Period during a pandemic: The neglected reality of Nigerian girls and women.

Underneath the façade of supposedly bubbly girls, living daily lives in many parts of Nigeria lies the problem of lack of access to proper menstrual hygiene management tools or kits. From schools to business places, religious organizations amongst others, a hive of women and girls face the harsh reality of inability to manage their periods due to poor access to water, sanitation, and hygiene facilities, common in many low- and middle-income countries of which Nigeria sits top. The issue of privacy and dignity during menstruation is still one area in which women and girls in Nigeria are failed every day. All of these further taking a toll on the emotional life, education, productivity of the girl child amongst others. The pandemic further impedes the ability/efforts of non-governmental organizations hitherto saddled with the responsibility of tutoring young girls in mostly rural and underserved communities the art of making re-useable pads to address the challenge of period poverty. Deep-seated Menstrual taboos, common among many Nigerian tribes have also served as major setbacks to proper menstrual hygiene management. With all of these, the period poverty struggle, made worse by poor water sanitation and hygiene facilities in Nigerian communities continues. There is still an urgent need to increase sensitization, and advocacy to break menstrual taboos, reduce cost and improve access to menstrual hygiene products and facilities especially following the COVID-19 pandemic and its attendant overbearing effects

Novel dual-function CellDetect® staining technology: wedding morphology and tinctorial discrimination to detect cervical neoplasia

<p>Abstract</p> <p>Background</p> <p>A persistent goal of oncologic histochemistry is to microscopically identify neoplasia tinctorially. Consequently, the newly developed CellDetect^®staining technology, that appears to exhibit this property, warrants clinical evaluation. The objective of this study was to compare the diagnostic results using CellDetect^®to the outcomes of standard microscopic examination based on hematoxylin and eosin (H&E) staining for the recognition of different squamous epithelial phenotypes of the uterine cervix.</p> <p>Methods</p> <p>Pairs of adjacent sections were made from 60 cervical biopsy cases that were diagnosed originally as either normal or neoplastic (CIN, SCC). One section of the pair was stained for H&E; the second section, with CellDetect^®. Based on the examination of these pairs by two experienced pathologists, we investigated the following issues:(1) diagnostic agreement between the pathologists on each pair; (2) agreement between H&E and CellDetect^®for each pair (3) tinctorial characteristics in micro-regions (n = 130) evaluated as either normal, reactive or neoplastic.</p> <p>Results</p> <p>Qualitatively, CellDetect^®-stained preparations displayed cyto-morphological detail comparable to H&E images. Tinctorially, <it>non-neoplastic </it>cells appeared green/blue when stained withCellDetect^®, contrasting with cytologically <it>neoplastic </it>foci, where cells of every grade were red/magenta in color. Due to these tinctorial characteristics, even small foci of neoplasia could be readily distinguished that were inconspicuous on H&E at low magnification. In some instances, this prompted re-examination of the H&E and revision of the diagnosis. Quantitatively, we found that despite diagnostic variation between pathologists, in about 3% of the cases, each pathologist made the same diagnosis regardless of whether CellDetect^®or H&E was used, i.e. there was 100% self-agreement for each pathologist between stains. Particularly noteworthy was the finding of a 0% false negative rate, coupled with a 10-15% false positive rate. Regarding specificity, the performance in <it>reactive </it>squamous processes was similar to that observed for morphologically normal squamous epithelium.</p> <p>Conclusions</p> <p>In this first order assessment of clinical applicability, CellDetect^®staining technology was at least comparable to results using H&E, and perhaps surperior. CellDetect^®provided a uniquely useful tinctorial clue for the detection of neoplasia, which exhibited an impressive 0% false negative rate. A more extensive, blinded study is needed to confirm these promising findings.</p

Global Outcome Assessment Life-long after stroke in young adults initiative-the GOAL initiative : study protocol and rationale of a multicentre retrospective individual patient data meta-analysis

Introduction Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients. Methods and analysis The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Peer reviewe

Building and Combining Matching Algorithms

International audienceThe concept of matching is ubiquitous in declarative programming and in automated reasoning. For instance, it is a key mechanism to run rule-based programs and to simplify clauses generated by theorem provers. A matching problem can be seen as a particular conjunction of equations where each equation has a ground side. We give an overview of techniques that can be applied to build and combine matching algorithms. First, we survey mutation-based techniques as a way to build a generic matching algorithm for a large class of equational theories. Second, combination techniques are introduced to get combined matching algorithms for disjoint unions of theories. Then we show how these combination algorithms can be extended to handle non-disjoint unions of theories sharing only constructors. These extensions are possible if an appropriate notion of normal form is computable

Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53% of the variance in generic HRQOL (P < 0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL

Diabetes symptoms predictors of health-related quality of life in adolescents and young adults with type 1 or type 2 diabetes

The objective was to investigate the patient-reported diabetes symptoms predictors of generic health-related quality of life (HRQOL) in adolescents and young adults (AYA) with type 1 or type 2 diabetes. The 15-item PedsQL™ 3.2 Diabetes Module Diabetes Symptoms Summary Score and PedsQL™ 4.0 Generic Core Scales were completed in a 10-site national field test study by 513 AYA ages 13-25 years with type 1 (n = 424) or type 2 (n = 89) diabetes. Diabetes symptoms were tested for bivariate and multivariate linear associations with generic HRQOL. Diabetes symptoms were associated with decreased HRQOL in bivariate analyses. In predictive analytics models utilizing hierarchical multiple regression analyses controlling for relevant demographic and clinical covariates, diabetes symptoms accounted for 38 and 39% of the variance in patient-reported generic HRQOL for type 1 and type 2 diabetes, respectively, reflecting large effect sizes. The diabetes symptoms facets hyperglycemia symptoms, hypoglycemia symptoms, and nonspecific diabetes symptoms individually accounted for a significant percentage of the variance in separate exploratory predictive analytics models after controlling for demographic and clinical covariates, with small-to-large effect sizes. Diabetes symptoms are potentially modifiable predictors of generic HRQOL in AYA with diabetes. Identifying specific diabetes symptoms or symptoms facets that are the most important predictors from the patient perspective facilitates a patient-centered approach in clinical research, clinical trials, and practice designed to enhance overall generic HRQOL in AYA with diabetes