban residents (AOR = 1.56; 95% CI: 1.28– 6.21), family history of myopia (AOR = 2.31; 95% CI: 1.33– 4.54), near-work activity of 5– 7 hours (AOR = 2.41; 95% CI: 1.31– 5.76) and ≥ 8 hours (AOR = 4.35; 95% CI: 1.96– 9.66), outdoor activity for < 3 hours (AOR = 1.65 95% CI: (1.14– 4.53), were significantly associated with myopia.Conclusion: The prevalence of myopia among medical students at the University of Gondar College of Medicine and Health Sciences was high. Urban residency, positive family history, longer time spent on near-work activities and less outdoor activity were positively associated with myopia.Keywords: myopia, medical students, Gondar, Ethiopia

Undernourished pregnant and lactating women from food insecure settings, most commonly found in low- and middle-income countries, are at risk of adverse maternal and infant health outcomes. Often, undernourishment is characterized by low body mass index (BMI), low mid upper arm circumference (MUAC), short stature, and/or micronutrient deficiencies, which put pregnant women at risk for complications such intrauterine growth restriction and preterm birth (Kozuki et al. 2015). The World Health Organization recommends balanced energy-protein (BEP) supplementation in populations at risk of undernourishment (defined as more than 20% of women with a BMI less than 18.5 kg/m2) to reduce the risk of stillbirth and small for gestational age neonates (World Health Organization 2016). The consequences of undernourishment among lactating mothers have commonly been overlooked. Lactating mothers require additional calories to produce quality and quantity milk, which in turn confers health and development benefits to the infant (Nommsen et al. 1991; Dewey et al. 1991; American College of Obstetricians and Gynecologists 2016). There is a high prevalence of malnutrition in mothers and children from low- and middle-income countries, and research from randomized controlled trials is needed to clarify if BEP could be a valuable intervention during lactation. BEP supplementation products are ready-to-eat or prepared foods that provide protein (accounts for less than 25% of the total energy content) and energy. When given during pregnancy, BEP products are fortified with micronutrients or an additional micronutrient supplement is given (typically multiple micronutrients or iron-folic acid). The current evidence coming from systematic reviews and meta-analyses has focused on studies where BEP is given during pregnancy (Imdad and Bhutta 2012; Ota et al. 2015; Stevens et al. 2015; Lassi et al. 2020; Perumal et al. 2021) but not lactation. This evidence is difficult to disentangle because there is significant heterogeneity in the populations, comparison/control groups, study design, and BEP product formulations (i.e., energy and protein content). Given these limitations, in 2017, an expert panel organized by the Bill and Melinda Gates Foundation (BMGF) created guidelines for the macro- and micronutrient content of BEP supplements (Report of an Expert Consultation held at the Bill & Melinda Gates Foundation 2017). This group also suggested that these BEP products should be developed and tested on pregnant and lactating women in low-resource settings. A number of studies (all randomized interventions) were subsequently funded by BMGF. As these studies’ investigators were developing protocols independently, in 2020 BMGF convened the Maternal Nutrition Harmonization Workshop to harmonize key variables across these trials. This effort was expanded, and the Maternal BEP Studies Harmonization Initiative was formed to examine the pooled effect of BEP across pregnancy and lactation. The current protocol describes our prospective individual participant data (IPD) meta-analysis that focuses on BEP given during lactation. Subsequent work will examine BEP given during pregnancy. Given the high prevalence of infant stunting in low- and middle-income countries (World Health Organization 2018b; Local Burden of Disease Child Growth Failure Collaborators 2020), and the importance of supporting the nutrient intake of mothers providing breastmilk to infants, this IPD meta-analysis will focus on assessing the effect of BEP given to mothers during lactation on infant length-for-age z scores (LAZ) at 6 months of age. We will also examine additional infant and maternal anthropometric and health outcomes.

Leadership is the working component of any organization; it’s the nerve cell for organizations to exist, function, progress, and flourish by utilizing human and material resources wisely and effectively. Hence, the study of leadership, particularly, in the healthcare sector is very important to bring about quality service delivery both in private and public sectors. The 21st century is characterized by a high pace of changes in technology, social, economic and political, and that healthcare leaders will have a tremendous impact on the lives of many people around the globe, if they possess the technical and functional competences of leadership styles. Leaders at all levels of a healthcare culture can learn the timeless and inevitable lessons through participating stakeholders to have their voices on the critical healthcare issues. The purpose of the review is to explore and highlight the importance of leadership in healthcare organizations. Throughout the review, the authors have learnt that a genuine healthcare leadership bypasses old practices and involves everyone. The study discovers that the complexities, challenges and barriers of healthcare industry are inherent and inevitable, but through thorough and further leadership study in the field, they can be somehow understood, minimized and be used as steppingstones.