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Objectives Malaria and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are associated with adverse pregnancy outcomes. This study reports the prevalence and risk factors of curable STIs/RTIs, STI/RTI co-infection and STI/RTI and malaria co-infection among HIV-negative pregnant women at their first antenatal care visit in Kenya, Malawi and Tanzania.Methods HIV-negative pregnant women of all gravidae (n=4680) were screened for syphilis with point-of-care tests and treated if positive. Separately, women provided blood samples (n=4569) for rapid plasma reagin (RPR) testing; positive cases were confirmation by Treponema pallidum particle agglutination (TPPA). Women also provided dried blood spots for batch testing of malaria by retrospective polymerase chain reaction (PCR (n=4226) methods. A randomly selected subgroup of women provided vaginal swabs for chlamydia, gonorrhoea and trichomoniasis testing by retrospective PCR batch testing (n=1431), and bacterial vaginosis diagnosis by Nugent scoring (n=1402).Results Malaria prevalence was 14.6% (95% CI 13.6 to 15.7), 45.9% (43.4 to 48.4) of women were positive for at least one curable STI/RTI and 6.7% (5.5 to 8.1) were co-infected with malaria and a curable STI/RTI. Prevalence of individual STIs/RTIs ranged from 28.5% (26.2 to 30.9) for bacterial vaginosis to 14.5% (12.7 to 16.4) for trichomoniasis, 13.8% (12.1 to 15.7) for chlamydia, 2.7% (1.9 to 3.6) for gonorrhoea and 1.7% (1.4 to 2.2) for RPR/TPPA-confirmed syphilis. The prevalence of STI/RTI co-infection was 10.1% (8.7 to 11.8). Paucigravidae, at highest risk of malaria, were also at greater risk of having chlamydia, gonorrhoea and bacterial vaginosis than multigravidae.Conclusions Of women infected with malaria, 49.0% also had a curable STI/RTI and one in five women with at least one STI/RTI were co-infected with more than one STI/RTI. Current antenatal interventions that address malaria and curable STIs/RTIs remain suboptimal. New approaches to preventing and managing these infections in pregnancy are urgently needed.Trial registration number NCT03208179.

Objectives: Malaria and sexually transmitted and reproductive tract infections (STIs/RTIs) are highly prevalent in sub-Saharan Africa and associated with poor pregnancy outcomes. We investigated the individual and combined effects of malaria and curable STIs/RTIs on fetal growth in Kenya, Tanzania, and Malawi. Methods: This study was nested within a randomized trial comparing monthly intermittent preventive treatment for malaria in pregnancy with sulfadoxine-pyrimethamine vs dihydroartemisinin-piperaquine, alone or combined with azithromycin. Fetal weight gain was assessed by serial prenatal ultrasound. Malaria was assessed monthly, and Treponema pallidum, Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and bacterial vaginosis at enrollment and in the third trimester. The effect of malaria and STIs/RTIs on fetal weight/birthweight Z-scores was evaluated using mixed-effects linear regression. Results: In total, 1435 pregnant women had fetal/birth weight assessed 3950 times. Compared to women without malaria or STIs/RTIs (n = 399), malaria-only (n = 267), STIs/RTIs only (n = 410) or both (n = 353) were associated with reduced fetal growth (adjusted mean difference in fetal/birth weight Z-score [95% confidence interval]: malaria = -0.18 [-0.31,-0.04], P = 0.01; STIs/RTIs = -0.14 [-0.26,-0.03], P = 0.01; both = -0.20 [-0.33,-0.07], P = 0.003). Paucigravidae experienced the greatest impact. Conclusion: Malaria and STIs/RTIs are associated with poor fetal growth especially among paucigravidae women with dual infections. Integrated antenatal interventions are needed to reduce the burden of both malaria and STIs/RTIs.

Abstract Background The prevalence of small for gestational age (SGA) may vary depending on the chosen weight-for-gestational-age reference chart. An individual participant data meta-analysis was conducted to assess the implications of using a local reference (STOPPAM) instead of a universal reference (Intergrowth-21) on the association between malaria in pregnancy and SGA. Methods Individual participant data of 6,236 newborns were pooled from seven conveniently identified studies conducted in Tanzania and Malawi from 2003–2018 with data on malaria in pregnancy, birthweight, and ultrasound estimated gestational age. Mixed-effects regression models were used to compare the association between malaria in pregnancy and SGA when using the STOPPAM and the Intergrowth-21 references, respectively. Results The 10th percentile for birthweights-for-gestational age was lower for STOPPAM than for Intergrowth-21, leading to a prevalence of SGASTOPPAM of 14.2% and SGAIG21 of 18.0%, p

Amro Omari,1,2 Momin Samad,3 Saaquib R Bakhsh,1,2 Jahan Tajran,4 George A Williams1,2 1Beaumont Eye Institute, Royal Oak, MI, USA; 2Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Michigan State College of Human Medicine, Grand Rapids, MI, USA; 4Wayne State University School of Medicine, Detroit, MI, USACorrespondence: Amro Omari, Beaumont Eye Institute, 3535 West 13 Mile Road Suite #555, Royal Oak, MI, 48073, USA, Tel +1 248-551-2020, Email Amro.omari@beaumont.orgBackground and Objective: To assess the use of a smartphone-based fundus camera in diagnosing acute posterior segment disease in the emergency room (ER) of an academic center, where standard fundus cameras are currently unavailable.Study Design/Patients and Methods: Images were obtained on 10 eyes with various types of posterior segment pathology. These were analyzed retrospectively by 35 reviewers (21 residents and 14 attending physicians). Accuracy of diagnosis was compared to in-office fundus photography.Results: The average probability of correct diagnosis was over 78%. There was no difference between resident and attending reviewers, except for one of the vitreous hemorrhage cases where residents performed better (p=0.039).Conclusion: Smartphone-based cameras are effective in screening for ocular diseases in the ER of academic centers, where residents and fellows are often the first providers to see various types of vision and life-threatening pathology.Keywords: fundus camera, emergency room, posterior segment, smartphone, retina

Trachurus trachurus (Linnaeus, 1758) is a semipelagic fish common in the waters of the Moroccan Mediterranean and is of major economic importance because it occupies an important place in fish landings. The population of the eastern coast was monitored during the period from October 2017 to September 2018 using monthly sampling. This work focused on the study of the growth biology of this species. In total, 390 specimens were sampled. The total lengths of the individuals collected varied between 7.8 cm and 33.8 cm for a weight that varied from 3.78 g to 310.52 g. The study of the growth of this Carangidae and the estimation of its age are based on the reading of the otoliths. The increase in length follows the linear Von Bertalanffy model; thus, it is rapid for juveniles and decreases with age. Similar growth in length and differential growth in weight were demonstrated between the two sexes. This difference is apparent only from the fourth year onwards and remains in favour of females. The results obtained constitute a valuable contribution to a better understanding of Trachurus trachurus biology and to the implementation of stock assessments to ensure the sustainability of catches of this species.

In the context of the challenges imposed by climate change, which exerts constant pressure on water security in Morocco, the Moulouya River, one of the main sources of surface water, frequently undergoes spatiotemporal variations in its quality. This situation is particularly worrying in the upstream part of the river, where the old Zaida mine is located, which is now inactive and leaves significant residues in the form of slag heaps in direct contact with the waters of the Moulouya River. To assess the impact of this abandoned mining waste, eight (08) water sampling stations (S1 to S8) were chosen to analyse the concentrations of two (02) essential metals, namely, lead and zinc. The results revealed lead concentrations of approximately 0.13 mg/L on average during the dry period and 0.09 mg/L during the humid period. The average zinc concentration was 0.29 mg/L during the dry season and 0.32 mg/L during the humid season. The maximum concentrations were recorded at the stations closest to the aforementioned mine, in particular, S1, S2 and S3. Other maximum concentrations were observed at station S6. These results highlighted the significant impact of mining slag heaps exposed to the open sky on the physico-chemical and metallic quality of Moulouya waters. This finding highlights the urgency of continued monitoring of this vital water resource to protect it against potential risks of contamination.

The study examined the strategies used by teacher educators in their teaching practices and gender integration in Kenya, Uganda and Tanzania. The nature of the engagement of educational leaders and administrators in supporting teaching, learning and mainstreaming gender issues in teaching was also examined. A total of 165 sampled respondents were reached. This included 81 government officials and educational leaders (18 government officials and 63 educational leaders) and 84 tutors. The study used a concurrent mixed-method approach where the combined qualitative and quantitative data collection methodologies were applied to answer the study questions. The study data were collected directly from the project participants through semi-structured interviews and survey questionnaires. 60% of preprimary and primary tutors from Kenya demonstrated knowledge and skills in pedagogical practices compared to 13% from Tanzania and 20% from Uganda. The findings also revealed that most tutors do not think training and application of lifelong professional development strategies on key pedagogical aspects and content are essential for achieving a gender-responsive and inclusive training and support program. These key areas include support for gender-based violence victims, support for pregnant girls and mothers to continue education; gender-sensitive expectations towards girls' and boys' achievements; gender-sensitive expectations around girls' and boys' behavior, lesson demonstration, and lesson observation. The study recommends that there should be integration of gender issues in delivering training for the tutors of the colleges in East Africa. The training should focus on enhancing pedagogical practices and related educational leadership and management.

This study investigated the degree of practicing soft skills by science teachers using the descriptive approach. To achieve the study's objective, an observation card was developed. It was used to monitor three lessons for each subject (n=60) science teachers, who were distributed into six groups according to work experience and educational qualification, in the Directorate of Education of Bani Kinanah District in Irbid Governorate. The results showed that science teachers practice soft skills such as communication, problem-solving, negotiation, planning and time management, teamwork, leadership, and critical thinking to a high degree, with an explained variance (9.13%), on all dimensions of the observation card. However, the results also indicated statistically significant differences ([alpha] = 0.05) between the arithmetic means of the teaching practices of soft skills among science teachers resulting from the different levels of educational qualification and teaching experience. Thus, teachers with educational qualifications typically practice soft skills to a greater extent with an average level of (14.48%) than their peers without educational degrees. Teachers with advanced experience are more likely to exercise soft skills with an average level of (11.73%) than their counterparts with medium and simple experience. Therefore, the study recommended including soft skills practice as a university course, endorsing it in universities, and continuous training for science teachers on teaching practices for soft skills through training courses and workshops.

Contemporary science teaching pedagogy in Namibia places a strong emphasis on fostering inquiry-based instruction and practical work in secondary school science education. In recent years, there has been a growing recognition of the need to move beyond traditional, rote-based methods towards more learner-centred approaches that encourage active inquiry and critical thinking. Teachers are encouraged to design lessons that promote inquiry, where learners actively investigate scientific phenomena, ask questions, and develop solutions through hands-on experimentation. Science practical work, which involves conducting experiments and investigations, is considered a cornerstone of this approach as it provides learners with opportunities to apply theoretical knowledge, develop laboratory skills, and gain a profounder understanding of scientific concepts. This sequential explanatory mixed methods study explored Namibian secondary school teachers' conceptions of teaching science practical work through inquiry-based instruction to provide a comprehensive understanding of teachers' perspectives and practices. Findings from this study revealed that many teachers held traditional views of science practical work, emphasizing cookbook-style experiments and memorisation. These teachers often faced challenges in implementing inquiry-based instruction due to a lack of training and resources to facilitate science practical work. However, a subset of teachers who embraced inquiry-based methods reported increased learner engagement, critical thinking, and in-depth understanding of scientific concepts. Additionally, the findings underscored the importance of aligning teacher conceptions with contemporary pedagogical approaches for effective secondary science education in Namibia. The study thus, highlighted the need for professional development and support to help more teachers transition to inquiry-based instruction and improve science education in Namibian secondary schools.

The present work concerns the development of a food waste prevention strategy in a restaurant operating within a hotel in the city of Saidia in Eastern Morocco. The food service sector was chosen for this study because it is the second highest contributing sector to food waste on the global scale. Therefore, the role it plays in environmental pollution should not be neglected. The food waste prevention strategy adopted in this work consisted in performing a food waste audit at first. Then, the purchasing, storage, and handling conditions of food were improved. Finally, waste sorting was performed. The average daily food waste generated by the case study restaurant was 320.3 kg/day. The highest amount of average daily food waste (166.7 kg/day) was generated during food preparation, while storage waste had the lowest amount (30.1 kg/day). The most wasted food commodities were vegetables (50.8 kg/day), fruits (47.1 kg/day), sauces (39.9 kg/day), and cereals (38.4 kg/day). While the least wasted food commodities were eggs (10.2 kg/day) and dairy products (11.7 kg/day). The majority of the food waste generated in this study was avoidable, and fish and seafood were the food commodities with the lowest Eco-efficiency (high cost – high waste). The food waste percentage decreased from 35% to 20% within approximately 4 months following the execution of the food waste prevention strategy.

Entrepreneurship Education (EE) programming is being developed at tertiary-level academic institutions, to develop the next generation of entrepreneurs. We collected data from undergraduate students from the Western region of Tecnológico de Monterrey in Mexico (N=25). The aim was to measure entrepreneurial intention by exposing the sample to a new educational structure that engages students in entrepreneurial activities. The Entrepreneurship program is highly specialized with a maximum of 25 students. This allows for students to receive individualized attention aiding in the development of their entrepreneurial projects. Tecnológico de Monterrey is number 4 in The Princeton Review's Top Undergraduate Schools for Entrepreneurship Ranking 2023. The school uses process-based approaches to EE. Guided by the Theory of Planned Behavior (TPB), we assessed changes in the students' attitudes toward entrepreneurship, perceived behavioral control, and intentions to become an entrepreneur. Using a seven-point Likert scale, the data was collected using anonymous online links at two points during the semester: the beginning of the semester (T1) and the end of the 1st Period (T2). The data was analyzed with SPSS software and the Friedman Calculator. Our research findings indicate a high score at T1. There was a slight change at T2, but the change was not statistically significant. Consequently, we introduce and review other approaches to Entrepreneurship Education that might be more effective. Noteworthy is that the sample is immersed in an entrepreneurial university context, both within and outside the academic setting, which fosters a strong motivation among students to contribute societal value through entrepreneurial endeavors.

Abstract Background Small-for-gestational-age (SGA) is associated with increased neonatal mortality and morbidity. In low and middle income countries an accurate gestational age is often not known, making the identification of SGA newborns difficult. Measuring foot length, chest circumference and mid upper arm circumference (MUAC) of the newborn have previously been shown to be reasonable methods for detecting low birth weight (

Common mode voltage (CMV) causes various issues, including a negative impact on the performance of a hybrid electric vehicle’s power system (HEV). Many papers have published methods that mitigate CMV, almost all of which attempt to avoid zero vectors, but this increases total harmonic distortion (THD). This work describes a simple and efficient method for reducing CMV in a two-level three-phase voltage source inverter (VSI) with an RL load. This method uses only active vectors. It replace the zero vector with the two opposite vectors V2 and V5. for T1 and T2 respectively in a one sampling period Ts. A numerical simulation, using Matlab-Simulink. is achieved to assess the effectiveness of the proposed control technique. The obtained results show a reduction in THD value (17% improvement) and a decrease in the peak value of CMV from (${{ + {V_{dc}}} \over 2}$+Vdc2 and ${{ - {V_{dc}}} \over 6}$−Vdc6) to $\pm {{{V_{dc}}} \over 6}$±Vdc6. These results are compared to those obtained by using the traditional predictive control model MPC.

Nawaf J Shatnawi,1 Nabil A Al-Zoubi,1 Hasan Hawamdeh,2 Yousef S Khader,3 Abd El-Karim Omari,1 Muhammad R Khammash1 1Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Basic Medical Science, Faculty of Medicine, Hashemite University, Zarqa, Jordan; 3Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan Purpose: The aim of this study was to present the redefined clinical spectra of diabetic foot syndrome (RCS-DFS) and determine whether the RCS-DFS can be used to predict amputations. Patients and methods: This is a retrospective study of type 2 diabetic patients referred with DFS for management at King Abdullah University Hospital (KAUH) between January 2014 and December 2015. Data collection form and diabetic foot (DF) characteristic chart were used to document the following: demographic data, diabetes-related parameters, DF characteristics, surgical interventions and amputations. The predominant clinical presentations of DF problems (ulcer, sepsis or gangrene) were integrated with the clinical criteria for diabetic foot infection (DFI) diagnosis and classification of Infectious Diseases Association of America (IDSA)/International Working Group on Diabetic Foot (IWGDF) to redefine the clinical spectra of DFS. Related risk characteristics and amputation rate at all levels were compared between the three RCS. Results: In this study, there were 95 (47.0%) septic DFS (SDFS) patients, 65 (32.2%) ulcerative DFS (UDFS) patients and 42 (20.8%) gangrenous DFS (GDFS) patients. Poor glycemic control (HbA1c >7.5%), hypertension, history of the same foot problems, duration of symptoms, revascularizations and ischemic severity were significantly different between the three RCS. UDFS had the highest rate of limb salvage without amputations (70.8%). GDFS had the highest rate for final toe amputations (52.4%) and major amputations (23.8%). Final minor amputation rate was around 20% for both SDFS and GDFS. Conclusion: Redefining DFS into ulcerative, septic and gangrenous by integration of the predominant clinical presentation and the clinical criteria for DFI diagnosis and classification of IDSA/IWGDF showed significant differences in amputation rate. Therefore, it can be used clinically to categorize patients with DFS to predict amputations and to help in planning their management. Further prospective studies are suggested to validate these results. Keywords: diabetes mellitus, classification, diabetic foot syndrome, amputations

Abstract Background Although death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. Verbal autopsy (VA) interviews are alternatively used to determine causes of death in places without or with incomplete hospital records. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania. Methods The study was conducted from January 2006 to December 2012 in 14 villages under Korogwe HDSS. Vital events such as births, deaths and migrations were routinely updated quarterly. A standard VA questionnaire was administered to parents/close relatives of the deceased to determine cause of death. Results Overall, 1325 deaths of individuals with median age of 46 years were recorded in a population with 170,471.4 person years observed (PY). Crude mortality rate was 7.8 per 1000 PY (95% CI 7.2–8.4) and the highest rate was observed in infants (77.9 per 1000 PY; 95% CI 67.4–90.0). The overall mortality increased between 2006 and 2007, followed by a slight decline up to 2011, with the highest decrease observed in 2012. Causes of deaths were established in 942 (71.1%) deaths and malaria (198 deaths, 21.0%) was the leading cause of death in all age groups except adults (15–59 years). HIV/AIDS (17.6%, n = 365) was the leading cause of death in individuals aged 15–59 years followed by malaria (13.9%) and tuberculosis. Non-communicable diseases (NCDs) including stroke, hypertension, cancer, and cardiac failure caused majority of deaths in elderly (60 years and above) accounting for 37.1% (n = 348) of all deaths, although malaria was the single leading cause of death in this group (16.6%). Conclusion The study showed a significant decline of deaths in the Korogwe HDSS site and malaria was the main cause of death in all age groups (except adults, aged 15–59 years) while HIV/AIDS and NCDs were the main causes in adults and elderly, respectively. Further surveillance is required to monitor and document changes in cause-specific mortality as malaria transmission continues to decline in this and other parts of Tanzania.

Mononuclear Fe ions ligated by nitrogen (FeNx) dispersed on nitrogen-doped carbon (Fe-N-C) serve as active centers for electrocatalytic O2 reduction and thermocatalytic aerobic oxidations. Despite their promise as replacements for precious metals in a variety of practical applications, such as fuel cells, the discovery of new Fe-N-C catalysts has relied primarily on empirical approaches. In this context, the development of quantitative structure-reactivity relationships and benchmarking of catalysts prepared by different synthetic routes and by different laboratories would be facilitated by the broader adoption of methods to quantify atomically dispersed FeNx active centers. In this study, we develop a kinetic probe reaction method that uses the aerobic oxidation of a model hydroquinone substrate to quantify the density of FeNx centers in Fe-N-C catalysts. The kinetic method is compared with low-temperature Mössbauer spectroscopy, CO pulse chemisorption, and electrochemical reductive stripping of NO derived from NO2- on a suite of Fe-N-C catalysts prepared by diverse routes and featuring either the exclusive presence of Fe as FeNx sites or the coexistence of aggregated Fe species in addition to FeNx. The FeNx site densities derived from the kinetic method correlate well with those obtained from CO pulse chemisorption and Mössbauer spectroscopy. The broad survey of Fe-N-C materials also reveals the presence of outliers and challenges associated with each site quantification approach. The kinetic method developed here does not require pretreatments that may alter active-site distributions or specialized equipment beyond reaction vessels and standard analytical instrumentation.