Sub-regional disparities in the use of antenatal care service in Mauritania: findings from nationally representative demographic and health surveys (2011-2015).

BACKGROUND: Skilled antenatal care (ANC) has been identified as a proven intervention to reducing maternal deaths. Despite improvements in maternal health outcomes globally, some countries are signaling increased disparities in ANC services among disadvantaged sub-groups. Mauritania is one of sub-Saharan countries in Africa with a high maternal mortality ratio. Little is known about the inequalities in the country's antenatal care services. This study examined both the magnitude and change from 2011 to 2015 in socioeconomic and geographic-related disparities in the utilization of at least four antenatal care visits in Mauritania. METHODS: Using the World Health Organization's Health Equity Assessment Toolkit (HEAT) software, data from the 2011 and 2015 Mauritania Multiple Indicator Cluster Surveys (MICS) were analyzed. The inequality analysis consisted of disaggregated rates of antenatal care utilization using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population attributable risk, Ratio and Population attributable fraction). A 95% Uncertainty Interval was constructed around point estimates to measure statistical significance. RESULTS: Substantial absolute and relative socioeconomic and geographic related disparities in attending four or more ANC visits (ANC4+ utilization) were observed favoring women who were richest/rich (PAR = 19.5, 95% UI; 16.53, 22.43), educated (PAF = 7.3 95% UI; 3.34, 11.26), urban residents (D = 19, 95% UI; 14.50, 23.51) and those living in regions such as Nouakchott (R = 2.1, 95% UI; 1.59, 2.56). While education-related disparities decreased, wealth-driven and regional disparities remained constant over the 4 years of the study period. Urban-rural inequalities were constant except with the PAR measure, which showed an increasing pattern. CONCLUSION: A disproportionately lower ANC4+ utilization was observed among women who were poor, uneducated, living in rural areas and regions such as Guidimagha. As a result, policymakers need to design interventions that will enable disadvantaged subpopulations to benefit from ANC4+ utilization to meet the Sustainable Development Goal (SDG) of reducing the maternal mortality ratio (MMR) to 140/100, 000 live births by 2030

Molecular dynamics simulations suggest changes in electrostatic interactions as a potential mechanism through which serine phosphorylation inhibits DNA Polymerase β’s activity

DNA polymerase ß is a 39 kDa enzyme that is a major component of Base Excision Repair in human cells. The enzyme comprises two major domains, a 31 kDa domain responsible for the polymerase activity and an 8 kDa domain, which bind ssDNA and has a deoxyribose phosphate (dRP) lyase activity. DNA polymerase ß was shown to be phosphorylated in vitro with protein kinase C (PKC) at serines 44 and 55 (S44 and S55), resulting in loss of its polymerase enzymic activity, but not its ability to bind ssDNA. In this study, we investigate the potential phosphorylation-induced structural changes for DNA polymerase ß using molecular dynamics simulations. The simulations show drastic conformational changes of the polymerase structure as a result of S44 phosphorylation. Phosphorylation-induced conformational changes transform the closed (active) enzyme structure into an open one. Further analysis of the results points to a key hydrogen bond and newly formed salt bridges as potential drivers of these structural fluctuations. The changes observed with S55/44 and S55 phosphorylation were less dramatic and the integrity of the H-bond was not compromised. Thus the phosphorylation of S44 is the major contributor to structural fluctuations that lead to loss of enzymatic activity

COVID‐19, nationalism, and the politics of crisis: A scholarly exchange

In this article, several scholars of nationalism discuss the potential for the COVID‐19 pandemic to impact the development of nationalism and world politics. To structure the discussion, the contributors respond to three questions: (1) how should we understand the relationship between nationalism and COVID‐19; (2) will COVID‐19 fuel ethnic and nationalist conflict; and (3) will COVID‐19 reinforce or erode the nation‐state in the long run? The contributors formulated their responses to these questions near to the outset of the pandemic, amid intense uncertainty. This made it acutely difficult, if not impossible, to make predictions. Nevertheless, it was felt that a historically and theoretically informed discussion would shed light on the types of political processes that could be triggered by the COVID‐19 pandemic. In doing so, the aim is to help orient researchers and policy‐makers as they grapple with what has rapidly become the most urgent issue of our times

Metal-Support Interactions and C1 Chemistry: Transforming Pt-CeO2into a Highly Active and Stable Catalyst for the Conversion of Carbon Dioxide and Methane

There is an ongoing search for materials which can accomplish the activation of two dangerous greenhouse gases like carbon dioxide and methane. In the area of C1 chemistry, the reaction between CO2 and CH4 to produce syngas (CO/H2), known as methane dry reforming (MDR), is attracting a lot of interest due to its green nature. On Pt(111), high temperatures must be used to activate the reactants, leading to a substantial deposition of carbon which makes this metal surface useless for the MDR process. In this study, we show that strong metal-support interactions present in Pt/CeO2(111) and Pt/CeO2 powders lead to systems which can bind CO2 and CH4 well at room temperature and are excellent and stable catalysts for the MDR process at moderate temperature (500 °C). The behavior of these systems was studied using a combination of in situ/operando methods (AP-XPS, XRD, and XAFS) which pointed to an active Pt-CeO2-x interface. In this interface, the oxide is far from being a passive spectator. It modifies the chemical properties of Pt, facilitating improved methane dissociation, and is directly involved in the adsorption and dissociation of CO2 making the MDR catalytic cycle possible. A comparison of the benefits gained by the use of an effective metal-oxide interface and those obtained by plain bimetallic bonding indicates that the former is much more important when optimizing the C1 chemistry associated with CO2 and CH4 conversion. The presence of elements with a different chemical nature at the metal-oxide interface opens the possibility for truly cooperative interactions in the activation of C-O and C-H bonds.Fil: Zhang, Feng. State University of New York. Stony Brook University; Estados UnidosFil: Gutiérrez, Ramón A.. Universidad Central de Venezuela; VenezuelaFil: Lustemberg, Pablo German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Física de Rosario. Universidad Nacional de Rosario. Instituto de Física de Rosario; Argentina. Consejo Superior de Investigaciones Científicas; EspañaFil: Liu, Zongyuan. Brookhaven National Laboratory; Estados UnidosFil: Rui, Ning. Brookhaven National Laboratory; Estados UnidosFil: Wu, Tianpin. Argonne National Laboratory; Estados UnidosFil: Ramírez, Pedro J.. Zoneca-cenex; México. Universidad Central de Venezuela; VenezuelaFil: Xu, Wenqian. Argonne National Laboratory; Estados UnidosFil: Idriss, Hicham. King Abdullah University of Science and Technology; Arabia SauditaFil: Ganduglia Pirovano, M. Verónica. Consejo Superior de Investigaciones Científicas; EspañaFil: Senanayake, Sanjaya D.. Brookhaven National Laboratory; Estados UnidosFil: Rodriguez, José A.. Brookhaven National Laboratory; Estados Unidos. State University of New York. Stony Brook University; Estados Unido

A boundary element analysis on the influence of Krc and e/d on the performance of cyclically loaded single pile in clay

The environment prevalent in oceans necessitates the piles supporting offshore structures to be designed against lateral cyclic loading initiated by wave action. Such quasi-static load reversal induces deterioration in the strength and stiffness of the soil-pile system, introducing progressive reduction in the bearing capacity associated with increased settlement of the pile foundation. To understand the effect of lateral cyclic load on axial response of single piles in soft clay, a numerical model was previously developed and validated by the author. Using the methodology, further analysis has been carried out to investigate how the variation in relative pilesoil stiffness and eccentricity effects the degradation of axial pile capacity due to the effect of lateral cyclic load. This paper presents a brief description of the methodology, analysis and interpretations of the theoretical results obtained from the further analysis and the relevant conclusions drawn there from

Future Seismic Hazards in Southern California - Phase I: Implications of the 1992 Landers Earthquake Sequence

Southern California and its seismologists received a wake-up call on June 28, 1992. The largest earthquake to strike southern California in 40 years occurred near the town of Landers, located 30 km north of the San Andreas fault. It had a magnitude of 7.5 (M7.5). Three and one-half hours later, a M6.5 aftershock struck the Big Bear area 40 km (kilometers) to the west of Landers. An ad hoc working group was rapidly convened in July, 1992, to evaluate how the Landers-Big Bear earthquake sequence might affect future large earthquakes along major faults in southern California. In particular, what are the chances of large earthquakes in the next few years and how do they compare to previous estimates (such as those of the Working Group on California Earthquake Probabilities -- WGCEP, 1988)? Such an evaluation was made for central California after the Lorna Prieta earthquake of 1989 (WGCEP, 1990). The charge to the Landers ad hoc working group included analyzing the seismicity for the last several years in southern California and the new paleoseismic, geologic, and geodetic data recently available for southern California. To inform the public about the potential hazard of plausible earthquakes, the working group was also asked to map the predicted severity of ground shaking for such earthquakes compared to that from the Landers earthquake

Comparison of Efficacy and Safety of Ciclosporin to Prednisolone in the Treatment of Erythema Nodosum Leprosum: Two Randomised, Double Blind, Controlled Pilot Studies in Ethiopia.

BACKGROUND: Erythema Nodosum Leprosum (ENL) is a serious complication of leprosy. It is normally treated with high dose steroids, but its recurrent nature leads to prolonged steroid usage and associated side effects. There is little evidence on the efficacy of alternative treatments for ENL, especially for patients who have become steroid resistant or have steroid side effects. These two pilot studies compare the efficacy and side effect profile of ciclosporin plus prednisolone against prednisolone alone in the treatment of patients with either new ENL or chronic and recurrent ENL. METHODS AND RESULTS: Thirteen patients with new ENL and twenty patients with chronic ENL were recruited into two double-blinded randomised controlled trials. Patients were randomised to receive ciclosporin and prednisolone or prednisolone treatment only. Patients with acute ENL had a delay of 16 weeks in the occurrence of ENL flare-up episode, with less severe flare-ups and decreased requirements for additional prednisolone. Patients with chronic ENL on ciclosporin had the first episode of ENL flare-up 4 weeks earlier than those on prednisolone, as well as more severe ENL flare-ups requiring 2.5 times more additional prednisolone. Adverse events attributable to prednisolone were more common that those attributable to ciclosporin. CONCLUSIONS: This is the first clinical trial on ENL management set in the African context, and also the first trial in leprosy to use patients' assessment of outcomes. Patients on ciclosporin showed promising results in the management of acute ENL in this small pilot study. But ciclosporin, did not appear to have a significant steroid-sparing effects in patients with chronic ENL, which may have been due to the prolonged use of steroids in these patients in combination with a too rapid decrease of steroids in patients given ciclosporin. Further research is needed to determine whether the promising results of ciclosporin in acute ENL can be reproduced on a larger scale

STRONG GROUND MOTIONS AND DAMAGE PATTERNS FROM THE 1999 DUZCE EARTHQUAKE IN TURKEY

The Mw 7.1 Duzce earthquake occurred on 12 November 1999 along the North Anatolian Fault in northwestern Turkey. This paper documents observations from a field reconnaissance team, addressing two principal aspects of this significant earthquake: the recorded ground motions and the distribution and severity of the earthquake effects on the built environment. In general, the recorded ground motions from this earthquake were smaller than predicted by ground motion predictive equations available at the time of the event. One anomalous recording is presented and potential causes for this irregular motion based on observations from field reconnaissance are discussed. The effects of rupture directivity on the near-fault recordings are assessed and the effects of soil conditions on the recorded ground motions are examined. The patterns of building damage based on post-earthquake reconnaissance are presented for the most strongly shaken cities in the near-fault region: Duzce, Kaynasli, and Bolu. Damage in Duzce was concentrated in the southern part of the city, which is underlain by softer sediments. Damage in Bolu was distributed evenly throughout the city; whereas damage was concentrated on more recent alluvial sediments in Kaynasli. No evidence of liquefaction or ground failure was observed in the populated areas surveyed after the earthquake

Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars

The Patient and Observer Scar Assessment Scale (POSAS) is a questionnaire that was developed to assess scar quality. It consists of two separate six-item scales (Observer Scale and Patient Scale), both of which are scored on a 10-point rating scale. After many years of experience with this scale in burn scar assessment, it is appropriate to examine its psychometric properties using Rasch analysis. Cross-sectional data collection from seven clinical trials resulted in a data set of 1,629 observer scores and 1,427 patient scores of burn scars. We examined the person-item map, item fit statistics, reliability, response category ordering, and dimensionality of the POSAS. The POSAS showed an adequate fit to the Rasch model, except for the item surface area. Person reliability of the Observer Scale and Patient Scale was 0.82 and 0.77, respectively. Dimensionality analysis revealed that the unexplained variance by the first contrast of both scales was 1.7 units. Spearman correlation between the Observer Scale Rasch measure and the overall opinion of the clinician was 0.75. The Rasch model demonstrated that the POSAS is a reliable and valid scale that measures the single-construct scar qualit