Determinants of apparent rural-urban differentials in measles vaccination uptake in Indonesia

Introduction: Regional differences in vaccination uptake are common in both developed and developing countries, and are often linked to the availability of healthcare services and socioeconomic factors. In 2007, 0.9 million eligible Indonesian children missed measles vaccination, and 19 456 cases of measles were documented among Indonesian children. The authors investigated rural– urban differentials in measles vaccination coverage among young Indonesian children, and sought to identify key factors influencing the probability of a child receiving the first dose of measles vaccination in Indonesia. Methods: Data used in the analyses were sourced from the nationally representative Indonesia Demographic and Health Survey 2007. The influence of location of residence, household wealth, maternal and paternal education, total children ever born and use of skilled birth attendants on measles vaccination coverage was investigated using bivariate analysis and chi-square tests. The independent effects of these variables were established using binomial logistic regression analysis. Results: Indonesia’s 2007 first-dose measles national vaccination coverage was, at 72.8%, lower than the 2008 global first-dose measles vaccination average coverage of 82%. Bivariate analysis revealed that the first-dose measles vaccination coverage in rural areas of Indonesia was 68.5%, compared with 80.1% in urban regions (p<0.001). The apparent significance of rural residence in impairing vaccination coverage was marginal after controlling for the sex of the child, maternal age, maternal and paternal education, wealth, and access to skilled health workers. Conclusion: Apart from sustainable initiatives to increase measles vaccination coverage globally, it is important to close the rural–urban gap in Indonesia’s measles vaccination uptake. Addressing critical determinants of inferior measles vaccination coverage in Indonesia’s rural regions will facilitate major improvements in Indonesia’s child health trends. This article suggests initiatives for addressing three of such determinants in Indonesia’s rural areas: poverty, parental education and access to skilled health workers.RC Fernandez, N Awofeso, A Rammoha

Intrathecal baclofen in management of a patient with very severe tetanus

Tetanus is uncommon in developed countries. The majority of tetanus cases occur in third world countries and 50% of these cases occur in neonates. There are more than 800,000 deaths due to tetanus each year in the world. We present a case of 40-year-old male patient diagnosed to have very severe tetanus - Grade IV as per Ablett classification of severity, managed in our hospital with aggressive treatment for 27-days and use of intrathecal baclofen he showed drastic improvement in this status.  He was discharged in neurological intact conditions with hemodynamic stability.

Reinforcement Learning-assisted Evolutionary Algorithm: A Survey and Research Opportunities

Evolutionary algorithms (EA), a class of stochastic search methods based on the principles of natural evolution, have received widespread acclaim for their exceptional performance in various real-world optimization problems. While researchers worldwide have proposed a wide variety of EAs, certain limitations remain, such as slow convergence speed and poor generalization capabilities. Consequently, numerous scholars actively explore improvements to algorithmic structures, operators, search patterns, etc., to enhance their optimization performance. Reinforcement learning (RL) integrated as a component in the EA framework has demonstrated superior performance in recent years. This paper presents a comprehensive survey on integrating reinforcement learning into the evolutionary algorithm, referred to as reinforcement learning-assisted evolutionary algorithm (RL-EA). We begin with the conceptual outlines of reinforcement learning and the evolutionary algorithm. We then provide a taxonomy of RL-EA. Subsequently, we discuss the RL-EA integration method, the RL-assisted strategy adopted by RL-EA, and its applications according to the existing literature. The RL-assisted procedure is divided according to the implemented functions including solution generation, learnable objective function, algorithm/operator/sub-population selection, parameter adaptation, and other strategies. Finally, we analyze potential directions for future research. This survey serves as a rich resource for researchers interested in RL-EA as it overviews the current state-of-the-art and highlights the associated challenges. By leveraging this survey, readers can swiftly gain insights into RL-EA to develop efficient algorithms, thereby fostering further advancements in this emerging field.Comment: 26 pages, 16 figure

Assessment on facile Diels–Alder approach of α-pyrone and terpenoquinone for the expedient synthesis of various natural scaffolds

The development of highly facile synthetic procedures for the expedient synthesis of complex natural molecules is always in demand. As this aspect, the Diels–Alder reaction (DAR) has a versatile approach to the synthesis of complex natural compounds and highly regio-/stereoselcetive heterocyclic scaffolds. Additionally, α-pyrone and terpenoquinone are two versatile key intermediates that are prevalent in various bioactive natural compounds for instance, (±)-crinine, (±)-joubertinamine, (±)-pancratistatin, (−)-cyclozonarone, and 8-ephipuupehedione, etc. Hence, the current review summarizes the Diels–Alder reaction application of α-pyrone and terpenoquinone to the constructive synthesis of various natural products over the past two decades (2001–2021). Equally, it serves as a stencil for the invention and development of new synthetic strategies for high-complex molecular structured natural and heterocyclic molecules. Graphical Abstract: [Figure not available: see fulltext.] © 2022, The Author(s).Russian Science Foundation, RSF; Council on grants of the President of the Russian Federation: 21-13-00304, HШ-2700.2020.3This work was financially supported by the Grants Council of the President of the Russian Federation (# HШ-2700.2020.3) and Russian Scientific Foundation (Grant # 21-13-00304).Council on grants of the President of the Russian Federation, HШ-2700.2020.3, Zyryanov Grigory V., Российский Фонд Фундаментальных Исследований (РФФИ), Grant # 21-13-00304, Zyryanov Grigory V

Microwave-Assisted Synthesis of N-Substituted Maleimide Derivatives as Exogenous Antioxidant Agents

A series of N-substituted maleimide derivatives have been developed via acetic acid-mediated microwave reaction pathway, which was identified as the incomparable method for this maleimide compounds. All the synthesized compounds were tested for antioxidant activity by DPPH and H 2 O 2 methods. Compounds 5h and 5m were displayed with higher antioxidant activity in two methods. The structure–activity relationship demonstrated that the compounds having electron releasing substitutions 5h and 5m generally show beneficial activity than electron capture substitution cores. Thus, compounds 5h and 5m may be useful as an exogenous antioxidant. © 2018 Wiley Periodicals, Inc

A convenient synthetic approach to 5-(het)arylhydrazine substituted 1,2,4‑triazines

Received: 09.09.2020. Accepted: 20.12.2020. Published:30.12.2020.A convenient synthesis of 1,2,4‑triazines bearing the moieties of (hetero) arylhydrazines at the position of C5 of the 1,2,4‑triazine core is reported