Search

Autoethnography has been used to examine employees' physical and emotional experiences of workplace bullying and mobbing. In this approach of inquiry, data were extracted through; personal narratives, lived experiences, and opinions through meaning-making. Power structures in academia were found to play a significant role in academic bullying because authorities may perceive their power base to be under threat hence the desperate need to eliminate the perceived threat. Findings also suggest power structures in academia and "reluctant complicit mobbing" may be inclined to support bullies thereby impacting employee performance, production, health, and wellbeing. The African culture that subordinates and younger members of society should revere their bosses and elders was also found to influence bullying and mobbing. The authors hope to persuade academic authorities to formulate reporting systems and viable policies that protect employees. Values in individuals could be developed and reinforced, further strengthening individual's abilities and resilience to face and deal with adverse events.

Abstract Background Anti-HER2 therapies, including the HER2 antibody–drug conjugates (ADCs) trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd), have led to improved survival outcomes in patients with HER2-overexpressing (HER2+) metastatic breast cancer. However, intrinsic or acquired resistance to anti-HER2–based therapies remains a clinical challenge in these patients, as there is no standard of care following disease progression. The purpose of this study was to elucidate the mechanisms of resistance to T-DM1 and T-DXd in HER2+ BC patients and preclinical models and identify targets whose inhibition enhances the antitumor activity of T-DXd in HER2-directed ADC-resistant HER2+ breast cancer in vitro and in vivo. Methods Targeted DNA and whole transcriptome sequencing were performed in breast cancer patient tissue samples to investigate genetic aberrations that arose after anti-HER2 therapy. We generated T-DM1 and T-DXd–resistant HER2+ breast cancer cell lines. To elucidate their resistance mechanisms and to identify potential synergistic kinase targets for enhancing the efficacy of T-DXd, we used fluorescence in situ hybridization, droplet digital PCR, Western blotting, whole-genome sequencing, cDNA microarray, and synthetic lethal kinome RNA interference screening. In addition, cell viability, colony formation, and xenograft assays were used to determine the synergistic antitumor effect of T-DXd combinations. Results We found reduced HER2 expression in patients and amplified DNA repair–related genes in patients after anti-HER2 therapy. Reduced ERBB2 gene amplification in HER2-directed ADC–resistant HER2+ breast cancer cell lines was through DNA damage and epigenetic mechanisms. In HER2-directed ADC–resistant HER2+ breast cancer cell lines, our non-biased RNA interference screening identified the DNA repair pathway as a potential target within the canonical pathways to enhance the efficacy of T-DXd. We validated that the combination of T-DXd with ataxia telangiectasia and Rad3-related inhibitor, elimusertib, led to significant breast cancer cell death in vitro (P

Emerging technologies are characterized by malleability and incompleteness, rendering them profoundly unpredictable. Science and Technology Studies (STS) have underscored the significance of prospective narratives, such as technological visions, in managing the inherent uncertainty of emerging technologies. However, the dynamics of prospective narratives within the settings of organizations remain underexplored in organizational studies (OS). Therefore, this paper explores the mechanism by which organizations frame emerging technologies and navigate the future’s intrinsic uncertainty. We investigate these issues through an ethnographic case study of EnerCo, a large electricity utility. We find that the process of constitution of a technological vision is driven by iterative enactments of anticipating, which involves creatively formulating prospective narratives, and disseminating, which encompasses transferring and translating prospective narratives into new social settings. By bridging the STS literature on technological expectation and the OS practice framework of zoom in/out, we offer a fresh outlook on the reciprocal relationship between organizational dynamics and technoscientific narratives.

OBJECTIVE: Pulmonary annular hypoplasia and valvar dysplasia are key morphological features affecting long-term outcomes of tetralogy of Fallot. This retrospective study aimed to analyse factors affecting contemporary long-term outcomes with a focus on pulmonary annular growth and function over time. METHODS: 131 consecutive isolated tetralogy of Fallot repairs performed between 2004 and 2014 at University Children’s Hospital Zurich were included. Median age and weight at the time of repair were 4.8 (interquartile range [IQR] 3.2–6.3) months and 6.1 (IQR 5.1–7) kg, respectively. Based on the severity of native pulmonary annular hypoplasia, the cohort was divided into group 1 (preoperative pulmonary annular Z score < –4; n = 20), group 2 (Z score –2 to –4; n = 56) and group 3 (Z score > –2; n = 54). A transannular patch was used in 88/131 (67.2%) patients: 80%, 67.9% and 61.1% in groups 1, 2 and 3, respectively. The primary outcome was defined as right ventricular outflow tract (RVOT) reoperation or pulmonary valve replacement. Secondary outcome was composite pulmonary valve dysfunction defined as peak gradient >40 mm Hg or severe pulmonary regurgitation at follow-up. A multiple Cox regression model was used to quantify the association of age at tetralogy of Fallot repair, preoperative pulmonary annular Z score and RVOT approach with primary and secondary outcome. Follow-up was 98.5% complete, with a median follow-up duration of 9.6 (95% confidence interval [CI] 9–10.4) years. RESULTS: All patients were alive at last follow-up resulting in 100% survival. 20/131 patients underwent pulmonary valve replacement (14 surgical and 6 catheter interventional) while 5/131 underwent RVOT reoperations other than valve replacement. The Kaplan-Meier 10-year freedom from primary outcome was 85% (95% CI 78–92%); 69% (46–100%), 91% (82–100%) and 84% (74–95%) for groups 1, 2 and 3, respectively (log rank p = 0.16). Composite dysfunction at follow-up was observed in 29.8% (overall): 45%, 28.6% and 25.9% for groups 1, 2 and 3, respectively (p = 0.12). The multiple Cox regression analysis for primary outcome indicated that the use of a transannular patch results in a Hazard Ratio (HR) of 3.3 (95% CI 0.7–14.7, p = 0.13). Additionally, the presence of composite dysfunction at discharge results in a HR of 2.1 (95% CI 0.8–5.4, p = 0.1). Age (in months) with a HR of 0.8 (95% CI 0.6–1, p = 0.06) and group 2 with a HR of 0.4 (95% CI 0.14–1.2, p = 0.11) showed a trend to being protective for the primary outcome. However, the 95% CI of all estimates included the HR of 1. CONCLUSIONS: Transannular patch use and composite dysfunction at discharge, although not statistically significant at 5% level, may be associated with pulmonary valve replacement and RVOT reoperation. Avoiding the use of a transannular patch or using reconstructive techniques to achieve a better composite dysfunction at discharge could reduce the primary outcome. Large multicentre studies are needed to demonstrate more precisely the impact of pulmonary annulus Z scores on outcome.

O impacto das mudanças ocorridas no mundo do trabalho sobre a constituição identitária e as carreiras dos trabalhadores não é uniforme, apesar de sua abrangência e intensidade, conforme evidenciam estudos recentes sobre o tema. Assim, objetivou-se compreender especificamente o processo de construção das identidades de trabalho de trabalhadores da área da tecnologia da informação (TI) por se associarem aos novos modelos de carreira. Trata-se de um estudo de casos múltiplos, realizado por meio de entrevistas com oito trabalhadores de TI, sendo as informações submetidas à análise narrativa. Os resultados evidenciaram que a forma identitária narrativa e o discurso de carreira possibilidade destacam-se nos relatos dos participantes, sendo que, em alguns casos, suas narrativas se encontram ancoradas em discursos associados à empregabilidade, mobilidade, precarização do trabalho e incerteza em relação ao futuro. Conclui-se, assim, que a identidade de trabalho dos investigados é formada por aspectos da identidade organizacional, profissional e vocacional, sendo essa última a mais saliente, o que parece indicar uma tendência dos processos de carreira no contexto do trabalho contemporâneo.

Electromagnetic (EM) body models predict the impact of human presence and motions on the Radio-Frequency (RF) field originated from wireless devices nearby. Despite their accuracy, EM models are time-consuming methods which prevent their adoption in strict real-time computational imaging and estimation problems, such as passive localization, RF tomography, and holography. Physicsinformed Generative Neural Network (GNN) models have recently attracted a lot of attention thanks to their potential to reproduce a process by incorporating relevant physical laws and constraints. They can be used to simulate or reconstruct missing data or samples, reproduce EM propagation effects, approximated EM fields, and learn a physics-informed data distribution, i.e., the Bayesian prior. Generative machine learning represents a multidisciplinary research area weaving together physical/EM modelling, signal processing, and Artificial Intelligence (AI). The paper discusses two popular techniques, namely Variational Auto-Encoders (VAEs) and Generative Adversarial Networks (GANs), and their adaptations to incorporate relevant EM body diffraction methods. The proposed EM-informed GNN models are verified against classical EM tools driven by diffraction theory, and validated on real data. The paper explores emerging opportunities of GNN tools targeting real-time passive RF sensing in communication systems with dense antenna arrays. Proposed tools are also designed, implemented, and verified on resource constrained wireless devices. Simulated and experimental analysis reveal that GNNs can limit the use of time-consuming and privacy-sensitive training stages as well as intensive EM computations. On the other hand, they require hyper-parameter tuning to achieve a good compromise between accuracy and generalization.

The main feature of neurodegenerative diseases, including Alzheimer’s disease, is the network of complex and not fully recognized neuronal pathways and targets involved in their onset and progression. The therapeutic treatment, at present mainly symptomatic, could benefit from a polypharmacological approach based on the development of a single molecular entity designed to simultaneously modulate different validated biological targets. This strategy is principally based on molecular hybridization, obtained by linking or merging different chemical moieties acting with synergistic and/or complementary mechanisms. The coumarin core, widely found in nature, endowed with a recognized broad spectrum of pharmacological activities, large synthetic accessibility and favourable pharmacokinetic properties, appears as a valuable, privileged scaffold to be properly modified in order to obtain compounds able to engage different selected targets. The scientific literature has long been interested in the multifaceted profiles of coumarin derivatives, and in this review, a survey of the most important results of the last four years, on both natural and synthetic coumarin-based compounds, regarding the development of anti-Alzheimer’s compounds is reported.

Background: The link between limited health literacy (HL), an often forgotten social determinant of health, inadequate access to health care, and poor health outcomes demonstrates the need for better patient education. Understanding HL supports patient education on multiple levels. Purpose: Our objective was to measure HL and its association with sociodemographic variables. Methods: A cross-sectional study with 328 patients was completed in 2 health centers. Three instruments, the Brief HL tool (BRIEF), Short Assessment of HL Spanish and English (SAHL-S&E), and the All Aspects of HL Scale (AAHLS), were administered. Participants also reported sociodemographic characteristics and perceptions. Results: Limited and marginal HL existed in 49% (BRIEF) and 20% (SAHL-S&E) of participants. Differences in HL were identified by race, ethnicity, and education (p-values < 0.05) for the BRIEF and SAHL-S&E. Limited functional and critical HL existed in 23% and 25% of participants (AAHLS). Ninety percent reported confidence accessing health information, and 33% and 41% perceived their health as being poor and good. Discussion: Results provide evidence of limited HL and merit in assessing HL in multiple ways. Translation to Health Education Practice: Measuring HL provides a background for designing multilevel patient education efforts, reducing health inequalities, and informing the healthcare workforce.

Abstract Background Airway remodeling is an important pathological feature of chronic airway diseases, which leads to a progressive decline in lung function. The present study examined the anti-remodeling and anti- inflammatory effect of BIBF1000, a triple-tyrosine kinase inhibitor that targets VEGF, PDGF, and FGF receptor signaling in a mouse model of repeated ovalbumin (OVA) challenges. Methods Female Balb-c mice were immunized intraperitoneally on days 0 and 12 with 50 µg ovalbumin plus 1 mg of Al(OH)3 in 200 μl saline. Intranasal OVA challenges (20 µg/50 µl in PBS) were administered on days 26, 29, and 31, and were repeated twice a week for 3 months. Animals received vehicle or BIBF1000 (25 mg/kg, b.i.d.) through gavage from day 26 to the end of fourth month. On day 120, bronchoalveolar lavage (BAL) and lung tissue were collected for biochemical and immunohistological analysis. Results Compared to vehicle controls, treatment with BIBF1000 reduced the numbers of BAL eosinophils, macrophages, neutrophils, and lymphocytes by 70.0%, 57.9%, 47.5%, and 63.0%, respectively, and reduced IL-5 and IL-13 in BAL. Treatment with BIBF1000 reduced airway mucus secretion, peribronchial fibrosis, small airway, and pulmonary arterial wall thickness, compared to vehicle controls. Furthermore, treatment with BIBF1000 also reduced the expression of inflammatory mediators (TNF-α, IL-1β, IL-5, IL-13, MMP-2, MMP-9, COX-2, and iNOS) and inhibited ERK and AKT phosphorylation. Conclusions The protective effect afforded by triple-tyrosine kinase inhibition with BIBF1000 in reducing allergen-induced airway and arterial remodeling was associated with down-regulation of inflammatory mediators, as well as inhibition of ERK and AKT signaling pathways.

Abstract Background and aims Kinin B1 receptors (B1Rs) are implicated in the pathogenesis of fibrosis. This study examined the anti-fibrotic effects of B1R blockade with BI 113823 in two established mouse models of hepatic fibrosis induced by intraperitoneal carbon tetrachloride (CCl4) injection or bile duct ligation (BDL). The mechanisms underlying the protection afforded by B1R inhibition were examined using human peripheral blood cells and LX2 human hepatic stellate cells (HSCs). Methods Fibrotic liver diseases were induced in mice by intraperitoneal carbon tetrachloride (CCl4) injection for 6 weeks, and by bile duct ligation (BDL) for 3 weeks, respectively. Mice received daily treatment of vehicle or BI 113823 (B1R antagonist) from onset of the experiment until the end of the study. Results B1Rs were strongly induced in fibrotic mouse liver. BI 113823 significantly attenuated liver fibrosis and portal hypertension (PH), and improved survival in both CCl4 and BDL mice. BI 113823 significantly reduced the expression of fibrotic proteins α-SMA, collagens 1, 3, 4, and profibrotic growth factors PDGF, TGFβ, CTGF, VEGF, proliferating cell nuclear antigen; and reduced hepatic Akt phosphorylation in CCl4- and BDL-induced liver fibrosis. BI 113823 also reduced expression of Cytokines IL-1, IL-6; chemokines MCP-1, MCP-3 and infiltration of inflammatory cells; and inhibited human monocyte and neutrophil activation, transmigration, TNF-α & MPO production in vitro. BI 113823 inhibited TGF-β and B1R agonist-stimulated human-HSC activation, contraction, proliferation, migration and fibrosis protein expression, and inhibited activation of PI3K/Akt signalling pathway. Conclusions B1Rs merits consideration as a novel therapeutic target for chronic liver fibrosis and PH.

Abstract We conducted a pilot trial of an intervention targeting intersectional stigma related to being pregnant and living with HIV while promoting capabilities for achieving ‘respected motherhood’ (‘what matters most’) in Botswana. A pragmatic design allocated participants to the intervention (N = 44) group and the treatment-as-usual (N = 15) group. An intent-to-treat, difference-in-difference analysis found the intervention group had significant decreases in HIV stigma (d = − 1.20; 95% CI − 1.99, − 0.39) and depressive symptoms (d = − 1.96; 95% CI − 2.89, − 1.02) from baseline to 4-months postpartum. Some, albeit less pronounced, changes in intersectional stigma were observed, suggesting the importance of structural-level intervention components to reduce intersectional stigma.

The advent of Chat Generative Pre-Trained Transformer (ChatGPT), a conversational artificial intelligence application, has sparked considerable interest and debate within the educational sphere. This narrative article explores the potential implications of ChatGPT on dental education, including its applications, challenges, and ethical considerations. In the realm of dental school admissions, the use of ChatGPT raises questions about academic integrity and the equitable access to resources for applicants. While it may offer benefits in aiding students with writer's block, concerns arise regarding plagiarism and the authenticity of personal statements. Furthermore, its impact on the learning experiences of dental students presents both opportunities and challenges. While ChatGPT can serve as a helpful learning tool, its use may also hinder the development of critical thinking skills and lead to issues of academic dishonesty. In the realm of research, ChatGPT holds promise for facilitating literature analysis, question-answering, and information retrieval. However, its limitations, such as the lack of domain-specific knowledge and potential for bias, must be considered. Ethical concerns surrounding AI-generated content, including misinformation and transparency, necessitate careful regulation and oversight. Looking ahead, the integration of generative AI models into dental education requires collaborative efforts to establish best practices and ethical guidelines. Future research should focus on developing tailored AI models specific to dental education and investigating their long-term effects on learning outcomes and patient care. Ultimately, as educators, it is imperative to embrace technological advancements while ensuring responsible and equitable integration into dental education curricula. [ABSTRACT FROM AUTHOR]

Abstract Background This study examined whether BI113823, a novel selective kinin B1 receptor antagonist can reverse established pulmonary arterial hypertension (PAH), prevent right heart failure and death, which is critical for clinical translation. Methods Left pneumonectomized male Wistar rats were injected with monocrotaline to induce PAH. Three weeks later, when PAH was well established, the rats received daily treatment of BI113823 or vehicle for 3 weeks. Results Treatment with BI113823 from day 21 to day 42 after monocrotaline injection reversed established PAH as shown by normalized values of mean pulmonary arterial pressure (mPAP). BI113823 therapy reversed pulmonary vascular remodeling, pulmonary arterial neointimal formation, and heart and lung fibrosis, reduced right ventricular pressure, right heart hypertrophy, improved cardiac output, and prevented right heart failure and death. Treatment with BI113823 reduced TNF-α and IL-1β, and macrophages recruitment in bronchoalveolar lavage, reduced CD-68 positive macrophages and expression of proliferating cell nuclear antigen (PCNA) in the perivascular areas, and reduced expression of iNOS, B1 receptors, matrix metalloproteinase (MMP)-2 and MMP-9 proteins, and the phosphorylation of ERK1/2 and AKT in lung. Treatment with BI113823 reduced mRNA expression of ANP, BNP, βMHC, CGTF, collange-I and IV in right heart, compared to vehicle treated controls. In human monocytes cultures, BI113823 reduced LPS-induced TNF-α production, MMP-2 and MMP-9 expression, and reduced TNF-α-induced monocyte migration. Conclusions We conclude that BI113823 reverses preexisting severe experimental pulmonary hypertension via inhibition of macrophage infiltration, cytokine production, as well as down regulation of matrix metalloproteinase proteins.

Background and Objectives: Despite a well-established universal HIV diagnosis and treatment program, Botswana continues to face a high HIV prevalence, in large part due to persistent stigma, which particularly affects pregnant women and interferes with healthcare engagement. Tackling stigma as a fundamental cause of HIV disparities is an important but understudied aspect of current HIV interventions. Our multinational and multicultural team used a theory-driven, multi-stage iterative process to develop measures and interventions to first identify and then target the most culturally-salient aspects of stigma for mothers living with HIV in Botswana. This methodology report examines the stage-by-stage application of the “What Matters Most” (WMM) theory and lessons learned, sharing a replicable template for developing culturally-shaped anti-stigma interventions. Methods: First, we conducted initial qualitative work based on the WMM theory to identify key structural and cultural factors shaping stigma for women living with HIV in Botswana. Second, we developed a psychometrically validated scale measuring how “what matters most” contributes to and protects against stigma for this population. Third, we designed an anti-stigma intervention, “Mothers Moving towards Empowerment” (MME), centered on the local values identified using WMM theory that underly empowerment and motherhood by adapting a cognitive behavioral therapy (CBT)-informed, group-based, and peer-co-led anti-stigma intervention specifically for pregnant women living with HIV. Fourth, we conducted a pilot study of MME in which participants were allocated to two trial arms: intervention or treatment-as-usual control. Results: Our qualitative research identified that bearing and caring for children are capabilities essential to the concept of respected womanhood, which can be threatened by a real or perceived HIV diagnosis. These values informed the development and validation of a scale to measure these culturally-salient aspects of stigma for women living with HIV in Botswana. These findings further informed our intervention adaptation and pilot evaluation, in which the intervention group showed significant decreases in HIV stigma and depressive symptoms compared to the control group. Participants reported overcoming reluctance to disclose their HIV status to family, leading to improved social support. Conclusion and Global Health Implications: Previous studies have not utilized culturally-based approaches to assess, resist, and intervene with HIV-related stigma. By applying WMM in each stage, we identified cultural and gendered differences that enabled participants to resist HIV stigma. Focusing on these capabilities that enable full personhood, we developed an effective culturally-tailored anti-stigma intervention for pregnant women living with HIV in Botswana. This theory-driven, multi-stage approach can be replicated to achieve stigma reduction for other outcomes, populations, and contexts. Copyright © 2022 Poku et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Abstract Background To examine the effects of BI 1029539 (GS-248), a novel selective human microsomal prostaglandin E synthase-1 (mPGES-1) inhibitor, in experimental models of acute lung injury (ALI) and sepsis in transgenic mice constitutively expressing the mPGES1 (Ptges) humanized allele. Methods Series 1: Lipopolysaccharide (LPS)-induced ALI. Mice were randomized to receive vehicle, BI 1029539, or celecoxib. Series 2: Cecal ligation and puncture-induced sepsis. Mice were randomized to receive vehicle or BI 1029539. Results Series 1: BI 1029539 or celecoxib reduced LPS-induced lung injury, with reduction in neutrophil influx, protein content, TNF-ɑ, IL-1β and PGE2 levels in bronchoalveolar lavage (BAL), myeloperoxidase activity, expression of mPGES-1, cyclooxygenase (COX)-2 and intracellular adhesion molecule in lung tissue compared with vehicle-treated mice. Notably, prostacyclin (PGI2) BAL concentration was only lowered in celecoxib-treated mice. Series 2: BI 1029539 significantly reduced sepsis-induced BAL inflammatory cell recruitment, lung injury score and lung expression of mPGES-1 and inducible nitric oxide synthase. Treatment with BI 1029539 also significantly prolonged survival of mice with severe sepsis. Anti-inflammatory and anti-migratory effect of BI 1029539 was confirmed in peripheral blood leukocytes from healthy volunteers. Conclusions BI 1029539 ameliorates leukocyte infiltration and lung injury resulting from both endotoxin-induced and sepsis-induced lung injury.

The study investigated whether positive alternative discipline approaches have improved the culture of teaching and learning in South Africa. The implementation of positive alternative discipline approaches encountered difficulties and challenges that plunged schools into crisis. The culture of teaching and learning subsequently deteriorated over the past years, notwithstanding various disciplinary interventions. Three hundred and thirty-three teachers of schools in the Mpumalanga province of South Africa participated in this quantitative survey. The questionnaires provided valid responses and an official statistician analysed and tested them using the Cronbach alpha coefficient to establish acceptable reliability. Findings reported the teachers' unwilling to implement alternative disciplinary approaches imposed upon them. Therefore, the study recommended the creation of a positive invitational framework flexible enough to accommodate differences among schools to improve the culture of teaching and learning. This recommended framework, customised based on the lived experiences of teachers, must become a mandatory component of a continuous review process for disciplinary improvement to occur.

Despite the significant outcomes attained by scientific research, breast cancer (BC) still represents the second leading cause of death in women. Estrogen receptor-positive (ER+) BC accounts for the majority of diagnosed BCs, highlighting the disruption of estrogenic signalling as target for first-line treatment. This goal is presently pursued by inhibiting aromatase (AR) enzyme or by modulating Estrogen Receptor (ER) α. An appealing strategy for fighting BC and reducing side effects and resistance issues may lie in the design of multifunctional compounds able to simultaneously target AR and ER. In this paper, previously reported flavonoid-related potent AR inhibitors were suitably modified with the aim of also targeting ERα. As a result, homoisoflavone derivatives 3b and 4a emerged as well-balanced submicromolar dual acting compounds. An extensive computational study was then performed to gain insights into the interactions the best compounds established with the two targets. This study highlighted the feasibility of switching from single-target compounds to balanced dual-acting agents, confirming that a multi-target approach may represent a valid therapeutic option to counteract ER+ BC. The homoisoflavone core emerged as a valuable natural-inspired scaffold for the design of multifunctional compounds.

The explosion of artificial intelligence methods has paved the way for more sophisticated smart mobility solutions. In this work, we present a multi-camera video content analysis (VCA) system that exploits a single-shot multibox detector (SSD) network to detect vehicles, riders, and pedestrians and triggers alerts to drivers of public transportation vehicles approaching the surveilled area. The evaluation of the VCA system will address both detection and alert generation performance by combining visual and quantitative approaches. Starting from a SSD model trained for a single camera, we added a second one, under a different field of view (FOV) to improve the accuracy and reliability of the system. Due to real-time constraints, the complexity of the VCA system must be limited, thus calling for a simple multi-view fusion method. According to the experimental test-bed, the use of two cameras achieves a better balance between precision (68%) and recall (84%) with respect to the use of a single camera (i.e., 62% precision and 86% recall). In addition, a system evaluation in temporal terms is provided, showing that missed alerts (false negatives) and wrong alerts (false positives) are typically transitory events. Therefore, adding spatial and temporal redundancy increases the overall reliability of the VCA system.

Abstract Background With high rates of HIV and multiple vulnerable subgroups across diverse settings, there is a need for culturally based, HIV stigma reduction interventions. Pregnant women who are living with HIV are especially in need of services to protect not only their own but also their children’s lives. Uptake of HIV services worldwide is hindered by stigma towards persons living with HIV/AIDS. While cultural context plays a key role in shaping HIV stigma, these insights have not yet been fully integrated into stigma reduction strategies. By utilizing the “What Matters Most” stigma framework, we propose that an intervention to counter culturally salient aspects of HIV stigma will improve treatment adherence and other relevant outcomes. A pragmatic clinical trial in Botswana will evaluate the “Mothers Moving towards Empowerment” (MME) intervention, which seeks to address HIV stigma in Botswana and to specifically engage pregnant mothers so as to promote antiretroviral therapy (ART) adherence in the postpartum period. Methods This study will test MME against treatment as usual (TAU) among pregnant mothers diagnosed with HIV and their infants. Outcomes will be assessed during pregnancy and 16 weeks postpartum. Women who meet eligibility criteria are assigned to MME or TAU. Women assigned to MME are grouped with others with similar estimated delivery dates, completing up to eight intervention group sessions scheduled before week 36 of their pregnancies. Primary outcomes among mothers include (i) reducing self-stigma, which is hypothesized to mediate improvements in (ii) psychological outcomes (quality of life, depression and social functioning), and (iii) adherence to antenatal care and ART. We will also examine a set of follow-up infant birth outcomes (APGAR score, preterm delivery, mortality (at