Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool: A Cross sectional study at district Bannu, KP, Pakistan

Objective To determine the parents refusal rate, associated factors and the perceptions of refusal parents in routine immunization by using “WHO SAGE Working Group on Vaccine Hesitancy survey tool”. Material and Methods A cross sectional survey was conducted by using multi stage cluster sampling at the remote district Bannu Khyber Pakhtunkhwa Province, Pakistan from March 2019 to July 2019.A WHO validated questionaire was used. Our outcome variable was “Ever refusal from routine immunization (yes/No)”.logistic regression was run for association and multi regression was applied to see counfounders. Result Out of total 610 parents, the refusal rate was 170(27.9%).Mostly the mother of the children has no education 145(85.3%,P 0.03).Mother has no mobile but the father has 152(89.4%, p=<.001) higher frequency to have mobile. The refusal rate was high in those having secure food 88(51.8%) as compare to minimal 62(36.5%) and highly insecure food 20(11.8%,P=<.05).On multivariate logistic regression, those father who were employee (adjusted OR = 0.59; 95% CI 0.37 to 0.94; p = 0.02) and having higher education (adjusted OR = 0.21; 95% CI 0.08 to 0.50; p=<.001) were less likely to refuse to vaccinate their children while in contrast those having highly insecure food were more likely to refuse (adjusted OR = 2.2; 95% CI 1.0 to 0.50; p = 0.04) as compare to minimal insecure food (adjusted OR = 1.6; 95% CI 1.0 to 2.5; p = 0.02). Conclusion Refusal rate among parents was very high while those parents who’s can’t read or write and with no education, having mobile phone, unemployment and secure food were more to be associated with refusal

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Homogenous electrochemical water oxidation by a nickel(II) complex based on a macrocyclic N-heterocyclic carbene/pyridine hybrid ligand

Water-soluble homogeneous nickel catalysts have been rarely investigated for catalytic water oxidation as compared to their heterogeneous counterparts. Herein, we report homogenous electrochemical water oxidation by a nickel(ii) complex, ([NiL](PF6)(2) (L = bis(2-pyridyl-methylimidazolylidene)methane), based on a macrocyclic N-heterocyclic carbene/pyridine hybrid ligand under neutral and alkaline conditions. The catalyst displayed the stable catalytic current of 0.65 mA cm(-2) at the overpotential of 0.80 V (similar to 0.55 V at GCE for CV) with a similar to 93% Faradaic efficiency at pH 9.0 for oxygen evolution in long-term bulk electrolysis. The CV, UV-vis, ESI-MS, SEM, and EDX results demonstrated that the catalyst was impressively stable even after long-term controlled potential electrolysis (CPE) (11 h) and homogeneous in nature. The synthesis of this catalyst is straightforward, and its complex is air and moisture stable. To the best of our knowledge, this is the first study on the investigation of a Ni-NHC complex for water oxidation under aqueous conditions (acetate/phosphate). According to the literature, the role of the phosphate ion in homogenous nickel-catalysed water oxidation was found to vary from catalyst poisoning to activation. Interestingly, the catalytic activity of our catalyst in phosphate buffer was significantly higher than that with acetate ions at the same pH value; this might indicate the key role of phosphate ions as proton acceptors, which boosted the catalyst activity via enhanced PCET during catalysis

Synthesis of 2D MOF having potential for efficient dye adsorption and catalytic applications

Synthesis of 2D MOFs is often sensitive to the reaction conditions like temperature and solvent etc. Cu(ii)-5-azidoisophthalate MOF (Cu(ii)-5N(3)IP) has been synthesized at room temperature as well as under solvothermal conditions. The azide functional group remained stable during solvothermal synthesis at 85 degrees C. Cu(ii)-5N(3)IP crystallized in a Kagome-type structure. Typical Cu-2 paddle-wheels are connected to each other by 5N(3)IP ligands in infinite 2D sheets in the (001) plane, featuring 1D infinite channels within each layer. This MOF is used for the adsorption of methylene blue (MB), rhodamine B (RhB), methyl orange (MO), and Congo red (CR). The adsorption is selective to the dimensions, shapes and ionic strengths of the dyes. Cu(ii)-5N(3)IP exhibited adsorption rates in the order MB > CR > RhB > MO. Cu(ii)-5N(3)IP is used as a catalyst for aerobic oxidation and Knoevenagel condensation. 3-10 mol% of Cu-5N(3)IP selectively catalyzes the oxidation of benzyl alcohol to benzaldehyde in 9-20 h at 60 degrees C. In Knoevenagel condensation, the reaction of both unsubstituted and substituted benzaldehydes at room temperature was observed at a very low catalyst loading of 3 mol% of MOF within a short time of 3-60 min. This 2D MOF has proved to be more efficient for dye adsorption and the catalytic applications under investigation (such as alcohol oxidation and Knoevenagel condensation) than its analogous 3D or 0D materials

Measurement of the dynamic response of compressed hydrogen by inelastic X-ray scattering

Measurement of the dynamic properties of hydrogen and helium under extreme pressures is a key to understanding the physics of planetary interiors. The inelastic scattering signal from statically compressed hydrogen inside diamond anvil cells at 2.8 GPa and 6.4 GPa was measured at the Diamond Light Source synchrotron facility in the UK. The first direct measurement of the local field correction to the Coulomb interactions in degenerate plasmas was obtained from spectral shifts in the scattering data and compared to predictions by the Utsumi-Ichimaru theory for degenerate electron liquids. © 2010 IOP Publishing Ltd

Phytochromes function as thermosensors in Arabidopsis\textit{Arabidopsis}

Plants are responsive to temperature, and some species can distinguish differences of 1°C. In $\textit{Arabidopsis}$, warmer temperature accelerates flowering and increases elongation growth (thermomorphogenesis). However, the mechanisms of temperature perception are largely unknown. We describe a major thermosensory role for the phytochromes (red light receptors) during the night. Phytochrome null plants display a constitutive warm-temperature response, and consistent with this, we show in this background that the warm-temperature transcriptome becomes derepressed at low temperatures. We found that phytochrome B (phyB) directly associates with the promoters of key target genes in a temperature-dependent manner. The rate of phyB inactivation is proportional to temperature in the dark, enabling phytochromes to function as thermal timers that integrate temperature information over the course of the night.SB was supported by a Churchill Scholarship from the Winston Churchill Foundation of the United States. The work in JL’s laboratory is supported by a Fellowship from the Gatsby Foundation (GAT3272/GLC). This work was supported by responsive mode grants from the Biotechnology and Biological Sciences Research Council (BB/I013350/1 and BB/N010248/1) and the European Research Council (EC FP7 ERC 243140) to PW. The work in PW’s laboratory is supported by a Fellowship from the Gatsby Foundation (GAT3273/GLB). CK was supported by a DFG grant to ES (SCHA 303/16-1)