Search

Sahra Ibrahimi,1– 3 Bamba Youssouf,4 Christine Potts,1 Alexandre Dumouza,1 Rani Duff,1 Landry-Serges Malaba,1 Bettina Brunner1 1International Development Division, Abt Associates, Rockville, MD, USA; 2Department of Global Health, Denison University, Granville, OH, USA; 3Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA; 4Matchboxology, Johannesburg, Gauteng, province, South AfricaCorrespondence: Sahra Ibrahimi, Global Development Group, Abt Associates, 6130 Executive Blvd, Rockville, MD, USA, Tel +1 413-406-4401, Email ibrahimi.sahra3@gmail.comBackground: In response to limited contraception availability and a lack of knowledge about family planning (FP) in the Democratic Republic of the Congo (DRC), the United States Agency for International Development (USAID) Integrated Health Program (IHP) in the DRC has been providing FP services, including outreach programs in the DRC. Our study aims to assess the FP outreach program by understanding the participants’ perception of the campaign, its impact on their behavior, and their feedback regarding the campaign. Additionally, we draw insights from lessons learned and provide recommendations.Methods: Between July and August 2022, we conducted 47 in-person participant interviews with women of reproductive age who used the outreach services provided by USAID IHP. Participants were randomly selected from Sud-Kivu, Kasai-Oriental, Haut-Katanga, and Tanganyika provinces. Consent and confidentiality were assured, and responses were recorded and transcribed in a Word document. We used Excel for data coding and analysis.Results: The campaign reached 95.7% of women interviewed; however, some participants could not recall specific message details. Most respondents (89.3%) reported that the campaign motivated them to make FP decisions and change their behaviors. While 14.8% of women reported making FP decisions independently, 85.1% reported making the decision jointly with their partners. Our analysis resulted in three emerging themes: 1) Increased FP outreach and improved perception of FP, 2) Improved perceived behavioral changes due to FP outreach, and 3) The need for program improvement by including men and providing additional information about possible FP side effects.Implications: Our study provides insights into how women receive information and whether they find it useful and share it with other women in their community. In particular, women’s feedback about the FP outreach program and our recommendations can inform future policies and interventions.Keywords: DRC, family planning, reproductive health, community outreach, USAID

Andreas Fichtner,1,2 Benedikt Brunner,3 Enrico Kloemich,1 Thomas Grab,4 Thomas Pohl,4 Tobias Fieback4 1Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany; 2Emergency Department, Freiberg Hospital, Freiberg, Saxony, Germany; 3University of Gothenburg, Department of Marine Sciences, Gothenburg, Sweden; 4Scientific Diving Center, Bergakademie Freiberg, Freiberg, Saxony, GermanyCorrespondence: Andreas FichtnerEmergency Department, Freiberg Hospital, Donatsring 20, Freiberg, 09599, Saxony, GermanyTel +49-3731-772198Email andreas@drfichtner.infoObjective: A well-accepted step in emergency sonography is the estimation of a fluid deficit through Inferior Vena Cava (IVC) diameter variability with known cut-offs especially in bleeding. We sought to answer, whether a non-bleeding fluid deficit can be quantified through sonographic assessment of IVC diameter variability and related aortic parameters. Sport divers were used as human hypovolemic vasoconstriction models since immersion is known to cause relevant volume depletion through vasoconstriction and induced diuresis.Materials and Methods: Forty-one sport divers performed 342 single and repetitive dives to account for intra- and interindividual variability and were assessed for inferior Vena Cava and neighboring aortic diameters as well as their cardiac/respiratory variations. Dive-related weight loss was measured together with sonographic vessel diameter changes inferior to the right atrium.Results: Highest correlation with dive-related weight loss of max. 2.9 kg per an average 47 minutes dive was found with r=0.34 for the difference of IVC maximum diameter related to minimum Aortic diameter. Single or combined parameters, as well as Collapsibility Index, showed lower or no correlations. Vascular parameters were able to explain 7.5% of the variance of fluid losses, whereas interindividual effects explained 10%. The remaining 82.5% is of mixed intraindividual counterregulatory effects.Conclusion: IVC diameter changes in immersion-induced hypovolemic centralization provides qualitative information on relevant fluid loss only. Confounding factors like inter and intraindividual variability prevent a sufficient correlation for useful quantification of the experienced non-bleeding fluid deficit in the clinical setting.Keywords: emergency sonography, fluid status, IVC-parameters, caval index

Fatih Karbeyaz,1 Seraphina Kissling,2 Paul Julius Jaklin,1 Jaqueline Bachofner,1 Barbara Brunner,1 Beat Müllhaupt,1 Thomas Winder,3 Joachim C Mertens,1 Benjamin Misselwitz,1,4 Stefanie von Felten,5 Alexander R Siebenhüner6,7 1Division of Gastroenterology and Hepatology, University Hospital Zurich and Zurich University, Zurich, Switzerland; 2Master Program in Biostatistics, University of Zurich, Zurich, Switzerland; 3Division of Oncology, Landeskrankenhaus Feldkirch, Feldkirch, Austria; 4Department of Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland; 5Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; 6Department of Medical Oncology and Hematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; 7Department of Medical Oncology, Cantonal Hospital Schaffhausen, Schaffhausen, SwitzerlandCorrespondence: Alexander R SiebenhünerKlinik für Medizinische Onkologie und Hämatologie, Universitätsspital Zürich, Rämistrasse 100, Zürich, CH-8091, SwitzerlandEmail alexander.siebenhuener@usz.chBackground: Direct-acting antivirals (DAA) have revolutionized the therapy of chronic hepatitis C (CHC) and have replaced previous PEG-interferon/ribavirin (PEG-IFN/RBV) treatment. Patients with CHC and advanced liver disease are at increased risk for hepatocellular carcinoma (HCC). However, the effects of DAA-based CHC treatment on subsequent HCC incidence remain poorly understood.Patients and Methods: This retrospective single-institution cohort study included 243 consecutive patients after PEG-IFN/RBV and 263 patients after DAA treatment. Multivariable cause-specific Cox proportional hazards models were used to compare time to HCC between treatment types, censoring patients who died or had an orthotopic liver transplantation (OLT) at the time of the competing event. Age, gender, BMI, viral load, cirrhosis, fibrosis stage, diabetes, virus genotype and previous PEG-IFN/RBV (before DAA) were used as covariates. In addition, we performed a propensity score-matched analysis.Results: Nineteen HCC cases were observed after DAA therapy compared to 18 cases after PEG-IFN/RBV treatment. Patients were followed for a median of 4.1 years (IQR: 3.5– 4.7) for DAA and 9.3 years (IQR: 6.6– 12.4) for the PEG-IFN/RBV group. In an unadjusted Cox model, a hazard ratio (HR) of 6.40 (CI: 2.20– 18.61, p=0.006) for HCC following DAA vs PEG-IFN/RBV was estimated. In multivariable Cox proportional hazard models, age and liver cirrhosis were identified as further HCC risk factors but the HR estimates for DAA vs PEG-IFN/RBV still indicate a considerably increased hazard associated with DAA treatment (HR between 7.23 and 11.52, p≤ 0.001, depending on covariates). A HR of 6.62 (CI: 2.01– 21.84, p=0.002) for DAA vs PEG-IFN/RBV was estimated in the propensity score-matched analysis. The secondary outcomes death and OLT did not differ between treatment groups.Conclusion: In a cohort study from a tertiary care hospital rates of HCC after the start of DAA treatment were higher compared to PEG-IFN/RBV treatment. Our data reinforce the recommendation that surveillance should be continued after successful CHC treatment.Keywords: hepatocellular carcinoma, chronic hepatitis C, direct-acting antivirals, PEG-interferon and ribavirin, viral load, liver transplantation, sustained virological response

The existence of oxidative microbial sulfur cycling in the deep biosphere has been postulated, but it is difficult to identify because isotope effects of reductive sulfur cycling generally overprint those of oxidative sulfur cycling. In the sediments at Integrated Ocean Drilling Program (IODP) Site C0007 (Holes A-C) drilled and sampled during IODP Expedition 316 at the Nankai Trough, Japan, sulfur and oxygen isotope compositions of dissolved and solid-phase sulfur compounds show evidence for a discrete zone of deep oxidative sulfur cycling. The sulfate concentration profile and isotope values show two distinct sulfate reduction regimes: one for downward-diffusing sulfate in the uppermost 36 m of sediment (unit I), and another zone below 90 m, where sulfate diffuses upward from a deep subsurface fluid. The sulfur and oxygen isotope composition of sulfate and a dramatic change in solid-phase iron geochemistry indicate that oxidative sulfur cycling occurs at depth. The highly dynamic sedimentary and tectonic regime at Nankai Trough has created an environment in the subsurface where geochemical gradients can sustain deep oxidative sulfur cycling over long durations of time. doi: 10.1130/G31085.1

The German Aerospace Research Establishment is focusing on the development of a novel and very versatile light weight robot via a holistic mechanotronic approach. The first stage of the development involves the establishment of a multisensor gripper for the ROTEX robot which was on-board the COLUMBIA shuttle during the early part of 1993. Research efforts have also resulted in a very light-weight seven-axes robot that featured a combination of microprocessor, electronics and mechanical controls.