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OBJECTIVE: Availability of surgical equipment and access to essential clinical services remains an important barrier to surgical care delivery, particularly in low- and middle-income countries (LMICs). This study aims to characterize the relative availability of essential equipment for otolaryngology-head and neck surgery (OHNS) care across World Bank income groups. METHODS: We conducted a cross-sectional survey on otolaryngologists perceptions on the availability of surgical equipment and ancillary services in their respective practice settings per a 5-point Likert scale ranging from never to always available. The study was disseminated online via professional societies, personal contacts, and social media. Eligible participants included otolaryngologists from 194 WHO-recognized countries, which were grouped by World Bank income group classification and WHO region. RESULTS: The study involved 146 otolaryngologists, 69 (47%) from high-income countries (HICs), and 77 (53%) from LMICs. LMIC respondents were predominantly from the African and South-East Asian regions, which comprised 48% and 7.8% of all LMIC respondents, respectively. Results revealed significant differences in the availability of otologic, rhinologic, and endoscopic airway equipment between HICs and LMICs. Differences existed among commonly used equipment such as tympanomastoidectomy equipment and rigid bronchoscopy, to subspecialized equipment such as functional endoscopic sinus surgery equipment and cochlear implants (p

Abstract Background Estimates of Group B Streptococcus (GBS) disease burden, antimicrobial susceptibility, and serotypes in pregnant women are limited for many resource-limited countries including Kenya. These data are required to inform recommendations for prophylaxis and treatment of infections due to GBS. Methods We evaluated the prevalence, antimicrobial susceptibility patterns, serotypes, and risk factors associated with rectovaginal GBS colonization among pregnant women receiving antenatal care at Kenyatta National Hospital (KNH) between August and November 2017. Consenting pregnant women between 12 and 40 weeks of gestation were enrolled. Interview-administered questionnaires were used to assess risk factors associated with GBS colonization. An anorectal swab and a lower vaginal swab were collected and cultured on Granada agar for GBS isolation. Positive colonies were tested for antimicrobial susceptibility to penicillin G, ampicillin, vancomycin, and clindamycin using the disk diffusion method. Serotyping was performed by latex agglutination. Logistic regression was used to identify factors associated with GBS colonization. Results A total of 292 women were enrolled. Median age was 30 years (Interquartile range {IQR} 26–35) and a median gestational age of 35 weeks (IQR 30–37). Overall GBS was identified in 60/292 (20.5%) of participants. Among the positive isolates, resistance was detected for penicillin G in 42/58 (72.4%) isolates, ampicillin in 32/58 (55.2%) isolates, clindamycin in 14/46 (30.4%) isolates, and vancomycin in 14/58 (24.1%) isolates. All ten GBS serotypes were isolated, and 37/53 (69.8%) of GBS positive participants were colonized by more than one serotype. None of the risk factors was associated with GBS colonization. Conclusion The prevalence of GBS colonization was high among antenatal women at KNH. In addition, a high proportion of GBS isolates were resistant to commonly prescribed intrapartum antibiotics. Hence, other measures like GBS vaccination is a potentially useful approaches to GBS prevention and control in this population. Screening of pregnant mothers for GBS colonization should be introduced and antimicrobial susceptibility test performed on GBS positive samples to guide antibiotic prophylaxis.

The main purpose of this study was to explore how engaging in lesson study improves secondary mathematics teachers' effective lesson implementation to support students' learning better. The research was conducted in Jimma City, Ethiopia, and employed design-based research with qualitative data collected from two secondary schools and 12 mathematics teachers. A purposive sampling technique was used to select participants. Interviews, observations, and document analysis were the main sources of data. The data were analyzed thematically supported by Atlas-ti qualitative data analysis software. Findings indicated that engaging in lesson study improved mathematics teachers' effective lesson implementation. LS improved participants' practice of lesson presentation, use of diverse student-centered teaching methods, assessment, behavior management, instructional aids, time management, and feedback strategies. School leaders' positive attitudes and teachers' commitment were found to be supportive, while shortage of time and teachers' high teaching load were constraints. It would be vital to integrate lesson study into teachers' school-based professional development programs to improve mathematics teachers' effective lesson implementation in the study setting. The study suggests further investigation in more secondary schools by incorporating quantitative evidence with larger a sample size.

Photovoltaic (PV) energy source generation is becoming more and more common with a higher penetration level in the smart grid because of PV energy’s falling production costs. PV energy is intermittent and uncertain due to its dependence on irradiance. To overcome these drawbacks, and to guarantee better smart grid energy management, we need to deal with PV power prediction. The work presented in this paper concerns the study of the performance of the fuzzy MPPT approach to extract a maximum of power from solar panels, associated with PV power estimation based on short time scale irradiance forecasting. It is particularly applied to a case study of a tropical insular region, considering extreme climatic variability. To validate our study with real solar data, measured and predicted irradiance profiles are used to feed the PV system, based on solar forecasting in a tropical insular context. For that, a spatio-temporal autoregressive model (STVAR) is applied. The measurements are collected at three sites located on Guadeloupe island. The high variability of the tropical irradiance profile allows us to test the robustness and stability of the used MPPT algorithms. Solar forecasting associated with the fuzzy MPPT technique allows us to estimate in advance the produced PV power, which is essential for optimal energy management in the case of smart energy production systems. Simulation of the proposed solution is validated under Matlab/Simulink software. The results clearly demonstrate that the proposed solution provides good PV power prediction and better optimization performance: a fast, dynamic response and stable static power output, even when irradiation is rapidly changing.

Dementia prevention in Africa is critically underexplored, despite the continents high prevalence of modifiable risk factors. With a predominantly young and middle-aged population, Africa presents a prime opportunity to implement evidence-based strategies that could significantly reduce future dementia cases and mitigate its economic impact. The multinational Africa-FINGERS program offers an innovative solution, pioneering culturally sensitive, multidomain interventions tailored to the unique challenges of the region.  Leveraging insights from landmark global studies such as Worldwide-FINGERS and Alzheimers Disease Neuroimaging Initiative, the program employs a multideterminant precision prevention framework, grounded in community based systems dynamics. Africa-FINGERS further integrates cutting-edge state-of-the-art multimodal biomarker evaluations tailored to regional contexts, with the goal of advancing brain health and establishing a global standard for dementia prevention. This groundbreaking initiative highlights the potential for scalableand sustainable interventions, thus is poised to transform dementia risk reduction efforts across the continent. HIGHLIGHTS: Dementia rates are escalating in Africa, largely due to longer life spans and increased prevalence of modifiable risk factors. Yet, few regional interventions have directly targeted lifestyle factors to reduce dementia risk. The multinational Africa-FINGERS study will address this gap by adapting the successful FINGERS lifestyle intervention to African populations. Africa-FINGERS will pioneer a culturally informed, multidomain dementia risk reduction intervention in the African region through feasibility dementia prevention trials in rural and urban sites across Kenya and Nigeria in the first instance, enrolling 600 at-risk adults (≥ 50 years). The program adopts participatory research methods to develop culturally appropriate interventions and build infrastructure to evaluate dementia biomarkers from ante and post mortem samples. A cost-effectiveness analysis will be conducted to guide the strategic implementation of Africa-FINGERS into regional health systems. The Africa-FINGERS strategy aligns with the Worldwide-FINGERS framework and integrates the global Alzheimers Disease Neuroimaging Initiative approach, emphasizing multimodal analysis.

BACKGROUND: Adherence challenges with oral tenofovir-based pre-exposure prophylaxis (PrEP) are common. We developed a point-of-care assay to objectively assess tenofovir in urine and conducted a pilot trial examining the impact of counselling informed by use of this urine assay on long-term PrEP adherence. METHODS: This randomised trial enrolled women not in serodiscordant partnerships 3 months after PrEP initiation at the Kenya Medical Research Institute to compare standard-of-care adherence counselling versus counselling informed by the urine assay (urine-test counselling group) every 3 months for 12 months. In the standard of care group, urine samples were stored and tested at study end without participant feedback. Here we report the adherence primary outcome of hair concentrations of tenofovir at 12 months as a long-term metric (undetectable levels defined long-term non-adherence), as well as urine concentrations of tenofovir at each visit as a short-term adherence metric and acceptability of the assay assessed by quantitative surveys. Data were analysed by randomisation group. This completed trial was registered with ClinicalTrials.gov (NCT03935464). FINDINGS: From March 17, 2021 to Jan 18, 2022 we enrolled 49 women in the urine-test counselling group and 51 in the standard of care group; retention was 86 (86%) of 100. Nine (21%) of 42 in the urine-test counselling group had hair samples at 12 months with tenofovir concentrations below the limit of quantification compared with 15 (37%) of 41 in the standard of care group. The relative odds of long-term non-adherence in the standard of care group compared with urine-test counselling were 3·53 (95% CI 1·03-12·03; p=0·044). Pre-intervention, urine tenofovir was detectable in 65% in the urine-test counselling group and 71% in the standard of care group (p=0·68). At 12 months, 31 (72%) of 43 in the intervention group had detectable urine tenofovir compared with 19 (45%) of 42 in the standard of care group (p=0·0015). 40 (93%) of 43 participants liked the test very much and only one disliked the test. One participant in the standard of care group was withdrawn at the 6-month visit due to HIV seroconversion. INTERPRETATION: A low-cost urine tenofovir assay to inform PrEP counselling resulted in improvement in both short-term and long-term metrics of adherence. This urine tenofovir assay could help to improve long-term PrEP adherence. FUNDING: National Institute of Allergy and Infectious Diseases and National Institutes of Health.

Climate change will impact mountain watershed streamflow both directly—with changing precipitation amounts and variability—and indirectly—through temperature shifts altering snowpack, melt, and evapotranspiration. To understand how these complex processes will affect ecosystem functioning and water resources, we need tools to distinguish connections between water sources (rain/snowmelt), groundwater storage, and exit fluxes (streamflow/evapotranspiration), and to determine how these connections change seasonally and as climate shifts. Here, we develop novel watershed-scale approaches to understand water source, storage, and exit flux connections using a dynamic-flux particle tracking model (EcoSLIM) applied in California's Cosumnes Watershed, which connects the Sierra Nevada and Central Valley. This work develops new visualizations and applications to provide mechanistic understanding that underpins the interpretation of isotopic field data at watershed scales to distinguish sources, flow paths, residence times, and storage selection. In our simulations, streamflow comes primarily from snow-derived water while evapotranspiration generally comes from rain. Most streamflow starts above 1,000 m while evapotranspiration is sourced relatively evenly across the watershed and is generally younger than streamflow. Modeled streamflow consists primarily of water sourced from precipitation in the previous 5 years but before the current water year, while ET consists primarily of water from precipitation in the current water year. ET, and to a lesser extent streamflow, are both younger than water in groundwater storage. However, snowmelt-derived streamflow preferentially discharges older water from snow-derived storage. Dynamic-flux particle tracking and new approaches presented here enable novel model-tracer comparisons in large-scale watersheds to better understand watershed behavior in a changing climate.

The content of soluble sugar in cowpea (Vigna unguiculata L. Walp.) seeds is important for their acceptability to consumers. The objective of this study was to evaluate the genetic control of soluble sugar content in cowpea using diallel analysis. For this purpose, half-diallel crosses were made among seven diverse parents. The amount of total soluble sugar was estimated by the phenol sulfuric acid reagent method and reducing sugar were measured by the DNS (3,5-dinitrosalicylic acid) reagent method. The total soluble sugar ranged from 11.12 (VYA) to 40.79 mg gâ1 (IT93K-693-2) with a mean of 22.31 mg gâ1. Reducing soluble sugar showed a mean value of 9.11 mg gâ1 and ranged from 13.61 (TVx 3236) to 4.98 mg gâ1 (Lori niébé). Diallel analysis showed that both additive and non-additive gene effects were significant in the genetic control of these traits. However, dominance variance was greater than additive variance for soluble sugar. The traits were controlled mainly by an overdominance model, suggesting the advantage of delaying selection to later generations. Soluble sugar content was found to be highly heritable, with broad-sense heritability ranging from 0.987 to 0.976. Narrow-sense heritability ranged from 0.154 to 0.422 and revealed the lower importance of additive variance. Parents and F1 hybrids differed significantly on the basis of their general and specific combining abilities, respectively. Recessive alleles had positive effects on total soluble sugar and reducing soluble sugar. These results could help cowpea breeders improve the acceptability of cowpea seeds and cowpea-based foods by appropriate selection. Keywords: Cowpea, Genetic improvement, Diallel analysis, Soluble sugar

Introduction Despite decades of research, programming and investment into improving sexual and reproductive health and rights outcomes, there has been inadequate attention paid to sexual activity. (1,2) Information, education and [...], Objective To refine a standard questionnaire on sexual practices, experiences and health-related outcomes to improve its cross-cultural applicability and interpretability. We aimed to explore participants' willingness and ability to answer the draft questionnaire items, and determine whether items were interpreted as intended across diverse geographic and cultural environments. Methods We conducted cognitive interviews (n = 645) in three iterative waves of data collection across 19 countries during March 2022-March 2023, with participants of diverse sex, gender, age and geography. Interviewers used a semi-structured field guide to elicit narratives from participants about their questionnaire item interpretation and response processes. Local study teams completed data analysis frameworks, and we conducted joint analysis meetings between data collection waves to identify question failures. Findings Overall, we observed that participants were willing to respond to even the most sensitive questionnaire items on sexual biography and practices. We identified issues with the original questionnaire that (i) affected the willingness (acceptability) and ability (knowledge barriers) of participants to respond fully; and/or (ii) prevented participants from interpreting the questions as intended, including poor wording (source question error), cultural portability and very rarely translation error. Our revisions included adjusting item order and wording, adding preambles and implementation guidance, and removing items with limited cultural portability. Conclusion We have demonstrated that a questionnaire exploring sexual practices, experiences and health-related outcomes can be comprehensible and acceptable by the general population in diverse global contexts, and have highlighted the importance of rigorous processes for the translation and cognitive testing of such a questionnaire. [phrase omitted] [phrase omitted] Objectif Adapter un questionnaire standard sur les pratiques et experiences sexuelles ainsi que les resultats lies a la sante sexuelle, afin d'ameliorer son intelligibilite et son applicabilite transculturelle. Nous souhaitions analyser la volonte des participants et leur capacite a repondre aux differentes thematiques abordees dans le projet de questionnaire, puis determiner si certaines questions avaient ete interpretees comme prevu selon les environnements geographiques et culturels. Methodes Nous avons mene des entretiens cognitifs (n = 645) repartis en trois periodes iteratives de collecte de donnees dans 19 pays entre mars 2022 et mars 2023, avec des participants de sexes, genres, ages et origines differents. Les personnes chargees de l'entretien ont utilise un guide pratique semi-structure pour interroger les participants sur la maniere dont ils ont interprete les questions et entrepris d'y repondre. Des equipes locales impliquees dans cette etude ont rempli des cadres d'analyse de donnees, puis nous avons organise des reunions de reflexion conjointes entre les periodes de collecte de donnees afin de recenser les questions qui se sont soldees par un echec. Resultats De maniere generale, nous avons constate que les participants etaient disposes a repondre au questionnaire, y compris aux thematiques les plus sensibles sur leur historique et leurs pratiques sexuelles. Nous avons identifie, dans le questionnaire initial, des problemes qui (i) ont eu un impact sur la volonte (acceptabilite) et la capacite (connaissances insuffisantes) des participants a y repondre pleinement; et/ou (ii) ont empeche les participants d'interpreter les questions comme prevu, notamment en raison d'une mauvaise formulation (erreur dans la question source), d'une absence de transposition culturelle et, dans de tres rares cas, d'une erreur de traduction. Dans le cadre de nos revisions, nous avons modifie l'ordre et la formulation des questions, ajoute des notes explicatives et un guide de mise en reuvre, mais aussi supprime les questions difficiles a transposer dans d'autres contextes culturels. Conclusion Nous avons montre qu'un questionnaire explorant les pratiques et experiences sexuelles ainsi que les resultats lies a la sante pouvait etre comprehensible et acceptable pour l'ensemble de la population dans divers contextes a travers le monde. Nous avons egalement souligne l'importance d'etablir des processus rigoureux de traduction et devaluation cognitive pour ce type de questionnaire. [phrase omitted] Objetivo Ajustar un cuestionario estandar sobre las practicas, las experiencias y los resultados relacionados con la salud sexual para mejorar su aplicabilidad e interpretabilidad transcultural. El objetivo consistia en explorar la disposicion y la capacidad de los participantes para responder al borrador del cuestionario y determinar si las preguntas se interpretaban segun lo previsto en diferentes entornos geograficos y culturales. Metodos Se realizaron entrevistas cognitivas (n = 645) en tres rondas iterativas de recopilacion de datos en 19 paises durante marzo de 2022 y marzo de 2023, con participantes de diversos sexos, generos, edades y regiones geograficas. Los entrevistadores utilizaron una guia de campo semiestructurada para obtener relatos de los participantes sobre sus procesos de interpretacion y respuesta a las preguntas del cuestionario. Los equipos de estudio locales completaron los marcos de analisis de datos y se celebraron reuniones conjuntas de analisis entre las rondas de recopilacion de datos para identificar fallos en las preguntas. Resultados En general, se observo que los participantes estaban dispuestos a responder incluso a las preguntas mas delicadas del cuestionario sobre biografia y practicas en materia sexual. Se identificaron problemas con el cuestionario original que (i) afectaban a la disposicion (aceptabilidad) y la capacidad (barreras de conocimiento) de los participantes para responder plenamente; o (ii) evitaban que los participantes interpretaran las preguntas segun lo previsto, incluida una redaccion deficiente (error en la pregunta original), portabilidad cultural y, muy raramente, error de traduccion. Las revisiones incluyeron el ajuste del orden y la redaccion de las preguntas, la adicion de preambulos y orientaciones de implementacion, y la eliminacion de preguntas con una portabilidad cultural limitada. Conclusion Se ha demostrado que un cuestionario que explora las practicas, las experiencias y los resultados relacionados con la salud sexual puede ser comprensible y aceptable para la poblacion general en diversos contextos mundiales. Ademas, se ha destacado la importancia de contar con procesos rigurosos para la traduccion y las pruebas cognitivas de un cuestionario de este tipo.

Engaging in sexual relationships is part of adulthood, but doing so in a foreign country can be risky because unsafe sexual experiences can have severe consequences for international students. This review explored sexual and reproductive health (SRH) experiences and needs of international university students in Western countries to identify challenges and gaps and to discuss critical SRH interventions. Four databases (Scopus, Embase, Web of Science, and PubMed) were searched for peer-reviewed journal articles published between 2000 and 2023. After screening 1607 articles, 10 met the inclusion criteria. Results of the review showed that many international students lack comprehensive knowledge about sexual health and sexually transmitted infections. They often obtain SRH information from informal sources, face language barriers, and experience difficulties navigating the healthcare systems of their host countries. University sexual wellness programs should examine how cultural orientations impact the sexual health of international students and provide culturally appropriate SRH interventions. [Note: The publication year for v14 n1 (2024) may be incorrect. The correct publication year for this article is 2023.]

Information about the type of gene action governing the inheritance of cowpea seed flavonoid content and antioxidant activity is prerequisite for starting an effective breeding program for developing improved varieties. For this purpose, half-diallel crosses among seven diverse parents were made. The homozygous parents and 21 F1 hybrids were evaluated at Maroua in the Sudano-Sahelian zone of Cameroon using a randomized complete block design with three replicates. Flour samples produced from decorticated seeds were used for biochemical analysis. Analysis of variance showed significant differences (P

IntroductionThe pace of innovation has accelerated in virtually every area of tau research in just the past few years.MethodsIn February 2022, leading international tau experts convened to share selected highlights of this work during Tau 2022, the second international tau conference co-organized and co-sponsored by the Alzheimer's Association, CurePSP, and the Rainwater Charitable Foundation.ResultsRepresenting academia, industry, and the philanthropic sector, presenters joined more than 1700 registered attendees from 59 countries, spanning six continents, to share recent advances and exciting new directions in tau research.DiscussionThe virtual meeting provided an opportunity to foster cross-sector collaboration and partnerships as well as a forum for updating colleagues on research-advancing tools and programs that are steadily moving the field forward.

The tropical insular region is characterized by a large diversity of microclimates and land/sea contrasts, creating a challenging solar forecasting. Therefore, it is necessary to develop and use performant and robustness forecasting techniques. This paper examines the predictive performance of a novel solar forecasting approach, the multiscale hybrid forecast model (MHFM), as a function of several parameters. The MHFM model is a technique recently used for irradiance forecasting based on a hybrid autoregressive (AR) and neural network (NN) model combined with multiscale decomposition methods. This technique presents a relevant performance for 1 h ahead global horizontal irradiance forecast. The goal of this work is to highlight the strength and limits of this model by assessing the influence of different parameters from a metric error analysis. This study illustrates modeling process performance as a function of daily insolation conditions and testifies the influence of learning data and test data time scales. Several forecast horizon strategies and their influence on the MHFM performance were investigated. With the best strategy, a rRMSE value from 4.43 % to 10.24 % was obtained for forecast horizons from 5 min to 6 h. The analysis of intra-day solar resource variability showed that the best performance of MHFM was obtained for clear sky days with a rRMSE of 2.91 % and worst for cloudy sky days with a rRMSE of 6.73 % . These works constitute an additional analysis in agreement with the literature about influence of daily insolation conditions and horizons time scales on modeling process.

Purpose: The main purpose of this study was to explore how engaging in lesson study enhances secondary school mathematics teachers' pedagogical practice in lesson planning in Jimma, Ethiopia. Design/methodology/approach: The study employed a design-based research approach with qualitative and quantitative data collected from two secondary schools, and 12 mathematics teachers. A purposive sampling technique was used to select participants. Interviews, observations, questionnaires and document analysis were the main sources of data. Qualitative data were analyzed using themes with the support of Atlas-ti qualitative data analysis software. Quantitative data were analyzed using the Wilcoxon ranked signs test. Findings: The findings revealed that engaging secondary school mathematics teachers in lesson study enhanced their lesson planning competence. As a result, teachers began to carefully plan detailed lessons, use curriculum materials and create more student-oriented lessons. Lesson study was found to be a potent model on which to build secondary school mathematics teachers' lesson planning competence. Hence, it would be rewarding to integrate lesson study into the present school-based teachers' pedagogical capacity-building program in the study settings. Research limitations/implications: The data were collected from particular localities with a small sample size in the quantitative phase. Therefore, it is difficult to generalize to the entire secondary school teachers in the country. However, thick descriptions were provided that would allow readers to determine the transferability of the findings to their specific school context. Future research should investigate the effects that enhanced TPP in lesson planning has on teachers' mathematics teaching in more schools using a larger sample size. Practical implications: This study provides insight into and empirical evidence of how engaging in the process of LS is essential to enhance teachers' lesson planning competence. It adds important knowledge to a small but growing model of lesson study research. It also informs future researchers in the practical use of LS where lesson planning is a crucial concern in many secondary schools of the country. Originality/value: This research was originally conducted to build mathematics teachers' pedagogical practice in lesson planning through lesson study in Ethiopian secondary school contexts.

Beach volleyball has been one of the fastest-growing sports over the past 30 years, and its continued popularity due to the Olympics and expanded global media coverage has caused schools to see the benefits of adding beach volleyball to their curriculum. It also makes an excellent lifetime sport due to the low impact of playing in the sand. This article will share instructional ideas for teaching beach volleyball concepts with or without a sand court for physical education grades 6-12. Included in the article are offensive strategies, serving strategies, defensive strategies, and equipment

Beach volleyball has been one of the fastest-growing sports over the past 30 years, and its growing popularity has caused schools to see the benefits of adding beach volleyball to their physical education curriculum. As physical education curriculums continue to evolve, there is a need for new and exciting games, activities, and sports, including beach volleyball, to help better engage student participation and physical fitness. This article will share modified instructional ideas for teaching beach volleyball to 6-12 grade students. The article includes drills, lead-up games, and game modifications for beach volleyball.