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Maternal health care services utilization and associated factors among pregnant women in Kersa district, Jimma zone, Southwest Ethiopia
Background Ethiopia has a high rate of maternal mortality, documented at 412 deaths per 100,000 live births in 2016. One of the most important interventions to reduce maternal death from pregnancy-related problems is the use of maternal health care services. However, the utilization of these services continues to be low in rural areas of Ethiopia. Therefore, this study aimed to assess the utilization and its associated factors of maternal health care services among pregnant women in rural areas of Kersa district, Jimma zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted among 562 pregnant women in rural areas of Kersa District, Jimma Zone, Southwest Ethiopia, from October to December 2020. Cluster sampling was used to select study participants. The data was collected through face-to-face interviews using a pretested and structured questionnaire. The data was entered using Epi-data version 3.1 and SPSS version 21 was used for data cleaning, coding, labeling, and analysis. Bivariate and multivariable logistic regression analyses were performed to determine the association between dependent and independent variables. The significance level for analyses was set at p ≤ 0.05. Results Of the 562 women interviewed, 50.7% received at least one antenatal care (ANC) visit, more than two-thirds (70.5%) started ANC late, and only 2.8% completed ANC4 + visits. Nearly half (47.2%) of the women gave birth in a health facility. Women aged 20–29 years (AOR: 2.82; 95% CI: 1.27, 6.22) and 30–39 years (AOR: 1.86; 95% CI: 1.01, 3.42), women whose husbands were private employees (AOR: 2.23; 95% CI: 1.14, 4.38), women with good knowledge of pregnancy danger signs (AOR: 1.99; 95% CI: 1.34, 2.94), good road conditions (AOR: 2.63; 95% CI: 1.67, 4.13), and low transportation costs (AOR: 3.16; 95% CI: 1.64, 6.08) were positively associated with antenatal care attendance. Factors associated with institutional delivery service use were women aged 20–29 years (AOR: 3.47; 95% CI: 1.47, 8.17), private employee women (AOR: 5.46; 95% CI: 1.02, 29.17), women whose husbands were private employees (AOR: 2.38; 95% CI: 1.11, 5.11), households with a medium wealth index (AOR: 1.77; 95% CI: 1.05, 2.97), and rich households (AOR: 1.88; 95% CI: 1.09, 3.24), distance to health facility ≤ 1 hour (AOR: 4.95; 95% CI: 1.18, 20.76), and low transportation costs (AOR: 2.81; 95% CI: 1.51, 5.29). Conclusion Maternal healthcare service utilization among pregnant women in the study area was lower than national targets and international recommendations. Therefore, increasing women’s awareness of maternal healthcare services, addressing physical access to institutional delivery services, strengthening access to transportation such as making ambulance services more accessible, improving road conditions, and increasing household income would likely increase service utilization.
A modified TOPSIS algorithm for the assessment of sports quality in higher education using circular pythagorean fuzzy information
Sleep phenotyping in a rat model of susceptibility to substance use disorders
Alcohol use disorders (AUD) are bidirectionally associated with significant sleep disturbances, yet the underlying neural mechanisms remain poorly understood. The Marchigian Sardinian alcohol Preferring (msP) rat is a validated preclinical model that mirrors several genetic and behavioral traits of patients with AUD. This study aimed to characterize the sleep-wake architecture and EEG spectral activity in naïve msP rats compared to Wistar controls. We performed 24-hour polysomnography recordings, revealing that male msP rats (n = 9) spent 7.5% more time awake and less time in NREM sleep relative to Wistar rats (n = 9). This was accompanied by a more fragmented sleep-wake pattern, with a higher number of waking and sleep episodes, state transitions, and sleep fragmentation index. Spectral analysis demonstrated lower high-frequency power, with significant reductions in sigma and beta power during NREM sleep and increased theta/beta ratios during wakefulness. Slow-wave activity, an indicator of sleep pressure, showed a blunted rise and fall across the sleep cycle in msP rats, with reduced amplitude and slope of slow waves during early sleep. Moreover, msP rats exhibited decreased spindle activity, with significantly lower spindle incidence, amplitude, and duration. These findings suggest that msP rats display significant sleep disturbances, including disrupted NREM sleep and altered spectral characteristics in brain activity that partially resemble changes reported in individuals with AUD. This altered sleep profile may reflect neural circuit dysfunctions linked to substance use vulnerability, offering potential insights into the neurobiological basis of sleep disturbances in these complex neuropsychiatric disorders.
Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala
What big eyes this whale has — but not the better to see you with
Translational genomics of osteoarthritis in 1,962,069 individuals
Abstract Osteoarthritis is the third most rapidly growing health condition associated with disability, after dementia and diabetes1. By 2050, the total number of patients with osteoarthritis is estimated to reach 1 billion worldwide2. As no disease-modifying treatments exist for osteoarthritis, a better understanding of disease aetiopathology is urgently needed. Here we perform a genome-wide association study meta-analyses across up to 489,975 cases and 1,472,094 controls, establishing 962 independent associations, 513 of which have not been previously reported. Using single-cell multiomics data, we identify signal enrichment in embryonic skeletal development pathways. We integrate orthogonal lines of evidence, including transcriptome, proteome and epigenome profiles of primary joint tissues, and implicate 700 effector genes. Within these, we find rare coding-variant burden associations with effect sizes that are consistently higher than common frequency variant associations. We highlight eight biological processes in which we find convergent involvement of multiple effector genes, including the circadian clock, glial-cell-related processes and pathways with an established role in osteoarthritis (TGFβ, FGF, WNT, BMP and retinoic acid signalling, and extracellular matrix organization). We find that 10% of the effector genes express a protein that is the target of approved drugs, offering repurposing opportunities, which can accelerate translation.
Feasibility of shear wave elastography for assessing steatosis in early-stage non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic fat accumulation with varying degrees of severity. This study aimed to evaluate the feasibility of shear wave elastography (SWE) for assessing the grade of liver steatosis in early-stage NAFLD without fibrosis. A total of 260 subjects were categorized into four groups of G0 (n = 81), G1 (n = 63), G2 (n = 54), and G3 (n = 62). Conventional ultrasound and point SWE examinations were used to assess the grade of liver steatosis in varies degrees and compared with MRI-proton density fat fraction (MRI-PDFF), which was used to quantify hepatic fat content. SWE demonstrated high reproducibility across all groups with interclass correlation coefficients ranging from 0.80 to 0.94. The correlation between SWE and MRI-PDFF were 0.68, 0.71, 0.68 and 0.53 for G0-G3 NAFLD. For conventional ultrasound, the diagnostic performance were 0.77 (95% CI: 0.71–0.83), 0.76 (95% CI: 0.71–0.82), 0.76 (95% CI: 0.70–0.83), for G0 versus G1-3, G0-1 versus G2-3, and G0-2 versus G3. For SWE, the diagnostic performance were 0.88 (95% CI: 0.84–0.92), 0.86 (95% CI: 0.81–0.90), and 0.81 (95% CI: 0.75–0.87), for G0 versus G1-3, G0-1 versus G2-3, and G0-2 versus G3. The SWE showed better diagnostic performance than conventional ultrasound in G0 versus G1-3 (p = 0.003), G0-1 versus G2-3 (p = 0.002), but not in G0-2 versus G3 (p = 0.262). SWE is a reliable tool for assessing the grade of liver steatosis, which could be a valuable tool for monitoring and grading NAFLD in early-stage.
Automated classification of midpalatal suture maturation stages from CBCTs using an end-to-end deep learning framework
Correction: Attitudes, practices, and zoonoses awareness of community members involved in the bushmeat trade near Murchison Falls National Park, northern Uganda
Age-related stress gene expression in neonatal sepsis involves regulatory networks and immune cell infiltration
The role of obesity in physiological stress, balance, and proprioception during repetitive manual material handling tasks
Manual laborers often experience fatigue-related incidents, which increase their risk of balance disturbances and falls. Previous research indicates that obese individuals may reach critical fatigue levels during repetitive lifting. This study examines whether this BMI-based fatigue pattern also applies to other manual handling activities. Therefore, assessing balance impairment under high physiological stress conditions will help quantify the increased fall risk in obese individuals. Thirty participants performed carrying and pushing/pulling tasks, with weights determined using the Liberty Mutual Equations to align with NIOSH criteria. Balance tests were conducted before and after each task. A two-way ANOVA compared energy expenditure rate (EER) across BMI classifications and sex, while a mixed-effects model analyzed the effects of EER, BMI, and sex on balance and proprioception tests. Results indicated a positive correlation between BMI and EER for both carrying (p = 0.003) and pushing/pulling (p = 0.013). In the mixed-effects model, BMI (p = 0.032) and EER (p = 0.037) were positively correlated with knee proprioception loss, whereas EER was negatively correlated with balance (p = 0.020). These findings confirm that obese individuals face critical fatigue levels, as well as impaired proprioception and balance, during repetitive handling tasks.
Evaluation of combined BCG and SARS-CoV-2 vaccination for immune enhancement and lung protection in Syrian hamsters
The early-life fecal microbiota is associated with litter of origin but not with susceptibility to ETEC F4ab-mediated post-weaning diarrhea in CHCF1 genotyped pigs
Introduction Universal biomarkers in the fecal microbiota that predict susceptibility to post-weaning diarrhea (PWD) would be valuable for future intervention strategies. Genetic susceptibility to enterotoxigenic E. coli (ETEC) infection in pigs is a major determinant of PWD and may unfavourably alter early-life gut microbiota composition. We investigated whether pigs genetically susceptible to ETEC F4ab/ac had different fecal microbiota composition and diversity pre- and post-weaning compared to genetically resistant pigs. Method Fecal microbiotas were characterized using long-read sequencing of the 16S rRNA gene in 24 CHCF1 heterozygous susceptible (RS) and 24 CHCF1 homozygous resistant (RR) pigs. These pigs were tested at early lactation (post-natal day (PND) 8) and late lactation (PND 22), which are critical periods for microbiota development and immune maturation. Twelve pigs from each group were weaned and transported to an experimental facility at PND 23, and were tested again at PND 24, prior to an ETEC F4ab challenge. This enabled studying immediate fecal microbiota changes after weaning and investigating whether CHCF1 RS pigs had compromised microbiotas compared to CHCF1 RR pigs preceding infection. Results Across time, CHCF1 RS pigs had a higher number of observed OTUs (coef: 103, 95% CI [18.90; 192.76], p = 0.01) compared to CHCF1 RR pigs. There were no significant differences in the overall bacterial communities or differentially abundant taxa between genotypes. Littermates had bacterial communities more similar to each other compared to non-littermates during lactation (PND 8: R2 = 0.2, p = 0.001 and PND 22: R2 = 0.23, p = 0.001) and the litter effect persisted after weaning (PND 24: R2 = 0.4, p = 0.001). Conclusion We did not find major differences in the fecal microbiota between CHCF1 genotypes, pre- or post-weaning, that could help explain subsequent susceptibility to ETEC F4ab-mediated PWD. Litter explained a major part of the variation in the overall fecal bacterial community between pigs in the study.
Assessing cross cultural urban park emotional wellbeing impact in Shanghai and London
Ultra-orphan diseases: A cross-sectional quantitative analysis of the natural history of isolated sulfite oxidase deficiency
Objective Isolated sulfite oxidase deficiency (ISOD; OMIM #272300) is a devastating rare neurometabolic disorder due to biallelic pathogenic variants in the SUOX gene, that typically results in neonatal refractory epilepsy and progressive severe encephalopathy. Knowledge on the quantitative natural history of ISOD is limited and clinical outcome parameters for future clinical trials remain to be defined. Material and methods We performed a comprehensive analysis of published cases (N=74) with ISOD applying quantitative retrospective natural history modeling (QUARNAM). Main outcome parameters were age of disease onset, diagnostic delay and survival. Clinical characteristics and potential associations between biochemical parameters and clinical outcome (i.e. age of disease onset, survival) were explored. Results The median survival period of the study cohort was 60 months. ISOD typically presented shortly after birth with a median age of onset of 3 days. Median age at diagnosis was 10 months, leading to a substantial median diagnostic delay of 5.7 months. Homocysteine concentrations in plasma correlated with age of disease onset. An association of biochemical parameters of cysteine metabolism and survival could not be identified. Conclusion The present analysis describes long-term outcome measures adding to the quantitative understanding of the natural history of ISOD, which might be helpful in the planning of prospective clinical trials and potentially stimulate development of targeted therapies in the future.
Air bubble dispersion imaging in whipping cream with specified fat contents by fuzzy phase classification implemented in electrical impedance tomography
Abstract The air bubble dispersion in whipping cream during agitation has been imaged by fuzzy phase classification implemented in electrical impedance tomography (fEIT) for internal morphological structure visualization. The fEIT consists of non-linear conductivity $$\:\sigma\:$$ reconstruction and fuzzy phase classification to classify $$\:\sigma\:$$ into a probabilistic cluster $$\:{u}_{j}$$ ( $$\:j=1$$ : oil-in-water phase, $$\:j=2$$ : air bubble). In the experiments, probabilistic air bubble cluster $$\:{u}_{2}$$ of whipping cream with five milk fat (MF) contents were reconstructed by fEIT during agitation to image the air bubble dispersion. The $$\:{u}_{2}$$ demonstrated the air bubble dispersion within the sensor area caused by agitation. The spatial average $$\:\langle{u}_{2}\rangle$$ was increased and then decreased due to the incorporation and subsequent departure of air bubbles during agitation. The peak $$\:{\langle{u}_{2}\rangle}_{\:}$$ time t s , which represents the critical saturation point of air bubbles, was decreased as MF content increased, which was verified by OR measurement and microscope observation. Compared to $$\:\sigma\:$$ reconstructed by EIT influenced by the liquid water phase, fat and air bubbles, $$\:\langle{u}_{2}\rangle$$ reconstructed by fEIT successfully imaged air bubble dispersion in whipping cream. Furthermore, fEIT demonstrated comparable performance to OR measurements in evaluating the internal morphological structure of whipping cream during agitation, while providing the advantage of inline measurement.
Bidirectional genetic links between chronic obstructive pulmonary disease and frailty: Genome-wide association study insights
Background Recent research underscores a potential correlation between chronic obstructive pulmonary disease (COPD) and frailty, suggesting a shared genetic foundation. However, specific genetic factors and mechanisms underlying this association remain unclear. This study aimed to explore genetic connections between COPD and frailty using genome-wide association studies to enhance our understanding and improve clinical management and prevention strategies for these conditions. Method We utilised summary statistics for genome-wide association studies to examine the genetic correlations between COPD and frailty using linkage disequilibrium score regression. Local genetic correlations were evaluated using the ρ-heritability estimates from summary statistics method. Using the established two-sample Mendelian randomization approach, causal relationships have been identified. Shared genetic variants were quantified using a bivariate causal mixture model. Shared loci and single nucleotide polymorphisms were identified by conjoint false discovery rate (conjFDR). Gene enrichment and transcriptome-wide association studies (TWAS) were conducted to explore potential transcriptomic associations across tissues. Results We observed a significant genetic correlation between COPD and frailty (Rg = 0.4324, P = 6.09 × 10 − 26). MiXeR estimated 3,200-shared causal variants. Additionally, we discovered 16 shared loci linked to 91 genes, offering novel insights into gene expression across diverse tissues. The TWAS revealed 25 shared genes, representing a significant advance in understanding the genetic overlap between COPD and frailty. Furthermore, out of the 25 SNPs identified through TWAS, 4 overlapped with the lead SNPs, specifically [HLA-DRB1, PBX3, SLC22A5/OCTN2, SLMAP]. Conclusions Our study shows a common genetic foundation for COPD and frailty, identifying multiple shared loci and offering insights into their underlying causal connections. These findings enhance our understanding of the biological mechanisms linking these conditions and may guide future research and treatment strategies for related diseases.
New method for transient cold wall heat flux measurements for unlimited exposure times
Abstract This paper presents a new method to measure high cold wall surface heat fluxes temporally resolved. It is based on a system identification approach, the so-called Non-Integer System Identification (NISI) method, which allows to correlate the surface heat flux to one single in-depth temperature measurement. Here, the model parameters are found experimentally by non-destructive calibration of the actual sensor hardware. The key feature of the new method is that the sensing wall segment is actively water-cooled at the backside, so that a transient, i.e. temporally varying, heat flux can be determined over long periods of time without damaging the sensing element. In the paper, the NISI model equation is derived from the heat equation considering this cooled backside boundary condition. We prove the useful applicability of our new approach by assessing data from a numerical thermal simulation. The determined heat flux shows excellent agreement with the known input data.
Self-reported life experiences of members of the LGBTQ+ community in Accra, Ghana
Background Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ+) community members encompass individuals whose sexual orientations and gender identities do not align with the heterosexual norms in society. Even though this population has gained increasing prominence worldwide, most societies particularly in sub-Saharan Africa (SSA) abhor these sexual orientations. We explored the self-reported life experiences of members of the LGBTQ+ community in Accra, Ghana. Methods In this qualitative enquiry, we recruited fifteen (15) members of the LGBTQ+ community in Accra via purposive snowballing sampling technique. We conducted in-depth interviews using a pre-tested interview guide and the interviews were audio taped and transcribed verbatim. Thematic analysis was conducted with the aid of NVivo 10.0. Results The participants recounted their experiences within their individual families, within the LGBTQ+ community, and their experiences with the public in Ghana and as well as within their extended families. The participants claimed that the general society (public) in Ghana stigmatizes against members of the LGBTQ+ community with most families rejecting members who claim to be LGBTQ+ persons. The participants however claimed that the LGBTQ+ community served as a major source of support for them and helped them cope with the rejection and stigma associated with their sexual orientations. They further claimed that the stigma and rejection contributed to poor mental health of most LGBTQ+ persons with most of them seeking asylum in more inclusive and welcoming jurisdictions. Conclusion Members of the LGBTQ+ community in Ghana face stigma and societal pressures in their families and public spaces, creating stress that contributes to mental health challenges. We recommend that the Government of Ghana through the Ministry of Gender, Children and Social Protection and the Ghana Health Service increases public education to improve cultural competence and inclusivity of this vulnerable population in society to reduce stigma and discrimination.