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Abstract Background Coagulase-negative staphylococci (CoNS) have been linked to severe conditions such as bloodstream infection, with biofilm formation regarded as the major virulence mechanism. This study determined virulence genes (VGs) (icaA, icaB, icaC, and icaD) responsible for biofilm formation and antibiotic resistance genes (ARGs) (blaZ, mecA, and aac(6’)-Ie-aph(2’’)-Ia) in CoNS isolated from blood samples of 70 neonates with sepsis in Dar es Salaam, Tanzania. We used VITEK®MS (BioMérieux, France) for speciation and phenotypically detected biofilm production using the Congo red agar. Polymerase chain reaction was performed for ARGs and VGs detection; principal component analysis was used to ascertain their relationship. Results Out of 70 CoNS, Staphylococcus epidermidis, 27 (36.8%) was the most commonly isolate, subsequently to Staphylococcus haemolyticus, 24 (34.3%). The intercellular adhesion genes (ica) were detected in all isolates, with IcaD found in 70 (100.0%), followed by icaB 69 (98.6%), icaC 69 (98.6%), and icaA 65 (92.9%). Four virulence gene combinations (icaADBC, icaBCD, icaACD, and icaABD) were detected, predominantly icaADBC 63 (90.0%). Sixty-one (87.1%) isolates harbored three ARGs, mostly the mecA gene 69 (98.6%), followed by blaZ 67 (95.7%) and aac (6’)-Ie-aph (2’’)-Ia, 65 (92.7%). We observed a moderate positive correlation between mecA and icaA genes (r = 0.4341). Sixty-five (97.0%) isolates resistant to penicillin harbored blaZ genes, and all 62 (100%) resistant to oxacillin harbored mecA genes. Of the 66 isolates resistant to gentamycin, 62 (93.9%) harbored the aac (6’)-Ie-aph (2’’)-Ia gene. The mecA gene contributed most of the resistance, followed by aac(6’)-Ie-aph(2’’)-Ia genes. However, the icaA and icaD genes significantly influenced the virulence of CoNS. Conclusions Most CoNS isolated from blood samples of neonates with sepsis harbor a variety of clinically relevant virulence and resistance genes, indicating their ability to cause severe infections that are difficult to treat. Significantly, 59 (84.3%) isolates were phenotypically penicillin, gentamycin, and oxacillin resistant; the antibiotics recommended in the national guidelines for empiric treatment of neonatal sepsis.

Introduction: Impulsivity means acting with the least thought towards future behaviors or acting based on thoughts that are not the best option for a person or others. This study was conducted to investigate psychometric properties of the Persian version of the Impulsive Behavior Scale (IBS) of Barratt on pre-hospital personnel of Shiraz University of Medical Sciences in 2023. Materials and Methods: This methodological study was conducted 18 pre-hospital emergency centers of Shiraz University of Medical Sciences during 2022-2023. In this study, the Persian version of the IBS has been used. Face and content validity of the scale in this study was confirmed using qualitative and quantitative methods, and construct validity was confirmed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The reliability of the questionnaire was calculated by Cronbach's alpha and intra-class correlation coefficient (ICC) for each field and the scale. Results: The IBS had three unplanned, motor and attentional subscales with 23 items and the varimax rotation showed variance of 52.06%. In CFA, root mean square error of approximation (RMSEA) was equal to 0.093 and normalized fit index (NFI), comparative fit index (CFI), goodness of fit (GFI) and incremental fit index (IFI) were higher than 0.9. Cronbach's alpha coefficient in the scale was 0.85%, and the intra-subject correlation coefficient (ICC) was 0.84%. Conclusion: The study results showed that the scale for pre-hospital personnel had the required validity and reliability, and it can be used for the impulsive behavior in pre-hospital personnel.

The interaction between electromagnetic radiation generated by current technologies (mobile phones and 4G/5G wireless antennas) and bees is an ongoing research topic with wider ecological and environmental implications, as bees play a crucial role in pollination and maintaining ecosystems. Since the interaction between bees and electromagnetic radiation is a complex and multifactorial issue, studies are needed in Romania to better understand the connection between non-ionizing electromagnetic radiation and bees. The aim of this paper was to highlight the importance and relevance of the impact of non-ionizing electromagnetic radiation on bees, in order to understand the potential threats to their health and the ecosystem. In order to explore the impact of electromagnetic radiation on bees, we considered publications accessible in the published scientific databases (2007-2024). Data were collected from more than 100 publications and finally 83 studies were considered, from which 76 studies were finally selected. The authors emphasized the negative effect on bees exposed to non-ionizing electromagnetic radiation (changes in flight behavior, disorientation, inability to identify the food source), emphasizing the relationship between the practical consequences of exposure to electromagnetic radiation and the decline of bee populations (CCD).

The developing process of a technology with the potential to increase efficiency in a sericulture farm represents one of the most important levers in the efficient exploitation of silkworms and mulberry (Bombyx mori). The development of an optimized technology, with the aim of making the activities carried out in a sericulture farm more efficient, is the main objective of this study. At the same time, the concept of "Pharma-Farming" is being explored, which promotes an integrated and sustainable approach in the management of sericulture farms by integrating sericulture and moriculture products and by-products. The use of the principles underlying the "Pharma-Farming" system could contribute to optimizing integrated processes and increasing the performance and sustainability of this agricultural sector. The integration of by-products obtained during the rearing of silkworms can represent a valuable opportunity not only to increase farmers' incomes through product diversification, but also to improve the quality of life. Exploring this concept facilitates the integration of by-products obtained from the sericulture farm into the pharmaceutical production chain, contributing to the creation of an additional source of raw materials and promoting a circular and sustainable economy. This research is carried out in a collaboration between three partners with expertise in the field of sericulture, and uses the resources of each to successfully address the development and implementation of the technology in different areas of Romania.

The COVID-19 pandemic had adverse health outcomes on individuals and communities. In this cross-sectional study we evaluated the admission rates in a tertiary-level hospital during the first wave of the pandemic (March 22, 2020 to August 31, 2020).

Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Abstract Many individuals with psychotic symptoms have less complex language than healthy individuals. Word etymology is a lexical feature that has not yet been studied in clinical populations, but among healthy individuals, words of Old French origin are chosen over Germanic-origin words to convey formality (e.g. “inquire” vs. “ask”). Differences in language complexity among individuals with psychotic symptoms may relate to differences in etymological content in speech. Here, we determined the proportion of Germanic-origin word use and Old-French-origin word use in a large cohort of individuals with recent-onset psychosis or at clinically high risk for psychosis, hypothesizing that individuals with recent onset psychosis would have increased use of Germanic-origin words and decreased use of Old-French-origin words. This hypothesis was borne out, even after adjusting for sex, age, recruitment site, education, racial identity, and for a subset, IQ. Etymology proportions were associated with role but not social functioning in individuals with psychotic symptoms, consistent with the premise that they reflect speech formality. Understanding speech differences in the psychosis spectrum through the lens of etymology may lead to new interventions to improve role functioning.

This paper engages in a decolonial exploration of the immigrant experience through the lens of “otherness.” Drawing upon literature on postcolonialism and decoloniality, the paper sought to interrogate the discourses and structures that perpetuate the marginalisation and alienation of immigrant students within host societies. Data utilised in this paper emanated from a qualitative study that sought to capture the experiences of twelve immigrant students and twelve non-immigrant students from two secondary basic education learning institutions in Mthatha, situated in the Eastern Cape province of South Africa. The paper critically examines the role of colonial legacies, systemic inequalities, and cultural hegemony in producing and sustaining the otherness of immigrant students. In doing so, it offers insights into the complexities of immigrant identities and challenges dominant narratives that reinforce exclusionary practices. Ultimately, this decolonial inquiry provides recommendations that seek to contribute to broader discussions on social justice, inclusion, and the transformative potential of decolonising approaches in addressing issues of otherness within contemporary societies.

Abstract Background Pectin from Taiwan Citrus depressa Hayata’s peels (CDH pectin) and sodium alginate (Na alginate) were mixed in neutral acidity to produce microhydrogel beads or microspheres. The potential use of the microspheres such as encapsulation materials for quercetin and nobiletin, DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging activity, toxic elements absorption ability, and thermal characteristics were explored. Results Different ratios of CDH pectin and Na alginate produced microspheres of varying sizes and shapes. The highest yield (47.59%) with the broadest diameter was obtained at a Na alginate—CDH pectin ratio of 2:1, while the smallest yield was obtained from Na alginate—CDH pectin ratio of 1:3 (24.13%). Increasing the amount of Na alginate resulted in more spherical microspheres, higher heavy metals (cobalt and nickel) removal rates, yet a lower swelling ratio. A high pectin concentration also increased the encapsulation efficiency of quercetin and nobiletin, reaching 91.5% and 86.74%, respectively. Quercetin and nobiletin release analysis (in vitro) showed a slow release of drugs from the microspheres. Less than 20% quercetin and nobiletin were released from the microspheres in SGF (simulated gastric fluid) pH 1.2 solution after 2 h and more than 40% of the encapsulated drug was released in SIF (simulated intestinal fluid) pH 6.8 after 4 h. The strong DPPH scavenging activity of quercetin (99%) was not hindered by encapsulation materials. ICP-OES (inductively coupled plasma–optical emission spectrometry) analysis demonstrated that the biopolymer can absorb cobalt and nickel from water. Thermogravimetric analysis (TGA) result showed that the combination of CDH pectin and Na alginate produced a biopolymer that exhibited a weight loss of only 1.86–4.33% at 100 °C. Conclusions These findings suggest that microspheres produced from CDH pectin cross-linked with sodium alginate had potential in nobiletin and quercetin encapsulation. Moreover, the polymer could absorb heavy metals and exhibit an important characteristic for hot food and beverage packaging applications.

Background: The aim of this research is to analyze the transformation of workers perceptions of the safety climate in an oil and gas company in Indonesia when they experience a change in ownership from a multinational to a national company. Methods: This cross-sectional study used questionnaires distributed offline and online in three periods of ownership of Company X. Data analysis was carried out descriptively by comparing workers perception scores regarding the safety climate at Company X when managed by the multinational holder, transition period, and national holder. Results: Workers perceptions of the safety climate in Company X when it experienced a change in ownership from a multinational company to a national company has a trend of decreasing scores (from 8.07 to 7.48). Overall, a decreasing trend in scores occurred in several sub-variables of safety climate, namely management commitment (8.33 to 7.56), communication (8.10 to 7.64), safety priority (8.55 to 7.68), personal appreciation of risk (8.25 to 5.48), involvement (7.50 to 7.36), and personal priority and need for safety (8.25 to 5.48). Conclusions: Ownership changes cause a trend of decrease in employee perceptions of the safety climate at Company X. Company's priority on safety related to production target factors is decreasing due to the change of ownership. On the other hand, the national period had a higher score in supportive environments and work environments, compared to the multinational period.

Despite evidence indicating a decrease in ovarian reserve among BRCA patients, this factor seems to not impact their spontaneous fertility negatively.

Background: Coronavirus disease 19 (COVID-19) has become a global pandemic; its unparalleled speed of spread has left us all in a worldwide alarming situation. Aims: The aim was to study the prevalence of COVID-19 infection in asymptomatic antenatal patients at term and its maternal and fetal outcomes and neonates being followed up till 18 months for developmental assessment. This was a prospective observational study carried out from September 1, 2020, to March 31, 2023. Materials and Methods: This prospective observational study was conducted on 250 pregnant women attending the antenatal care outpatient department in a Zonal Hospital in Northeastern India expected to undergo delivery in the next 5 days, and all suspected COVID-19 pregnant women were included in the study. Asymptomatic pregnant women not expecting delivery in the next 5 days were excluded. All neonates born to these 250 mothers were followed till 18 months of age and were then assessed for the impact of COVID-19 on the developmental milestones. The prevalence of COVID-19 was calculated in the study population. The Chi-square test was used to compare categorical variables in COVID-19-positive and -negative groups. P

Background and Aim: Heat stress (HS) can negatively impact oocytes by disrupting mitochondrial activity, increasing the production of reactive oxygen species, and decreasing antioxidant levels. This study investigated the impact of orange peel (OP) exposure on zebrafish oocytes (ZOs) diameter, survival rate, and germinal vesicle breakdown (GVBD) during HS. Materials and Methods: We investigated the antioxidant effect of flavonoids (concentration = 328.58 ppm) derived from OP (Citrus sinensis) added to in vitro maturation (IVM) media of ZOs (Danio rerio) under non-heat stress (NHS) and HS conditions to mimic in vivo HS conditions due to the global warming phenomenon on females. ZO in stage 3 (n = 1080) was treated with 4 μL of OP extract (not treated/control) under HS: 32°C (Heat stress 32°C solution/Heat stress 32°C orange peel [HS32S/HS32O]) and 34°C (Heat stress 34°C solution/Heat stress 34°C orange peel [HS34S/HS34O]); and NHS: 28°C (Non-heat stress solution/Non-heat stress orange peel [NHSS/NHSO]), during maturation. After 24 h of maturation, we observed the oocyte diameter, survival rate, and GVBD rate. The data were analyzed with IBM Statistics 23 software using two-way analysis of variance and Kruskal–Wallis (p < 0.05). Results: The highest oocyte diameter data were in NHS treated with OP extract (NHSO) group (0.759 ± 0.01; mean ± standard error) compared with HS group using and without OP extract (HS32S [0.583 ± 0.02]; HS32O [0.689 ± 0.02]; HS34S [0.554 ± 0.02]; and HS34O [0.604 ± 0.02]). The survival rate of OP treated group, namely, NHSO (93% ± 3%), HS32O (85% ± 2%), and HS34O (80% ± 2%) was higher than that of the group without treatment (NHSS [83% ± 3%], HS32S [71% ± 6%], and HS34S [63% ± 3%]). ZO treated with OP extract (NHSO [93% ± 3%], HS32O [85% ± 2%], and HS34O [80% ± 2%]) showed a higher GVBD rate than the group without treatment (NHSS [83% ± 3%], HS32S [71% ± 6%], and HS34S [63% ± 3%]). Conclusion: It revealed that OP can enhance the oocyte diameter, survival rate, and GVBD rate of ZO under NHS and HS. Further investigation should be conducted to determine the effect of OP extract (C. sinensis) on in vivo conditions in females as an alternative treatment to face global warming.

Abstract Background In 1993, WHO declared tuberculosis (TB) as a global health emergency considering 10 million people are battling TB, of which 30% are undiagnosed annually. In 2020 the COVID-19 pandemic took an unprecedented toll on health systems in every country. Public health staff already engaged in TB control and numerous other departments were additionally tasked with managing COVID-19, stretching human resource (HR) capacity beyond its limits. As part of an assessment of HR involved in TB control in India, The World Bank Group and partners conducted an analysis of the impact of COVID-19 on TB human resources for health (HRH) workloads, with the objective of describing the extent to which TB-related activities could be fulfilled and hypothesizing on future HR requirements to meet those needs. Methods The study team conducted a Workload Indicators and Staffing Needs (WISN) analysis according to standard WHO methodology to classify the workloads of priority cadres directly or indirectly involved in TB control activities as over-, adequately or under-worked, in 18 districts across seven states in India. Data collection was done via telephone interviews, and questions were added regarding the proportion of time dedicated to COVID-19 related tasks. We carried out quantitative analysis to describe the time allocated to COVID-19 which otherwise would have been spent on TB activities. We also conducted key informant interviews (KII) with key TB program staff about HRH planning and task-shifting from TB to COVID-19. Results Workload data were collected from 377 respondents working in or together with India’s Central TB Division (CTD). 73% of all respondents (n = 270) reported carrying out COVID-19 tasks. The average time spent on COVID-19 tasks was 4 h / day (n = 72 respondents). Multiple cadres highly instrumental in TB screening and diagnosis, in particular community outreach (ASHA) workers and CBNAAT/TrueNAAT laboratory technicians working at peripheral, block and district levels, were overworked, and spending more than 50% of their time on COVID-19 tasks, reducing time for TB case-finding. Qualitative interviews with laboratory technicians revealed that PCR machines previously used for TB testing were repurposed for COVID-19 testing. Conclusions The devastating impact of COVID-19 on HR capacity to conduct TB case-finding in India, as in other settings, cannot be overstated. Our findings provide clear evidence that NTEP human resources did not have time or essential material resources to carry out TB tasks during the COVID pandemic without doing substantial overtime and/or compromising on TB service delivery. To minimize disruptions to routine health services such as TB amidst future emerging infectious diseases, we would do well, during periods of relative calm and stability, to strategically map out how HRH lab staff, public health resources, such as India’s Health and Wellness Centers and public health cadre, and public-private sector collaboration can most optimally absorb shocks to the health system.

Abstract Background Antimicrobial resistance affects the treatment of several bacterial infections, including pneumonia. This subsequently increased the morbidity and mortality rates of patients with bacterial pneumonia, especially in resource-limited settings. In this study, we aimed to determine the patterns of multidrug-resistant (MDR) bacteria isolated from the sputum samples of patients with bacterial pneumonia attending a tertiary hospital in Tanzania. Methodology A retrospective cross-sectional study was conducted. It involved reviewing the laboratory sputum data in the laboratory information system at Muhimbili National Hospital in Tanzania. The sputum samples were previously processed using standard methods (culture, Gram staining, and biochemical tests) to isolate and identify the bacteria. At the same time, antibiogram profiles were determined using antimicrobial susceptibility tests. Bacterial isolates that expressed MDR patterns were identified. Demographic information was collected from patients' medical records. We used the chi-square test to determine factors associated with MDR. A p-value

Western flower thrips, Frankliniella occidentalis (WFT), is one of the most destructive insect pests of vegetables and ornamental crops globally. Ultraviolet-C (UV-C) exposure has been shown to reduce populations of arthropod pests, including whiteflies and two-spotted spider mites, but has not been fully assessed for WFT. The goal of this study was to determine if UV-C radiance could be a viable strategy for inclusion in integrated pest management (IPM) programs for WFT. The objectives were to (1) assess the relationship among UV-C dose (irradiance × duration) and mortality of WFT adults and second instar larvae, (2) determine the effect of UV-C on WFT fecundity and egg hatch, and (3) assess the effect of the WFT lethal dose of UV-C on three WFT-prone ornamental plants. A UV-C dose is measured in Joules, which equals power (watts) × exposure time. A dose-dependent relationship between UV-C exposure and mortality of WFT larvae and adults was observed. At the doses of 0.98 and 0.68 J/cm2 (5 and 4 min exposure, respectively), 50% of the larvae died within 24 and 48 h, respectively. The UV-C dose needed to achieve 50% mortality was higher for adults than larvae, occurring at 5.2 and 4.4 J/cm2 (35 min and 25 min exposure, respectively) within 72 and 120 h, respectively. The number of eggs laid by surviving WFT subjected to UV-C treatment was less than by those that were untreated, and the egg-laying period was significantly shorter among those treated with UV-C. When leaves containing WFT eggs were exposed to UV-C doses known to cause 30–40% mortality in adults, 86–98% fewer eggs hatched compared to untreated controls. Ornamental plants exposed to UV-C doses lethal to eggs, second instars, and adult WFT either showed no damage, or when damage occurred, plants recovered within 14–30 days. Additional studies under controlled greenhouse conditions are needed to elucidate the effectiveness of UV-C radiance against WFT over time and its compatibility with biological control and other IPM practices.

In today`s digital era, it is all the more desirable that all businesses, whether gigantic or minor in operation, should adopt financial technology and grow their businesses within their region and outside of the region. The Micro, Small & Medium Enterprises (MSME) segment is the mainstay of the Indian economic environment thus it is crucial that MSME players adopt financial technology in their routine commercial transactions. The present research study was conducted to investigate the enablers of usage of a Mobile Wallet by MSMEs in rural areas of India using interpretive structural modeling. It aims to categorize the foremost enablers and assess the relative relations between the recognized ten key enablers and proposes a hierarchical outline of vital enablers on MSME entrepreneurs from several hill states of India. The most prominent enabler that promoted the use of mobile wallets among MSME entrepreneurs included risk factors and perceived cost. The study suggested that multi-dimensional determinations are required to make certain of the use of mobile wallets by MSME entrepreneurs so that they can assess maximum economic opportunities and support the fiscal expansion of the state and the country.

This study examines the existing credit rating methodology proposed in the literature to explore the development of a new credit rating model based on the financial variables of the enterprise. The focus is on the period after the financial crisis of 2018. This study aims to develop a credit rating model using neural networking and tests the same for its accuracy. The goal of this study is to address the issue brought up by previous research on subjectivity in the data used to determine creditworthiness. The database for the study includes financial data up to July 2022 from December 2018. A model is created to assess an enterprise's creditworthiness using neural networking. This study first evaluated the existing credit rating models proposed in the literature. Next, based on financial data and neural networking, a model is developed. It was evident that the model developed in this study has an accuracy of 85.16% and 76.47% on train and test data respectively. There exist several models to determine the creditworthiness of borrowers but all failed to address the concern of subjectivity in the data. The model created in this study made use of cutting-edge technology such as neural networking and financial data. This paper's unique approach and model construction based on a comparison of existing models is rare in the literature and justify the originality of this paper with a practical value at the global level.

Campomanesia sessiliflora (O.Berg) Mattos is a Brazilian native plant species used in a popular medicinal tea for treating gastrointestinal, urinary, and dermatological pathologies. This study evaluated the toxicity of Campomanesia sessiliflora (O.Berg) Mattos via acute and subacute toxicity tests. It also analyzed mutagenic and genotoxic potentials by the micronucleus test, which detects genetic material damage indicating mutagenicity, and the comet assay, which assesses DNA damage levels as a genotoxicity indicator. The plant extract initially originated from the ultrasonic maceration of Campomanesia sessiliflora (O.Berg) Mattos leaves in a hydroethanolic solution. The involved animals were adult Wistar rats. Ten females were available to evaluate acute toxicity and estimate the LD50, receiving a dose of 2000 mg/kg. The subacute toxicity evaluation used 35 females and 35 males divided into seven groups: negative control (saline control – SC), positive control (cyclophosphamide control – CC), 125 mg/kg (125), 250 mg/kg (250), 500 mg/kg (500), 1000 mg/kg (1000), and the satellite group (ST). Genotoxicity and mutagenicity experiments applied bone marrow micronucleus and comet assays. Acute and subacute toxicity tests did not present behavioral, physical, and physiological changes (p≥0.05). Administering the Campomanesia sessiliflora (O.Berg) Mattos extract reduced spleen size in male and female animals, without histopathological changes. However, doses above 500 mg/kg showed significant genotoxic and mutagenic effects in the comet and micronucleus assays compared to the control group. The extract did not exhibit acute or subacute toxicity, but doses higher than 500 mg/kg indicated some level of genotoxicity and mutagenicity.

Objectives The objectives are to determine the prevalence of urinary tract infection (UTI) and associated factors among patients diagnosed with benign prostatic hyperplasia and prostate cancer.Design Hospital-based cross-sectional study.Settings Urology clinic and urology ward at Muhimbili National Hospital, which is the main tertiary hospital in Tanzania’s largest city.Participants Patients with benign prostate hyperplasia and prostate cancer presenting with genitourinary symptoms.Main outcome measure The primary outcome was the occurrence of UTI and factors associated with UTI in patients with benign prostatic hyperplasia and prostate cancer.Results 402 participants were enrolled, with a median age of 68 years and IQR of 61–75 years. The proportion of UTI was 46.5% (95% CI 41.56% to 51.53%). UTI was more prevalent among inpatients, patients with indwelling urinary catheters, patients with prostate size>80 cm3 and those with residual urine volume of >100 mL. In multivariate analysis, age>60 years (adjusted OR (aOR)=2.0, 95% CI 1.13 to 3.55, p=0.018), post-void residual urine volume>100 mL (aOR 1.32, 95% CI 0.67 to 2.59 p=0.001), patient with incomplete bladder emptying (aOR=2.57, 95% CI 1.44 to 4.59, p=0.001) and prolonged catheter duration (aOR=1.24, 95% CI 1.11 to 1.38, p=0.005) were significantly associated with UTI.Conclusion Almost half of the patients with an enlarged prostate and genitourinary symptoms had a laboratory-confirmed UTI. The risk of UTI increases with age, incomplete bladder emptying and increased duration of catheterisation. A 1-day increase in the duration of catheterisation increased the risk of UTI by 24%.

The high milk (20% of weight) feeding in initial life is beneficial for growth, feed efficiency, and welfare of calves. The experiment aimed to evaluate the impact of different milk-feeding regimens on the growth, intake, physiological responses, blood and faeces attributes, feed efficiency, and feeding cost in crossbred calves. Thirty (n=30) healthy pre-weaned crossbred calves (75% HF × 25% Kankrej) were divided into five groups using a completely randomized design. The calves were fed milk 10% of body weight (T1); 4 L/day during the entire experiment (T2); 6,4,2 L/day during 2-6, 7-9, and 10-13 weeks of age (T3); and early weaning protocols 7, 5 L/day during 2-6, and 7-9 weeks of age (T4); as well as 8, 4 L/day during 2-6, and 7-9 weeks of age (T5), respectively after an adaptation of seven days. The feeding of concentrate, dry, and green fodder was common in all groups. The effect of milk-feeding regimens on body weight, body measurements, intake, and feed efficiency were non-significant. The evaluation of physiological responses, faecal consistency score, and blood haematology indicated that it was safe to feed different milk regimens. The milk feeding up to 13 weeks of age (T1, T2, T3) significantly lowered the cost of feeding for weight gain than the early weaning protocol (T4, T5). Among them, the feeding of T3 regimen was economical for weight gain without affecting the growth performance, feed efficiency, and health attributes of crossbred calves.

Available online since 1 October 2024

Available online since 1 October 2024

The South Coast of Indonesia, especially in the Puger Village area East Subdistrict Puger Jember Regency still face challenge in increase quality education children. Devotion this aiming for describe effectiveness of mentoring programs student Coast through guidance Study in frame reduce number blind reading, writing and arithmetic for students Puger Wetan. Blind numbers of letters, especially blind reading, writing, arithmetic (reading, writing, arithmetic) for elementary school students, becomes problem serious that hinders progress and potential children in the future. Target tutoring for child blind reading, writing and arithmetic more focused on children child class on that is student grades 3-6 are divided into 2 groups that is child who has Can reading, writing and arithmetic and blind children reading, writing and arithmetic. The method used is PAR (Participatory Action Research), namely with identify ability latest students, giving guidance student in accordance level ability, identify appropriate methods, monitoring and evaluation, and review results. As a result, there are improvement ability as much as 36% of students who previously blind reading, writing and arithmetic, so that number blind reading, writing and arithmetic capable decrease as much as 19%.

Summary: Advancing age is a negative prognostic factor for cutaneous melanoma. However, the role of extracellular vesicles (EVs) within the melanoma tumor microenvironment (TME) has remained unexplored in the context of aging. While the size and morphology of the EVs isolated from young vs. aged fibroblasts remained unaltered, the contents of the protein cargo were changed. Aging reduced the expression of the tetraspanin CD9 in both the dermal fibroblasts and released EVs. CD9 is a crucial regulator of EV cargo sorting. Modulating the CD9 expression in fibroblasts was sufficient to alter its levels in EVs. Mass spectrometry analysis of EVs released by CD9 knockdown (KD) vs. control cells revealed a significant increase in angiopoietin-like protein 2 (ANGPTL2), an angiogenesis promoter. Analysis of primary endothelial cells confirmed increased sprouting under CD9 KD conditions. Together, our data indicate that aged EVs play an important role in promoting a tumor-permissive microenvironment.

Coffee producers in Indonesia need help with product quality, capital, and marketing. This international Community Service activity aims to promote Lampung coffee to the Turkish coffee market and improve the quality of Lampung coffee production and marketing. The activities were carried out in Istanbul, Turkey, with participants consisting of lecturers and students of the Master of Accounting FEB University of Lampung and management/employees of Kahvegihbikahve, one of the SME's coffee producers in Istanbul, Turkey. The activity was carried out through three main stages: (1) Preparation: situation analysis, preparation of material, making brochures for Lampung coffee producers; (2) Implementation: providing material to participants discussion to strengthen understanding and application of the material. (3) Evaluation and Reporting: comprehensive evaluation of community service results so that the participants can get to know the characteristics and taste of coffee in two countries (Indonesia, especially Lampung coffee and Turkish coffee), can understand and learn strategies for increasing the quality and quantity of coffee products and their marketing. So, it can make a positive contribution to the Indonesian and Turkish economies by increasing exports of coffee products and expanding the introduction of Indonesian coffee culture and taste.

Objective: Perform the validation and psychometric evaluation of the Brazilian-Portuguese translation of the Functional Outcome of Sleep Questionnaire 10 (FOSQ10). Materials and methods: 182 patients (65 females 48.3 ± 14.4 years and 117 males 46.9 ± 12.4 years), were evaluated by sleep physicians suspected of having Obstructive Sleep Apnea, underwent polysomnography and completed the FOSQ-10 and the Epworth Sleepiness Scale. APA & NCME, 2014 was used to validate the data as the American Educational Research Association recommended. Results: Quality indicators such as Bartlett's test of sphericity (χ2 = 1108.2; gL = 45; p = 0.000010) and KMO (0.83), and adherence measures, attest to the quality of the model. The indicators TLI (0.97), CFI (0.98), and RMSEA (0.04) fall within the expected values. Using the Eigenvalue > 1 technique, two factors explain 53% and 13.3% of the variances. In the Parallel Analysis technique, a single factor explained 59.4653% of the random variance, and the Unidimensionality indicators UniCo = 0.921, ECV = 0.822, and MIREAL = 0.253, were supported. Construct Validity: reliability coefficients Cronbach’s α = 0.87, McDonald’s ordinal Omega index 0.9, and the Composite Reliability 0.891 were satisfactory. Convergent validity: There was a significant Spearman correlation between FOSQ-10 and the Epworth Sleepiness Scale (r = 0.364 [−0.487; −0.226]). Criterion validity: Was not possible to differentiate the groups based on the severity of AHI using FOSQ-10P. Conclusions: The Brazilian translation of FOSQ-10 is valid and reliable for identifying significant effects of excessive daytime sleepiness in patients with Obstructive Sleep Apnea. Level of evidence: 2.

Abstract Background Nursing students are faced with a variety of challenges that demand effective cognitive and emotional resources. The physical and psychological well-being of the students plays a key part in the public health of the community. Despite the special lifestyle of nursing students, few studies have addressed chronic pain in this population. Accordingly, the present study aims to identify the predictors of chronic pain among nursing students. Methods This cross-sectional study was conducted on 1,719 nursing students aged 18–42 years, between February and November 2019. Sampling was carried out in several stages. Data were collected using seven instruments, namely a demographics survey, the characteristics of chronic pain form, Spielberger State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire-9 (PHQ-9), the Bar-on Emotional Quotient Inventory, Academic Satisfaction Scale, and Procidano and Heller Social Support Scale. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors. Results The average age of the participants was 22.4 ± 2.96 years. The results of univariate analysis showed that gender (P = 0.506), mother’s education (P = 0.056, P = 0.278, P = 0.278), father’s education (P = 0.817, P = 0.597, P = 0.41), place of residence (P = 0.215), depression (P = 0.501), grade point average (P = 0.488), academic satisfaction (P = 0.183) and chronic pain weren’t significantly correlated with chronic pain in nursing students. The results of the multiple logistic regression models showed that chronic pain was positively correlated with age, social support, state anxiety, and trait anxiety (OR = 1.07, 95% CI: 1.02–1.12; OR = 0.95, 95% CI: 0.93–0.97; OR = 1.03, 95% CI: 1.02–1.05; and OR = 1.97, 95% CI: 0.95–1.99; respectively). Conclusion The prevalence of chronic pain was relatively high in these students. In addition, age, social support, and anxiety could be important factors in the development or persistence of chronic pain in nursing students. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as referral for treatment, home medications for pain relief, and outcomes of chronic pain are suggested in future longitudinal studies.

. This study aimed to develop a paper-based glucose sensor using artificial sweat and saliva samples, a non-invasive, practical, and affordable concept for measuring glucose levels. The chosen method was the colorimetric method using the Glucose Oxidase (GOx) enzyme, Horseradish Peroxidase (HRP) enzyme, and 3,3?-diaminobenzidine (DAB) chromogen. The wax stamping method was utilized on a piece of filter paper to test the glucose sensor. The test was carried out in several stages, including testing various concentrations of reagents and wax stamping sizes, fabricating the glucose sensors, and testing multiple concentrations of glucose, artificial sweat, and artificial saliva. The RGB method was used to test the resulting color. The data obtained were then validated using UV-Vis Spectrophotometry. The GOx concentration on the glucose sensor affected the color change velocity. The HRP, DAB, and wax stamping size concentration simultaneously indicated a strong correlation with changes in the color intensity that appeared on the glucose sensor. The glucose sensor in this study could measure the glucose concentration of the artificial sweat and saliva samples, respectively, from 0-3000 and 0.9987. This study proved a strong correlation between the reagents' concentration and the color intensity on the developed glucose sensor.

Vipul Vilas Wagh,1 Tanvi Kottat,1 Suchita Agrawal,2 Shruti Purohit,2 Tejaswini Arun Pachpor,3,4 Leelavati Narlikar,5 Vasudeo Paralikar,2 Satyajeet Pramod Khare1 1Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, MH, India; 2Psychiatry Unit, KEM Hospital Research Centre, Pune, MH, India; 3Department of Biosciences and Technology, School of Science and Environment Studies, Dr. Vishwanath Karad MIT World Peace University, Pune, MH, India; 4Department of Biotechnology, MES Abasaheb Garware College, Pune, MH, India; 5Department of Data Science, Indian Institute of Science Education and Research, Pune, MH, IndiaCorrespondence: Vasudeo Paralikar; Satyajeet Pramod Khare, Email paralikarv2010@gmail.com; satyajeetkhare@gmail.comIntroduction: Stigma contributes to a significant part of the burden of schizophrenia (SCZ), therefore reducing false positives from the diagnosis would be liberating for the individuals with SCZ and desirable for the clinicians. The stigmatization associated with schizophrenia advocates the need for high-precision diagnosis. In this study, we present an ensemble learning-based approach for high-precision diagnosis of SCZ using peripheral blood gene expression profiles.Methodology: The machine learning (ML) models, support vector machines (SVM), and prediction analysis for microarrays (PAM) were developed using differentially expressed genes (DEGs) as features. The SCZ samples were classified based on a voting ensemble classifier of SVM and PAM. Further, microarray-based learning was used to classify RNA sequencing (RNA-Seq) samples from our case-control study (Pune-SCZ) to assess cross-platform compatibility.Results: Ensemble learning using ML models resulted in a significantly higher precision of 80.41% (SD: 0.04) when compared to the individual models (SVM-radial: 71.69%, SD: 0.04 and PAM 77.20%, SD: 0.02). The RNA sequencing samples from our case-control study (Pune-SCZ) resulted in a moderate precision (59.92%, SD: 0.05). The feature genes used for model building were enriched for biological processes such as response to stress, regulation of the immune system, and metabolism of organic nitrogen compounds. The network analysis identified RBX1, CUL4B, DDB1, PRPF19, and COPS4 as hub genes.Conclusion: In summary, this study developed robust models for higher diagnostic precision in psychiatric disorders. Future efforts will be directed towards multi-omic integration and developing “explainable” diagnostic models. Keywords: Schizophrenia, peripheral blood, gene expression, machine learning, ensemble learning

Probiotics are microflora that can improve intestinal health and the immune system, positively impacting human health. This study aimed to evaluate the ability of free cells and Limosilactobacillus fermentum InaCC B1295 (LFB1295) cells encapsulated with cellulose microfiber hydrogel (CMFH) from oil palm fronds (OPF) against gastric acid, bile ox gall, autoaggregation, coaggregation, and hydrophobicity of surface cells to reach the columns with high viability numbers and be capable of attaching to and colonizing the colon. The research was carried out experimentally by referring to previous research methods. Research data in resistance to gastric acid and bile salts, autoaggregation, coaggregation, and cell surface hydrophobicity were analyzed statistically using the t-test and displayed in table and figure form. The results showed that free cells were more susceptible to gastric acid and bile salts than CMFH-encapsulated cells from OPF, as indicated by a much more promising reduction in the viability of free cells compared to CMFH-encapsulated LFB1295 cells from OPF. Hence, LFB1295 free cells had higher autoaggregation, cell surface hydrophobicity, and coaggregation values than CMGH-encapsulated cells from OPF. Free and encapsulated cells generally have high coaggregation values with fellow lactic acid bacteria (LAB), Pediococcus pentosaceus, compared to coaggregation with pathogenic bacteria, namely S. aureus and E. coli. These findings indicate that free cells or cells encapsulated with CMFH-OPF have excellent acid and bile salts, autoaggregation, coaggregation, and hydrophobicity and qualify as probiotics.

Along with the rapid development of technology, various types of transportation have experienced increased innovation in shapes, colours, models, and even engines. However, one thing that needs special attention is the number of pollutants or emissions released by vehicles. One effort to reduce emissions is increasing the production of Battery-Based Electric Motorized Vehicles. Battery-based electric vehicles developed in Indonesia include electric cars and electric motorcycles. Among these types of electric vehicles, Indonesian society widely adopts electric motorcycles. However, sales of electric motorbikes were only 15 thousand units, lower than sales of petrol motorbikes which reached 5 million units. This study contributes to understanding further how the community responds to electric motorcycles in detail through sentiment analysis on social media data. Consumer acceptance of electric motorcycles can be seen from the numerous active Twitter users in Indonesia who provide positive and negative comments on the presence of electric motorcycles. Text information based on public comments in Indonesia via Twitter is collected using Sentiment Analysis in R Studio. Twitter comments will be classified into positive, negative, and neutral groups. The results show 63% positive, 21% unfavourable, and 14% neutral opinions. This condition means that Indonesian society accepts and has a supportive opinion of the presence of electric motorcycles. The government and entrepreneurs can use this information to create electric motorcycles that align with the community's preferences.

Introduction: Muscular injuries impose a significant morbidity and economic burden, affecting the sporting outcomes in soccer. The impact of the COVID-19 pandemic on their incidence among professional Colombian soccer players is unknown. Objective: To compare the incidence of muscular injuries in profesional soccer players during the periods of January 2019 to August 2020 (pre-pandemic competition + no competition during pandemic) and September 2020 to December 2021 (competition during pandemic). Methods: A retrospective cohort study across 2019, 2020, and 2021. A robust interrupted time series analysis was conducted to compare the injury incidence between both periods, focusing on changes in slope, level, autocorrelation, and variance. Results: Fifty-two muscular injuries were reported in 94 players. During the pandemic competition period, there was an increase in the level (difference: -12.03; 95% CI -21.13 to -2.93; p-value = 0.01) and in the autocorrelation coefficient (difference: 0.64; p-value = 0.01) of injury incidence proportions compared to the pre-pandemic competition + no competition period. The frequency of severe injuries was higher during the pandemic competition period (2021 season: 57.9%) than in the pre-pandemic competition period (2019 season: 5.0%). During the 2021 season, 63% of the players experienced a COVID-19 infection. Conclusions: The incidence and severity of muscular injuries increased during the competition period amidst the COVID-19 pandemic; a higher number of matches may be one of the ontributing factors.

In computer network, communication from one computer to another computer can be intercepted, the way to intercept communication between network devices is with Address Resolution Protocol Poisoning attack. This attack can steal data such as usernames and passwords, modify traffic, and stop the traffic itself. This research implements the Network Forensic Generic Process model as a reference in Network Forensics practice. Apart from that, this research also measures quality of service to compare parameters before the attack and when the attack occurred. The tools used in this research are Wireshark, XArp, and Snort. This research succeeded in obtaining authentic information from the evidence obtained. The results of quality of service measurements showed that the quality of service parameters changed when the attack occurred. This research can be a reference in improving network security by better understanding the threats that may be encountered and providing valuable insight for future security prevention and response efforts.

Abstract Background Verbatim transcription of qualitative audio data is a cornerstone of analytic quality and rigor, yet the time and energy required for such transcription can drain resources, delay analysis, and hinder the timely dissemination of qualitative insights. In recent years, software programs have presented a promising mechanism to accelerate transcription, but the broad application of such programs has been constrained due to expensive licensing or “per-minute” fees, data protection concerns, and limited availability of such programs in many languages. In this article, we outline our process of adapting a free, open-source, speech-to-text algorithm (Whisper by OpenAI) into a usable and accessible tool for qualitative transcription. Our program, which we have dubbed “Vink” for voice to ink, is available under a permissive open-source license (and thus free of cost). Results We conducted a proof-of-principle assessment of Vink’s performance in transcribing authentic interview audio data in 14 languages. A majority of pilot-testers evaluated the software performance positively and indicated that they were likely to use the tool in their future research. Our usability assessment indicates that Vink is easy-to-use, and we performed further refinements based on pilot-tester feedback to increase user-friendliness. Conclusion With Vink, we hope to contribute to facilitating rigorous qualitative research processes globally by reducing time and costs associated with transcription and by expanding free-of-cost transcription software availability to more languages. With Vink running on standalone computers, data privacy issues arising within many other solutions do not apply.

Abstract Background Feedstuffs and poultry feeds of low quality are major limitations to the growth of the poultry sector. Methods A qualitative study approach using key informant interviews was used to collect information. The thematic analysis method using a prescribed coding frame was used to analyze the data. Three themes emerged from the data: overview and business environment, consequences and propositions, and quality and enforcement. Results The study revealed that poultry feed sub sector is constituted by several players operating at varying scale of business dealing in either imported concentrates, feed stuffs or complete feed. The sector was not well regulated and there was no systematic surveillance done to evaluate the quality of products (feeds and feedstuffs) sold to the farmers. Some regions did not have any feed analytical facilities and therefore farmers mainly depended on subjective judgement using their sense of sight, smell, taste and touch to evaluate the quality of feedstuffs. Regulatory services such as certification of animal feed mills were insufficient not surprising that poultry farmers complained about feedstuff adulteration. The only requirement in place to operate feed and feedstuff business was an annual trade license. The actors/players in poultry feed business operated independently of their formal body or association. Conclusion This study showed that there is legislation gap in the animal feed sector. The players in the sector were at liberty not to follow standards that ensure quality feeds and feedstuffs.

Eduardo Jorge Fonseca Lima,1,2 Luiza Campos Corrêa de Araújo,1 Karine Ferreira Agra,2 Ana Julia Xavier Mendoza,1 Julia Pierre de Brito Siebra,1 Carmina Silva dos Santos2,3 1Department of Medicine, Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil; 2Lato Sensu Postgraduate Department, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil; 3Nursing Department, Faculdade Pernambucana de Saúde, Recife, Pernambuco, BrazilCorrespondence: Eduardo Jorge Fonseca Lima, Instituto de Medicina Integral Professor Fernando Figueira, Rua dos Coelhos, N° 300, Boa Vista, Recife, Pernambuco, Brazil, Tel +5581 21224166, Email eduardojorge@imip.org.brIntroduction: Community-acquired pneumonia (CAP) is one of the most common causes of childhood morbidity and mortality, causing about two million deaths per year worldwide. The complicated CAP (CCAP) results from the worsening of CAP. Their incidence has reduced in the last 30 years due to vaccination. However, the coronavirus disease (COVID-19) pandemic reduced vaccination coverage, resulting in increased incidence of CCAP in 2021 and 2022.Objective: To analyze the clinical and epidemiological profile of CAP in children under five years of age in two periods: pre- (2018 to 2019) and during the COVID-19 pandemic (2020 to 2022).Methods: This cross-sectional retrospective study was conducted at the Professor Fernando Figueira Institute of Integral Medicine (IMIP). We analyzed the sociodemographic and clinical variables of children with CAP aged below five years who were admitted to IMIP from 2018 to 2022. Analysis encompassed the Pearson’s Chi-square test, Fischer’s exact test, and Student’s T tests.Results: A total of 468 children were analyzed: 382 in the pre-pandemic period and 86 during the COVID-19 pandemic. Concerning the antibiotic therapy, the most prescribed was Ampicillin (45.00%) in both periods. The combination of Oxacillin and Ceftriaxone was prescribed in 6.86% of cases in the pre-pandemic period; this value increased to 20.90% during the COVID-19 pandemic. Pleural effusion represented 12.10% of cases in the pre-pandemic period and 24.40% during the COVID-19 pandemic. The presence of pleural empyema went from 1.60% to 8.20%, and necrotizing pneumonia from 1.30% to 5.90% in the respective periods. Regarding ICU admission, 5.30% were admitted during the pre-pandemic period and 34.10% during the COVID-19 pandemic. Clinical suspicion of influenza presented a positivity rate of 17.60%.Conclusion: Children with CAP presented a higher frequency of complications during the COVID-19 pandemic. Further research is needed to find the cause of increased CAP complications in this period.Keywords: pneumonia, bacterial, children, COVID-19, pleural effusion

Diaries have served as a vehicle to document personal narratives and as a research tool. However, diaries remain relatively underutilized in most research disciplines, particularly in the field of global health. This review aimed to explore the application, utility, and methodological potential of diaries as a qualitative data collection tool in the health sector within low- and middle-income countries. We applied a search string across several databases, which yielded 1796 articles that were screened for eligibility. Eleven articles, covering topics including menstrual health, HIV, and mental illness, met our criteria and were included in this review. Across studies, authors highlighted a need to provide instructions in a diary's early pages and make diaries appealing to the participants by incorporating color. Researchers and participants described diaries as an appropriate tool for conducting research especially among vulnerable populations (e.g. children) or on sensitive or stigmatized topics (e.g. HIV and menstrual health). Some participants said that diary entry clashed with existing obligations, leading to time conflicts and increased workload. Challenges related to diary comprehension suggests a need for researchers to engage more pointedly with participants to co-design diaries in a manner that facilitates understandability (e.g. language, use of audio/video recording among low literacy population) and age-appropriateness. An undercurrent across studies entailed a tension between what researchers desire from diaries (insights regarding a phenomenon of interest captured in a relatively timely manner) versus the original purpose of diaries (a space for individuals to note a variety of topics at a self-appointed pace). Studies generally under-report process insights from participants. Most studies stem from 2020 onward suggesting that this qualitative approach may continue to expand in the future. Our review organizes pertinent diary characteristics into a framework that may facilitate reporting of diary usage in global health research.

Background Resistance to antiretrovirals against human immunodeficiency virus (HIV) poses a threat to zero transmission of HIV by 2030. Few studies have been conducted on HIV drug resistance (HIVDR) mutations targeting adolescents. We determined the prevalence, pattern of HIVDR mutations, and factors associated with unsuppressed HIV viral load among adolescents on antiretroviral therapy (ART). Methods From March to June 2020, we conducted a cross-sectional study at the Infectious Disease Clinic in Dar es Salaam, Tanzania. HIV‐1 viral load was tested using m2000rt Real-Time HIV‐1 assay. A sample with a viral load equal or more than 1,000 copies/ml was tested for HIVDR mutations. We determined the factors associated with unsuppressed viral load using logistic regression. A p-value less than 0.05 was considered significant. Results We enrolled 131 participants with a median age (interquartile range) of 15 (13–18) years. Of all, 24(18.3%) had a viral load above 1000 copies/ml. HIVDR mutations were found in 19/24(68.4%). Mutation to protease inhibitors, nucleotide reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors were 1(5.2%), 9(47.4%), and 11(57.9%), respectively. Non-antiretroviral therapy and orphanages were independently associated with unsuppressed viral load. Conclusion The prevalence of HIVDR and unsuppressed HIV viral load among adolescents are relatively high. The use of non-antiretroviral therapy and orphanage influenced the persistence of high viral load. Strategies for surveillance of HIVDR early warning signs should be devised among adolescents.

Background Globally, the rate of antiretroviral therapy coverage for pregnant women living with human immunodeficiency virus (HIV) increased by 38% between 2010 and 2015 but only by 2% between 2016 and 2020. Objectives We aimed to determine the prevalence of vertical transmission of HIV among infants from mothers living with HIV and associated factors in the Eastern Lake Zone and Southern Highland of Tanzania from January to December 2022. Methods This retrospective cross-sectional study extracted data from the Open Laboratory Data Repository database collected from January to December 2022 at 93 health facilities. A total of 1,411 infants exposed to HIV from the Mbeya (851), Songwe (304), and Mara regions (256) were enrolled. Results The prevalence for vertical transmission of HIV was 2.48% (35/1411). We observed a non-significant difference in the prevalence of vertical transmission in children whose first test was done below six weeks of life (1.89%) and other age groups (2.52-2.62%) (p

Background: Limited access to ultrasound services in low and middle-income countries (LMICs) prompts the development of an intensive training program for midwives. The aim of this study was to evaluate the quality of ultrasound images produced by midwives and assess their competency in gestational age assessment using femur length. Methods: A cross-sectional study conducted in 11 healthcare facilities across four districts in Zambia involved the evaluation of 928 images captured during the implementation of the Training in Ultrasound to Determine Gestational Age (TUDA) program in 2021. TUDA, collaboration under the DIPLOMATIC Study, trained 24 midwives intensively for 14 days, followed by eight weeks of supervised scanning. Image assessment utilized the Sarries four-point tool, and statistical analyses included descriptive and inferential statistics. Results: Midwives achieved an 87.95 % competency level in basic ultrasound scans for gestational age determination using femur length. Assessment by four evaluators showed an average proportion of good-quality images also at 87.95 %. There were no statistically significant differences among assessors, indicating consistency in evaluations. Trainers and radiographers exhibited different average proportions of good-quality images at 91.5 % and 83.9 %, respectively, with no statistically significant differences observed between them.Furthermore, analysis of image quality revealed significant variation among different facilities. Specifically, in Chipata, 24.32 % of scans were classified as poor quality, while in George Clinic, only 2.30 % were considered poor quality. A Chi-square test indicated a substantial correlation between health facility and image quality (χ2 = 15.99, p = 0.025). However, no significant correlations were found between image quality and factors such as work experience, age group, or gender. Conclusion: This study provides critical evidence for successfully training midwives to competent produce high-quality ultrasound images for determining gestational age. These findings are essential for guiding interventions aimed at enhancing ultrasound service delivery and ensuring consistent, high-quality healthcare outcomes, because this is critical for effective prenatal care in Zambia. This has high potential to improve prenatal care. Recommendation: Zambia needs to train more midwives to provide routine ultrasound services during Antenatal Care (ANC) which may ultimately reduce preterm and still births. We recommend the inclusion of ultrasound scanning in-service and pre-service training and establishment of standardized protocols and guidelines for ultrasound scanning services during antenatal clinics.