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Abstract Micro-ultrasound has recently been introduced as a low-cost alternative to multi-parametric MRI for imaging prostate cancer. Early clinical studies have demonstrated promising results; however, robust validation via comparison with whole-mount pathology has yet to be achieved. Due to micro-ultrasound probe design and tissue deformation during scanning, it is difficult to accurately correlate micro-ultrasound imaging planes with ground truth whole-mount pathology slides. In this study, we developed a multi-step methodology to co-register micro-ultrasound and MRI to whole-mount pathology. The three-step process had a registration error of 3.90 ± 0.11 mm and consists of: (1) micro-ultrasound image reconstruction, (2) 3D landmark registration of micro-ultrasound to MRI, and (3) 2D capsule registration of MRI to whole-mount pathology. This process was then used in a preliminary reader study to compare the diagnostic accuracy of micro-ultrasound and MRI in 15 patients who underwent radical prostatectomy for prostate cancer. Micro-ultrasound was found to have equivalent performance to retrospective MRI review for index lesion detection (91.7% vs. 80%), while demonstrating an increased detection of tumor extent (52.5% vs. 36.7%) with similar false positive regions-of-interest (38.3% vs. 40.8%). Prospective MRI review had reduced detection of index lesions (73.3%) and tumor extent (18.9%) but improved false positive regions-of-interest (22.7%) relative to micro-ultrasound and retrospective MRI. Further evaluation is needed with a larger sample size.

We report that unsuccessful treatment outcomes were 11.8% for tuberculosis (TB) disease and 21.8% for TB infection among persons deprived of liberty in Uganda Prisons Service facilities. Remedial efforts should include enhancing referral networks to ensure treatment continuity, strengthening data systems for complete outcome documentation, and prioritizing short-course treatment regimens.

Animals navigate by learning the spatial layout of their environment. We investigated spatial learning of mice in an open maze where food was hidden in one of a hundred holes. Mice leaving from a stable entrance learned to efficiently navigate to the food without the need for landmarks. We developed a quantitative framework to reveal how the mice estimate the food location based on analyses of trajectories and active hole checks. After learning, the computed ‘target estimation vector’ (TEV) closely approximated the mice’s route and its hole check distribution. The TEV required learning both the direction and distance of the start to food vector, and our data suggests that different learning dynamics underlie these estimates. We propose that the TEV can be precisely connected to the properties of hippocampal place cells. Finally, we provide the first demonstration that, after learning the location of two food sites, the mice took a shortcut between the sites, demonstrating that they had generated a cognitive map.

Abstract The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients’ risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary.

Abstract The European Commission requested EFSA to update the scientific guidance for the preparation of applications for authorisation of novel foods, previously developed following the adoption of Regulation (EU) 2015/2283 on novel foods. This guidance document provides advice on the scientific information needed to be submitted by the applicant towards demonstrating the safety of the novel food. Requirements pertain to the description of the novel food, production process, compositional data, specifications, proposed uses and use levels and anticipated intake of the novel food. Furthermore, information needed in sections on the history of use of the novel food and/or its source, absorption, distribution, metabolism, excretion, toxicological information, nutritional information and allergenicity is also described. The applicant should integrate and interpret the data presented in the different sections to provide their overall considerations on how the information supports the safety of the novel food under the proposed conditions of use. Where potential health hazards have been identified, they are to be discussed in relation to the anticipated intake of the novel food and the proposed target populations. On the basis of the information provided, EFSA will assess the safety of the novel food under the proposed conditions of use.

Abstract Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on glucosyl hesperidin (GH) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF, which is produced from hesperidin and dextrin by enzymatic reactions, is a powder consisting mainly of monoglucosyl hesperidin (MGH) and unreacted hesperidin (flavonoid), which account in total for up to 92.8% (on dry basis) of the product. The applicant proposed to use the NF in specific drinks and food supplements leading to a maximum intake of up to 364 mg per day for adults. The target population is the general population, except for food supplements for which the proposed target population is children from 1 year onwards and adults. Taking into consideration the composition of the NF and the proposed uses, the consumption of the NF is not nutritionally disadvantageous. There are no concerns regarding genotoxicity of the NF. Based on a 90‐day oral toxicity study conducted with the NF, the Panel considers the NOAEL at the mid‐dose group, i.e. ~ 1000 mg/kg body weight (bw) per day. By applying an uncertainty factor of 200, the resulting intake providing sufficient margin of exposure for humans would be 5 mg/kg bw per day. The available human intervention studies did not report clinically relevant changes in haematological or clinical chemistry parameters following the administration of GH/MGH at supplemental doses of up to 3 g/day for 12 weeks. Overall, the Panel considers that the margin of exposure (~ 200) between the intake of the NF at the proposed uses and use levels and the NOAEL from the 90‐day study is sufficient. The Panel concludes that the NF, glucosyl hesperidin, is safe for the target population at the proposed uses and use levels.

Abstract Background Uganda imports approximately 90% of its medicines, with about 60% being distributed by the private sector. To discourage importation and promote local production of 37 selected locally manufactured medicines, the Ugandan government through the Ministry of Health in 2017 increased the import verification fees from 2 to 12%. The increase in verification fees ultimately affects cost and availability of these medicines. This study aimed to assess the cost and availability of the selected essential medicines after the 12% increase in verification fees in Uganda. Methods A cross sectional study among 328 wholesale and retail pharmacies and seven key informant interviews was conducted using a pretested data collection checklist and in-depth interview guide from February to September 2021 in Uganda. Data on the availability and prices of the medicines before (2017) and after (2020) the increase in verification fees was collected. Paired sample T-Test was used to test if there is a significant difference in prices before and after the 12% increase in verification fees. Results Mean availability of imported medicines was higher (54.8%, CI: 49.3–60.4) than the locally produced medicines (37.1%, CI: 31.9–42.7) except for locally manufactured parenteral preparations (54.6.%, CI: 49.1–60.1). Availability of locally produced medicines was mainly low (45%) while the imported medicines were fairly high (74%). Most commonly available locally manufactured medicines were Surgical spirit (89.9%), ORS (86%), Dextrose 5% solution (74.4%), Paracetamol 500 mg Tablets (73.8%) and Sodium Chloride 0.9% solution (72.9%). Most commonly available imported medicines were; Omeprazole 20 mg (94.2%), Amoxicillin Trihydrate 125 mg/5 ml (92.4%), Ciprofloxacin 500 mg (91.4%), Paracetamol Suspension 120 mg/5 ml (91.5%) and Metronidazole 200 mg Tablets (88.1%). Increase in lowest-priced local and imported medicines was significant for 10 (23.8%) and 7 (15.9%) of the medicines respectively. The median prices of imported medicines were generally higher than locally produced medicines. The median unit prices of 12 (28.6%) locally produced medicines and 20 (47.6%) imported medicines were higher than the international median unit prices. Conclusions The overall availability of imported medicines was still higher than the local medicines. The median prices of local and imported medicines generally increased or remained the same after the introduction of import verification fees. There is a need for price controls and transparency in the private sector.

Abstract Background During 2020 and immediately prior to the COVID-19 pandemic, Sudan was experiencing multiple emergencies including violence, seasonal flooding, and vector-borne disease outbreaks. After more than ten years since its last case of wild poliovirus, Sudan declared a circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak on 9 August 2020. Methods cVDPV2 outbreak response data and programme documents of the Federal Ministry of Health and WHO were reviewed. Surveillance data was verified through WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from acute flaccid paralysis (AFP) cases and the environment. Results This outbreak in Sudan led to a total of 58 confirmed cases of cVDPV2 from 15 of the 18 states. Two nationwide vaccination campaigns were held to increase immunity of children under-five against poliovirus type 2. Funding challenges were overcome by intense additional resource mobilization from in-country sources. The funding gap was bridged from domestic resources (49%) sourced through GPEI partners, and in-country humanitarian funding mechanisms. Conclusions During an outbreak response and challenge of funding shortfall, mobilizing in-country resources is possible through coordinated approaches, regular communication with partners, disaggregation of needs, and matching in-kind and financial support to fill gaps. A cVDPV2 outbreak requires a fast, resourced, and quality response to stop virus circulation.

In this retrospective longitudinal observational study, data from one site of the Fight Retinal Blindness! Registry (University of Zurich, Switzerland) was used to investigate the quantity and distribution of recurrent fluid in neovascular age-related macular degeneration (nAMD). Study eye eligibility required treatment-naïve nAMD, receiving at least three anti-vascular endothelial growth factor injections, followed by a treatment discontinuation of at least six months and subsequence fluid recurrence. To quantify fluid, a regulatory approved deep learning algorithm (Vienna Fluid Monitor, RetInSight, Vienna, Austria) was used. Fifty-six eyes of 56 patients with a mean age of 76.29 ± 6.58 years at baseline fulfilled the inclusion criteria. From baseline to the end of the first treatment-free interval, SRF volume had decreased significantly (58.0 nl (IQR 10–257 nl) to 8.73 nl (IQR 1–100 nl), p

Background: The surveillance of antimicrobial consumption (AMC) is critical to developing appropriate antimicrobial stewardship interventions. It is a key component of World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance and the Uganda Antimicrobial Resistance National Action Plan 2018–2023. Our study’s objective was to determine the national consumption of all antimicrobials. Methods: Data on all imported antimicrobials were retrieved from paper-based records and entered in the web-based National Drug Authority (NDA) management information system from 2021. The import data for the year is a proxy for nationwide consumption because they account for 95% of all medical products. The NDA authorizes all imports to the country regardless of final distribution in the supply chain. The data were analyzed in accordance with WHO Anatomical Therapeutic Chemical codes and defined daily dose (DDD) methodology. We also retrieved consumption data for 2018, 2019, and 2020 that were previously submitted by Uganda to WHO’s Global Antimicrobial Resistance and Use Surveillance System. Results: In 2021, the average DDD per 1000 inhabitants was 29.02 for all antimicrobials; 80.7% of antimicrobials consumed were oral. Penicillins (27.6%) were the most consumed antimicrobial class, followed by sulfonamides and trimethoprim (15.5%). Based on WHO’s Access, Watch, and Reserve (AWaRe) antibiotic classification, 62.91% of AMC was from the access class, with watch class averaging 14.51% in the period 2018–2021. Watch class AMC spiked in 2021 (34.2%) during COVID-19 pandemic compared to 2020 (24.29%). Azithromycin and ciprofloxacin were the most consumed watch class antimicrobials in 2021. Conclusions: The relatively high consumption of injectable antimicrobials and year over year increase in watch class AMC requires urgent stewardship interventions. Further work is needed to establish a system for longitudinal AMC surveillance that is well resourced and funded to overcome the challenges of estimation and provide more accurate data on consumption and use patterns.

Water pollution is a major environmental problem that has existed for decades, perhaps even longer, and is becoming more and more serious, necessitating the need for efficient, accurate and if possible inexpensive methods of monitoring and evaluating its impact on aquatic ecosystems. Algae, as photosynthetic organisms, have gained considerable attention as reliable biological indicators of water pollution due to their high sensitivity to environmental changes and their wide distribution in all categories of aquatic habitats. The unique characteristics of algae, a wide variety of species and their ubiquity in different types of water make them suitable candidates for such indicators. Algae respond rapidly to changes in water chemistry, temperature and nutrient levels, making them sensitive to various types of pollution including heavy metal pollution, organic pollutants and excess nutrients, various methods and techniques can be used to measure and assess algae responses to water. Pollution, determining both quantitatively and qualitatively the level of pollution. These techniques range from traditional microscopy-based identification and enumeration to more advanced molecular methods such as DNA barcoding and high-throughput sequencing. In addition, the use of bioindicators derived from algal communities, such as algal and biotic indices, is discussed as a valuable tool in water quality assessment. The potential of algae to detect and monitor pollution events, assess the ecological health of water bodies, and evaluate the effectiveness of pollution control measures is high and incompletely exploited in Romania and beyond. Factors such as natural variability, species-specific responses, and the need for standardized protocols, emphasizing the importance of considering these factors when interpreting algal data, are crucial issues and still need to be well established. Continuing research in this field is crucial for perfecting the use of algae as indicators and developing standardized protocols at the international level (EU and not only) for their application in water quality assessment.

The use of certain plant species as pioneers in the colonization of degraded or polluted lands in Romania has great potential. These resilient species play a crucial role in restoring ecological balance and promoting sustainable development. Salix alba has proven effective in stabilizing the soil, preventing the erosion of the soil and the banks of flowing waters and improving water quality. Its extensive root system helps absorb excess nutrients and contaminants from the soil, thus reducing pollution levels. Another valuable pioneer plant is Robinia pseudoacacia, which has a high tolerance to harsh environmental conditions and can thrive in polluted areas. Its nitrogen-fixing properties contribute to enriching the soil, making it suitable for the growth of other plant species, it has economic value as a melliferous species and provides habitat for various invertebrate or vertebrate species, thus supporting biodiversity. In the case of heavily degraded areas, it can be advantageous to use pioneer herbaceous plants such as Festuca arundinacea, Agropyron repens or leguminous plants. These herbaceous species have deep root systems that help stabilize the soil, prevent erosion, and increase soil fertility. Moreover, they can tolerate unfavorable soil conditions, i.e., polluted, compacted soil, soil with little humus, and harsher, drier microclimates. The concept of using pioneer plant species for land rehabilitation and restoration can be a cheaper method for ecological reconstruction. By selecting and implementing the use of these plant species, we can gradually recover degraded lands, restore biodiversity, and create sustainable ecosystems. However, the success of such initiatives depends on long-term interdisciplinary planning, monitoring, and management to ensure the desired results, sometimes taking decades to reach stable, self-sustaining ecosystems. Through their resilience and ecological benefits, these plants contribute to the revitalization of ecosystems and to the promotion of environmental sustainability, to the economic recovery of lands that would otherwise be useless and would continue to be a source of pollution.

Glacial groundwater can mobilize deep-seated methane from beneath glaciers and permafrost in the Arctic, leading to atmospheric emissions of this greenhouse gas. We present a temporal, hydro-chemical dataset of methane-rich groundwater collected during two melt seasons from a high Arctic glacial forefield to explore the seasonal dynamics of methane emissions. We use methane and ion concentrations and the isotopic composition of water and methane to investigate the sources of groundwater and the origin of the methane that the groundwater transports to the surface. Our results suggest two sources of groundwater, one shallow and one deep, which mix, and moderate methane dynamics. During summer, deep methane-rich groundwater is diluted by shallow oxygenated groundwater, leading to some microbial methane oxidation prior to its emergence at the surface. Characterization of the microbial compositions in the groundwater shows that microbial activity is an important seasonal methane sink along this flow-path. In the groundwater pool studied, we found that potential methane emissions were reduced by an average of 29% (±14%) throughout the summer due to microbial oxidation. During winter, deep groundwater remains active while many shallow systems shut down due to freezing, reducing subsurface methane oxidation, and potentially permitting larger methane emissions. Our results suggest that ratios of the different groundwater sources will change in the future as aquifer capacities and recharge volumes increase in a warming climate.

Abstract Following a request from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the tolerable upper intake level (UL) for manganese. Systematic reviews of the literature of human and animal data were conducted to assess evidence regarding excess manganese intake (including authorised manganese salts) and the priority adverse health effect, i.e. manganese‐induced neurotoxicity. Available human and animal studies support neurotoxicity as a critical effect, however, data are not sufficient and suitable to characterise a dose–response relationship and identify a reference point for manganese‐induced neurotoxicity. In the absence of adequate data to establish an UL, estimated background dietary intakes (i.e. manganese intakes from natural dietary sources only) observed among high consumers (95th percentile) were used to provide an indication of the highest level of intake where there is reasonable confidence on the absence of adverse effects. A safe level of intake of 8 mg/day was established for adults ≥ 18 years (including pregnant and lactating women) and ranged between 2 and 7 mg/day for other population groups. The application of the safe level of intake is more limited than an UL because the intake level at which the risk of adverse effects starts to increase is not defined.

Abstract Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on monosodium salt of l‐5‐methyltetrahydrofolic acid (5‐MTHF) as a novel food (NF) pursuant to Regulation (EU) 2015/2283 and to address the bioavailability of folate from this source in the context of Directive 2002/46/EC, Regulation (EU) No 609/2013 and Regulation (EC) No 1925/2006. The NF is produced by chemical synthesis and consists of at least 95% (w/w) of 5‐MTHF and 4%–5% (w/w) of sodium. It is proposed to be used as a partial or complete substitute to folic acid and other sources of added folate in a number of food categories. The production process, composition, specifications and stability of the NF do not raise safety concerns. When used as an ingredient in different food matrices, proper processing/storage conditions need to be considered to preserve the stability of the NF. Regarding bioavailability, the Panel considers that the NF readily dissociates into Na and l‐methylfolate ions, which subsequently are absorbed and enter the circulation. Thus, the bioavailability of 5‐MTHF from the NF is comparable to that of other currently authorised salts of 5‐MTHF. The Panel considers that the consumption of the NF is not nutritionally disadvantageous as long as the combined intake of the NF and the other supplemental forms of folate under their authorised conditions of use is below the ULs established for the different age groups of the general population. The Panel concludes that the NF is safe under the proposed conditions of use. The Panel also concludes that the NF is a source from which folate is bioavailable.

Abstract Background The local manufacture of pharmaceuticals is an opportunity to develop a broader manufacturing and knowledge-based economy and reduce over dependence on imports. To promote local production, the Ugandan government introduced Buy Uganda Build Uganda policy geared towards promoting use of locally manufactured goods. It also increased import verification fees in 2017 for 37 selected locally manufactured essential medicines from 2 to 12% to discourage importation of these medicines. This study assessed the impact of the increase in verification fees on local production capacity of the medicines. Methods This was a mixed methods study looking at production capacity before and after introduction of the 12% import verification fees. It was conducted among six (6) local pharmaceutical industries in Uganda and seven (7) key informant interviews with experts in the pharmaceutical sector between February and September 2021. Results The overall increase in local production capacity of the selected medicines was 8.2% from 2017 to 2020. The most significant increases were in the production of capsules (100.6%, P = 0.03) and oral liquids (170.8%, P = 0.0001). All the industries registered an increase in number of employees between 2017 and 2020 with an average percentage increase of 42%. There was a 14.7% (95% CI 2.76–17.6%) change in installed capacity of the compression machine (P = 0.033) and 27.7% (95% CI 24.6–33.9%) change in installed capacity of the Blow–Fill–Seal (BFS) filling machines (P = 0.011). There was also an increase in the number and capacity of installed utilities such as the heating ventilation and air conditioning (968%) and standby generators (131%). Only two (2) industries registered an increase in critical quality control equipment and one had all the critical equipment available by 2020. Most of the key informants reported positive impact of the increment of import verification on local manufacturing capacity. Conclusions Local pharmaceutical production capacity increased with the increase in import verification fees with significant increases in production of oral liquids and capsules. Successful implementation of policies supporting local production will promote the development of local pharmaceutical industries. Governments should consider increasing the list of medicines to benefit from the import verification fees increase by adding all essential generic medicines for which there is adequate domestic production capacity and technical skills.

In the current geopolitical context, following the Russian invasion of Ukraine, the energy consequences are severe for almost all European countries, whether they are EU members or not. A blind energy policy pursued over the last 20–30 years by most EU countries has led to an over-reliance on a single source for gas and/or oil: Russia. Moreover, the hasty implementation of measures to shut down fossil fuel-fired power plants without finding viable alternatives in place has exacerbated this poisonous dependence on Russian gas sources. As a result, following the new geopolitical framework, Europe is forced to revert to an old source of energy, coal, at least for a certain period, revise its energy and environmental policy. Many countries such as Italy, Germany, Poland, the Czech Republic, etc. have already passed or intend to move to the reopening of coal mines and thermal power plants that use this source. Poland, which obtains about 75% of its energy from coal, initially set itself the goal of giving up this resource in 2049, but now this deadline will be “much more” postponed. Germany has kept its 2030 target for this goal, if all goes well. Considering all this and because Romania is not independent of the energy viewpoint, we consider that also in this case it is beneficial from the economic and energy security perspective to keep in operation the coal mines and the thermal power plants that use this raw material, beyond the horizon of 2050. This can be done by refurbishing mines and thermal power plants and by implementing efficient management, totally different from what has happened over the years so far. Only when the so-called clean, “renewable” or other energy sources with a soft environmental impact can cover the energy deficit can the use of fossil fuels and, especially, coal be safely abandoned.

In a larger or smaller geographical area, before human activity intervened, the distribution of plant and animal species is the result of hundreds of millions of years of evolution. Through various anthropogenic activities, this distribution has been greatly disrupted, introducing intentionally or unintentionally a number of plant or animal species in geographical areas where they would not have existed without human intervention. So this ecological balance achieved by nature in millions of years, in geological times, is threatened and destroyed by man in a very short time, years or at most decades. There is no single, unanimously accepted definition of invasive species. Most agree that the invasive species is introduced into a geographical area other than the one from which the species originated and, as a result, this species finds the conditions to spread at high speed, to the detriment of some native species, generating ecosystem problems, sometimes very large. Other specialists make a clear difference in terms of non-native species, calling exotic species, those that are present in new ecosystems, do not cause disturbances and invasive species, ie species that reach other ecosystems, cause their dysfunctions. As for invasive plants, they obviously do not have their own mobility and their invasive appearance is less obvious than in the case of invasive animal species. However, the effects of these invasive plants are often severe, and are not limited to ecological aspects but, directly or indirectly, the effects can be even serious at the economic level or in terms of human health. The Research Institute for Nature and Forest (INBO) and the Center for Ecology and Hydrology (CEH) have compiled an inventory (DAISIE - Delivering Alien Invasive Species Inventories for Europe) which currently contains 12104 allogeneic taxa for Europe. This was made possible by an international effort involving more than 300 researchers and funded by European funds. The database is constantly updated, with over 1650 experts constantly working on this issue. The severity of this phenomenon is illustrated by the difficult to estimate costs of invasive species, in Europe the accounting of these costs being earlier, but they are tens of billions of euros annually. By comparison, combating invasive species costs the United States more than 80 billion euros a year. Romania is no exception, the problem of invasive plants being a very important aspect with negative implications for the economy and the quality of human life.

Background and Aim: Human papillomavirus types 16 and 18 cause most cervical cancers worldwide. Existing VLP-based vaccines are unable to eliminate ongoing highly oncogenic infections. This study suggests an SLP-based vaccine for already infected patients, even with precancerous lesions. Methods: HPV16/18 E6 and E7 proteins' potent HLA class I and class II-restricted epitopes were extracted from IEDB or predicted by ANNs (IC50 < 50 nM, percentile rank < 2%). Population coverage was assessed via HLA-SLP interactions. SLP constructs, containing specific epitopes linked by cleavable peptides (LMRK, LLSVGG), underwent rigorous screening for allergenicity, toxicity, physicochemical parameters, antigenicity, and diversity. 3D structure prediction employed homology and ab initio modeling and was validated via QMEAN4 score and Ramachandran plots. Molecular docking (HADDOCK-2.4) evaluated SLP-TLR2 interactions. MD studies (GROMACS-2023.1) investigated SLP behavior in an electroneutral aqueous environment (300 K, 1 atm, 100 ns) via RMSD, RMSF, SASA, and Rgyr dynamics. Results: 28 class I and 16 class II-restricted epitopes had an IC50 < 50 nM and provided population coverages of 98.18% (class I) and 99.81% (class II). The selected 25 SLPs expressed a mean 1.5×10−2 toxicity score, no allergenic properties, a mean instability index of 37.61, and a mean VaxiJen score of 0.97. The QMEAN4 score ([0.665;0.813]), with >90% of the residues in the most favorable regions reflect good quality 3D structures. Molecular docking studies provided a ΔG of −13.20±1.42 kcal/mol, and an average Kd of 3.5×10−9 M. MD simulations reflect favorable thermodynamic properties, based on mild RMSD ([0.1;0.87] nm), RMSF, SASA (49.37±1.54 nm2) and Rgyr ([1.15;1.34]) fluctuations over the 100-ns simulations. Conclusions: 25 in silico-designed SLPs stimulate both innate and adaptive immunity, with little to no toxic or allergenic effects. The presented vaccination platform could exert both a therapeutic (by tumor cell clearance) and a prophylactic effect (by eradicating E6 and E7+ premalignant cells).

Co-management has been widely promoted in protected area management on the premise that it may simultaneously enhance biodiversity conservation outcomes and improve livelihoods of the park-border communities. However, the success of this management approach remains a growing debate raising the question of its effectiveness. To contribute to this debate, we used local community perceptions and secondary ecological data to assess the extent to which co-management has effectively contributed to biodiversity conservation and socio-economic development outcomes in the Vwaza Marsh Wildlife Reserve. Face-to-face individual interviews using a semi-structured questionnaire were used to collect data on the perceptions of co-management from 160 purposively selected heads of households. A desk study was used to collect data on trends in animal populations, animal mortality, and prohibited activities including incidences of poaching for the past 30 years (pre-and post-introduction of co-management). Results showed that local communities have positive perceptions of the conservation work in the Vwaza Marsh Wildlife Reserve. Further, there was an improved people-park relationship and a recovery of animal populations in the reserve after the introduction of co-management. These findings point to the success of co-management in the area. However, misunderstandings over revenue sharing were still a thorny issue, somehow creating mistrust between parties. We concluded that while it may still be early to achieve more demonstrable conservation outcomes, co-management appears to bring hope for effective biodiversity conservation and socio-economic development in the Vwaza Marsh Wildlife Reserve. Participatory evaluation of co-management involving key stakeholders is recommended in the Vwaza Marsh Wildlife Reserve based on the findings of this study and lessons learnt over the years.

Abstract Background Globally, there is recognition of the value of using mobile phones among health providers in improving health systems performance. However, in many Low- and Middle-income countries where there is shortage of health providers, Community Health Workers have assumed some responsibilities especially relating to identifying and reporting on health problems within their communities. Despite the known benefits of using mobile phone technology to deliver health services, there is limited information on the extent to which Community Health Workers are able to effectively use the technology in data collection and reporting. The aim of this study was to determine the feasibility of utilizing phone-based text messages on Lymphatic Filariasis morbidity surveillance by Community Health Workers. Methods This was a cross sectional study whose data was collected through key informant interviews and focused group discussions among community health workers, health providers and staff of neglected tropical diseases control program. Collected transcripts were analysed through Thematic content analysis as it allowed for the identification of data codes through inductive reasoning. Results The use of mobile phone-based text messages in data collection and reporting lymphatic filariasis morbidity cases by Community Health Workers was perceived by study participants to be a relevant tool and feasible due to the ease of use of the technology. The tool was reported by end-users to significantly increase their performance and efficiency was gained in terms of reduced paper work, increased the number of patients accessing health care services and the ability to report in real-time. All respondents were confident that Community Health Workers were the right persons to interact with communities in tracking and reporting morbidity cases using mobile technology. Conclusion Mobile phone-based text messages have proven to be effective in routine workflows such as, data collection and reporting on Lymphatic Filariasis morbidity cases, patient to provider communication, decision making and supportive supervision. Mobile phones have also improved efficiency and general performance of end users in terms of increased number of cases identified and efficiency gained in terms of reduced paper work and the ability to collect and report in real-time.

Abstract The ability of the liver to regenerate after injury makes it an ideal organ to study for potential therapeutic interventions. Mesenchymal stem cells (MSCs) possess self‐renewal and differentiation properties, as well as anti‐inflammatory properties that make them an ideal candidate for therapy of acute liver injury. The primary aim of this study is to evaluate the potential for reversal of hepatic injury using human umbilical cord–derived MSCs. Secondary aims include comparison of various methods of administration as well as comparison of activated versus nonactivated human umbilical cord stem cells. To induce liver injury, humanized mice were fed high‐cholesterol high‐fat liquid diet with alcohol binge drinking. Mice were then treated with either umbilical cord MSCs, activated umbilical cord MSCs, or a placebo and followed for survival. Blood samples were obtained at the end of the binge drinking and at the time of death to measure alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Histology of all mouse livers was reported at time of death. Activated MSCs that were injected intravenously, intraperitoneally, or both routes had superior survival compared with nonactivated MSCs and with placebo‐treated mice. AST and ALT levels were elevated in all mice before treatment and improved in the mice treated with stem cells. Conclusion: Activated stem cells resulted in marked improvement in survival and in recovery of hepatic chemistries. Activated umbilical cord MSCs should be considered an important area of investigation in acute liver injury.

Background: COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. Materials and Methods: We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. Results: A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. Conclusions: COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

The objective of this article is to examine the impacts of molybdenum disulphide (MoS2) and graphite-filled (Gr) polyetheretherketone (PEEK) composites that have been fabricated through 3D printing on their mechanical properties and crystallinity. Seven samples and thirty-five dog bones were produced using different filament strands to conduct the analysis. Before extrusion into filaments, the solid lubricants, MoS2, and graphite were uniformly dispersed within the PEEK through mechanical blending. At a concentration of 10 wt.%, the PEEK/MoS2 composites exhibited the highest tensile strength, measuring approximately 104 MPa, while the PEEK/Gr composites displayed the lowest tensile strength at the same concentration, approximately 36 MPa. In addition, the PEEK/MoS2 composites demonstrated better elongation, approximately 4.7%, compared to the PEEK/Gr composites, which exhibited approximately 2.3% elongation. X-ray diffraction (XRD) data revealed that neither MoS2 nor graphite significantly interacted with the PEEK matrix. The degree of crystallinity, as determined by density matrices, indicated that the printed PEEK composites possessed a higher level of crystallinity, approximately 62% at a concentration of 5 wt.%, than the calculated values. This suggests that the filament-making and 3D printing processes had an annealing effect. The significance of solid lubricant content and dispersion in shaping the mechanical properties and crystal formation of 3D-printed PEEK composites is emphasized in this study. Furthermore, this research provides valuable insights for optimizing PEEK-based materials for various applications.

Romania, since the pre-accession phase to the European Union, has committed itself to implementing environmental policies in accordance with European legislation. Regarding the stage reached, only a part of these obligations regarding the ecological sanitation of some post-industrial sites were respected, an insignificant part. Many places in Romania are characterized by an emanating, historical pollution. This is the result of decades of inefficient communist economy, with little respect for the environment, high energy consumption and little-added value. To continue solving these problems of historical pollution, enormous funds are needed and the ecological remediation and reconstruction works will be more numerous and increasing. An efficient, environmentally friendly and inexpensive solution is the application of bioremediation methods. These ecological methods are widely observable worldwide, especially in developed countries. Phytoremediation, in turn, is a major method of depollution of contaminated ecosystems, especially those polluted with oil residues from old petrochemical plants or heavy metals from metal mining and processing activities. These economic activities had a wide spread on the Romanian territory during the socialist epoque, and that is why today many polluted areas have remained ecologically unhealthy. Phytoremediation being a much cheaper method than others, which falls within the concept of sustainable development, has great economic and ecological potential in Romania and must be assumed as a variant that should be quickly applied to the situation on the ground. This will be even more necessary in the context in which budgetary allocations for solving environmental problems are in competition with other needs that require the same limited source of funding.

Abstract Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on aqueous extract of Labisia pumila as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is a standardised hydroalcoholic extract from a dried whole plant (including roots) of L. pumila, mixed with maltodextrin (as a drying aid), and proposed by the applicant to be used as a food supplement in amounts up to 750 mg/day. The target population is the general adult population, except pregnant and lactating women. The major constituents of this NF are carbohydrates (up to 85.5%), with a smaller amount of proteins (up to 6.5%), gallic acid (up to 3.7%) and fats (up to 1.6%). The Panel considers that taking into account the composition of the NF and the proposed conditions of use, consumption of the NF is not nutritionally disadvantageous. The provided genotoxicity studies do not raise concerns about the genotoxicity of the NF. Based on the available toxicological data, the Panel considers an intake of up to 5 mg/kg body weight per day as safe. For the target population, this level corresponds to 350 mg/day, which is lower than the use level proposed by the applicant. The Panel concludes that the NF is safe for the target population up to 350 mg/day.

Human papillomavirus types 16 and 18 cause the majority of cervical cancers worldwide. Despite the availability of three prophylactic vaccines based on virus-like particles (VLP) of the major capsid protein (L1), these vaccines are unable to clear an existing infection. Such infected persons experience an increased risk of neoplastic transformation. To overcome this problem, this study proposes an alternative synthetic long peptide (SLP)-based vaccine for persons already infected, including those with precancerous lesions. This new vaccine was designed to stimulate both CD8+ and CD4+ T cells, providing a robust and long-lasting immune response. The SLP construct includes both HLA class I- and class II-restricted epitopes, identified from IEDB or predicted using NetMHCPan and NetMHCIIPan. None of the SLPs were allergenic nor toxic, based on in silico studies. Population coverage studies provided 98.18% coverage for class I epitopes and 99.81% coverage for class II peptides in the IEDB world population’s allele set. Three-dimensional structure ab initio prediction using Rosetta provided good quality models, which were assessed using PROCHECK and QMEAN4. Molecular docking with toll-like receptor 2 identified potential intrinsic TLR2 agonist activity, while molecular dynamics studies of SLPs in water suggested good stability, with favorable thermodynamic properties.

Abstract Background Brucellosis is a contagious zoonotic disease of great public health and economic significance especially in developing countries. The disease affects humans and several species of livestock and wildlife. Studies on Brucellosis in wildlife in Uganda have been limited to single populations particularly in Queen Elizabeth National Park. This study aimed at estimating the percentage of positive samples of Brucella spp. in wildlife in four major national parks of Uganda. This was a retrospective survey which utilized archived samples collected from wildlife during the annual disease surveillance activities between 2013 and 2017. Results A total of 241 samples from seven species namely African buffalo (Syncerus caffer, n = 109), African elephant (Loxodonta africana, n = 22), giraffe (Giraffa camelopardalis rothschildi, n = 41), Uganda kob (Kobus kob thomasi, n = 36), lion (Panthera leo, n = 6), plain zebra (Equus quagga, n = 25), and bushbuck (Tragelaphus scriptus, n = 2), were tested for antibodies using the Rose Bengal Plate Test. The overall percentage of positive samples in the four national parks was 31.1% (75/241; 95% CI: 25.6–37.2). Kidepo Valley National Park had a significantly higher percentage of positive samples of 55.9% (19/34; 95% CI: 39.5–71.1) compared to other sampled national parks (p

Abstract Background The level of preparedness of the health care workers, the health facility and the entire health system determines the magnitude of the impact of an Ebola Virus Disease (EVD) outbreak as demonstrated by the West African Ebola outbreak. The objective of the study was to assess preparedness of the health care facilities and identify appropriate preparedness measures for Ebola outbreak response in Kasese and Rubirizi districts in western Uganda. Methods A cross sectional descriptive study was conducted by interviewing 189 health care workers using a structured questionnaire and visits to 22 health facilities to determine the level of health care system preparedness to EVD outbreak. District level infrastructure capabilities, existence of health facility logistics and supplies, and health care workers’ knowledge of EVD was assessed. EVD Preparedness was assessed on infrastructure and logistical capabilities and the level of knowledge of an individual health work about the etiology, control and prevention of EVD. Results Twelve out of the 22 of the health facilities, especially health center III’s and IV’s, did not have a line budget to respond to EVD when there was a threat of EVD in a nearby country. The majority (n = 13) of the facilities did not have the following: case definition books, rapid response teams and/or committees, burial teams, and simulation drills. There were no personal protective equipment that could be used within 8 h in case of an EVD outbreak in fourteen of the 22 health facilities. All facilities did not have Viral Hemorrhagic Fever (VHF) incident management centers, isolation units, guidelines for burial, and one-meter distance between a health care worker and a patient during triage. Overall, 54% (n = 102) of health care workers (HCWs) did not know the incubation period of EVD. HCWs who had tertiary education (aOR = 5.79; CI = 1.79–18.70; p = 0.003), and were Christian (aOR = 10.47; CI = 1.94–56.4; p = 0.006) were more likely to know about the biology, incubation period, causes and prevention of EVD. Conclusions Feedback on the level of preparedness for the rural districts helps inform strategies for building capacity of these health centers in terms of infrastructure, logistics and improving knowledge of health care workers.

Sustainable conservation of crop wild relatives is one of the pathways to securing global food security amid climate change threats to biodiversity. However, their conservation is partly limited by spatio-temporal distribution knowledge gaps mostly because they are not morphologically charismatic species to attract conservation attention. Therefore, to contribute to the conservation planning of crop wild relatives, this study assessed the present-day distribution and predicted the potential effect of climate change on the distribution of 15 Vigna crop wild relative taxa in Benin under two future climate change scenarios (RCP 4.5 and RCP 8.5) at the 2055-time horizon. MaxEnt model, species occurrence records, and a combination of climate- and soil-related variables were used. The model performed well (AUC, mean = 0.957; TSS, mean = 0.774). The model showed that (i) precipitation of the driest quarter and isothermality were the dominant environmental variables influencing the distribution of the 15 wild Vigna species in Benin; (ii) about half of the total land area of Benin was potentially a suitable habitat of the studied species under the present climate; (iii) nearly one-third of the species may shift their potentially suitable habitat ranges northwards and about half of the species may lose their suitable habitats by 5 to 40% by 2055 due to climate change; and (iv) the existing protected area network in Benin was ineffective in conserving wild Vigna under the current or future climatic conditions, as it covered only about 10% of the total potentially suitable habitat of the studied species. The study concludes that climate change will have both negative and positive effects on the habitat suitability distribution of Vigna crop wild relatives in Benin such that the use of the existing protected areas alone may not be the only best option to conserve the wild Vigna diversity. Integrating multiple in situ and ex situ conservation approaches taking into account “other effective area-based conservation measures” is recommended. This study provides a crucial step towards the development of sustainable conservation strategies for Vigna crop wild relatives in Benin and West Africa.

BackgroundPatients with hypertrophic cardiomyopathy (HCM) have an increased prevalence of atrial fibrillation (AF) compared to the general population, and left atrium (LA) remodeling is strongly correlated with the risk of AF. This prospective, monocentric study aimed to assess the role of LA electrocardiographic and echocardiographic (structural and functional) parameters in predicting the risk for incident AF in patients with HCM.Methods and ResultsThe study population consisted of 126 HCM patients in sinus rhythm (52.6 ± 16.2 years, 54 men), 118 of them without documented AF. During a median follow-up of 56 (7–124) months, 39 (30.9%) developed a new episode of AF. Multivariable analysis showed that LA booster pump function (assessed by ASr, HR = 4.24, CI = 1.84–9.75, and p = 0.038) and electrical dispersion (assessed by P wave dispersion – Pd, HR = 1.044, CI = 1.029–1.058, and p = 0.001), and not structural parameters (LA diameter, LA volume) were independent predictors of incident AF. Seventy-two patients had a LA diameter < 45 mm, and 16 of them (22.2%) had an AF episode during follow-up. In this subgroup, only Pd emerged as an independent predictor for incident AF (HR = 1.105, CI = 1.059–1.154, and p = 0.002), with good accuracy (AUC = 0.89).ConclusionLeft atrium booster pump function (ASr) and electrical dispersion (Pd) are related to the risk of incident AF in HCM patients. These parameters can provide further stratification of the risk for AF in this setting, including in patients considered at lower risk for AF based on the conventional assessment of LA size.

Abstract Background Therapeutic ineffectiveness of artemisinin-based combination therapy (ACT) increases the risk of malaria-related morbidity and mortality, and raises healthcare costs. Yet, little has been done to promote the pharmacovigilance (PV) of ACT ineffectiveness in sub-Saharan Africa, particularly in Uganda. This study aimed to determine the extent and associated factors of the past 6 months reporting of suspected or confirmed ACT therapeutic ineffectiveness by healthcare professionals (HCPs), and difficulties and potential solutions to the PV of ACT therapeutic ineffectiveness. Methods Survey of 685 HCPs conducted using a self-administered questionnaire from June to July 2018 in a nationally representative sample of public and private health facilities in Uganda. HCPs disclosed if they had spontaneously reported ACT therapeutic ineffectiveness to appropriate authorities in the previous 6 months. Multivariable logistic regression models were used to identify determinants of past 6-months, HCP-reported ACT therapeutic ineffectiveness. Results One in five (20%, 137/685; 95% CI 17–23%) HCPs reported ACT therapeutic ineffectiveness to an appropriate authority in the previous 6 months. HCPs commonly reported ACT therapeutic ineffectiveness to immediate supervisors (72%, 106/147), mostly verbally only (80%, 109/137); none had ever submitted a written report of ACT therapeutic ineffectiveness to Uganda’s National Pharmacovigilance Centre. Common difficulties of reporting ACT therapeutic ineffectiveness were: unavailability of reporting procedures (31%, 129/421), poor follow-up of treated patients (22%, 93/421) and absence of reporting tools (16%, 68/421). Factors associated with reporting ACT therapeutic ineffectiveness in the past 6 months were: hospital-status (vs other; OR = 2.4, 95% CI 1.41–4.21), HCPs aged under 25 years (OR = 2.2, 95% CI 1.29–3.76), suspicion of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.3, 95% CI 1.29–3.92), receipt of patient-complaint(s) of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.9, 95% CI 1.62–5.12) and HCPs from northern (vs central; OR = 0.5, 95% CI 0.28–0.93) and western (vs central; OR = 0.4, 95% CI 0.17–0.77) parts of Uganda. Conclusion One in five HCPs reported ACT therapeutic ineffectiveness, mostly verbally to supervisors. The existing adverse drug reaction (ADR)-reporting infrastructure could be leveraged to promote the PV of ACT therapeutic ineffectiveness.

The hypertrophication phenomenon (excessive eutrophication, induced by human activities) affects more and more the waters in the western area of the Black Sea, including the Romanian sector. This phenomenon is generated by the accumulation, in large volumes, in the sea waters, of some compounds, especially phosphorus, nitrous and nitrates, which mainly originate in the agriculture made in the river basin of the Black Sea, and from certain industrial activities, as well as from the household waters reaching the flowing waters that are tributary to the Danube. Romanian sea waters are affected by the transport of these compounds mainly by the Danube, but also by the ones coming from the Dniester and the Dnieper. There is a common responsibility for the fact that these phosphorus and nitrous compounds, which generate the hypertrophication in the waters of the Black Sea, belonging to all the states from the river basin of the three large flowing waters, to a larger or smaller extent, which is frequently hard to quantify. The negative economic impact consists of the more and more frequent pollution with algae of the sea water and beaches in the Romanian area, disturbing phenomenon which even banishes tourists. Then, the changes in the biocoenosis structure also lead to loses in aquaculture and fishing. It is necessary to implement a system to identify polluters, to quantify the amount of pollution of each involved part to share the costs between them.

The issue of the plastic waste, PET bottles, food packing dump that is carried by the flowing waters in Romania is older and still rigorous. Causes are represented by the irresponsible throwing, in the environment, of wastes by the local inhabitants, tourists, and sometimes, paradoxically, by some of the authorities. Considering that these wastes pollute the areas in the rivers’ proximity, some reservoirs, the riverbed of the Danube and that most of the reach the Black Sea, things seem to be more stringent . A significant part of the plastic is turned into micro particles which are spread in the environment, ending swallowed by humans and animals, leading to serious effects on the health. Economic losses generated by dump accumulation in tourism or from the problems generated against hydroelectric plants are also significant. Moreover, in some cases, it might lead to cross-border problems, as waste reaches the territories of neighboring states through flowing waters, especially due to flash floods and floods. Solving these issues involves more aspects, from the awareness of the causes of some citizens’ irresponsible behavior to finding solutions and involving all the responsible factors.

Abstract Background Efficient testing to identify poor quality artemisinin-based combination therapy (ACT) is important to optimize efforts to control and eliminate malaria. Healthcare professionals interact with both ACT and malaria patients they treat and hence could observe, first-hand, suspect poor quality artemisinin-based combinations linked to poor malaria treatment outcomes and the factors associated with inappropriate use or treatment failure. Methods A cross-sectional study of 685 HCP perspectives about the efficacy of ACT between June and July 2018 at selected health facilities in Uganda. Medicine samples were obtained from the seven regions of Uganda and tested for quality using the Germany Pharma Health Fund™ minilabs. Results The average age of the 685 respondents was 30 (SD = 7.4) years. There was an almost equal distribution between male and female respondents (51:49), respectively. Seventy percent (n = 480) were diploma holders and the nurses contributed to half (49%, n = 334) of the study population. Sixty-one percent of the HCPs reported having ever encountered ACT failures while treating uncomplicated malaria. Nineteen percent of HCPs thought that dihydroartemisinin/piperaquine gave the most satisfactory patient treatment outcomes, while 80% HCPs thought that artemether/lumefantrine gave the least satisfactory patient treatment outcomes, possibly due to dosing schedule and pill burden. Healthcare professionals from the Central region (OR = 3.0, CI 0.3–1.0; P = 0.0001), Eastern region (OR = 5.4, CI 2.9–9.8; P = 0.0001) and Northern region (OR = 5.3, CI 2.9–9.9; P = 0.0001) had a higher chance of encountering ACT failure in 4 weeks prior to the survey as compared to those from the western region. Healthcare professionals from private health facilities also had higher chances of encountering ACT failures in past 4 weeks as compared to those from public health facilities (OR = 2.7, CI 1.7–3.9; P = 0.0001). All 192 samples passed the quality screening tests. The random sample of 10% of all samples randomly obtained by the laboratory staff also passed the chemical content analysis and dissolution tests. Conclusion ACT medicines are widely available over-the-counter to the public and it is very difficult to report and monitor a decrease in efficacy or treatment failure. The perspectives of HCPs on treatment failure or lack of efficacy may potentially guide optimization efforts of sampling methodologies for the quality survey of ACT medicines.

Parkia biglobosa (Jacq.) G. Don, Pterocarpus erinaceus Poir, Milicia excelsa (Welw.) C. C. Berg, Prosopis africana (Guill., Perrot. and Rich.) Taub., Afzelia africana Sm. and Khaya senegalensis (Desv.) A. Juss. are the most highly valued indigenous tree species in the agroforestry systems of the Ouémé catchment area. However, information on the population structure of these species is lacking, thus limiting the development of their sustainable conservation, utilization and restoration strategies. This study addressed this gap. It assessed the population structures and regeneration status of the six species from Don, Tan-Houègbo, Atchabita, Bétékoukou, Glazoué, Tchaorou, Zagnanado, Tévèdji, Sinaou and Bétérou along the catchment. Data were collected from 78 permanent rectangular plots (50 × 30 m) randomly installed within 10 provenances. Dendrometric data including diameter at breast height (dbh) of adult trees (dbh ≥ 10 cm), collar diameter, total height of seedlings and saplings, number of individuals per species according to adult, sapling and seedling were recorded. The population structure was described using ecological and dendrometric parameters (relative frequency, importance value index (IVI), mean densities, basal area, mean height), and diameter size-class distributions. Seedling:sapling and sapling:adult ratios were also computed and analyzed for determining regeneration patterns. Based on IVI, Parkia biglobosa (95.85%) and Khaya senegalensis (65.92%) were the most represented species in the catchment area. The analysis of variances showed that dendrometric parameters of the six species varied significantly between provenances. Seedling:sapling and sapling:adult ratios were

Evidence has demonstrated that immediate HIV treatment initiation upon a positive HIV test, referred to as Test and Treat, can help people living with HIV live longer, healthier lives and prevent HIV transmission. Although Tanzania adopted the evidence-based Test and Treat strategy since 2016, men were not being adequately reached for HIV services. A national campaign was launched to promote the new HIV services with a focus on men. To inform the development and implementation of the campaign, we conducted formative audience insights-gathering (AIG) sessions to assess facilitators and barriers to accessing HIV Test and Treat services and inform the concepts and materials for the campaign. Qualitative AIG interviews and focus group discussions were conducted with 54 people who were unaware or aware of their HIV status and currently or not currently on treatment, as well as health workers. Facilitators and barriers included a fear of testing positive, the desire to belong , control their narratives, and reinvent themselves to achieve their dreams and live a happy life. The campaign played off a My Happiness! creative concept to position antiretroviral therapy (ART) as a solution to fears around what life would be like after a positive HIV diagnosis. The development and implementation of the campaign were informed by the AIG sessions and national stakeholders, leading to strong partners’ buy-in that supported the scale-up of the ongoing campaign from 12 to 26 regions via the collaborative efforts of government, donors, and implementing partners.

Although several international and national HIV/AIDS conferences exist, there was not a national conference in Tanzania focusing on HIV/AIDS disseminating and implementation research conducted in the country and abroad. This created a missed opportunity for researchers to share their research findings with local policymakers and HIV program implementers who can influence the adoption and implementation of promising research in public health and clinical practice settings. In response, the first HIV/AIDS D&I Research Forum designed to enhance local D&I efforts for HIV research, was organized in Tanzania in 2018. This paper explores the perceived benefits of the HIV/AIDS D&I Research Forum and potential challenges of developing similar forums and recommendation for future HIV research D&I conference in Tanzania. During the second day of the Forum, which was held in September 2018 in Morogoro, Tanzania, a 1-hour structured brainstorming session was conducted with the Forum attendees (n = 50), including researchers, medical professionals, policymakers, representatives from different ministries. Transcription of the brainstorming session was analyzed to identify benefits of the Forum, perceived challenges for organizing similar HIV/AIDS research dissemination events, and recommendations for addressing the challenges. Overall, participants perceived the forum to be beneficial because it provided opportunities for strategic collaborations between researchers, policymakers, and other stakeholders and for them to discuss challenges for D&I efforts. Forum attendees also identified several potential challenges for future D&I research forums such as the abstract requirement which may deter non-researchers, costs, meeting frequencies, and lack of funding and coordination between organizations involved in D&I research efforts. To address these concerns, a recommendation was made to host a biennial national conference in order to allow more time for ethical review and feedback that can enhance contribution of the project to D&I efforts and to raise funds. The benefits identified for the Forum highlight the importance of organizing similar D&I meetings for HIV-related research at the national level in Tanzania. However, the potential challenges discussed need to be addressed in order to develop a sustainable national D&I research conference by incorporating recommendations that forum attendees proposed.

A field experiment was conducted in 2018/2019 growing season at the Scientific Industrial Research and Development Center under irrigated conditions using the simple alpha lattice (7∗7) design, with three replications. The objective of the study was to determine the performance of 44 elite rice lines that were selected and shared from elite doubled haploid germplasm and five cultivars were used as checks. All evaluated genotypes exhibited significant variation in the traits measured except for number of grains/panicle, total tillers/plant, and effective tillers/plant. Elite line 70462 was found to be the highest yielding, with yield advantage of 66% over the high yielding local check (Nerica 7). High values for broad sense heritability were recorded for days to 50% heading, panicle length, culm length, number of filled grains/panicle, 1000-grain weight, grain length, grain shape, and grain yield and indicated lesser influence of environment in expression of these traits, hence amenable to simple selection. Correlation analysis revealed that grain yield manifested significantly positive correlation with filled grains/panicle contributing the highest correlation (r = 0.784), followed by culm length (r = 0.605), spikelet fertility/panicle (r = 0.677), grain length (r = 0.551), 1000-grain weight (r = 0.518), panicle length (r = 0.449), and number of grains/panicle (r = 0.328). Based on grain yield, number of filled grains/panicle and spikelet fertility/panicle, panicle length, and earliness, lines 70462, 60143, 70383, Arica 3, Sahel 177, 6040, 70537, 60409, and 70476 had the best performance. Selection of these traits would be more effective for yield improvement in rice and these promising lines could be used in the varietal development and can be tested in multilocational trials and on-farm trials in Zimbabwe with the possibility of release and commercialization.

Background: Infections with Wuchereria bancrofti are associated with reduced immunity against concomitant infections. Indeed, our previous study described a 2.3-fold increased HIV incidence among individuals with W. bancrofti infection, as measured by the circulating filarial antigen of the adult worm. This new study aimed to retrospectively determine microfilariae status of the participants to assess if the previously described increased HIV susceptibility was associated with the presence of MF in the same cohort. Methods: CFA positive but HIV negative biobanked human blood samples (n = 350) were analyzed for W. bancrofti MF chitinase using real time PCR. Results: The PCR provided a positive signal in 12/350 (3.4%) samples. During four years of follow-up (1109 person years (PY)), 22 study participants acquired an HIV infection. In 39 PY of W. bancrofti MF chitinase positive individuals, three new HIV infections occurred (7.8 cases per 100 PY), in contrast to 19 seroconversions in 1070 PY of W. bancrofti MF chitinase negative individuals (1.8 cases per 100 PY, p = 0.014). Conclusions: In the subgroup of MF-producing Wb-infected individuals, the HIV incidence exceeded the previously described moderate increased risk for HIV seen in all Wb-infected individuals (regardless of MF status) compared with uninfected persons from the same area.

The African baobab (Adansonia digitata L.) is a multipurpose orphan tree species of the semi-arid and sub-humid Sub-Saharan Africa where it plays an important role in rural livelihoods. Its wide distribution and dense nutrition properties make it an important species for food and nutrition security in Africa. However, despite the increasing interest in the species over the past two decades, the full potential of baobab remains underexploited. This review highlights strides made over the past 20 years (2001–2020) towards harnessing and unlocking the potential values of baobab in Benin, West Africa, to contribute to food and nutrition security. Challenges and threats are identified, and next steps suggested to guide research and development initiatives for orphan tree fruit species like baobab to address hunger and malnutrition in Africa.

Abstract Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on Eurycoma longifolia (Tongkat Ali) root extract as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is standardised water extract prepared from the dried ground root chips of Tongkat Ali (Eurycoma longifolia Jack) and proposed by the applicant to be used as food supplement in amounts up to 200 mg/day. The target population is the adult population, except pregnant and lactating women. The characteristic components of the NF are glycosaponins (40–65%) and eurycomanone (0.8–1.5%). It can also contain canthin‐6‐one alkaloids and isoscopoletin (coumarin). The NF has been present in various international markets since 2009. The Panel notes positive results from the submitted in vitro chromosome aberration test, which indicates clastogenic properties of the NF. In the requested follow‐up in vivo mammalian alkaline comet assay, the NF induced positive results at the highest dose tested (2,000 mg/kg body weight (bw)) at the tissues of the first site of contact (stomach and duodenum). Histopathological evaluation of the tested tissues indicated that the positive results of the comet assay were rather due to genotoxicity than cytotoxicity. Taken together, the Panel concludes that the NF has the potential to induce DNA damage, which is of concern, particularly locally for tissues that represent first sites of contact. The Panel concludes that the safety of NF has not been established under any condition of use.

The article aims to summarize the main features of Elena Pulcini’s social philosophy, starting with her latest work entitled Between care and justice. Passions as social resources. Empathy, compassion and indignation are just some of the moral sentiments that show the limits of the anthropological model of homo oeconomicus; at the same time, these sentiments are at the center of a new theoretical paradigm that combines care and justice in order to avoid the partiality of unilateral ethical-political models: just as justice can become unfair, if careless, care work can easily assume the unrecognizable semblances of exploitative relationships when conceived and practiced regardless of a fair material and symbolic recognition of its performances. The intellectual testament of Elena Pulcini is as an urgent invitation to overcome the widespread emotional illiteracy and proposes a promising strategy to face the challenges due to the space-time distance of the Other in the global age.

BackgroundWomen living with HIV in sub-Saharan Africa are at increased risk to develop cervical cancer (CC), which is caused by persistent infection with 13 oncogenic human papilloma viruses (HR-HPVs). It is important to accurately identify and target HIV-positive women at highest risk to develop CC for early therapeutic intervention.MethodsA total of 2,134 HIV+ and HIV− women from South-West Tanzania were prospectively screened for cervical cancer and precancerous lesions. Women with cervical cancer (n=236), high- and low-grade squamous intraepithelial lesions (HSIL: n=68, LSIL: n=74), and without lesion (n=426) underwent high-resolution HPV genotyping.ResultsEighty percent of women who were diagnosed with HSIL or LSIL were living with HIV. Any lesion, young age, HIV status, and depleted CD4 T cell counts were independent risk factors for HPV infections, which were predominantly caused by HR-HPV types. While multiple HR-HPV type infections were predominant in HIV+ women with HSIL, single-type infections predominated in HIV+ CC cases (p=0.0006). HPV16, 18, and 45 accounted for 85% (68/80) and 75% (82/110) of HIV+ and HIV− CC cases, respectively. Of note, HPV35, the most frequent HPV type in HSIL-positive women living with HIV, was rarely detected as a single-type infection in HSIL and cancer cases.ConclusionHPV16, 18, and 45 should receive special attention for molecular diagnostic algorithms during CC prevention programs for HIV+ women from sub-Saharan Africa. HPV35 may have a high potential to induce HSIL in women living with HIV, but less potential to cause cervical cancer in single-type infections.

BackgroundCervical cancer - caused by persistent High Risk Human Papilloma Virus (HR HPV) infections - is the second most common cancer affecting women globally. HIV infection increases the risk for HPV persistence, associated disease progression and malignant cell transformation. We therefore hypothesized that this risk increase is directly linked to HIV infection associated dysfunction or depletion of HPV-oncoprotein-specific T-cell responses.MethodsThe 2H study specifically included HIV+ and HIV- women with and without cervical lesions and cancer to analyze HPV oncogene-specific T cell responses in relation to HPV infection, cervical lesion status and HIV status. Oncoprotein E6 and E7 specific T-cell responses were quantified for the most relevant types HPV16, 18 and 45 and control antigens (CMV-pp65) and M.tb-PPD in 373 women, using fresh peripheral blood mononuclear cells in an IFN-γ release ELISpot assay.ResultsOverall, systemic E6- and E7-oncoprotein-specific T-cell responses were infrequent and of low magnitude, when compared to CMV-pp65 and M.tb-PPD (p < 0.001 for all HR HPV types). Within HIV negative women infected with either HPV16, 18 or 45, HPV16 infected women had lowest frequency of autologous-type-E6/E7-specific T-cell responses (33%, 16/49), as compared to HPV18 (46% (6/13), p = 0.516) and HPV45 (69% (9/13), p = 0.026) infected women. Prevalent HPV18 and 45, but not HPV16 infections were linked to detectable oncoprotein-specific T-cell responses, and for these infections, HIV infection significantly diminished T-cell responses targeting the autologous infecting genotype. Within women living with HIV, low CD4 T-cell counts, detectable HIV viremia as well as cancerous and precancerous lesions were significantly associated with depletion of HPV oncoprotein-specific T-cell responses.DiscussionDepletion of HPV-oncoprotein-specific T-cell responses likely contributes to the increased risk for HR HPV persistence and associated cancerogenesis in women living with HIV. The low inherent immunogenicity of HPV16 oncoproteins may contribute to the exceptional potential for cancerogenesis associated with HPV16 infections.

A three-dimensional hydrogen-bonded network based on a rare mok topology has been constructed using an organic molecule synthesized in the solid state. The molecule is obtained using a supramolecular protecting-group strategy that is applied to a solid-state [2+2] photodimerization. The photodimerization affords a novel head-to-head cyclobutane product. The cyclobutane possesses tetrahedrally disposed cis-hydrogen-bond donor (phenolic) and cis-hydrogen-bond acceptor (pyridyl) groups. The product self-assembles in the solid state to form a mok network that exhibits twofold interpenetration. The cyclobutane adopts different conformations to provide combinations of hydrogen-bond donor and acceptor sites to conform to the structural requirements of the mok net.

The protected natural areas are those areas where we find the most representative and valuable elements of the natural heritage (heritage). On the Globe there are a multitude of categories, of ranks of protected areas, from nature monuments, to National Parks and Biosphere Reservations, from areas under one hectare to hundreds of thousands of square kilometers. The EU has in the field of nature protection the European Ecological Network Natura 2000; this network consists of more than 26 000 protected sites covering aprox. 20% of the EU's land area. This is the largest, more complex network of environment protection in the world. It provides protection for endangered European species and habitats and, indirectly, contributes to the prosperity of the countries on whose territory it is implemented, through the ecological services provided. In Romania, at the level of 2018, the total protected areas represent about 23.65% of the total area; compared to other European countries, the area of these protected areas should be increased. But beyond the comparison with other countries, the need to increase the area of protected areas lies in the fact that, in the context of climate change on Earth, the only way in the future to safely address their effects is to protect the environment and to reduce as much as possible the anthropic “footprint”.

Hydraulic energy is the ability of a physical system (running water, generally speaking river) to perform a mechanical work when flowing from a higher position to a lower position. Thanks to the water circuit in nature, maintained by the Sun's energy, hydraulic energy is a type of renewable energy. This form of energy is utilized through hydropower plants. Some of the hydroelectric plants are very large, such as the Roman-Serbian border Porţile de Fier I (Iron Gates I, in english) (the largest on the Danube) and the Portţile de Fier II (Iron Gates II). Other hydroelectric plants are medium but also very small, such as those installed on the small rivers in the Făgăraş Mountains, such as the rivers Capra, Buda, Topolog etc., some even in the Natura 2000 protected areas; more than 500 micro-hydropower plants after National Geographic. But there is a contradiction: the ecological quality of the rivers must increase, but we also need to increase the percentage of renewable energy. With their negative environmental impact, hydropower plants of any size, does not generate a so “green” energy just as it desires. Solving the discrepancy between the economically and ecologically interests, is the key to sustainable development in the Danube area.