Comparative Evaluation of Direct Thrombin and Factor Xa Inhibitors with Antiplatelet Agents under Flow and Static Conditions: An In Vitro Flow Chamber Model

Dabigatran and rivaroxaban are novel oral anticoagulants that specifically inhibit thrombin and factor Xa, respectively. The aim of this study is to elucidate antithrombotic properties of these anticoagulant agents under arterial and venous shear conditions. Whole blood samples treated with dabigatran or rivaroxaban at 250, 500, and 1000 nM, with/without aspirin and AR-C66096, a P2Y12 antagonist, were perfused over a microchip coated with collagen and tissue thromboplastin at shear rates of 240 and 600 s−1. Fibrin-rich platelet thrombus formation was quantified by monitoring flow pressure changes. Dabigatran at higher concentrations (500 and 1000 nM) potently inhibited thrombus formation at both shear rates, whereas 1000 nM of rivaroxaban delayed, but did not completely inhibit, thrombus formation. Dual antiplatelet agents weakly suppressed thrombus formation at both shear rates, but intensified the anticoagulant effects of dabigatran and rivaroxaban. The anticoagulant effects of dabigatran and rivaroxaban were also evaluated under static conditions using thrombin generation (TG) assay. In platelet-poor plasma, dabigatran at 250 and 500 nM efficiently prolonged the lag time (LT) and moderately reduce peak height (PH) of TG, whereas rivaroxaban at 250 nM efficiently prolonged LT and reduced PH of TG. In platelet-rich plasma, however, both anticoagulants efficiently delayed LT and reduced PH of TG. Our results suggest that dabigatran and rivaroxaban may exert distinct antithrombotic effects under flow conditions, particularly in combination with dual antiplatelet therapy

The Kagiso-Shanduka trust educational innovation: an exploration of the initiation phase of the KST whole-school development model in the Free State province

A dissertation submitted to the University of the Witwatersrand in fulfillment of the requirements for the degree of Master of Education Johannesburg, 2018This study explored the initiation phase of the Kagiso-Shanduka Trust (KST) whole-schooldevelopment model, which is implemented in Fezile Dabi (FD) education district in the Free State Province, South Africa. The research was conceptualised and conducted between 2015 and 2016. I employed a qualitative research methodology and case-study approach to collect data to answer my research questions. The data sources emerged from interviews conducted with five participants who I purposively selected. They are executive members from KST and a senior official from Fezile Dabi District in the Free State Department of Education. I interviewed each participant separately at their places of work. The study identifies the nature of processes and the factors that influenced the adoption of the KST W-SD model. I used the concepts of engagement and mobilisation to unpack the processes and the factors in the initiation phase of the KST W-SD model because they are key concepts that provides descriptive data. These data point out the direction and intensity the change is taking and determine the sustainability elements in the initiation of a change project. Engagement and mobilisation are conscious efforts that bring about insights on the totality of a change project and the adaptations instituted in the initiation phase of a change project. The following findings emerged from the study: 1) there are conditions that gave rise to the need for the model, 2)the model was conceptualised by each organisation individually (KT and FS), then in a dual partnership (KST) and in a tripartite (PPP) through stakeholder engagement and mobilisation, 3) the descriptions fits the conceptualisation, 4)stakeholder engagement and mobilisation created awareness, interest, problem solving opportunities and ownership during interactions of partners, 5) the model was consequently consolidated with six elements, 6) the model elements are integrated and provide a comprehensive package for whole school development, and 7) the model is a product of investment on organisational capacities and capabilities developed over a period of time as well as shared interest and purpose. It is recommended that more research involving private, public partnerships be conducted more frequently on current educational innovation models.MT 201

Rivaroxaban vs Dabigatran for Thromboprophylaxis After Joint-replacement Surgery: Exploratory Indirect Comparison Based on Metaanalysis of Pivotal Clinical Trials

Aim To indirectly compare rivaroxaban and dabigatran for prevention of venous thromboembolism (VTE) after total hip or knee arthroplasty (THA, TKA) based on their pivotal efficacy/safety trials embracing a total of 20 618 patients. Methods Pooled risk differences (RD) for rivaroxaban vs enoxaparin and dabigatran vs enoxaparin obtained from separate meta-analyses of two sets of trials were used to indirectly estimate RDs for rivaroxaban vs dabigatran. Results Primary efficacy (any VTE+all-cause mortality) and safety (major bleeding) outcomes in enoxaparin arms largely differed across similarly designed rivaroxaban and dabigatran trials (differences in venography adjudication and bleeding events definitions). However, incidence of symptomatic VTE and incidence of major/non-major clinically relevant bleeding (including surgical site) were consistent in this respect. RDs (as percentages) for symptomatic VTE were: rivaroxaban-enoxaparin = -0.4% (95% confidence interval [CI], -0.9 to 0.05); dabigatran-enoxaparin = -0.09% (95% CI, -1.0 to 0.8); rivaroxaban-dabigatran = - 0.3% (95% CI, -1.3 to 0.7; P = 0.275). RDs for major/clinically relevant bleeding were rivaroxaban-enoxaparin = 0.99% (95%CI, 0.29 to 1.69); dabigatran-enoxaparin = 0.02% (95% CI, -1.0 to 1.0); rivaroxaban-dabigatran = 0.97 (95% CI, -0.43 to 2.37; P = 0.085). Mortality rates (all-cause, VTE-related, bleeding-related) were very low not indicating differences between any two of the three treatments. Conclusion Methodological differences disable indirect comparisons of rivaroxaban vs dabigatran that would be based on major efficacy/safety outcomes of their pivotal trials. The two drugs do not seem to differ regarding incidence of symptomatic VTE. Risk of a relevant bleeding is higher with rivaroxaban than with enoxaparin and the same tendency exists also vs dabigatran. Direct rivaroxaban vs dabigatran comparisons in this setting are needed

National Food and Nutrition Security Survey: Free State Province report

This report is based on the empirical evidence collected from selected Small Area Layers (SALs) within the five districts of Free State Province. SAL is the smallest geographical unit usually allocated to a single enumerator during census enumeration. In other words, it constitutes a small piece of land for an enumerator to cover to administer a questionnaire during a census or study (Statistics South Africa). Each of the SALs in this survey had 35 visiting points (households). The results provide a baseline assessment of the status quo of food and nutrition security in the province. The data was collected during COVID-19 lockdown around January-February 2022. This greatly influenced and changed the picture from what would ordinarily obtain under a normal situation. The project benefited from the valuable insights and input of the advisory board that provided comments and reviewed the research reports. Albeit they cannot be held accountable for errors or omissions that may exist in the report. Whilst this research project has benefited from the valuable insights and input of a Technical Advisory Group (TAG) that provided comments and reviewed the final research report, the ultimate responsibility for the contents therein (including but not limited to unintentional errors, inaccuracies, or omissions) rests with the authors and researchers involved. Users of this research should exercise their judgment and discretion when interpreting the findings and recommendations presented herein.

Patient satisfaction with antiretroviral services at primary health-care facilities in the Free State, South Africa – a two-year study using four waves of cross-sectional data

<p>Abstract</p> <p>Background</p> <p>The study's first objective was to determine the levels of patient satisfaction with services at antiretroviral treatment (ART) assessment sites. Differences in patient satisfaction with several aspects of service over time and among health districts were measured. The second objective was to examine the association between human resource shortages and levels of patient satisfaction with services.</p> <p>Methods</p> <p>Four cross-sectional waves of data were collected from a random sample of 975 patients enrolled in the Free State's public-sector ART programme. One-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in patient satisfaction among the Province's five districts and among the four waves of data. Correlation coefficient analysis using Pearson's <it>r </it>was used to assess the association between ART nurse vacancy rates and patient satisfaction with the services provided by nurses over time.</p> <p>Results</p> <p>With respect to both general services and the services provided by nurses, our results indicate high overall satisfaction among Free State patients receiving public-sector ART. However, our data present a less positive picture of patient satisfaction with waiting times. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. In fact, waiting times at assessment sites were the most important predictor of discontent among ART patients. Significant geographical (<it>P </it>< 0.001) and temporal differences (<it>P </it>< 0.005) were observed in these three aspects of patient satisfaction. Patients were most satisfied in Thabo Mofutsanyana District and least satisfied in Motheo District. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. Finally, our analysis revealed a strong negative association (<it>r </it>= -0.438, <it>P </it>< 0.001) between nurse vacancy rates and mean satisfaction levels with services performed by nurses at baseline. Patients attending facilities with high professional nurse vacancy rates reported significantly less satisfaction with nurses' services than did those attending facilities with fewer vacant nursing posts.</p> <p>Conclusion</p> <p>Collectively, our findings show high levels of patient satisfaction with ART-related services, but also confirm claims by other studies, which have identified human resource shortages as the most important obstacle to a successful South African AIDS strategy.</p

La Bohème, April 19, 2007

This is the concert program of the La Bohème performances on Thursday - Sunday, April 19 - 22, 2007 at 8:00 p.m., at the Boston University Theater, 264 Huntington Avenue, Boston, Massachusetts. The work performed was La Bohème by Giacomo Puccini. Digitization for Boston University Concert Programs was supported by the Boston University Center for the Humanities Library Endowed Fund

SVCNet: Scribble-based Video Colorization Network with Temporal Aggregation

In this paper, we propose a scribble-based video colorization network with temporal aggregation called SVCNet. It can colorize monochrome videos based on different user-given color scribbles. It addresses three common issues in the scribble-based video colorization area: colorization vividness, temporal consistency, and color bleeding. To improve the colorization quality and strengthen the temporal consistency, we adopt two sequential sub-networks in SVCNet for precise colorization and temporal smoothing, respectively. The first stage includes a pyramid feature encoder to incorporate color scribbles with a grayscale frame, and a semantic feature encoder to extract semantics. The second stage finetunes the output from the first stage by aggregating the information of neighboring colorized frames (as short-range connections) and the first colorized frame (as a long-range connection). To alleviate the color bleeding artifacts, we learn video colorization and segmentation simultaneously. Furthermore, we set the majority of operations on a fixed small image resolution and use a Super-resolution Module at the tail of SVCNet to recover original sizes. It allows the SVCNet to fit different image resolutions at the inference. Finally, we evaluate the proposed SVCNet on DAVIS and Videvo benchmarks. The experimental results demonstrate that SVCNet produces both higher-quality and more temporally consistent videos than other well-known video colorization approaches. The codes and models can be found at https://github.com/zhaoyuzhi/SVCNet.Comment: accepted by IEEE Transactions on Image Processing (TIP