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Background: Concerns about surgical site infection (SSI) give rise to practices and procedures not evidence-based. Objectives: This study investigates whether the type of patient transfer to operating rooms plays a role in developing surgical site infection. Methods: Three thousand four hundred and seventy-one patients were divided into two groups: transfer group with stretcher (ST) (n = 1699) and patient bed transfer group (PBT) (n = 1772). The data of the two groups and the SSI rates were comparatively analyzed. Results: The SSI rate was 2.5% (n = 43) in the ST group and 2.8% (n = 49) in the PBT group, and there was no statistically significant difference. Both types of patient transfer had similar effects on the probability of SSI development. The odds ratio was 1.095 for stretcher transfer while 0.913 for patient bed transfer. Conclusion: Patients transfer to operating rooms on their beds are comfortable and safe. Furthermore, it has a similar effect to stretcher transfer on the probability of surgical site infection. Therefore, it is safer and cheaper to act based on evidence instead of trusting our concerns.

Abstract Objective: To perform a comprehensive economic evaluation of border closure for an island nation in the face of severe pandemic scenarios. Methods: The costing tool developed by the New Zealand (NZ) Treasury (CBAx) was used for the analyses. Pandemic scenarios were as per previous work;1 epidemiological data were from past New Zealand influenza pandemics. Results: The net present value of successful border closure was NZ$7.86 billion for Scenario A (half the mortality rate of the 1918 influenza pandemic) and $144 billion for preventing a more severe pandemic (10 times the mortality of scenario A). Cost–utility analyses found border closure was relatively cost‐effective, at $14,400 per QALY gained in Scenario A, and cost‐saving for Scenario B (taking the societal perspective). Conclusions: This work quantifies the economic benefits and costs from border closure for New Zealand under specific assumptions in a generic but severe pandemic threat (e.g. influenza, synthetic bioweapon). Preparing for such a pandemic response seems wise for an island nation, although successful border closure may only be feasible if planned well ahead. Implications for public health: Policy makers responsible for generic pandemic planning should explore how border closure could be implemented, including practical and legal frameworks.

Countries are well advised to prepare for future pandemic risks (e.g., pandemic influenza, novel emerging agents or synthetic bioweapons). These preparations do not typically include planning for complete border closure. Even though border closure may not be instituted in time, and can fail, there might still plausible chances of success for well organized island nations.To estimate costs and benefits of complete border closure in response to new pandemic threats, at an initial proof-of-concept level. New Zealand was used as a case-study for an island country.An Excel spreadsheet model was developed to estimate costs and benefits. Case-study specific epidemiological data was sourced from past influenza pandemics. Country-specific healthcare cost data, valuation of life, and lost tourism revenue were imputed (with lost trade also in scenario analyses).For a new pandemic equivalent to the 1918 influenza pandemic (albeit with half the mortality rate, "Scenario A"), it was estimated that successful border closure for 26 weeks provided a net societal benefit (e.g., of NZ$11.0 billion, USD$7.3 billion). Even in the face of a complete end to trade, a net benefit was estimated for scenarios where the mortality rate was high (e.g., at 10 times the mortality impact of "Scenario A", or 2.75% of the country's population dying) giving a net benefit of NZ$54 billion (USD$36 billion). But for some other pandemic scenarios where trade ceased, border closure resulted in a net negative societal value (e.g., for "Scenario A" times three for 26 weeks of border closure-but not for only 12 weeks of closure when it would still be beneficial).This "proof-of-concept" work indicates that more detailed cost-benefit analysis of border closure in very severe pandemic situations for some island nations is probably warranted, as this course of action might sometimes be worthwhile from a societal perspective.

For more than 30 years, vaccines have played an important part in pneumonia prevention. Recent advances have created opportunities for further improving child survival through prevention of childhood pneumonia by vaccination. Maximizing routine immunization with pertussis and measles vaccines, coupled with provision of a second opportunity for measles immunization, has rapidly reduced childhood deaths in low-income countries especially in sub-Saharan Africa. Vaccines against the two leading bacterial causes of child pneumonia deaths, Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (pneumococcus), can further improve child survival by preventing about 1 075 000 child deaths per year. Both Hib and pneumococcal conjugate vaccines have proven safety and effectiveness for prevention of radiologically confirmed pneumonia in children, including in low-income and industrializing countries. Both are recommended by WHO for inclusion in national programmes, and, at sharply tiered prices, these vaccines generally meet international criteria of cost-effectiveness for low-income countries. Vaccines only target selected pneumonia pathogens and are less than 100% effective, so they must be complemented by curative care and other preventative strategies. As part of a comprehensive child survival package, the particular advantages of vaccines include the ability to reach a high proportion of all children, including those who are difficult to reach with curative health services, and the ability to rapidly scale up coverage with new vaccines. In this review, we discuss advances made in optimizing the use of established vaccines and the potential issues related to newer bacterial conjugate vaccines in reducing childhood pneumonia morbidity and mortality.

Abstract Background The aim of this study was to evaluate the effects of nasal septum deviation and inferior turbinate hypertrophy on nasal obstruction by utilizing the Nose Obstruction Symptom Evaluation (NOSE) values and paranasal sinus computed tomography (PSCT) findings for correct preoperative evaluation. Methods Ninety-six patients (57 males and 39 females) aged between 18 and 54 years (mean age, 30.3 ± 9.7 years) participated in this study. Among them, 56 patients underwent septoplasty combined with inferior turbinate outfracture, while 40 patients underwent septoplasty alone. Preoperative nasal examinations were performed on all patients. The direction, location, nasal septum deviation classification, and inferior turbinate hypertrophy size classification were carefully evaluated and compared with the NOSE survey results. PSCT of 56 patients were evaluated and classified by calculating the coronal location of septum deviation, the axial location of septum deviation, the coronal angle of septum deviation, and the axial angle of septum deviation. Results A positive correlation was found between the coronal location of the septal deviation and the preoperative NOSE 2, and the NOSE total, and the difference of postoperative and preoperative NOSE (p = 0.032, p = 0.007, p = 0.021, respectively). There was a statistically significant relationship between the coronal location of the septal deviation classification and the NOSE preoperative total values (p = 0.26). A negative statistically significant correlation was found between inferior turbinate hypertrophy and preoperative NOSE 5 values (p = 0.029). Conclusion We conclude that the combination of PSCT and the NOSE scale is helpful in determining the severity of nasal obstruction prior to surgery. Specifically, we found that nasal septum deviations located in the anterior and coronal planes have a greater impact on nasal obstruction compared to deviations in the axial plane. Inferior turbinate fracture does not provide more benefit than septoplasty alone in treating patients’ nasal obstruction. These findings emphasize the importance of a comprehensive approach in addressing nasal obstruction for optimal patient outcomes.

Abstract Background The aim of this study was to evaluate the quality of life (QoL) of patients with dentofacial deformity (n = 107) compared with that of healthy individuals (n = 108) from 2019 to 2020. Methods Oral Health Impact Profile 14 (OHIP-14) and the Orthognathic Quality of Life Questionnaire (OQLQ) were administered to the individuals before surgery (T1) and 6 months after surgery (T2). Results Preoperative scores (T1) were greater in the surgical group than in the control group in all domains of both surveys (p ≤ 0.001). Postoperative scores (T2) in the surgery group decreased significantly after surgery in all domains in both surveys (p

Two-way tests in independent groups designs are the most frequently used statistical techniques in various fields. In this paper, we present twowaytests package to investigate the effects of two treatments and the associated interaction on the dependent variable. The package offers two-way tests involving two-way ANOVA, parametric bootstrap based generalized test, generalized pivotal quantity based generalized test, two-way ANOVA for trimmed means, two-way ANOVA using M-estimators for location, and two-way ANOVA for medians. The package provides some basic descriptive statistics, pairwise comparisons, variance homogeneity and normality tests, and well-arranged graphical approaches. Furthermore, its web application is freely available at http://www.softmed.hacettepe.edu.tr/twowaytests.

Cooperative Adaptive Cruise Control (CACC), as an advanced version of adaptive cruise control (ACC), automates brake and engine controls based on the information received from wireless V2V communications and remote sensors, enabling smaller vehicle-following time gaps. It can improve the safety of vehicle platooning and increase fuel savings. As an extension of our previous investigation of truck drivers' acceptance of CACC, this case study investigates factors affecting the use of CACC for truck platooning. Nine commercial fleet drivers were recruited to operate two following trucks in a CACC-enabled string on freeways in Northern California. We analyzed the usage of CACC time gaps and its correlation with truck drivers' stated preferences for these time gaps, and we found that the highest preferred Gap 3 (1.2 s) was used the most. Moreover, a Bayesian regression model was built to show that truck drivers are more likely to disengage CACC when driving in low-speed traffic or on downgrades where this CACC could not provide sufficient braking. In high-speed traffic or on upgrades, truck drivers are more likely to engage CACC, particularly at Gap 3. Truck position, however, does not affect truck drivers' time gap selection. The findings encourage the adoption of CACC in the trucking industry through implementing driver-preferred time gaps and responsive braking systems, and operating on routes with minimal interference to truck speeds. [ABSTRACT FROM AUTHOR]

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The sensitivity of a low-noise superconducting transition edge sensor (TES) is determined by the thermal conductance of the support structure that connects the active elements of the device to the heat bath. Low-noise devices require conductances in the range 0.1 to 10 pW K − 1 and so have to rely on diffusive phonon scattering in long, narrow, amorphous SiN x legs. We show that it is possible to manufacture and operate TESs having short, ballistic low-dimensional legs (cross section 0.5 × 0.2 μ m) that contain multi-element phononic interferometers and ring resonators. These legs transport heat in effectively just 5 elastic modes at the TES's operating temperature (< 150 mK), which is close to the quantised limit of 4. The phononic filters then reduce the thermal flux further by frequency-domain filtering. For example, a micromachined 3-element ring resonator reduced the flux to 19% of a straight-legged ballistic device operating at the quantised limit and 38% of a straight-legged diffusive reference device. This work opens the way to manufacturing TESs where performance is determined entirely by filtered, few-mode, ballistic thermal transport in short, low-heat capacity legs, free from the artifacts of two level systems. [ABSTRACT FROM AUTHOR]

Abstract The global demand from multi-sectoral partners for operational tools for One Health implementation and capacity building is increasing, yet a validated global inventory of One Health tools did not exist. Here, we map and analyze available One Health tools and assess their suitability to support One Health implementation, including the One Health Joint Plan of Action 2022–2026 (OH JPA). Our objectives were to identify (i) publicly available One Health tools to support capacity building and OH JPA implementation; (ii) optimal outcomes for countries/regions using available One Health tools; (iii) linkages to OH JPA Action Tracks and pathways in the One Health Theory of Change (TOC); and (iv) gaps and priorities for the development of additional One Health tools. One Health High Level Expert Panel (OHHLEP) members compiled information on One Health tools that were publicly available and released up to June 30, 2023, via online sources and partner networks including the Quadripartite organizations. Inclusion criteria addressed One Health relevance, use at the national, subnational, or regional level in ≥5 locations, and publicly available information. Tools were assessed for applicability by OH JPA action track, TOC pathway, scope, and intended outcomes, as well as the extent to which tools addressed gender equality, social inclusion, and environmental dimensions of One Health. Of 132 candidate tools, 50 (38%) met the inclusion criteria. These tools addressed all six OH JPA Action Tracks, but relatively fewer tools addressed Action Tracks 4 (Food Safety), 5 (Antimicrobial Resistance), and 6 (Environmental Integration). Tools were available to support all three TOC outcome pathways, and many addressed more than one Action Track and TOC outcome pathway. Most available One Health tools addressed assessment and to a lesser extent implementation, with fewer tools available for action planning, prioritization, and monitoring. Gaps and opportunities for improving One Health tools were identified, including the integration of the environment dimension, gender equality, and social inclusion. Ultimately, our findings will contribute to further the advancement of One Health globally, including via OH JPA implementation, while spurring adjustments to existing One Health tools and the development of new ones to address key gaps. One Health impact statement The One Health approach is gaining momentum globally, and this study represents the first integrated mapping and analysis of globally available One Health tools. Our findings aim to improve the quality, applicability, and availability of tools to support One Health implementation at the subnational, national, regional, and global levels, including through the Quadripartite’s One Health Joint Plan of Action. By using the OHHLEP definition of One Health to assess available One Health tools and map them onto the One Health Joint Plan of Action, we identify the need for a systematic approach and enhanced integration across dimensions of One Health to lead to sustainable One Health systems.

In this case report, primary pulmonary mycobacteriosis in a domestic cat was assessed using histopathological and immunohistochemical methods. The cat was admitted to a private veterinary clinic and presented with hyporexia, lethargy, and dyspnea with an abdominal component. For diagnostic purposes, thorax radiography was performed. Radiographic lung imaging showed the presence of opaque foci that were widely distributed throughout the lung. The cat’s condition gradually deteriorated, and the cat died 2 hours after being brought to the clinic. Following owner consent, gross post-mortem examination was performed immediately after death at the same clinic. White foci measuring 2–10 mm in diameter covered the surface of the lungs and were present throughout the parenchyma, mostly multifocally and occasionally coalesc­ing. No other macroscopical pathological findings were observed in other organs or on the skin. Some of the lung tissue with macroscopic lesions underwent further histo­pathological and immunohistochemical examination. Multifocal to coalescing areas of caseous necrosis (without a fibrous capsule) with, karyorrhectic nuclei, and numerous macrophages were observed. Ziehl-Neelsen staining revealed many acid-fast bacteria. Immunohistochemical staining revealed positive immunostaining for Mycobacterium spp. This case study highlights the importance of considering zoonotic risks in cats diagnosed with primary pulmonary mycobacteriosis. Primarna pljučna mikobakterioza pri mački: imunohistokemična in histopatološka ocena Izvleček: V tem poročilu o primeru je bila ocenjena primarna pljučna mikobakterioza pri domači mački z uporabo histopatoloških in imunohistokemičnih metod. Mačka je bila sprejeta v zasebno veterinarsko kliniko zaradi simptomov hiporeksije, letargije in dispneje z abdominalno komponento. Za diagnostične namene je bila opravljena rentgenska preiskava prsnega koša, ki je pokazala prisotnost motnih žarišč, široko razporejenih po pljučih. Stanje mačke se je posto­poma slabšalo, umrla je dve uri po prihodu v kliniko. Po privolitvi lastnika je bila takoj po smrti opravljena raztelesba. Bela žarišča, premera od 2 do 10 mm, so prekrivala površino pljuč. Prisotna so bila po celotnem parenhimu večinoma multifokalno in mestoma zlivajoče. V drugih organih in na koži ni bilo opaznih drugih makroskopskih patoloških sprememb. Nekatere dele pljučnega tkiva z makroskopskimi spremembami smo dodatno histopatološko in imunohistokemično pregledali. Opazili smo multifokalna do zlivajoča se območja kazeozne nekroze (brez fibrozne kapsule) s karioznimi jedri in številnimi makrofagi. Ziehl-Neelsenovo barvanje je razkrilo številne acidofilne bakterije. Imunohistokemično barvanje je pokazalo pozitivno imunobarvanje za Mycobacterium spp. To poročilo o primeru poudarja pomen upoštevanja zoonotskih tveganj pri mačkah z diagnozo primarne pljučne mikobakterioze. Ključne besede: mikobakterioza mačk; imunohistokemija; histopatologija; pluča

This study investigates power control algorithms for cell-free massive MIMO (CF-M-MIMO) systems, with the aim of enhancing spectral efficiency (SE) and overall system capacity. A novel Heuristic Iterative Power Control (HIPC) algorithm is proposed and compared against the Equal Power Control (EPC) and Max-Min Fairness Power Control (MMFPC) algorithms within both small-cell and CF-M-MIMO systems under Minimum Mean Squared Error (MMSE) and Maximum Ratio (MR) conditions. The simulation results demonstrate that the HIPC algorithm significantly outperforms both EPC and MMFPC by achieving higher SE and improving user fairness, particularly in CF-M-MIMO systems. Moreover, the robustness and effectiveness of the HIPC algorithm under MR conditions underscore its practical utility. These contributions provide important guidance on the design and implementation of CF-M-MIMO systems, establishing the HIPC algorithm as a valuable tool for optimizing power control and enhancing system performance.

In this study, a case of plasmacytoma with widespread metastasis in a nine-year-old male Rottweiler dog was described by histopathological and immunohistochemical methods. Macroscopic examination revealed multifocal white or pink-red colored masses ranging in size from 0,5 to 3 cm in the lung, liver, mediastinal and mesenterial lymph nodes, spleen, heart, pancreas, intestine and kidneys. In microscopic examination, tumor foci consisting mostly of atypical plasma cells were observed in the lung, liver, spleen, pancreas, mediastinal and mesenteric lymph nodes, intestine, and kidneys. Tumor-type giant cells were observed in tumor foci in the lung, mitotic figures in tumor foci in other organs, including the lung, and abundant tumor cells in capillary vessels. In Methyl Green Pyronin staining of lung, liver, spleen, pancreas, mediastinal and mesenterial lymph nodes, intestine and kidney sections, the cytoplasm of plasma cells was observed to be stained pink. Congo Red staining applied to liver and spleen sections showed amyloid deposits stained in brick red color. In addition, in the immunohistochemical staining of lung, liver, spleen, pancreas, mediastinal and mesenterial lymph nodes, intestine and kidney sections with Proliferating Cell Nuclear Antigen (PCNA) antibody, severe immunoreactivity was detected in tumor cells. As a result, due to the presence of rarely reported widespread metastases in the lung, liver, spleen, pancreas, mediastinal and mesenterial lymph nodes, intestine and kidneys of the diagnosed plasmacytoma case, it was deemed appropriate to publish the case in order to contribute to the literature by attracting the attention of veterinarians.

Purpose: To compare dry eye findings in diabetes mellitus patients with and without diabetic foot. Methods: Diabetes mellitus patients with and without diabetic foot were included in this controlled cross-sectional study. Tear break-up time (BUT) and Schirmer test results of each participant were noted. Ocular Surface Disease Index (OSDI) questionnaire was administered to each participant. Results: There were 48 diabetic patients in the study; half of them had diabetic foot (n=24). The patients with and without diabetic foot were similar in age and sex distribution. The median levels of BUT (4.0 [3.0 – 6.0] seconds for the right eye, 4.5 [3.0 – 6.5] seconds for the left eye in patients with diabetic foot) (4.0 [3.8 – 6.2] seconds for the right eye, 5.0 [3.8 – 5.2] second for the left eye in patients without diabetic foot) and Schirmer’s test (7.0 [5.0 – 17.0] mm for the right eye, 11.0 [6.8 – 17.0] mm for the left eye in patients with diabetic foot) (11.0 [7.0 – 15.8] mm for the right eye, 14.5 [6.5 – 18.5] mm for the left eye in patients without diabetic foot) were similar in both groups of patients. The scores of OSDI were similar in patients with diabetic foot (22.7 [13.5 – 36.2]) and without diabetic foot (28.4 [13.6 – 41.5]) (p=0.749). Conclusion: The Schirmer test, BUT test, and OSDI score were lower in patients with diabetic foot, but they were not statistically significant. In future studies, peripheral neuropathy examination and corneal confocal microscopy may be beneficial when evaluating dry eye parameters in this group of patients.

For more than 30 years, vaccines have played an important part in pneumonia prevention. Recent advances have created opportunities for further improving child survival through prevention of childhood pneumonia by vaccination. Maximizing routine immunization with pertussis and measles vaccines, coupled with provision of a second opportunity for measles immunization, ha rapidly reduced childhood deaths in low-income countries especially in sub-Saharan Africa. Vaccines against the two leading bacterial causes of child pneumonia deaths, Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (pneumococcus), can further improve child survival by preventing about 1 075 000 child deaths per year. Both Hib and pneumococcal conjugate vaccines have proven safety and effectiveness for prevention of radiologically confirmed pneumonia in children, including in low-income and industrializing countries. Both are recommended by WHO for inclusion in national programmes, and, at sharply tiered prices, these vaccines generally meet international criteria of cost-effectiveness for low-income countries. Vaccines only target selected pneumonia pathogens and are less than 100% effective, so they must be complemented by curative care and other preventative strategies. As part of a comprehensive child survival package, the particular advantages of vaccines include the ability to reach a high proportion of all children, including those who are difficult to reach with curative health services, and the ability to rapidly scale up coverage with new vaccines. In this review, we discuss advances made in optimizing the use of established vaccines and the potential issues related to newer bacterial conjugate vaccines in reducing childhood pneumonia morbidity and mortality. Depuis plus de 30 ans, les vaccins jouent un role important dans la prevention de la pneumonie. Des progres recents ont genere des opportunites d&apos;ameliorer encore la survie des enfants a travers la prevention par la vaccination des pneumonies infantiles. La delivrance au plus grand nombre possible des vaccinations anticoquelucheuse et antirougeoleuse systematiques, associee a l&apos;offre d&apos;une seconde opportunite de vaccination contre la rougeole, ont permis de reduire rapidement la mortalite chez l&apos;enfant dans les pays a faible revenu, et notamment en Afrique subsaharienne. Les vaccins contre les deux principales causes de mortalite infantile par pneumonie, a savoir les bacteries Haemophilus influenzae type b (Hib) et Streptococcus pneumoniae (pneumocoque), peuvent permettre d&apos;accroitre encore la survie des enfants, en prevenant environ 1 075 000 deces infantiles par an. Les vaccins anti-Hib et antipneumococcique conjugues ont tous deux fait la preuve de leur innocuite et de leur efficacite dans la prevention des pneumonies radiologiquement confirmees chez l&apos;enfant, et notamment dans les pays a faible revenu et en cours d&apos;industrialisation. L&apos;OMS recommande d&apos;introduire dans les programmes nationaux de vaccination ces deux vaccins qui, moyennant une forte modulation de leur prix, remplissent generalement les criteres internationaux de rapport cout/efficacite pour les pays a faible revenu. Toutefois, ils visent selectivement certains pathogenes a l&apos;origine de pneumonies et ne sont pas efficaces a 100%, de sorte qu&apos;ils doivent etre completes par des soins curatifs et par d&apos;autres strategies de prevention. Dans le cadre d&apos;un ensemble complet d&apos;interventions pour la survie de l&apos;enfant, ces vaccins offrent l&apos;avantage de pouvoir atteindre une forte proportion des enfants, y compris ceux difficiles a toucher par les services de sante curatifs, et de permettre un elargissement rapide de la couverture des nouveaux vaccins. Dans cette etude, nous examinons les progres realises vers un usage optimal des vaccins etablis et les problemes que pourrait soulever l&apos;utilisation de vaccins antibacteriens conjugues plus recents pour reduire la morbidite et la mortalite par pneumonie chez l&apos;enfant. Durante mas de 30 anos las vacunas han sido un arma fundamental para la prevencien de la neumonia. Aigunos progresos recientes han brindado nuevas oportunidades para seguir mejorando la supervivencia infantil previniendo la neumonia en la ninez mediante vacunacion. La optimizacion de la inmunizacion sistematica con las vacunas antitosferinosa y antisarampionosa, unida a la implementacien de una segunda oportunidad para la inmunizacien contra el sarampion, ha reducido rapidamente la mortalidad en la ninez en los paises de ingresos bajos, sobre todo del Africa subsahariana. Las vacunas contra las dos causas bacterianas principales de muerte por neumonia en la infancia, Haemophilus influenzae tipo b (Hib) y Streptococcus pneumoniae (neumococico), pueden mejorar aun mas la supervivencia infantil previniendo alrededor de 1 075 000 defunciones infantiles cada ano. Las vacunas conjugadas contra Hib y contra el neumococo han demostrado su seguridad y eficacia en la prevencion de la neumonia confirmada radiolegicamente en los ninos, tanto en los paises de bajos ingresos como en les nuevos paises industrializados. La OMS recomienda la inclusien de ambas en les programas nacionales, y a precios fuertemente escalonados estas vacunas satisfacen en general les criterios internacionales de costoeficacia para les paises de ingresos bajos. Las vacunas actuan solo contra algunos de les agentes patogenos causantes de neumonia y su eficacia es inferior al 100%, de modo que requieren como complemento atencien curativa y otras estrategias de prevencion. Componente de un paquete integral de supervivencia infantil, las vacunas presentan corne ventajas particulares la posibilidad de dar alcance a un alto porcentaje de ninos, incluidos aquellos a les que les servicios de salud curativos solo consiguen Ilegar con grandes dificultades, y la posibilidad de expandir rapidamente la cobertura con vacunas nuevas. En este analisis consideramos les avances logrados para optimizar el use de las vacunas establecidas y las cuestiones que pueden plantear las nuevas vacunas antibacterianas conjugadas en lo tocante a reducir la morbilidad y la mortalidad infantiles pot neumonia., Introduction Pneumonia is the commonest cause of childhood mortality, particularly in countries with the highest child mortality, and it has been identified as the major "forgotten killer of children" by [...]