September November Research Articles

Stillbirth prevention with counseling during antenatal care visits in pregnant women: A systematic review

At important stages in women's lives, antenatal care (ANC) serves as a means of communication for women, their families and communities. This study aimed to determine the effectiveness of counseling during ANC as an intervention to prevent stillbirths. Narrative studies with scientific journal database sources published in PubMed, EBSCO and Science Direct were used. This study was conducted during September–November 2023. The keywords used were stillbirth, counseling, ANC, and pregnancy, and the search included research published within five years of the study. A total of 185 articles were found, and 12 articles were selected for review. The findings indicate that an effective intervention to prevent stillbirth can be carried out through counseling during ANC visits. Antenatal counseling is the intervention of choice to change the behavior of pregnant women and health workers and improve the quality of ANC as a strategy for preventing stillbirths. ANC counseling topics that are effective in preventing stillbirth include weight control, breastfeeding, nutrition, physical activity, alcohol, smoking, HIV, drugs, and safe medication during pregnancy. By enhancing the quality of ANC and focusing on education and support, healthcare providers can play a crucial role in preventing stillbirths and promoting maternal and infant health.

Adherence to Preoperative Fasting Guidelines in Elective Surgical Patients.

Preoperative fasting is recommended by international guidelines as a means to minimize the risk of aspiration of gastric content during induction of anesthesia or surgery. Prolonged preoperative fasting is, however, discouraged due to the associated side effects such as dehydration and electrolyte imbalance, which can negatively impact recovery after surgery. An initial quality improvement study revealed poor implementation of the best practice guidelines on preoperative fasting in three departments of a hospital and an institutional action plan was devised to enforce adherence to these guidelines. This present study aimed to assess compliance with the action plan and for that matter, adherence to international consensus on preoperative fasting in three surgical departments. Adult patients undergoing elective cardiac, thoracic, and vascular surgery at a university teaching hospital were surveyed over four months (September October, November, and December of 2023). Data on the length of preoperative fasting was collected using a standardized questionnaire. A total of 306 patients who were scheduled for elective surgery were included in the study. Of the 306 patients, 139 (45.4%) had vascular surgeries, 108 (35.4%) received cardiac surgeries, and 59 (19.3%) had thoracic surgeries. For clear fluids, the overall median fasting time (Q1, Q3) was 4.5 (2.7, 7.4) hours, and for solid food, 14.5 (12.1, 19.0) hours. Extended abstinence from clear fluids and solid food for more than 12 hours was observed in 43 (14.1%) and 231 (75.5%) instances, respectively, while abstinence from solid food for more than 24 hours was noticed in 40 (13.1%)cases. When compared to patients having operations in the morning, those scheduled for afternoon surgery had longer median fasting periods from clear fluids and solid food, p<0.001: 6.2 (4.0, 12.0) hours vs. 3.4 (2.0, 5.2) hours for clear fluids and 16.7 (12.6, 22.6) hours vs. 13.2 (9.6, 15.2) hours for solid food, respectively. Patients continue to abstain from clear fluids and solid food for extended periods of time, despite the fact that there is worldwide agreement regarding shorter periods of preoperative fasting. Compared to patients undergoing morning surgery, individuals hospitalized for afternoon procedures were more likely to fast for extended periods of time.

Assessment of muscle mass in the patient of the intensive care unit as an indicator of risk of sarcopenia at the José María Cabral y Báez Regional Hospital in the period September–November 2023

Assessment of muscle mass in the patient of the intensive care unit as an indicator of risk of sarcopenia at the José María Cabral y Báez Regional Hospital in the period September–November 2023

Climatic influence of the Antarctic ozone hole on the East Asian winter precipitation

The Antarctic ozone hole exerts a substantial impact on the climate of the Southern Hemisphere, yet research exploring its potential influence on the Northern Hemisphere climate is limited. This study unveils a significant positive relationship between interannual variations of Antarctic total column ozone (TCO) during September–October and East Asian precipitation in the subsequent boreal winter. Specifically, ~10% of the East Asian winter precipitation variability is attributed to Antarctic TCO during September–October. Both observational data and model results indicate that the increased Antarctic TCO during September–October triggers a simultaneous meridional southern Indian Ocean tripole sea surface temperature anomalies (SSTA) through the negative phase of the Southern Annular Mode. This SSTA pattern persists from September–November through the boreal winter, subsequently weakening the local-scale zonal-vertical circulation anomalies in the Indian Ocean. The process leads to positive outgoing longwave radiation (OLR) anomalies over the southern Marine Continent. As a result, the linear response of wind anomalies at 850 hPa over East Asia to the OLR-induced diabatic heating anomalies exhibits southwesterlies, as demonstrated by a linear baroclinic model. These anomalous winds facilitate the transport of abundant moisture from the tropics to East Asia, favoring the formation of winter precipitation. We employ the Specified-Chemistry version of the Whole Atmosphere Community Climate Model to validate that the increase of September–October Antarctic ozone substantially enhances East Asian precipitation during boreal winter. Importantly, the relationship between Antarctic ozone and East Asian winter precipitation is found to be independent of El Niño-Southern Oscillation and the Indian Ocean Dipole Mode. Our findings provide a fresh insight into the prediction of the East Asian winter precipitation.

Implementing a Compliance Monitoring Process to Promote Chlorhexidine Gluconate Bathing and Hand Hygiene: An Initiative to Decrease Central Line–Associated Bloodstream Infections

Background Chlorhexidine gluconate (CHG) bathing has proven to reduce central line–associated bloodstream infections (CLABSI) in hospitalized patients. The aim of this study is to evaluate whether the implementation of a compliance monitoring process for CHG bathing and strict hand hygiene as part of the traditional CLABSI prevention bundle will reduce the overall hospital CLABSI standardized infection ratio (SIR). Methods A quasi-experimental study was conducted in intensive care and non-intensive care inpatient hospital units in an urban 361-bed teaching hospital in Western Pennsylvania. The pre-intervention period consisted of January–August 2021, the intervention period consisted of September–November 2021, and the post-intervention and sustainability period consisted of December 2021–June 2022. A compliance monitoring process for the initiation of a daily bath using a 4% CHG solution and strict hand hygiene surveillance was implemented as part of the standard CLABSI prevention bundle (which includes standardized insertion checklists and processes, daily necessity assessment, dressing change and integrity standards, five moments hand hygiene standards, CHG disk [Biopatch], end caps [Curos], and care of tubing). Outcomes A statistically significant increase in hand hygiene (p=&lt;0.001) and in CHG bathing compliance (p=0.014) helped reduce the overall hospital CLABSI SIR from 1.45 to 0.82, standing for an overall 43.4% decrease. Cost reduction was statistically significant (p=0.011) and was an estimated $1.4 million dollars in savings for the hospital. Next Steps Incorporate the compliance monitoring component for CHG bathing and hand hygiene as part of the best strategy for CLABSI bundle prevention within the healthcare system.

Changes in Cannabis Use Patterns in Psychiatric Populations Pre- and Post-Legalization of Recreational Cannabis Use in Canada: A Repeated Cross-Sectional Survey

Objective: Since the federal Canadian government legalized cannabis in 2018, cannabis use in the general population has slightly increased. However, little is known about the impact of cannabis legalization on pattens of cannabis use in psychiatric populations. Method: We studied changes in daily/almost daily and average 30-day cannabis use amongst individuals currently using cannabis who reported past 12-month experiences of specific mental health disorders and among those without past 12-month experiences of any mental health disorder before and after Canadian legalization of recreational cannabis use (N = 13,527). Data came from Canadian respondents in Wave 1 (August–October 2018), Wave 2 (September–October 2019), and Wave 3 (September–November 2020) of the International Cannabis Policy Study (ICPS). Results: After adjustment for covariates, among individuals currently using cannabis, the odds of using cannabis daily/almost daily increased only in individuals with schizophrenia between Wave 1 and Waves 3 (aOR = 9.19, 95% CI: 2.46 – 34.37). Similarly, significant increases in average 30-day cannabis use between Wave 1 (M = 12.80, SE = 1.65) and Wave 3 (M = 18.07, SE = 1.03) were observed only among individuals with schizophrenia [F (1,2) = 4.58, p &lt; .05). No significant changes in daily/almost daily or average past 30-day cannabis use were observed in those without mental health problems or those reporting anxiety, depression, PTSD, bipolar disorder, or substance use disorders. Conclusions: Since legalization, cannabis use has significantly increased only among people with schizophrenia, highlighting the need for targeted public health prevention programs.

Interannual Influence of Antarctic Sea Ice on Southern Hemisphere Stratosphere‐Troposphere Coupling

AbstractWhile weakening of the boreal polar vortex may be caused by autumnal Arctic sea ice loss, less is known about the interannual influence of Antarctic sea ice on stratosphere‐troposphere coupling in the Southern Hemisphere. Identifying any relationship over the short satellite period is difficult due to sampling variability and anthropogenic modification of the austral polar vortex. To circumvent these issues, we use large ensembles of fixed boundary condition simulations from the Community Atmosphere Model (CAM) and Whole Atmosphere Community Climate Model (WACCM) to assess if and how interannual fluctuations in winter Antarctic sea ice influence spring planetary‐scale waves and the coupled stratosphere‐troposphere circulation. Low Antarctic sea ice conditions are found to modulate tropospheric stationary waves to project constructively onto the climatological stationary wave, enhancing upward planetary wave propagation into the austral polar stratosphere. In WACCM, the resulting vortex weakening coincides with development of negative Southern Annular Mode conditions during September–November.

Role of atmospheric and oceanic processes on interannual summertime (2016–2017) decrease of sea ice in the Antarctic regions of the Southern Ocean

In this article, the interannual variability of sea ice in the Antarctic sea ice regions between 2013–2018 is studied using a global ocean sea ice coupled model and satellite observation. The numerical model reasonably well simulates satellite observed interannual variability of sea ice concentration (SIC) and sea surface temperature (SST) in the Antarctic regions of Southern Ocean during all four austral seasons; summer (December–February), autumn (March–May), winter (June–August), and spring (September–November).A comparison of satellite and model shows that, during last two decades between 2001–2020, summertime of 2016–2017 had the lowest (highest) SIC (SST) across the Antarctic sea ice regions. Mixed layer heat budget analysis has been performed to comprehend how thermodynamic processes affect changes in SIC and SST in the Antarctic sea ice regions. The strong positive net atmospheric heat flux and the negative ocean vertical entrainment during summertime of 2016–2017 resulted in increased SST compared to other years, which lead to decreased SIC during above years. Also, loss of sea ice during summertime of 2016–2017 in the Antarctic sea ice regions are linked with significant decrease of wind stress magnitude and increase of wind stress curl.

Radio Occultation Modeling Experiment (ROMEX): Determining the Impact of Radio Occultation Observations on Numerical Weather Prediction

Abstract The international radio occultation (RO) community is conducting a collaborative effort to explore the impact of a large number of RO observations on numerical weather prediction (NWP). This effort, the Radio Occultation Modeling Experiment (ROMEX), has been endorsed by the International Radio Occultation Working Group, a scientific working group under the auspices of the Coordination Group for Meteorological Satellites (CGMS). ROMEX seeks to inform strategies for future RO missions and acquisitions. ROMEX is planned to consist of at least one 3-month period during which all available RO data are collected, processed, archived, and made available to the global community free of charge for research and testing. Although the primary purpose is to test the impact of varying numbers of RO observations on NWP, the 3 months of RO observations during the first ROMEX period (ROMEX-1, September–November 2022) will be a rich dataset for research on many atmospheric phenomena. The RO data providers have sent their data to EUMETSAT for processing. The total number of RO profiles averages between 30 000 and 40 000 per day for ROMEX-1. The processed data (phase, bending angle, refractivity, temperature, and water vapor) will be distributed to ROMEX participants by the Radio Occultation Meteorology Satellite Application Facility (ROM SAF). The data will also be processed independently by the UCAR COSMIC Data Analysis and Archive Center (CDAAC) and available via ROM SAF. The data are freely available to all participants who agree to the conditions that the providers be acknowledged, and the data are not used for commercial or operational purposes.

Seasonal variations and social disparities in asthma hospitalizations and outcomes

Objective Exposure to asthma exacerbating triggers may be dependent on the season and an individual’s social factors and subsequent means to avoid triggers. We assessed for seasonal variations and differential outcomes based on race and income in admissions for asthma in a United States nationwide assessment. Methods This retrospective study assessed adult hospitalizations for asthma 2016–2019 using the National Inpatient Sample. Hospitalizations were categorized by season: winter (December–February), spring (March–May), summer (June–August), fall (September–November). Multivariable linear and logistic regression were used to assess associations between season, race, income quartile (determined by the median income within a patient’s ZIP code), and outcomes. Results The study included 423,140 admissions with a mean age of 51 years, and 73% of the cohort being female and 56% non-white. Admissions peaked during winter (124, 145) and were lowest in summer (80,525). Intubation rates were increased in summer compared to winter (2.73 vs 1.93%, aOR = 1.19, 95% CI: 1.04–1.37) as were rates of noninvasive positive pressure ventilation (NIPPV) (7.92 vs 7.06%, aOR = 1.08, 95% CI: 1.00–1.17). Compared to white patients, intubation (2.53 vs 1.87%, absolute difference 0.66%, aOR = 1.14, 95% CI: 1.02–1.29) and NIPPV (9.95 vs 5.45%, absolute difference 4.5%, aOR = 1.69, 95% CI: 1.57–1.82) were increased in Black patients. No significant associations between income and clinical outcomes were found. Conclusions Asthma admission peak during winter, while summer admissions and non-white race are associated with higher rates of NIPPV and intubation. Public health initiatives and strategically timed outpatient visits could combat seasonal variation and social disparities in asthma outcomes.

Trend and Variability Analysis of Annual Maximum Rainfall Using Observed and Remotely Sensed Data in the Tropical Climate Zones of Uganda

Understanding rainfall variability and trends is crucial for effective water resource management and disaster preparedness, particularly in tropical regions like Uganda. This study analyzes the trends and variability of the Annual Maximum Series (AMS) and seasonal rainfall data across four rainfall stations in Uganda, comparing observed data with various Remotely Sensed Rainfall (RSR) products. The key methods used in this study include the Mann–Kendall test and Sen’s slope estimator for trend analysis, AMS rainfall variability analysis using statistical performance metrics such as the Nash–Sutcliffe Coefficient of Efficiency (NSE) and Percent Bias (PBIAS), and data distribution comparisons based on goodness-of-fit evaluation using the Kolmogorov–Smirnov (KS) test. The results indicate that most trends in the seasonal rainfall and AMS data are statistically insignificant. However, the September to November (SON) observed rainfall at the Gulu station shows a statistically significant increasing trend of 7.68 mm/year (p-value = 0.03). Based on the PBIAS metric, GPCC and NOAA_CPC products outperform other RSR data products. At the Jinja station, NOAA_CPC has a PBIAS value of −12.93% and GPCC, −14.64%; at Soroti, GPCC has −9.66% and NOAA_CPC, −14.79%; at Mbarara, GPCC has −5.93% and NOAA_CPC, −11.63%; and at Gulu, GPCC has −3.05% and NOAA_CPC, −19.23%. The KS test results show significant differences in the distribution of RSR data and observed rainfall data, though GPCC shows significant agreement at the Gulu (p-value = 0.60) and Mbarara (p-value = 0.14) stations. Additionally, NOAA_CPC outperforms other RSR data products at the Mbarara station, with a KS p-value of 0.24. This study highlights the limitations of current RSR datasets in replicating observed AMS rainfall data. Based on KS test results, GPCC is identified as a better product for hydrological applications at the Gulu, Jinja, and Soroti station areas compared to other RSR products. For the Mbarara station, NOAA_CPC outperforms other RSR products.

Comparison of the Psychological Impact of COVID-19 on Healthcare Workers between 2022 and 2023 in a Romanian COVID-19 Hub Hospital

We assessed depression, anxiety, and stress in healthcare workers (HCWs) in 2023 and the evolution of depression in 2023 compared with 2022. In September–November 2023, 181 HCWs from the Infectious Diseases Hospital, Cluj-Napoca, Romania, completed the Depression, Anxiety, and Stress 21 Scale (DASS-21 R), the Patient Health Questionnaire 9 (PHQ-9), and the Hamilton Anxiety Rating Scale (HAM-A). The prevalence of moderate-to-severe levels was 13.8% for DASS-Depression, 18.8% for DASS-Anxiety, 16.1% for DASS-Stress, 19.9% for PHQ-9, and 18.2% for HAM-A. Moderate-to-severe PHQ-9 depression was significantly lower in the 2023 study group (19.9%, N = 181) compared with 2022 (30.6%, N = 114) (p = 0.04), also within the 2022–2023 follow-up participants (N = 88) (p = 0.03). We did not find significant statistical differences between those infected vs. non-infected, vaccinated vs. non-vaccinated, or working with vs. not working with SARS-CoV-2 infected patients. Males were significantly more stressed (p = 0.02) and anxious (p = 0.03), and physicians in training had the highest prevalence of moderate-to-severe depression (31.6%), followed by physicians (25.6%). In 2023, depression, anxiety, and stress symptoms decreased but remained within a concerning range. By addressing these psychological issues, we may reduce the possibility of medical errors and prevent professional crises in the healthcare system.

Familial hypercholesterolemia care by Dutch pediatricians—mind the gaps

PurposeFamilial hypercholesterolemia (FH) leads to elevated low-density lipoprotein cholesterol levels, which increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). Since the first functional and morphologic changes of the arterial wall occur in childhood, treatment should start early in childhood to mitigate the elevated risk of ASCVD. Pediatricians play an important role in the detection and care of children with FH. In this study, we aim to explore potential gaps in FH care amongst Dutch pediatricians, in order to enhance their knowledge and awareness of detecting and treating children with FH.MethodsAn anonymous online survey, deployed using Google Forms, including 26 closed and semi-closed questions on FH care in children was distributed by the Dutch Association of Pediatrics via a newsletter to which the majority of the practicing Dutch pediatricians subscribe. In addition, we requested that the pediatric departments of all Dutch hospitals in the Netherlands distribute this survey personally among their employed pediatricians. Respondents were instructed to answer the questions without any help or use of online resources.ResultsBetween September 1st, 2023 and November 1st, 2023, 158 (an estimated 11% response rate) Dutch pediatricians completed the survey. They reported a median (IQR) of 15.0 (6.0–22.0) years of experience as a pediatrician, and 34 (21.5%) were working in academic hospitals. The majority (76.6%) of pediatricians correctly identified a typical FH lipid profile but 68 (43.0%) underestimated the true prevalence of FH (1:300). Underestimation and unawareness of the increased risk of FH patients for ASCVD were reported by 37.3% and 25.9% of pediatricians, respectively. Although 70.9% of the pediatricians correctly defined FH, only 67 (42.4%) selected statins and ezetimibe to treat severe hypercholesterolemia.Conclusions:The results of this study suggest significant gaps in knowledge and awareness of FH in children among Dutch pediatricians. FH care in children needs improvement through educational and training initiatives to mitigate the life-long risk of ASCVD from early life.What is Known:• Familial hypercholesterolemia (FH) leads to elevated LDL-cholesterol levels, which increases the risk of premature atherosclerotic cardiovascular disease (ASCVD).• The process of atherosclerosis starts in childhood• Pediatricians play an important role in the detection and treatment of children with FH.What is New:• Our results highlight significant gaps in care for children with FH amongst pediatricians and this may lead to suboptimal detection and treatment.• FH care in children needs improvement by educational initiatives to ultimately prevent ASCVD in adulthood.

Temporal distributions of aerosols over the Horn of Africa–Ethiopia using MODIS satellite data: Part 01

There are large temporal variations in the optical properties and types of aerosols. These are due to the effects of environmental and meteorological conditions, industrial and agricultural influences, and other human influences and natural factors in each ecological functional area. Aerosol optical depth AOD and Ångström exponent AE parameters were extracted from the Moderate Resolution Imaging Spectroradiometer MODIS satellite with a 3 km resolution of MOD04_3K and MYD04_3K. The study covers sixteen selected stations in Horn Africa–Ethiopia with neighboring Eritrea, Djibouti, and South Sudan countries clustered into four regions for the periods of 2001–2022 to obtain detailed information on the temporal behaviors and classification of aerosols in each season. The results show that the temporal variability of AOD and AE values is large, with values ranging from 0.00 to 2.10 and 0.67 to 1.23, with minimum values most likely between December 16 and January 07, and maximum values between June 22 and July 24 for both Terra and Aqua in the southeast and northeast clusters, respectively. The lowest AOD and AE values were most common in the Belg (during September–November) and sometimes in Bega (during December–February), while the highest were in the Kiremt season (during June–August). The minimum values were observed at the Kebri Dahar site, and the maximum were at the Erta Ale site, which belongs to Ethiopia. Appropriate AOD and AE thresholds were used to classify the aerosol types into marine (MR), dust (DS), biomass burning (BB), desert dust (DD), urban (UR), and the residual cases were considered mixture (MX) types. The study concludes that marine aerosols were the most abundant at 47.71%, followed by urban aerosols at 28.29%, while desert dusts, enriched at 14.65%, accounted for the third place with free of dust particles. The Mann–Kendall (MK) statistical trend test was applied to the annual time series in all clustered regions and shows an almost positive increasing variability with a slight decrease in the forward series and vice–versa.

A Comparison of the Impacts of Two Consecutive Double-Peaked La Niña Events on Antarctic Sea Ice in Austral Spring

Abstract Among nine La Niña events since 1980, there are seven double-peaked La Niña events that typically persist for 2 years and peak twice in the two consecutive boreal winters. In the study, the individual impacts of the first and second peak episodes of such La Niña on the Antarctic sea ice in austral spring (September–November) were compared. The results suggest a difference. The first episode induces a tripolar distribution of sea ice concentration (SIC) with a negative anomaly in the Bellingshausen Sea sandwiched with positive anomalies in the Ross Sea and the northeastern Weddell Sea. The second causes an SIC reduction in most parts of the Southern Ocean except for the eastern Ross–western Amundsen Seas where an increase is observed. Mechanistically, the first episode forces one single Rossby wave train to propagate southeastward, causing a strong cyclone anomaly over the eastern Ross–Amundsen–Bellingshausen Seas along with a weak anticyclone over the Weddell Sea. In comparison, the second La Niña excites two branches of Rossby wave trains emanating from the southeastern tropical Indian Ocean and the central equatorial Pacific, respectively, which induce three anomalous anticyclones and two anomalous cyclones over the Southern Ocean. These different atmospheric circulation anomalies shape their different sea ice distributions between the two La Niña episodes through both dynamic and thermodynamic processes. The modeling results from CAM5 verify these differences. Significance Statement Under global warming, the double-peaked La Niña occurs more frequently. The first and second La Niña episodes in such double-peaked La Niña are distinct from each other not only in their onset and developing mechanisms but also in their climate impacts. Based on observational analyses and model experiments, the study investigated the distinctive impacts of the first and second episodes on the austral spring Antarctic sea ice. The results reveal that the first episode excites one single southeastward-propagated Rossby wave train, while the second episode forces two branches of Rossby wave trains. These different atmospheric responses in the Southern Hemisphere shape the distinct sea ice distributions both dynamically and thermodynamically. The study also indicates the diversity of tropical–Antarctic teleconnections.

Improved mapping of highland bamboo forests using Sentinel-2 time series and machine learning in Google Earth Engine

Recent advances in the application of spectral bands from satellite observations and machine learning algorithms (MLA) in the Google Earth Engine (GEE) cloud-computing platform have been demonstrated to enhance the accuracy of mapping forest resources. This study presents a novel method for mapping the natural distribution of highland bamboo (Oldeania alpina) using spectral bands and three machine learning algorithms, namely random forest, gradient tree boosting, and classification and regression tree. First, spectral bands, vegetation indices and textural features including contrast, entropy and inverse difference moment were derived from the Sentinel-2 elevation data. Second, observations were categorized as the dry season (December–February), short rainy season (March-May), main (long) rainy season (June-August), wet season (September–November) and annual composite. Third, the machine learning algorithms were tested using 1882 ground control points collected from field and high spatial resolution images. Finally, the best-performing machine learning algorithm was used to classify and map bamboo forests. The five land cover categories identified were bamboo stands, natural forest, other vegetation, non-vegetated areas and water bodies. The result shows that the random forest classifier is a robust algorithm with an overall accuracy of 94% considering all the annual composite’s spectral, vegetation and textural variables. The highland bamboo coverage (91 km2) in the Andracha district provided valuable insights. Bamboo stands were mostly distributed in the southern and southeastern parts of the district. Here, we show that image compositing and multiple input parameters using machine learning techniques can overcome challenges facing land cover classification, which can hinder accurate mapping of Afromontane forests. We conclude that the incorporation of vegetation indices and textural features in land cover classification increases accuracy of mapping natural highland bamboo coverage and distribution. The application of this new method is a promising prospect not only in Ethiopia but also in Afromontane forests elsewhere in Africa.

Tuberculosis preventive treatment among the household contacts of tuberculosis patients – Coverage and correlates in a block of Murshidabad district, West Bengal: A cross-sectional study

BackgroundIndia started implementing tuberculosis preventive treatment (TPT) among all household contacts of Tuberculosis (TB) cases, as a globally accepted strategy for elimination of TB. ObjectivesWe aimed to assess the extent of TPT coverage and adherence; ascertain the reasons for non-initiation and non-adherence; and to determine the correlates of coverage. MethodsWe conducted a cross-sectional study in a block of Murshidabad district, West Bengal during September–November’2023. A calculated sample of 301 eligible household contacts of ‘index cases’ (microbiologically-confirmed drug-sensitive pulmonary TB) registered during October’22 to March’23 were studied. We interviewed the participants/respondents with pre-designed schedule and prior informed consent. Descriptive and inferential statistics were applied through Statistical Package for Social Sciences (version 20). ResultsOf 301 contacts, 179(59.5%) individually traced/counseled at the household; 238 (79.1%) were screened for TB symptoms. TPT initiation was 74.8% (225/301) with 47.1% within seven days of treatment initiation of index case; TPT not offered by health personnel (59.2%) being major reason for non-initiation. Completion rate with adherence to full course was 69.3% (156/225); perceived lack of need (50.7%) and migration (21.7%) being major reasons for non-adherence. Overall coverage of full course TPT among total eligible contacts was only 51.8% (156/301). On multivariable logistic regression; male gender (aOR = 1.982; 95% CI = 1.004–3.915), contacts with individual tracing/counseling (aOR = 13.507; 95% CI = 6.781–26.906) and who had symptoms screening (aOR = 5.694; 95% CI = 2.223–14.587) predicted significantly higher TPT coverage. ConclusionCascade of care indicators for TPT remains suboptimal in the area and indicates need for further strengthening of programmatic aspects of its implementation.

Controls on Dissolved Barium and Radium‐226 Distributions in the Pacific Ocean Along GEOTRACES GP15

AbstractRadium‐226(226Ra) and barium (Ba) exhibit similar chemical behaviors and distributions in the marine environment, serving as valuable tracers of water masses, ocean mixing, and productivity. Despite their similar distributions, these elements originate from distinct sources and undergo disparate biogeochemical cycles, which might complicate the use of these tracers. In this study, we investigate these processes by analyzing a full‐depth ocean section of 226Ra activities (T1/2 = 1,600 years) and barium concentrations obtained from samples collected along the US GEOTRACES GP15 Pacific Meridional Transect during September–November 2018, spanning from Alaska to Tahiti. We find that surface waters possess low levels of 226Ra and Ba due to export of sinking particulates, surpassing inputs from the continental margins. In contrast, deep waters have higher 226Ra activities and Ba concentrations due to inputs from particle regeneration and sedimentary sources, with 226Ra inputs primarily resulting from the decay of 230Th in sediments. Further, dissolved 226Ra and Ba exhibit a strong correlation along the GP15 section. To elucidate the drivers of the correlation, we used a water mass analysis, enabling us to quantify the influence of water mass mixing relative to non‐conservative processes. While a significant fraction of each element's distribution can be explained by conservative mixing, a considerable fraction cannot. The balance is driven using non‐conservative processes, such as sedimentary, rivers, or hydrothermal inputs, uptake and export by particles, and particle remineralization. Our study demonstrates the utility of 226Ra and Ba as valuable biogeochemical tracers for understanding ocean processes, while shedding light on conservative and myriad non‐conservative processes that shape their respective distributions.

Assessment of incidental cardiac uptake in bone scintigraphy across Spain: The ECCINGO study

AimMyocardial uptake on bone scintigraphy has become useful for the detection of transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to assess the prevalence of myocardial uptake in patients over 18 years of age with no clinical suspicion of cardiac amyloidosis (CA) who had undergone bone scintigraphy. Methods and resultsThis was an observational, retrospective, multicenter study across 21 Spanish hospitals (September–November 2019). Of the 9864 scans analyzed (locally and centrally), incidental cardiac uptake was observed in 71 patients (0.72%), a prevalence that increased with age. A previous diagnosis of heart failure was found in 16.9% of patients with positive uptake, with >50% in NYHA II. ATTR-CA was diagnosed in 10 patients, with a mean delay of 10.4 months (95% CI: 5.1–15.7). All were >70 years old, primarily male, and had greater left ventricular hypertrophy than patients without a confirmed diagnosis (p<0.0001). ATTR-CA patients had higher rates of orthostatic hypotension (30.0% vs. 3.8% in non-ATTR-CA; p=0.025). ConclusionsThis is the first retrospective, national, multicenter study evaluating the prevalence of incidental cardiac uptake in bone scintigraphy performed for non-cardiac reasons, showing a prevalence of 0.72% in this population. Referral of these patients may facilitate early diagnosis of CA with a resulting benefit for patients.

Real-world use, perception, satisfaction, and adherence of calcipotriol and betamethasone dipropionate PAD-cream in patients with plaque psoriasis in Spain and Germany: results from a cross-sectional, online survey

Background Psoriasis significantly impacts patients’ quality of life (QoL). Dissatisfaction and non-adherence are major barriers associated with topical treatments. A cream based on the polyaphron dispersion (PAD) Technology containing a fixed-dose of calcipotriol (CAL) and betamethasone dipropionate (BDP) was designed for a patient-friendly psoriasis management. The CAL/BDP PAD-cream demonstrated efficacy, convenience, and safety/tolerability in clinical trials. Objectives This research assesses the real-world use, perception, satisfaction, and adherence of CAL/BDP PAD-cream among plaque psoriasis patients. Methods Between September–November 2023, psoriasis patients from Spain and Germany using or having used CAL/BDP PAD-cream for >2 weeks were recruited via Wefight network to complete a 30-questions online survey. Anonymized results were pooled for descriptive statistical analysis. Results The survey was completed by 129 patients (mean age: 43 years; 66% females; mean psoriasis duration: 12 years). Most patients (93%) were satisfied with CAL/BDP PAD-cream. The 66% reported high adherence (visual analogue scale 80-100) and 91% preferred CAL/BDP PAD-cream to their previous topical(s). Patients highlighted its ease/convenience of application, tolerability, and lack of itching/burning. Conclusions Psoriasis patients treated with CAL/BDP PAD-cream in a real-world setting show high satisfaction, good adherence, and a positive perception of the product, suggesting that favorable outcomes observed in clinical trials translate to real clinical practice.