A rapid landscape review of postpartum anaemia measurement: challenges and opportunities

BACKGROUND: Anaemia is a reduction in haemoglobin concentration below a threshold, resulting from various factors including severe blood loss during and after childbirth. Symptoms of anaemia include fatigue and weakness, among others, affecting health and quality of life. Anaemic pregnant women have an increased risk of premature delivery, a low-birthweight infant, and postpartum depression. They are also more likely to have anaemia in the postpartum period which can lead to an ongoing condition and affect subsequent pregnancies. In 2019 nearly 37% of pregnant women globally had anaemia, and estimates suggest that 50-80% of postpartum women in low- and middle-income countries have anaemia, but currently there is no standard measurement or classification for postpartum anaemia. METHODS: A rapid landscape review was conducted to identify and characterize postpartum anaemia measurement searching references within three published systematic reviews of anaemia, including studies published between 2012 and 2021. We then conducted a new search for relevant literature from February 2021 to April 2022 in EMBASE and MEDLINE using a similar search strategy as used in the published reviews. RESULTS: In total, we identified 53 relevant studies. The timing of haemoglobin measurement ranged from within the immediate postpartum period to over 6 weeks. The thresholds used to diagnose anaemia in postpartum women varied considerably, with < 120, < 110, < 100 and < 80 g/L the most frequently reported. Other laboratory results frequently reported included ferritin and transferrin receptor. Clinical outcomes reported in 32 out of 53 studies included postpartum depression, quality of life, and fatigue. Haemoglobin measurements were performed in a laboratory, although it is unclear from the studies if venous samples and automatic analysers were used in all cases. CONCLUSIONS: This review demonstrates the need for improving postpartum anaemia measurement given the variability observed in published measures. With the high prevalence of anaemia, the relatively simple treatment for non-severe cases of iron deficiency anaemia, and its importance to public health with multi-generational effects, it is crucial to develop common measures for women in the postpartum period and promote rapid uptake and reporting

ImageNet Large Scale Visual Recognition Challenge

The ImageNet Large Scale Visual Recognition Challenge is a benchmark in object category classification and detection on hundreds of object categories and millions of images. The challenge has been run annually from 2010 to present, attracting participation from more than fifty institutions. This paper describes the creation of this benchmark dataset and the advances in object recognition that have been possible as a result. We discuss the challenges of collecting large-scale ground truth annotation, highlight key breakthroughs in categorical object recognition, provide a detailed analysis of the current state of the field of large-scale image classification and object detection, and compare the state-of-the-art computer vision accuracy with human accuracy. We conclude with lessons learned in the five years of the challenge, and propose future directions and improvements.Comment: 43 pages, 16 figures. v3 includes additional comparisons with PASCAL VOC (per-category comparisons in Table 3, distribution of localization difficulty in Fig 16), a list of queries used for obtaining object detection images (Appendix C), and some additional reference

Working time flexibility components and working time regimes in Europe: using company-level data across 21 countries

Working time ?exibility comprises a wide variety of arrangements, from part-time, overtime, to long-term leaves. Theoretical approaches to grouping these arrangements have been developed, but empirical underpinnings are rare. This article investigates the bundles that can be found for various ?exible working time arrangements, using the Establishment Survey on Working Time and Work–Life Balance, 2004/2005, covering 21 EU member states and 13 industries. The results from the factor analyses con?rmed that working time arrangements can be grouped into two bundles, one for the employee-centred arrangements and second for the employer-centred arrangements, and that these two bundles are separate dimensions.Wealso tested the stability of the factor analysisoutcome, showing that although we ?nd some deviations from the pan-Europe and pan-industry outcome, the naming of the components as ?exibility for employees and ?exibility for employers can be considered rather stable. Lastly, we ?nd three country clusters for the 21 European countries using the bundle approach. The ?rst group includes the Northern European countries along side Poland and Czech Republic, the second group the continental European countries with UK and Ireland, and lastly, the southern European countries with Hungary and Slovenia

Is quality affordable for community health systems? Costs of integrating quality improvement into close-to-community health programmes in five low-income and middle-income countries.

INTRODUCTION: Countries aspiring to universal health coverage view close-to-community (CTC) providers as a low-cost means of increasing coverage. However, due to lack of coordination and unreliable funding, the quality of large-scale CTC healthcare provision is highly variable and routine data about service quality are not trustworthy. Quality improvement (QI) approaches are a means of addressing these issues, yet neither the costs nor the budget impact of integrating QI approaches into CTC programme costs have been assessed. METHODS: This paper examines the costs and budget impact of integrating QI into existing CTC health programmes in five countries (Ethiopia, Indonesia, Kenya, Malawi, Mozambique) between 2015 and 2017. The intervention involved: (1) QI team formation; (2) Phased training interspersed with supportive supervision; which resulted in (3) QI teams independently collecting and analysing data to conduct QI interventions. Project costs were collected using an ingredients approach from a health systems perspective. Based on project costs, costs of local adoption of the intervention were modelled under three implementation scenarios. RESULTS: Annualised economic unit costs ranged from $62 in Mozambique to$254 in Ethiopia per CTC provider supervised, driven by the context, type of community health model and the intensity of the intervention. The budget impact of Ministry-led QI for community health is estimated at 0.53% or less of the general government expenditure on health in all countries (and below 0.03% in three of the five countries). CONCLUSION: CTC provision is a key component of healthcare delivery in many settings, so QI has huge potential impact. The impact is difficult to establish conclusively, but as a first step we have provided evidence to assess affordability of QI for community health. Further research is needed to assess whether QI can achieve the level of benefits that would justify the required investment

Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends.

Separately addressing specific groups of people who share patterns of behavioral change might increase the impact of behavioral interventions to prevent transmission of sexually transmitted infections. We propose a method based on machine learning to assist the identification of such groups among men who have sex with men (MSM). By means of unsupervised learning, we inferred "behavioral clusters" based on the recognition of similarities and differences in longitudinal patterns of condomless anal intercourse with nonsteady partners (nsCAI) in the HIV Cohort Study over the last 18 years. We then used supervised learning to investigate whether sociodemographic variables could predict cluster membership. We identified 4 behavioral clusters. The largest behavioral cluster (cluster 1) contained 53% of the study population and displayed the most stable behavior. Cluster 3 (17% of the study population) displayed consistently increasing nsCAI. Sociodemographic variables were predictive for both of these clusters. The other 2 clusters displayed more drastic changes: nsCAI frequency in cluster 2 (20% of the study population) was initially similar to that in cluster 3 but accelerated in 2010. Cluster 4 (10% of the study population) had significantly lower estimates of nsCAI than all other clusters until 2017, when it increased drastically, reaching 85% by the end of the study period. We identified highly dissimilar behavioral patterns across behavioral clusters, including drastic, atypical changes. The patterns suggest that the overall increase in the frequency of nsCAI is largely attributable to 2 clusters, accounting for a third of the population

Evaluating Multimedia Features and Fusion for Example-Based Event Detection

Multimedia event detection (MED) is a challenging problem because of the heterogeneous content and variable quality found in large collections of Internet videos. To study the value of multimedia features and fusion for representing and learning events from a set of example video clips, we created SESAME, a system for video SEarch with Speed and Accuracy for Multimedia Events. SESAME includes multiple bag-of-words event classifiers based on single data types: low-level visual, motion, and audio features; high-level semantic visual concepts; and automatic speech recognition. Event detection performance was evaluated for each event classifier. The performance of low-level visual and motion features was improved by the use of difference coding. The accuracy of the visual concepts was nearly as strong as that of the low-level visual features. Experiments with a number of fusion methods for combining the event detection scores from these classifiers revealed that simple fusion methods, such as arithmetic mean, perform as well as or better than other, more complex fusion methods. SESAME’s performance in the 2012 TRECVID MED evaluation was one of the best reported

A novel isolator-based system promotes viability of human embryos during laboratory processing

In vitro fertilisation (IVF) and related technologies are arguably the most challenging of all cell culture applications. The starting material is a single cell from which one aims to produce an embryo capable of establishing a pregnancy eventually leading to a live birth. Laboratory processing during IVF treatment requires open manipulations of gametes and embryos, which typically involves exposure to ambient conditions. To reduce the risk of cellular stress, we have developed a totally enclosed system of interlinked isolator-based workstations designed to maintain oocytes and embryos in a physiological environment throughout the IVF process. Comparison of clinical and laboratory data before and after the introduction of the new system revealed that significantly more embryos developed to the blastocyst stage in the enclosed isolator-based system compared with conventional open-fronted laminar flow hoods. Moreover, blastocysts produced in the isolator-based system contained significantly more cells and their development was accelerated. Consistent with this, the introduction of the enclosed system was accompanied by a significant increase in the clinical pregnancy rate and in the proportion of embryos implanting following transfer to the uterus. The data indicate that protection from ambient conditions promotes improved development of human embryos. Importantly, we found that it was entirely feasible to conduct all IVF-related procedures in the isolator-based workstations

Two decades of community-based conservation yield valuable insights into marine turtle nesting ecology

For the Western Indian Ocean region, there is a significant knowledge gap regarding marine turtle nesting on the continental coast of East Africa. Here we present results from a long-term (2000-2020) community-based monitoring programme in and around Watamu Marine National Park, Kenya, covering 30 km of coastline (c. 6% of the national total). Conservation actions effectively protected nesting turtles and resulted in a near-total cessation of illegal egg harvesting in Watamu Marine National Park. Collected data indicate this is an important marine turtle nesting index site in Kenya and the wider region. Green turtle Chelonia mydas nests were most common (95%), followed by olive ridley turtles Lepidochelys olivacea (4%), with occasional nests of hawksbill Eretmochelys imbricata and leatherback turtles Dermochelys coriacea. Clutches per season increased significantly over the 20-year monitoring period for green turtles (50%) and showed a positive trend for olive ridley turtles. Watamu remains an area at risk from human pressures such as coastal development. Clutch distribution along the Watamu Marine National Park beach has shifted over time, probably because of coastal development and disturbance. Illegal take of adults and eggs continues in areas north and south of the Watamu Marine National Park, possibly slowing rates of recovery. Clutches deemed at risk were moved to a safe location within the National Park, and hatching success was high. Continued conservation efforts, including wider engagement with stakeholders to reduce human pressures, are needed to ensure the perpetuation of this nesting site.Peer reviewe