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C24H25FN4O10, triclinic, P1̄ (no. 2), a = 7.7217(3) Å, b = 9.9451(4) Å, c = 15.9291(6) Å, α = 101.741(1)∘, β = 98.762(1)∘, γ = 96.148(1)∘, V = 1171.56(8) Å3, Z = 2, Rgt(F) = 0.0389, wRref(F2) = 0.1162, T = 170 K.

Environmental nonprofit organizations (ENPOs) play a critical role in climate governance. Though ENPOs dedicate significant efforts to advocacy and providing public services, their interaction with public opinion on global warming has not been fully explored. Through multilevel regression analysis on county-level data in the U.S., this article examines the relationship between the presence of ENPOs and public perceptions of global warming, taking into account variations among ENPOs. The findings indicate that: (1) the overall presence of ENPOs is slightly, but not significantly, positively correlated with public perceptions of global warming, with advocacy-oriented ENPOs showing a more robust and statistically significant correlation; (2) there is an inverted-U relationship between the presence of ENPOs and public opinion on global warming, with advocacy-oriented ENPOs reaching tipping points earlier than service-oriented ENPOs; and (3) the partisanship of liberal counties influences this association. This study suggests a potential role for nonprofits in policymaking by interacting with public opinion.

Abstract The existing monocular depth estimation methods based on deep learning have difficulty in estimating the depth near the edges of the objects in an image when the depth distance between these objects changes abruptly and decline in accuracy when an image has more noises. Furthermore, these methods consume more hardware resources because they have huge network parameters. To solve these problems, this paper proposes a depth estimation method based on weighted fusion and point‐wise convolution. The authors design a maximum‐average adaptive pooling weighted fusion module (MAWF) that fuses global features and local features and a continuous point‐wise convolution module for processing the fused features derived from the (MAWF) module. The two modules work closely together for three times to perform weighted fusion and point‐wise convolution of features of multi‐scale from the encoder output, which can better decode the depth information of a scene. Experimental results show that our method achieves state‐of‐the‐art performance on the KITTI dataset with δ1 up to 0.996 and the root mean square error metric down to 8% and has demonstrated the strong generalisation and robustness.

There is significant communication and interdependence among the gut, the microbiome, and the brain during development. Diseases, such as necrotizing enterocolitis (NEC), highlight how injury to the immature gastrointestinal tract leads to long-term neurological consequences, due to vulnerabilities of the brain in the early stages of life. A better understanding of the developing gut–microbiota–brain axis is needed to both prevent and treat the devastating consequences of these disease processes. The gut–microbiota–brain axis is a bidirectional communication pathway that includes metabolic, nervous, endocrine, and immune components. In this review, we discuss gut development, microbiome colonization and maturation, and the interactions that influence neurodevelopment in the context of NEC. We describe the components of the gut–brain axis and how the microbiome is an integral member of this relationship. Finally, we explore how derangements within the microbiome and gut–microbiota–brain axis affect the normal development and function of the other systems and long-term neurodevelopmental consequences for patients.

Plaque vulnerability has been the subject of several recent studies aimed at reducing the risk of stroke and carotid artery stenosis. Atherosclerotic plaque development is a complex process involving inflammation mediated by macrophages. Plaques become more vulnerable when the equilibrium between macrophage recruitment and clearance is disturbed. Lipoperoxides, which are affected by iron levels in cells, are responsible for the cell death seen in ferroptosis. Ferroptosis results from lipoperoxide-induced mitochondrial membrane toxicity. Atherosclerosis in ApoE(−/−) mice is reduced when ferroptosis is inhibited and iron intake is limited. Single-cell sequencing revealed that a ferroptosis-related gene was substantially expressed in atherosclerosis-modeled macrophages. Since ferroptosis can be regulated, it offers hope as a non-invasive method of treating carotid plaque. In this study, we discuss the role of ferroptosis in atherosclerotic plaque vulnerability, including its mechanism, regulation, and potential future research directions.

Ovarian cancer is the second leading cause of death in women with gynecological malignancy in China. Circular RNAs are a class of noncoding regulatory RNAs reported to be involved in cancer development and progression. Previous studies, including our own, have indicated that hsa_circ_0007444 is downregulated in ovarian cancer tissues. This study aims to elucidate the function and mechanism of hsa_circ_0007444 in ovarian cancer progression. The expression of hsa_circ_0007444 is determined by quantitative real-time PCR (qRT-PCR). Cell proliferation, invasion, migration and apoptosis are examined by cell counting-kit 8 (CCK-8), transwell and flow cytometry assays. Tumor growth and metastasis are assessed in vivo using Balb/c nude mouse xenograft model and tail vein injection model. And the mechanism of action of hsa_circ_0007444 is analysed by RNA-binding protein immunoprecipitation (RIP), luciferase reporter and rescue assays. hsa_circ_0007444 is downregulated in ovarian cancer tissues and cell lines compared with that in normal ovarian tissues and normal epithelial cell line. Gain- and loss-of-function results indicate that hsa_circ_0007444 inhibits cell proliferation, invasion, migration and increases cell apoptosis of ovarian cancer cells in vitro, and inhibits tumor growth and lung metastasis in vivo. Mechanistically, hsa_circ_0007444 can interact with AGO2 and sponge miR-23a-3p, thereby upregulating DICER1 expression, which is an important tumor suppressor in ovarian cancer. And miR-23a-3p mimics can rescue the inhibitory effect of hsa_circ_0007444 on ovarian cancer cell proliferation, invasion and migration. Therefore, hsa_circ_0007444 can inhibit ovarian cancer progression through the hsa_circ_0007444/miR-23a-3p/DICER1 axis.

In this study, a dual-probe competitive enzyme-linked immunosorbent assay (ELISA) based on magnetic nanoparticles for the simultaneous detection of fumonisin B1 (FB1), FB2 and FB3 in maize samples was established. A magnetic capture probe (MNPs-FB1) was synthesized by the active ester method, and a monoclonal antibody-horseradish peroxidase (McAb-HRP) probe was prepared by a modified sodium periodate method. The reaction conditions of the assay were optimized. The linear ranges for FB1 and the total amount of FB1, FB2 and FB3 (FBs) were 0.07–1.98 and 0.10–9.86 ng/mL, respectively. The average recoveries of FBs from spiked maize samples ranged from 86.2% to 105.1%. The correlation coefficient between the results of the developed assay and those of liquid chromatography-tandem mass spectrometry (LC-MS/MS) was 0.996 6. These results suggest that this assay is characterized by rapidity, high accuracy and good repeatability and provides a new method for the detection of FBs in maize samples.

Despite advances in antiemetics and protocolized postoperative nausea vomiting (PONV) management, it remains one of the most common postoperative adverse events. In patients who developed PONV despite antiemetic prophylaxis, giving a rescue treatment from the same class of medication is known to be of limited efficacy. Given the widespread use of 5-HT3 antagonists as PONV prophylaxis, another class of effective intravenous rescue antiemetic is in dire need, especially when prophylaxis fails, and rescue medication is utilized. Dopamine antagonists were widely used for the treatment of PONV but have fallen out of favor due to some of their side effect profiles. Amisulpride was first designed as an antipsychotic medication but was found to have antiemetic properties. Here we will review the historical perspective on the use of dopamine receptor antagonist antiemetics, as well as the evidence on the efficacy and safety of amisulpride.

Introduction: Artesunate, a derivative of artemisinin, has anti-malarial effects, and in recent years has also been reported to have anti-tumor activity. However, its anti-tumor mechanisms are not well understood.Methods: In this study, we focused on the targeting of Hsp90 by artesunate to inhibit tumor cell proliferation, which we examined using immunoprecipitation, a proliferation assay, flow cytometry, western blotting, a tumor xenograft animal model, and immunohistochemistry. Furthermore, to examine the tumor-suppressive effects of artesunatein nude mice, we used artesunate-loaded PLGA-PEG nanoparticles.Results: The binding of artesunate to Hsp90 was found to reduce the expression of its client proteins AKT, ERK, p-AKT, p-ERK, and EGFR, thereby blocking the cell cycle at the G0/G1 → S stage in lymphoma cells and inducing apoptosis. In addition, the results of tumor xenograft experiments revealed that artesunate reduced the expression of AKT and ERK proteins in tumor tissues, inhibited tumor proliferation, and reduced tumor size and weight. Furthermore, nanoparticle encapsulation was demonstrated to enhance the anti-cancer activity of artesunate.Discussion: We thus established that artesunate inhibits the proliferation of lymphoma cells by targeting the Hsp90 protein, and we accordingly believe that this compound has potential for development as a novelanti-tumor drug.

Physalis pubescens L. is an annual or perennial plant in the family Solanaceae It is used in traditional medicine for treating sore throats, coughs, urinary discomfort, and astringent pain, and externally for pemphigus and eczema in northern China. The proliferation inhibitory activity and mechanisms of the ethyl acetate extract (PHY-EA) from the leaves of Physalis pubescens were investigated. High performance liquid chromatography was used to identify the chemical composition of PHY-EA; sulforhodamine B was used to detect the proliferation inhibitory effect of PHY-EA on MCF-7, CA-46, Hela, HepG2, B16, and other tumor cells; flow cytometry was used to detect the effect of PHY-EA on the lymphoma cell cycle and apoptosis; Western blot was used to detect the expression of the cycle- and apoptosis-related proteins. The expression of Ki-67 and cleaved caspase 3 was detected by immunohistochemistry. The results showed that PHY-EA contained physalin B, physalin O, and physalin L. PHY-EA blocked the cell cycle of G2/M→G0/G1 in lymphoma cells and induced apoptosis in tumor cells. Mouse transplantation tumor experiments showed that PHY-EA had a significant inhibitory effect on mouse transplantation tumors, and the tumor volume and weight were significantly reduced. In conclusion, PHY-EA has a good antiproliferative effect on Burkkit lymphoma, indicating its potential medicinal value.

This study used Cite Space to analyse the domestic literature on feedback recommendation applications between 2003 and 2023. It is found that domestic scholars have conducted in-depth research in the areas of recommender systems, collaborative filtering, and implicit feedback, focusing on hotspots such as deep learning, matrix decomposition, and user feedback. Although the existing research focuses on improving the efficiency of information access and user satisfaction, the in-depth research on multi-source feedback integration methods still faces challenges. Future research can leverage new technologies such as deep learning to mine more user behaviour data and achieve more accurate personalized recommendations.

CRISPR-based genome editing technologies continue to drive major advances in life sciences. A major challenge for realizing widespread use of genome editing in plants and agriculture is establishing methods that enable the rapid, comprehensive, and precise evaluation of editing technologies using transient methods. Here we report a new and rapid genome editing evaluation method using Agrobacterium infiltration techniques to enable broad-spectrum, simplistic, and precise assessments of genome editing efficiencies. We employed an anthocyanin marker to facilitate visual screenings of genome-edited cells for use in adult strawberry fruits as well as tomato fruits, cotton leaves, and sugar beet leaves. Using this method, we demonstrate the ability to quickly measure genome editing efficiencies mediated by SpCas9, LbCas12a, A3A-PBE, ABE8e, and PPE. This new method will allow researchers to rapidly and easily evaluate genome editing tools across a broad spectrum of plant species, further expediting the development of genome-edited agricultural crops.

Objective To explore the risk factors of pain in de novo Parkinson's disease (PD) patients. Methods A total of 129 de novo PD patients collected from The Affiliated Brain Hospital of Nanjing Medical University from October 2018 to September 2021 were included. According to the Item ⁃17 of the Unified Parkinson's Disease Rating Scale Ⅱ (UPDRSⅡ⁃17th), patients were classified as PD patients without pain (UPDRSⅡ⁃17th was 0, n = 88) and PD patients with pain (UPDRSⅡ⁃17th ≥ 2, n = 41）. Mini⁃ Mental State Examination (MMSE) and corrected Montreal Cognitive Assessment (corrected MoCA) were used to assess cognitive function. Meanwhile, Hamilton Depression Rating Scale ⁃24 Items (HAMD ⁃24) was used to assess the depression status and the UPDRSⅢ was used to assess the motor function. The modified version of Hoehn ⁃Yahr staging was used to assess disease severity. The related risk factors of pain in PD patients were analyzed by univariate and multivariate forward Logistic regression. Results The in of pain in PD patients was 31.78% (41/129). Compared with PD without pain group, PD with pain group had lower scores in MMSE (Z = ﹣2.389, P = 0.017) and corrected MoCA (Z = ﹣2.166, P = 0.030), but higher scores in HAMD-24 (Z = ﹣4.024, P = 0.000), UPDRS Ⅲ (Z = ﹣3.639, P = 0.000）and Hoehn-Yahr staging grading (Z = ﹣2.232, P = 0.026). Further analysis of the differences between 2 groups in 7 domains of HAMD-24 showed PD with pain group had higher scores of the anxiety/somatization (Z = ﹣3.707, P = 0.000), mental disorder (Z = ﹣2.519, P = 0.012), retardation symptom (Z = ﹣2.048, P = 0.041), sleep disturbances (Z = ﹣3.484, P = 0.000) and despair symptom (Z = ﹣3.069, P = 0.002) than PD without pain group. Logistic regression analysis showed long duration (OR = 1.354, 95%CI: 1.013-1.809; P = 0.041), high HAMD-24 score (OR = 1.095, 95%CI: 1.033-1.162; P = 0.002) and high UPDRS Ⅲ score (OR = 1.040, 95%CI: 1.001- 1.082; P = 0.046) were risk factors of pain in PD patients. Conclusions Pain in PD has a high incidence in de novo PD patients. Long duration, a depressed state and severe motor symptoms are main risk factors for the development of pain in PD patients.

Fog computing, which provides low-latency computing services at the network edge, is an enabler for the emerging Internet of Things (IoT) systems. Offloading tasks to the fog that is closer to IoT users for processing has become a means to ensure that tasks are completed quickly. Fog computing cannot only reduce the congestion of the backbone network but also ensure that the task is completed within the specified time. Since fog resources are limited, there will be resource competition among IoT devices. How to quickly and efficiently make an optimal computation offloading decision for individual selfish IoT devices is a fundamental research issue. This article regards the process of multiple IoT devices competing for fog devices as a game and proposes a distributed computation offloading algorithm. The goal is to optimize the balance of computation delay, energy consumption, and cost for fog nodes. The competition between IoT nodes eventually reaches an equilibrium point, that is the Nash equilibrium point. We prove the existence of Nash equilibrium by Weighted Potential Game. In addition, if a large number of IoT devices select the same node for offloading, which will cause the fog node to run out of power and make some networks unable to work normally. Further, causing part of the network to be paralyzed. Therefore, the paper considers the fairness of offloading to extend the network life cycle. A calculation rate adjustment algorithm is designed for the fairness of offloading to ensure that fog nodes do not run out of power and fail. This paper not only fully considers the performance of the IoT device, but also considers the fairness of the fog. Numerous experiments proved the effectiveness of the proposed algorithm.

ObjectiveThis study aimed to investigate a new noninvasive traction method on the treatment of severe cervical kyphotic deformity.MethodsThe clinical data of patients with severe cervical kyphosis (Cobb > 40°) treated in Peking University Third Hospital from March 2004 to March 2020 were retrospectively summarized. 46 cases were enrolled, comprising 27 males and 19 females. Fifteen patients underwent skull traction, and 31 patients underwent suspensory traction. Among them, seven used combined traction after one week of suspensory traction. Bedside lateral radiographs were taken every two or three days during traction. The cervical kyphosis angle was measured on lateral radiographs in and extended position at each point in time. The correction rate and evaluated Japanese Orthopedic Association (JOA) scoring for the function of the spinal cord were also measured. The data before and after the operation were compared with paired sample t-test or Wilcoxon signed-rank test.ResultsNo neurological deterioration occurred during the skull traction and the cervical suspensory traction. There were 12 patients with normal neurological function, and the JOA score of the other 34 patients improved from 11.5 ± 2.8 to 15.4 ± 1.8 at the end of follow up (P

A method of high performance liquid chromatography tandem high resolution mass spectrometry (HPLC-HRMS) was developed for the separation and identification of chemical components in Rheum lhasaense A. J. Li et P. K. Hsiao extract. The separation of compounds was carried out on an Agilent Zorbax SBC18 column (150 mm×4.6 mm×5 μm). The mobile phase was composed with acetonitrile and water with the flow rate of 0.5 mL/min. Electrospray ionisation source (ESI) was used, and Rheum lhasaense A. J. Li et P. K. Hsiao extract was analyzed by MS and MSn full scan at positive and negative ion modes. Through comprehensive analysis of the mass spectra and chromatographic behaviors of the compounds, and comparing with the related data from standard substrates, literatures and database, the main chemical components of Rheum lhasaense A. J. Li et P. K. Hsiao extract were deduced and identified. A total of 63 compounds are identified from Rheum lhasaense A. J. Li et P. K. Hsiao extract at negative ion mode, and 54 compounds are identified at positive ionization mode. These compounds contain 22 tannins, 28 stilbenes, 6 flavonoids, 3 phenylpropanoids, 2 butyrophenones and 2 organic acids, which of 53 compounds are firstly discovered in Rheum lhasaense A. J. Li et P. K. Hsiao. And as reported in the literature, enquinones are not found. This method is fast and sensitive, which not only improves the identification efficiency of trace compounds in Rheum lhasaense A. J. Li et P. K. Hsiao complex matrix, but also achieves the analysis and identification of different types of compounds. It is helpful to provide scientific basis for further clarifying the material basisand quality control standards of Rheum lhasaense A. J. Li et P. K. Hsiao.

In planetary science, it is an important basic work to recognize and classify the features of topography and geomorphology from the massive data of planetary remote sensing. Therefore, this article proposes a lightweight model based on VGG-16, which can selectively extract some features of remote sensing images, remove redundant information, and recognize and classify remote sensing images. This model not only ensures the accuracy, but also reduces the parameters of the model. According to our experimental results, our model has a great improvement in remote sensing image classification, from the original accuracy of 85%–98% now. At the same time, the model has a great improvement in convergence speed and classification performance. By inputting the remote sensing image data of ultra-low pixels (64 * 64) into our model, we prove that our model still has a high accuracy rate of 95% for the remote sensing image with ultra-low pixels and less feature points. Therefore, the model has a good application prospect in remote sensing image fine classification, very low pixel, and less image classification.

Low back pain (LBP) is one of the most common occupational injuries that nurses experience in their daily work, which ultimately causes disability or difficulty in performing heavy physical activity. There is scarce information that presents a direct figure about the prevalence of LBP in Chinese nurses.

In order to solve the problem that the total sugar content of the chlortetracycline fermentation tank can not be automatically detected online, a prediction method which combines the output recursive wavelet neural network and the Gauss process regression is proposed in this paper. A soft sensor model between the measurable parameters (inputs) and the total sugar content (output) of the chlortetracycline fermentation tank was established. The soft sensor model was trained by self updating algorithm. Based on field data, the accuracy and generalization ability of the soft sensor model were analyzed. It is shown that the prediction accuracy of the combined model proposed in this paper is better than that of other single models. The results demonstrate the superiority of the method, and MRE and RMSE are used to evaluate the performance of the soft sensor model. It shows that the prediction precision of the soft sensor model based on ORWNN-GPR combination is relatively high in the long period of fermentation, and is suitable for on-line prediction of the total sugar content of the chlortetracycline fermentation tank. The soft sensor method can effectively reduce the labor intensity of the analysts and saves the production cost for enterprise.

The mechanical properties of hybrid fibre (polypropylene and wood)-reinforced expanded polystyrene (EPS) lightweight aggregate concrete was studied under various sand contents. Cubic and prismatic compression tests were carried out, through which the basic mechanical properties and stress-strain curves of the specimens were obtained. Moreover, the microstructures of the fibre-reinforced concrete with different sand proportions were analysed via scanning electron microscopy (SEM). The test results showed that as the sand proportion increased, the cubic compressive strength and prismatic compressive strength of the EPS lightweight aggregate concrete increased. The optimal slump was obtained when the sand ratio was 25%, after which the slump declined. The EPS lightweight aggregate concrete exhibited obvious elastoplastic behaviour during compression, and the corresponding stress-strain curve could be divided into four stages: the elastic stage, strengthening stage, softening stage and collapse platform stage. Moreover, based on the test results and the damage theory and considering the coupling relationship between plasticity and damage, a damage constitutive model was proposed for hybrid fibre-reinforced EPS lightweight aggregate concrete under uniaxial compression.

ObjectivesThe objective of this study was to evaluate a person-centered abortion care mobile-based intervention on perceived social stigma, social support, mental health and post-abortion care experiences among Kenyan women who received abortion services at private clinics.MethodsThis randomized controlled study enrolled women who obtained an abortion from private clinics in Nairobi county, Kenya and randomized them into one of three study arms: 1) standard of care (follow-up by service provider call center); 2) post-abortion phone follow-up by a peer counselor (a woman who has had an abortion herself and is trained in person-centered abortion care); or 3) post-abortion phone follow-up by a nurse (a nurse who is trained in person-centered abortion care). All participants were followed-up at two- and four-weeks post-abortion to evaluate intervention effects on mental health, social support, and abortion-related stigma scores. A Kruskal-Wallis one-way ANOVA test was used to assess the effect of each intervention compared to the control group. In total, 371 women participated at baseline and were each randomized to the study arms.ResultsUsing Kruskal-Wallis tests, the nurse arm improved mental health scores from baseline to week two; however this was only marginally significant (p = 0.059). The nurse arm also lowered stigma scores from baseline to week four, and this was marginally significant (p = 0.099). No other differences were found between the study arms. This person-centered mobile phone-based intervention may improve mental health and decrease perceived stigma among Kenyan women who received abortion services in private clinics.ConclusionsNurses trained in person-centered abortion care, in particular, may improve women's experiences post-abortion and potentially reduce feelings of shame and stigma and improve mental health in this context.

Binary expression systems like the LexA-LexAop system provide a powerful experimental tool kit to study gene and tissue function in developmental biology, neurobiology, and physiology. However, the number of well-defined LexA enhancer trap insertions remains limited. In this study, we present the molecular characterization and initial tissue expression analysis of nearly 100 novel StanEx LexA enhancer traps, derived from the StanEx1 index line. This includes 76 insertions into novel, distinct gene loci not previously associated with enhancer traps or targeted LexA constructs. Additionally, our studies revealed evidence for selective transposase-dependent replacement of a previously-undetected KP element on chromosome III within the StanEx1 genetic background during hybrid dysgenesis, suggesting a molecular basis for the over-representation of LexA insertions at the NK7.1 locus in our screen. Production and characterization of novel fly lines were performed by students and teachers in experiment-based genetics classes within a geographically diverse network of public and independent high schools. Thus, unique partnerships between secondary schools and university-based programs have produced and characterized novel genetic and molecular resources in Drosophila for open-source distribution, and provide paradigms for development of science education through experience-based pedagogy.

When some parts of the world are still debating whether the public wearing masks will help prevent and control the COVID-19. We have used questionnaires to investigate the wearing of masks and its influencing factors among residents in 11 cities in Shanxi Province. The questionnaire was designed based on the health belief model. We processed the collected data using the structural equation method. The results we got are as follows: (1) the average score of perceived severity is 3.14, indicating that the respondents had a strong sense of risk; (2) The average score of perceived benefits was 4.00, indicating that respondents thought that wearing masks can prevent COVID-19; (3) The average score of perceived barriers was 2.42, indicating that the respondents believed that there were fewer barriers against wearing masks during the epidemic; (4) The average score of perceived susceptibility was 3.23, indicating that respondents believed that they had a strong risk awareness of COVID-19 infection; (5) The average score of self-efficacy was 4.00, indicating that respondents had a strong belief in wearing masks correctly. The structural equation model shows that self-efficacy (λ = 0.40) and perceived susceptibility (λ = −0.15) had direct effects on the behavior of wearing masks. A wide range of mediating effects exists in the model. Perceived severity has an effect on the behavior of wearing masks through perceived susceptibility (λ = 0.41), perceived benefits through self-efficacy (λ = 0.68) and perceived susceptibility (λ = −0.35), and perceived barriers through self-efficacy (λ = −0.28). People are in the early adopter phase. Each dimension has a direct or indirect impact on the wearing of masks during the COVID-19 epidemic.

Background: Globally, opportunities to validate government reports through external audits are rare, notably in India. A cross-sectional maternal health study in Uttar Pradesh, India’s most populous state, compares government administrative data and externally collected data on maternal health service indicators. Objectives: Our study aims to determine the level of concordance between government-reported health facility data compared to externally collected health facility data on the same maternal healthcare quality indicators. Second, our study aims to explore whether the level of agreement between government administrative data versus the externally collected data differs by level of facility or by type of maternal health service. Methods: Facility assessment surveys were administered to key health staff by government-hired enumerators from January 2017 to March 2017 at nearly 750 government health facilities across UP. The same survey was re-conducted by external data collectors from August 2017 to October 2017 at 40 of the same facilities. We conduct comparative analyses of the two datasets for agreement among the same measures of maternal healthcare quality. Results: The findings indicate concordance between most indicators across government administrative data and externally collected health facility data. However, when stratified by facility-level or service type, results suggest significant over-reporting in the government administrative data on indicators that are incentivized. This finding is consistent across all levels of facilities; however, the most significant disparities appear at higher-level facilities, namely District Hospitals. Conclusion: This study has a number of important programmatic and policy implications. Government administrative health data have the potential to be highly critical in informing large-scale quality improvements in maternal healthcare quality, but its credibility must be readily verifiable and accessible to politicians, researchers, funders, and most importantly, the public, to improve the overall health, patient experience, and well-being of women and newborns.

BACKGROUND:Program decision-making for trachoma elimination currently relies on conjunctival clinical signs. Antibody tests may provide additional information on the epidemiology of trachoma, particularly in regions where it is disappearing or elimination targets have been met. METHODS:A cluster-randomized trial of mass azithromycin distribution strategies for trachoma elimination was conducted over three years in a mesoendemic region of Niger. Dried blood spots were collected from a random sample of children aged 1-5 years in each of 24 study communities at 36 months after initiation of the intervention. A multiplex bead assay was used to test for antibodies to two Chlamydia trachomatis antigens, Pgp3 and CT694. We compared seropositivity to either antigen to clinical signs of active trachoma (trachomatous inflammation-follicular [TF] and trachomatous inflammation-intense [TI]) at the individual and cluster level, and to ocular chlamydia prevalence at the community level. RESULTS:Of 988 children with antibody data, TF prevalence was 7.8% (95% CI 6.1 to 9.5) and TI prevalence was 1.6% (95% CI 0.9 to 2.6). The overall prevalence of antibody positivity to Pgp3 was 27.2% (95% CI 24.5 to 30), and to CT694 was 23.7% (95% CI 21 to 26.2). Ocular chlamydia infection prevalence was 5.2% (95% CI 2.8 to 7.6). Seropositivity to Pgp3 and/or CT694 was significantly associated with TF at the individual and community level and with ocular chlamydia infection and TI at the community level. Older children were more likely to be seropositive than younger children. CONCLUSION:Seropositivity to Pgp3 and CT694 correlates with clinical signs and ocular chlamydia infection in a mesoendemic region of Niger. TRIAL REGISTRATION:ClinicalTrials.gov NCT00792922.