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Background: Anemia is one of the most common nutritional deficiency disorders affecting pregnant women; its prevalence in developed countries is 14% and in developing countries 51%. It is therefore important to understand the prevalence and associated factors of anemia in our study area. This will encourage antenatal caregivers to identify and treat anemia early in pregnancy. Objective: Therefore, the study's goal was to determine the prevalence of anemia and its contributing factors among pregnant women receiving prenatal care. Methods: Between April 2021 and May 2021, 295 pregnant women attending prenatal care participated in a cross‐sectional facility‐based study. Epidata software was used to enter the data, which were then exported to SPSS software for Windows version 23 for analysis. To determine the factors contributing to anemia in pregnant women, descriptive statistics collected with the study were performed together with bivariable logistic regression and the log‐binomial model. Results: Among the 295 study participants, 24.7% were anemic. Out of these, most were mild types 78.1%. Illiterate pregnant women (ARR 2.89; 95% CI: 1.76–6.43, p value = 0.037), with no iron‐containing food intake per day (ARR 1.74; 95% CI: 1.59–1.95, p value = 0.01), and infected with malaria (ARR 1.58; 95% CI: 1.76–2.53, p value = 0.03) had higher odds of being anemic, compared to their counterpart. Gestational age of the first (ARR 0.21; 95% CI: 0.03–0.98, p value = 0.01), and second (ARR 0.8; 95% CI: 0.43–0.96, p value = 0.013) trimester has lower odds of being anemic compared to their counterpart. Conclusion: Anemia in pregnant women is found to be a moderate public health issue in the research location. It is strongly and independently impacted by malaria infection and iron‐containing meal consumption. Reducing the prevalence of anemia is made possible by improved iron‐containing meal consumption. In addition, it is strongly advised that pregnant women receive education and should take iron supplements during pregnancy visits. [ABSTRACT FROM AUTHOR]

AbstractTissue engineering has emerged as a biological alternative aimed at sustaining, rehabilitating, or enhancing the functionality of tissues that have experienced partial or complete loss of their operational capabilities. The distinctive characteristics of electrospun nanofibrous structures, such as their elevated surface-area-to-volume ratio, specific pore sizes, and fine fiber diameters, make them suitable as effective scaffolds in tissue engineering, capable of mimicking the functions of the targeted tissue. However, electrospun nanofibers, whether derived from natural or synthetic polymers or their combinations, often fall short of replicating the multifunctional attributes of the extracellular matrix (ECM). To address this, nanomaterials (NMs) are integrated into the electrospun polymeric matrix through various functionalization techniques to enhance their multifunctional properties. Incorporation of NMs into electrospun nanofibrous scaffolds imparts unique features, including a high surface area, superior mechanical properties, compositional variety, structural adaptability, exceptional porosity, and enhanced capabilities for promoting cell migration and proliferation. This review provides a comprehensive overview of the various types of NMs, the methodologies used for their integration into electrospun nanofibrous scaffolds, and the recent advancements in NM-functionalized electrospun nanofibrous scaffolds aimed at regenerating bone, cardiac, cartilage, nerve, and vascular tissues. Moreover, the main challenges, limitations, and prospects in electrospun nanofibrous scaffolds are elaborated. [ABSTRACT FROM AUTHOR]

Plastic pollution poses a significant threat to the environment and human health on a global level. This study aimed to investigate plastic pollution in the Harari region of Ethiopia. The result indicated that 62% of respondents demonstrated good knowledge about plastic waste, and 59% of them perceived plastic waste as harmful. Polyethylene terephthalate, high-density polyethylene, polyvinyl chloride, low-density polyethylene, polypropylene, polystyrene, and polycarbonates were the types of plastic waste identified. Being female (AOR = 1.82), aged 15–45 (AOR = 1.82), married (AOR = 1.83), and having families >3 (AOR = 2.15) were significantly positively associated with good plastic waste management practice. Being illiterate (AOR = 0.52), and having poor knowledge about plastic waste (AOR = 0.54) were significantly negatively associated with poor management practice. The findings indicated that the Harari region is prone to adverse health and environmental effects from plastic pollution. Policies restricting plastic use, training municipal waste collectors and health extension workers, and improving public awareness are indispensable. [ABSTRACT FROM AUTHOR]

Background. Group B Streptococcus (GBS) colonizes the rectovaginal area of women and vertically transmitted to neonates. This bacterium has been linked to severe neonatal complications including pneumonia, septicemia, and meningitis. GBS shows an increased resistance to commonly used antibiotics. Thus, we assessed the vertical transmission, contributing factors, and antimicrobial resistance patterns of GBS among newborns delivered at selected Hospitals in Jigjiga City. Methods. Hospital‐based cross‐sectional study was conducted from 1st June 2022 to 30th April 2023. A total of 849 pregnant women admitted to delivery wards from two hospitals were screened for GBS colonization. Subsequently, 162 GBS‐colonized pregnant women and their newborn babies were included. A semistructured questionnaire and a review of medical records were used to collect the sociodemographic and clinical characteristics of the study participants. Trained nurses collected swab samples from the vaginal‐rectal area of pregnant women and the nasal, ear canal, and umbilical areas of newborn babies. Samples were inoculated on Todd Hewitt broth media supplemented with gentamycin and nalidixic acid and then subcultured on blood agar. Colony characteristics, Gram stain, and catalase test were used for identification. All gram‐positive cocci, B‐hemolytic, and catalase‐negative isolates were further identified using Christie–Atkins–Munch–Petersen and a bacitracin test. The modified Kirby‐Bauer disk diffusion method was used for antimicrobial susceptibility testing. Data were analyzed using SPSS version 26. Logistic regression analysis was used to determine the factors associated with vertical transmission of GBS, and statistical significance was set at p values <0.05. Result. The overall vertical transmission rate was 41.4% (67/162). History of preterm labor (Adjusted odds ratio (AOR) = 2.25; 95% CI: 1.11, 4.59), history of urinary tract infection (UTI) at current pregnancy (AOR = 2.25; 95% CI: 1.11, 4.59), and prolonged rupture of membranes greater than 18 hours (AOR = 2.23; 95% CI: 1.13, 4.4) were significantly associated with vertical transmission of GBS from previously colonized mothers to their newborn babies. Regarding GBS antibiotic susceptibility profile, a significant degree of resistance was observed to penicillin (29.9%), tetracycline (22.4%), ampicillin (20.9%), and clindamycin (19.4%). Conclusion. Our study documented a high prevalence of vertical transmission rate of GBS from pregnant women to their babies, with an overall transmission rate of 41.4%. The study identified the presence of antimicrobial‐resistant GBS to penicillin, ampicillin, clindamycin, ciprofloxacin, and chloramphenicol. The organism was susceptible to vancomycin, followed by azithromycin, ceftriaxone, and erythromycin. Our study also reported MDR at 13.4%. Based on our findings, there is a need for antenatal culture‐based GBS screening, maternal vaccination, and large‐scale epidemiological and serotype identification studies to be put into practice in the study area. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease is a zoonotic disease caused by the intermediate stage of dog tapeworm Echinococcus granulosus. Objectives: The study investigated the prevalence of hydatid cysts and the risk factors in cattle slaughtered at the Bishoftu municipal abattoir. It also analyzed the economic loss and community's awareness of this matter. Animals: 480 cattle brought for slaughtering were included in the study. Methods: A cross‐sectional study was conducted from December 2022 to April 2023 in Bishoftu municipal abattoir involving antemortem examination of cattle and postmortem hydatid cyst investigation, assessment of associated economic loss, and community awareness survey. Animals were selected systematically and cysts were investigated using standard meat inspection procedures. Results: 10.4% of the slaughtered cattle were found positive for hydatid cysts, with no statistically significant association with the considered risk factors. From 85 collected cysts, the lungs accounted for 55.3%, the liver for 29.4%, and the remaining 15.3% were from the spleen, kidney, and heart. About 47.1% of the cysts were fertile and 52.9% were infertile, of which, 37.5% were nonviable. In a survey of 100 individuals, 33.0% were unaware of hydatid disease, and 61.0% were unaware that the disease is zoonotic. Annual economic loss due to the case was estimated at 5,444,564.4 ($97,224.4). Conclusion: This study identified hydatid disease as a significant issue in cattle in Bishoftu, indicating the need for preventative and control measurements. Strategies such as deworming, controlling street dogs, establishing standardized abattoirs, and raising public awareness should be applied to alleviate the problem in Bishoftu and nationwide. [ABSTRACT FROM AUTHOR]

Background: The knowledge and practices of nurses are determinant factors of pediatric pain management, but there are no pooled results concerning prevalence and associated factors. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of good knowledge, good practices, and associated factors for pediatric pain management in Ethiopia. Methods: PubMed, Cochrane, Scopus, CINAHL, Google Scholar, and university repositories in Ethiopia were searched. It was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and Newcastle–Ottawa Scale was used to assess the quality. Cross-sectional studies conducted any time were included. STATA 17 was used to analyze the data after extraction. Heterogeneity was assessed via I2 statistics, Galbraith plot and meta-regression. A random effects model was used in the presence of heterogeneity. Funnel plots and Egger's regression were used to assess publication bias. Subgroup analyses were conducted by the study period and sample size. Sensitivity analysis was also performed. Results: Nine studies with a total of 2355 nurses were included. The pooled prevalence of good knowledge and practices for pediatric pain management among nurses was 60% and 42%, respectively. The percentages were higher from 2015–2021 than from 2022–2024. Education, training, pain management protocols, and tools were the main variables analyzed. Hence, pre-service training (OR: 3.1, CI: 2.21–4.36), in-service training (OR: 3.04, CI: 1.78–5.18), and pain management protocol (OR: 2.53, CI: 1.59–4.03) were associated with good knowledge. MSc degrees (OR: 7.45, CI: 2.74–20.21), pre-service training (OR: 2.26, CI: 1.53–3.34), in-service training (OR: 3.27, CI: 1.72–6.25), presence of protocol (OR: 2.68, CI: 1.79–3.99), presence of tool (OR: 2.74, CI: 1.96–3.83), presence of policy (OR: 6.2, CI: 2.98, 12.91), knowledge of nurses (OR: 4.47, CI: 3.24, 6.18) and child cooperativeness (OR: 1.98, CI: 1.46, 2.67) were associated with good practices of pediatric pain management. Conclusion: The pooled prevalence of good knowledge and good practices was low. Education, training, and the availability of pain management protocols were the most important factors. Therefore, education and training provisions should focus on nurses working in pediatric wards. Trial registration: PROSPERO registration number: CRD42024572462. [ABSTRACT FROM AUTHOR]

Despite infection and sepsis being a major public health challenge, early detection and timely management are often hindered by several factors. These includes the similarity of clinical presentations between infectious and non-infectious conditisons, as well as limitations of current diagnostic methods such as lengthy turnaround times and low sensitivity. Consequently, there is increasing interest in identifying biomarkers that can quickly and accurately differentiate bacterial sepsis from other inflammatory processes, whether infectious or non-infectious. Procalcitonin has emerged as one of the most extensively studied and utilized biomarkers in managing infection and sepsis, especially within the framework of antibiotic stewardship. This review aims to examine the role of Procalcitonin in guiding antibiotic stewardship. It explores the production and release of procalcitonin and its relevance in the context of infection and sepsis. The discussion focus on the clinical and economic impacts of using procalcitonin to guide the initiation and discontinuation of antibiotics in managing these conditions. [ABSTRACT FROM AUTHOR]

Background: Occupational or work-related injuries are mostly common among hospitals' sanitary workers (SWs) in developing countries like Ethiopia. This is due to improper practiced of devices, unhygienic workplace, neglected and undermined risk factors, as well as due to lack of policy initiatives; but not studied well. Objective: The aim of the study was to assess the occupational injuries and its associated factors among SWs in public hospitals, eastern Ethiopia: A Modified Poisson regression Model Analysis. Methods: An institution-based cross-sectional study was conducted in eight public hospitals in eastern Ethiopia from May 2023 to August 30th, 2023. Out of fourteen hospitals, eight of them were selected randomly. Eight data collectors and 4 supervisors were assigned. Face-to-face interview was conducted. Eight hundred hospital SWs were recruited for the study. Occupational injury was measured using Boolean logic questionnaire either YES [1] or NO [0] for the last 12 months and the 7 days. Descriptive statistical was used for means, medians, standard deviations, and frequencies, proportions, and percentages. Modified Poisson regression was used to explore the relationship of outcome and independent variables. Accordingly, bi-variable analysis was performed to estimate unadjusted prevalence ratio (UPR). While, multi-variable model was used adjusted PR(APR) for those variables have significant values of p ≤0.20 at bi-variate analysis with confidence interval of 95% (CI:95%). Result: Out of eight hundred nine SWs, 729(90.1%) were participated on the study. Self-reported occupational injuries among SWs in the last 12 months were 44.0% (95% CI: 40.4, 47.7). Of these, 92.2% (95%CI: 88.7,94.90%) and 7.8% (95%CI: 5.1, 11.3%) occupational injuries was reported from the cleaners and waste collectors, respectively. The model found that SWs those acquired diseases after recruited in the hospitals (APR:1.3;95%CI:1.1,1.6), those had sleeping disorder (APR:1.2;95%CI:1.0,1.), those had workload (APR:1.3; 95%CI:1.0, 1.8), those exposed with occupational hazards (APR:1.4; 95%CI:1.3, 1.7) were at the risk of occupational injuries as compared to their counter parts. Meanwhile, SWs those didn't get supervision (APR: 1.0;95%CI: 1.0, 1.2) and those non-adherence to personal protective equipment (PPE) (APR:1.3;95%CI:1.0,1.5) were more likely to at the risk of occupational injuries. Conclusion: The current study concluded that there was a high prevalence of occupational injuries among SWs in the current selected public hospitals. The study also found that non-compliant with PPE, work load, sleeping disorders, attitude towards workplace safety and unsupervised activities and working in high-risk environment tends to increase the risk for occupational injuries. In addition to occupational injuries the study found that SWs those acquired occupational diseases such as asthma, respiratory tract problems, allergy, infections, kidney problems and dermatology problems after recruited in hospitals. [ABSTRACT FROM AUTHOR]

Metal halide perovskites are crystalline materials with a sharp increase in popularity and rapidly becoming a major contender for optoelectronic device applications. In this work, we provide the optoelectronic features of a possible novel candidate, ZSnCl3 (Z = Na/K) Sn‐based on a detailed numerical simulation. The output of the current computations is compared to the results that are currently available, and a respectable agreement is noted. The studied compounds were cubic in nature and structurally stabe. The mechanical properties reflect the mechanical stability and ductility of the proposed materials. The Sn‐based single perovskite compounds proposed in this study are mechanically stable and ductile. The narrow direct band gap for NaSnCl3 and KSnCl3 are 1.36 eV and 1.47 eV, respectively, using the HSE06 hybrid function with the Boltztrp2 integrated in Quantum ESPRESSO (QE) software. The effective use of these compounds in perovskite solar cells and other optoelectronic applications was confirmed by optical absorption spectral measurements conducted in the photon energy range of 0–20 eV. [ABSTRACT FROM AUTHOR]

Background: Multidrug‐resistant (MDR) bacteria have significantly affected the management and treatment of wound infections globally. Data on the prevalence of MDR bacterial profiles that cause wound infections in Ethiopia are scarce. Therefore, this study aimed to determine MDR as well as extended‐spectrum beta‐lactamase production profiles of Gram‐negative rods that are difficult to treat with conventional antibiotics and that cause wound infections. Objective: The aim of the study was to determine the prevalence of extended‐spectrum beta‐lactamase producer Gram‐negative rods and associated factors among patients with wound infection at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Materials and Methods: This hospital‐based cross‐sectional study was conducted at University of Gondar Comprehensive Specialized Hospital between May and July 2022. Convenience sampling was used to recruit 228 participants. Swabs from different wound types were inoculated onto the MacConkey agar and blood agar plates and incubated overnight at 37°C for 24 h. Biochemical tests were performed on isolated colonies for the identification of bacterial species based on their biochemical reaction. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby–Bauer method by using Muller–Hinton agar, and the zone of inhibition was interpreted as resistant, intermediate, and sensitive as per the recommendation of Clinical Laboratory Standard Institute. Isolates were tested against ceftriaxone, cefotaxime, and ceftazidime for extended‐spectrum beta‐lactamase screening using the Kirby–Bauer disk diffusion method, and combined disk tests were applied for phenotypic confirmatory test of extended‐spectrum beta‐lactamase producing isolates. Result: Of 228 study participants, 162 (71.1%) were culture‐positive. Among culture‐positive patients, 165 Gram‐negative bacteria were recovered. The most common Gram‐negative isolates were Pseudomonas aeruginosa (47; 28.5%), followed by Escherichia coli (43; 26.1%) and Klebsiella pneumoniae (24; 14.5%). The susceptibility rates of the isolate for imipenem and tobramycin were 97.0% and 73.2%, respectively, and the overall multidrug resistance rate was 80.5%. Extended‐spectrum beta‐lactamase producer bacteria were also isolated. Besides, all (100%) of extended‐spectrum beta‐lactamase producer bacteria were MDR. Living in rural areas (AOR 5.8; 95% CI [2.01–16.7]), hospital admission (AOR 3.95; 95% CI [1.13–13.83]), antibiotic use (AOR 2.83; 95% CI [1.03–7.72]), and comorbidity (AOR 0.25; 95% CI [0.07–0.59]) were significantly associated with wound infection. Conclusions and Recommendations: There was a high prevalence of Gram‐negative bacterial isolates in this study. Pseudomonas aeruginosa (28.5%) was the predominant isolate. In addition, high rates of multidrug resistance were observed. The high level of multidrug resistance in this study implies that definitive therapy should be based on culture and susceptibility analysis to promote the rational use of antibiotics and to reduce the emergence of bacterial resistance to antimicrobials. [ABSTRACT FROM AUTHOR]

In present study the green synthesis of silver oxide nanoparticles has been effectively achieved using novel plant extract Phragmanthera Macrosolen. This method provides sustainable alternative for nanoparticle synthesis, demonstrating the potential of Phragmanthera Macrosolen as a reducing and stabilizing agent in the production of Ag2O NPs. The synthesized nanoparticles were characterized for their structural, morphological, and optical properties, confirming their successful formation and potential applications in various fields. The effects of different pH values and annealing temperature of the samples on the properties of Ag2O NPs formations, as well as photo-catalytic activities towards Toluidine Blue dye degradations, were studied. Powder XRD reveals that the crystallite natures of Ag2O NPs a long with crystalline size ranges from 25.85 to 35.90 nm. FIB-SEM and HR-TEM images displayed that the Ag2O NPs as spherical shapes. UV-vis spectroscopy displayed that Ag2O NPs belong to a direct-band gap of 2.1–2.6 eV. FTIR- study shown that the green synthesized Ag2O NPs may be steadied via the interfaces of –OH as well as C = O groups in the carbohydrate, flavonoid, tannin, as well as phenolic acid existing in P. macrosolen L. leaf. The chemical states, electron-hole recombinations and purity of Ag and O in the synthesized Ag2O NPs were confirmed through X-ray Photoelectron Spectroscopy (XPS) and PL analysis respectively. Fascinatingly, the synthesized Ag2O NPs at pH 12 displayed high photo-catalytic degradations for TB dyes. The photo-catalytic degradations of the TB dyes were monitored spectro-photo-metrically in wave-length ranges of 200–900 nm, as well as high efficiency (98.50%) with half-life of 9.5798 min and kinetic rate constant of 0.07234 min−1, was obtained after 45 min of reactions. From this study, it can be concluded that Ag2O NPs synthesized from Phragmanthera Macrosolen aqueous extract are promising in the remediation of environmental pollution and water treatment. In this light, the study reports that Phragmanthera Macrosolen green synthesis of Ag2O NPs can effectively address environmental pollution in cost-effective, eco-friendly, and sustainable ways. [ABSTRACT FROM AUTHOR]

In present study the green synthesis of silver oxide nanoparticles has been effectively achieved using novel plant extract Phragmanthera Macrosolen. This method provides sustainable alternative for nanoparticle synthesis, demonstrating the potential of Phragmanthera Macrosolen as a reducing and stabilizing agent in the production of Ag2O NPs. The synthesized nanoparticles were characterized for their structural, morphological, and optical properties, confirming their successful formation and potential applications in various fields. The effects of different pH values and annealing temperature of the samples on the properties of Ag2O NPs formations, as well as photo-catalytic activities towards Toluidine Blue dye degradations, were studied. Powder XRD reveals that the crystallite natures of Ag2O NPs a long with crystalline size ranges from 25.85 to 35.90 nm. FIB-SEM and HR-TEM images displayed that the Ag2O NPs as spherical shapes. UV-vis spectroscopy displayed that Ag2O NPs belong to a direct-band gap of 2.1–2.6 eV. FTIR- study shown that the green synthesized Ag2O NPs may be steadied via the interfaces of –OH as well as C = O groups in the carbohydrate, flavonoid, tannin, as well as phenolic acid existing in P. macrosolen L. leaf. The chemical states, electron-hole recombinations and purity of Ag and O in the synthesized Ag2O NPs were confirmed through X-ray Photoelectron Spectroscopy (XPS) and PL analysis respectively. Fascinatingly, the synthesized Ag2O NPs at pH 12 displayed high photo-catalytic degradations for TB dyes. The photo-catalytic degradations of the TB dyes were monitored spectro-photo-metrically in wave-length ranges of 200–900 nm, as well as high efficiency (98.50%) with half-life of 9.5798 min and kinetic rate constant of 0.07234 min−1, was obtained after 45 min of reactions. From this study, it can be concluded that Ag2O NPs synthesized from Phragmanthera Macrosolen aqueous extract are promising in the remediation of environmental pollution and water treatment. In this light, the study reports that Phragmanthera Macrosolen green synthesis of Ag2O NPs can effectively address environmental pollution in cost-effective, eco-friendly, and sustainable ways. [ABSTRACT FROM AUTHOR]

Introduction: Although postoperative antibiotic prophylaxis has not been shown to prevent surgical site infections, prolonged antibiotic administration is common in low- and middle-income countries. We developed a quality improvement program to reduce unnecessary postoperative antibiotics through hospital-specific guideline development and the use of a brief, multidisciplinary discussion of antibiotic indication, choice, and duration during clinical rounds. We assessed reduction in the number of patients receiving ≥24 h of antibiotic prophylaxis after clean and clean-contaminated surgery. Methods: We piloted the program at a referral hospital in Ethiopia from February to September 2023. After a 6-week baseline assessment, multidisciplinary teams adapted international guidelines for surgical prophylaxis to local disease burden, medication availability, and cost restrictions; stakeholders from surgical departments provided feedback. Surgical teams implemented a "timeout" during rounds to apply these guidelines to patient care; compliance with the timeout and antibiotic administration was assessed throughout the study period. Results: We collected data from 636 patients; 159 (25%) in the baseline period and 477 (75%) in the intervention period. The percentage of patients receiving ≥24 h of antibiotic prophylaxis after surgery decreased from 50.9% in the baseline period to 40.9% in the intervention period (p = 0.027) and was associated with a 0.5 day reduction in postoperative length of stay (p = 0.047). Discussion: This antibiotic stewardship pilot program reduced postoperative antibiotic prophylaxis in a resource-constrained setting in Sub-Saharan Africa and was associated with shorter length of stay. This program has the potential to reduce unnecessary antibiotic use in this population. [ABSTRACT FROM AUTHOR]

• Potential plant growth-promoting rhizobacteria screened from tomato rhizosphere soil. • Biochemical and molecular characterization of selected four isolates were done and taxonomy identified. • Plant growth promoting traits of the candidate strains were evaluated both at laboratory and greenhouse level. • Greenhouse trail and symbiotic effectiveness of the strains conducted using tomato as host plant. • To improve tomato-strain interaction different possible phosphorus sources were added. Numerous phosphate solubilizing bacteria (PSB) are found in the rhizosphere, benefiting the host plant in different mechanisms and promoting sustainable agriculture. They improve soil fertility with minimum cost requirements using an eco-friendly approach, which is an essential attribute for small-scale farm production. Thus, isolation, characterization, and evaluation of symbiotic effectiveness are hierarchical procedures to develop bioinoculants. Using a dual (plate and liquid medium) screening technique and a greenhouse trial, four potential PSB strains (Mk-1–25, Mk-13–16, Mk-20–7, and Mk-20–20) were selected from tomato rhizosphere soil. All isolates exhibited the following traits: produced colony clear-zone, lowered liquid medium pH, gram-positive, produced urease and IAA, dissolved substantial P from various substrates, symbiotically effective, and improved tomato growth and yield. Taxonomically, they belong to Bacillus and Priestia species (i.e., Mk-1–25 Bacillus halotolerance, Mk-13–16 Bacillus amyloliquefaciens, Mk-20–7 Bacillus megaterium, and Mk-20–20 Priestia megaterium). Among the current strains, Bacillus halotolerance recorded higher SI (3.11), was able to grow in extreme conditions (10% salt, up to 45 °C), produced HCN and siderophore, and improved tomatoes' shoot length and weight, in contrast, Mk-20–20 produced HCN, siderophore, was able to fix nitrogen, improved tomato germination, shoot dry weight, and fruit weight. Various P-supplements (Ca 3 (PO 4) 2 , bonemeal, FePO 4 , AlPO 4 , compost, and DAP fertilizer) were added to induce tomato-strain symbiotic interaction; hence, compost substantially promoted the interaction and resulted in higher symbiotic effectiveness. Ca 3 (PO 4) 2 was a good media composite preferred by most PSB strains; consequently, a higher concentration (219 µg/ml) of dissolved P was recorded from the liquid medium after 10 days of incubation than other substrates. Based on the data obtained from laboratory and greenhouse trials, the current strains were found to be potential candidate. Future work should confirm their efficacy at the field level using model host crops at different sites to recommend them as farm inputs and biofertilizer. [ABSTRACT FROM AUTHOR]

New roads bring new opportunities including access to employment. However, new employment opportunities might encourage early school dropout and school absenteeism. We investigate the link between rural roads, children's labor allocation, and educational outcomes by focusing on the recent Ethiopian road construction program. In the analysis, we combine household panel data with novel road network data. To address endogeneity concerns, we combine a difference-in-difference estimation model with a matching technique. Our findings consistently show that road access does not encourage school absenteeism or school dropouts to join the labor force. The findings remain consistent across gender and age groups. [ABSTRACT FROM AUTHOR]

There is a need to develop innovative protective shield structures to withstand extreme loads, such as impact and blast loading. Sandwich structures that absorb significant kinetic energy as strain energy through plastic deformation offer superior protection. This study conducts a numerical analysis of structured sandwich protective structures subjected to airblast loads using finite element modeling. First, an experimental result from the literature was used to validate and verify finite element models of an architected sandwich structure modeled in Abaqus/Explicit software. Second, parametric studies were conducted on sandwich structures with additional layers of insert plates and newly proposed core topologies for viable shield protection against airblast loading. The finite element analysis results indicated that, under the same impulsive load, the control sandwich panel exhibited higher kinetic energy, demanding a proportionally larger internal energy. Conversely, sandwich structures with additional inner core insert plates dissipated the imposed kinetic energy more efficiently, due to the inelastic plastic deformation of the proposed core configurations. Moreover, the energy absorption capacity and back sheet displacement time-history were significantly improved by dense-hierarchical inner core configurations. Additionally, the parametric study analysis showed that increasing the number of insert plates and designing the core topology of cellular walls to be redundant, dense-hierarchical, and braced against buckling significantly reduced core collapse mechanisms such as folding, buckling, and crushing. However, despite these benefits, a reversed effect on the areal specific energy absorption index was observed. [ABSTRACT FROM AUTHOR]

Background: Female Genital Mutilation/Cutting (FGM/C) is a form of gender-based violence that has negative health consequences. The decision to perform FGM/C is often made collectively and a variety of actors influence the decision. There is inconsistent and inconclusive evidence that health education interventions lead behavioural changes related to FGM/C among key decision-makers. Therefore, the aim of this systematic review and meta-analysis was to examine the effectiveness of health education interventions on decision-makers intentions not to perform FGM/C in the future. Methods: A systematic review and meta-analysis were performed according to the Preferred Item for Systematic Review and Meta-analysis (PRISRMA) guideline. Studies were obtained from databases such as PubMed, Google Scholar, EMBASE, CINAHL, Cochrane, African Journals Online and relevant lists of identified studies (interventional studies related to FGM/C among key decision-makers). Unpublished sources and organizational websites were also searched for relevant articles. The quality of studies was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project's. The meta-analysis was carried out using STATA.17 and Review Manager 5.3 software. Heterogeneity and publication bias were assessed using the I2 statistic and funnel plot, respectively. The pooled effect size with a 95% confidence interval was presented using a forest plot and random effect model. Results: This meta-analysis included nineteen studies with a total of 13,326 study participants. The overall pooled relative risk of intention not to perform FGM/C in the future was 1.55 (95% CI;1.24, 1.94). In the subgroup analysis, the effect of health education on intention not to perform in the future was higher in studies that used both health education and other interventions (RR = 3.75, 95% CI; 2.04, 6.88) compared to those using only health education (RR = 1.35, 95% CI; 0.95, 1.92). Studies with longer intervention duration (above 12 months) had a greater effect on intention not to perform (RR = 1.34, 95% CI; 0.86, 2.09) compared to studies with a short intervention period (6–12 months) (RR = 1.14, 95% CI; 0.61, 2.15). Conclusion: This review examined the impact of health education on key decisions-makers' intention not to perform FGM/C in the future. Although the pooled effect size estimate may have been influenced by heterogeneity, the results suggest that education about FGM/C has a positive influence on the intentions of key decision-makers. It is recommended that health education interventions target local decision-makers such as religious and clan leaders and include them in initiatives aimed at preventing and eliminating FGM/C. PROSPERO registration number: CRD42024542541. [ABSTRACT FROM AUTHOR]

Novel asymmetrical Fe(III) Schiff base coordination complexes, with the N4O2 coordination environment, exhibiting abrupt spin crossover (SCO) behaviour with a wide hysteresis loop of 27 K, have been synthesised from an ethylenediamine based asymmetrical Schiff base ligand viz. N-(2-aminoethyl)salicylaldimine (saen) and characterised via single crystal XRD measurements, variable temperature magnetic studies and Mössbauer measurements. The single crystal XRD measurements prove that the compound is a mixture of two fractions, one with methanol and the other without methanol, viz, [Fe(saen)2]NO3·CH3OH at 299 K (1–299) and at 173 K (1–173) and [Fe(saen)2]NO3 at 173 K (2–173), confirming that the Fe(III) centre has a distorted octahedral coordination geometry having two deprotonated asymmetrical tridentate saen ligands, counterbalanced by a nitrate anion and methanol solvent molecule in 1 while 2 has a non-solvate form. An extended hydrogen bonding network between the amino hydrogen atoms of the saen ligand, nitrate counteranion, and methanol solvate molecule is observed in fraction 1, while an extended zig-zag hydrogen bonding between the nitrate anion and amino hydrogens of saen is observed in fraction 2. Furthermore, the complex has been characterised by variable temperature magnetic susceptibility measurements and 57Fe Mössbauer spectroscopy, confirming the SCO nature. [ABSTRACT FROM AUTHOR]

This paper studies the autoregressive integrated moving average (ARIMA) state space model combined with Kalman smoothing to impute missing values in a univariate time series before detecting change points. We estimate a scale-dependent time-average variance constant that depends on the length of the data section and is robust to mean shifts under serial dependence. The consistency of the proposed estimator is shown under the assumption allowing heavy tailedness. Integrating the proposed estimator with the moving sum and wild binary segmentation procedures to determine the number and locations of change points is discussed. Furthermore, the performance of the proposed methods is evaluated through extensive simulation studies and applied to the Beijing multi-site air quality dataset to impute missing values and detect mean changes in the data. [ABSTRACT FROM AUTHOR]

Background: Meconium-stained amniotic fluid (MSAF) is a condition in which meconium is present in the uterus during ante-natal and complicates 10–15% of all live births. Scanty information is known about the determinants of meconium-stained amniotic fluid. Hence, this study aimed to identify determinants of meconium-stained amniotic fluid among women delivered at southwestern referral hospitals in southwest Ethiopia, in 2024. Methods: An institutional-based case-control study was employed from January 1, 2024, to June 30, 2024. The study was conducted in four southwestern referral hospitals in southwest Ethiopia. The final sample size includes 321(107 cases and 214 controls). The sample size was proportionally allocated for cases and controls for each referral hospital. Simple random sampling was used to select patient charts and data was collected from the chart using questions/tools developed after reviewing relevant literature. Data were entered using Epi-data version 3.1 and analyzed using SPSS version 25. Data was analyzed using binary logistic regression. All independent variables with P- the value of < 0.25 in univariable analysis were considered for multivariable logistic regression. Determinant factors of meconium-stained amniotic fluid were identified at a 95% confidence interval with a p-value < 0.05 was utilized to declare statistical significance. Results: A total of 107 cases and 214 controls were included in this study. The finding from this study stated that induction of labor [AOR = 2.37, 95% CI = 1.28–8.89], obstructed labor [AOR = 2.62, 95%CI = 1.1–6.79], duration of labor greater than 24 h [AOR = 2.8, 95% CI = 1.55–15.44], and premature rupture of the membrane [AOR = 2.98, 95%CI = 1.1–8.23] were found to be significantly associated with meconium-stained amniotic fluid. Conclusion: Conclusively, a mother with induced or obstructed labor, labor duration greater than 24 h, and premature rupture of membrane need special attention during delivery care to reduce potential risk factors to feto-maternal outcomes related to meconium-stained amniotic fluid. [ABSTRACT FROM AUTHOR]

Antimicrobial infectious diseases have been a fatal problem worldwide. In the present finding, "Giant Calotrope" leaf extract mediated zinc and cobalt oxide nanoparticles (ZnO and Co3O4 NPs) were synthesized within the ratios of precursor salt to leaf extract as 1:1 (50:50), 1:2 (50:100, and 1:3 (50:150) mL using 0.5 M of precursor salts. The NPs were characterized using thermal gravimetry coupled with differential thermal analysis (TGA/DTA), X‐ray diffraction (XRD), scanning electron microscopy with energy dispersive spectroscopy (SEM‐EDS), Fourier transform infrared (FTIR) spectroscopy, transmission electron microscopy with high‐resolution transmission electron microscopy (TEM‐HRTEM), selected area electron diffraction (SAED), and ultraviolet‐visible (UV–vis) spectroscopy. TGA/DTA showed that both ZnO and Co3O4 NPs were stable beginning from 500 °C to 800 °C and XRD data proves the size of ZnO and Co3O4 NPs to be 29.40, 25.86, 37.01, 22.5, 14.0, and 23.3 nm for the 1:1, 1:2, and 1:3 ratios, respectively. SEM coupled with TEM‐HRTEM, SAED confirms the spherical shape of Co3O4 and ZnO NPs. FTIR shows the presence of saturated and unsaturated biomolecules in the leaf of a giant calotrope. The bandgap energy of ZnO NPs was 3.46, 3.49, and 3.44 eV, and for the Co3O4 NPs, 4.60, 4.80, and 4.44 eV for the 1:1, 1:2, and 1:3 ratios, respectively. The antimicrobial applications of ZnO and Co3O4 NPs were investigated against Streptococcus pyogenes, Escherichia coli, and Fusarime oxysporum. Among the 1:1, 1:2, and 1:3 ratios of ZnO and Co3O4 NPs, the 1:2 provides 11, 13, 10.5, and 11 mm zones of inhibition against S. pyogenes and E. coli, respectively. Similarly, the 1:2 ratios of ZnO and Co3O4 NPs showed 11 and 17 mm inhibition zones against F. oxysporum. [ABSTRACT FROM AUTHOR]

This study identified research trends, intellectual connections, and social connections in the field of museum visitor experiences. It also outlines future research to understand existing scientific research and shed light on key areas of research. The study reviewed 407 articles published in peer-reviewed journal articles, which were generated from the Scopus database. Bibliometric analysis software VOSviewer and Harzing POP were used. Citation analysis, co-authorship analysis, bibliometric coupling, and co-occurrence analysis have been employed. Findings highlight the need for increased representation from scholars in the Global South to ensure a more inclusive and comprehensive understanding of museum visitors' experiences worldwide. Nine key research areas for future studies were identified: sustainability, mixed reality, social media, accessibility, emotion, co-creation, interpretation, exhibition, and museum visitors' experience and engagement. The results benefit stakeholders and researchers by allowing them to stay informed about the latest developments and breakthroughs in the global academic landscape and visitors' experiences in museums. [ABSTRACT FROM AUTHOR]

Aflatoxin constitutes a significant concern for food and feed safety, posing detrimental health risks to both animals and humans. This study aimed to examine the prevalence and concentration of aflatoxins in maize feed, total mixed ration, and wheat bran collected from specialized dairy farms and local markets in three major urban centers in eastern Ethiopia. A total of 180 feed samples were collected from September 2021 to January 2022 in Chiro town, Dire Dawa city, and Harar city. These samples underwent thorough extraction and immunoaffinity clean-up before aflatoxin analysis using HPLC/FLD. The results revealed that AFB1, AFB2, AFG1, AFG2, and TAF contamination was detected in 72.2%, 66.1%, 71.1%, 68.7%, and 82.8% of the feed samples, respectively. The corresponding mean levels of each aflatoxin were 28.15 ± 3.50, 3.3 ± 0.40, 19.87 ± 1.87, 2.7 ± 0.32, and 54.01 ± 4.72 µg/kg, respectively. The occurrence and levels of aflatoxin varied across different study sites and feed types. Notably, feeds from Dire Dawa city exhibited significantly higher mean levels of AFB1 (43.98 ± 5.3 µg/kg), AFB2 (5.69 ± 0.6 µg/kg), AFG1 (32.25 ± 2.7 µg/kg), and AFG2 (5.01 ± 0.5 µg/kg) than feeds from other urban centers did. Additionally, a significantly higher occurrence of AFB1 (29.4%) and AFG1 (28.3%) was detected in feed from Dire Dawa city. Similarly, the total mixed ration (TMR) displayed significantly higher levels of AFB1 (50.67 ± 5.2 µg/kg), AFB2 (4.74 ± 0.6 µg/kg), AFG1 (32.87 ± 2.6 µg/kg), and AFG2 (3.86 ± 0.5 µg/kg) compared to the other feed types. Moreover, a significantly higher occurrence of AFB1 (30.7%) and AFG1 (28.7%) was detected in the TMR. Furthermore, a moderate correlation was observed between the count of aflatoxigenic Aspergillus species and the levels of TAF in the feed samples. Overall, this study underscores the widespread presence of aflatoxin contamination in dairy feeds in eastern Ethiopia, highlighting the urgent need for stringent monitoring and mitigation measures to ensure food and feed safety, as well as public health. [ABSTRACT FROM AUTHOR]

Cloud is a serious problem that affects the quality of remote-sensing (RS) images. Existing cloud removal techniques suffer from notable limitations, such as being specific to certain data types, cloud conditions, and spatial extents, as well as requiring auxiliary data, which hampers their generalizability and flexibility. To address the issue, we propose a maximum-value compositing approach by generating cloud masks. We acquired 432 daily MOD09GA L2 MODIS imageries covering a vast region with persistent cloud cover and various climates and land-cover types. Labeled datasets for cloud, land, and no-data were collected from selected daily imageries. Subsequently, we trained and evaluated RF, SVM, and U-Net models to choose the best models. Accordingly, SVM and U-Net were chosen and employed to classify all the daily imageries. Then, the classified imageries were converted to two sets of mask layers to mask clouds and no-data pixels in the corresponding daily images by setting the masked pixels' values to −0.999999. After masking, we employed the maximum-value technique to generate two sets of 16-day composite products, MaxComp-1 and MaxComp-2, corresponding to SVM and U-Net-derived cloud masks, respectively. Finally, we assessed the quality of our composite products by comparing them with the reference MOD13A1 16-day composite product. Based on the land-cover classification accuracy, our products yielded a significantly higher accuracy (5–28%) than the reference MODIS product across three classifiers (RF, SVM, and U-Net), indicating the quality of our products and the effectiveness of our techniques. In particular, MaxComp-1 yielded the best results, which further implies the superiority of SVM for cloud masking. In addition, our products appear to be more radiometrically and spectrally consistent and less noisy than MOD13A1, implying that our approach is more efficient in removing shadows and noises/artifacts. Our method yields high-quality products that are vital for investigating large regions with persistent clouds and studies requiring time-series data. Moreover, the proposed techniques can be adopted for higher-resolution RS imageries, regardless of the spatial extent, data volume, and type of clouds. [ABSTRACT FROM AUTHOR]

Background: Congenital diaphragmatic hernia(CDH) is a rare congenital anomaly characterized by herniation of abdominal contents into thoracic cavity through a defect in diaphragm. While commonly diagnosed prenatally or in neonatal period, late-presenting CDH can occur and may mimic other thoracic emergencies such as tension pneumothorax, complicating diagnosis and management. Case presentation: A two-year old male black child from Ethiopia presented to the emergency department with sudden onset of acute respiratory distress. Initial clinical assessment and chest radiography suggested a diagnosis of tension pneumothorax due to the presence of significant mediastinal shift and apparent pleural air. Despite insertion of chest tube, the child's condition did not improve, raising suspicion of alternative diagnosis. Careful observation of initial chest x-ray and subsequent chest ultrasound revealed a left sided congenital diaphragmatic hernia with herniation of stomach and intestine into thoracic cavity compressing the left lung and causing mediastinal shift. After the diagnosis of CDH was confirmed, the child was stabilized and emergent surgical repair performed. Postoperative recovery was uneventful, and the child was discharged with no significant long-term complications. Conclusion: This case underscores the importance of considering CDH in the differential diagnosis of acute respiratory distress in a child. It highlights the diagnostic challenges and potential risks of emergency interventions based on initial misdiagnosis. Even if x -ray looks like typical of tension pneumothorax, it showed giant cystic air filled structure pushing the mediastinal structure to contralateral side with loss of left diaphragmatic outline which raised suspicion of congenital cystic lung mass or congenital diaphragmatic hernia. Advanced imaging and high index of suspicion are crucial for accurate diagnosis and timely management, ultimately improving patient outcomes. Consideration of alternative diagnosis when our initial intervention with insertion of chest tube fail to provide symptom improvement in suspected pneumothorax should raise suspicion of congenital diaphragmatic hernia like in our case. [ABSTRACT FROM AUTHOR]

This research intends to shed light on the household migration decision‐making process of Ethiopian irregular migrants heading to the Republic of South Africa. Data were drawn from a cross‐sectional household survey (n = 659) and in‐depth interviews (n = 24) conducted in 2022. Descriptive statistics, binary logistic regressions and thematic analysis were employed to analyse the data. Our findings reveal that being a young male, having a large household size, the presence of family members and smugglers positively influence households' decisions for irregular migration. Possession of farmland, being employed and married have a negative influence on household decisions for migration. The study findings further show that prior information about the migration destination is important in the household's migration decision‐making process. We suggest that government actions and policy interventions should be based on such empirical evidence to promote safe and regular migrations while addressing potential migrants' aspirations and needs in their pursuit of a better life. [ABSTRACT FROM AUTHOR]

The study assessed the concentration of natural radionuclides in soil samples from the Bambasi district in Ethiopia's Benishangul Gumuz region using a gamma‐ray spectrometer equipped with a high‐purity germanium (HPGe) detector. The measured activity concentrations of 238U, 232Th, and 40K in soil samples varied from 46.2 ± 2.25 to 88.49 ± 5.73 Bq/kg, 73.4 ± 4.12 to 119.65 ± 8.45 Bq/kg, and 176.78 ± 8.63 to 396.71 ± 25.39 Bq/kg, respectively. The average concentration of 238U and 232Th exceeded the recommended worldwide population weighted average values of 32.0 and 45.0 Bq/kg, respectively, while the average concentration of 40K was below the recommended value of 420.0 Bq/kg. The mean absorbed dose rate was calculated to be 91.6 ± 5.1 nGy/h, which is above the recommended safe value of 59 nGy/h. The average annual effective dose equivalents for indoor and outdoor exposure were determined to be 2.65 ± 0.14 mSv/y and 0.66 ± 0.1 mSv/y, respectively. The calculated mean values of the internal hazard index, external hazard index, and gamma index across all soil samples were 0.72 ± 0.05, 0.55 ± 0.02, and 0.72 ± 0.02, respectively, all below the recommended safe threshold of one. These findings suggest that the activity concentrations observed in the soil samples exceed safe levels, indicating the necessity for further investigation into radioactivity levels and epidemiological studies regarding potential hazards from high background radiation. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Anxiety disorders are prevalent and anxiety symptoms (ANX) co‐occur with many psychiatric disorders. We aimed to identify genomic loci associated with ANX, characterize its genetic architecture, and genetic overlap with psychiatric disorders.We included a genome‐wide association study of ANX (meta‐analysis of UK Biobank and Million Veterans Program, n = 301,732), schizophrenia (SCZ), bipolar disorder (BIP), major depression (MD), attention‐deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), and validated the findings in the Norwegian Mother, Father, and Child Cohort (n = 95,841). We employed the bivariate causal mixture model and local analysis of covariant association to characterize the genetic architecture including overlap between the phenotypes. Conditional and conjunctional false discovery rate analyses were performed to boost the identification of loci associated with anxiety and shared with psychiatric disorders.Anxiety was polygenic with 12.9k genetic variants and overlapped extensively with psychiatric disorders (4.1k–11.4k variants) with predominantly positive genetic correlations between anxiety and psychiatric disorders. We identified 119 novel loci for anxiety by conditioning on the psychiatric disorders, and loci shared between anxiety and MD n=47$$ \left(n=47\right) $$, BIP n=33$$ \left(n=33\right) $$, SCZ n=71$$ \left(n=71\right) $$, ADHD n=20$$ \left(n=20\right) $$, and ASD n=5$$ \left(n=5\right) $$. Genes annotated to anxiety loci exhibit enrichment for a broader range of biological pathways including cell adhesion and neurofibrillary tangle compared with genes annotated to the shared loci.Anxiety is highly polygenic phenotype with extensive genetic overlap with psychiatric disorders, and we identified novel loci for anxiety implicating new molecular pathways. The shared genetic architecture may underlie the extensive cross‐disorder comorbidity of anxiety, and the identified molecular underpinnings may lead to potential drug targets. [ABSTRACT FROM AUTHOR]

Infectious bronchitis virus (IBV) is a significant threat to poultry worldwide, but its status in Ethiopia remains understudied. Thus, this study aimed to detect the virus and associated risk factors in South West Ethiopia. Ninety oropharyngeal swab samples were purposively collected from symptomatic chickens located in Jimma town, Seqa Chekorsa, and Tiro Afeta woredas of the Jimma zone between November 2021 and April 2022 to detect IBV virus by using RT‐PCR. A side‐by‐side questionnaire was administered to assess risk factors. Total RNA was extracted, reverse transcription polymerase chain reaction (RT‐PCR) was conducted, and products were visualized under UV light. The overall proportion of IBV was 16.6% (15/90). No statistical association was observed between any of the animal risk factors and the detection of the virus (P = 0.57, 0.586, and 1). However, the proportion of birds infected by the virus was higher in males, exotic breeds, and adults compared to females, local breeds, and young birds. Similarly, none of the management risk factors had a significantly different effect on virus detection (P = 0.25, 0.09, 0.088, and 0.726). However, improper carcass disposal (OR = 0.43, 95% CI: 0.13–1.4), lack of veterinary services (OR = 2.7, 95% CI: 0.8–8.3), and the presence of wild birds/rodents (OR = 4.4, 95% CI: 0.88‐22.3) were associated with increased IBV risk but not cleaning of feeders/drinkers (OR = 1.1, 95% CI: 0.2–4.8). These findings underscore the need for enhanced biosecurity practices and further research to implement informed IBV control strategies in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is a global public health concern that is fueled by the overuse of antimicrobial agents. Low- and middle-income countries, including those in Africa,. Point prevalence surveys (PPS) have been recognized as valuable tools for assessing antimicrobial utilization and guiding quality improvement initiatives. This systematic review and meta-analysis aimed to evaluate the prescription rates, indications, and quality of antimicrobial use in African health facilities. Methods: A comprehensive search was conducted in multiple databases, including PubMed, Scopus, Embase, Hinari (Research4Life) and Google Scholar. Studies reporting the point prevalence of antimicrobial prescription or use in healthcare settings using validated PPS tools were included. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A random-effects meta-analysis was conducted to combine the estimates. Heterogeneity was evaluated using Q statistics, I² statistics, meta-regression, and sensitivity analysis. Publication bias was assessed using a funnel plot and Egger's regression test, with a p-value of < 0.05 indicating the presence of bias. Results: Out of 1790 potential studies identified, 32 articles were included in the meta-analysis. The pooled prescription rate in acute care hospitals was 60%, with significant heterogeneity (I2 = 99%, p < 0.001). Therapeutic prescriptions constituted 62% of all the prescribed antimicrobials. Prescription quality varied: documentation of reasons in notes was 64%, targeted therapy was 10%, and parenteral prescriptions were 65%, with guideline compliance at 48%. Hospital-acquired infections comprised 20% of all prescriptions. Subgroup analyses revealed regional disparities in antimicrobial prescription prevalence, with Western Africa showing a prevalence of 65% and 44% in Southern Africa. Publication bias adjustment estimated the prescription rate at 54.8%, with sensitivity analysis confirming minor variances among studies. Conclusion: This systematic review and meta-analysis provide valuable insights into antimicrobial utilization in African health facilities. The findings highlight the need for improved antimicrobial stewardship and infection control programs to address the high prevalence of irrational antimicrobial prescribing. The study emphasizes the importance of conducting regular surveillance through PPS to gather reliable data on antimicrobial usage, inform policy development, and monitor the effectiveness of interventions aimed at mitigating AMR. [ABSTRACT FROM AUTHOR]

Background: Calf diarrhea is a major cause of morbidity and mortality in the livestock sector worldwide and it can be caused by multiple infectious agents. In Ethiopia, cattle are the most economically important species within the livestock sector, but at the same time the young animals suffer from high rates of morbidity and mortality due to calf diarrhea. However, studies including both screening and molecular characterization of bovine enteric pathogens are lacking. Therefore, we aimed to both detect and molecularly characterize four of the major enteric pathogens in calf diarrhea, Enterotoxigenic Escherichia coli (E. coli K99 +), Cryptosporidium spp., rotavirus A (RVA), and bovine coronavirus (BCoV) in calves from central Ethiopia. Diarrheic and non-diarrheic calves were included in the study and fecal samples were analyzed with antigen-ELISA and quantitative real-time PCR (qPCR). Positive samples were further characterized by genotyping PCRs. Results: All four pathogens were detected in both diarrheic and non-diarrheic calves using qPCR and further characterization showed the presence of three Cryptosporidium species, C. andersoni, C. bovis and C. ryanae. Furthermore, genotyping of RVA-positive samples found a common bovine genotype G10P[11], as well as a more unusual G-type, G24. To our knowledge this is the first detection of the G24 RVA genotype in Ethiopia as well as in Africa. Lastly, investigation of the spike gene revealed two distinct BCoV strains, one classical BCoV strain and one bovine-like CoV strain. Conclusions: Our results show that Cryptosporidium spp., E. coli K99 + , RVA and BCoV circulate in calves from central Ethiopia. Furthermore, our findings of the rare RVA G-type G24 and a bovine-like CoV demonstrates the importance of genetic characterization. [ABSTRACT FROM AUTHOR]

Notwithstanding the dramatic admission of the historical injustice against females in the Ethiopian constitution three decades back and the education policy that reflected the enthusiasm to address gender inequality, in practice, it failed to create a fairly inclusive higher education environment that is friendly to women. The aim of this study is to understand the gaps in the existing policy instruments in terms of ensuring gender equality in Ethiopian higher education. The relevant policies and strategies implemented in higher education were examined using women's empowerment frameworks as its analytical lens. The findings reveal that the micro-level policies that are enacted since the mid-1990s until the beginning of 2020s are gradually drifting away from the constitutional promise to make up for past historical injustices against women. This is further complicated by the absence of coherence between system and institutional level policies manifested in the form visible gaps and silences vi-a-vis declared aims to redress gender inequality and inequity in higher education. Finally, the study proposes relevant policy directions to come up with viable gendered instruments at the system and institutional levels. [ABSTRACT FROM AUTHOR]

This paper focuses on an efficient computational method for solving the singularly perturbed Burger-Huxley equations. The difficulties encountered in solving this problem come from the nonlinearity term. The quasilinearization technique linearizes the nonlinear term in the differential equation. The finite difference approximation is formulated to approximate the derivatives in the differential equations and then accelerate its rate of convergence to improve the accuracy of the solution. The stability and consistency analysis were investigated to guarantee the convergence analysis of the formulated method. Numerical examples are considered for numerical illustrations. Numerical experiments were conducted to sustain the theoretical results and to show that the proposed method produces a more correct solution than some surviving methods in the literature. [ABSTRACT FROM AUTHOR]

Understanding inter-annual variation in the density of young-of-the-year fish is an important tool for assessing stock status and guiding management decisions. We analyzed data spanning from 2003 to 2022 collected at Lipno Reservoir in Czechia. The study aimed to identify factors influencing the density of pikeperch (Sander lucioperca), a valuable predatory fish species in European waters. A bimodality test for the size class distribution has revealed the existence of two distinct YOY cohorts: extremely small (ES) and ordinary fingerlings. Using the Bayesian horseshoe prior method with 37 potential predictors, followed by linear regression, we observed that certain environmental factors similarly influenced both cohorts. Higher temperatures during spring and summer, coupled with increased densities of large and medium-sized cladocerans, positively affected the density of both cohorts. However, distinct influences were observed: for ordinary fingerlings, increased summer precipitation and a lower abundance of predators were beneficial, whereas, for ES fingerlings, summer copepod density emerged as an additional positive factor. This study emphasizes the importance of a detailed investigation of factors influencing pikeperch recruitment. Examining these drivers provides a clearer insight into the causes of variations in the early life stage, which is crucial for monitoring and managing populations in temperate reservoirs. [ABSTRACT FROM AUTHOR]

Introduction: Work-related musculoskeletal disorders (WRMSDs) are the leading cause of disability worldwide. Shopkeepers are prone to developing work-related musculoskeletal disorders, but they are largely overlooked in research and policy actions, particularly in developing countries. So far, there is a lack of data on the magnitude and factors influencing work-related musculoskeletal disorders among shopkeepers in Ethiopia. Therefore, the current study aimed to explore the prevalence and risk factors of work-related musculoskeletal disorders among shopkeepers in Gondar City, Ethiopia. Methods: A workplace-based cross-sectional study was conducted from July to August 2022, in Gondar city, Northwest Ethiopia. A multistage sampling technique was used to select 625 shopkeepers. The data were collected using an interviewer-administered standardized Nordic Musculoskeletal Questionnaire. Analysis was made using Stata version 14. Factors associated with the prevalence of work-related musculoskeletal disorders were identified using the multivariable Poisson regression model. The adjusted prevalence ratio with 95% confidence intervals (CIs) and p-value < 0.05 were applied to establish the significance of associations. Results: The overall prevalence of work-related musculoskeletal disorders among shopkeepers in the past 12 months was found to be 81.1% (N = 507). The most frequently affected body part was the lower back (46.6%), followed by the upper back (43.8%) and shoulder (35.4%). Being female (p = 0.043), being in the age group of ≥40 years (p = 0.028), being overweight (p = 0.035), experiencing job stress (p = 0.006) and prolonged sitting (p = 0.045) were significant factors for the prevalence of work-related musculoskeletal disorders among shopkeepers. Conclusion: This study revealed that shopkeepers face an alarmingly high prevalence of work-related musculoskeletal disorders. Female, older, overweight, stressed and shopkeepers who sit in the same position for long periods of time were identified as particularly vulnerable groups. These findings call for the urgent development and implementation of preventive measures, including ergonomic adjustments, education and training programs, stress management techniques and the promotion of physical activity, to protect this vulnerable workforce from the debilitating effects of work-related musculoskeletal disorders and to ensure their long-term health and well-being. [ABSTRACT FROM AUTHOR]

Natural radionuclide activity concentrations were measured in ceramic, gypsum, and brick samples from manufacturers, dealers, and construction sites in and around Addis Ababa, Ethiopia, using an HPGe detector. The study's main aim is to assess the activity concentration of building materials and their health impacts. Average activity concentrations (Bq kg−1) for 226Ra in ceramic, gypsum, and brick samples were obtained as 81 ± 1, 1.34 ± 0.17, and 39 ± 1, respectively. In ceramic, gypsum, and brick, concentrations of 232Th were obtained as 166 ± 4, 0.68 ± 0.18, and 103 ± 3, respectively, while concentrations of 40K were found to be 755 ± 16,15 ± 1, and 921 ± 24, respectively. Some of the materials that were tested, especially the ceramic samples, had slightly higher concentrations of radionuclides in comparison to other analysed samples. In all samples except ceramic, Raeq was < 370 Bq kg−1, which is the recommended limiting dose for bulk medium. Furthermore, the corresponding radiological parameters, such as absorbed dose, annual effective dose equivalent, excess lifetime cancer risk (ELCR), internal (Hin) and external (Hex) hazard indexes, gamma index (Iγ), and alpha index (Iα) were determined. The ELCR average values in this study are slightly higher than the global average, and the indoor and outdoor absorbed dose rates are greater than the limiting criteria of 84 and 59 n Gy h−1, respectively. Therefore, it is important to assess the potential radiation risk of ceramic samples, which should be used in a controlled manner to reduce gamma exposure to residents. Finally, the computed data could be used as a baseline to assess any future radiation exposure from construction materials. [ABSTRACT FROM AUTHOR]

Natural gypsum has been studied as a building material, and it has been discovered that it is one of the potential sources of indoor radioactivity due to naturally occurring radioactive elements in it. The levels of radioactive elements obtained in natural gypsum available in Abay gorge Dejen district were accomplished by a well shielded and calibrated gamma spectrometry with high purity Ge detector to evaluate the radiation hazard to workers in Dejen gypsum factories and dwellers in buildings decorated with gypsum products. The results of this study revealed that radioactive elements 238U, 232Th, and 40K are found in raw gypsum samples, with specific activity ranging from 1.47 ± 0.26 to 2.42 ± 0.37 Bqkg−1, 1.10 ± 0.26 to 2.60 ± 0.48 Bqkg−1, and 4.27 ± 1.92 to 44.53 ± 2.84 Bqkg−1, respectively. The mean specific activities are 1.90 ± 0.33 Bqkg−1 for 238U, 1.99 ± 0.39 Bqkg−1 for 232Th, and 28.16 ± 2.57 Bqkg−1 for 40K, which are significantly lower than the intercontinental approved values. All of the calculated radioactive risk indices were significantly lower than the global recommended values for building materials. The values of various radioactive indices indicate that the use of gypsum powder obtained from studied samples in the construction of residences is considered safe. [ABSTRACT FROM AUTHOR]

In today's world, the use of paper and cardboard increasing but the availability of raw materials and the environmental impact on the paper industry is a big concern. To address these concerns, researchers are exploring the potential of agricultural waste products as raw materials for pulp production. This study uses morphological, chemical composition, FTIR, XRD, and thermogravimetric analysis to examine the potential of banana pseudo-stem as a raw material for paper pulp to address environmental concerns and raw material shortages in the paper industry. The study reveals favorable characteristics for papermaking, including long fiber length (1750 μm), thin cell wall thickness (9.7 μm), and large lumen diameter (22.15 μm). The chemical composition of banana pseudo-stem contains cellulose (44.93 %), hemicellulose (23.7 %), and Klason lignin (11.1) showing its suitability for pulp production. FTIR analysis highlights the functional groups present on the banana pseudo-stem. The XRD analysis shows that it has a similar cellulosic peak and crystallinity index with common raw materials used in pulp production. The thermogravimetric analysis shows that the banana pseudo-stem has high thermal stability. The findings demonstrate that banana pseudo-stem, both by itself and in combination with other raw materials, might be a potential raw material for the pulp production. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic presents an unprecedented challenge to community wellbeing and mental health. However, quantifiable information on the extent of mental health problems and associated factors due to the pandemic is still lacking in low-income countries. Thus, this study aimed to investigate the levels of depression, anxiety, and stress and their association with risk and resilience factors among residents of Jimma town in Southwestern Ethiopia. A community-based cross-sectional study was conducted between October 2021 and November 2021. Data were collected from 1196 adult Jimma town residents selected through multi-stage sampling. The following scales were used for the cross-sectional assessment of depressions, anxiety and stress and their associations: depression, anxiety, and stress-21(DASS-21), World Health Organization (WHO) wellbeing, University of California, Los Angeles Loneliness Scale (UCLA), Childhood trauma questionnaire, and brief resilience scales. A pre-tested, interviewer-completed questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated with depression, anxiety, and stress. Odds ratios consistent with 95% CI were used to report the presence of an association between risk and resilience factors and the outcome variable at a P-value < 0.05. Overall, 963 (80.53%) respondents had divergent DASS-21 score findings. Specifically, 27.68%, 31.52% and 21.32% experienced depression, anxiety, and stress respectively. Higher DASS-21 scores were associated with the presence of one or more COVID-19 risk factors for anyone close to the participants (AOR = 1.53, 95% CI 1.03–2.27), feelings of stress/burden (β = 1.09, 95% CI 1.07–1.12), positive coping (β = 1.044, 95% CI 1.01–1.07), loneliness (β = 1.063, 95% CI 1.04–1.08), and childhood trauma (β = 1.03, 95% CI 1.01–1.04). In contrast, lower DASS-21 scores were associated with beliefs about the necessity of solidarity-based behavior (β = 0.94, 95% CI 0.90–0.98), resilience (β = 0.92, 95% CI 0.87–0.97) and wellbeing (β = 0.90, 95% CI 0.87–0.94). In the course of the COVID-19 pandemic in 2021, symptoms of depression, anxiety, and stress in the study community were prevalent, and associated with numerous risk and resilience factors. Although causality cannot be inferred, these findings underscore the importance of strengthening mental health services and may guide COVID-19 prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Lead (Pb) in drinking water is a serious concern due to its adverse health impacts. Aiming to identify sources and contributing factors of waterborne Pb, this study tracked Pb at different locations in Addis Ababa's (capital of Ethiopia) water distribution system, successively from 3 water sources, 15 storage reservoirs and 88 taps. The mean Pb concentration at sources was 2.6 µg/L, significantly varying from the concentration at taps, 15.9 µg/L (ANOVA Post Hoc, P = 0.02). A significant variation of Pb was also observed among the city's water distribution sub-systems and source waters (ANOVA Post Hoc, P = 0.006). Surface waters exhibited a negative Langelier saturation index (LSI) and higher corrosivity. Analysis from first-drop and flushed water samples showed that water stagnation for 6–8 hours would increase Pb leaching by 11.5 Points (95% CI [6.23, 16.78]). Metal plumbing releases more Pb compared to plastics (t30 = −4.358, P < 0.001), where the leaching is higher from new faucets than the old (r = −0.368, P < 0.05). A multiple linear regression (R2 = 0.61, F5, 80 = 24.617, P < 0.001) predicted that a 1% increase of Fe in the water can raise the Pb concentration by 0.35% (t80 = 7.033, P < 0.001), while 1% increment of Zn can raise Pb by 0.21% (t80 = 4.45, P < 0.001). The analysis suggests that leaded-brass and galvanised-steel could be important Pb sources. In conclusion, Pb contamination in Addis Ababa's drinking water system chiefly arises from the plumbing and pipelines, where the main portal of entry lies between storage reservoirs and taps. Water properties (hardness, tendency to scale formation and corrosivity), water stagnation time in pipelines, and material types and age of premise plumbing were significant contributing factors. [ABSTRACT FROM AUTHOR]

In this article, a uniformly convergent numerical scheme is developed to solve a singularly perturbed convection‐diffusion equation with a small delay having a boundary layer along the left side. A priori bounds of continuous solution and its derivatives are discussed. To solve the problem, the Crank–Nicolson scheme in the time direction and the exponentially fitted finite difference scheme in the space direction are used. The stability of the method is analyzed. It is proved that the developed scheme converges uniformly with first order in space and second order in time. To validate the applicability of the theoretical finding of the developed scheme, numerical experiments are carried out by considering two test examples. [ABSTRACT FROM AUTHOR]

Background: Priority-setting becomes more difficult for decision-makers when the demand for health services and health care resources rises. Despite the fact that the Ethiopian healthcare system places a strong focus on the efficient utilization and allocation of health care resources, studies of efficiency in healthcare facilities have been very limited. Hence, the study aimed to evaluate efficiency and its determinants in public health centers. Methods: A cross-sectional study was conducted in the East Wollega zone, Oromia Regional State, Ethiopia. Ethiopian fiscal year of 2021–2022 data was collected from August 01–30, 2022 and 34 health centers (decision-making units) were included in the analysis. Data envelope analysis was used to analyze the technical efficiency. A Tobit regression model was used to identify determinants of efficiency, declaring the statistical significance level at P < 0.05, using 95% confidence interval. Results: The overall efficiency score was estimated to be 0.47 (95% CI = 0.36–0.57). Out of 34 health centers, only 3 (8.82%) of them were technically efficient, with an efficiency score of 1 and 31 (91.2%) were scale-inefficient, with an average score of 0.54. A majority, 30 (88.2%) of inefficient health centers exhibited increasing return scales. The technical efficiency of urban health centers was (β = -0.35, 95% CI: -0.54, -0.07) and affected health centers' catchment areas by armed conflicts declined (β = -0.21, 95% CI: -0.39, -0.03) by 35% and 21%, respectively. Providing in-service training for healthcare providers increased the efficiency by 27%; 95% CI, β = 0.27(0.05–0.49). Conclusions: Only one out of ten health centers was technically efficient, indicating that nine out of ten were scale-inefficient and utilized nearly half of the healthcare resources inefficiently, despite the fact that they could potentially reduce their inputs nearly by half while still maintaining the same level of outputs. The location of health centers and armed conflict incidents significantly declined the efficiency scores, whereas in-service training improved the efficiency. Therefore, the government and health sector should work on the efficient utilization of healthcare resources, resolving armed conflicts, organizing training opportunities, and taking into account the locations of the healthcare facilities during resource allocation. [ABSTRACT FROM AUTHOR]

The advancement of genetic engineering has revolutionized the field of immunology by allowing the utilization of intrinsic antibody structures. One of the biologics that are being produced by recombinant antibody technology is single‐chain fragments variable (scFv). Genes of variable regions, the heavy and light chains that are genetically linked into a single transcript by a short flexible linker peptide, are used to generate this fragment from cellular and synthetic libraries. The specificity and affinity of these molecules are comparable to those of parental antibodies. Fusion with marker proteins and other potent molecules improves their stability, circulation half‐life, activity, and efficient purification. Besides, this review comprises construction protocols, therapeutics, and diagnostic applications of scFv, as well as related challenges. Nonetheless, there are still issues with efficacy, stability, safety, intracellular administration, and production costs that need to be addressed. [ABSTRACT FROM AUTHOR]

Introduction: Chronic and highly contagious, trachoma is a condition characterized by recurrent bacterial infection with ocular strains of Mycoplasma trachoma. It spreads through fingers, flies, and fomites, especially in situations where there is overcrowding. If untreated, the illness may result in blindness. Trachoma is an ancient disease and has previously been a significant public health problem in many areas of the world, including parts of Europe and North America. There are at least 400 million cases of active trachoma in the world, 8 million of which have resulted in blindness. Trachoma is a serious public health issue that is very common in Ethiopia. Therefore, the objective of this study is to identify the determinants of active trachoma among rural children aged 1–9 years old in Aw-bare woreda, Somali region of Ethiopia. Method: A cross-sectional community-based study involving children aged 1–9 who lived in six selected rural kebeles in the Awbare woreda Somali region and carried out using an ordinal logistic regression model. The study comprised 377 children in total. Our sample youngsters were chosen through a two-stage cluster sampling procedure. Then also chose our sample kebeles by simple random sampling. The main environmental, personal, and demographic factors that influenced the outcomes of active trachoma status were modeled using partial proportional odds modeling and descriptive statistics. Result: The study showed that the prevalence of active trachoma was found to be 47.7%. The covariate secondary level of education of mother OR = 1.357; 95% CI (1.051, 1.75), P-value = 0.0192, Inside house cooking place of children family OR = 0.789:95% CI (0.687, 0.927), P-value = 0.0031, children stay at home OR = 2.203:95%CI (1.526, 3.473), P-value = 0.0057,rich income family OR = 1.335:95%CI(1.166,1.528),P-value = 0.0001,Amount of water fetched per day OR = 2.129,95%CI(1.780,2.547),P-Vaue = 0.0001 were significant effect on active trachoma. PPOM represents the best fit as it has the smallest AIC and BIC. It is also more parsimonious. Conclusion: The mother's educational level, the location where the children spent the majority of their time indoors cooking, the fly density during the interview, the family's income, the child's age in years, the distance to the water source, the quantity of water fetched daily, and the number of people sharing a room have all been found to be significant predictors of the child's active trachoma status. Thus, increasing maternal education, access to clean water, and socioeconomic position are all crucial measures in preventing trachoma. Preventing trachoma also involves reducing the number of kids in a room and enhancing activities linked to personal cleanliness, such as giving kids a thorough facial wash to remove debris and discharge from their eyes. [ABSTRACT FROM AUTHOR]

This work investigates the use of a fuzzy logic controller (FLC) for two-wheeled differential drive mobile robot trajectory tracking control. Due to the inherent complexity associated with tuning the membership functions of an FLC, this work employs a particle swarm optimization algorithm to optimize the parameters of these functions. In order to automate and reduce the number of rule bases, the genetic algorithm is also employed for this study. The effectiveness of the proposed approach is validated through MATLAB simulations involving diverse path tracking scenarios. The performance of the FLC is compared against established controllers, including minimum norm solution, closed-loop inverse kinematics, and Jacobian transpose-based controllers. The results demonstrate that the FLC offers accurate trajectory tracking with reduced root mean square error and controller effort. An experimental, hardware-based investigation is also performed for further verification of the proposed system. In addition, the simulation is conducted for various paths in the presence of noise in order to assess the proposed controller's robustness. The proposed method is resilient against noise and disturbances, according to the simulation outcomes. [ABSTRACT FROM AUTHOR]

Background: Hyperuricemia is frequently observed in patients with type 2 diabetes (T2D) and is associated with increased risk of gout and cardiovascular disease (CVD). Empagliflozin lowers serum urate levels by enhancing its urinary excretion. Objective: To compare initiators of empagliflozin vs dipeptidyl peptidase-4 inhibitor (DPP4i) and initiators of empagliflozin vs glucagon-like peptide-1 receptor agonist (GLP-1RA) with respect to the risk of incident gout events. Design and Participants: Using three claims-based datasets from 08/2014 to 09/2019, we generated two cohorts (cohort 1: empagliflozin vs DPP4i; cohort 2: empagliflozin vs GLP-1RA) of adult patients with T2D and without prior history of gout or gout-specific medication dispensing separately in each dataset. To assess the risk of incident gout, we estimated hazard ratios (HR) and rate differences (RD) per 1000 person-years (PY) with their 95% confidence intervals (CI) before and after 1:1 propensity score (PS) matching adjusting for 141 baseline covariates. Key Results: We identified 102,262 pairs of 1:1 propensity score-matched adults in cohort 1 and 131,216 pairs in cohort 2. Over a mean follow-up period of 8 months on treatment, the risk of gout was lower in patients initiating empagliflozin compared to DPP4i (HR = 0.69: 95% CI (0.60–0.79); RD = − 2.27: 95% CI (− 3.08, 1.46)) or GLP-1RA (HR = 0.83: 95% CI (0.73–0.94); RD = − 0.99: 95% CI (− 1.66, − 0.32)). Results were consistent across subgroups (sex, age, body mass index, chronic kidney disease, heart failure, cardiovascular disease, and concurrent diuretic use) and sensitivity analyses. Conclusions: Among adults with T2D, the initiation of empagliflozin vs a DPP4i or GLP-1RA was associated with lower risk of incident gout, complementing results from a post hoc analysis of the EMPA-REG OUTCOME trial and previously published observational research focusing on the sodium-glucose co-transporter-2 inhibitor class in more narrowly defined study populations. [ABSTRACT FROM AUTHOR]

In Ethiopia, even though there is an effort to increase ART services, different challenges remain in the provision of HIV/AIDS treatment and care services, and little has been done to evaluate patient satisfaction levels. The purpose of this study is to assess the determinants of HIV/AIDS treatment and care service quality. A facility-based cross-sectional study was conducted during from October 2023 to November 2023 in Woliso Town. The total sample size was generated using a systematic random sampling method from the source population. The results of the study showed that client satisfaction with HIV/AIDS treatment and care service quality was 272 (81.4%) with 95% CI: 76.9–85.3%. Government employees were 67% less likely to be satisfied with HIV/AIDS treatment and care service quality (AOR = 0.33 95% CI: 0.11, 0.99) when compared to unemployed clients. The odds of client satisfaction were 6.72 times higher among study participants who do not have health insurance membership cards (AOR = 6.72 95% CI: 3.42, 13.91) compared to those who have health insurance membership cards. The odds of client satisfaction were 2.77 times higher among study participants who reported the availability of community referral for any social support (AOR = 2.77 95% CI: 1.12, 6.84) when compared to those who did not report. Those study participants for whom privacy was kept during the examination were 8.67 times higher to be satisfied (AOR = 8.67 95% CI: 2.53, 29.68) compared to those for whom privacy was not kept during the examination. In conclusion, the client satisfaction on HIV/AIDS treatment and care service quality was relatively high in the study area. Occupational status, health insurance membership cards, availability of community referral for any social support and keeping privacy during examination have significant associations with HIV/AIDS treatment and care service quality in terms of client satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Up to 50% of diabetic patients with neuropathy suffer from chronic pain, namely painful diabetic neuropathy (PDN), an unmet medical need with significant impact on quality of life. Gabapentin is widely used for PDN, albeit with frequent dose-limiting effects. Trazodone, an antidepressant with multi-modal action, has shown promising results when given at low doses as an add-on to gabapentin. Upon previous clinical trials and experimental evidence, a fixed-dose combination (FDC) of both compounds, at low doses, was developed for neuropathic pain. Methods: This was a phase II, randomized, double-blind, placebo and reference controlled, dose-finding, multicenter, international, prospective study. Male and female diabetic patients aged 18–75 years and affected by PDN were eligible for enrolment. Patients were randomized (1:1:1:1:2 ratio) to trazodone and gabapentin (Trazo/Gaba) 2.5/25 mg t.i.d. for 8 weeks, Trazo/Gaba 5/50 mg t.i.d. for 8 weeks, Trazo/Gaba 10/100 mg t.i.d. for 8 weeks, gabapentin (Gaba), or placebo (PLB). The aim of the study was to collect preliminary information on the effect of the 3 different FDCs of Trazo/Gaba on pain intensity based on the 11-point numeric rating score (NRS) after 8 weeks of treatment. The secondary objectives were the evaluation of the percentage of responders, neuropathic pain symptoms, anxiety, sleep, quality of life, safety, and tolerability. The primary efficacy endpoint was evaluated with last observation carried out forward (LOCF), using an analysis of covariance (ANCOVA), including treatment and centers as factors and baseline as covariate and applying linear contrast test, excluding the active treatment. Only if the linear contrast test was significant (p < 0.05), the step-down Dunnett test would be used to determine the minimum effective dose significantly different from PLB. If linearity was not verified, an adjusted ANCOVA model and comparisons with Dunnett test were performed. Before the application of the ANCOVA model, the non-significance of interaction treatment per baseline was verified. Results: A total of 240 patients were included in the modified intention-to-treat (m-ITT) population: 39 in Trazo/Gaba 2.5/25 mg, 38 in Trazo/Gaba 5/50 mg, 37 in Trazo/Gaba 10/100 mg, 83 in PLB, and 43 in Gaba. After 8 weeks of treatment, changes of the average daily pain score based on the 11-point NRS from baseline were − 2.52 ± 2.31 in Trazo/Gaba 2.5/25 mg group, − 2.24 ± 1.96 in Trazo/Gaba 5/50 mg group, − 2.46 ± 2.12 in Trazo/Gaba 10/100 mg group, − 1.92 ± 2.21 in Gaba group, and − 2.02 ± 1.95 in the PLB group. The linear contrast test did not result in significant differences (p > 0.05) among treatment groups. Consequently, the minimum effective dose against PLB was not determined. The multiple comparison with Dunnett adjustment did not show any statistically significant differences vs. PLB after 8 weeks of treatment: Trazo/Gaba 2.5/25 mg (95% confidence interval (CI) − 1.2739, 0.2026; p = 0.1539); Trazo/Gaba 5/50 mg (95% CI − 0.9401, 0.5390; p = 0.5931); Trazo/Gaba 10/100 mg (95% CI − 1.0342, 0.4582; p = 0.4471). However, patients receiving the lowest dose of Trazo/Gaba 2.5/25 mg showed a statistically significant difference to PLB after 6 weeks of treatment (95% CI − 1.6648, − 0.2126; p = 0.0116). Positive results were also found for responder patients, other items related to the pain, anxiety, depression, sleep, and quality of life, consistently in favor to the lowest Trazo/Gaba FDC. Two serious adverse events (SAEs) occurred but were judged unrelated to the study treatment. Treatment-emergent adverse events (TEAEs) were mainly mild-to-moderate in intensity and involved primarily nervous system, gastrointestinal disorders, and investigations. Conclusions: The primary end point of the study was the change from baseline of the average daily pain score based on the 11-point NRS after 8 weeks of treatment. While the primary endpoint was not reached, patients treated with Trazo/Gaba 2.5/25 mg t.i.d. showed statistically significant improvement of pain and other scores after 6 weeks and reported consistent better results in comparison to PLB on primary and secondary endpoints for the overall study duration. According to these results, the lowest dose of Trazo/Gaba FDC may be the best candidate for further clinical development to confirm the potential benefits of the FDC drug for this condition. Clinical Trial Registration: NCT03749642. [ABSTRACT FROM AUTHOR]

Background: In diabetes care and management guidelines, shared decision-making (SDM) implementation is explicitly recommended to help patients and health care providers to make informed shared decisions that enable informed choices and the selection of treatments. Despite widespread calls for SDM to be embedded in health care, there is little evidence to support SDM in the management and care of diabetes. It is still not commonly utilized in routine care settings because its effects remain poorly understood. Hence, the current systematic review and meta-analysis aimed to evaluate the effectiveness of SDM for glycaemic control among type 2 diabetes adult patients. Methods: Literature sources were searched in MEDLINE, PubMed, Cochrane library and HINARI bibliographic databases and Google Scholar. When these records were searched and reviewed, the PICO criteria (P: population, I: intervention, C: comparator, and O: outcome) were applied. The extracted data was exported to RevMan software version 5.4 and STATA 17 for further analysis. The mean differences (MD) of glycated hemoglobin (HbA1c) were pooled using a random effect model (REM), and sub-group analysis were performed to evaluate the effect size differences across the duration of the follow-up period, modes of intervention, and baseline glycated hemoglobin level of patient groups. The sensitivity analysis was performed using a leave-one-out meta-analysis to quantify the impact of each study on the overall effect size in mean difference HbA1c%. Finally, the statistically significant MD of HbA1c% between the intervention groups engaged in SDM and control groups received usual care was declared at P ˂0.05, using a 95% confidence interval (CI). Results: In the database search, 425 records were retrieved, with only 17 RCT studies fulfilling the inclusion criteria and were included in the meta-analysis. A total of 5416 subjects were included, out of which 2782(51.4%) were included in trial arms receiving SDM and 2634(48.6%) were included in usual diabetes care. The Higgins (I2) test statistics were calculated to be 59.1%, P = 0.002, indicating statistically significant heterogeneity was observed among the included studies, and REM was used as a remedial to estimate the pooled MD of HbA1c% level between patients who participated in SDM and received usual care. As a result, the pooled MD showed that the SDM significantly lowered HbA1c by 0.14% compared to the usual care (95% CI = [-0.26, -0.02], P = 0.02). SDM significantly decreased the level of HbA1c by 0.14% (95% CI = -0.28, -0.01, P = 0.00) when shared decisions were made in person or face-to-face at the point of care, but there was no statistically significant reduction in HbA1c levels when patients were engaged in online SDM. In patients with poorly controlled glycaemic level (≥ 8%), SDM significantly reduced level of HbA1c by 0.13%, 95% CI = [-0.29, -0.03], P = 0.00. However, significant reduction in HbA1c was not observed in patients with ˂ 8%, HbA1c baseline level. Conclusions: Overall, statistically significant reduction of glycated hemoglobin level was observed among T2DM adult patients who participated in shared decision-making compared to those patients who received diabetes usual care that could lead to improved long-term health outcomes, reducing the risk of diabetes-related complications. Therefore, we strongly suggest that health care providers and policy-makers should integrate SDM into diabetes health care and management, and further study should focus on the level of patients' empowerment, health literacy, and standardization of decision supporting tools to evaluate the effectiveness of SDM in diabetes patients. [ABSTRACT FROM AUTHOR]

Background: Coxiella burnetii is causing infections in both humans and animals, resulting in Q fever and Coxiellosis, respectively. Information on the occurrence of C. burnetii infection is scarce in Ethiopia. This study estimated the sero-prevalence of C. burnetii infection and associated risk factors in four common livestock species from Addis Ababa, Adama, and Modjo abattoirs and pastoral areas of Oromia, Ethiopia. Results/principal findings: Sera samples were analyzed for the presence of anti-C. burnetii antibodies using an indirect Enzyme Linked Immunosorbent Assay kit. Out of the 4140 serum samples tested, 777 (18.77%; 95% CI: 17.59, 19.99) were found positive for C. burnetii. The sero-prevalence estimate was 27.17% at Addis Ababa abattoir, 19.41% at Adama abattoir, 19.13% at Modjo abattoir and 12.1% in animals tested from pastoral areas. Sera analysis at the animal species level showed that cattle exhibited the lowest sero-prevalence estimate (11.83%; 95% CI, 10.27–13.53%), while the highest was observed in camels (28.39%; 95% CI, 25.16–31.80%). The sero-prevalence estimate was 21.34% (95% CI, 18.86–23.99%) in goats and 20.17% (95% CI, 17.49–23.07%) in sheep. The results of multivariable logistic regression analysis showed that species, age, sex of animals and tick infestation were important risk factors for C. burnetii infection. The odds of infection were 3.22 times higher in camels and almost twice as high in goats and sheep compared to cattle. Adult animals were infected more likely (OR = 3.23) than young ones. Interestingly, a significant difference was observed in the sero-prevalence of infection between animals that were infested with ticks (OR = 16.32) and those which were tick-free. Conclusion: This study provides valuable insights into the sero-epidemiology of C. burnetii infection in four common livestock species at major abattoirs and pastoral areas of Ethiopia. The findings highlight the need for further studies and implementing surveillance and biosecurity measures to prevent the spread of the disease in both humans and livestock to safeguard the economical and public health aspects. Author summary: Coxiella burnetii causes infections in both humans and animals, resulting in Q fever and Coxiellosis, respectively. This bacterium poses significant public health, veterinary, and economic risks worldwide due to its potential to cause severe illness and low infectious dose. Therefore, it is important to estimate the sero-prevalence of C. burnetii infection and associated risk factors in cattle, sheep, goats, and camels, respectively. The serum samples were analyzed for the presence of anti-C. burnetii antibodies using an indirect Enzyme Linked Immunosorbent Assay (iELISA) kit. A prevalence estimate of 18.77% was observed for C. burnetii. The sero-prevalence estimate at abbatoirs and pastoral areas was found in the order of Addis Ababa (27.17%)>Adama (19.41%)>Modjo (19.13)>pastoral areas (12.1%). The risk factors were identified as animal species, age, sex, and tick infestation. Camels were more vulnerable than sheep, goats and cattle. The adults were infected more than young. The ticks may be a potential vector for the transmission of the pathogen. [ABSTRACT FROM AUTHOR]