Low Uptake Rates Research Articles

Social Health Insurance for Universal Health Coverage in Low and Middle-Income Countries (LMICs): a retrospective policy analysis of attainments, setbacks and equity implications of Kenya’s social health insurance model

ObjectivesTo analyse the potential of the Social Health Insurance (SHI) model to support the achievement of Universal Health Coverage (UHC) in Low and Middle-Income Countries (LMICs) through a policy analysis...

Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers

BackgroundBreast cancer subtypes Luminal A and Luminal B are classified by the expression of PAM50 genes and may benefit from different treatment strategies. Machine learning models based on H&E images may contain features associated with subtype, allowing early identification of tumors with higher risk of recurrence.MethodsH&E images (n = 630 ER+/HER2-breast cancers) were pixel-level segmented into epithelium and stroma. Convolutional neural network and multiple instance learning were used to extract image features from original and segmented images. Patient-level classification models were trained to discriminate Luminal A versus B image features in tenfold cross-validation, with or without grade adjustment. The best-performing visual classifier was incorporated into envisioned diagnostic protocols as an alternative to genomic testing (PAM50). The protocols were then compared in time-to-recurrence models.ResultsAmong ER+/HER2-tumors, the image-based protocol differentiated recurrence times with a hazard ratio (HR) of 2.81 (95% CI: 1.73–4.56), which was similar to the HR for PAM50 (2.66, 95% CI: 1.65–4.28). Grade adjustment did not improve subtype prediction accuracy, but did help balance sensitivity and specificity. Among high grade participants, sensitivity and specificity (0.734 and 0.474, respectively) became more similar (0.732 and 0.624, respectively) in grade-adjusted models. The original and epithelium-specific images had similar performance and highest accuracy, followed by stroma or binarized images showing only the epithelial-stromal interface.ConclusionsGiven low rates of genomic testing uptake nationally, image-based methods may help identify ER+/HER2-patients who could benefit from testing.

Anticorrelation of net uptake of atmospheric CO2 by the world ocean and terrestrial biosphere in current carbon cycle models

Abstract. The rate at which atmospheric carbon dioxide (CO2) would decrease in response to a decrease in anthropogenic emissions or cessation (net zero emissions) is of great scientific and societal interest. Such a decrease in atmospheric CO2 on the centennial scale would be due essentially entirely to transfer of carbon into the world ocean (WO) and the terrestrial biosphere (TB), which are sink compartments on this timescale. The rate of decrease in excess atmospheric CO2 and the apportionment of this decrease into the two sink compartments have been examined in two prior model intercomparison studies, subsequent either to a pulse emission of CO2 or to abrupt cessation of anthropogenic CO2 emissions. The present study examines and quantifies inter-model anticorrelation in those studies in the net rate and extent of uptake of CO2 into the two sink compartments. Specifically, in each study the time-dependent coefficients characterizing the net transfer rate into the two sink compartments (evaluated as the net transfer rate normalized to excess atmospheric CO2 above the pre-pulse amount for the pulse experiment or as the net transfer rate divided by excess atmospheric CO2 above the preindustrial amount for the abrupt cessation experiment) were found to exhibit strong anticorrelation across the participating models. That is, models for which the normalized rate of uptake into the WO was high exhibited low uptake rate into the TB and vice versa. This anticorrelation in net transfer rate results in anticorrelation in net uptake extent into the two compartments that is substantially greater than would be expected simply from competition for excess CO2 between the two sink compartments. This anticorrelation, which is manifested in diminished inter-model diversity, can lead to artificially enhanced confidence in current understanding of the consequences of potential future reductions of CO2 emissions and in the global warming potentials of non-CO2 greenhouse gases relative to that of CO2.

HPV Vaccine Awareness and Uptake Among Sexually Transmitted Infections Clinic Users: A Cross-Sectional Study in Bologna, Italy.

Human Papillomavirus (HPV) infection poses a significant health risk, particularly for high-risk groups such as men who have sex with men (MSM), people living with HIV (PLHIV), and transgender individuals. Despite the availability of effective vaccines, uptake among these groups remains suboptimal due to various social and behavioral barriers (BeSD). A cross-sectional survey was conducted at the Sexually Transmitted Infections (STIs) clinic in Bologna, Italy, from 8 April to 12 April 2024 using a paper questionnaire, investigating HPV vaccine uptake and BeSD factors influencing vaccination decisions. Statistical analyses included descriptive statistics and multivariate logistic regression. Among the 236 respondents, PLHIV and transgender individuals demonstrated lower uptake rates (60.0% and 15.6%) if compared to women under 30 years old (72.7%). Concern about HPV infection varied significantly across groups, with MSM showing the highest worry (48.7%). Perceptions of vaccine safety and access were mixed, influencing vaccination decisions. Multivariate analysis indicated that age inversely correlated with infection worry (OR: 0.94, 95% CI: 0.91-0.98), while being a woman under 30 (OR: 164.0, 95% CI: 17.2-1560.18) or MSM (OR: 3.53, 95% CI: 1.37-9.11) was positively associated with vaccine uptake. The study identifies disparities in HPV vaccine uptake among STI clinic users in Bologna, Italy, emphasizing the need for targeted public health campaigns. These campaigns could engage STI clinics and address awareness, safety perceptions, and access barriers to enhance vaccination coverage among sexual and gender minorities.

13 C-MFA helps to identify metabolic bottlenecks for improving malic acid production in Myceliophthora thermophila

BackgroundMyceliophthora thermophila has been engineered as a significant cell factory for malic acid production, yet strategies to further enhance production remain unclear and lack rational guidance. 13C-MFA (13C metabolic flux analysis) offers a means to analyze cellular metabolic mechanisms and pinpoint critical nodes for improving product synthesis. Here, we employed 13C-MFA to investigate the metabolic flux distribution of a high-malic acid-producing strain of M. thermophila and attempted to decipher the crucial bottlenecks in the metabolic pathways.ResultsCompared with the wild-type strain, the high-Malic acid-producing strain M. thermophila JG207 exhibited greater glucose uptake and carbon dioxide evolution rates but lower oxygen uptake rates and biomass yields. Consistent with these phenotypes, the 13C-MFA results showed that JG207 displayed elevated flux through the EMP pathway and downstream TCA cycle, along with reduced oxidative phosphorylation flux, thereby providing more precursors and NADH for malic acid synthesis. Furthermore, based on the 13C-MFA results, we conducted oxygen-limited culture and nicotinamide nucleotide transhydrogenase (NNT) gene knockout experiments to increase the cytoplasmic NADH level, both of which were shown to be beneficial for malic acid accumulation.ConclusionsThis work elucidates and validates the key node for achieving high malic acid production in M. thermophila. We propose effective fermentation strategies and genetic modifications for enhancing malic acid production. These findings offer valuable guidance for the rational design of future cell factories aimed at improving malic acid yields.

COVID-19 vaccine or booster uptake and hesitancy for children aged 6 months–5 years in the United States: A national descriptive study using the household pulse survey between March and May 2023

The Centers for Disease Control and Prevention recommends that children aged 6 months–5 years (children under 5) receive multiple doses of COVID-19 vaccine, including updated (bivalent) COVID-19 vaccine. However, since the updated vaccines became available for children under 5, there has been limited knowledge regarding hesitancy toward the original vaccine or boosters in vaccinating children. To address this gap, this study utilized data from the Household Pulse Survey conducted from March 1, 2023 to May 8, 2023 (Phase 3.8). The purpose of the study was to examine the proportion of children under 5 who had received at least one dose of COVID-19 vaccine and to assess the likelihood of vaccination, categorized as willingness to vaccinate, moderate hesitancy, and strong hesitancy. Additionally, we identified sociodemographic factors that may influence the level of vaccine hesitancy for children. Overall, 24.5 % (95 % CI: 22.2–26.8) of children under 5 had received at least one dose of the COVID-19 vaccine, with the highest percentage among non-Hispanic Asians (42.1 %, 95 % CI: 36.4–47.8). Respondents who had not received the vaccine showed a statistically significant decrease in their inclination to vaccinate children. There was a higher level of vaccine hesitancy among females compared to males regarding vaccinating children under 5. As household income and educational attainment decreased, there was an observed increase in the proportion of individuals showing strong vaccine hesitancy. Households without health insurance had significantly lower vaccine uptake and higher rates of strong vaccine hesitancy compared to those with health insurance. Parents, guardians, and healthcare providers play essential roles in vaccinating children under 5. Targeted interventions are needed to address vaccine hesitancy and promote the importance of booster doses in the vaccination of children.

Spontaneous gradient copolymers of N-vinylsuccinimide/N-vinylsuccinamic acid with O-cholesteryl (meth)acrylate via RAFT polymerization as potential drug delivery systems

Today, biocompatible and bioinspired well-defined copolymers with the ability to form nanoparticles are of great interest as potential drug delivery systems. In this study, we report the synthesis of novel biocompatible copolymers from monomers with different activity and capable of forming gradient copolymers by RAFT polymerization. In particular, the copolymerization of N-vinylsuccinimide (VSI) and O-cholesteryl (meth)acrylate (Ch(M)A) mediated by S,S’-dibenzyl trithiocarbonate (DBTTC) has been thoroughly studied by varying the monomer ratio and the ratio of monomer to RAFT agent. Important dependencies such as molecular weight and monomer conversion versus time, and molar fraction of monomer units as a function of monomer conversion were investigated. The obtained copolymers were thoroughly characterized using a number of physicochemical methods such as 1H NMR, 1H–13C HSQC and ATR-IR-spectroscopy, size-exclusion chromatography, static and dynamic light-scattering, as well as thermogravimetric analysis. In addition, the reactivity ratios of VSI and ChMA were determined and the dyad and triad compositions of the copolymers were calculated from the obtained values. The synthesized P(VSI-co-Ch(M)A) were subjected to selective hydrolysis of succinimide ring to convert it into succinamic acid. This approach yields a set of bioinspired amphiphilic copolymers based on N-vinylsuccinamic acid (VSAA) and Ch(M)A. The synthesized series of P(VSI-co-Ch(M)A) and P(VSAA-co-Ch(M)A) were used to obtain nanoparticles by nanoprecipitation or self-assembly via direct dissolution in aqueous medium. In addition, the method of surface hydrolysis of VSI units in pre-formed P(VSI-co-Ch(M)A) nanoparticles was applied to produce nanoparticles with hydrophilic negatively charged surface and enhanced stability. All techniques were optimized to prepare nanoparticles with characteristics suitable for systems considered for drug delivery. Successful loading of the antitumor drug irinotecan into nanoparticles was achieved with high encapsulation efficacies. The storage stability of empty and irinotecan loaded nanoparticles were studied in various media (water, saline solution, serum containing cell culture medium) under room and refrigerator conditions. The developed empty nanoparticles exhibited low rate of uptake by macrophages and low cytotoxicity to irinotecan-sensitive colon cancer cells (Caco-2). In turn, the irinotecan-loaded nanoparticles demonstrated inhibitory activity against Caco-2 cells comparable to the free drug.

Effect of Glyphosate on Behavioral Changes in a Fresh Water Fish, Labeio Rohita in Sarju River of Gonda, Uttar Pradesh

The present study showed that the glyphosate is toxic and causes behavioral changes in Labeio rohita. The LC50, values of glyphosate conducted to be as 0.018 ml/l; 0.015; m1/1; 0.012 m1/1 and 0.010 m1/1 at 24, 48, 72 and 96 hours. A thick coat of mucus over the body and loss of stability noticed may be due to none functioning of the brain. The colors of the tested fishes appeared little pale as compared to the normal fishes. Hyper excitability followed by lethargy was observed by the jerky and random movement of fishes just after the addition of toxicants. Due to the low rate of oxygen uptake, fishes came to the surface to engulf air frequently. Herbicides, commonly employed to control unwanted vegetation in crops, can enter water bodies through runoff, leading to unintended consequences for aquatic ecosystems.

Factors affecting human papillomavirus vaccine acceptance among parents of Primary 4 to 6 boys and girls in Hong Kong.

Human papillomavirus (HPV) poses a substantial but underestimated healthcare burden in Hong Kong. This study investigated factors affecting parental acceptance of HPV vaccination after the introduction of an immunisation programme for primary school girls. We assessed parental perceptions and related factors concerning HPV vaccination for both boys and girls. We conducted a cross-sectional survey between December 2021 and February 2022 among parents of Primary 4 to 6 students in Hong Kong. Our self-administered online survey collected data regarding socio-demographic characteristics, awareness and knowledge of HPV vaccination, attitudes towards HPV vaccination, and acceptance of HPV vaccination. Characteristics were compared between boys' parents and girls' parents. Factors associated with vaccine acceptance were analysed by multivariate logistic regression. We observed high awareness of HPV vaccination among boys' parents and girls' parents; however, they demonstrated relatively poor knowledge of HPV and the HPV vaccine. An alarming low HPV vaccination uptake rate was also observed. Attitudes towards the HPV vaccine were similar between parent groups. A majority of parents believed that the HPV vaccine was safe and effective in preventing infection. Parents of boys showed lower HPV vaccine acceptance. Factors associated with acceptance differed between parent groups. High awareness of HPV and HPV vaccine is predictive of vaccine acceptance. Boys' parents are less likely to accept HPV vaccination and emphasis should be placed on addressing potential HPV vaccine hesitancy in this group. Public education should also aim to raise awareness of government vaccination programme, and implementation of catch-up vaccination programme to school children beyond primary school should be considered.

What's in a treatment name? How people with posttraumatic stress disorder (PTSD) symptoms interpret and react to PTSD treatment names.

Prior research has rarely examined how people understand or react to the names of psychological treatments. In the case of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), such reactions may be relevant to the low rates of uptake of such treatments. Participants who screened positive for PTSD (n = 887) completed questions assessing their initial reactions to PTSD treatment names as well as how a different name would affect their openness to treatment. In addition, they gave brief responses to open-ended questions about the reason for their initial reactions, and content analysis was used to better understand these reasons. The results indicated that among the treatment name options, cognitive processing therapy (CPT) and present-centered therapy (PCT) were viewed most positively. Approximately 40% of the sample preferred plain language alternatives for treatment names. Content analyses focused on descriptions of the treatments-which could be accurate or inaccurate-as well as whether respondents evaluated a treatment name itself as positive or negative. Some names conveyed treatments more accurately (e.g., CPT and written exposure therapy) than others (e.g., eye movement desensitization and reprocessing and prolonged exposure [PE]). Some names were also evaluated more positively (e.g., PCT) than others (e.g., PE). The general term "trauma-focused therapy" was seen as positive and clear. Addressing the ways patients react to psychological terms and treatment names could help clarify misperceptions about evidence-based psychotherapies and promote more widespread uptake of effective treatments for PTSD.

Macropinocytosis mediates resistance to loss of glutamine transport in triple-negative breast cancer

Triple-negative breast cancer (TNBC) metabolism and cell growth uniquely rely on glutamine uptake by the transporter ASCT2. Despite previous data reporting cell growth inhibition after ASCT2 knockdown, we here show that ASCT2 CRISPR knockout is tolerated by TNBC cell lines. Despite the loss of a glutamine transporter and low rate of glutamine uptake, intracellular glutamine steady-state levels were increased in ASCT2 knockout compared to control cells. Proteomics analysis revealed upregulation of macropinocytosis, reduction in glutamine efflux and increased glutamine synthesis in ASCT2 knockout cells. Deletion of ASCT2 in the TNBC cell line HCC1806 induced a strong increase in macropinocytosis across five ASCT2 knockout clones, compared to a modest increase in ASCT2 knockdown. In contrast, ASCT2 knockout impaired cell proliferation in the non-macropinocytic HCC1569 breast cancer cells. These data identify macropinocytosis as a critical secondary glutamine acquisition pathway in TNBC and a novel resistance mechanism to strategies targeting glutamine uptake alone. Despite this adaptation, TNBC cells continue to rely on glutamine metabolism for their growth, providing a rationale for targeting of more downstream glutamine metabolism components.

Because kids don't come with manuals

Parents often struggle with discipline as well as how best to support their children's social and emotional growth. Unfortunately, many pediatricians, nurses, teachers, and other professionals involved in the lives of young children and their families lack the formal training and/or time to address parenting questions and concerns. And, although evidence‐based parenting programs do exist, their impact is limited by low rates of uptake. Logistical barriers to implementation and workforce shortages limit their availability, and even when available, families often face numerous obstacles to enrolling in and completing programs. From a public health perspective, lack of accessibility and low exposure rates severely limit their potential for reducing the prevalence of behavioral and emotional problems and for promoting psychological wellbeing.

Uptake and correlates of influenza vaccine among older adults residing in rural regions of south China: a cross-sectional study.

Seasonal influenza continues to pose a substantial public health challenge for older adults residing in rural areas worldwide. Vaccination remains the most efficacious means of preventing influenza. This study aimed to investigate the extent of influenza vaccine coverage and identify the factors influencing vaccine uptake among older adults in rural regions of south China. A cross-sectional study utilizing convenience sampling was conducted in two rural sites in Guangdong Province. Individuals needed to meet specific inclusion criteria: (1) attainment of 60 years of age or older; (2) originating from rural households; (3) demonstrating a voluntary desire to partake in the survey, either through written or verbal informed consent. Data encompassed variables such as socio-demographic information, influenza infection and vaccination history, knowledge and attitudes toward influenza vaccination, and perceived beliefs regarding the influenza vaccine. Univariate and multivariable logistic regression analyses were employed to ascertain the factors associated with influenza vaccine utilization. In the multivariable model, adjustments were made for gender, age, legal marital status, highest educational attainment, and monthly income. A total of 423 participants were ultimately included in this study, with the majority falling within the age range of 60-75 years (81.3%). Only one-third of the participants had received an influenza vaccine in the past year (30.0%). Notably, nearly half of the older adults exhibited hesitancy toward influenza vaccination (45.1%). The multivariable analysis revealed that rural older people with a robust understanding of influenza vaccines and a positive attitude toward them (adjusted odds ratio [aOR] = 2.60, 95% confidence interval [CI]: 1.41-4.81), along with a high level of trust in vaccination service providers (aOR = 2.58, 95% CI: 1.01-6.63), were positively associated with receiving influenza vaccination in the past year. This study reveals a low rate of influenza vaccine uptake among older adults residing in rural areas of south China. Given the limited adoption of influenza vaccination and the significant threat it poses, there is an urgent imperative to devise precise interventions aimed at enhancing the effectiveness of influenza vaccination programs.

Caregiver acceptance of human papillomavirus vaccine for their female children in Chileka, Blantyre, Malawi

IntroductionMalawi is one of the countries enduring an enormous burden of cervical cancer. Human Papillomavirus (HPV) vaccination offers a feasible and effective tool for reducing the burden. Such a prospect however, is being impeded by low uptake rates of the HPV vaccine in the country. This study, therefore, sought to identify barriers to caregiver acceptance of the HPV vaccine for their female children in Chileka, Blantyre, Malawi and to establish the consequential willingness to vaccinate their children. MethodologyA cross-sectional study was conducted using qualitative methods. We conducted 6 Focus Group Discussions (FGDs) with 4 groups of women and 2 groups of men in 4 villages located in a semi-urban area, Chileka, Blantyre. The guiding questionnaire was designed to draw out two main outcomes: barriers to caregiver acceptance of the HPV vaccine and willingness to vaccinate children. The data was analysed by thematic analysis by an inductive approach using NVivo software version 11. ResultsLack of knowledge on cervical cancer and HPV vaccination coupled with numerous misconceptions are the main barriers discouraging the population from accepting the HPV vaccine. Consequently, there was little desire to get their children vaccinated against HPV. Though responsibility to get the children vaccinated was mainly attributed to women, men argued that they need to have a final say in their children’s vaccination. ConclusionIn the wake of the revealed barriers and low acceptance of the HPV vaccine, it is imperative to organize effective and sustainable awareness programmes for the improvement of the HPV vaccine’s uptake.

Cervical Cancer Screening and Prevention Uptake in Females with Autism Spectrum Disorder.

This study reports on uptake rates of cervical cancer prevention and screening in a clinically-referred cohort of adolescent and adult females with autism spectrum disorder (ASD). Females with ASD (11-65years) were invited to participate in an online survey to report on uptake of the human papillomavirus (HPV) vaccination and cervical cancer screening. Participants also provided demographic and clinical information. Chi-square statistical analysis was utilized to examine the relationship between categorical variables and receipt of cervical cancer prevention and screening. Forty-one out of 73 (56%) of adolescent (11-17years) and 51/108 (47%) of adult (≥ 18years) females with ASD reported having received at least one dose of the HPV vaccine. Only 30/73 (41%) and 37/108 (34%) of adolescents and adults respectively, were fully vaccinated (≥ 2 doses). Language impairment was the only clinical factor found to be associated with non-receipt of the HPV vaccine. Thirty-one out of 82 (38%) adult females (≥ 21years) with ASD had received at least one pap smear. Language impairment, intellectual disability, non-independent living, and lower level of education were all associated with not receiving a pap smear. Females with ASD are vulnerable to invasive cervical cancer disease due to low uptake rates of the HPV vaccine and routine pap smear screening.

Utilizing Low Sample Uptake Rates and A Nitrogen Mixed-gas Plasma for the Elimination of Oxide-based Interferences in ICPMS Analyses

Utilizing Low Sample Uptake Rates and A Nitrogen Mixed-gas Plasma for the Elimination of Oxide-based Interferences in ICPMS Analyses

Effects of long-term nitrogen addition on root nitrogen acquisition strategy: Insights from a 19-year experiment in two temperate tree species

Nitrogen (N) serves as the primary limiting nutrient for plant growth in the majority of terrestrial ecosystems. However, the effect of long-term N addition on root N acquisition, in particular the seasonal dynamics, is still not well understood. In a 19-year N addition experiment on plantations of ectomycorrhizal tree species Larix gmelinii (larch) and arbuscular mycorrhizal tree species Fraxinus mandshurica (ash), we determined root morphological, chemical and mycorrhizal traits, as well as soil properties. Concurrently, we used a field isotopic hydroponic method to measure root uptake rates of NH4+, NO3-, and glycine in the early, mid and late growing season. Following N addition, mycorrhizal colonization rates in both species were reduced in early and late growing season. Root tissue density was reduced but specific root length and area were increased in ash under N addition across growing seasons, however, no significant differences in these traits were found in larch. Under N addition, both species showed lower uptake rates of all N forms and the total N than the controls throughout the growing season, except for the glycine-uptake of larch in early growing season. N addition did not modify the N-uptake preference in both species, but the contributions of specific N form to the total N varied with seasons. Collectively, referring to the framework of “root economics space”, these two species particularly ash showed greater reliance on the “do-it-yourself” strategy for N acquisition under long-term N addition, although the degree of which somewhat varied with season. Seasonal dynamics in root N-uptake rates of ash were mainly related to soil temperature and moisture, rather than soil N properties, showing less direct impact of N addition. Our findings provide deep insights into the effect of N deposition on root N acquisition strategy and related functions of forest ecosystem.

Siloxane-based segmented poly(urethane-urea) elastomers with enhanced mechanical properties, hydrophobicity and anti-calcification based on hierarchical phase separation for potential applications of polymeric heart valve

The polymeric heart valves have attracted considerable attention for treating valvular heart diseases with favorable biocompatibility, stability and adjustable mechanical properties. However, the thrombosis, calcification, and mechanical durability in the dynamic blood environment have limited further applications. Polycarbonate (PCDL) and polysiloxane (PDMS) had high flexibility, low toxicity, excellent hydrolytic and oxidative stability and efficient biocompatibility, but PCDL was susceptible to calcification and PDMS was susceptible to protein adsorption. To solve these difficulties, PDMS and PCDL were chosen as soft segments to combine the virtues of excellent biocompatibility, hydrolytic stability, and good anti-calcification and anti-protein adsorption, and a series of PCDL-PDMS poly(urethane-urea) elastomers (PCDL-PDMS PUU) were synthesized using a two-step polymerization reaction based on the amino-terminated polydimethylsiloxane (H2N-PDMS-NH2), polycarbonate diol (PCDL) and isophorone diisocyanate. The thermodynamic incompatibility between PDMS and PCDL and hierarchical hydrogen bonds were used to construct microscopic micro-separation, enabling the combination of enhanced mechanical strength, toughness, tear resistance and biocompatibility. The effect of the molar ratio of PCDL and PDMS and hierarchical H-bonding interactions on the physical properties, biostability and biocompatibility of PCDL-PDMS PUU were investigated. It was found the PCDL-PDMS PUU could achieve relatively stable mechanical strength behavior, and the Young’s modulus and tear strengths increased with the increasing proportion of H2N-PDMS-NH2. Meanwhile, PCDL-PDMS PUU showed low water uptake rate lower than 2 %, very good anti-hydrolysis performance, low hemolysis rate of less than 2 % and low adhesion to platelet cells. What’s more, PCDL-PDMS PUU showed enhanced calcification resistance when compared with a commercial polyurethane, ElastollanTM 1180A. Therefore, the results demonstrated that PCDL-PDMS PUU elastomers showed great potential to be explored as heart valves material considering high biostability, superior biocompatibility and mechanical performances.

Gender preferences for multiple attributes of soil and water conservation in Northern Rwanda

Despite the dominance of female labor in agricultural production, female-controlled farm plots have lower efficiency compared to plot managed by male-headed households, which indicates a huge gender disparity in agricultural productivity. Overlooking gender preferences when designing interventions that promote the conservation of soil and water resources might face challenges in adoption and could result in ineffective policies to close the gender gap. This study seeks to analyze gender-specific preferences regarding attributes of soil and water conservation (SWC) in northern Rwanda. A best-worst survey was conducted among 653 respondents, comprising 253 males and 400 females, representing 422 households surveyed between September and December 2019. The analysis of BWS data involved assessing attribute-level relative importance, Pearson correlation, and maximum difference scaling using multinomial logit (MNL). Findings from attribute-level importance analysis revealed significant gender-based disparities in preferences across three important SWC attribute scenarios: the high scenario (between 65 % and 100 %), the moderate scenario (between 50 % and 65 %), and the basic scenario (with <50 % relative importance). The study identified heterogeneity in preferences regarding the relative importance of SWC attribute levels. Pearson correlation analysis revealed substantial synergies among attribute levels linked to land consolidation, improved land tenure, and joint SWC decision-making between genders. Additionally, the study identified trade-offs among multiple levels of SWC attributes, including households' SWC decision-making and physical and structural measures. The results from MNL regression show that both males and females exhibit positive preferences for multiple levels of SWC attributes, but show negative preferences when it comes to household decisions involving multiple SWC strategies. The study highlights the importance of equal opportunities for males and females’ participation in agricultural transformation through the adoption of SWC technologies as a fundamental step towards sustainable agricultural intensification. It advocates for gender transformational approaches to incentivize the scaling up of SWC practices and promote packages with lower uptake rates. Additionally, the study suggests enhancing knowledge and extension education in SWC to better understand diverse needs and preferences of female farmers.

Barriers and Enablers of Cervical Cancer Screening Among Saudi Women.

Cervical cancer is a significant global health issue, with low screening uptake rates in many regions, including Saudi Arabia. This study sought to understand the barriers and enablers of cervical cancer screening among Saudi women, particularly in Makkah, Saudi Arabia. To identify barriers and enablers influencing cervical cancer screening uptake among Saudi women. This cross-sectional study was conducted in Makkah, Saudi Arabia, among 418 Saudi women aged 21-65. A questionnaire collected data on demographics, reproductive health, service utilization, and attitudes toward cervical cancer screening. Statistical tests such as the chi-square test and Mann-Whitney test were used for inferential analyses to determine significance, with a p-value of less than 0.05 considered significant. The study identified significant factors influencing cervical cancer screening uptake, including age, marital status, and household monthly income (p<0.001, p<0.001, and p=0.018, respectively). Health conditions such as hypertension, dyslipidemia, and miscarriage history also showed significant associations with screening uptake (p<0.001, p=0.009, and p<0.001, respectively). Additionally, the availability of screening services and encouragement from healthcare providers were linked to higher screening rates (p<0.001 and p=0.006, respectively). However, perceived benefits, barriers, susceptibility, and seriousness were not significantly associated with screening uptake (p>0.05). The study identified several demographic and healthcare service utilization factors influencing cervical cancer screening uptake among Saudi women. These findings can be instrumental in informing public health measures, awareness campaigns, and healthcare policies aimed at increasing cervical cancer screening rates in Saudi Arabia.