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IntroductionThe COVID-19 pandemic has exerted devastating effects on healthcare delivery systems, specifically those for pregnant women. The aim of this review was to determine the maternal perception of antenatal health care services during the COVID-19 pandemic critical phase.MethodsScopus, Web of Science, SAGE, and Ovid were systematically searched using the keywords "maternal", "COVID-19 pandemic", "maternal health service", and "maternal perception". Articles were eligible for inclusion if they were original articles, written in English, and published between January 1, 2020, and December 12, 2022. This review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible articles were assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used for data synthesis.ResultsOf 2683 articles identified, 13 fulfilled the inclusion criteria and were included in the narrative synthesis. Five themes emerged regarding the determinants of maternal perception of antenatal healthcare services during the COVID-19 pandemic critical phase: lack of psychosocial support, poor maternal healthcare quality, poor opinion of virtual consultation, health structure adaptation failure to meet women's needs, and satisfaction with maternal health services.ConclusionMaternal perception, specifically pregnant women's psychosocial and maternal health needs, should be focused on the continuation of maternal care during the COVID-19 pandemic. It is critical to identify the maternal perception of maternal health services during the pandemic to ensure health service equity in the "new normal" future.

Forecasting a currency exchange rate is one of the most challenging tasks nowadays. Due to government monetary policy and some uncertain factors, such as political stability, it becomes difficult to correctly forecast the currency exchange rate. Previously, many investigations have been done to forecast the exchange rate of the United State Dollar(USD)/Bangladeshi Taka(BDT) using statistical time series models, machine learning models, and neural network models. But none of the previous methods considered the underlying macroeconomic factors of the two countries, such as GDP, import/export, government revenue, etc., for forecasting the USD/BDT exchange rate. We have included various time-sensitive macroeconomic features directly impacting the USD/BDT exchange rate to address this issue. These features will create a new dimension for researchers to predict and forecast the USD/BDT exchange rate. We have used various types of models for predicting and forecasting the USD/BDT exchange rate and found that Among all our models, Time Distributed MLP provides the best performance with an RMSE of 0.1984. Finally, we have proposed a pipeline for forecasting the USD/BDT exchange rate, which reduced the RMSE of Time Distributed MLP to 0.1900 and has proven effective in reducing the error of all our models.

Background Social stigma associated with infectious diseases existed throughout the history of pandemics due to fears of contagion and death. This study aims to assess social and self-stigma resulting from COVID-19 infection and other associated factors in Egypt during the pandemic. Methods A cross-sectional study was conducted on 533 adult Egyptians via an online questionnaire. The questionnaire included social stigma toward current and recovered COVID-19 patients and the negative self-image of being a COVID-19 patient. Results The mean calculated overall COVID-19-related stigma score for the studied sample was 4.7±3.1. The highest reported stigma category was mild stigma: Social stigma towards current COVID-19 patients (88.2%), Social stigma toward recovered COVID-19 patients (64.2%), Negative self-image for being a COVID-19 patient; perceived self-stigma (71.6%) and total stigma score (88.2%) respectively. The overall stigma score was negatively associated with a higher level of education and getting information from healthcare workers and positively associated with getting information from social networks. Conclusion Social and self-stigma related to COVID-19 infection was mild from the Egyptian perspective but found in a large proportion of the population and mainly affected by getting information from healthcare workers or through social media and being more among those with lower education levels. The study recommends more legislative control on social media for disseminating health-related information and conducting awareness campaigns to counteract these adverse effects.

Background Preeclampsia significantly contributes to maternal and perinatal morbidity and mortality. It is imperative to identify women at risk of developing preeclampsia in the effort to prevent adverse pregnancy outcomes through early intervention. Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) level changes are noticeable several weeks before the onset of preeclampsia and its related complications. This study evaluated the feasibility of the sFlt-1/PlGF biomarker ratio in predicting preeclampsia and adverse pregnancy outcomes using a single cut-off point of >38. Methods This is a prospective cohort study conducted at a single tertiary centre, in an urban setting in Kuala Lumpur, Malaysia, between December 2019 and April 2021. A total of 140 medium to high risk mothers with singleton pregnancies were recruited at ≥20 weeks’ gestation. sFlt-1/PlGF ratio was measured and the participant monitored according to a research algorithm until delivery. The primary outcome measure was incidence of preeclampsia and the secondary outcome measure was incidence of other adverse pregnancy outcomes. Results The overall incidence of preeclampsia was 20.7% (29/140). The mean sFlt-1/PlGF ratio was significantly higher in preeclampsia (73.58 ± 93.49) compared to no preeclampsia (13.41 ± 21.63) (p = 0.002). The risk of preeclampsia (adjusted OR 28.996; 95% CI 7.920–106.164; p38 compared with sFLT-1/PlGF ratio ≤38. The area under the receiver-operator characteristic curve (AUC) for a combined approach (maternal clinical characteristics and biomarker) was 86.9% (pConclusions It is feasible to use single cut-off point of >38 ratio of the biomarkers sFlt-1/PlGF in combination with other parameters (maternal clinical characteristics) in predicting preeclampsia and adverse pregnancy outcomes among medium to high risk mothers without restricting outcome measurement period to 1 and 4 weeks in a single urban tertiary centre in Kuala Lumpur, Malaysia.

Veterinary medicine uses antibiotics randomly for treatment and growth promotion. Milk of dairy animals contains substantial quantities of antibiotics that have harmful effects on health. It is therefore necessary to test commercially available milk using immunological, chromatographic, or microbiological methods to confirm the absence of antibiotic residues. This study aims to perform a microbiological test, followed by a quantitative confirmation analysis, on raw milk to assess the presence of antibiotic residues. Tests were conducted on 200 milk samples collected from markets and farms in Saudi Arabia and Egypt. The microbial inhibitor test (Delvotest SP-NT) revealed that 40 samples were positive for antibiotic residues. The positive samples were further tested using liquid chromatography-tandem mass spectrometry (LC-MS/MS) as a confirmatory quantitative test for 29 antibiotics that belong to five groups: tetracyclines, sulfonamides, fluoroquinolones, macrolides, and lactamases. Only four samples tested positive for oxytetracycline residues above the maximum residue limit. Based on these results, researchers suggest a monitoring system that considers both microbial and HPLC-MS/MS methods when detecting antibiotic residues in bovine milk. The analysis of risk to human health revealed that antibiotic residues at the detected levels do not pose any health risks to consumers.

The Ministry of Public Health in Yemen continues the implementation of school and community-based preventive chemotherapy with praziquantel and albendazole for the control and elimination of schistosomiasis and soil-transmitted helminths (STH). The latest remapping to update the distribution of schistosomiasis and STH was conducted seven years ago. This study aimed to estimate the prevalence, intensity and associated risk factors of Schistosoma mansoni and STH among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen. A cross-sectional study was carried out among schoolchildren aged 6-15 years in four selected schools. Biological, demographic, socioeconomic and environmental data were collected using a pre-tested questionnaire. S. mansoni and STH eggs were detected and counted by the microscopic examination of Kato-Katz fecal smears. Out of 417 schoolchildren, 17.0% were infected with at least one intestinal helminth. Prevalence of S. mansoni and STH were 6.5% and 9.1%, respectively. The most prevalent parasite among STH was Ascaris lumbricoides (8.4%). Unemployed fathers (Adjusted Odds Ratio (AOR) = 3.2; 95% Confidence interval (CI): 1.23, 8.52; P = 0.018), eating exposed food (AOR: 2.9; 95%CI = 1.24, 6.89; P = 0.014), not washing hands before eating and after defecation (AOR: 4.8; 95%CI = 1.77, 12.81; P = 0.002), and schools located close to water stream (AOR: 22.1; 95%CI = 5.12, 95.46; P

The disruptive potentials of drones are rapidly growing including for the delivery of blood samples in healthcare. Maintenance of the quality of blood samples is important to ascertain that the drone is a safe mode of transportation, particularly during emergencies and in critical cases. The influence of the drone carriage material on blood samples transportation was investigated in this study. Two phases of drone simulation flights were conducted in Cyberjaya, Malaysia. In Phase 1, the effect of drone carriage material on the internal storage temperature during blood samples transportation was determined. Three types of carriage materials were compared: aluminium, expanded polystyrene (EPS) foam, and polypropylene (PP) plastic. In Phase 2, the quality of drone-transported blood samples was assessed, using the best material from Phase 1 as the drone carriage material. Biochemical and hematological analyses of 60 blood samples were conducted using five parameters. In Phase 1, EPS foam was found to be the best material to maintain a stable and favorable internal storage temperature at mean kinetic temperature ±SD of 4.70 ±1.14°C. Much higher and unfavorable mean kinetic temperatures were recorded for aluminium (11.46 ±0.35°C) and plastic (14.17 ±0.05°C). In Phase 2, laboratory tests show that the quality of blood samples was well maintained, and the mean biochemical and hematological parameters of drone-transported blood samples showed no significant alteration compared to ground controls. Drone carriage material is an important determinant of the quality of blood samples transported by drone, particularly in hot equatorial climates as in Malaysia. The blood storage temperature was best maintained using EPS foam, as evidenced by the favorable average temperature and preservation of hematological and biochemical parameters of the blood samples.

BackgroundThe emergence of dengue in malaria-endemic countries with limited diagnostic resources, such as Yemen, can be problematic because presumptive treatment of febrile cases as being malaria is a common practice. Co-infections with dengue and malaria are often overlooked and misdiagnosed as being a mono-infection because of clinical similarities. In Hodeidah city, Yemen, the capacity to conduct the diagnosis can be aggravated by the war context. To assess the magnitude of the problem, we determined the proportions of malaria, dengue and co-infection in relation to clinical characteristics among febrile outpatients.MethodsThis cross-sectional study included 355 febrile outpatients from Hodeidah city during the malaria transmission season (September 2018 -February 2019). Sociodemographic and clinical characteristics were collected using a pre-designed, structured questionnaire. Malaria was confirmed using microscopy and rapid diagnostic tests (RDTs), while dengue was confirmed using RDTs.ResultsMono-infection proportions of 32.4% for falciparum malaria and 35.2% for dengue were found, where about two-thirds of dengue patients had a recent probable infection. However, co-infection with falciparum malaria and dengue was detected among 4.8% of cases. There was no statistically significant difference between having co-infection and mono-infection with malaria or dengue in relation to the sociodemographic characteristics. On the other hand, the odds of co-infection were significantly lower than the odds of malaria among patients presenting with sweating (OR = 0.1, 95% CI: 0.05-0.45; p ConclusionsMono-infection with malaria or dengue can be detected among about one-third of febrile outpatients in Hodeidah, while almost 5.0% of cases can be co-infected. Sociodemographic and clinical characteristics cannot easily distinguish malaria patients from dengue-infected or co-infected ones, reinforcing the necessity of laboratory confirmation and avoidance of treating febrile patients as being presumed malaria cases.

With the widespread of multicore systems, automatic parallelization becomes more pronounced, particularly for legacy programs, where the source code is not generally available. An essential operation in any parallelization system is detecting data dependence among parallelization candidate instructions. Conducting dependence analysis at the binary-level is more challenging than that at the source-level due to the much lower semantics of the binary code. In this paper, we consider using the elaborate 'static' analysis of abstract interpretation, for the first time, at runtime for data dependence detection. Specifically, our system interprets instructions at a hot region, while at the same time, collect programs semantics for seen program points, thereby conducting abstract interpretation analysis dynamically. The analysis is guaranteed to be correct as long as execution does not exit the region prematurely. Moreover, successive hot region re-entries will resume previous analysis, albeit much faster in case no major change in the program semantics. Such approach provides for more rigorous analysis than other simple dynamic analysis which would typically miss parallelization opportunities. The proposed approach also does not require any hardware support, availability of the source code, as well as any code re-compilation. To study the performance and accuracy of our approach, we have extended the Padrone dynamic code modification framework, and conduct an initial study on a set of PolyBench kernels and selected programs from SPEC CPU. Experimental results show accurate dependence detection with low overhead.

A distinction has always been made between long-term and short-term memory (also now called working memory, WM). The obvious difference between these two kinds of memory concerns the duration of information storage: information is supposedly transiently stored in WM while it is considered durably consolidated into long-term memory. It is well acknowledged that the content of WM is erased and reset after a short time, to prevent irrelevant information from proactively interfering with newly stored information. In the present study, we used typical WM radial maze tasks to question the brief lifespan of spatial WM content in rodents. Groups of rats were submitted to one of two different WM tasks in a radial maze: a WM task involving the repetitive presentation of a same pair of arms expected to induce a high level of proactive interference (PI) (HIWM task), or a task using a different pair in each trial expected to induce a low level of PI (LIWM task). Performance was effectively lower in the HIWM group than in LIWM in the final trial of each training session, indicative of a "within-session/short-term" PI effect. However, we also observed a different "between-session/long-term" PI effect between the two groups: while performance of LIWM trained rats remained stable over days, the performance of HIWM rats dropped after 10 days of training, and this impairment was visible from the very first trial of the day, hence not attributable to within-session PI. We also showed that a 24 hour-gap across training sessions known to allow consolidation processes to unfold, was a necessary and sufficient condition for the long-term PI effect to occur. These findings suggest that in the HIWM task, WM content was not entirely reset between training sessions and that, in specific conditions, WM content can outlast its purpose by being stored more permanently, generating a long-term deleterious effect of PI. The alternative explanation is that WM content could be transferred and stored more permanently in an intermediary form or memory between WM and long-term memory.

Visceral leishmaniasis (VL) is a debilitating, often fatal disease caused by Leishmania donovani complex; however, it is a neglected tropical disease. L. donovani complex comprises two closely related species, L. donovani that is mostly anthroponotic and L. infantum that is zoonotic. Differentiation between these two species is critical due to the differences in their epidemiology and pathology. However, they cannot be differentiated morphologically, and their speciation using isoenzyme-based methods poses a difficult task and may be unreliable. Molecular characterization is now the most reliable method to differentiate between them and to determine their phylogenetic relationships. The present study aims to characterize Leishmania species isolated from bone marrows of Yemeni pediatric patients using sequence analysis of the ribosomal internal transcribed spacer-1 (ITS1) gene. Out of 41 isolates from Giemsa-stained bone marrow smears, 25 isolates were successfully amplified by nested polymerase chain reaction and sequenced in both directions. Phylogenetic analysis using neighbor joining method placed all study isolates in one cluster with L. donovani complex (99% bootstrap). The analysis of ITS1 for microsatellite repeat numbers identified L. infantum in 11 isolates and L. donovani in 14 isolates. These data suggest the possibility of both anthroponotic and zoonotic transmission of VL-causing Leishmania species in Yemen. Exploring the possible animal reservoir hosts is therefore needed for effective control to be achieved.

BACKGROUND: The accuracy of the conclusions from in vivo efficacy anti-malarial drug trials depends on distinguishing between recrudescences and re-infections which is accomplished by genotyping genes coding P. falciparum merozoite surface 1 (MSP1) and MSP2. However, the reliability of the PCR analysis depends on the genetic markers' allelic diversity and variant frequency. In this study the genetic diversity of the genes coding for MSP1 and MSP2 was obtained for P. falciparum parasites circulating in Yemen. METHODS: Blood samples were collected from 511 patients with fever and screened for malaria parasites using Giemsa-stained blood films. A total 74 samples were infected with P. falciparum, and the genetic diversity was assessed by nested PCR targeting Pfmsp1 (Block2) and Pfmsp2 (block 3). RESULTS: Overall, 58%, 28% and 54% of the isolates harboured parasites of the Pfmsp1 K1, MAD20 and RO33 allelic families, and 55% and 89% harboured those of the Pfmsp2 FC27 and 3D7 allelic families, respectively. For both genetic makers, the multiplicity of the infection (MOI) was significantly higher in the isolates from the foothills/coastland areas as compared to those from the highland (P

BACKGROUND: Intestinal protozoan diseases in Yemen are a significant health problem with prevalence ranging from 18% to 27%. The present study is a cross-sectional study aimed at determining the factors associated with the high prevalence of intestinal protozoan infections among patients seeking health care in Sana'a City, the capital of Yemen. METHODOLOGY/PRINCIPAL FINDINGS: Stool samples were collected from 503 patients aged between 1 and 80 years old; 219 were males and 284 females. Biodata were collected via pretested standard questionnaire. Faecal samples were processed and examined for (oo)cysts or ova using a wet mount preparation after formal-ether concentration technique. Cryptosporidium oocysts were detected using the Ziehl-Neelsen staining technique. The overall prevalence of intestinal protozoan infections was 30.9%. Infection rates of Giardia duodenalis, Entamoeba histolytica/dispar and Cryptosporidium were 17.7%, 17.1% and 1%, respectively. Other parasites detected included Ascaris lumbricoides (2.4%), Schistosoma mansoni (0.3%), Hymenolepis nana (1.4%) and Enterobius vermicularis (0.4%). Multivariate analysis using forward stepwise logistic regression based on intestinal protozoan infections showed that contact with animals (OR = 1.748, 95% CI = 1.168-2.617) and taking bath less than twice a week (OR = 1.820, 95% CI = 1.192-2.779) were significant risk factors of protozoan infections. CONCLUSIONS/SIGNIFICANCE: This present study indicated that intestinal protozoan infections are still a public health problem in Yemen, with Giardia and Entamoeba infections being most common. Statistical analysis indicated that low personal hygiene and contact with animals were important predictors for intestinal protozoan infections. As highlighted in this study, in order to effectively reduce these infections, a multi-sectoral effort is needed. Preventive measures should include good hygienic practices, good animal husbandry practices, heightened provision of educational health programs, health services in all governorates including rural areas. Furthermore, it is also essential to find radical solutions to the recent water crises in Yemen.

Cutaneous leishmaniasis (CL) is a neglected tropical disease endemic in the tropics and subtropics with a global yearly incidence of 1.5 million. Although CL is the most common form of leishmaniasis, which is responsible for 60% of DALYs lost due to tropical-cluster diseases prevalent in Yemen, available information is very limited.This study was conducted to determine the molecular characterization of Leishmania species isolated from human cutaneous lesions in Yemen. Dermal scrapes were collected and examined for Leishmania amastigotes using the Giemsa staining technique. Amplification of the ribosomal internal transcribed spacer 1(ITS-1) gene was carried out using nested PCR and subsequent sequencing. The sequences from Leishmania isolates were subjected to phylogenetic analysis using the neighbor-joining and maximum parsimony methods. The trees identified Leishmania tropica from 16 isolates which were represented by two sequence types.The predominance of the anthroponotic species (i.e. L. tropica) indicates the probability of anthroponotic transmission of cutaneous leishmaniasis in Yemen. These findings will help public health authorities to build an effective control strategy taking into consideration person-to-person transmission as the main dynamic of transmission of CL.

Background: The accuracy of the conclusions from in vivo efficacy anti-malarial drug trials depends on distinguishing between recrudescences and re-infections which is accomplished by genotyping genes coding P. falciparum merozoite surface 1 (MSP1) and MSP2. However, the reliability of the PCR analysis depends on the genetic markers’ allelic diversity and variant frequency. In this study the genetic diversity of the genes coding for MSP1 and MSP2 was obtained for P. falciparum parasites circulating in Yemen. Methods: Blood samples were collected from 511 patients with fever and screened for malaria parasites using Giemsa-stained blood films. A total 74 samples were infected with P. falciparum, and the genetic diversity was assessed by nested PCR targeting Pfmsp1 (Block2) and Pfmsp2 (block 3). Results: Overall, 58%, 28% and 54% of the isolates harboured parasites of the Pfmsp1 K1, MAD20 and RO33 allelic families, and 55% and 89% harboured those of the Pfmsp2 FC27 and 3D7 allelic families, respectively. For both genetic makers, the multiplicity of the infection (MOI) was significantly higher in the isolates from the foothills/coastland areas as compared to those from the highland (P<0.05). Pfmsp2 had higher number of distinct allelic variants than Pfmsp1 (20 vs 11). The expected heterozygosity (HE) for Pfmsp1 and Pfmsp2 were 0.82 and 0.94, respectively. Nonetheless, a bias in the frequency distribution of the Pfmsp1 allelic variants was noted from all areas, and of those of Pfmsp2 in the samples collected from the highland areas. Conclusions: Significant differences in the complexity and allelic diversity of Pfmsp1 and Pfmsp2 genes between areas probably reflect differences in the intensity of malaria transmission. The biased distribution of allelic variants suggests that in Yemen Pfmsp1 should not be used for PCR correction of in vivo clinical trials outcomes, and that caution should be exercised when employing Pfmsp2. [ABSTRACT FROM AUTHOR]