Search

Real-world data on treatment outcomes or the quality of large-scale chronic hepatitis B (CHB) treatment programs in sub-Saharan Africa (SSA) is extremely difficult to obtain. In this study, we aimed to provide data on the prevalence and incidence of mortality, loss to follow-up (LFTU), and their associated factors in patients with CHB in three treatment centres in Eritrea. Additional information includes baseline clinical profiles of CHB patients initiated on nucleos(t)ide analogue (NUCs) along with a comparison of treatment with Tenofovir disoproxil fumarate (TDF) vs. TDF + Lamuvudine (LAM) using specific biochemical, haematological and virologic parameters. A multicenter retrospective cohort study was conducted on CHB patients in Asmara, Eritrea (2018–2021). Demographic, clinical, and laboratory information was collected from medical records using a structured checklist. Relevant parametric and nonparametric statistics were employed to explore treatment outcomes and to evaluate differences between groups. Where appropriate, Kaplan-Meier (KM) curves and univariate and multivariate Cox regression models were implemented. A two-sided p-value < 0.05 was considered significant. A total of 413 patients with HBV (median age (IQR) at diagnosis: 39 (IQR: 28–50 years; females: 118(28.6%); followed for a total of 22,921 person days) were studied. HBV/HIV co-infection was observed in 15(3.6%) and baseline ALT and AST were elevated in 99(31.2%) and 101(32.8%), respectively. The Fibrosis-4 (FIB-4) index estimates suggested that cirrhosis was highly likely in 33 (14%) patients with 49 (20.8%) patients in the indeterminate FIB-4 score category. During the follow-up period, 4.6% (95% CI: 2.5–6.6%) died, while 23.9% (95% CI: 19.8–28%) were LTFU. In the adjusted Cox proportional hazards model, LTFU were independently associated with baseline serum HBV DNA (IU/mL) (aHR = 1.3, 95% CI 1.04–1.7; p-value = 0.02); Not initiated on NUC (aHR = 3.9, 95% CI: 1.1–13.7, p-value = 0.02); and FIB-4 Score (aHR = 1.05, 95% CI: 1-1.1; p-value = 0.01). Of the 413 patients enrolled in the study, 98 cases (23.73%) were initiated on treatment. In the head-to-head comparison of the results in TDF and TDF + LAM after 12 weeks of treatment, VR was observed in 14(45.2%) vs. 17(54.8%), respectively, translating into an overall VR of 60.7% (95% CI 46.9–74.6). Furthermore, VR in TDF vs. TDF + LAM were similar, 14(45.2%) vs. 17(54.4%) respectively, p-value = 0.3). This study uncovered multiple systems- and patient-centered gaps in the three HBV treatment programs in Asmara, Eritrea. These include late presentation, high incidence of LTFU, inconsistencies in routine data, and poor data management. Interventions should target improvements in laboratory infrastructure, adherence to patient monitoring guidelines, HBV literacy, better tracking of patients, and documentation of patient's information. [ABSTRACT FROM AUTHOR]

The Hawzien-Ger’alta area is home to several remarkable Medieval rock-hewn churches that hold great religious, historical, and geoheritage significance. These churches are currently facing a range of detrimental issues. These include the deterioration of architectural features and decorative elements, fading, peeling, obscuring and concealing of paintings, weakening and collapse of the churches’ structural integrity, and spalling and pitting in the pillars, walls, and roofs. To assess these challenges, a comprehensive investigation of the geological and geotechnical properties of the rock mass from which the churches are carved has been conducted using the Rock Mass Rating (RMR) and rock mass stability (Q) techniques. The findings of this investigation reveal that the churches are carved from weak to medium-strength rock masses. These geotechnical properties imply significant challenges on the long-term stability of the Hawzien-Ger’alta rock-hewn churches and their preservation. These challenges arise from both inherent geotechnical problems (weathering and material loss, discontinuities, groundwater seepage, and surface water infiltration) and human-induced factors (such as improper restoration works). To tackle these challenges, several measures need to be implemented. These include raising public awareness and providing education on the importance of proper restoration, and some urgent technical measures in some of the churches, such as reinforcement to enhance structural stability, and effective water management systems to mitigate water-related degradation. There is also an urgent need to set up preservation guidelines to enhance restoration efforts and foster collaborative partnerships to strengthen conservation initiatives. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a major public health challenge in Ethiopia. TB treatment outcomes were suboptimal compared to the expected target of the national TB control Program. The provision of standard anti-TB treatment is the primary component of the directly observed treatment, short-course strategy. The aim of this study was to assess the TB treatment outcomes and the determinants of an unfavorable treatment outcome. The study used a cross-sectional study design at baseline and record review to identify treatment outcomes. A total of 1,161 TB patients were recruited from eight randomly selected districts and one town administration in the Jimma Zone, Ethiopia. Treatment outcomes were grouped into favorable and unfavorable. Of the total participants, 86.9% had a favorable treatment outcome, and 5.7% an unfavorable treatment outcome. The rest were transferred out and not recorded cases. Women were more likely to experience an unfavorable treatment outcome [adjusted odds ratio (AOR) = 1.96, 95% CI 1.06, 3.64]. Patients who were perceived to not be stigmatized were less likely to have an unfavorable treatment outcome (AOR = 0.32, 95% CI 0.15, 0.73). Patients who had a monthly income of > 3,500 Ethiopian birr were less likely to have an unfavorable outcome than patients who did not have a regular income (AOR = 0.04, 95% CI 0.01, 0.45). The observed treatment success rate is lower than the World Health Organization’s target of successfully treating > 90% of detected TB cases. It is imperative to ensure that information, education and communication/behavior change communication strategies consider the needs of women and patients with perceived TB stigma. Furthermore, designing locally acceptable and affordable interventions may help to address the financial challenges of TB treatment adherence. [ABSTRACT FROM AUTHOR]

Current poultry vaccines against influenza A viruses target the globular head region of the hemagglutinin (HA1), providing limited protection against antigenically divergent strains. Experimental subunit vaccines based on the conserved ectodomain of the matrix protein 2 (M2e) induce cross-reactive antibody responses, but fail to fully prevent virus shedding after low pathogenic avian influenza (LPAI) virus challenge, and are ineffective against highly pathogenic avian influenza (HPAI) viruses. This study assessed the benefits of combining nanoparticles bearing three tandem M2e repeats (NR-3M2e nanorings or NF-3M2e nanofilaments) with an HA1 subunit vaccine in protecting chickens against a heterologous HPAI H5N1 virus challenge. Chickens vaccinated with the combined formulations developed M2e and HA1-specific antibodies, were fully protected from clinical disease and mortality, and showed no histopathological lesions or virus shedding, unlike those given only HA1, NR-3M2e, or NF-3M2e. Thus, the combined vaccine formulations provided complete cross-protection against HPAI H5N1 virus, and prevented environmental virus shedding, crucial for controlling avian influenza outbreaks. [ABSTRACT FROM AUTHOR]

Uptake of the COVID-19 vaccine among pregnant persons is lower than the general population. This scoping review explored pregnant people's attitudes towards the COVID-19 vaccine, reasons for vaccine hesitancy, and whether attitudes about COVID-19 vaccines differ by country of origin. A scoping review was conducted across PubMed, Embase, CINHAL, and Scopus. Inclusion criteria were articles published in English from 2019–2022 focused on attitudes towards COVID-19 vaccination among pregnant persons. Data analysis was done via the 5Cs framework for vaccine hesitancy: Constraints, Complacency, Calculation, Confidence, and Collective Responsibility. 44 articles were extracted. A lack of confidence in vaccine safety was the most prevalent theme of hesitancy among pregnant persons. This was largely driven by a lack of access to information about the vaccine as well as mistrust of the vaccine and medical professionals. Meanwhile, vaccine acceptance was mostly driven by a desire to protect themselves and their loved ones. Overall, COVID-19 vaccine hesitancy among pregnant persons continues to be high. Vaccine hesitancy is primarily driven by fear of the unknown side effects of the vaccine on pregnant persons and their fetuses along with a lack of information and medical mistrust. Some differences can be seen between high income and low- and middle-income countries regarding vaccine hesitancy, showing that a single solution cannot be applied to all who are vaccine hesitant. General strategies, however, can be utilized to reduce vaccine hesitancy, including advocating for inclusion of pregnant persons in clinical trials and incorporating consistent COVID-19 vaccine counseling during prenatal appointments. [ABSTRACT FROM AUTHOR]

Accurate estimation of infiltration rates is crucial for effective irrigation system design and evaluation by optimizing irrigation scheduling, preventing soil erosion, and enhancing water use efficiency. This study evaluates and compares selected infiltration models for estimating water infiltration rates in the Shillanat-iv irrigation scheme in northern Ethiopia. Soil samples were collected to determine textural classes using hydrometer soil texture analysis and the United States Department of Agriculture (USDA) textural triangle. The soil textural map of the study was created using the inverse distance weight interpolation technique in ArcGIS version 10.4. Infiltration rates were measured using the double-ring infiltrometer for five soil textures: clay loam, loam, sandy clay loam, clay, and sandy loam. Six infiltration models (Kostiakov, Modified Kostiakov, Revised Modified Kostiakov, Philip, Horton, and Novel) were employed and evaluated using statistical parameters. Model calibration and validation were conducted using data from 38 points within the study area. The parameter values of the infiltration models were optimized using SPSS statistical software using least-squares errors. The results showed that, Revised Modified Kostiakov, Modified Kostiakov, and Novel infiltration models demonstrated superior capability in estimating infiltration rates for clay loam, loam, and sandy loam soil textures, respectively. Horton's model outperformed other models in estimating infiltration rates for both sandy clay loam and clay soil textures. The appropriately fitted infiltration models can be utilized in designing the irrigation system to estimate the infiltration rate of soil textures within the selected irrigation scheme and at similar sites with comparable soil textures. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background and Objective: The combination of niraparib and abiraterone acetate (AA) plus prednisone is under investigation for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) and metastatic castration-sensitive prostate cancer (mCSPC). Regular-strength (RS) and lower-strength (LS) dual-action tablets (DATs), comprising niraparib 100 mg/AA 500 mg and niraparib 50 mg/AA 500 mg, respectively, were developed to reduce pill burden and improve patient experience. A bioequivalence (BE)/bioavailability (BA) study was conducted under modified fasting conditions in patients with mCRPC to support approval of the DATs. Methods: This open-label randomized BA/BE study (NCT04577833) was conducted at 14 sites in the USA and Europe. The study had a sequential design, including a 21-day screening phase, a pharmacokinetic (PK) assessment phase comprising three periods [namely (1) single-dose with up to 1-week run-in, (2) daily dose on days 1–11, and (3) daily dose on days 12–22], an extension where both niraparib and AA as single-agent combination (SAC; reference) or AA alone was continued from day 23 until discontinuation, and a 30-day follow-up phase. Patients were randomly assigned in a parallel-group design (four-sequence randomization) to receive a single oral dose of niraparib 100 mg/AA 1000 mg as a LS-DAT or SAC in period 1, and patients continued as randomized into a two-way crossover design during periods 2 and 3 where they received niraparib 200 mg/AA 1000 mg once daily as a RS-DAT or SAC. The design was powered on the basis of crossover assessment of RS-DAT versus SAC. During repeated dosing (periods 2 and 3, and extension phase), all patients also received prednisone/prednisolone 5 mg twice daily. Plasma samples were collected for measurement of niraparib and abiraterone plasma concentrations. Statistical assessment of the RS-DAT and LS-DAT versus SAC was performed on log-transformed pharmacokinetic parameters data from periods 2 and 3 (crossover) and from period 1 (parallel), respectively. Additional paired analyses and model-based bioequivalence assessments were conducted to evaluate the similarity between the LS-DAT and SAC. Results: For the RS-DAT versus SAC, the 90% confidence intervals (CI) of geometric mean ratios (GMR) for maximum concentration at a steady state (Cmax,ss) and area under the plasma concentration–time curve from 0–24 h at a steady state (AUC 0–24h,ss) were respectively 99.18-106.12% and 97.91-104.31% for niraparib and 87.59-106.69 and 86.91-100.23% for abiraterone. For the LS-DAT vs SAC, the 90% CI of GMR for AUC0–72h of niraparib was 80.31-101.12% in primary analysis, the 90% CI of GMR for Cmax,ss and AUC 0–24h,ss of abiraterone was 85.41-118.34% and 86.51-121.64% respectively, and 96.4% of simulated LS-DAT versus SAC BE trials met the BE criteria for both niraparib and abiraterone. Conclusions: The RS-DAT met BE criteria (range 80%–125%) versus SAC based on 90% CI of GMR for Cmax,ss and AUC 0–24h,ss. The LS-DAT was considered BE to SAC on the basis of the niraparib component meeting the BE criteria in the primary analysis for AUC 0–72h; abiraterone meeting the BE criteria in additional paired analyses based on Cmax,ss and AUC 0–24h,ss; and the percentage of simulated LS-DAT versus SAC BE trials meeting the BE criteria for both. ClinicalTrials.gov Identifier: NCT04577833. [ABSTRACT FROM AUTHOR]

The relationship between normal-weight obesity (NWO)—high percent body fat (%BF) in individuals with normal body mass index (BMI)—and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18–64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (β = 2.55; 95% CI − 0.82, 5.92); however, diastolic blood pressure (β = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (β = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (β = 8.73: 1.56, 15.90), triglyceride (β = 20.99: 0.78, 41.22), total cholesterol (β = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (β = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements. [ABSTRACT FROM AUTHOR]

About 20% of world population suffer from acute urticaria at some stage in their lives. Recent studies showed coagulation dysfunction in chronic urticaria. The involvement of coagulation changes in acute urticaria remains unclear. Fifty-eight acute urticaria patients were enrolled in this study and divided into two groups (referred to throughout as infection-related and infection-unrelated acute urticaria). The routine laboratory parameters including coagulation tests between the two groups were compared. The correlation between coagulation tests and CRP at acute phase was also assessed. Dynamic change of routine coagulation test results at acute phase and resolving phase was compared. The potential performance of coagulation for infection indication was tested. We found d-dimer, fibrin degradation product (FDP), and fibrinogen (Fg) increased in the acute phase of infection-related acute urticaria patients. d-dimer, FDP, Fg, and APTT are positively correlated with CRP in the acute phase. d-dimer and FDP decreased in the resolving phase of infection-related acute urticaria patients. Higher d-dimer (> 0.48 mg/L) and FDP (> 3.84 mg/L) may indicate infection-related acute urticaria. In conclusion, in acute urticaria with low venous thromboembolism risk, d-dimer level and dynamic change can be potentially used for the infection-related clinical practice management. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Truncus arteriosus (TA) is a rare congenital heart defect that can be prenatally detected by fetal echocardiography. However, prognostication and prenatal counseling focus primarily on surgical outcomes due to limited fetal and neonatal pre-surgical mortality data. We aimed to describe the incidence and identify predictors of pre-surgical mortality in prenatally detected TA. This two-center, retrospective cohort study included fetuses diagnosed with TA between 01/2010 and 04/2020. The primary outcome was pre-surgical mortality, defined by fetal or neonatal pre-surgical death or primary listing for transplantation prior to discharge. Univariable regression modeling, Chi-square tests, and t tests assessed for associations between prenatal clinical, demographic, and fetal echocardiographic (fetal-echo) variables and pre-surgical mortality. Of 23 pregnancies with prenatal diagnosis of TA, 4 (17%) were terminated. Of the remaining 19, pre-surgical mortality occurred in 4 (26%), including 2 (11%) fetal deaths and 2 (11%) neonatal pre-surgical deaths. No transplantation listings. Of liveborn fetuses (n = 17), 15 (88%) underwent a neonatal surgery, and 1 (6%) required ECMO. As compared to the survivors, the pre-surgical mortality group had a higher likelihood of having left ventricular dysfunction (0% vs. 40%; p = 0.01), right ventricular dysfunction (0% vs. 60%; p = 0.002), cardiovascular profile score < 7 (0% vs. 40%; p = 0.01), skin edema (0% vs. 40%; p = 0.01), and abnormal umbilical venous (UV) Doppler (0% vs. 60%; p = 0.002). The presence of truncal valve regurgitation or stenosis neared significance. In this cohort with prenatally diagnosed TA, there is significant pre-surgical mortality, including fetal death and neonatal pre-surgical death. Termination rate is also high. Fetal-echo variables associated with pre-surgical mortality in this cohort include ventricular dysfunction, low CVP, skin edema, and abnormal UV Doppler. Knowledge about prenatal risk factors for pre-surgical mortality may guide parental counseling and postnatal planning in prenatally diagnosed TA. [ABSTRACT FROM AUTHOR]

Black engineering transfer students face unique challenges while navigating the transfer process from a community college to a 4-year institution. The purpose of this paper is to better understand the experiences of these students and the ways in which they adjust to the 4-year school. We identify specific challenges noted by Black engineering transfer students in their experiences related to: (1) heuristics of teaching and learning that they had to adapt to in order to successfully navigate new campus environments; (2) information gaps that students encountered in what faculty seemed to expect them to already know; and (3) problems in having to adjust to the differences in the academic demands of the 4-year engineering program. In addition to unpacking our findings along these specific domains, we attend to the potential impact of having these challenges in a large, urban, metropolitan area. [ABSTRACT FROM AUTHOR]

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. 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. Here, Kandeil et al. show that the Western movement of this clade was followed by reassortment with viruses circulating in wild birds in North America which resulted in different genotypes exhibiting a wide range of disease severity in mammal models (mice, ferrets, chicken) ranging from asymptomatic disease to severe neurological pathology. [ABSTRACT FROM AUTHOR]

The spectral efficiency (SE) can approximately double when using full-duplex (FD) multiuser MIMO communications. However, there are difficulties because of multiuser interferences, self-interference (SI), and co-channel interference (CCI). To improve the SE of the downlink (DL), this paper proposes CCI-aware enhancement to SLNR (signal-to-leakage-and-noise-ratio) signal-to-leakage-and-noise-ratio (SLNR). It considers a suppressing filter at the receiver to cancel the interferences again designing a beamformer based on CCI-plus-noise covariance matrices for every user at the transmitting side. Additionally, we propose an improvement in the SLNR method by using SI-plus-noise covariance matrices to design uplink (UL) beamformers. Unlike zero-forcing and block-diagonalization, the SLNR approach serves numerous antennas at users and BS (base station). The total SE of the communication yielded using the optimized precoder, i.e., obtained from the SLNR-based precoding. To achieve maximum energy efficiency (EE), we use a power consumption model. Simulation results confirm that full-duplex performs well compared to half-duplex (HD) when the number of antennas at every user in uplink as well downlink channels grow, for all Rician factors, for slight powers of the CCI and SI, and a limited number of antennas at the BS. With the proposed scheme for given transmit power and circuit power, we demonstrate that FD has a higher EE than HD. [ABSTRACT FROM AUTHOR]

Barley is one of the most important cereal crops cultivated over a wider environment in the diverse agro-ecologies in Ethiopia. Study on genotype by environment interaction and stability analysis using thirty barley genotypes was conducted across nine environments in randomized complete block design with three replications to study the magnitude of genotype by environment interaction and to evaluate the stability and adaptability of barley genotypes with high mean yield performance. Additive main effect and multiplicative interaction (AMMI), genotype main effect and genotypes by environment interaction (GGE) and Eberhart and Russell models were employed for stability and adaptability analysis. Thus, AMMI analysis of variance for grain yield showed highly significant (P ≤ 0.001) differences due to genotypes, environment and genotype by environment interaction. Accordingly, environment accounted for (54.61%) of the total variations followed by genotype (10.69%) and G × E interaction (34.70%). Moreover, a substantial percentage of the G × E interaction sum of squares was explained by IPCA1 (45.48%) followed by IPCA2 (24.65%) and IPCA3 (13.02%) while the first two IPCAs explained 70.13%. Moreover, AMMI and GGE were found to be efficient in grouping the barley growing environment in the central highland, whereas Debre Markos and Bekoji were good representative testing environments. Generally, the current study indicated that 3514-A, 24,990, and 17,148 were desirable genotypes for subsequent breeding line identification and variety development. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer with increasing incidence in western countries. Most HCC patients have advanced cancer at the time of diagnosis due to the asymptomatic nature of early-stage HCC and do not qualify for potentially curative surgical treatment, thus, highlighting the need for new therapeutic strategies. Long noncoding RNAs (lncRNAs) comprise a large and heterogeneous group of non-protein coding transcripts that play important regulatory roles in numerous biological processes in cancer. In this study, we performed RNA sequencing of liver biopsies from ten HCC, ten hepatitis C virus-associated HCC, and four normal livers to identify dysregulated lncRNAs in HCC. We show that the lncRNA p53-upregulated-regulator-of-p53-levels (PURPL) is upregulated in HCC biopsies and that its expression is p53-dependent in liver cancer cell lines. In addition, antisense oligonucleotide-mediated knockdown of PURPL inhibited cell proliferation, induced apoptosis, and sensitized HepG2 human HCC cells to treatment with the chemotherapeutic agent doxorubicin. In summary, our findings suggest that PURPL could serve as a new therapeutic target for reversing doxorubicin resistance in HCC. [ABSTRACT FROM AUTHOR]

4D Flow MRI is a diagnostic tool that can visualize and quantify patient-specific hemodynamics and help interventionalists optimize treatment strategies for repairing coarctation of the aorta (COA). Despite recent developments in 4D Flow MRI, shortcomings include phase-offset errors, limited spatiotemporal resolution, aliasing, inaccuracies due to slow aneurysmal flows, and distortion of images due to metallic artifact from vascular stents. To address these limitations, we developed a framework utilizing Computational Fluid Dynamics (CFD) with Adaptive Mesh Refinement (AMR) that enhances 4D Flow MRI visualization/quantification. We applied this framework to five pediatric patients with COA, providing in-vivo and in-silico datasets, pre- and post-intervention. These two data sets were compared and showed that CFD flow rates were within 9.6% of 4D Flow MRI, which is within a clinically acceptable range. CFD simulated slow aneurysmal flow, which MRI failed to capture due to high relative velocity encoding (Venc). CFD successfully predicted in-stent blood flow, which was not visible in the in-vivo data due to susceptibility artifact. AMR improved spatial resolution by factors of 101 to 103 and temporal resolution four-fold. This computational framework has strong potential to optimize visualization/quantification of aneurysmal and in-stent flows, improve spatiotemporal resolution, and assess hemodynamic efficiency post-COA treatment. [ABSTRACT FROM AUTHOR]

Angioedema is characterized by swelling of the skin or mucous membranes. Overproduction of the vasodilator bradykinin (BK) is an important contributor to the disease pathology, which causes rapid increase in vascular permeability. BK formation on endothelial cells results from high molecular weight kininogen (HK) interacting with gC1qR, the receptor for the globular heads of C1q, the first component of the classical pathway of complement. Endothelial cells are sensitive to blood-flow-induced shear stress and it has been shown that shear stress can modulate gC1qR expression. This study aimed to determine the following: (1) how BK or angioedema patients' (HAE) plasma affected endothelial cell permeability and gC1qR expression under shear stress, and (2) if monoclonal antibody (mAb) 74.5.2, which recognizes the HK binding site on gC1qR, had an inhibitory effect in HK binding to endothelial cells. Human dermal microvascular endothelial cells (HDMECs) grown on Transwell inserts were exposed to shear stress in the presence of HAE patients' plasma. Endothelial cell permeability was measured using FITC-conjugated bovine serum albumin. gC1qR expression and HK binding to endothelial cell surface was measured using solid-phase ELISA. Cell morphology was quantified using immunofluorescence microscopy. The results demonstrated that BK at 1 µg/mL, but not HAE patients' plasma and/or shear stress, caused significant increases in HDMEC permeability. The mAb 74.5.2 could effectively inhibit HK binding to recombinant gC1qR, and reduce HAE patients' plasma-induced HDMEC permeability change. These results suggested that monoclonal antibody to gC1qR, i.e., 74.5.2, could be potentially used as an effective therapeutic reagent to prevent angioedema. [ABSTRACT FROM AUTHOR]

Introduction: We have experienced a pandemic induced by the interaction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) structural proteins with innate structures. These interactions are especially prevalent for patients with underlying pathologies, such as cardiovascular diseases. However, there has been limited work to uncover the range of responses induced by SARS-CoV-2 structural proteins. Thus, our objective was to investigate how endothelial cell pro-thrombotic and pro-inflammatory responses are altered after exposure to SARS-CoV-2 spike, nucleocapsid, and membrane-envelope proteins. We hypothesized that after a short duration exposure, endothelial cells would have a heightened thrombotic and inflammatory potential. With longer exposures, this may lead to altered disease progression and the observed increased mortality and morbidity rates in patients with underlying vascular pathologies. Methods: To test this hypothesis, human endothelial cells were exposed to SARS-CoV-2 structural proteins. After the exposure, the expression of thrombomodulin, PECAM-1, connexin-43, and gC1qR were assessed. In parallel, standard cell culture readouts were assessed to determine if these incubations altered cell growth and metabolism. Results and Conclusions: We observed significant increases in thrombotic and inflammatory marker expression, with no change to the cell culture parameters (with the exception of a reduction in cell density in response to one SARS-CoV-2 structural protein). Importantly, these observations were dependent on the viral structural protein the cells were exposed to, suggesting that the interactions of SARS-CoV-2 with innate cells is complex and must be uncovered. Combined, this suggests that SARS-CoV-2 structural proteins can regulate inflammatory and thrombotic responses that underlie common pathologies observed during COVID-19. [ABSTRACT FROM AUTHOR]

Eritrea was the first African country to complete a nationwide switch in 2016 away from HRP2-based RDTs due to high rates of false-negative RDT results caused by Plasmodium falciparum parasites lacking hrp2/hrp3 genes. A cross-sectional survey was conducted during 2019 enrolling symptomatic malaria patients from nine health facilities across three zones consecutively to investigate the epidemiology of P. falciparum lacking hrp2/3 after the RDT switch. Molecular analyses of 715 samples revealed the overall prevalence of hrp2-, hrp3-, and dual hrp2/3-deleted parasites as 9.4% (95%CI 7.4–11.7%), 41.7% (95% CI 38.1–45.3%) and 7.6% (95% CI 5.8–9.7%), respectively. The prevalence of hrp2- and hrp3-deletion is heterogeneous within and between zones: highest in Anseba (27.1% and 57.9%), followed by Gash Barka (6.4% and 37.9%) and Debub zone (5.2% and 43.8%). hrp2/3-deleted parasites have multiple diverse haplotypes, with many shared or connected among parasites of different hrp2/3 status, indicating mutant parasites have likely evolved from multiple and local parasite genetic backgrounds. The findings show although prevalence of hrp2/3-deleted parasites is lower 2 years after RDT switching, HRP2-based RDTs remain unsuitable for malaria diagnosis in Eritrea. Continued surveillance of hrp2/3-deleted parasites in Eritrea and neighbouring countries is required to monitor the trend. [ABSTRACT FROM AUTHOR]

Barley production worldwide is limited by several abiotic and biotic stresses and breeding of highly productive and adapted varieties is key to overcome these challenges. Leaf scald, caused by Rhynchosporium commune is a major disease of barley that requires the identification of novel sources of resistance. In this study two subsets of genebank accessions were used: one extracted from the Reference set developed within the Generation Challenge Program (GCP) with 191 accessions, and the other with 101 accessions selected using the filtering approach of the Focused Identification of Germplasm Strategy (FIGS). These subsets were evaluated for resistance to scald at the seedling stage under controlled conditions using two Moroccan isolates, and at the adult plant stage in Ethiopia and Morocco. The results showed that both GCP and FIGS subsets were able to identify sources of resistance to leaf scald at both plant growth stages. In addition, the test of independence and goodness of fit showed that FIGS filtering approach was able to capture higher percentages of resistant accessions compared to GCP subset at the seedling stage against two Moroccan scald isolates, and at the adult plant stage against four field populations of Morocco and Ethiopia, with the exception of Holetta nursery 2017. Furthermore, four machine learning models were tuned on training sets to predict scald reactions on the test sets based on diverse metrics (accuracy, specificity, and Kappa). All models efficiently identified resistant accessions with specificities higher than 0.88 but showed different performances between isolates at the seedling and to field populations at the adult plant stage. The findings of our study will help in fine-tuning FIGS approach using machine learning for the selection of best-bet subsets for resistance to scald disease from the large number of genebank accessions. [ABSTRACT FROM AUTHOR]

Rainfall is an important hydro-meteorological variable that has various applications in water resource planning and development. Adequate rain gauge network gives immediate and precise rainfall data that are crucial for effective and economical water resource management. This study describes a multi-criteria decision analysis (MCDA) in combination with kriging and entropy methods to optimize rain gauge networks in the Tekeze River basin, northwestern Ethiopia. The Tekeze River basin is a trans-boundary river basin in the northwestern part of Ethiopia having a drainage area 86 510 km2. The MCDA was used for selecting suitable locations for additional rain gauges in the basin. The kriging and entropy methods were used to determine the optimal number of rain gauge stations in the basin. Initial analysis showed that the existing 63 rain gauge stations in the basin are not adequate and result in about 12% rainfall estimation error. Optimization of rain gauge network in the Tekeze River basin resulted in 216 additional gauging stations. The total optimal number of rain gauges for the Tekeze River would thus be 279. The results of the study revealed that the combined use of the MCDA, kriging, and entropy methods is useful to optimize the spatial distribution and number of rain gauge stations in a basin. [ABSTRACT FROM AUTHOR]

Malnutrition is common in Addis Ababa, Ethiopia, in part due to suboptimal diets limited in essential nutrients. Despite previous dietary diversification efforts, animal source food (ASF) consumption remains low, potentially due to supply-side factors affecting ASF market vendors. This study sought to identify supply-side policies and interventions to support urban ASF market vendors and to alleviate the challenges they face. We conducted a qualitative study among 40 urban food market vendors (interviewed in February 2018) to investigate their perceptions of changes in ASF markets over time, the reasons behind these changes, and the challenges faced. Data were analysed using inductive thematic analysis. Findings showed that market vendors agreed that all ASF prices have increased in the past two years, driven by supply shortages, high input costs, consumer demand for ASFs and socio-economic status, among other less prominent causes. Vendors perceived their main challenges to be food supply, religious fasting, consumer demand, price increases and fluctuations, transportation, market infrastructure, and government policies. We identified several potential supply-side interventions and policies that can help optimize ASF markets and eliminate market inefficiencies, including: improving storage facilities to reduce dependability on seasonality; improving road infrastructure to reduce transportation costs and difficulties; stabilizing input costs; and improving the physical market infrastructure to ensure opportunities for business growth. These market-based policies and interventions can help support and stabilize ASF markets by alleviating the barriers faced by urban vendors. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), calls for prompt and accurate diagnosis and rapid turnaround time for test results to limit transmission. Here, we evaluated two independent molecular assays, the Biomeme SARS-CoV-2 test, and the Precision Biomonitoring TripleLock SARS-CoV-2 test on a field-deployable point-of-care real-time PCR instrument, Franklin three9, in combination with Biomeme M1 Sample Prep Cartridge Kit for RNA 2.0 (M1) manual extraction system for rapid, specific, and sensitive detection of SARS-COV-2 in cell culture, human, and animal clinical samples. The Biomeme SARS-CoV-2 assay, which simultaneously detects two viral targets, the orf1ab and S genes, and the Precision Biomonitoring TripleLock SARS-CoV-2 assay that targets the 5′ untranslated region (5′ UTR) and the envelope (E) gene of SARS-CoV-2 were highly sensitive and detected as low as 15 SARS-CoV-2 genome copies per reaction. In addition, the two assays were specific and showed no cross-reactivity with Middle Eastern respiratory syndrome coronavirus (MERS-CoV), infectious bronchitis virus (IBV), porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis (TGE) virus, and other common human respiratory viruses and bacterial pathogens. Also, both assays were highly reproducible across different operators and instruments. When used to test animal samples, both assays equally detected SARS-CoV-2 genetic materials in the swabs from SARS-CoV-2-infected hamsters. The M1 lysis buffer completely inactivated SARS-CoV-2 within 10 min at room temperature enabling safe handling of clinical samples. Collectively, these results show that the Biomeme and Precision Biomonitoring TripleLock SARS-CoV-2 mobile testing platforms could reliably and promptly detect SARS-CoV-2 in both human and animal clinical samples in approximately an hour and can be used in remote areas or health care settings not traditionally serviced by a microbiology laboratory. [ABSTRACT FROM AUTHOR]

Landslides, mainly triggered by rainfall, are one of the most common natural hazards in the northern and central highlands of Ethiopia, resulting in the loss of human life and property. As part of the Ethiopian highlands, Mgulat Mountain (88.6 km2) is a typical example for the occurrence of landslides and associated damages. The main aim of this research was to generate landslide susceptibility map (LSM) for the first time by considering various causative factors typical for the Mgulat Mountain area. The methods used include frequency ratio (FR) and kinematic analysis (KA) supported by GIS tools. The research involved conventional fieldwork (e.g., geological mapping, landslides inventory) and analysis and interpretation of images. From the geological mapping, major rock units were identified: quaternary deposit, basalt, red sandstone, tillite, and white sandstone. A total of 220 landslides (15.45 km2) were identified in the study area from field survey, Google Earth and aerial photo interpretation. Five causative factors (lithology, slope steepness, distance from drainage, land use-land cover (LULC), and slope aspect) were selected based on their contribution to landslide initiation as the landslide conditioning factors for generation of the LSM. From the five causative factors, lithology and slope steepness were found to be influential as landslide conditioning factors. Specifically, lithology (red sandstone and tillite), distance to stream (0 to 300 m), LULC (bare land and settlement), and slope steepness (> 25°) have FR > 1, indicating a high relationship with landslide occurrence. Based on the generated LSM, five susceptibility classes or zones were identified (very low, low, moderate, high, and very high susceptibility). The area of each class as percentage of total area was found to be 19.53, 24.15, 22.57, 18.74, and 15.01%, for the very low to the very high class, respectively. The results of KA show potentially and marginally planar, topple, and wedge failures. The generated LSM can serve as an important tool or guide for further land-use planning and to prevent and mitigate landslide-related risks. Consequently, to consider cost-effective and technically sound mitigation measures, detailed and site-specific multidisciplinary investigations are recommended. [ABSTRACT FROM AUTHOR]

The Mekelle basin (area ~ 5500 km2) is located at the immediate western margin of the Afar Depression, which has a history of collision, subsidence, uplift, magmatism and now rifting. The evolution of such small to medium size basins as the Mekelle in a complicated geodynamic set-up is a subject of debate, because several different mechanisms of basin formation could apply. To address the possible basin evolution scenarios, we combine structural and dynamic analyses of northern Ethiopia, with strong emphasis on the basin and basin bounding basement rocks. The northern basin bounding block is uplifted by about 1500 m compared with the western and southwestern basin-bounding blocks. In the basin, superposition of large-scale orthogonal brittle shear fabrics and the development of young, parallel to subparallel extensional fractures and domino faulting have produced a total of ~ 2200 m vertical displacement. These observations, coupled with the absence of gradual roll-down of the internal basin (i.e., absence of bending/folding of an elastic beam supported at both ends), imply that Mekelle basin is not an IntraCONtinental Sags (ICONS) or plate interior basin, as previously described, but is instead a multi-tectonic triggered basin. Integrated satellite images using ground-controlled measurements and deep borehole data were used to decipher the entire evolution of the basin starting from the late-collisional deformation through the regional up-doming to the sills/dikes injection and basin formation. [ABSTRACT FROM AUTHOR]

Underwater wireless sensor networks (UWSNs) have played an increasingly important role in the fields of ocean exploration, underwater environment monitoring, underwater navigation target tracking, terrain-assisted navigation, and so on. However, UWSNs are a dynamic network, which are unlike terrestrial wireless sensor networks, and the complexity of underwater environment poses many challenges for the positioning of sensor nodes. Aiming at the difficulty of location update, this paper proposes a UWSN positioning technology based on iterative optimization and data position correction (IO-DPC). Firstly, particle swarm optimization technology is used to perform the rough positioning stage of sensor nodes, and iterative optimization is performed for many times. Then, data position correction work is carried out, and a scheme is designed for correcting underwater sensor data position when base station receives the data packet. An underwater ocean current model is established, and IO-DPC technology is simulated in various underwater simulation environments. Experimental results show that IO-DPC technology has higher positioning accuracy than other traditional technologies. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the completeness of child health records maintained and collected within community health information system in Ethiopia. Methods: A household listing was carried out in 221 enumeration areas in food insecure areas of Ethiopia to determine the presence of a child less than 24-months. This list of children was then compared against the information stored at the local health posts. A household survey was administered to a sample of 2155 households that had a child less than 24-months of age to assess determinants and consequences of exclusion from the health post registers. Results: Out of the 10,318 children identified during the listing, 36% were found from the health post records. Further analysis based on the household survey data indicated that health posts that had adopted nationally recommended recordkeeping practices had more complete records (p < 0.01) and that children residing farther from health posts were less likely to be found from the registers (p < 0.05). Mothers whose child was found from the registers were more likely to know a health extension worker (p < 0.01), had a contact with one (p < 0.01), and their child was more likely to have received growth monitoring (p < 0.05). Conclusions for Practice: The incompleteness of the data collected at the health posts poses a challenge for effective implementation of the national health extension program and various complementary programs in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor disorders (PFDs), include urinary incontinence, overactive bladder, anal incontinence, and pelvic organ prolapse negatively affect physical, psychosocial, and economic wellbeing of women. In developing countries, less than a quarter of women with PFDs seek health care for their problem. Health care seeking for PFDs, and its associated factors, is little known in Ethiopia. This study aimed to assess health care seeking for PFDs, associated factors, and deterrents for seeking care. Methods: From a community based cross sectional study conducted form August 10 to September 4, 2016 to assess pelvic floor disorders, seven hundred four participants with PFDs drawn for health care seeking behavior analysis. Data were collected through interviewed administered questionnaire. Poisson regression model with robust variance was used to investigate the association of the independent variable with health care seeking behaviors. The results are reported in crude and adjusted prevalence ratio with 95% confidence intervals. Result: Two hundred twenty five (32%; CI: 26.8–35.5) women sought care for their PFDs. Majority 160 (71%) of them seek care from government health facilities. Middle wealth index Adjusted Prevalence Ratio (APR) = 1.4, CI: 1.1, 1.8), autonomous decision making on own health (APR = 1.3, CI: 1.1, 1.7), and sever impact of PFDs on quality of life (APR = 1.4, CI:1.1, 1.9) were identified as associated factors for health care seeking. Conclusion: A large number of women with pelvic floor disorder did not seek health care: this calls for urgent and tailored intervention to enhance health care seeking behaviors of women with PFD. [ABSTRACT FROM AUTHOR]

The first Canadian H3N2 canine influenza A outbreak involving an Asian-origin H3N2 canine influenza virus (CIV) began in southwestern Ontario, Canada, in late December 2017. More H3N2 CIV cases were identified in central and eastern Ontario between March and October 2018. Based on epidemiological investigation, 5 clusters were identified (C1, C2, C3a, C3b, and C4); however, the origin of infection has only been revealed for epidemiological cluster C1. Here, we use phylogenetic analyses to unravel the links of virus transmission between the 5 epidemiological clusters and the origin of infection for all epidemiological clusters. Our results demonstrate that the Canadian H3N2 CIV sequences were grouped into four distinct phylogenetic clusters with minimal genetic diversity between these clusters. Large scale phylogenetic analysis of H3N2 CIV from around the globe showed that the Canadian CIVs formed a distinct new clade along with CIVs that have been circulating in the USA since 2017–2018 and in China since 2017. This clade shares a common ancestor of Asian origin. This study concludes that the H3N2 CIV outbreak in Ontario was driven by multiple introductions of South Korean/Chinese-origin H3N2 CIVs over 10 months. [ABSTRACT FROM AUTHOR]

Background: Africa is the most vulnerable continent in the world; which recurrent droughts, extreme temperature and rainfall affects agriculture and food security. The aim of this study was to analyze the trends in extreme temperature and rainfall in major sesame producing areas in western Tigray using RClimDex software. We selected eight temperature and nine rainfall indices from 27 extreme temperature and rainfall indices, which are recommended by joint CCL/CLIVAR/JCOMM Expert Team on Climate Change Detection and Indices (ETCCDI). A non-parametric Mann–Kendall test and Sen's slope estimates were used to test the statistical significance and trend of each of the extreme temperature and rainfall indices, respectively. Results: Number of heavy rainy days, number of very heavy rainy days, very wet days, extremely wet days, and maximum 5 days precipitation showed a negative trend, with significant (p < 0.05) decrease throughout the study area. Monthly maximum value of maximum and minimum value of maximum temperature, monthly maximum and minimum value of minimum temperature, hot days and hot nights revealed positive trend throughout the study areas. Total rainfall was decreasing significantly (p < 0.05) by 13.34 mm, 13.8 mm, 14.65 mm, 10.9 mm and 8.4 mm/year at Humera and Dansha, Adiremets, Maygaba, Maytsebri and Sheraro, and Adigoshu, respectively. Spatial analysis on extreme temperature also indicated there was relatively lower variability on minimum temperature in Humera, Dansha, Adiremets, and Adigoshu. On average, the western part of Tigray experienced a reduction in total rainfall ranging 8.45 to 14.7 mm/year; and increase in average maximum temperature of 0.04 to 0.051 °C/year since 1983 to 2016. The results also revealed an increase in warm nights and warm days ranging from 0.31 to 0.62 days, and 0.38 to 0.71 days/year, respectively. Conclusions: Increase in temperature and decrease in amount of rainfall may have a negative impact on crop transpiration, photosynthetic rate and soil water balance; exacerbating distribution and infestation of malaria and leishmaniasis. The results in this study could have an important role in identifying possible present and future production strategies on sesame, cotton, and sorghum crops, which are essential cash crops produced by farmers and investors. [ABSTRACT FROM AUTHOR]

Neutropenia is a common side-effect of oncology drugs. We aimed to study the impact of exposure and dosing schedule on neutropenia to guide selection of dosing schedules that minimize neutropenia potential while maintaining the desired minimum concentration (Cmin) required for target engagement. Dose, frequency and PK parameters were chosen for five hypothetical drugs of various half-lives to (1) achieve same exposure with continuous dosing and evaluate impact of 4 intermittent dosing schedules; and (2) achieve same nadir for continuous and intermittent dosing and evaluate impact on % time above Cmin, a surrogate assumed to indicate target engagement. Absolute neutrophil count (ANC) profiles were simulated using Friberg model, a widely used semi-mechanistic myelosuppression model, assuming drug concentration directly reduce the proliferation rate of stem cells and progenitor cells in proliferation compartment. The correlations between different PK measures and neutropenia metrics were explored. In (1), when the same daily dose was used, intermittent schedules offered better management of ANC nadir. The reduced average drug exposure with intermittent dosing led to lower% time above Cmin. In (2), when the dose was adjusted to achieve the same nadir, drugs with moderate half-life (8–48 h) showed similar % time above Cmin regardless of schedule, while continuous dosing was better for a short half-life (4 h). Area under the concentration curve (AUC) was highly correlated with neutropenia. In summary, continuous dosing, with the dose selected correctly, is most effective to maintain % time above Cmin while providing similar tolerability as intermittent dosing with a higher dose. But dose interruptions could be required to manage individual toxicities. Intermittent schedules, on the other hand, allow recovery of ANC, enabling more orderly schedules. [ABSTRACT FROM AUTHOR]

Legumes are a critical component of many agricultural systems and a major contributor to global food systems. Common bean (Phaseolus vulgaris L.) is the most widely grown legume crop in Ethiopia. It is an important source of food, income, and soil fertility management in southwestern (SW) and northeastern (NE) Ethiopia, and used as medicine, fodder, and honeybee forage in the NE. Diversity and use of farmers' varieties of common bean (Phaseolus vulgaris) bean were investigated in five administrative zones in SW and NE Ethiopia. Structured and semi-structured interviews were conducted with 288 general informants and 48 key informants in five agroecological zones inhabited by four cultural groups. Thirty-nine varieties were identified based on farmers' naming practices. Varietal richness and diversity were found to be highest in the humid, tepid mid-highlands of Kefa (13) and Bench Maji and Sheka (12). However, farmers in both research areas typically plant only one or two varieties. Interestingly, the number of varieties per household was highest (2.3) in South Wollo Zone of the NE, where only six varieties were found. We find that varieties per household are limited by small landholdings in the SW and varietal richness in the NE. Given these limitations, policies and programs to conserve varietal diversity and increase productivity are more likely to be effective if organized at the community level in the SW and the household level in the NE. Agromorphological and genetic characterization of common bean varieties would facilitate the management and conservation of their diversity as a source of resilience. [ABSTRACT FROM AUTHOR]

Background: Hypertrophic cardiomyopathy (HCM) is associated with heart failure, atrial fibrillation and sudden death. Reduced myocardial function has been reported in HCM despite normal left ventricular (LV) ejection fraction. Additionally, LV fibrosis is associated with elevated T1 and might be an outcome predictor.Objective: To systematically compare tissue phase mapping and feature tracking for assessing regional LV function in children and young adults with HCM and pediatric controls, and to evaluate structure-function relationships among myocardial velocities, LV wall thickness and myocardial T1.Materials and Methods: Seventeen pediatric patients with HCM and 21 age-matched controls underwent cardiac MRI including standard cine imaging, tissue phase mapping (two-dimensional cine phase contrast with three-directional velocity encoding), and modified Look-Locker inversion recovery to calculate native global LV T1. Maximum LV wall thickness was measured on cine images. LV radial, circumferential and long-axis myocardial velocity time courses, as well as global and segmental systolic and diastolic peak velocities, were quantified from tissue phase mapping and feature tracking.Results: Both tissue phase mapping and feature tracking detected significantly decreased global and segmental diastolic radial and long-axis peak velocities (by 12-51%, P<0.001-0.05) in pediatric patients with HCM vs. controls. Feature tracking peak velocities were lower than directly measured tissue phase mapping velocities (mean bias = 0.3-2.9 cm/s). Diastolic global peak velocities correlated moderately with global T1 (r = -0.57 to -0.72, P<0.01) and maximum wall thickness (r = -0.37 to -0.61, P<0.05).Conclusion: Both tissue phase mapping and feature tracking detected myocardial velocity changes in children and young adults with HCM vs. controls. Associations between impaired diastolic LV velocities and elevated T1 indicate structure-function relationships in HCM. [ABSTRACT FROM AUTHOR]

Background: The neutrophil-lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC).Methods: In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis.Results: On entry into the study ('baseline'), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage.Conclusion: NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models. [ABSTRACT FROM AUTHOR]

Background: Interrupted aortic arch (IAA) is a rare but severe congenital abnormality often associated with bicuspid aortic valve (BAV). Complex re-interventions are often needed despite surgical advances, but the impact of aortic hemodynamics in repaired patients is unknown.Objective: Investigate effect of IAA repairs on aortic hemodynamics, wall shear stress and flow derangements via 4-D flow MRI.Materials and Methods: We retrospectively analyzed age- and gender-matched cohorts (IAA [n=6], BAV alone [n=6], controls [n=6]) undergoing cardiac MRI including 4-D flow. Aortic dimensions were measured from standard MR angiography. We quantified peak systolic velocities, regurgitant fractions and wall shear stress in the ascending aorta (AAo), transverse arch and descending aorta (DAo) from 4-D flow, and we graded helix/vortex flow patterns from 3-D blood flow visualization.Results: Children and young adults with IAA had a wide range of arch dimensions, peak systolic velocities, regurgitant fractions and flow grades. Peak transverse arch systolic velocities were higher in patients with IAA versus controls (P=0.02). Flow derangements in the AAo were found in patients with IAA (median grade=2, 5/6 patients, P=0.04) and BAV (median grade=3, 5/6 patients, P=0.03) versus controls. Flow derangements in the DAo were only seen in patients with IAA (median grade=1, 5/6 patients, P=0.04), and 5/6 people with IAA had helical flow in head and neck vessels. Wall shear stress was increased in people with IAA along the superior transverse arch and proximal DAo versus controls (P=0.02).Conclusion: Complex congenital aortic arch repairs can change aortic hemodynamics. Associated cardiac defects can further alter findings. Studies are warranted to investigate clinical implications in larger cohorts. [ABSTRACT FROM AUTHOR]

Objective: Typical primary care practices are often not equipped to meet the medical, developmental or social needs of infants discharged from a neonatal intensive care unit (NICU). These needs are exacerbated for infants and caregivers residing in poverty. This article discusses a multidisciplinary, family-centered medical home designed to address the needs of this special population. Methods: This is a descriptive analysis of a cohort of patients in the Next Steps Program (NSP), a multidisciplinary primary care medical home. Key program elements include: continuity of care from the NICU to primary care, routine developmental surveillance, care coordination, and proactive screening to address medical and social needs. Results: The NSP has become a primary referral source for local NICUs, with a total of 549 medically fragile infants enrolled from its inception in 2011 through 2016. Caregivers and patients experience psychosocial stressors at averages statistically significantly higher than the rest of the Commonwealth of Pennsylvania and the US. Although patients in the program use medical resources beyond that of typically developing infants, hospital utilization among this patient cohort is trending down. Discussion: Caring for medically fragile NICU graduates can be daunting for families given the array of necessary services, supports, and resources to maximize their potential. A multidisciplinary primary care medical home, such as the NSP, is a successful model of patient care demonstrating favorable associations with health care utilization, care coordination, and addressing/improving family functioning and their experience. [ABSTRACT FROM AUTHOR]

Bicuspid aortic valve (BAV) disease demonstrates a range of clinical presentations and complications. We aim to use cardiac MRI (CMR) to evaluate left ventricular (LV) parameters, myocardial strain and aortic hemodynamics in pediatric BAV patients with and without aortic stenosis (AS) or regurgitation (AR) compared to tricuspid aortic valve (TAV) controls. We identified 58 pediatric BAV patients without additional cardiovascular pathology and 25 healthy TAV controls (15.3 ± 2.2 years) who underwent CMR with 4D flow. BAV cohort included subgroups with no valvulopathy (n = 13, 14.3 ± 4.7 years), isolated AS (n = 19, 14.5 ± 4.0 years), mixed valve disease (AS + AR) (n = 13, 17.1 ± 3.2 years), and prior valvotomy/valvuloplasty (n = 13, 13.9 ± 3.2 years). CMR data included LV volumetric and mass indices, myocardial strain and aortic hemodynamics. BAV patients with no valvulopathy or isolated AS had similar LV parameters to controls excepting cardiac output (p < 0.05). AS + AR and post-surgical patients had abnormal LV volumetric and mass indices (p < 0.01). Post-surgical patients had decreased global longitudinal strain (p = 0.02); other subgroups had comparable strain to controls. Patients with valvulopathy demonstrated elevated velocity and wall shear stress (WSS) in the ascending aorta (AAo) and arch (p < 0.01), while those without valve dysfunction had only elevated AAo velocity (p = 0.03). Across the cohort, elevated AAo velocity and WSS correlated to higher LV mass (p < 0.01), and abnormal hemodynamics correlated to decreased strain rates (p < 0.045). Pediatric BAV patients demonstrate abnormalities in LV parameters as a function of valvular dysfunction, most significantly in children with AS + AR or prior valvotomy/valvuloplasty. Correlations between aortic hemodynamics, LV mass and strain suggest valvular dysfunction could drive LV remodeling. Multiparametric CMR assessment in pediatric BAV may help stratify risk for cardiac remodeling and dysfunction. [ABSTRACT FROM AUTHOR]

The nature of multi-hop data transmission in wireless sensor network will cause serious load unbalance which will produce great restrains in related applications considering the limited energy resource. Relative load balance algorithms are usually performed inside the clusters without considering about the energy consumption of the whole network. A cluster-based balanced energy consumption algorithm (BECA) is proposed by introducing in multiple inter-cluster links to distribute the load, so as to achieve global load balance. Moreover, an efficient data collecting mechanism is proposed based on BECA to improve the traffic balance further. Simulating results based on NS2 show that BECA can obtain better balance properties and prolong the network lifetime effectively. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor disorders, which diminish the quality of life, disproportionally affect women in developing countries. However, there is a knowledge gap in the understanding of the factors associated with the problem in many countries including Ethiopia. Therefore, we aimed to assess the factors associated with pelvic floor disorders in Ethiopia. Materials and methods: A community-based cross-sectional study was conducted among 3432 ever-married women selected through a stratified multistage sampling procedure from the Kersa Health and Demography Surveillance System. Data were collected using structured questionnaires through face-to-face interviews. A Poisson regression model with robust variance estimation was used to investigate the association of the independent variable with pelvic floor disorder. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: Overall, the prevalence of pelvic floor disorders was 20.5% (95% CI: 19%–22%). Women who had no education (APR = 1.47; 95% CI: 1.06, 2.04) or had undergone five or more vaginal deliveries (APR = 1.56; 95% CI: 1.18, 2.05), an abortion (APR = 1.85; 95% CI: 1.43, 2.38) or episiotomy (APR = 1.39; 95% CI: 1.02, 1.90) were independently associated with having pelvic floor disorders. Conclusion: Obstetric events are strongly associated with pelvic floor disorders. This finding highlights the greater need for policies to focus on prevention, diagnosis and treatment services to mitigate women's suffering from pelvic floor disorders. [ABSTRACT FROM AUTHOR]