Search

This paper identifies and examines three key approaches prevalent in the geographical study of migration: the displacement and mobilities approach, the transit and waiting approach, and the immigrant settlement approach. Each approach is analyzed in terms of its treatment of time and migratory experiences, critiquing them for reinforcing conventional temporal categories: the past, present, and future. It argues that these categories are problematic as they oversimplify the complex spatiotemporal nature of migration. The paper proposes the concept of "temporal logics" to problematize and de-reify these categories, enabling a more nuanced analysis of time in migration, mobility, and displacement processes. [ABSTRACT FROM AUTHOR]

Background: Smear-positive TB patients greatly contribute to community-level transmission of this disease. Locating hotspots would make it easier to prioritize and target control interventions. This study aimed to assess the spatial distribution of smear-positive index TB cases and their secondary cases and the predictors of clustering of smear-positive TB cases. Methods: This study was conducted in the Silti Zone of Central Ethiopia from 2020 to 2022. The data of smear-positive index TB patients were collected from the unit TB registries of healthcare facilities. Contacts of all index TB patients were screened in the community and tested to identify secondary TB patients. We performed spatial analysis, including Moran's I statistic, the Getis-Ord Gi* statistic and geographically weighted regression (GWR), to assess the global distribution, local clustering and predictors of clustering of smear-positive TB patients, respectively. Additionally, we used inverse distance weighting (IDW) interpolation to predict the distribution of smear-positive TB cases and develop a continuous raster map for places with no data. Results: Spatial autocorrelation analysis revealed that the distribution of smear-positive TB patients exhibited significant clustering (Moran's I = 0.70029; p value < 0.000). The Getis-Ord Gi* output indicated the presence of statistically significant hotspots as well as cold spots in the study area. Significant hotspots were found in 11 Kebeles of the Silti, Dalocha and Misrak Silti districts. Significant coldspots were also found in five kebeles of the Silti and Misrak districts. GWR analysis revealed that no education, primary education, family size and thatched roof houses were significant predictors of the spatial clustering of smear-positive TB cases. We also found that the majority of the secondary TB cases were found in hotspots identified through spatial analysis. Conclusion: The study revealed a heterogenous distribution of smear positive TB in the study area and it could act as a model that can be replicated in other regions. The identified hotspots of TB could be targeted through location-based interventions such as systematic active screening in the form of outreach programs to improve the performance of TB prevention and control, including reducing the transmission of TB. Educational status, family size and housing type were some of the factors that significantly influenced the spatial distribution of smear-positive TB in the study area. The distribution of secondary TB cases found through household contact screening coincided with the identified hotspots, indicating greater transmission of the disease in these places. [ABSTRACT FROM AUTHOR]

The diarrheagenic Escherichia coli (DEC) is the major cause of diarrheal diseases in Africa, including Ethiopia. However, the genetic diversity of E. coli pathotypes found in Ethiopia has not been studied well. This study aimed to characterize potential DEC belonging to enteropathogenic (EPEC), Shiga toxin-producing (STEC), enteroaggregative (EAEC), enterotoxigenic (ETEC), and enteroinvasive (EIEC) E. coli pathotypes from stool specimens of patients attending primary healthcare units (n = 260) in Addis Ababa and Hossana using whole-genome sequencing. Real-time PCR assays were used to identify DEC isolates belonging to EPEC, STEC, EAEC, ETEC, and EIEC pathotypes, which were then subjected to whole-genome sequencing on the Illumina platform. Twenty-four whole-genome nucleotide sequences of DEC strains with good enough quality were analyzed for virulence-associated genes (VAGs), antibiotic resistance genes (ARGs), phylogenetic groups, serogroups, and sequence types. The majority (62.5%) of DEC isolates belonged to the phylogenetic group B1. The identified DEC isolates belonged to 21 different serogroups and 17 different sequence types. All tested DEC isolates carried multiple VAGs and ARGs. The findings highlight the high diversity in the population structure of the studied DEC isolates, which is important for designing targeted interventions to reduce the diarrheal burden in Ethiopia. [ABSTRACT FROM AUTHOR]

Loss to follow-up (LTFU) from Option B plus, a lifelong antiretroviral therapy (ART) for pregnant women living with human immunodeficiency virus (HIV), irrespective of their clinical stage and CD4 count, threatens the elimination of vertical transmission of the virus from mothers to their infants. However, evidence on reasons for LTFU and resumption after LTFU to Option B plus care among women has been limited in Ethiopia. Therefore, this study explored why women were LTFU from the service and what made them resume or refuse resumption after LTFU in Ethiopia. An exploratory, descriptive qualitative study using 46 in-depth interviews was employed among purposely selected women who were lost from Option B plus care or resumed care after LTFU, health care providers, and mother support group (MSG) members working in the prevention of mother-to-child transmission unit. A thematic analysis using an inductive approach was used to analyze the data and build subthemes and themes. Open Code Version 4.03 software assists in data management, from open coding to developing themes and sub-themes. We found that low socioeconomic status, poor relationship with husband and/or family, lack of support from partners, family members, or government, HIV-related stigma, and discrimination, lack of awareness on HIV treatment and perceived drug side effects, religious belief, shortage of drug supply, inadequate service access, and fear of confidentiality breach by healthcare workers were major reasons for LTFU. Healthcare workers' dedication to tracing lost women, partner encouragement, and feeling sick prompted women to resume care after LTFU. This study highlighted financial burdens, partner violence, and societal and health service-related factors discouraged compliance to retention among women in Option B plus care in Ethiopia. Women's empowerment and partner engagement were of vital importance to retain them in care and eliminate vertical transmission of the virus among infants born to HIV-positive women. [ABSTRACT FROM AUTHOR]

A hyperactive tumour microenvironment (TME) drives unrestricted cancer cell survival, drug resistance, and metastasis in ovarian carcinoma (OC). However, therapeutic targets within the TME for OC remain elusive, and efficient methods to quantify TME activity are still limited. Herein, we employed an integrated bioinformatics approach to determine which immune-related genes (IRGs) modulate the TME and further assess their potential theragnostic (therapeutic + diagnostic) significance in OC progression. Using a robust approach, we developed a predictive risk model to retrospectively examine the clinicopathological parameters of OC patients from The Cancer Genome Atlas (TCGA) database. The validity of the prognostic model was confirmed with data from the International Cancer Genome Consortium (ICGC) cohort. Our approach identified nine IRGs, AKT2, FGF7, FOS, IL27RA, LRP1, OBP2A, PAEP, PDGFRA, and PI3, that form a prognostic model in OC progression, distinguishing patients with significantly better clinical outcomes in the low-risk group. We validated this model as an independent prognostic indicator and demonstrated enhanced prognostic significance when used alongside clinical nomograms for accurate prediction. Elevated LRP1 expression, which indicates poor prognosis in bladder cancer (BLCA), OC, low-grade gliomas (LGG), and glioblastoma (GBM), was also associated with immune infiltration in several other cancers. Significant correlations with immune checkpoint genes (ICGs) highlight the potential importance of LRP1 as a biomarker and therapeutic target. Furthermore, gene set enrichment analysis highlighted LRP1's involvement in metabolism-related pathways, supporting its prognostic and therapeutic relevance also in BLCA, OC, low-grade gliomas (LGG), GBM, kidney cancer, OC, BLCA, kidney renal clear cell carcinoma (KIRC), stomach adenocarcinoma (STAD), and stomach and oesophageal carcinoma (STES). Our study has generated a novel signature of nine IRGs within the TME across cancers, that could serve as potential prognostic predictors and provide a valuable resource to improve the prognosis of OC. [ABSTRACT FROM AUTHOR]

While drought is known to affect crop yields negatively, there is limited knowledge of the strategies used by animal‐pollinated plants to cope with such conditions. In this study, we simulated low and moderate drought conditions in a greenhouse experiment and examined the vegetative and reproductive traits of a buzz‐pollinated species (Solanum lycopersicum). Our findings indicate that individuals exposed to both drought conditions decreased in height and bore fewer leaves but increased in the ratio of root length to dry mass. The number of flowers produced per day and the overall flower production were higher in plants under control conditions. We found no differences in the onset of flowering between the treatments, but the plants exposed to low drought showed peak flowering earlier. Among the morphometric traits, flower height, floral diameter, petal length, and petal width were significantly lower in both drought conditions. Individuals in the moderate‐drought treatment displayed greater variation in reproductive traits than those in the low‐drought treatment. Overall, drought stress negatively impacted the aboveground vegetative growth and the reproductive efforts of plants. [ABSTRACT FROM AUTHOR]

This study investigated the influence of bacterial cyclic lipopeptides (LP; surfactins, iturins, fengycins) on microbial interactions. The objective was to investigate whether the presence of bacteria inhibits fungal growth and whether this inhibition is due to the release of bacterial metabolites, particularly LP. Selected endophytic bacterial strains with known plant-growth promoting potential were cultured in the presence of Fusarium oxysporum f.sp. strigae (Fos), which was applied as model fungal organism. The extracellular metabolome of tested bacteria, with a focus on LP, was characterized, and the inhibitory effect of bacterial LP on fungal growth was investigated. The results showed that Bacillus velezensis GB03 and FZB42, as well as B. subtilis BSn5 exhibited the strongest antagonism against Fos. Paraburkholderia phytofirmans PsJN, on the other hand, tended to have a slight, though non-significant growth promotion effect. Crude LP from strains GB03 and FZB42 had the strongest inhibitory effect on Fos, with a significant inhibition of spore germination and damage of the hyphal structure. Liquid chromatography tandem mass spectrometry revealed the production of several variants of iturin, fengycin, and surfactin LP families from strains GB03, FZB42, and BSn5, with varying intensity. Using plate cultures, bacillomycin D fractions were detected in higher abundance in strains GB03, FZB42, and BSn5 in the presence of Fos. Additionally, the presence of Fos in dual plate culture triggered an increase in bacillomycin D production from the Bacillus strains. The study demonstrated the potent antagonistic effect of certain Bacillus strains (i.e., GB03, FZB42, BSn5) on Fos development. Our findings emphasize the crucial role of microbial interactions in shaping the co-existence of microbial assemblages. [ABSTRACT FROM AUTHOR]

Background: High viral load during pregnancy and breastfeeding period is the risk factor for vertical transmission of human immunodeficiency virus (HIV). Currently, Dolutegravir (DTG)-based regimens are recommended to attain adequate viral load suppression (VLS) among women. However, its effect on VLS has not been investigated among women in PMTCT care in Ethiopia. Objective: This study aimed to investigate the rate of viral load non-suppression among women exposed to DTG-based versus Efavirenz (EFV)-based regimens in Ethiopia. Methods: An uncontrolled before-and-after study design was conducted among 924 women (462 on EFV-based and 462 on DTG-based regimens) enrolled in PMTCT care from September 2015 to February 2023. The outcome variable was the viral load (VL) non-suppression among women on PMTCT care. A modified Poisson regression model was employed, and the proportion was computed to compare the rate of VL non-suppression in both groups. The risk ratio (RR) with a 95% confidence interval (CI) was calculated to assess viral load non-suppression among women on DTG-based and EFV-based regimens by adjusting for other variables. Results: The overall rate of non-suppressed VL was 16.2% (95% CI: 14.0–18.8%). Mothers on DTG-based regimens had approximately a 30% (adjusted risk ratio (aRR): 0.70; 95% CI: 0.52–0.94) lesser risk of developing non-suppressed VL than women on EFV-based regimens. Besides, older women were 1.38 times (aRR: 1.38; 95% CI: 1.04–1.83); mothers who did not disclose their HIV status to their partners were 2.54 times (aRR: 2.54; 95% CI: 1.91–3.38); and mothers who had poor or fair adherence to antiretroviral (ARV) drugs were 2.11 times (aRR: 2.11; 95% CI: 1.45–3.07) at higher risk of non-suppressed VL. Conclusion: Women on DTG-based regimens had a significantly suppressed VL compared to those on EFV-based regimens. Thus, administering DTG-based first-line ART regimens should be strengthened to achieve global and national targets on VLS. [ABSTRACT FROM AUTHOR]

Background: Mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a major public health challenge in Ethiopia. The objective of this review was to assess the pooled magnitude of MTCT of HIV and its risk factors among mother-infant pairs who initiated antiretroviral therapy (ART) after Option B+ in Ethiopia. Methods: A systematic search of literature from PubMed, Hinari, African Journals Online (AJOL), Science Direct, and Google Scholar databases was conducted from June 11, 2013 to August 1, 2023. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to guide the article selection process and reporting. Observational studies that reported the magnitude and/or risk factors on MTCT of HIV among mother-infant pairs who initiated ART after the implementation of Option B+ in Ethiopia were included. We applied a random-effect model meta-analysis to estimate the overall pooled magnitude and risk factors of MTCT of HIV. A funnel plot and Egger's regression test were employed to check publication bias, and heterogeneity was assessed using I2 statistics. The protocol was registered in the PROSPERO database with registration ID number CRD42022325938. Result: Eighteen published articles on the magnitude of MTCT and 16 published articles on its risk factors were included in this review. The pooled magnitude of MTCT of HIV after the Option B+ program in Ethiopia was 4.05% (95% CI 3.09, 5.01). Mothers who delivered their infants at home [OR: 9.74; (95% CI: 6.89–13.77)], had not been on ART intervention [OR: 19.39; (95% CI: 3.91–96.18)], had poor adherence to ART [OR: 7.47; (95% CI: 3.40–16.45)], initiated ART during pregnancy [OR: 5.09; (95% CI: 1.73–14.97)], had WHO clinical stage 2 and above [OR: 4.95; (95% CI: 1.65–14.88]], had a CD4 count below 350 at enrolment [OR: 5.78; (95% CI: 1.97–16.98], had no or low male partner involvement [OR: 5.92; (95% CI: 3.61–9.71]] and whose partner was not on ART [OR: 8.08; (95% CI: 3.27–19.93]] had higher odds of transmitting HIV to their infants than their counterparts. Conclusion: This review showed that the pooled magnitude of MTCT of HIV among mother-infant pairs who initiated ART after the Option B + program in Ethiopia is at the desired target of the WHO, which is less than 5% in breastfeeding women. Home delivery, lack of male partner involvement, advanced HIV-related disease, lack of PMTCT intervention, and poor ARV adherence were significant risk factors for MTCT of HIV in Ethiopia. [ABSTRACT FROM AUTHOR]

Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

The study adopted a descriptive survey design. The participants of the study were secondary school principals (47) and supervisors (16) selected using availability sampling. The method of data collection was a principals’ instructional management rating scale. The quantitative data were analyzed using descriptive statistics, and an independent t-test, p < .05. The findings indicated that the practice of the ten instructional leadership functions was mainly poor, with some good with slightly better practices. The findings from an independent-sample t-test analysis showed that there were no statistically significant mean score differences between principals and supervisors’ ratings of the three dimensions of instructional leadership. To improve the instructional leadership practice in the schools, practical pre-and in-service training should be given to improve the knowledge and skill of instructional leadership of the principals. [ABSTRACT FROM AUTHOR]

Background: Standard Precautions (SPs) are the minimal infection prevention and control (IPC) measures that apply to all patient care activities at all times, regardless of whether the patient has a suspected or proven disease, in any place where healthcare service is provided. These evidence-based practices protect healthcare workers (HCWs) from infection while preventing the spread of infectious agents among patients, visitors, and the environment. Objectives: Assessed compliance of HCWs working in public hospitals in Addis Ababa to infection prevention and control SPs, and factors associated with noncompliance. Methods: In a hospital-based cross-sectional study, 422 HCWs were recruited from nine public hospitals in Addis Ababa using a stratified random sampling technique. Data were collected using self-administered questionnaires, entered into a computer using Epi data, and analyzed using SPSS version 25. The association between the independent and the outcome variables was investigated using logistic regression. Odd ratios with corresponding 95% confidence intervals (CI) were used as measures of the strength of the association between the outcome and the explanatory variables. A p-value below 5% was considered an indicator of statistical significance. Results: The level of knowledge of HCWs about IPC and SPs was 51.9% and 36.49% of the respondents were compliant with SPs. Receiving IPC Training [Adjusted Odds Ratio (AOR) = 1.81, 95% CI 1.06, 3.09], knowing SPs [AOR = 3.46, 95% CI = 1.83, 6.54], presence of a mechanism in the hospital to enforce the IPC practices [AOR = 1.71 95% CI = 1.01, 2.89], and availability of cleaning and disinfection chemicals in the hospital [AOR = 2.18, 95%CI = 1.15, 4.13] were significantly associated with the HCWs' compliance with SPs. Conclusion: Compliance with IPC standard precautions of HCWs in public hospitals of Addis Ababa is suboptimal. Working in medical units, less work experience, lack of training, poor knowledge, absence of a mechanism to enforce adherence, and inadequate resources are independent predictors for non-compliance of the HCWs. [ABSTRACT FROM AUTHOR]

Uterine corpus endometrial carcinoma (UCEC) poses significant clinical challenges due to its high incidence and poor prognosis, exacerbated by the lack of effective screening methods. The standard treatment for UCEC typically involves surgical intervention, with radiation and chemotherapy as potential adjuvant therapies. In recent years, immunotherapy has emerged as a promising avenue for the advanced treatment of UCEC. This study employs a multi-omics approach, analyzing RNA-sequencing data and clinical information from The Cancer Genome Atlas (TCGA), Gene Expression Profiling Interactive Analysis (GEPIA), and GeneMANIA databases to investigate the prognostic value of MutL Homolog 1 (MLH1) gene expression in UCEC. The dysregulation of MLH1 in UCEC is linked to adverse prognostic outcomes and suppressed immune cell infiltration. Gene Set Enrichment Analysis (GSEA) data reveal MLH1's involvement in immune-related processes, while its expression correlates with tumor mutational burden (TMB) and microsatellite instability (MSI). Lower MLH1 expression is associated with poorer prognosis, reduced responsiveness to Programmed cell death protein 1 (PD-1)/Programmed death-ligand 1 (PD-L1) inhibitors, and heightened sensitivity to anti-cancer agents. This comprehensive analysis establishes MLH1 as a potential biomarker for predicting prognosis, immunotherapy response, and drug sensitivity in UCEC, offering crucial insights for the clinical management of patients. [ABSTRACT FROM AUTHOR]

Urban drainage and waterlogging prevention are critical components of urban water management systems, as they help to mitigate the risks of flooding and water damage in cities. The accurate collection of liquid level and flow rate data at the end of these systems is crucial for their effective monitoring and management. However, existing water equipment for this purpose has several shortcomings, including limited accuracy, inflexibility, and difficulty in operation under specific working conditions. A new type of multi-parameter flexible smart water gauge was developed to address these issues. This technology uses underwater simulation robot technology and is designed to overcome the deficiencies of existing water equipment. The flexibility of the gauge allows it to be adapted to different working conditions, ensuring accurate data collection even in challenging environments. The accuracy of the new water gauge was tested through a series of experiments, and the results showed that it was highly accurate in measuring both liquid level and flow rate. This new technology has the potential to be a key tool in smart water conservancy, enabling the more efficient and accurate monitoring of water levels and flow rates. By providing a new solution to the problem of collecting terminal equipment for urban drainage and waterlogging prevention, this technology can help to improve the resilience and sustainability of urban water management systems. [ABSTRACT FROM AUTHOR]

Background: Patent omphalomesenteric duct is one of the birth defects included in the spectrum of vitelline duct abnormalities. It is a rare anomaly with estimated prevalence of 0.13–0.2% in the general population. The most common presentation of patent vitelline duct is yellowish or mucoid type umbilical discharge which is usually noted in neonatal age or infancy. The main stay of diagnosis is clinical and outcome is favorable as long as timely surgical correction is offered. Here we present a 2 years old male child who presented with ileal prolapse through patent vitelline duct which is an exceptional mode of presentation of this pathology. Case presentation: 2 years old Ethiopian male child who was noticed to have umbilical discharge since early infancy presented with protrusion of pinkish mass per the umbilicus of 4 h duration. He had no signs and symptoms of bowel obstruction. Abdominal examination revealed a prolapsed bowel which was viable via the umbilicus which was about 6 cm long. Otherwise, he had no abdominal tenderness or rigidity. He was explored with a smiley incision just above the umbilicus. The prolapsed bowel was reduced gently to the abdominal cavity. The tract of the Patent vitelline duct was identified and completely resected along with a wedge of ileum at its base. Primary repair of the ileal end where the tract was inserted was done in two layers and abdomen was closed in layers. The child had smooth post op course and was discharged on the 4th post-operative day. Conclusion: Prolapse of a bowel through the umbilicus is unusual presentation of a rare anomaly namely patent vitelline duct. This presentation warrants early surgical intervention before bowel ischemia issues. Hence, all clinicians dealing with children should be aware of this rare pathology so that urgent surgical management can be offered. [ABSTRACT FROM AUTHOR]

Context and background: Sub-Saharan African development strategies emphasize optimizing agricultural and forestry resources through foreign and domestic investments in large-scale farms and plantations. While these land-based initiatives are believed to enhance economic development, concerns arise regarding their impact on marginalized groups and the environment. Goal and Objectives: This study reviews the legal and policy frameworks to analyze the enabling environment for sustainable and inclusive land-based investment in Ethiopia, Ghana, and Mozambique. Methodology: We reviewed legal frameworks and incentives for inclusive and green investment. Then, we analyzed peer-reviewed studies on land-based agricultural investments and impacts. Our findings were presented at national Multi-Stakeholders Platform workshops for validation Results: Legal and policy frameworks concerning land, resources, and property rights, alongside incentive mechanisms to attract investors, reveal contradictions between investment promotion and Constitutional recognition of land as communal property. Customary laws positively influence land and resource management but may restrict women's land rights with varying regional applications. Inconsistent implementation of investment incentives, particularly in the inefficient and non-transparent land acquisition process, was noted. Transformative land investment requires legitimate tenure systems, robust land use plans, inclusivity promotion, improved government coordination, environmental awareness, and fiscal incentives for green and inclusive investment. [ABSTRACT FROM AUTHOR]

Background: Ensuring regular supervision, capacity building and motivation are crucial for the successful retention of health extension workers (HEWs). Failure in these aspects could increase the attrition rate of HEWs. To date, there has not been a comprehensive nationwide study on HEW attrition that could act as a source of evidence for policy makers. This study explored HEW attrition, including leaving the health sector entirely and its regional variation, trends and predictors of attrition out of the health system. Methods: This study explored the attrition of HEWs from the beginning of the program until the end of 2018. A district-based mixed method study was conducted to review the personnel files of HEWs. A multistage sampling technique was employed to select 3,476 HEWs, and a probability weight was assigned for each observation. Descriptive statistics were calculated for the outcome and predictor variables. A logistic regression model was used to model attrition out of the health system. A qualitative study was conducted to understand the reasons why HEWs leave their jobs. Thematic analysis was performed using Nvivo version 12. Results: The magnitude of attrition of HEWs was found to be 21.1% during the fifteen years of HEP implementation. Of the total 704 who left their job as an HEW, 530 (73%) left the health system altogether. Number of biological children [AOR = 0.61, 95% CI; 0.42–0.89], having an additional education [AOR = 8.34, 95% CI; 3.67–18.98], obtaining official recognition [AOR = 0.29, 95% CI; 0.10–0.83], administrative reprimand [AOR = 1.66, 95% CI; 1.07 -2. 56), distance between district health office and health post [AOR = 1.75, 95%CI; 1.18–2.59) and COC status [AOR = 2.06, 95%CI 1.39–3.06) were independent predictors of leaving the health sector. High regional variation in attrition was observed, ranging from 38.5% in Addis Ababa to just 6.1% in the Harari region. The trend of attrition has steadily increased over time, with a high of 1,999 attritions per 10,000 HEW in 2018. Psychosocial factors, administrative issues, career advancement incentives, and workplace-related problems were the themes that emerged from the qualitative study as reasons for attrition of HEWs. Conclusion: Even though the magnitude of attrition was relatively low, there was high regional variation and incremental trends. Moreover, the out-of-health sector attrition is also high. Critically examining the HEP policy environment to increase the number of HEWs deployed per health post to reduce workload and improving HEW incentives, including career development, may assist in increasing HEW job satisfaction, which in turn could help to reduce attrition, including leaving the health sector. [ABSTRACT FROM AUTHOR]

In this work, the use of brick powders (BPs) as an alternative to sand in self-compacting concrete (SCC) is investigated. Currently, the Indian Standards permit about 10% fine materials in sand below the 150-micron sieve. There is very little research conducted to determine the impact of fines on SCC properties, and this study is focused on addressing this research gap. Crushed BPs were used because they are conventionally available and because the sand scarcity problem can be addressed to a large extent using BPs. The effect of the BP addition on the fundamental properties of combined fillers, the flow and rheology of mortars, and the strength and durability aspects of SCCs were investigated at 5% and 12.5% weight dosages. Results showed that adding BPs reduced the D50 size of the combined gradation; however, the packing density was not improved. Due to the greater surface area of brick particles, which may have raised the paste demand for a given mixture volume and increased the dominance of frictional and interlocking properties in the mixture, the workability of SCCMs was negatively impacted at both dosages of BP. The flow loss behaviour changed very little within the first 30 min after the addition of BP in the mixture, suggesting excellent consistency and minimal to no bleeding. Due to the greater water absorption of brick particles, both dosages of BP increased the absolute viscosity of the mixture, corroborating the trends seen by flow characteristics. At 5% and 10% dosage, the yield stress of the mixture increased and decreased, respectively. In contrast to the decreased value, which could have been caused by other factors like aggregate angularity, surface roughness, and interlocking mechanisms, the increased value is attributed to the increase in surface area of BP particles, which results in more solids and solid-to-solid interactions in the paste. Regarding SCC properties, the BP addition at 5% and 12.5% dosages passed all flow-related tests (filling, passing, and segregation ability), demonstrating its efficacy in SCCs. The BP addition at 5% dosage decreased the early and later age compressive strengths of SCCs by 3%–14%, provided comparable flexural strengths, increased split tensile strength, decreased water absorption and sorptivity values, increased resistivity, and provided a comparable charge-passed value. At higher dosages of 12.5%, the strength and the charge passed value increased. Overall, it can be concluded that many SCC properties were either improved or remained unaffected by the BP addition, and thus, a viable alternative exists at the studied dosages. [ABSTRACT FROM AUTHOR]

Background: Breast self-examination (BSE) is considered one of the main screening methods in detecting earlier stages of breast cancer. It is a useful technique if practiced every month by women above 20 years considering that breast cancer among women globally contributed to 685,000 deaths in 2020. However, the practice of breast self-examination among healthcare professionals is low in many developing countries and it is not well known in Rwanda. Therefore, this research was intended to measure the level of breast self-examination practice and its associated factors among female healthcare professionals working in selected hospitals in Kigali, Rwanda. Methods: A cross-sectional study was conducted among 221 randomly selected female healthcare professionals in four district hospitals in Kigali, Rwanda. A self-administered structured questionnaire was used as data collection instrument. The predictor variables were socio-demographic and obstetrics variables, knowledge on breast cancer and breast self-examination as well as attitude towards breast cancer and breast self-examination. Sample statistics such as frequencies, proportions and mean were used to recapitulate the findings in univariate analysis. Multiple logistic regression analysis was employed to identify statistically significant variables that predict breast self-examination practice. Adjusted odds ratio with 95% confidence level were reported. P-value < 0.05 was used to declare statistical significance. Results: Breast self-examination was practiced by 43.5% of female healthcare professionals. This prevalence is low compared to other studies. Attitude towards breast self-examination and breast cancer was the only predictor variable that was significantly associated with breast self-examination practice [AOR = 1.032; 95% CI (1.001, 1.065), p-value = 0.042]. However, number of pregnancy and number of children were not significantly associated with BSE practice in the multi-variate analysis. In addition, there was a positive linear link between knowledge and attitude, with a correlation coefficient (r) of 0.186 (p = 0.005). Conclusions: The breast self-examination practice among healthcare professionals was found to be low. Attitude towards breast cancer and breast self-examination was positively associated with BSE practice. Moreover, attitude and knowledge were positively correlated. This suggests the need for continuous medical education on breast self-examination and breast cancer to increase the knowledge & BSE practice level of female healthcare professionals. [ABSTRACT FROM AUTHOR]

Diarrhea is one of the important public health problems in developing countries. Salmonella and Shigella species are the major bacterial causal agents of diarrhea. The increasing burden of antimicrobial resistance is posing difficulty in the treatment of these pathogens. This study aimed to assess the occurrence of Salmonella and Shigella in the feces of diarrheic patients receiving health services in Addis Ababa, Ethiopia, and to determine their antimicrobial susceptibility profile. A cross-sectional study involving 13 health centers was conducted where 428 diarrheic patients were recruited. Standard microbiology techniques were used to isolate Salmonella and Shigella from stool samples. In addition, Salmonella isolates were confirmed by polymerase chain reaction (PCR). The Kirby–Bauer disc diffusion method was employed to assess susceptibility to 11 antimicrobials for each of the Salmonella and Shigella isolates. The prevalence of Salmonella and Shigella spp. among diarrheic patients was 8.4%; n = 36 and 5.6%; n = 24, respectively. Thirty (83.3%) of Salmonella isolates were susceptible to all antimicrobials tested, whereas 4 (10.8%) of isolates were resistant to 2 or more antimicrobials and 2 (5.6%) were multidrug resistant. Resistance to ampicillin was recorded in only one (2.7%) of Salmonella isolates; however, resistance to ampicillin was recorded in 12 (50%) of the Shigella isolates. Half of the Shigella isolates (n = 12) were resistant to 2 or more antimicrobials while 5 (20.8%) of them were resistant to 3 or more antimicrobials. The overall rate of resistance to antimicrobials was more common in Shigella compared to Salmonella isolates. In conclusion, Salmonella and Shigella were isolated from the feces of diarrheic patients, with a higher rate of antimicrobial resistance in Shigella isolates, which could make the treatment of shigellosis challenging. Therefore, increasing hygienic practices during food preparation to reduce the burden of Salmonella and Shigella infection and prudent use of antimicrobials are recommended to limit the spread of antimicrobial resistant strains. [ABSTRACT FROM AUTHOR]

Background: Up to 80% of adults with attention deficit hyperactivity disorder (ADHD) may have a concomitant psychiatric disorder. ADHD and depression, combined with the demands of University life, can pose serious challenges for students. However, there are limited studies conducted on this topic in our country. Therefore, the current study assessed the magnitude, relationship, and determinants of ADHD and depressive symptoms among students at the University of Gondar. Method: An institution-based cross-sectional study was employed among 1514 undergraduate students at the University of Gondar from June 1–20, 2022. A stratified, simple random sampling technique was applied. Structural equation modeling was employed. The degree of relationship was interpreted based on the adjusted regression coefficient with 95% confidence interval (CI) and p-value (<0.05). Result: In our study, 37.6% [CI: 35.2–40.1%] and 20.01% [CI: 18.1–22.1%] of the participants had depressive and ADHD symptoms, respectively. Chronic illness [β = 0.19, CI; 0.09, 0.30], alcohol use [β = 0.10, CI; 0.03, 0.17], social support [β = -0.23, CI; -0.29, -0.17], problematic internet use (PIU) [β = 0.23, CI; 0.18, 0.27], and insomnia [β = 0.24, CI; 0.17, 0.30] had a direct relationship with depressive symptoms. Mother education level [β = -0.09, CI; -0.13, -0.06], birth order [β = -0.09, CI; -0.11, -0.07], chat chewing [β = 0.18, CI; 0.06, 0.30], and depressive symptoms [β = 0.73, CI; 0.62, 0.86] had a direct relationship with ADHD. Chronic illness [β = 0.14, CI; 0.06, 0.22], PIU [β = 0.16, CI; 0.13, 0.21], social support [β = -0.16, CI; -0.22, -0.12], and insomnia [β = 0.17, CI; 0.13, 0.23] had an indirect effect on ADHD. Conclusion and recommendation: The prevalence of ADHD and depressive symptoms was high. Chronic disease, alcohol use, social support, PIU, and insomnia had a direct effect on depressive symptoms and an indirect effect on ADHD. Mother education, birth order, chat chewing, and depressive symptoms had a direct effect on ADHD. Our study provided useful clues for clinical treatment and school-based interventions that aim to improve college students' mental well-being. It is better to design school-based intervention and prevention programs to achieve timely diagnosis and treatment of these disorders among university students. [ABSTRACT FROM AUTHOR]

Background: The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention was implemented in Ethiopia to improve newborn birth weight (BW) by strengthening the contents and quality of antenatal care (ANC), especially point-of-care testing for maternal infections. This study examined the effect of the ENAT intervention on birth weight. Methods: We conducted a cluster randomized controlled trial of 22 clusters (health centers), randomized equally between 11 intervention and 11 control clusters. This study enrolled and followed pregnant women from ANC booking to the end of pregnancy or loss to follow-up. The primary outcome was mean BW, and the incidence of low birth weight (LBW) was the secondary outcome. We presented univariate comparisons of outcomes between the intervention and control arms for mean BW and LBW. Multilevel analyses using random effects models were performed to adjust for clustering and individual-level covariates. Results: We enrolled and followed up 4,868 and 4,821 pregnant women in the intervention and control arms, respectively, from March 2021-July 2022. During follow-up, 3445 pregnant women in the intervention and 3192 in the control delivered in the health centers, and BW measurements of their babies were recorded within 48 h. The mean BW was 3,152 g (standard deviation (SD) = 339.8 g) in the intervention and 3,044 g (SD = 353.8 g) in the control arms (mean difference, 108 g; 95% confidence interval (CI): 91.3-124.6; P = 0.000). Adjusting for clustering and several covariates, the mean BW remained significantly higher in the intervention arm than in the control arm (adjusted ß coef., 114.3; p = 0.011). The incidence of LBW was 4.7% and 7.3% in the intervention and control arms, respectively. The adjusted risk of LBW was significantly lower by 36% in the intervention arm than in the control arm (adjusted relative risk, 0.645; p = 0.027). Conclusion: This study provided sufficient evidence of the effectiveness of the ENAT intervention in improving birth weight in the study population. The intervention demonstrated that an increase in birth weight can be attained by availing point-of-care testing, strengthening infection prevention, and maternal nutrition within the ANC platform of public health facilities in a low-income setting. Trial Registration: Registered at Pan African Clinical Trial Registry (PACTR) database dated 09/05/2023, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25493. The unique identification number for the registry is PACTR202305694761480. [ABSTRACT FROM AUTHOR]

Pulmonary tuberculosis (PTB) is a bacterial infection that affects the lung. PTB remains one of the infectious diseases with the highest global mortalities. Chest radiography is a technique that is often employed in the diagnosis of PTB. Radiologists identify the severity and stage of PTB by inspecting radiographic features in the patient's chest X-ray (CXR). The most common radiographic features seen on CXRs include cavitation, consolidation, masses, pleural effusion, calcification, and nodules. Identifying these CXR features will help physicians in diagnosing a patient. However, identifying these radiographic features for intricate disorders is challenging, and the accuracy depends on the radiologist's experience and level of expertise. So, researchers have proposed deep learning (DL) techniques to detect and mark areas of tuberculosis infection in CXRs. DL models have been proposed in the literature because of their inherent capacity to detect diseases and segment the manifestation regions from medical images. However, fully supervised semantic segmentation requires several pixel-by-pixel labeled images. The annotation of such a large amount of data by trained physicians has some challenges. First, the annotation requires a significant amount of time. Second, the cost of hiring trained physicians is expensive. In addition, the subjectivity of medical data poses a difficulty in having standardized annotation. As a result, there is increasing interest in weak localization techniques. Therefore, in this review, we identify methods employed in the weakly supervised segmentation and localization of radiographic manifestations of pulmonary tuberculosis from chest X-rays. First, we identify the most commonly used public chest X-ray datasets for tuberculosis identification. Following that, we discuss the approaches for weakly localizing tuberculosis radiographic manifestations in chest X-rays. The weakly supervised localization of PTB can highlight the region of the chest X-ray image that contributed the most to the DL model's classification output and help pinpoint the diseased area. Finally, we discuss the limitations and challenges of weakly supervised techniques in localizing TB manifestations regions in chest X-ray images. [ABSTRACT FROM AUTHOR]

Background: Seroma is the most common complication following breast cancer surgery, with reported incidence up to 90%. Seroma causes patient discomfort, is associated with surgical site infections (SSI), often requires treatment and increases healthcare consumption. The quilting suture technique, in which the skin flaps are sutured to the pectoralis muscle, leads to a significant reduction of seroma with a decrease in the number of aspirations and surgical site infections. However, implementation is lagging due to unknown side effects, increase in operation time and cost effectiveness. Main objective of this study is to assess the impact of large scale implementation of the quilting suture technique in patients undergoing mastectomy and/or axillary lymph node dissection (ALND). Methods: The QUILT study is a stepped wedge design study performed among nine teaching hospitals in the Netherlands. The study consists of nine steps, with each step one hospital will implement the quilting suture technique. Allocation of the order of implementation will be randomization-based. Primary outcome is 'textbook outcome', i.e.no wound complications, no re-admission, re-operation or unscheduled visit to the outpatient clinic and no increased use of postoperative analgesics. A total of 113 patients is required based on a sample size calculation. Secondary outcomes are shoulder function, cosmetic outcome, satisfaction with thoracic wall and health care consumption. Follow-up lasts for 6 months. Discussion: This will be one of the first multicentre prospective studies in which quilting without postoperative wound drain is compared with conventional wound closure. We hypothesize that quilting is a simple technique to increase textbook outcome, enhance patient comfort and reduce health care consumption. [ABSTRACT FROM AUTHOR]

The ability to predict particle dispersion, interaction, and deposition in turbulent pipes is of value in improving the transport and process efficiency of high concentration particulate flows. In this work, the settling and deposition behavior of suspensions of dense particles in a cylindrical pipe has been studied using direct numerical simulation coupled with Lagrangian particle tracking, with the influence of Stokes number on deposition behavior examined. From the analysis performed, it can be concluded that particle deposition is sensitive to Stokes number. In particular, the dispersion function and mean vertical displacement of the particles are demonstrated to decrease considerably faster with time at the higher Stokes number. Particle migration towards the lower wall regions of the pipe also shows the formation of a solid bed of these particles, whilst over the same time period only dune‐like structures are produced at the lower Stokes number. Further analysis of the particle dynamics confirms these findings and generates insight into the particle dynamics within the deposition regions. [ABSTRACT FROM AUTHOR]

Cancer and diabetes mellitus (DM) are diagnosed within the same individual more frequently and share common risk factors. Although diabetes among cancer patients may result in more aggressive clinical courses of cancer, there is limited evidence about its burden and associated factors. Hence, this study aimed to assess the burden of diabetes and prediabetes among cancer patients and its associated factors. Institution-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from 10 January to 10 March 2021. A systematic random sampling technique was used to select 423 cancer patients. The data was collected using a structured interviewer-administered questionnaire. Prediabetes and diabetes diagnosis was made based on World Health Organization (WHO) criteria. Bi-variable and multivariable binary logistic regression models were fitted to identify factors associated with the outcome. Adjusted Odds Ratio (AOR) with a 95% confidence interval was estimated to show the direction and strength of associations. Variables with a p-value less than 0.05 in the multivariable model were considered significantly associated with the outcome. The final analysis was based on 384 patients with cancer. The proportion of prediabetes and diabetes was 56.8% (95% CI 51.7, 61.7) and 16.7% (95% CI 13.3, 20.8), respectively. Alcohol consumption was found to increase the odds of elevated blood sugar among cancer patients (AOR: 1.96; 95%CI: 1.11, 3.46). The burden of prediabetes and diabetes is alarmingly high among cancer patients. Besides, alcohol consumption was found to increase the odds of having elevated blood sugar among cancer patients. Hence, it is essential to recognize cancer patients are at high risk of having elevated blood sugar and design strategies to integrate diabetes and cancer care. [ABSTRACT FROM AUTHOR]

Background. Countries in the world have been experiencing the ongoing impact and spread of the coronavirus disease (COVID-19) virus pandemic. The health and financial burden of the pandemic has prompted the need for timely and effective vaccination to be considered as the best strategy for controlling disease transmission. However, vaccine acceptability remains an area of concern in developing countries like Ethiopia. Objective. To assess attitude, hesitancy in the COVID-19 vaccine acceptance, and associated factors among health science students at Wolaita Sodo University. Methods. A triangulated mixed-method study was conducted. Quantitative data were entered into SPSS Windows version 25 for analysis, and the qualitative data were transcribed using open code version 4.3. A binary logistic regression model was used to establish the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the strengths of the association. Thematic approach was used for qualitative data analysis. Results. A total of 352 students participated in this study. Having family members who were infected with COVID-19, information about COVID-19 vaccine, the need for a vaccine with the level of concern, intention to take COVID-19 vaccine, and academic year were strongly associated with vaccine acceptability. Graduating class and other senior students were about 4 and 2 times more likely to accept vaccination as compared to freshman-year students (AOR = 4.128; 95% CI: 1.351–12.610; P = 0.012) and (AOR = 2.195; 95% CI: 1.182–4.077; P value = 0.013), respectively. Even if 67% of students had a good attitude towards the vaccine, 56% of the students hesitated to take the vaccine. Conclusion. The majority of respondents had a constructive attitude towards the COVID-19 vaccine, and only a few of them were vaccinated against the COVID-19 virus. It is of utmost importance to design an evidence-based strategy to increase the uptake of vaccination for healthcare students and other nonhealth science students in universities. [ABSTRACT FROM AUTHOR]

Background: As adolescence is a transition period from childhood to adulthood malnutrition occurring at this age resonates through generations. Although there were many individual studies in Ethiopia about different form of malnutrition among adolescent, their results are inconclusive indicating the need for generating a pooled estimate of adolescent nutritional status and associated factors. This review and meta-analyses aimed at estimating the pooled prevalence of different forms of malnutrition and associated factors among adolescents in Ethiopia. Method and materials: We searched data bases from Pub Med, Cochrane Library, Health Inter Network Access to Research Initiative (HINARI), Science Direct and search engines; Google and Google Scholar and other sources; Reference of References and expert contact which were used to select the studies. Joanna Briggs Institute (JBI) quality appraisal tool was applied to identify eligible studies. STATA/SE V.14 was used to analyze the data. Effect size with 95% Confidence Interval (CI) and heterogeneity were estimated. Heterogeneity of studies was quantified with I2 statistic >50% used as an indicator of heterogeneity. Potential publication bias was assessed using Funnel plots and Egger's regression test. Trim and fill analysis was also performed. The presences of a statistical association between independent and dependent variables were declared at P <0.05. The PROSPERO registration number for the review is CRD42020159734. Results: The pooled prevalence of overweight/obesity, stunting and thinness were 10.63% (95% CI: 8.86, 12.40), 20.06% (95% CI: 15.61, 24.51) and 21.68% (95% CI: 9.56, 33.81), respectively. Being female (OR: 2.02, CI: 1.22–3.34), low dietary diversity score (OR: 2.26 CI: 1.28–3.99) and high physical activity (OR: 0.36, 95%CI: 0.14–0.88) were significantly associated with adolescent overweight/obesity. Urban residence (OR: 0.82, 95%CI: 0.68–0.99), protected drinking water source (OR: 0.50, CI: 0.27–0.90) and having family size<5 people (OR: 0.54, CI: 0.44–0.66) were independent predictors of adolescent stunting. Early adolescent age (10–14 years) (OR: 2.38, CI: 1.70–3.34), protected water source for drinking (OR: 0.36, CI: 0.21–0.61), low wealth index (OR: 1.80, CI: 1.01–3.19) and family size <5 people (OR: 0.50, CI: 0.28–0.89) were significantly (P < 0.05) associated with adolescent thinness. Conclusion: The prevalence of overweight/obesity, stunting and thinness are high in Ethiopian adolescents indicating the upcoming challenge of double burden of malnutrition. The results imply the presence of double burden of malnutrition among adolescents which heralds the need for programmatic and policy response in terms of addressing modifiable risk factors including: dietary practices, physical activity, water source and economic status of these adolescents. [ABSTRACT FROM AUTHOR]

Cryptococcal infection is well-documented in immunocompromised individuals. Cutaneous manifestations are not as common and are often difficult to diagnose due to variable presentations. Furthermore, there have been reports of coexisting cutaneous Cryptococcus and malignancy. We describe a patient that presented with a fast-growing mass (suspected sarcoma) in the hand that was ultimately treated for a Cryptococcus skin infection. We believe familiarity with the possibility of coexistence of these two conditions in an immunocompromised host could have brought about earlier diagnosis and possibly more effective treatment. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia. Method: Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P -value less than.05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD). Result: The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.23-8.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)). Conclusion: Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD. [ABSTRACT FROM AUTHOR]

Background: Vitamin A one of the important micronutrients that it cannot be made in the human body and must be taken from outside the body through the diet. Ensuring that vitamin A is available in any form in sufficient quantities remains a challenge, especially in regions where access to vitamin A-containing foods and healthcare interventions is limited. As a result, vitamin A deficiency (VAD) becomes a common form of micronutrient deficiency. To the best of our knowledge, there is limited evidence on determinants of good Vitamin A consumption in East African countries. Therefore, this study aimed to assess the magnitude and determinants of good vitamin A consumption in East African countries. Methods: A recent Demographic and Health Survey (DHS) of twelve East African countries were included to determine the magnitude and determinants of good vitamin A consumption. A total of 32,275 study participants were included in this study. A multilevel logistic regression model was used to estimate the association between the likelihood of good vitamin A-rich food consumption. Both community and individual levels were used as independent variables. Adjusted odds ratio and its 95% confidence interval were used to see the strength of the association. Result: The pooled magnitude of good vitamin A consumption was 62.91% with a 95% CI of 62.3 to 63.43. The higher proportion of good vitamin A consumption 80.84% was recorded in Burundi and the smallest good vitamin A consumption 34.12% was recorded in Kenya. From the multilevel logistic regression model, women's age, marital status, maternal education, wealth index, maternal occupation, children's age in a month, media exposure, literacy rate, and parity were significantly associated with good vitamin A consumption in East Africa. Conclusion: The magnitude of good vitamin A consumption in twelve East African countries is low. To increase good vitamin A consumption health education through the mass media and enhancing the economic status of women is recommended. Planners and implementers should give attention and priority to identified determinants to enhance good vitamin A consumption. [ABSTRACT FROM AUTHOR]

Background: Despite the expansion of the Integrated Community Case Management services for childhood illness, quality and utilization of services have remained low. To address the problem, the Government of Ethiopia introduced a complex intervention that included community engagement, capacity building of health workers and enhanced district-level ownership of sick child management. We examined whether this complex intervention was associated with improved management of sick children by health extension workers. Methods: The study was conducted in four Ethiopian regions. A baseline survey was conducted in 26 intervention and 26 comparison districts from December 2016 to February 2017, followed by an end-line survey 24 months later. We observed health extension workers' consultations of sick 2–59 months old children. The analysis has evaluated if children with pneumonia, diarrhoea and malnutrition were assessed, classified and treated according to guidelines, and included difference-in-difference analyses. Results: We observed 1325 consultations of sick children. At baseline, 86% of the sick children with cough in the intervention areas and 85% in comparison areas were assessed according to the guidelines, without any change at end-line associated with the intervention (difference-in-difference = -21%, p = 0.55). Sixty-two percent of children were assessed for dehydration at baseline in intervention and 47% in comparison areas, with no improvement associated with the intervention. Similarly, 87% of sick children in intervention and 91% in comparison areas were assessed for malnutrition, with no change over time associated with the intervention (difference-in-difference = 5%, p = 0.16). Appropriate pneumonia treatment with antibiotics declined and diarrhea treatment increased in both areas. Half of the malnourished children received ready-to-use therapeutic foods without any improvement associated with the intervention. Conclusion: The intervention was not associated with improved quality of the health extension workers' management of sick children. The lack of association may be linked to low fidelity in the implementation of the intervention. Our findings suggest that training healthcare providers without continued clinical mentoring and support does not improve the quality of care. Community-based programs can be strengthened by ensuring high coverage and continued clinical mentorships, supportive supervision, and supply of medicines and other essential commodities. Trial registration number: ISRCTN12040912, retrospectively registered on 19/12/ 2017. [ABSTRACT FROM AUTHOR]

Background: Loss to follow-up from lifelong antiretroviral therapy continued to be a major challenge affecting virtual elimination of mother-to-child transmission of human immunodeficiency virus, especially in Sub-Saharan Africa. Although there was a study conducted in Ethiopia, loss to follow-up was not clearly defined and some important variables were not addressed. Thus, this study was conducted to determine the incidence of loss to follow-up and its predictors among women on option B+ lifelong antiretroviral therapy program in Pawi district health facilities, northwest Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among 365 women who were enrolled for option B+ prevention of mother-to-child transmission service between June 2013 and March 2021 in Pawi district health facilities. A standard pretested checklist was used to extract data from all eligible women's records. The Kaplan–Meier survival curve for estimating survival probability and Cox proportional hazards model to identify independent predictors of loss to follow-up were employed after checking for proportional hazards assumptions using STATA-14 statistical software. Result: The overall incidence of loss to follow-up was 12.04 (95% CI: 9.50, 15.20) per 1000 person-months of observation time. Residing outside the catchment area (adjusted hazard ratio (AHR): 3.08, 95% CI: 1.59, 5.98), lactating at enrollment (AHR: 2.43, 95% CI: 1.24, 4.77), living in a sero-discordant relationship (AHR: 2.5, 95% CI: 1.13, 5.53), lack of sero-status disclosure (AHR: 2.59, 95% CI: 1.15, 5.85), new enrollment to lifelong antiretroviral therapy (AHR: 2.07, 95% CI: 1.05, 4.11), and fair (AHR: 2.69, 95% CI: 1.2, 6.04) or poor (AHR: 5.78, 95% CI: 2.76, 12.12) antiretroviral drug adherence level were independent predictors of loss to follow-up. Conclusion: We found a higher incidence of loss to follow-up relative to previous studies in Ethiopia. Thus, strengthening adherence support interventions, and effective counseling on sero-status disclosure and male partner involvement are important to retain women in care. [ABSTRACT FROM AUTHOR]

Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the concordance between the American College of Radiology TI-RADS (ACR TI-RADS) and fine needle aspiration cytology (FNAC), (2) the cancer rate in the ACR TI-RADS categories, (3) the characteristics of nodules evaluated by FNAC even if not formally indicated according to ACR TI-RADS ('not indicated FNACs"). Methods: From January 2021 to September 2022, patients attending the Endocrinology Unit of the CTO Hospital of Rome for evaluation of thyroid nodules were included. Results: 830 nodules had negative cytology, belonging to TIR2 and TIR1C. One hundred and thirteen nodules were determined to be suspicious for or consistent with malignancy belonging to TIR3B/TIR4/TIR5. Of this last group, 94% were classified as TR4/TR5 nodules. In total, 87/113 underwent surgery. Among these, 73 had histologically proven cancer, 14 turned out to be benign. "Not indicated FNACs" was 623. Among these, 42 cancers were present. Conclusions: This study confirmed the diagnostic power of ACR TI-RADS. In addition, these data suggest revising the ACR TI-RADS indication to FNAC, especially for TR4. [ABSTRACT FROM AUTHOR]

Podocytes are terminally differentiated epithelial cells in glomeruli. Podocyte injury and loss are features of many diseases leading to chronic kidney disease (CKD). The developmental origins of health and disease hypothesis propose an adverse intrauterine environment can lead to CKD later in life, especially when a second postnatal challenge is experienced. The aim of this study was to examine whether a suboptimal maternal environment would result in reduced podocyte endowment, increasing susceptibility to diabetes‐induced renal injury. Female C57BL/6 mice were fed a low protein diet (LPD) to induce growth restriction or a normal protein diet (NPD) from 3 weeks before mating until weaning (postnatal Day 21, P21) when nephron and podocyte endowment were assessed in one male and one female offspring per litter. Littermates were administered streptozotocin or vehicle at 6 weeks of age. Urinary albumin excretion, glomerular size, and podometrics were assessed following 18 weeks of hyperglycemia. LPD offspring were growth restricted and had lower nephron and podocyte number at P21. However, by 24 weeks the podocyte deficit was no longer evident and despite low nephron endowment neither albuminuria nor glomerulosclerosis were observed. Podocyte number was unaffected by 18 weeks of hyperglycemia in NPD and LPD offspring. Diabetes increased glomerular volume reducing podocyte density, with more pronounced effects in LPD offspring. LPD and NPD diabetic offspring developed mild albuminuria with LPD demonstrating an earlier onset. LPD offspring also developed glomerular pathology. These findings indicate that growth‐restricted LPD offspring with low nephron number and normalized podocyte endowment were more susceptible to alterations in glomerular volume and podocyte density leading to more rapid onset of albuminuria and renal injury than NPD offspring. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia. METHOD: Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P-value less than .05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD). RESULT: The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.238.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)). CONCLUSÍON: Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD. [ABSTRACT FROM AUTHOR]

The immunosuppressive tumour microenvironment (TME) plays a critical role in cancer progression and relapse by significantly influencing cancer pathogenesis through autocrine and paracrine signalling. Trefoil factor 3 (TFF3), a secreted protein, has been implicated in modulating the TME to promote cancer advancement. Herein, we investigated the potential association between TFF3 and key immunosuppressive TME components to distinguish a co-targetable oncotherapeutic strategy. The TFF3-PVRL2 association were identified and investigated by integrating multiple bioinformatic-tools. The virtual compound screening for PVRL2 inhibitors was done with EasyVS. The TFF3-PVRL2 protein-level correlation was validated by immunoblotting, and the effectiveness of co-inhibiting TFF3 and PVRL2 was assessed using siRNA and AMPC (a TFF3 inhibitor). Analysis of the TISIDB database revealed a positive correlation between TFF3 and PVRL2 mRNA levels across multiple cancer types. This correlation was confirmed at the protein level through immunoblot analysis. Further evaluation using TCGA pan-cancer datasets demonstrated that TFF3 and PVRL2 interact to establish an immunosuppressive TME, promoting cancer progression in BRCA, LUAD, PAAD, PRAD, and STAD. Enrichment analyses of positively correlated genes, PPI network hub proteins, and ceRNA networks involving TFF3 and PVRL2, conducted using LinkedOmics, STRING, and Cytoscape, provided insights into their potential co-functions in cancer. A cell-based assay was performed to evaluate the combined therapeutic efficacy of targeting both, TFF3 and PVRL2 and virtual screening identified potential drugs for inhibiting PVRL2. PVRL2 has emerged as a promising immunoinhibitory target with significant associations with TFF3 and represents a key co-targetable molecule for effective oncotherapeutic strategies. [Display omitted] • Elevated TFF3 expression is positively correlated with changes in immunosuppressive TME, thereby progressing tumour. • TFF3 and PVRL2 both contribute to an immunosuppressive TME and disease progression. • In vitro analyses confirmed a positive association between TFF3 and PVRL2 in multiple cancers. • Co-targeting TFF3 and PVRL2 has emerged as an effective and promising strategy for cancer treatment [ABSTRACT FROM AUTHOR]

Background: Stillbirth is an unfavorable outcome of pregnancy, which is still prevalent in many countries despite remarkable efforts made to improve the care of pregnant women. While producing estimates consistent with other national reports, all are hindered by limited data and important causes of death are likely to be missed. However; there is a scarcity of data on stillbirth in Ethiopia particularly in the Wolaita zone. Objective: To assess the prevalence and associated factors of stillbirth among women giving birth at public hospitals in the Wolaita zone, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted in public hospitals in the Wolaita zone. A stratified sampling technique was used to select 737 women. A pre-tested interviewer-administered questionnaire was used for data collection. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20. Bivariate and multiple logistic regression analysis were used and the crude and adjusted odds ratios at a 95% confidence interval with P-value <0.05 were considered to declare the result as statistically significant. Result: This study reported an 8.7% [95% CI: 6.5–10.8] prevalence of stillbirth. Women who lived in rural areas, had pregnancy and labor complications, a high number of pregnancies, a prior history of stillbirth, and a complicated delivery were associated with stillbirth. When compared to urban residents, being a rural resident increased the risk of stillbirth by 2.57 fold [adjusted OR = 2.57, 95% CI: 1.23, 5.40]. When compared to their counterparts, women who experienced complications during pregnancy and labor increased 6.23 fold [AOR = 6.23, 95% CI: 2.67–14.58], having a previous history of stillbirth increased 6.89 fold [AOR = 6.89, 95% CI: 2.57–13.57], and the type of delivery increased 7.13 fold the risk of stillbirth [AOR = 7.13, 95% CI: 2.71–18.73]. Conclusion and recommendation: The prevalence of stillbirth among women who gave birth in public hospitals in the Wolaita zone was found to be high compared to national and regional figures. Therefore, the federal and regional governments should strengthen inter-sectoral collaboration with health facilities to promote the maternal and health care services utilization. The zonal health department and other concerned bodies should focus on the implementation of the strategies and policies that address and reduce the causes of stillbirth. [ABSTRACT FROM AUTHOR]

Background: Diabetes has emerged as one of the most serious health issues of the twenty-first century. Diabetes and its complications expose individuals and their families to catastrophic healthcare costs, which have a severe impact on the country's economy. Though the prevalence of diabetes is rising quicker in Ethiopia, little is known about its economic impact. Hence, this study aimed to determine the total cost of diabetic mellitus and associated factors among patients attending hospitals in Southwest Shewa zone, Central Ethiopia.Methods: The study was conducted among diabetes patients who were on care and treatment from September to October 2020. Direct costs were calculated using the micro-costing technique, while indirect costs were calculated using the human capital approach. The statistical significance of cost difference between the groups of patient characteristics was determined using Wilcoxon and Kruskal-Wallis mean rank sum tests, and the factors associated with a total cost of illness were identified with Generalized Linear Model (GLM).Results: Out of the planned patients, 398 have responded and were included in the analysis; making a response rate of 98.5%. The mean monthly total cost of diabetic mellitus was US$ 37.7(95% CI, 23.45-51.95). Direct and indirect costs constituted 76.2% and 23.8% of the total cost, respectively. The mean direct and indirect cost of diabetic mellitus per patient per month was US$ 28.73(95% CI, 17.17-40.29) and US$ 9.50 (95% CI, 1.99-16.99) respectively. Statistical mean cost differences were observed by gender, age groups, family size, and comorbidities. The total cost of illness was associated with residence (p=0.007), family size (p=0.001), presence of co-morbidities (p=0.04), and history of ever-stopping treatments (p<0.0001).Conclusions: The total cost of diabetes condition was relatively high compared to other related literatures. The medical expenditures accounted for most direct costs for diabetic patients. As a result, the government should provide sufficient resources to safeguard patients against catastrophic medical costs. Efforts should be made to enhance access to diabetes care, and the supply of diabetic medications at all levels of health facilities. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress disorder (PTSD) is a chronic, impairing mental disorder that develops after exposure to a traumatic event. Despite many factors putting adolescent girls at risk of PTSD, little is known about the prevalence and how adolescent girls cope with the PTSD burden. So, this study aimed to investigate the prevalence of PTSD and associated factors among adolescent girls in three selected towns in Southwest Ethiopia. Methods: A community-based cross-sectional study was conducted among 397 adolescent girls from May 27 to July 27, 2021. The participants were selected by a systematic random sampling method. PTSD and substance use disorder were assessed by DSM V criteria for mental disorders. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD. Results: The prevalence of PTSD among the adolescent girls was 22%, and about three in four (72.7%) of the adolescent girls developed PTSD after exposure to sexual violence. Furthermore, PTSD was associated with Khat use disorder (AOR, 95% CI: 2.79 (1.47– 5.30), alcohol use disorder (AOR, 95% CI: 5.27 (2.21– 12.60), and suicidal behavior (AOR, 95% CI: 2.12 (1.20– 3.74)). Conclusion: The prevalence of PTSD was high among adolescent girls, and suicidal ideation or attempt, khat use disorder, and alcohol use disorder were risk factors for PTSD. Therefore, early screening for PTSD and comorbid risk factors among this particular age group and managing accordingly is warranted. [ABSTRACT FROM AUTHOR]

Ethiopia has the second-largest youth population in Africa with about 37.4 million people aged 10–24 years. To meet the needs of this population group, adolescent, and youth health (AYH) programs, including those focused on sexual and reproductive health (SRH) and youth development, have gained traction in Ethiopia in the last two decades, especially following the 2005 election in Ethiopia. However, adolescents and youths in Ethiopia continue to face a high burden of morbidity and mortality from multiple factors including, teenage pregnancy, unplanned pregnancy, compromised nutrition, HIV and STIs, unsafe abortion, early and child marriage, and unmet needs for family planning. To date, adolescents and youth-related interventions in Ethiopia are fragmented under various ministries, uncoordinated, underfunded, project-oriented, lack effective policy implementation, and lack meaningful participation of young people. Addressing adolescents and youth health and development issues require evidence-based, well-tailored, at scale, intensified, coordinated, and holistic national responses. Therefore, there is a need to advocate for a realization of robust government commitment to ensure a multi-sectoral, coordinated, at scale, and well-funded national response to address the multifaceted needs of young people in Ethiopia including their sexual and reproductive health. An example to emulate is the HIV/AIDS response in Ethiopia, which was led by a national council chaired by the President of the Federal Democratic Republic of Ethiopia and spearheaded by a secretariat leveraging resources and implementing a multisectoral national plan down to the kebele level. [ABSTRACT FROM AUTHOR]

The electrical activity produced during the heartbeat is measured and recorded by an ECG. Cardiologists can interpret the ECG machine's signals and determine the heart's health condition and related causes of ECG signal abnormalities. However, cardiologist shortage is a challenge in both developing and developed countries. Moreover, the experience of a cardiologist matters in the accurate interpretation of the ECG signal, as the interpretation of ECG is quite tricky even for experienced doctors. Therefore, developing computer-aided ECG interpretation is required for its wide-reaching effect. 12-lead ECG generates a 1D signal with 12 channels among the well-known time-series data. Classical machine learning can develop automatic detection, but deep learning is more effective in the classification task. 1D-CNN is being widely used for CVDS detection from ECG datasets. However, adopting a deep learning model designed for computer vision can be problematic because of its massive parameters and the need for many samples to train. In many detection tasks ranging from semantic segmentation of medical images to time-series data classification, multireceptive field CNN has improved performance. Notably, the nature of the ECG dataset made performance improvement possible by using a multireceptive field CNN (MRF-CNN). Using MRF-CNN, it is possible to design a model that considers semantic context information within ECG signals with different sizes. As a result, this study has designed a multireceptive field CNN architecture for ECG classification. The proposed multireceptive field CNN architecture can improve the performance of ECG signal classification. We have achieved a 0.72 F 1 score and 0.93 AUC for 5 superclasses, a 0.46 F 1 score and 0.92 AUC for 20 subclasses, and a 0.31 F 1 score and 0.92 AUC for all the diagnostic classes of the PTB-XL dataset. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV) and almost one-third of deaths in the world are attributed to it and many of these deaths occur in developing countries. Despite these evidences, after the implementation of universal test and treat (UTT) strategy, information regarding the incidence and predictors of tuberculosis among PLHIV is limited in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of tuberculosis among patients enrolled in Anti-Retroviral Therapy (ART) after universal test and treat program at St. Peter hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods: Institutional-based retrospective cohort study was conducted from November 1 to 30, 2020. Simple random sampling was used to select a total of 539 adults records which was enrolled on ART. Data was collected and entered into EPI DATA 3.1 and analyzed using STATA version 14.1. Time-to-event distributions were estimated using Kaplan–Meier estimates. Hazards across different categories were compared using log-rank tests. Predictors were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. Variables having P-value < 0.05 from the multivariable analysis were considered as a statistically significant. Result: Among 539 records reviewed, 529 (98%) were included in the final analysis. The total follow-up period was 1529 Person-Year (PY). The incidence rate in this cohort was found to be 4.84 per 100-person year (95%CI,3.83–6.11). CD4 count<200 (AHR: 3.14,95% CI:1.64–7.10), poor adherence (AHR:2.16, 95% CI:1.21–3.85), underweight (AHR:2.42, 95% CI: 1.30–4.51), not taking isoniazid prophylaxis therapy (AHR: 2.78,95% CI: 1.06–7.30), being bedridden 3.06; (AHR: 3.06, 95% CI: 1.50–6.24), and baseline WHO stage three or four (AHR:2.33, 95% CI:1.08–5.02) were independent predictors for the incidence of TB among HIV positive patients. Conclusion: In this study, the incidence of tuberculosis is relatively low as compared to studies done before the initiation of test and treat program in Ethiopia. low CD4count, poor level of adherence, low BMI, not taking IPT prophylaxis, bedridden functional status, and being on baseline WHO stage III or IV were found to increase the hazard of tuberculosis. Hence, close follow up, reminders, surveillance, and tracing mechanisms targeting this higher risk group would decrease Tuberculosis among PLHIV. [ABSTRACT FROM AUTHOR]

State-of-the-art nanomechanical resonators are heralded as a central component for next-generation clocks, filters, resonant sensors, and quantum technologies. To practically build these technologies will require monolithic integration of microchips, resonators, and readout systems. While it is widely seen that mounting microchip substrates into a system can greatly impact the performance of high-Q resonators, a systematic study has remained elusive, owing to the variety of physical processes and factors that influence the dissipation. Here, we analytically analyze a mechanism by which substrates couple to resonators manufactured on them and experimentally demonstrate that this coupling can increase the mechanical dissipation of nanomechanical resonators when resonance frequencies of resonator and substrate coincide. More generally, we then show that a similar coupling mechanism can exist between two adjacent resonators. Since the substrate–mode coupling mechanism strongly depends on both the resonator position on the substrate and the mounting of the substrate, this work provides key design guidelines for high-precision nanomechanical technologies. [ABSTRACT FROM AUTHOR]

Introduction. Pathogenic Escherichia coli strains cause diarrheal infection in children due to their virulence factors. A nonanalytical observational study followed by a purposive sampling technique was conducted from October 2017 to June 2018, to determine the antimicrobial susceptibility patterns and molecularly detect pathogenic Escherichia coli strains in under-five children at Wolaita Sodo town using molecular and the Kirby-Bauer disc diffusion method. Result. In the current investigation, out of 110 stool samples, Escherichia coli was isolated in 68 (61.8%) (95% CI: 52.1–70.9%). Out of 68 Escherichia coli isolates, 61.9% of Escherichia coli isolates were resistant, 9.4% were intermediately resistant, and 28.7% were susceptible. Among the antimicrobial agents, 91.2% of Escherichia coli isolates were highly sensitive to ciprofloxacin followed by norfloxacin (86.8%). Virulence genes were detected in 55.9% (38/68) (95% CI 52.1%–70.9%) of isolates. The following genes were detected: stx1 (6 (8.8%)), stx2 (4 (5.9%)), eaeA (5 (7.4%)), eaat (14 (20.5%)), and St (4 (5.9%)). Out of 68 Escherichia coli isolates, 43 (63.2%) isolates had shown multidrug resistance patterns. Furthermore, 11.8% of Escherichia coli isolates had shown resistance to eight different drugs. The multidrug resistance index value of Diarrheagenic Escherichia coli pathotypes was greater than or equal to 0.4, which indicates the high risk of resistance. Conclusion. This study demonstrated important pathogenic Escherichia coli strains and multidrug resistance in isolates containing virulence genes. Wise use of antimicrobials and improving the hygienic practices amongst parents of children reduce its occurrence. Therefore, appropriate usage of antimicrobial agents should also be highly practiced in hospitals. [ABSTRACT FROM AUTHOR]

This study examined the causes of mental health problems among urban residents in Bahir Dar City Administration. To achieve the objectives, data were gathered from residents, psychologists, psychiatrists, and medical doctors through deep interviews. The qualitative analysis of the data gathered through interviews revealed that mental health problem is prevalent and linked with social, psychological, and economic factors and female and the adult population was disposed to the mental health problem than the remaining populations. Based on the findings conclusions and possible recommendations were also forwarded. [ABSTRACT FROM AUTHOR]

Intrinsic and effective rate constants have an important role in the theory of diffusion-limited reactions. In a previous paper, we provide detailed microscopic expressions for these intrinsic rates [A. Vijaykumar, P. G. Bolhuis, and P. R. ten Wolde, Faraday Discuss. 195, 421 (2016)], which are usually considered as abstract quantities and assumed to be implicitly known. Using these microscopic expressions, we investigate how the rate of association depends on the strength and the range of the isotropic potential and the strength of the non-specific attraction in case of the anisotropic potential. In addition, we determine the location of the interface where these expressions become valid for anisotropic potentials. In particular, by investigating the particles' orientational distributions, we verify whether the interface at which these distributions become isotropic agrees with the interface predicted by the effective association rate constant. Finally, we discuss how large the intrinsic association rate can become, and what are the consequences for the existence of the diffusion limited regime. [ABSTRACT FROM AUTHOR]

We report experimental results showing how the noise in a Quantum-Dot Infrared photodetector (QDIP) and Quantum Dot-in-a-well (DWELL) varies with the electric field and temperature. At lower temperatures (below ~100 K), the noise current of both types of detectors is dominated by generation-recombination (G-R) noise which is consistent with a mechanism of fluctuations driven by the electric field and thermal noise. The noise gain, capture probability, and carrier life time for bound-to-continuum or quasi-bound transitions in DWELL and QDIP structures are discussed. The capture probability of DWELL is found to be more than two times higher than the corresponding QDIP. Based on the analysis, structural parameters such as the numbers of active layers, the surface density of QDs, and the carrier capture or relaxation rate, type of material, and electric field are some of the optimization parameters identified to improve the gain of devices. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a disease that imposes risks of diseases on multi-system. Failure to control hypertension leads patients to end up with unavoidable complications, including death. Noncompliance to treatment is the main factor to develop such devastating complications whereas knowledge of patients about their disease is a key factor for better compliance. Thus, the purpose of this study is to assess the level of knowledge about hypertension and associated factors among hypertensive patients in public health facilities of Gondar city. Methods: Facility-based cross-sectional study was conducted between March and April 2019 in Gondar town. A systematic sampling technique was applied to select a total of 389 patients. A structured interview questionnaire was used to gather the data. The data were analyzed using STATA version 14. Ordinal logistic regression analysis was performed at P < 0.05 with a 95% confidence interval to identify statistically significant variables. Results: A total of 385 respondents participated giving a response rate of 98.9%. The majority (55.3%) of the patients had a low level of, 17.9% had a moderate level of knowledge whereas 26.8% had a high level of knowledge about hypertension. Those working in government organizations had 5.5 times higher odds of having a high level of knowledge than other groups (AOR = 5.5; 95%CI = 1.21, 25). Patients who received longer than four years of treatment showed twice larger odds of knowledge than those with below two years of treatment (AOR = 2; 95%CI = 1.29, 3.22) Moreover, patients residing proximate to the hospital increases the odds of having a higher level of knowledge by 1.64 times versus patients living far away from the hospital (AOR = 1.64, 95% CI = 1.07–2.63). Conclusions: This finding revealed that knowledge about hypertension and risk factors among patients with hypertension was low. Employment in governmental organizations, longer duration of treatment, and residential proximity to hospitals/ health centers were statistically significant predictors of the participants' knowledge about hypertension. Therefore, it is important to give health education to patients working in non-governmental organizations and self-employed individuals about diseases and risk factors. In addition, emphasis should be given to patients receiving less than two years of treatment and coming from remote areas to improve their knowledge of the disease. [ABSTRACT FROM AUTHOR]

Ethiopia has the second-largest youth population in Africa with about 37.4 million people aged 10–24 years. To meet the needs of this population group, adolescent, and youth health (AYH) programs, including those focused on sexual and reproductive health (SRH) and youth development, have gained traction in Ethiopia in the last two decades, especially following the 2005 election in Ethiopia. However, adolescents and youths in Ethiopia continue to face a high burden of morbidity and mortality from multiple factors including, teenage pregnancy, unplanned pregnancy, compromised nutrition, HIV and STIs, unsafe abortion, early and child marriage, and unmet needs for family planning. To date, adolescents and youth-related interventions in Ethiopia are fragmented under various ministries, uncoordinated, underfunded, project-oriented, lack effective policy implementation, and lack meaningful participation of young people. Addressing adolescents and youth health and development issues require evidence-based, well-tailored, at scale, intensified, coordinated, and holistic national responses. Therefore, there is a need to advocate for a realization of robust government commitment to ensure a multi-sectoral, coordinated, at scale, and well-funded national response to address the multifaceted needs of young people in Ethiopia including their sexual and reproductive health. An example to emulate is the HIV/AIDS response in Ethiopia, which was led by a national council chaired by the President of the Federal Democratic Republic of Ethiopia and spearheaded by a secretariat leveraging resources and implementing a multisectoral national plan down to the kebele level. [ABSTRACT FROM AUTHOR]