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Background: Postnatal care (PNC) is essential for early identification and management of life-threatening obstetric complications. Despite efforts by the Ethiopian government to improve maternal and child health service use, PNC service has remained low, and disparity across geographic locations is a major public health problem. This study aimed to investigate the change and contributing factors in PNC service use across geographical locations (rural-urban) and over time (2016 to 2019) in Ethiopia. Methods: We analyzed data on women who gave birth from the 2016 and 2019 Ethiopian Demographic and Health Surveys. A total of 6,413 weighted samples (4,308 in 2016 and 2,105 in 2019) were included in the analysis. A multivariate decomposition analysis technique was used to determine the change and identify factors that contributed to the change across geographical locations and over time. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05. Results: The prevalence of PNC use was higher among urban residents, and the urban-rural disparity reduced from 32.59% in 2016 to 19.08% in 2019. The difference in the composition of explanatory variables was the only statistically significant for the urban-rural disparity in PNC use in both surveys. Specifically, female household heads (4.51%), delivery at a health facility (83.45%), and birth order of two to three (5.53%) and four or more (-12.24%) in 2016 significantly contributed to the urban-rural gap. However, in 2019, middle wealth index (-14.66%), Muslim religion (3.84%), four or more antennal care contacts (18.29%), and delivery at a health facility (80.66%) significantly contributed to the urban-rural gap. PNC use increased from 16.61% in 2016 to 33.86% in 2019. About 60% of the explained change was due to the difference in the composition of explanatory variables. Particularly, urban residence (-5.79%), a rich wealth index (2.31%), Muslim (3.42%), and other (-2.76%) religions, having radio or television (1.49%), 1–3 (-1.13%), and 4 or more (11.09%) antenatal care contacts, and delivery at a health facility (47.98%) were statistically significant contributors to the observed change. The remaining 40% of the overall change was due to the difference in unknown behaviors (coefficient) of the population towards PNC. Conclusions: There was a significant change in PNC service use by residence location and over time in Ethiopia, with urban women in both surveys being more likely to use PNC service. The urban-rural disparity in PNC uptake was due to the difference in the composition of explanatory variables, whereas the change over time was due to the change in both the composition of explanatory variables and population behavior towards PNC. Increased antenatal care contacts and delivery at a health facility played a major role in explaining the gap in PNC services across residences and over time in Ethiopia, highlighting the importance of stepping up efforts to enhance their uptake in rural settings. [ABSTRACT FROM AUTHOR]

We present a time-lapse 4-D high-resolution synchrotron imaging study of the morphological evolution of methane gas bubbles and hydrate film growth on these bubbles. Methane gas and partially water-saturated sand were used to form hydrate with a maximum hydrate saturation of 60%. We investigated the transient evolution of gas bubble size distribution during hydrate formation and observed three distinct stages: a) nucleation and hydrate film formation, b) rapid bubble break-up, c) gas bubble coalescence and hydrate framework formation. Our results show that the average gas bubble size distribution decreases from 34.17 μιτι (during hydrate nucleation) to 8.87 μιτι (during secondary bubble formation). The small-size methane bubble population (mean diameter below 10 μm) initially increases at the expense of the larger methane bubble population (mean diameter above 50 μη) due to breakage of the larger bubbles and coalescence of the smaller bubbles. We quantified that the average hydrate film thickness increases from 3.51 to 14.7 μ!! by tracking the evolution of a particular gas bubble. This thickness increase agrees with an analytical model with an average deviation error of 3.3%. This study provides insights into gas bubble distribution and hydrate film growth during hydrate formation, both of which impact the geophysical and mechanical properties of hydrate-bearing sediments. [ABSTRACT FROM AUTHOR]

Background: The community-based health insurance (CBHI) scheme is a growing initiative aimed at enhancing healthcare access for the most impoverished members of the community. The Ethiopian CBHI scheme aims to enhance access to essential healthcare services, including medical laboratory services, for the poorest members of the community, but there is limited evidence on satisfaction levels. The aim of this study was to assess the satisfaction level of CBHI beneficiaries with laboratory services and their associated factors among selected public hospitals in Jimma Zone, Oromia Region, Ethiopia. Methods: A facility-based cross-sectional study was conducted on selected public hospitals in the Jimma Zone from September to October 2023. A total of 421 CBHI beneficiaries were enrolled in the study using a convenient sampling technique, and interviewers administered structured questionnaires to collect data. Data were entered into Epi-data and analyzed using the Statistical Package of Social Sciences version 25. Descriptive analysis was used to summarize independent variables; bivariate and multivariable logistic regression analyses were done to test the association between independent and dependent variables; and statistical significance was declared at P<0.05. Results: More than half (55.8%) of the 419 study participants were female. Above half, 57.5% of the respondents were satisfied by the clinical laboratory services at public hospitals in Jimma Zone. Components with a higher satisfaction rate were providers' professional appearances (98.3%), procedures for specimen collection (87.6%), and availability of entertainment facilities at the waiting area (67.8%). On the contrary, longer waiting times to receive the test results (76.6%), inefficiency of the reception area (74.7%), and the inability of professionals to explain diagnostic procedures (58.0%) were associated with higher rates of dissatisfaction. Educational status and the number of hospital visits were found to have a statistically significant association with level of satisfaction with laboratory services. Conclusions: CBHI beneficiaries' satisfaction with laboratory service was at a moderate level in Jimma Zone public hospitals. Therefore, attention should be given to continuous monitoring of patients' satisfaction with services, improving reception areas, and practicing routine explanations about the purposes and procedures during specimen collection to improve the beneficiaries' satisfaction level with clinical laboratory services. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic response has been hindered by the absence of an efficient antiviral therapy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The reason why the previous preventative approach to COVID-19 solely through vaccines has failed could be a lack of understanding of how quickly the SARS-CoV-2 virus evolves. Given the absence of specific treatments for the virus, efforts have been underway to explore treatment options. Drug repurposing involves identifying new therapeutic uses for approved drugs, proving to be a time-saving strategy with minimal risk of failure. In this study, we report the successful use of a multidrug approach in patients with COVID-19. Successful administration of multidrug therapy, such as combinations of hydroxychloroquine and azithromycin, doxycycline and ivermectin, or ivermectin, doxycycline, and azithromycin, has been reported. Multidrug therapy is effective because of the differing mechanisms of action of these drugs, and it may also mitigate the emergence of drug-resistant SARS-CoV-2 strains. The medicines were lopinavir/ritonavir (Kaletra), bamlanivimab (monoclonal antibody), glycopyrrolate-formoterol (Bevespi), ciclesonide (Alvesco), famotidine (Pepcid), and diphenhydramine (Benadryl). [ABSTRACT FROM AUTHOR]

The incorporation of converter-based generating sources in utility-scale microgrids causes frequency instability and low-frequency oscillations (LFOs), which is also a reason for degeneration in system stability. Damping frequency control is an essential part of alternating current (AC) microgrid system operation and control. Sudden changes in load, variations in renewable power outputs due to changes in solar insolation or wind speed, and so on factors cause the system frequency to deviate from the nominal value. Therefore, the role of a frequency controller is to maintain the dynamic stability in an AC microgrid by retaining the system frequency at the nominal value. Again, AC microgrids with high renewable power penetration face even more difficulty in maintaining frequency stability because of their poor inertial response. The research presented here proposes a novel approach for grid-connected AC microgrid oscillation damping and frequency control that simultaneously takes into consideration time delay and noise. To improve the frequency response and dampen LFOs by providing the voltage and frequency within the specified range, a coordinated technique-based control approach is adopted. In the developed hybrid control, the frequency controller relies on active power modulation, while the power oscillation damping controller is dependent on reactive power modulation. To improve stability and reduce communication consequences such as noise and signal latency (time delay), the developed power oscillation damping controller and frequency controller are coordinated along with the robust linear quadratic Gaussian controller. The comparative investigation of the effectiveness of the coordinated control technique is employed in the software of MATLAB/Simulink for grid-connected AC microgrid. The outcome of the simulation illustrates the superior effectiveness of the suggested controller over the traditional droop controller for huge power flows under disturbance with various operating conditions, under/overfrequency events, time delay, and noise. This grid encouragement capability for AC microgrids is anticipated to lead to novel possibilities for generating revenue. [ABSTRACT FROM AUTHOR]

Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother–infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02–2.48), had low maternal education (left school < year 12—RR: 1.75, 95%CI: 1.09–2.81; completed year 12—RR: 1.57, 95%CI: 1.02–2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged—RR: 1.89, 95%CI: 1.13–3.18; most disadvantaged—RR: 2.06, 95%CI: 1.25–3.38). Children's SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life. [ABSTRACT FROM AUTHOR]

The fabrication of compact heat exchangers with precisely designed micro- and mini-channels is crucial for enhancing the efficiency of thermal management systems. Friction stir channeling (FSC) emerges as a cost-effective advanced manufacturing process to create complex integral channels, offering channel shape and size flexibility. This review article highlights the pivotal role of processing parameters in channel formation and maintaining their integrity, necessitating a comprehensive understanding of material flow dynamics. A rigorous assessment has been conducted on the channel under mechanical stresses, including tension, bending, and fatigue. The paper emphasizes the potential of FSC to revolutionize heat sink applications by exploring the fundamental concepts, governing parameters, ongoing enhancements in tool design, microstructural and mechanical properties, and heat transfer performance. [ABSTRACT FROM AUTHOR]

Compact size of the heat exchange module is an important design consideration in majority of the thermal management systems. Using winglet type vortex generators, a sizeable improvement in the compactness of a widely used finned-tube array is attempted through this study. Since the degree of thermal augmentation changes with the generators' position, around the tubes, this 3D comprehensive computational investigation aims to develop phenomenological correlations for the positional optimization, which are applicable over a wide range of operating conditions. Besides, this article is dedicated to understanding different aspects of the augmentation mechanism, including the tube-wake management and the performance improvement caused by the best design(s). Based on a parametric investigation, designs that are best suited for obtaining a sizeable performance augmentation of the system are identified. Furthermore, a critical assessment of the best designs is carried out to evaluate their impact on the heat transfer from wake-affected surfaces, both fins and tubes. It is encouraging to observe that the wake-affected surfaces also experience sizeable thermal augmentation, which increases further with the Reynolds number. While the total fin surface experiences a highest Colburn j -factor augmentation of 53.6%, the wake-affected fin undergoes 205.1% rise. An evident manifestation of the augmented Colburn j -factor is the reformed temperature distribution, which bears lower values all over the fins. [ABSTRACT FROM AUTHOR]

The spouted fluidized bed process is a multiphase heat and mass transfer flow. The process requires effective solid-gas and solid-solid interaction. Various numerical models have been developed to understand and optimize these interactions. However, most of these models have used spherical particle definition, whereas the actual particles are non-spherical. Here we present coupled Computational Fluid Dynamics(CFD) and Discrete Element Method(DEM) based model to analyze the fluidized bed process for non-spherical particles (Faceted cylinder). The model results are validated with experimental results for spherical particles. The model is further used to understand mixing during the process as a function of non-spherical particle geometry. Aspect ratio and corner count were the geometrical input parameters for faceted cylinder-shaped particles. Transient plots for bubble diameter and bed height for spouted fluidized beds were created for all cases. The bubble diameter and bed height values were much lower for faceted cylinder particles than for spherical particles. For non-spherical particles, the increased number of corners was a crucial factor that brought the outcomes closer to those of spherical-shaped particles. The aspect ratio values increased, and the bubble diameter shrank as a result of more resistance to particle movement. The results would be of great use to correctly simulate non- spherical particles based fluidized bed process and optimize various process parameters. The coupled CFD-DEM method was used to analyze the hydrodynamics of spouted fluidized beds for spherical and faceted cylinder particles by plotting bubble diameter and bed height Analysis showed that non-sphericity brought resistance to the movement of particles inside the chamber, affecting efficient mixing between phases. The increased number of corners for non-spherical particles became the dominating parameter compared to aspect ratio for resembling results of fluidized beds closer to spherical-shaped particles. Post-processing of the results by division tagging showed that non-spherical particles have less tendency to mix than spherical particles. [ABSTRACT FROM AUTHOR]

The present study reports air-based novel energy saving compact bank type earth air heat exchanger system (EAHE) (having only 25m2 area) fabricated from Polyvinylchloride pipes of nominal diameter 0.203 mm (8 inches) for inlet and outlet headers and main pipes and 0.150 mm (6 inches nominal diameter) for branched pipes, which is installed in Shaheed Bhagat Singh State University, Ferozepur in Punjab state, India (North West border area of India) and studied for the duration from April to August 2021 using the full factorial design with four inlet variables at multilevel to find a model equation between inlet and outlet variables, i.e., heat exchanger effectiveness and achieved temperature difference. An induced airflow mode has been used to provide near-uniform flow through all corresponding pipes of symmetrical-shaped earth air heat exchangers. The values of Dry bulb temperature (DBT) and wet bulb temperature (WBT) have been measured for air inlet, for air outlet, as well as for ambient air using resistance temperature detectors (RTD) installed at the requisite locations. Earth's undisturbed temperature (EUT) was also noted by installing RTD at a depth of 2 m, and the average measured value of EUT is found to be 28.5°C. The current system has imparted the temperature difference variation from 0.4 oC to 9.4 oC, and the effectiveness varied from 0.16 to 0.82 during the whole season. This system could give a cooling potential of 0.0523 kJ/s to 1.587 kJ/s using a mass flow rate of 0.163 kg/s.Experiments have been designed methodically to apply the full factorial technique. Most favorable parameters have been found for hot and dry and hot and humid weather. The current study is novel in terms of significantly improving the effectiveness of EAHE and addressing the central issue of space limitation in urban areas. [ABSTRACT FROM AUTHOR]

Objectives: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits early in life. The aim of this study was to examine parental perceptions of the BSBF program and identify key facilitators and barriers for its implementation., Methods: Twelve mothers of children who participated in the BSBF program in five Early Childhood Education and Care (ECEC) settings in NSW, Australia were recruited in this qualitative study. Data were collected via focus groups and interviews, transcribed verbatim and coded to categorize for inductive thematic analysis., Results: Five major themes emerged: Promoters of the BSBF oral health program, barriers to the BSBF oral health program implementation and participation, online resources, impact of the BSBF oral health program, and strategies for enhancing the BSBF oral health program. While participants reported that the program encouraged their children's toothbrushing, they found issues with the program's materials, ECEC center attendance, and communication about the oral health program with their children. The program improved message retention, attitudes, routines, and family perceptions toward oral health. Participants recommended oral health literacy, changed delivery formats, increased dental access, and inclusion of interactive elements to enhance the program., Conclusions: The findings from this study provide insight to improve parents' experiences and engagement in oral health promotion. This can help to raise awareness of the importance of child oral health among policymakers, healthcare professionals, and the public to inform public health policy discussions., (© 2024 The Author(s). Journal of Public Health Dentistry published by Wiley Periodicals LLC on behalf of American Association of Public Health Dentistry.)

Purpose: The identification of anaerobes, Mycobacterium and Nocardia species, and moulds by MALDI-TOF-MS remains a challenge. This study aimed to evaluate the performance of MALDI-TOF in the identification of these organisms., Methods: A total of 382 strains, comprising 128 (33.5 %) anaerobes, 126(33.0 %) mycobacterial, 113(29.6 %), mycelial fungi, and 15(3.9 %) Nocardia species were evaluated by VITEK MS Version 3.0. The results were compared with the identification of the isolates by DNA sequence analysis. The DNA sequences used for analysis were the 16S rRNA for anaerobic bacteria, hsp65 gene for mycobacteria, whereas both 16S rRNA and hsp65 gene for Nocardia species, and internal transcribed spacer (ITS) and 28S rRNA gene's D1/D2 regions of fungi., Results: The VITEK-MS accurately identified 78.3 % (299/382) of the strains at the species, and 9.4 % (36/382) at the genus level. Misidentifications were observed in 3.9 % (15/382) isolates. Of isolates tested, 8.4 % (32/382) were not identified by the system, and 7.06 % (27/382) were not included in the IVD database., Conclusion: An upgraded VITEK MS V3.0 database provides reasonably accurate and rapid identification of clinically relevant anaerobes, mycobacteria, Nocardia species, and moulds to the species level., Competing Interests: Declaration of competing interest The author(s) declare that there are no conflicts of interest., (Copyright © 2024. Published by Elsevier Inc.)

Aim: To report local tumour control, metastasis and survival rates of patients with small choroidal melanoma (CM) after treatment with ruthenium-106 (Ru-106) plaque brachytherapy., Methods: Retrospective case series of 353 consecutive eyes with small CM (thickness ≤2.5 mm and largest basal diameter ≤16 mm) treated with Ru-106 brachytherapy at the London Ocular Oncology Service, between October 2004 and May 2019., Results: The final cohort included 310 eyes and tumour recurrence was observed in 52 (17%) eyes. Ocular retention rate was 96%. Metastatic disease and tumour-related death occurred in 18 (5.8%) and 12 (3.9%) patients, respectively. Metastases were diagnosed after a median of 54 (54±35; range 3.6-118) months from initial treatment. Kaplan-Meier estimates for tumour recurrence, melanoma-related metastases and survival were 17% (95% CI 13.3% to 22.9%), 4.8% (95% CI 2.6% to 8.5%) and 98% (95% CI 94.4% to 99.1%) at 5 years and 26% (95% CI 18.3% to 35.3%), 16% (95% CI 8.7% to 27.7%) and 92% (95% CI 84.5% to 95.7%) at 10 years, respectively. On multivariable analysis, factors predictive for tumour recurrence included juxtapapillary location, larger plaque and final tumour thickness, and for metastasis exudative retinal detachment., Conclusion: Small CMs treated with Ru-106 brachytherapy show recurrence and death rates of 17% and 2% at 5 years and 26% and 8% at 10 years. As small CMs have better prognosis than large tumours, early treatment is the key for better survival outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)