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Abstract Background Although most pregnant women in Rwanda visit antenatal care (ANC) clinics, little has been studied about the quality of services being provided. We investigated the ANC providers’ (HCPs) current practices in relation to prevention, management and referral of maternal conditions as well as the information provided to pregnant women attending ANC services in Rwanda. Methods This facility-based, cross-sectional study included 312 ANC providers as participants and a review of 605 ANC medical records from 121 health centers. Data collection was performed using an interviewer-administered questionnaire and a structured observation checklist. For the analyses, descriptive statistics and bi-and multivariable logistic regression were used. Results Nurses and midwives in ANC services failed to report a number of pregnancy-related conditions that would need urgent referral to a higher level of health care. Midwives did somewhat better than nurses in reporting these conditions. There was no statistically significant difference in how nurses and midwives informed pregnant women about pregnancy-related issues. Ever been trained in how to manage a pregnant woman exposed to violence was reported by 14% of the participants. In 12, 13 and 15% of the medical records there was no report on tetanus immunization, anthelmintic treatment and syphilis testing, respectively. Conclusion The providers in ANC clinics reported suboptimal practices on conditions of pregnancy that needed urgent referral for adequate management. Information to pregnant women on danger signs of pregnancy, recommended medicines and tests do not seem to be consistently provided. Midwifery training in Rwanda should be expanded so that most of staff at ANC clinics are trained as midwives to help lower maternal and child mortality and morbidity.

Abstract Background In Rwanda, a majority of pregnant women visit antenatal care (ANC) services, however not to the extent that is recommended. Association between socio-demographic or psychosocial factors and poor utilization of antenatal care services (≤2 visits during the course of pregnancy irrespective of the timing) among recently pregnant women in Rwanda were investigated. Methods This population-based, cross sectional study included 921 women who gave birth within the past 13 months. Data was obtained using an interviewer-administered questionnaire. For the analyses, bi-and multivariable logistic regression was used and odds ratios were presented with their 95% confidence intervals. Results About 54% of pregnant women did not make the recommended four visits to ANC during pregnancy. The risk of poor utilization of ANC services was higher among women aged 31 years or older (AOR, 1.78; 95% CI: 1.14, 2.78), among single women (AOR, 2.99; 95% CI: 1.83, 4.75) and women with poor social support (AOR, 1.71; 95% CI: 1.09, 2.67). No significant associations were found for school attendance or household assets (proxy for socio-economic status) with poor utilization of ANC services. Conclusion Older age, being single, divorced or widowed and poor social support were associated with poor utilization of ANC services. General awareness in communities should be raised on the importance of the number and timing of ANC visits. ANC clinics should further be easier to access, transport should be available, costs minimized and opening hours may be extended to facilitate visits for pregnant women.

Abstract Establishing a sustainable life-support system for space exploration is a formidable challenge due to the vast distances, high costs, and environmental differences from Earth. Building upon the lessons from the Biosphere 2 experiment, we introduce the novel “Ecosphere” and “Biosealed” systems, self-sustaining ecosystems within customizable, enclosed containers. These systems incorporate terrestrial ecosystems and groundwater layers, offering a potential model for transplanting Earth-like biomes to extraterrestrial environments. Over 4 years, we conducted rigorous experiments and analyses to understand the dynamics of these enclosed ecosystems. We successfully mitigated moisture deficiency, a major obstacle to plant growth, by incorporating groundwater layers. Additionally, we quantified microbial communities proliferating in specific soils, including simulated lunar and Ryugu asteroid regolith, enhance plant cultivation in space environments. Metagenomic analysis of these simulated space soils revealed diverse microbial populations and their crucial role in plant growth and ecosystem stability. Notably, we identified symbiotic relationships between plants and Cyanobacteria, enhancing oxygen production, and demonstrated the potential of LED lighting as an alternative light source for plant cultivation in sun-limited space missions. We also confirmed the survival of fruit flies within these systems, relying on plant-produced oxygen and photosynthetic bacteria. Our research provides a comprehensive framework for developing future space life-support systems. The novelty of our work lies in the unique design of our enclosed ecosystems, incorporating groundwater layers and simulated extraterrestrial soils, and the detailed analysis of microbial communities within these systems. These findings offer valuable insights into the challenges and potential solutions for establishing sustainable human habitats in space, including the importance of microbial management and potential health concerns related to microbial exposure.

Background: Intracranial histiocytic sarcoma (HS) is uncommon in dogs, and no standard treatment has yet been defined for this disease. Herein, we describe a case of intracranial HS that responded favorably to nimustine treatment. Case Description: A 9-year-old, castrated Welsh Corgi Pembroke presented with a two-month history of quadriplegia. Intracranial disease was suspected on neurological examination, and magnetic resonance imaging (MRI) revealed a contrast-enhanced mass in the left frontal lobe. Following tissue biopsy, the patient received intravenous nimustine (ACNU) treatment. The patient's neurological symptoms partially improved, and a reduction in tumor volume was observed on MRI on day 99. After three administrations of ACNU, tumor regrowth was confirmed on day 124, and temozolomide was subsequently administered. The patient subsequently showed no major changes in clinical symptoms, but subsequently died suddenly on day 195. Conclusion: In this case, administration of ACNU provided temporary symptom improvement and tumor reduction. Therefore, ACNU monotherapy may be a therapeutic option for canine intracranial HS. [Open Vet J 2024; 14(10.000): 2700-2706]

Background: Lung tumors in dogs, significantly primary paragangliomas, are rare and have not been reported. This report describes a dog with a lung tumor diagnosed as a primary paraganglioma. Case Description: A 12-year-old spayed French bulldog presented with a left-sided pulmonary mass. The dog was in good general condition and had no clinical symptoms. Computed tomography (CT) revealed a pulmonary mass near the bifurcation of the posterior lobe bronchus of the left lung. The mass showed a strong contrast enhancement effect that was subsequently attenuated. The dog underwent Surgery to remove the mass from the left lung. Abnormal hypertension was observed during surgery, and hypertensive crisis was suspected. Based on the histopathology and preoperative and postoperative urinary metanephrine and normetanephrine levels, the dog was diagnosed with primary paraganglioma of the lung. Although the CT scan showed findings suggestive of the development of a neuroendocrine tumor, it was difficult to suspect the development of a paraganglioma. Conclusion: The possibility of catecholamine-producing tumors should be considered when we encounter a lung tumor with no clinical symptoms and a neuroendocrine tumor like contrast enhancement pattern on CT scan. [Open Vet J 2024; 14(10.000): 2714-2720]

Abstract Despite the success of immune checkpoint blockade (ICB) therapy for esophageal squamous cell cancer, the key immune cell populations that affect ICB efficacy remain unclear. Here, imaging mass cytometry of tumor tissues from ICB-treated patients identifies a distinct cell population of CD39+PD-1+CD8+ T cells, specifically the TCF1+ subset, precursor exhausted T (CD39+ Tpex) cells, which positively correlate with ICB benefit. CD39+ Tpex cells are predominantly in the stroma, while differentiated CD39+ exhausted T cells are abundantly and proximally within the parenchyma. Notably, CD39+ Tpex cells are concentrated within and around tertiary lymphoid structure (TLS). Accordingly, tumors harboring TLSs have more of these cells in tumor areas than tumors lacking TLSs, suggesting Tpex cell recruitment from TLSs to tumors. In addition, circulating CD39+ Tpex cells are also increased in responders following ICB therapy. Our findings show that this unique subpopulation of CD39+PD-1+CD8+ T cells is crucial for ICB benefit, and suggest a key role in TLS-mediated immune responses against tumors.

Ovarian neuroendocrine carcinoma is a rare and aggressive tumor with a poor prognosis. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are often used for diagnosis. However, no specific features exist, and preoperative diagnosis is often difficult. We present a case in which ovarian neuroendocrine carcinoma was diagnosed postoperatively, with the intention to discuss its imaging features on 18F fluoro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT). A 70-year-old woman presented to a local hospital with abdominal pain. CT showed a uterine mass and multiple swollen lymph nodes. The mass expanded from the uterus into the left ovarian vessels on dynamic MRI. The SUVmax of the mass and lymph nodes on 18F-FDG PET/CT were notably elevated to 53.2 and 33.0 respectively. Considering the tumor location and high SUVmax, a malignant uterine tumor was suspected. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omental biopsy, and resection of the left ovarian vessels were performed. Histological examination confirmed that the tumor was a neuroendocrine carcinoma derived from the left ovary. To the best of our knowledge, there are only few reports on the 18F-FDG uptake in ovarian neuroendocrine carcinomas. Conversely, in other organs, the carcinomas frequently exhibit markedly elevated SUVmax on 18F-FDG PET/CT. It is possible that ovarian neuroendocrine carcinomas share similar traits, and elevated SUVmax could indicate the potential presence of this histological type.

Objective: This study aimed to investigate the clinical efficacy of laparoscopic training using origami, a traditional Japanese papercraft, using laparoscopic forceps to create origami cranes. Methods: In this retrospective study, 4 surgeons were randomly divided into 2 groups: The training group, consisting of surgeons 1 and 2, and the non-training group, consisting of surgeons 3 and 4. Over the course of a one-year study period, the training group regularly underwent laparoscopic surgery training with a dry box, wherein they folded a total of 1000 origami cranes using laparoscopic instruments. The non-training group periodically underwent common laparoscopic surgery training of techniques such as suturing and ligation. Each surgeon regularly performed the transabdominal preperitoneal approach for inguinal hernias. Each training was conducted concurrently with the surgeries. The procedure time (peritoneum detachment, mesh placement, and closure of the peritoneum), total operation time (time from peritoneum detachment to closure of the peritoneum), and surgical outcomes were examined. Results: The training group showed greater improvement in the total operation time and more stable performance than the non-training group. Additionally, the time taken for peritoneum detachment was significantly shorter in the training group. Conclusion: Laparoscopic training using origami has the potential to enhance laparoscopic surgical skills and improve surgical outcomes.