Training on Scaling of Climate-Smart Washera and Wollo Sheep Breed Improvement Program

The International Center for Agricultural Research in the Dry Areas (ICARDA), The Amhara Regional Agricultural Research Institute (ARARI), the Accelerating the Impact of CGIAR Climate Research in Africa (AICCRA), and the Amhara Livestock and Fisheries Resource Development Office organized a workshop that took place on May 29, 2023, in Bahir Dar Ethiopia. The main goals of the workshop were assessing the advancements of already running community-based breeding programs (CBBPs) and recently formed production Units (PUs) and training livestock development agents and extension workers on managing and establishing production unit sites. The training course was attended by livestock from 16 districts in the Wollo and Gojjam areas, universities, ARARI, and regional and district-level livestock offices. Dr. Likawent Yeheyis, Deputy Director General of ARARI, gave a welcome and opening address to kick off the session. Mulatu Dagnew from the Regional Livestock Office, Asemu Tesfa from the Andassa Research Center, and Tesfaye Getachew from ICARDA each gave a presentation following that. Presentations helped to understand the development and status of CBBPs and PUs, as well as helped to understand how to create and maintain PU sites and breeding tram utilization modality. In the WaWo scaling project, 4280 households in CBBPs and Pu sites have access to the climate-smart breeding program. The training was attended by 67 people in total, 17 of them were women

Evaluating the effect of interventions for strengthening non-physician anesthetists' education in Ethiopia: a pre- and post-evaluation study

Background Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists' education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program. Methods A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists' education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students' perceptions of the learning environment. Results The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24-7.22, p 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15-6.55, p < 0.05). Conclusion The results suggest that the quality of non-physician anesthetists' education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention.Research into fetal development and medicin

Increasing cardiac pyruvate dehydrogenase flux during chronic hypoxia improves acute hypoxic tolerance

The pattern of metabolic reprogramming in chronic hypoxia shares similarities with that following myocardial infarction or hypertrophy, however the response of the chronically hypoxic heart to subsequent acute injury, and the role of metabolism is not well understood. Here, we determined the myocardial tolerance of the chronically hypoxic heart to subsequent acute injury, and hypothesised that activation of a key regulator of myocardial metabolism, the pyruvate dehydrogenase complex (PDC), could improve hypoxic tolerance. Mouse hearts, perfused in Langendorff mode, were exposed to 30min of hypoxia, and lost 80% of prehypoxic function (p=0.001), with only 27% recovery of pre-hypoxic function with 30min of re-oxygenation (p=0.046). Activation of the PDC with infusion of 1mM dicholorocacetate (DCA) during hypoxia and re-oxygenation did not alter function. Acute hypoxic tolerance was assessed in hearts of mice housed in hypoxia for 3wks. Chronic hypoxia reduced cardiac tolerance to subsequent acute hypoxia, with recovery of function 22% of pre-acute hypoxic levels, vs 39% in normoxic control hearts (p=0.012). DCA feeding in chronic hypoxia (per os, 70mg/kg/day) doubled cardiac acetylcarnitine content, and this fell following acute hypoxia. This acetylcarnitine use maintained cardiac ATP and glycogen content during acute hypoxia, with hypoxic tolerance normalised. In summary, chronic hypoxia renders the heart more susceptible to acute hypoxic injury, which can be improved by activation of the PDC and pooling of acetylcarnitine. This is the first study showing functional improvement of the chronically hypoxic heart with activation of the PDC, and offers therapeutic potential in cardiac disease with a hypoxic component

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding: Bill & Melinda Gates Foundation

Körlüğe Kadar Glokom Hastalarının Sağkalım Analizi: Gondar Üniversitesi Kapsamlı Özel Hastane Vakası, Gondar, Etiyopya

Objective: The objective of the study was to identify the best-fitted survival regression model and to find factors that accelerate the time of blindness of glaucoma patients in University of Gondar Comprehensive Specialized Hospital. Material and Methods: Secondary data was taken from the patient’s card, collected from January 2014-April 2018 in the hospital. In this study 401 glacoma patients’ record was considered. Kaplan-Meier survival analysis, Semiparametric and Parametric AFT model were applied to identify factors that lead blindness of glaucoma patients. Results: From the total 401 glaucoma patients 23.69% was blind. From the total sample 38.41% and 61.59% were female and male glaucoma patients, respectively. The median time of blindness for the two eyes or one eye was 16 months after confirmation of glaucoma disease. In the multivariable Weibull accelerated failure-time model it has found that age group (18-43) (TR =1.29233, CI: 1.039576 to 1.606536), advanced stage of glaucoma (TR =1.281674, CI: 1.096103 to 1.498662), duration of diagnosis 1-5 years (TR = 1.944649, CI: 1.332738 to 2.83751) and duration of diagnosis >= 6 years (TR = 2.683586, CI: 1.367533 to 5.26615) were significantly associated with the time to blindness. Conclusion: The multivariable Weibull model revealed that age, duration of diagnosis and stage of glaucoma were major factors that affect the survival probability of glaucoma patients. Finally, based on the results of the study we can conclude that the Weibull regression model was the best fitted parametric accelerated failure-time model for identifying the major factors related to glaucoma patients.Amaç: Çalışmanın amacı, en iyi sağkalım regresyon modelini belirlemek ve Gondar Üniversitesi Kapsamlı Özel Hastanesi’ndeki glokom hastalarının körlük süresini hızlandıran faktörleri bulmaktır. Gereç ve Yöntemler: İkinci veri Ocak 2014-Nisan 2018 arasında hastane tarafından toplanan hasta kartlarından alınmıştır. Bu çalışmada 401 glokom hastasının kayıtları dikkate alınmıştır. Glokom hastalarında körlüğe neden olan faktörleri belirlemek için Kaplan-Meier sağkalım analizi, Yarıparametrik ve Parametrik AFT model uygulanmıştır. Bulgular: 401 glokom hastasının %23.69’u kördü. Glokom hastalarının %38.41’i kadın, %61.59’u erkekti. Glokom hastalığı tanısı konduktan sonra bir ya da iki göz körlüğünün medyan süresi 16 aydır. Çok değişkenli Weibull hızlandırılmış başarısızlık-zaman modelinde yaş grubu (18-43) (TR =1.29233, CI: 1.039576;1.606536), ilerlemiş glokom evresi (TR =1.281674, CI: 1.096103;1.498662), tanı süresi 1-5 yıl (TR = 1.944649, CI: 1.332738;2.83751) körlük süresi ile anlamlı olarak ilişkili bulunmuştur. Sonuç: Çok değişkenli Weibull modeli yaş, hastalık süresi ve glokom evresinin glokom hastalarının sağkalım olasılığını etkileyen başlıca faktörler olduğunu ortaya çıkarmıştır. Sonuç olarak, çalışma sonuçlarına göre Weibull regresyon modeli; glokom hastaları ile ilişkili başlıca faktörleri belirlemede en iyi tahmini veren parametrik hızlandırılmış başarısızlık-zaman modelidir

Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia.

BackgroundIn all areas of the World Health Organization, the prevalence of hypertension was highest in Africa. High blood pressure is a significant risk factor for coronary and ischemic diseases, as well as hemorrhagic stroke. However, there were scarce data concerning the magnitude and risk factors of hypertension. Thus, this study aimed to identify the prevalence and associated factors of hypertension among adults in Addis Ababa city.MethodA community-based cross-sectional study was conducted from June to October 2018 in Addis Ababa city. Participants aged 18 years and older recruited using a multi-stage random sampling technique. Data were collected by face-to-face interview technique. All three WHO STEPS instruments were applied. Additionally, participants' weight, height, waist, hip, and blood pressure (BP) were measured according to standard procedures. Multiple logistic regressions were used and Odds ratios with 95% confidence intervals were also calculated to identify associated factors.ResultsIn this study, a total of 3560 participants were included.The median age was 32 years (IQR 25, 45). More than half (57.3%) of the respondents were females. Almost all (96.2%) of participants consumed vegetables and or fruits less than five times per day. Eight hundred and sixty-five (24.3%) of respondents were overweight, while 287 (8.1%) were obese. One thousand forty-one 29.24% (95% CI: 27.75-30.74) were hypertensive, of whom two-thirds (61.95%) did not know that they had hypertension. Factors significantly associated with hypertension were age 30-49 and ≥50 years (AOR = 2.79, 95% CI: 1.39-5.56) and (AOR = 8.23, 95% CI: 4.09-16.55) respectively, being male (AOR = 1.88, 95% CI: 1.18-2.99), consumed vegetables less than or equal to 3 days per week (AOR = 2.44, 95% CI: 1.21-4.93), obesity (AOR = 2.05, 95%CI: 1.13-3.71), abdominal obesity (AOR = 1.70, 95% CI: 1.10-2.64) and high triglyceride level (AOR = 2.06, 95% CI: 1.38-3.07).ConclusionIn Addis Ababa, around one in three adults are hypertensive. With a large proportion, unaware of their condition. We recommend integrating regular community-based screening programs as integral parts of the health promotion and disease prevention strategies. Lifestyle interventions shall target the modifiable risk factors associated with hypertension, such as weight loss and increased vegetable consumption