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How does the Church in Ghana address the growing concerns of health care delivery especially among the Ghana-Eυe from the perspective of Christianity? This is the question that this study sought to answer. Using literature research, this paper argued that holistic Christian health care is nothing short of ᶑagbε in the Eυe context. ᶑagbε is holistic well-being. Holistic well-being can hardly be separated from the salvation that Jesus offers. At his incarnation, Jesus brought the gospel of the kingdom of God/kingdom of heaven as holistic well-being for human benefit. While preaching his holistic gospel, Jesus also healed and taught people. His spectacular healing ministry and other deeds did not prove his divine sonship or messiahship but attested to the fact that in his life and ministry, the kingdom of God/heaven had come in power and glory. In Jesus then, one finds the full realisation of God’s ᶑagbε to heal the human body, soul and spirit. The study contributes to scholarship in helping to indigenize the meaning of salvation in the Eυe context. This wades into the debate on inculturation theology in Africa.

The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges.

ABSTRACT Introduction As countries adapted their disaster responses to the COVID‐19 pandemic, South Africa responded with an alert‐level risk approach based on epidemiological principles that impacted all societal levels. We explored the everyday experiences of people in Cape Town whose basic needs were met and who could report on the realities of the COVID‐19 pandemic control. Gaining insight into their perspectives contributes to knowledge that can inform policies and practices for managing future public health crises. Methods Community‐Based Participatory Research principles guided the design and a series of facilitated dialogues with 18 research participants. The thematic analysis was deepened through two colloquiums with members of an overarching research consortium and a participant reflection workshop. Findings The pandemic impacted individuals, their interpersonal relationships, workplaces and communities, leading to societal processes such as stigma, virtue signalling and the subversion of mandates. The public health response had mixed reactions, with useful information about preventive measures being diluted by COVID‐19 denialism and fake news. Health and other authorities were frequently perceived as out of touch with, and unresponsive to, the everyday realities of local communities. Conclusions Our study demonstrates the connectedness of people and the need to maintain and re‐establish severed connections. A holistic approach to health care and promotion from social determinants of health and a community‐engaged perspective may significantly increase the outcomes of public health responses. Participant and Public Contribution People with everyday experience of the COVID‐19 pandemic—including community members, healthcare workers, case managers, carers and researchers—collaborated on the study design, interview schedule, data interpretation, analysis and refinement of this article.

Abstract Compared with the extensively used ester‐based electrolyte, the hard carbon (HC) electrode is more compatible with the ether‐based counterpart in sodium‐ion batteries, which can lead to improved cycling stability and robust rate capability. However, the impact of salt anion on the electrochemical performance of HC electrodes has yet to be fully understood. In this study, the anionic chemistry in regulating the stability of electrolytes and the performance of sodium‐ion batteries have been systematically investigated. This work shows discrepancies in the reductive stability of the anionic group, redox kinetics, and component/structure of solid electrolyte interface (SEI) with different salts (NaBF4, NaPF6, and NaSO3CF3) in the typical ether solvent (diglyme). Particularly, the density functional theory calculation manifests the preferred decomposition of PF6− due to the reduced reductive stability of anions in the solvation structure, thus leading to the formation of NaF‐rich SEI. Further investigation on redox kinetics reveals that the NaPF6/diglyme can induce the fast ionic diffusion dynamic and low charge transfer barrier for HC electrode, thus resulting in superior sodium storage performance in terms of rate capability and cycling life, which outperforms those of NaBF4/diglyme and NaSO3CF3/diglyme. Importantly, this work offers valuable insights for optimizing the electrochemical behaviors of electrode materials by regulating the anionic group in the electrolyte.

Reproductive coercion (RC) is any intentional behavior that interferes with another’s reproductive decision-making or pregnancy outcome. This study aims to qualitatively examine RC experiences and perceptions among women and men in Ethiopia, Nigeria (Kano and Anambra States), and Uganda. This is a secondary analysis utilizing qualitative data from the Women’s and Girls’ Empowerment in Sexual and Reproductive Health study. Across sites, focus group discussions (38 groups; n=320 participants) and in-depth interviews (n=120) were conducted, recorded, and transcribed. Transcripts were loaded into Atlas.ti, and quotes describing experiences of reproductive control or abuse were coded as “reproductive coercion.” RC quotes were input into a matrix for thematic analysis. Emergent RC themes included indirect reproductive pressures, direct family planning interference, concurrent experiences of violence, and responses to RC. Indirect reproductive pressures included tactics to both promote and prevent pregnancy, while direct interference centered on pregnancy promotion. Women who were not compliant with their partners’ reproductive demands were often subjected to violence from multiple actors (i.e., parents, in-laws, community members) in addition to their partners. Despite concurrent forms of violence, women across sites resisted RC by using contraceptives covertly, choosing to abort, or leaving their abusive partnerships. Women and men across sites indicated that men were highly influential in fertility. RC behaviors were a mechanism of control over desired reproductive outcomes, which were often rooted in perceptions of childbearing as social status. Findings indicate a need for more nuanced community interventions targeting social norms, as well as improved RC screening and response within health services.

It is increasingly common for seismic networks to operate multiple independent automatic algorithms to characterise earthquakes in real-time, such as in earthquake early warning (EEW) or even standard network practice. Commonly used methods to select the best solution at a given time are simple and use ad hoc rules. An absolute measure of how well a solution (event origin and magnitude) matches the observations by the goodness-of-fit between the observed and predicted envelopes is a robust and independent metric to select optimal solutions. We propose such a measure that is calculated as a combination of amplitude and cross-correlation fit. This metric can be used to determine when a preferred solution reaches an appropriate confidence level for alerting, or indeed to compare two (or more) different event characterisations directly. We demonstrate that our approach can also be used to suppress false alarms commonly seen at seismic networks. Tests using the 10 largest earthquakes in Switzerland between 2013 and 2020, and events that caused false alarms demonstrate that our approach can effectively prefer solutions with small errors in location and magnitude, and can clearly identify and discard false origins or incorrect magnitudes, at all time scales, starting with the first event characterisation.

With the rapid growth in renewable energy, researchers worldwide are trying to expand energy storage technologies. The development of beyond-lithium battery technologies has accelerated in recent years, amid concerns regarding the sustainability of battery materials. However, the absence of suitable high-performance materials has hampered the development of the next-generation battery systems. MXenes, a family of 2D transition metal carbides and/or nitrides, have drawn significant attention recently for electrochemical energy storage, owing to their unique physical and chemical properties. The extraordinary electronic conductivity, compositional diversity, expandable crystal structure, superior hydrophilicity, and rich surface chemistries make MXenes promising materials for electrode and other components in rechargeable batteries. This report especially focuses on the recent MXene applications as novel electrode materials and functional separator modifiers in rechargeable batteries beyond lithium. In particular, we highlight the recent advances of surface and structure engineering strategies for improving the electrochemical performance of the MXene-based materials, including surface termination modifications, heteroatom doping strategies, surface coating, interlayer space changes, nanostructure engineering, and heterostructures and secondary materials engineering. Finally, perspectives for building future sustainable rechargeable batteries with MXenes and MXene-based composite materials are presented based upon material design and a fundamental understanding of the reaction mechanisms.

The series, ‘Mastering your Fellowship’, provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians (South Africa) (FCFP [SA]) examination. The series is aimed at helping family medicine registrars (and their supervisors) in preparing for this examination.

Many speculated that COVID-19 would severely restrict the delivery of essential health services, including family planning (FP), but evidence of this impact is limited, partly due to data limitations. We use cross-sectional data collected from regional and national samples of health facilities (n = 2,610) offering FP across seven low- and middle-income countries (LMICs) between 2019 and 2021, with longitudinal data from four geographies, to examine reported disruptions to the FP service environment during COVID-19, assess how these disruptions varied according to health system characteristics, and evaluate how disruptions evolved throughout the first two years of the pandemic, relative to a pre-pandemic period. Findings show significant variation in the impact of COVID-19 on facility-based FP services across LMICs, with the largest disruptions to services occurring in Rajasthan, India, where COVID-19 cases were highest among geographies sampled, while in most sub-Saharan African settings there were limited disruptions impacting FP service availability, method provision, and contraceptive supplies. Facility-reported disruptions to care were not reflected in observed changes to the number of FP clients or types of stockouts experienced in the first two years of the pandemic. Public and higher-level facilities were generally less likely to experience COVID-19-related disruptions to FP services, suggesting policy mitigation measures-particularly those implemented among government-operated health facilities-may have been critical to ensuring sustained delivery of reproductive healthcare during the pandemic.

This article proposes to explore the concept of videogames rules by Salen and Zimmerman through the work of Yoko Ono, specifically the event scores or performative instructions published in Grapefruit (2000 [1964]). To do so, the authors have created an interactive experience based on four event scores' rules where gameplay emerges from their direct application. The project is contextualized through those rules and the differences between Ono's work and Fluxus. The return on the creative act reveals an innovative approach outside of the imperatives of "fun," privileging an embracing of errors and incertitude.

Abstract Background Community-based programmes [CBPs], targeting increased physical activity and/or healthier eating, have been used in the prevention and management of non-communicable diseases. However, CBPs are only useful, insofar as they can be scaled up and sustained in some meaningful way. Social networks—defined as “social structures that exists between actors, individuals or organizations”—may serve as an important tool to identify underlying mechanisms that contribute to this process. This scoping review aimed to map and collate literature on the role of social network research in scaling-up and sustaining physical activity and/or diet CBPs in low-and middle-income countries [LMICs]. Methods Arksey and O’Malley’s framework and its enhancement were followed. Inclusion criteria were peer-reviewed articles exploring the role of social networks in scaled-up and/or sustained physical activity and/or diet CBPs in adult populations, published in English since 2000, and based in a LMIC. Databases searched were PubMed, Cochrane, Scopus, Web of Science, CINAHL, SocIndex, International Bibliography of the Social Sciences, and Google Scholar. Books, conference abstracts, and programmes focused on children were excluded. Two reviewers independently selected and extracted eligible studies. Included publications were thematically analysed using the Framework Approach. Results Authors identified 12 articles for inclusion, covering 13 CBPs. Most were based in Latin America, with others in the Caribbean, the Pacific Islands, Iran, and India. All articles were published since 2009. Only three used social network analysis methods (with others using qualitative methods). Five main social network themes were identified: centralisation, cliques, leaders, quality over quantity, and shared goals. Contextual factors to be considered when scaling-up programmes in LMICs were also identified. Conclusions This review has shown that the evidence of the use of social network research in programme scale-up has not yet caught up to its theoretical possibilities. Programmes aiming to scale should consider conducting social network research with identified network themes in mind to help improve the evidence-base of what network mechanisms, in what contexts, might best support the strengthening of networks in physical activity and diet programmes. Importantly, the voice of individuals and communities in these networks should not be forgotten.

Abstract In locally advanced rectal cancer (LARC) neoadjuvant chemoradiotherapy is regarded as standard treatment. We assessed acute toxicities in patients receiving conventional 3D-conformal radiotherapy (3D-RT) and correlated them with dosimetric parameters after re-planning with volumetric modulated arc therapy (VMAT). Patients were randomized within the multicenter CAO/ARO/AIO-12 trial and received 50.4 Gy in 28 fractions and simultaneous chemotherapy with fluorouracil and oxaliplatin. Organs at risk (OAR) were contoured in a standardized approach. Acute toxicities and dose volume histogram parameters of 3D-RT plans were compared to retrospectively calculated VMAT plans. From 08/2015 to 01/2018, 35 patients with LARC were treated at one study center. Thirty-four patients were analyzed of whom 1 (3%) was UICC stage II and 33 (97%) patients were UICC stage III. Grade 3 acute toxicities occurred in 5 patients (15%). Patients with acute grade 1 cystitis (n = 9) had significantly higher Dmean values for bladder (29.4 Gy vs. 25.2 Gy, p

Abstract Human-Building Interaction (HBI) is a convergent field that represents the growing complexities of the dynamic interplay between human experience and intelligence within built environments. This paper provides core definitions, research dimensions, and an overall vision for the future of HBI as developed through consensus among 25 interdisciplinary experts in a series of facilitated workshops. Three primary areas contribute to and require attention in HBI research: humans (human experiences, performance, and well-being), buildings (building design and operations), and technologies (sensing, inference, and awareness). Three critical interdisciplinary research domains intersect these areas: control systems and decision making, trust and collaboration, and modeling and simulation. Finally, at the core, it is vital for HBI research to center on and support equity, privacy, and sustainability. Compelling research questions are posed for each primary area, research domain, and core principle. State-of-the-art methods used in HBI studies are discussed, and examples of original research are offered to illustrate opportunities for the advancement of HBI research.

We use time-domain simulations of Jupiter observations to test and develop a beam reconstruction pipeline for the Simons Observatory Small Aperture Telescopes. The method relies on a mapmaker that estimates and subtracts correlated atmospheric noise and a beam fitting code designed to compensate for the bias caused by the mapmaker. We test our reconstruction performance for four different frequency bands against various algorithmic parameters, atmospheric conditions, and input beams. We additionally show the reconstruction quality as a function of the number of available observations and investigate how different calibration strategies affect the beam uncertainty. For all of the cases considered, we find good agreement between the fitted results and the input beam model within an ∼1.5% error for a multipole range ℓ = 30–700 and an ∼0.5% error for a multipole range ℓ = 50–200. We conclude by using a harmonic-domain component separation algorithm to verify that the beam reconstruction errors and biases observed in our analysis do not significantly bias the Simons Observatory r -measurement

Ethnic disharmony exists among the people of Ghana. What are the reasons for this? Ghana is an amalgamation of different ethnic groups, cultures, peoples and states to form one entity. The partition of Africa is mainly responsible for this, though there are other contributing factors. The project to partition Africa led, in large measure, to the erosion of the African identity. The 19th- and 20th-century European Christian mission to southern West Africa exploited this reality to their mission advantage. Unfortunately, the result seems to be counterproductive because the mission project, for the most part, produced a version of Christianity that failed to affirm the African identity. Concerned Africans, now on a mission to deconstruct the imperialist, European mission-constructed West African Christian identity, realise that biblical interpretation is one major source of this decolonial agenda. How does a mother-tongue reading of Ephesians 2 help decolonise Eυe Christianity and promote ethnic harmony in Ghana? Using mother-tongue biblical hermeneutics, this paper argues that the pursuit of ethnic harmony in Ghana is a decolonial hermeneutic with potential for fostering ethnic harmony in Ghana.

Abstract Background Despite of a multimodal approach, recurrences can hardly be prevented in glioblastoma. This may be in part due to so called glioma stem cells. However, there is no established marker to identify these stem cells. Methods Paired samples from glioma patients were analyzed by immunohistochemistry for expression of the following stem cell markers: CD133, Musashi, Nanog, Nestin, octamer-binding transcription factor 4 (Oct4), and sex determining region Y-box 2 (Sox2). In addition, the expression of osteopontin (OPN) was investigated. The relative number of positively stained cells was determined. By means of Kaplan–Meier analysis, a possible association with overall survival by marker expression was investigated. Results Sixty tissue samples from 30 patients (17 male, 13 female) were available for analysis. For Nestin, Musashi and OPN a significant increase was seen. There was also an increase (not significant) for CD133 and Oct4. Patients with mutated Isocitrate Dehydrogenase-1/2 (IDH-1/2) status had a reduced expression for CD133 and Nestin in their recurrent tumors. Significant correlations were seen for CD133 and Nanog between OPN in the primary and recurrent tumor and between CD133 and Nestin in recurrent tumors. By confocal imaging we could demonstrate a co-expression of CD133 and Nestin within recurrent glioma cells. Patients with high CD133 expression had a worse prognosis (22.6 vs 41.1 months, p = 0.013). A similar trend was seen for elevated Nestin levels (24.9 vs 41.1 months, p = 0.08). Conclusions Most of the evaluated markers showed an increased expression in their recurrent tumor. CD133 and Nestin were associated with survival and are candidate markers for further clinical investigation.

Objective: Interrupted time-series analyses, using 5 years of routinely collected health information system data, were conducted to estimate the magnitude of impact of the 2014–2015 Ebola virus disease (EVD) epidemic and determine trends in tuberculosis (TB) care services in Liberia. Methods: A segmented linear regression model was used to generate estimates and predictions for trends for three TB service indicators before, during, and after EVD, from January 2013 to December 2017. Results: It was found that the number of presumptive TB cases declined significantly at the start of the EVD outbreak, with an estimated loss of 3222 cases (95% confidence interval (CI) −5691 to −752; P = 0.014). There was also an estimated loss of 709 cases per quarter post-EVD (95% CI −1346 to −71; P = 0.032). However, over the post-EVD period, quarterly increases were observed in the proportion of smear-positive to presumptive cases (1.45%, 95% CI 0.38% to 2.5%; P = 0.011) and the proportion of treatment success to TB cases evaluated (3.3%, 95% CI 0.82% to 5.79%; P = 0.013). Conclusions: These findings suggest that the EVD outbreak (2014–2015) negatively affected TB care services. Rigorous quantitative analyses can be used to assess the magnitude of interruption and advocate for preparedness in settings with limited healthcare capacity.

The year 2022 created new challenges to our profession and to our lives. We used the unexpected struggles we have endured over the past two years as an encouragement to anticipate for the volatile and uncertain future. This pertains to the personal level, to the PSO-HNS and to the community we serve. To be triumphant, we need to amplify our voices about what matters in otolaryngologic health care, and to continually demonstrate how ORL-HNS research and training translate to the community and to the environment. Early this year, we spoke of this year’s battle cry: “Move Up and Forward.” I challenged all of us to upgrade some aspect of our lives, our profession, our colleagues, and our community. We have to “entrust ourselves to anything greater than ourselves.” The pandemic is certainly still here and we never cease to navigate these unforeseeable times. We still go on and constantly renew our professional aspirations and personal desires. We pray for more lustrous days and catch on from this experience so that we are better rehearsed and better equipped and all set for the next challenge. We keep the faith that we can make a difference and know that we can make longer strides. We have seen and dealt with challenges during this pandemic. We are overworked and worn out, we continue to struggle, and are figuring out how to stay focused and move forward. It is fitting for us to revitalize the energy that drives the PSO-HNS to be the amazing fellows for our country. Moving forward means using that “take the lead and earn the wings” attitude that we all have and applying it to our own profession. With these, I believe we have been made stronger. Our strength is made clear in being complacent with the bothersome and preparing for the unpredictable. This is taxing and demanding. We all need to continue to support one another for the years to come. The ORL-HNS specialty is unique and has trained us to be prepared for the unexpected. We will hold on and see it through, and we will reach out and keep in touch. We forge commitments to ourselves and to each other. A positive attitude is fundamental to be triumphant. We need to stay clear and confident; it will encourage others to be optimistic. This has not been the year that we had envisioned months ago, but it has been a year that has challenged us in ways we could not have foreseen. We acknowledge the challenge and remain energetic. We do not know why things happen the moment they occur, but we believe that there is a reason and that we must have faith, hope, and trust in the journey of life. We cannot live freely and thrive by living in the past. We must move up and forward. With that goal in mind, if we push everyone forward and move up toward our highest hopes and aspirations, the momentum of the PSO-HNS community will build toward positive change. It starts for each of us today. Find your compass and prove to yourself that constancy pays off. Choose your journey, choose your battles and follow your dreams. Let’s keep challenging one another to Move Up and Forward. Stay organized, have a purpose and be the best version of yourself.

This article proposes an analysis of recent alternative video games through the particularities of industrial music’s aesthetics. Considering a massive increase in video game production by solo designers since 2015, the author identifies how singular practices of game creation can be inspired by underground art forms. To further this research, five game developers were invited to participate through interviews: Yames, Selfish Dream, Valerie Dusk, Stef Pinto and Andrea Pignataro. The article proposes an analysis of the common production strategies between industrial culture and these game creators, more precisely by studying the singular use of noise in their games (audio but also visual and spatial) and how their creations act as noise in the context of the dominant video game industry by weakening its core definitions of what games are and the technocentrist history of the medium.

Enterotoxigenic Escherichia coli (ETEC) are common causes of infectious diarrhea among young children of low-and middle-income countries (LMICs) and travelers to these regions. Despite their significant contributions to the morbidity and mortality associated with childhood and traveler’s diarrhea, no licensed vaccines are available. Current vaccine strategies may benefit from the inclusion of additional conserved antigens, which may contribute to broader coverage and enhanced efficacy, given their key roles in facilitating intestinal colonization and effective enterotoxin delivery. EatA and EtpA are widely conserved in diverse populations of ETEC, but their immunogenicity has only been studied in controlled human infection models and a population of children in Bangladesh. Here, we compared serologic responses to EatA, EtpA and heat-labile toxin in populations from endemic regions including Haitian children and subjects residing in Egypt, Cameroon, and Peru to US children and adults where ETEC infections are sporadic. We observed elevated IgG and IgA responses in individuals from endemic regions to each of the antigens studied. In a cohort of Haitian children, we observed increased immune responses following exposure to each of the profiled antigens. These findings reflect the wide distribution of ETEC infections across multiple endemic regions and support further evaluation of EatA and EtpA as candidate ETEC vaccine antigens.

ABSTRACT The interaction between the HIV-1 capsid and human nucleoporin 153 (NUP153) is vital for delivering the HIV-1 preintegration complex into the nucleus via the nuclear pore complex. The interaction with the capsid requires a phenylalanine/glycine-containing motif in the C-terminus of NUP153 (NUP153C). This study used molecular modeling and biochemical assays to comprehensively determine the amino acids in NUP153 that are important for capsid interaction. Molecular dynamics, FoldX, and PyRosetta simulations delineated the minimal capsid binding motif of NUP153 based on the known structure of NUP153 bound to the HIV-1 capsid hexamer. Computational predictions were experimentally validated by testing the interaction of NUP153 with capsid using an in vitro binding assay and a cell-based TRIM-NUP153C restriction assay. This work identified eight amino acids from P1411 to G1418 that stably engage with capsid, with significant correlations between the interactions predicted by molecular models and empirical experiments. This validated the usefulness of this multidisciplinary approach to rapidly characterize the interaction between human proteins and the HIV-1 capsid. IMPORTANCE The human immunodeficiency virus (HIV) can infect nondividing cells by interacting with the host nuclear pore complex. The host nuclear pore protein NUP153 directly interacts with the HIV capsid to promote viral nuclear entry. This study used a multidisciplinary approach combining computational and experimental techniques to comprehensively map the effect of mutating the amino acids of NUP153 on HIV capsid interaction. This work showed a significant correlation between computational and empirical data sets, revealing that the HIV capsid interacted specifically with only six amino acids of NUP153. The simplicity of the interaction motif suggested other FG-containing motifs could also interact with the HIV-1 capsid. Furthermore, it was predicted that naturally occurring polymorphisms in human and nonhuman primates would disrupt NUP153 interaction with capsid, potentially protecting certain populations from HIV-1 infection.

Abstract Under tropical climate, broiler production is encumbered by several constraints which make it difficult for them to attain their genetic potential. The scarcity and high price of poultry feed and veterinary services and the harsh environmental conditions with respect to thermal stress are some of the challenges that hinder optimal growth of the birds. Limited availability of feedstuffs, including crucial feed ingredients like maize and oil seedcakes, is an important challenge to the sector, since feed still represents a major cost of producing broiler chickens. Additionally, the problem of climate change, which has become a global concern, is the main problem in broiler production under hot and humid climate. Under high ambient temperature, feed intake decreases, carbohydrates metabolism and protein synthesis efficiency are disturbed. Lipid utilization is lower and glucose or insulin homeostasis is altered while fat deposition and oxidative stress increases. Several strategies are used to ameliorate the effect of heat stress in poultry. The objective of this review was to summarize the challenge in broiler production under hot and humid climate and different approaches to fight heat stress in poultry.

Abstract Data of thoracic in-field reirradiation with two courses of stereotactic body radiotherapy (SBRT) is scarce. Aim of this study is to investigate feasibility and safety of this approach. Patients with a second course of thoracic SBRT and planning target volume (PTV) overlap were analyzed in this retrospective, multicenter study. All plans and clinical data were centrally collected. 27 patients from 8 centers have been amenable for evaluation: 12 with non-small-cell lung cancer, 16 with metastases, treated from 2009 (oldest first course) to 2020 (latest second course). A median dose of 38.5 Gy to the 65%-isodose over a median of 5 fractions was prescribed in the first course and 40 Gy in 5 fractions for the second SBRT-course. Median PTV of the second SBRT was 29.5 cm3, median PTV overlap 22 cm3. With a median interval of 20.2 months between the two SBRT-courses, 1-year OS, and -LCR were 78.3% and 70.3% respectively. 3 patients developed grade 1 and one grade 2 pneumonitis. No grade > 2 toxicity was observed. Peripheral location and dose were the only factors correlating with tumor control. A second SBRT-course with PTV overlap appears safe and achieves reasonable local control.

Résumé Ce rapport résume l'activité sismique en Suisse et dans les régions limitrophes au cours des années 2017 et 2018. En 2017 et 2018, le Service Sismologique Suisse a détecté et localisé respectivement 1227 et 955 séismes dans la zone considérée. L’événement le plus puissant dans la période analysée fut le séisme d’Urnerboden de magnitude ML 4.6, qui s’est produit le 6 mars 2017 dans la région frontalière des cantons d’Uri, de Glaris et Schwytz. Ce fut le plus grand séisme en Suisse depuis le séisme de magnitude ML 5.0 à Vaz en 1991. Les mouvements du sol associés au séisme d’Urnerboden approchèrent une intensité maximale de VI, et une intensité de IV fut reportée à une distance d’environ 50 km. Les mécanismes au foyer et les relocalisations relatives des hypocentres de répliques rendent compte d’une faille décrochante senestre de direction NNW–SSE. Le séisme d’Urnerboden et la sismicité historique environnante suggèrent l’existence de failles décrochantes sub-parallèles, probablement dans la partie supérieure du socle cristallin à l'extrémité orientale du massif de l'Aar. Une autre séquence remarquable s’est produite près de Château-d'Oex dans les Préalpes romandes en Suisse occidentale. Le plus puissant séisme de cette séquence s’est produit le 1er juillet 2017 avec une magnitude ML de 4.3. Les mécanismes au foyer et les relocalisations relatives de ses précurseurs et répliques permettent de visualiser une faille normale avec un pendage vers le NNE à environ 4 km de profondeur. Deux évènements associés à des failles normales superficielles d’orientation similaires se sont produits en 2017 et 2018, entre les Molasses sub-alpines et les unités structurales des Préalpes, près de Châtel-St-Denis et St. Silvestre. L'ensemble de ces évènements indiquent le long du front alpin, entre le lac Léman à l’ouest et la faille de Fribourg à l’est, un domaine NE–SW où s’opère une transition de déformation entre une région d’extension et une région de transtension. La complexité structurale de cette dernière est révélée par un séisme d’une magnitude ML 2.9 près de Tavel en 2018. Cet évènement décrit un segment de faille NW–SE au sein du socle cristallin, qui pourrait être relié à la zone de faille de Fribourg. Enfin, le séisme de magnitude ML 2.8 à Grenchen en 2017 procure une information rare sur la dynamique active de la partie superficielle de la ceinture de chevauchement du Jura dans l’avant-pays nord-ouest-alpin Suisse.

It is a great honor for me to congratulate the editorial staff and article contributors of the Philippine Journal of Otolaryngology-Head and Neck Surgery (PJOHNS) on its 41st year of publication. The editorial staff headed by Dr. José Florencio F. Lapeña, Jr. maintains a journal that is thriving and has earned the respect of the academic community. We thank him for his dedication, commitment, and vision that have made the PJOHNS an outstanding international journal for publication of articles in Otorhinolaryngology - Head and Neck Surgery (ORL-HNS). The PJOHNS has an ever-expanding role in highlighting research, case reports and clinical outcomes associated with ORL-HNS. In this age of detailed appraisal of the practice of medicine and surgery, an evidence-based approach to ORL-HNS is necessary. The PJOHNS should be the journal that attracts landmark papers that can influence how Ear, Nose, Throat (ENT) - Head and Neck Surgeons practice. For the past two years, we were in the midst of uncertainties and complexities, but we have learned to appreciate what we have, make the most of it, and tolerate difficulties. Resilience is inherent to the Filipino and that creates a sense of identity, compassion and concern for others. The pandemic is an ongoing test of our own resilience. It pushes us to change to a better normal. At the same time, the publication of scientific information is changing rapidly. The hard copy of the PJOHNS is still desired by many ENT Fellows, but even for them, it is insufficient. Researchers and clinicians demand immediate retrieval of any scientific article on any laptop or even cellphones. Availability of the PJOHNS is dynamic enough that it enhances the researcher’s experience on the PSO-HNS Website, and we are poised to be leaders in delivering scientific information via new platforms. The strength of the PJOHNS lies with a strong editorial group and with active and interested contributors and readers. I hope to count on your contribution to our journal by submitting to us your best papers and scientific articles and by your acceptance to review papers critically and objectively. Let us continue to be creative, innovative and search for our interest in research. Always believe in ourselves and find that there’s something within us that is greater than any challenge. Let’s put some deadline on these scientific dreams and make these dreams real. We’d rather do something great and fail than do nothing at all.

Summary: Here, we present a robust protocol for the facile and rapid synthesis of functionalized secondary amines in continuous flow. More specifically, we describe a detailed guide to perform a photocatalyzed Petasis reaction within 50 min using alkyl boronic acid as radical precursor and a Vapourtec E-series as key equipment. The desired functionalized amine has been synthesized in mmol scale and with a productivity rate of 0.2 mmol/h. The protocol is limited to alkyl boronic acids.For complete details on the generation and use of this protocol, please refer to Oliva et al. (2021).

Objectives: To measure trends in the supply of DMPA-SC in public and private health facilities and compare with other prominent modern methods. Study design: We used repeated cross-sectional data from service-delivery-point surveys in six settings: Burkina Faso, Democratic Republic of Congo (Kinshasa and Kongo Central), Nigeria (Kano and Lagos), and Uganda, each with 3-5 rounds of data collected between 2016 and 2020. We analyzed trends in DMPA-SC availability using percent of service delivery points offering the method and percent experiencing stockouts; trends were compared with those for DMPA-IM, IUD, implants, and other short-acting methods, by facility type. Results: All settings showed increased offering of DMPA-SC over time for both private and public facilities. Larger proportions of public facilities provided DMPA-SC compared to private facilities (66%–97% vs 16%–50% by 2019–2020). DMPA-SC was provided by fewer facilities than DMPA-IM (90%–100% public, 34%–69% private by 2019–2020), but comparable to implants (83%–100% public, 15%–52% private by 2019–2020) and IUDs (55%–91% public, 0%–44% private by 2019–2020). Trends of DMPA-SC stock varied by setting, with more consistent stock available in private facilities in the DRC and in public facilities in Burkina Faso and Nigeria. Uganda showed decreasing stock in public facilities but increasing stock in private facilities. Conclusion: DMPA-SC availability has been increasing since its introduction in sub-Saharan Africa, yet significant gaps in stock exist. Countries should consider alternative distribution models to address these issues. Implications: Our findings may help inform countries about the need to monitor DMPA-SC availability and to consider solutions that ensure contraceptive options are available to women who need them and disruptions to contraceptive use are minimized.

Digital trends are signs of imminent social changes that appear linked to the use of digital technologies. It is believed that digital media, due to its decentralized structure, induces more radical differences than centralized analog media. The aim of this research is to assess the potential for social differentiation implied in the dissemination of trends by digital media. To achieve this end, the research analyzed a corpus of 1,700 digital trends mapped on graph visualizations. Interpreting the results through Henri Lefebvre's materialist-dialectical differentialism, this research came to the conclusion that digital trends produce minimal differences, that is, they tend to maintain the status quo instead of questioning it, contradicting their association with phenomena such as revolution, disruption and innovation. In addition to investigating this specific issue, this research points towards possible collaborations between Information Design and Digital Humanities fields.

The Swiss Seismological Service (SED) at ETH has been developing methods and open-source software for Earthquake Early Warning (EEW) for more than a decade and has been using SeisComP for earthquake monitoring since 2012. The SED has built a comprehensive set of SeisComP modules that can provide EEW solutions in a quick and transparent manner by any seismic service operating SeisComP. To date, implementations of the Virtual Seismologist (VS) and Finite-Fault Rupture Detector (FinDer) EEW algorithms are available. VS provides rapid EEW magnitudes building on existing SeisComP detection and location modules for point-source origins. FinDer matches growing patterns of observed high-frequency seismic acceleration amplitudes with modeled templates to identify rupture extent, and hence can infer on-going finite-fault rupture in real-time. Together these methods can provide EEW for all event dimensions from moderate to great, if a high quality, EEW-ready, seismic network is available. In this paper, we benchmark the performance of this SeisComP-based EEW system using recent seismicity in Switzerland. Both algorithms are observed to be similarly fast and can often produce first EEW alerts within 4–6 s of origin time. In real time performance, the median delay for the first VS alert is 8.7 s after origin time (56 earthquakes since 2014, from M2.7 to M4.6), and 7 s for FinDer (10 earthquakes since 2017, from M2.7 to M4.3). The median value for the travel time of the P waves from event origin to the fourth station accounts for 3.5 s of delay; with an additional 1.4 s for real-time data sample delays. We demonstrate that operating two independent algorithms provides redundancy and tolerance to failures of a single algorithm. This is documented with the case of a moderate M3.9 event that occured seconds after a quarry blast, where picks from both events produced a 4 s delay in the pick-based VS, while FinDer performed as expected. Operating on the Swiss Seismic Network, that is being continuously optimised for EEW, the SED-ETHZ SeisComP EEW system is achieving performance that is comparable to operational EEW systems around the world.

We analyze the performance of a prototype earthquake early warning system deployed at the National Seismological Network of Costa Rica in collaboration with the Swiss Seismological Service by presenting the real-time performance during six earthquakes (Mw 5.1-6.4) that took place during 2018 and 2019. We observe that, despite only limited efforts to optimize the existing network of 158 stations, for EEW purposes, the network density allows fast determination of source parameters using both the Virtual Seismologist and the Finite Fault Rupture Detector algorithms. Shallow earthquakes on or near-shore are routinely identified within 11–20 s of their occurrence. The warning times for the capital city of San Jose are of 43 s for epicenters located at 220 km, like for the Mw 6.4 Armuelles earthquake. On the other hand, during the time analyzed, the EEW system did not provide positive warning times for earthquakes at distances less than 40 km from San Jose. Even though large (Mw > 7) distant historical earthquakes have not caused heavy damage in San Jose, there is potential for developing an EEW system for Costa Rica, especially for the purposes of rapid earthquake notifications, disaster response management, and seismic risk mitigation.

Introduction The World Health Organisation endorses community-based programmes as a cost-effective, feasible and a best buy in the prevention and management of non-communicable diseases (NCDs). These programmes are particularly successful when the community actively participates in its design, implementation and evaluation. However, they may be only useful insofar as they can be scaled up and sustained in some meaningful way. Social network research may serve as an important tool for determining the underlying mechanisms that contribute to this process. The aim of this planned scoping review is to map and collate literature on the role of social networks in scaling-up and sustaining community-based physical activity and diet programmes in low-income and middle-income countries.Methods and analysis This scoping review protocol has been planned around the Arksey and OMalley framework and its enhancement. Inclusion criteria are peer-reviewed articles and grey literature exploring the role of social networks in the scale-up and/or sustainability of NCD prevention community-based programmes in adult populations. Studies must have been published since 2000, in English, and be based in a low-income or middle-income country. The following databases will be used for this review: PubMed, Cochrane, Scopus, Web of Science, CINAHL, SocIndex, the International Bibliography of the Social Sciences, Google and Google Scholar. Books, conference abstracts and research focused only on children will be excluded. Two reviewers will independently select and extract eligible studies. Included publications will be thematically analysed using the Framework Approach.Ethics and dissemination Ethical approval will not be sought for this review as no individual-level data or human participants will be involved. This protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/KG7TX). The findings from the review will be published in an accredited journal. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews checklist will be used to support transparency and guide translation of the review.

The Finite-Fault Rupture Detector (FinDer) algorithm computes rapid line-source rupture models from high-frequency seismic acceleration amplitudes (PGA). In this paper, we propose two extensions to FinDer, called FinDerS and FinDerS+, which have the advantage of taking into account a geological property of the source fault, its structural maturity, as well as its relation to the earthquake slip distribution. These two new algorithms calculate real-time earthquake slip profiles by backprojecting seismic and/or geodetic displacement amplitudes onto the FinDer line-source. This backprojection is based on a general empirical equation established in previous work that relates dynamic peak ground displacement (PGD) at the stations to on-fault coseismic slip. While FinDerS projects PGD onto the current FinDer line-source, FinDerS+ allows the rupture to grow beyond the current model extent to predict future rupture evolution. For an informed interpolation and smoothing of the estimated slip values, FinDerS and FinDerS+ both employ a generic empirical function that has been shown to relate the along-strike gradient of structural maturity of the ruptured fault, the earthquake slip distribution, and the rupture length. Therefore, while FinDer derives magnitudes from a relatively uncertain and general empirical rupture length-magnitude relations, FinDerS and FinDerS+ provide alternate and better informed magnitude estimates using the mean slip of the profiles derived from the integration of fault source maturity. The two new algorithms can incorporate both seismic strong-motion and geodetic displacement data. In order to recover PGD from strong-motion instruments, we double-integrate and high-pass filter (> 0.075 Hz) the seismic acceleration records. Together, the three algorithms exploit the full spectrum of ground-motions, including high frequencies to derive a source fault model (FinDer) and low frequencies to determine the static offsets along this model (FinDerS and FinDerS+). We test the three algorithms for the 2019 MW 7.1 Ridgecrest (California), 2016 MW 7.0 Kumamoto (Japan), and 2008 MW 7.9 Wenchuan (China) earthquakes. Conclusively, low-frequency PGD data and integration of the fault maturity gradient do not speed-up calculations for these events, but provide additional information on slip distribution and final rupture length, as well as alternative estimates of magnitudes that can be useful to check for consistency across the algorithm suite. The FinDer algorithms systematically outperform previously established real-time PGD-based magnitude estimates in terms of speed and accuracy. The resulting slip distributions can be useful for improved ground-motion prediction given the observed relationship between seismic radiation and fault maturity.

Mast cells within the tumor microenvironment have controversial roles. Here, the authors show, using genetic mouse models, that in gastric cancer, mast cells at the periphery of the tumors are activated via cancer cell produced-IL33 and promote tumorigenesis by recruiting macrophages within the tumors.

The series, ‘Mastering your Fellowship’, provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP, SA) examination. The series is aimed at helping family medicine registrars (and their supervisors) prepare for this examination. Model answers are available online.

ABSTRACT Objective: To determine the effectiveness of the Philippine Health Insurance Corporation (PhilHealth) case rate system in reducing out-of-pocket expenses among non-no balance billing (NBB) patients undergoing thyroidectomy under the Department of Otorhinolaryngology – Head and Neck Surgery of the Baguio General Hospital and Medical Center from February to September 2018. Methods: Design: Prospective Cross- Sectional Setting: Tertiary Government Hospital Participants: Sixty-four (64) randomly selected patients with PhilHealth who underwent thyroidectomy who agreed to participate and reveal their statements of accounts Results: Among the study population, 20% belonged to the no balance billing (NBB) category, with zero out-of-pocket expenses during their confinement. Eighty percent (80%) belonged to the non-NBB category and also incurred zero hospital charges. In addition, there was no significant difference in the individual categories of the hospital expenses between the two groups except for the surgical procedures (p= .018, 95% CI). The accumulated total expenses also did not significantly differ between the two groups (p= .063, 95% CI). The minimum amount billed was PhP 1,984.95, while the maximum amount charged was PhP 38,898.65, with a median of PhP 18,703.28 and interquartile range of PhP 4,251.78 (XU: PhP 20,848.74, XL : PhP 16,596.96). There were no reported out-of-pocket expenses from non-NBB patients. The actual cost of thyroidectomy did not differ significantly from the case rate provided by PhilHealth among all the RVS categories. Conclusion: The PhilHealth case rate system is effective in reducing out-of-pocket expenses among non-NBB patients who underwent thyroidectomy in our institution during the study period. Keywords: out-of-pocket expenses; thyroidectomy; health care financing; health expenditures: universal health coverage

INTRODUCTION: While it is suspected that some ages were misreported during the 2014-2016 West African ebola outbreak, an analysis examining age data quality has not been conducted. The study objective was to examine age heaping and terminal digit preference as indicators for quality of age data collected in the Sierra Leone Ebola Database (SLED). METHODS: age data quality for adult patients was analyzed within SLED for the Viral Hemorrhagic Fever (VHF) database and the laboratory testing dataset by calculating Whipple´s index and Myers´s blended index, stratified by sex and region. RESULTS: age data quality was low in both the VHF database (Whipple´s index for the 5-year range, 229.2) and the laboratory testing dataset (Whipple´s index for the 5-year range, 236.4). Age was reported more accurately in the Western area and least accurately in the Eastern Province. Age data for females were less accurate than for males. CONCLUSION: age data quality was low in adult patients during the 2014-2016 ebola outbreak in Sierra Leone, which may reduce its use as an identifying or stratifying variable. These findings inform future analyses using this database and describe a phenomenon that has relevance in data collection methods and analyses for future outbreaks in developing countries.

The series, “Mastering your Fellowship”, provides examples of the question format encountered in the FCFP(SA) examination. The series aims to help family medicine registrars and their supervisors prepare for this examination. Model answers are available online.

In this paper, we model the temperature profile of the Earth with two heat sources: the first is the interior source, generally understood by geophysicists as the primary, if not only, source; the second is a source closer to the surface, explained herein. The model temperature profiles with our chosen best-fit parameters are compared with data from the Preliminary Reference Earth Model (PREM) to examine the relative sizes of the two sources; the near-surface source is found to be much larger than the interior source. If correct, the near-surface source could explain a number of paradoxes involving the heat coming from the Earth that have until now not been resolved. Keywords: Earth's heat sources, Tresinos

Sustainable intensification (SI) of low input farming systems is promoted as a strategy to improve smallholder farmer food security in southern Africa. Using the Limpopo province South Africa as a case study (four villages across a climate gradient), we combined survey data (140 households) and quantitative agronomic observations to understand climate-induced limitations for SI of maize-based smallholder systems. Insights were used to benchmark the agroecosystem model Agricultural Production System sIMulator, which was setup to ex ante evaluate technology packages (TPs) over 21-seasons (1998–2019): TP0 status quo (no input, broadcast sowing), TP1 fertiliser (micro dosing), TP2 planting density (recommended), TP3 weeding (all removed), TP4 irrigation, TP5 planting date (early, recommended), and TP6 all combined (TPs 1–5). An additional TP7 (forecasting) investigated varying planting density and fertiliser in line with weather forecasts. Input intensity levels were low and villages expressed similar challenges to climate risk adaptation, with strategies mostly limited to adjusted planting dates and densities, with less than 2% of farmers having access to water for irrigation. Simulations showed that combining all management interventions would be expected to lead to the highest mean maize grain yields (3200 kg ha ^−1 across villages) and the lowest harvest failure risk compared to individual interventions. Likewise, simulations suggested that irrigation alone would not result in yield gains and simple agronomic adjustments in line with weather forecasts indicated that farmers could expect to turn rainfall variability into an opportunity well worth taking advantage of. Our study emphasises the need for a cropping systems approach that addresses multiple crop stresses simultaneously.

A compact and efficient IC architecture is presented as an alternative to laser-trimmed precision thin-film resistors or look-up tables. The objective is to keep the device, such as a four-terminal Wheatstone bridge, but to compensate for post-manufacturing offset and to avoid the so-induced degradation of performances in terms of full-scale, non-linearity, power supply noise rejection and scale factor. Expected advantages are a reduced cost due to the electrical-only implementation and a possible on-field calibration of high-end sensors. Application of the proposed solution is illustrated on an example to demonstrate improvement factors on offset and sensitivity accuracy of 32 and 10, respectively. Additionally, the power supply rejection ratio is improved by 30 dB. The experimental results finally demonstrate both efficiency and versatility of the proposed solution thanks to a first silicon prototype, fabricated in a 0.35 μm Technology from AMS, connected to an off-the-shelf pressure sensor.

Abstract Object Stereotactic body radiotherapy (SBRT) for vertebral metastases has emerged as a promising technique, offering high rates of symptom relief and local control combined with low risk of toxicity. Nonetheless, local failure or vertebral instability may occur after spine SBRT, generating the need for subsequent surgery in the irradiated region. This study evaluated whether there is an increased incidence of surgical complications in patients previously treated with SBRT at the index level. Methods Based upon a retrospective international database of 704 cases treated with SBRT for vertebral metastases, 30 patients treated at 6 different institutions were identified who underwent surgery in a region previously treated with SBRT. Results Thirty patients, median age 59 years (range 27–84 years) underwent SBRT for 32 vertebral metastases followed by surgery at the same vertebra. Median follow-up time from SBRT was 17 months. In 17 cases, conventional radiotherapy had been delivered prior to SBRT at a median dose of 30 Gy in median 10 fractions. SBRT was administered with a median prescription dose of 19.3 Gy (range 15–65 Gy) delivered in median 1 fraction (range 1–17) (median EQD2/10 = 44 Gy). The median time interval between SBRT and surgical salvage therapy was 6 months (range 1–39 months). Reasons for subsequent surgery were pain (n = 28), neurological deterioration (n = 15) or fracture of the vertebral body (n = 13). Open surgical decompression (n = 24) and/or stabilization (n = 18) were most frequently performed; Five patients (6 vertebrae) were treated without complications with vertebroplasty only. Increased fibrosis complicating the surgical procedure was explicitly stated in one surgical report. Two durotomies occurred which were closed during the operation, associated with a neurological deficit in one patient. Median blood loss was 500 ml, but five patients had a blood loss of more than 1 l during the procedure. Delayed wound healing was reported in two cases. One patient died within 30 days of the operation. Conclusion In this series of surgical interventions following spine SBRT, the overall complication rate was 19%, which appears comparable to primary surgery without previous SBRT. Prior spine SBRT does not appear to significantly increase the risk of intra- and post-surgical complications.

Background Vertically oriented global health initiatives (GHIs) addressing the HIV/AIDS epidemic, including the President’s Emergency Plan for AIDS Relief (PEPFAR), have successfully contributed to reducing HIV/AIDS related morbidity and mortality. However, there is still debate about whether these disease-specific programs have improved or harmed health systems overall, especially with respect to non-HIV health needs. Methods As part of a larger evaluation of PEPFAR’s effects on the health system between 2005-2011, we collected qualitative and quantitative data through semi-structured interviews with District Health Officers (DHOs) from all 112 districts in Uganda. We asked DHOs to share their perceptions about the ways in which HIV programs (largely PEPFAR in the Ugandan context) had helped and harmed the health system. We then identified key themes among their responses using qualitative content analysis. Results Ugandan DHOs said PEPFAR had generally helped the health system by improving training, integrating HIV and non-HIV care, and directly providing resources. To a lesser extent, DHOs said PEPFAR caused the health system to focus too narrowly on HIV/AIDS, increased workload for already overburdened staff, and encouraged doctors to leave public sector jobs for higher-paid positions with HIV/AIDS programs. Conclusion Health system leaders in Uganda at the district level were appreciative of resources aimed at HIV they could often apply for broader purposes. As HIV infection becomes a chronic disease requiring strong health systems to manage sustained patient care over time, Uganda’s weak health systems will require broad infrastructure improvements inconsistent with narrow vertical health programming.