Developing institutional capacity for reproductive health in humanitarian settings: A descriptive study

© 2015 Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction. Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS. Materials and Methods. Descriptive study using an online questionnaire tool. Results. Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixtyeight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHSrelated disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, management of sexually-transmitted infections, adolescent RH, and family planning. Approximately half of participants reported that their institutions had experienced an increase in dedicated budget and staff for RHHS, a fifth no change, and 1 in 10 a decrease. The Interagency RH Kits were reportedly the most commonly used supplies to support RHHS implementation. Conclusion. The results suggest overall growth in institutional capacity in RHHS over the past decade, indicating that the field has matured and expanded from crisis response to include RHHS into DRR and other elements of the emergency management cycle. It is critical to consolidate the progress to date, address gaps, and sustain momentum

Evaluation of MU-MIMO Digital Beamforming Algorithms in B5G/6G LEO Satellite Systems

Satellite Communication (SatCom) systems will be a key component of 5G and 6G networks to achieve the goal of providing unlimited and ubiquitous communications and deploying smart and sustainable networks. To meet the ever-increasing demand for higher throughput in 5G and beyond, aggressive frequency reuse schemes (i.e., full frequency reuse), combined with digital beamforming techniques to cope with the massive co-channel interference, are recognized as a key solution. Aimed at (i) eliminating the joint optimization problem among the beamforming vectors of all users, (ii) splitting it into distinct ones, and (iii) finding a closed-form solution, we propose a beamforming algorithm based on maximizing the users' Signal-to-Leakage-and-Noise Ratio (SLNR) served by a Low Earth Orbit (LEO) satellite. We investigate and assess the performance of several beamforming algorithms, including both those based on Channel State Information (CSI) at the transmitter, i.e., Minimum Mean Square Error (MMSE) and Zero-Forcing (ZF), and those only requiring the users' locations, i.e., Switchable Multi-Beam (MB). Through a detailed numerical analysis, we provide a thorough comparison of the performance in terms of per-user achievable spectral efficiency of the aforementioned beamforming schemes, and we show that the proposed SLNR beamforming technique is able to outperform both MMSE and ZF schemes in the presented SatCom scenario

Evaluation of multi-user multiple-input multiple-output digital beamforming algorithms in B5G/6G low Earth orbit satellite systems

Satellite communication systems will be a key component of 5G and 6G networks to achieve the goal of providing unlimited and ubiquitous communications and deploying smart and sustainable networks. To meet the ever-increasing demand for higher throughput in 5G and beyond, aggressive frequency reuse schemes (i.e., full frequency reuse), combined with digital beamforming techniques to cope with the massive co-channel interference, are recognized as a key solution. Aimed at (i) eliminating the joint optimization problem among the beamforming vectors of all users, (ii) splitting it into distinct ones, and (iii) finding a closed-form solution, we propose a beamforming algorithm based on maximizing the users' signal-to-leakage-and-noise ratio served by a low Earth orbit satellite. We investigate and assess the performance of several beamforming algorithms, including both those based on channel state information at the transmitter, that is, minimum mean square error and zero forcing, and those only requiring the users' locations, that is, switchable multi-beam. Through a detailed numerical analysis, we provide a thorough comparison of the performance in terms of per-user achievable spectral efficiency of the aforementioned beamforming schemes, and we show that the proposed signal to-leakage-plus-noise ratio beamforming technique is able to outperform both minimum mean square error and multi-beam schemes in the presented satellite communication scenario

Variations des taux des protéines sériques lors des infestations helminthiques chez les mammifères

On peut dire que le dosage des protéines sériques totales est difficilement interprétable. En revanche le dosage fractionné des divers éléments protéiques par électrophorèse par exemple, pourra être utile pour expliquer la pathogénie de certaines maladies parasitaires. En particulier, les signes d'œdème observés chez les animaux malades, dus à la diminution du taux d'albumine donc de la pression oncotique

Federated Beamforming with Subarrayed Planar Arrays for B5G/6G LEO Non-Terrestrial Networks

Non-Terrestrial Networks (NTNs) will be an es-sential element in Beyond -5G (BSG) and 6G ecosystems, with the purpose of enabling seamless and global coverage, as well as supporting high data rate services. To achieve that, Full Frequency Reuse (FFR) schemes, along with digital beamforming techniques to cope with the Co-Channel Interference (CCI), are considered as promising strategies in 6G NTN. In this paper, we address the design of Cell-Free (CF) MIMO algorithms in NTN composed of multiple swarms of Non-GeoSynchronous Orbit (NGSO) nodes, in which each swarm performs distributed digital beamforming schemes. Furthermore, aiming at increasing the directivity of on-board antenna arrays for each NGSO node and enhancing the interference mitigation, we propose a Limited Field of View (LFoV) planar array architecture built up of smaller planar subarrays. We evaluate the performance of distributed beamforming schemes including both Channel State Information (CSI)-based, e.g., digital Minimum Mean Square Error (MMSE), and position-based such as analog Conventional Beamforming (CBF). We provide a numerical analysis of the performance in terms of per-user spectral efficiency. The results show that our proposed sub arrayed architecture designed for federated CF-MIMO beamforming outperforms the reference approach without subarraying in the proposed NTN system architecture

Herzchirurgie bei Zeugen Jehovas

Die Herzchirurgie bei Zeugen Jehovas stellt aufgrund der Ablehnung von Bluttransfusion eine medizinische und ethische Herausforderung dar. Die vorliegende Studie untersuchte 42 Patienten der Glaubensrichtung Zeugen Jehovas die sich einer Herzoperation mit Einsatz der Herzlungenmaschine unterzogen, im Hinblick auf Komplikationsraten, Sterblichkeit und Möglichkeiten der Alternativverfahren zur Anhebung der Hämoglobinkonzentration. Hier wurden perioperativ Erythropoetin und Eisenpräparate verabreicht. Der Verlauf des Hämoglobins war gekennzeichnet von einer ausgeprägten Hämodilution am Ende der Herzlungenmaschine und einem signifikanten Anstieg am 1. postoperativen Tag. Hier zeigte sich der Schwellenwert von 7.5 g/dl als richtungweisend. Die Intensiv- und Krankenhausdauer sowie das Auftreten eines Durchgangssyndroms und die Respiration korrelierten signifikant mit dem Hämoglobinwert. Durch die Jurisprudenz werden rechtliche Aspekte und Konflikte der ärztlichen Behandlung klar geregelt

Assessment of Beamforming Algorithms with Subarrayed Planar Arrays for B5G/6G LEO Non-Terrestrial Networks

Non-Terrestrial Networks (NTNs) in Beyond 5G (B5G) and 6G ecosystems are expected to play a crucial role in providing the requests of connections anywhere and anytime by offering wide-area coverage and ensuring service availability, continuity, and scalability. Full Frequency Reuse (FFR) schemes, which are able in cooperation with digital beamforming algorithms to cope with the substantial co-channel interference, are considered to be an efficient solution to meet the growing demand of high data rates in B5G/6G systems. In this paper, we propose a Limited Field Of View (LFOV) planar array architecture composed of smaller planar subarrays in order to increase the directivity of an on-board Low Earth Orbit (LEO) satellite antenna array and mitigate the interference. We evaluate the performance of feed-space beamforming schemes, including both full digital schemes based on Channel State Information (CSI) at the transmitter, such as Minimum Mean Square Error (MMSE), and full analog schemes that only require the users' locations, such as Conventional Beamforming (CBF). The numerical results of the system performance, presented by means of spectral efficiency, demonstrate a remarkable improvement in the proposed beamforming design with subarraying w.r.t. the one with no subarrayed configuration; in particular, we show that an analog beamforming scheme with subarraying can outperform a full digital beamforming scheme with no subarraying

Effectiveness and Safety of Switching to Ravulizumab From Eculizumab in Kidney Transplant Recipients With Atypical Hemolytic Uremic Syndrome:A Global aHUS Registry Analysis

Introduction: Atypical hemolytic uremic syndrome (aHUS) is a disease of complement dysregulation that may lead to kidney failure. Ravulizumab and eculizumab are complement C5 inhibitors approved for the treatment of aHUS. This study assessed the real-world effectiveness and safety of switching to ravulizumab from eculizumab in kidney transplant recipients with aHUS. Methods: The Global aHUS Registry is a multicenter study enrolling patients with aHUS since 2012. Effectiveness and safety outcomes were assessed in kidney transplant recipients with aHUS who switched to ravulizumab from eculizumab up to September 2, 2024. Results: Overall, 38 patients received a kidney transplant before ravulizumab initiation; 27 patients with ≥3 months of ravulizumab treatment were included in the patient characteristics and effectiveness analyses. Median (range) time on eculizumab and ravulizumab treatment was 66.1 (3.7, 158.3) and 24.1 (4.2, 49.3) months, respectively (n = 27); time from last kidney transplantation to ravulizumab initiation was 65.9 (3.7, 184.0) months. Following ravulizumab initiation, laboratory parameters remained stable, and no kidney transplant rejections/graft failures were reported. In the safety analysis (n = 38), 23 adverse events were reported in 19 patients (50.0%) at or after ravulizumab initiation, and none were considered treatment-related. No new events of thrombotic microangiopathy or kidney impairment and no meningococcal infections or deaths were reported. Conclusion: This analysis from the Global aHUS Registry provides real-world evidence to demonstrate that the transition to ravulizumab from eculizumab in kidney transplant recipients with aHUS is successful, with stable graft function with no treatment-related safety concerns. Trial Registration: ClinicalTrials.gov identifier: NCT01522183.</p

Zenker's Diverticulum: Can Protocolised Measurements with Barium SWALLOW Predict Severity and Treatment Outcomes? The "Zen-Rad" Study

Although barium swallow imaging is established in the investigation of Zenker's diverticulum (ZD), no agreed measurement protocol exists. We developed a protocol for measuring ZD dimensions and aimed to correlate measurements with symptoms and post-operative outcomes. This prospective study included patients with confirmed ZD who underwent flexible endoscopic septal division (FESD) between 2014 and 2018. ZD was confirmed on barium radiology with measurements reviewed by two consultant radiologists. Symptom severity pre- and post-FESD was measured using the Dysphagia, Regurgitation, Complications (DRC) scale. Regression analyses were conducted to identify dimensions associated with therapeutic success, defined as remission (DRC score ≤ 1) 6 months after index FESD. In total, 67 patients (mean age 74.3) were included. Interobserver reliability (intraclass correlation coefficients-ICCs) was greatest for pouch width (0.981) and pouch depth (0.934), but not oesophageal depth (0.018). Male gender (60.9%) was associated with larger pouch height (P = 0.008) and width (P = 0.004). A positive correlation was identified between baseline DRC score and pouch depth (ρ 0.326, P = 0.011), particularly the regurgitation subset score (ρ 0.330, P = 0.020). The index pouch depth was associated with FESD procedure time (rho 0.358, P = 0.041). Therapeutic success was achieved in 64.2% and was associated with shorter pouch height (median 14.5 mm vs. 19.0 mm, P = 0.030), pouch width (median 19.9 mm vs. 28.8 mm, P = 0.34) and cricopharyngeal length (median 20.2 mm vs. 26.3 mm, P = 0.036). ZD dimensions may be feasible and were evaluated using Barium radiology. Specific parameters appear to correlate with severity and post-FESD outcomes, which aid with pre-procedural planning