Wealth inequality and utilization of reproductive health services in the Republic of Vanuatu: insights from the multiple indicator cluster survey, 2007

<p>Abstract</p> <p>Background</p> <p>Although the Republic of Vanuatu has improved maternal indicators, more needs to be done to improve equity among the poorest in the use of reproductive health services to expedite the progress towards the Millennium Development Goal 5(MDG 5) target. While large developing country studies provide evidence of a rich-poor gap in reproductive health services utilization, not much is written in terms of Pacific Islands. Thus, this study aims to examine the degree of inequality in utilization of reproductive health services in a nationally representative sample of Vanuatu households.</p> <p>Methods</p> <p>This paper used data from the 2007 Vanuatu Multiple Indicator Cluster Survey (MICS). The analyses were based on responses from 615 ever married women, living with at least one child below two years of age. Outcomes included antenatal care (ANC) and use of birth attendants at delivery, place of delivery, and counseling and testing for HIV/AIDS. Descriptive statistics and multivariate logistic regression methods were employed in the analysis.</p> <p>Results</p> <p>Findings revealed that the economic well-being status of the household to which women belong, played a crucial role in explaining the variation in service utilization. Inequality in utilization was found to be more pronounced between the poorest and richest groups within the wealth quintiles. In adjusted models, mothers in the richest bands of wealth were 5.50 (95% confidence interval [CI]: 1.34-22.47), 2.12 (95% CI: 1.02-3.42), 4.0 (95% CI 1.58-10.10), and 2.0 (95% CI 1.02-5.88) times more likely to have assisted delivery from medically trained personnel, have institutional deliveries, and have counseling and testing for HIV/AIDS.</p> <p>Conclusions</p> <p>Association between household wealth inequality and utilization of ANC and delivery assistance from medically trained personnel, institutional delivery, and counseling and testing for HIV/AIDS suggest that higher utilization of reproductive health care services in Vanuatu poor-rich inequalities need to be addressed. Reducing poverty and making services more available and accessible to the poor may be essential for improving overall reproductive health care utilization rate in Vanuatu.</p

Wildfire Monitoring Based on Energy Efficient Clustering Approach for FANETS

Forest fires are a significant threat to the ecological system’s stability. Several attempts have been made to detect forest fires using a variety of approaches, including optical fire sensors, and satellite-based technologies, all of which have been unsuccessful. In today’s world, research on flying ad hoc networks (FANETs) is a thriving field and can be used successfully. This paper describes a unique clustering approach that identifies the presence of a fire zone in a forest and transfers all sensed data to a base station as soon as feasible via wireless communication. The fire department takes the required steps to prevent the spread of the fire. It is proposed in this study that an efficient clustering approach be used to deal with routing and energy challenges to extend the lifetime of an unmanned aerial vehicle (UAV) in case of forest fires. Due to the restricted energy and high mobility, this directly impacts the flying duration and routing of FANET nodes. As a result, it is vital to enhance the lifetime of wireless sensor networks (WSNs) to maintain high system availability. Our proposed algorithm EE-SS regulates the energy usage of nodes while taking into account the features of a disaster region and other factors. For firefighting, sensor nodes are placed throughout the forest zone to collect essential data points for identifying forest fires and dividing them into distinct clusters. All of the sensor nodes in the cluster communicate their packets to the base station continually through the cluster head. When FANET nodes communicate with one another, their transmission range is constantly adjusted to meet their operating requirements. This paper examines the existing clustering techniques for forest fire detection approaches restricted to wireless sensor networks and their limitations. Our newly designed algorithm chooses the most optimum cluster heads (CHs) based on their fitness, reducing the routing overhead and increasing the system’s efficiency. Our proposed method results from simulations are compared with the existing approaches such as LEACH, LEACH-C, PSO-HAS, and SEED. The evaluation is carried out concerning overall energy usage, residual energy, the count of live nodes, the network lifetime, and the time it takes to build a cluster compared to other approaches. As a result, our proposed EE-SS algorithm outperforms all the considered state-of-art algorithms.publishedVersio

A Novel Optimization for GPU Mining Using Overclocking and Undervolting

Cryptography and associated technologies have existed for a long time. This field is advancing at a remarkable speed. Since the inception of its initial application, blockchain has come a long way. Bitcoin is a cryptocurrency based on blockchain, also known as distributed ledger technology (DLT). The most well-known cryptocurrency for everyday use is Bitcoin, which debuted in 2008. Its success ushered in a digital revolution, and it currently provides security, decentralization, and a reliable data transport and storage mechanism to various industries and companies. Governments and developing enterprises seeking a competitive edge have expressed interest in Bitcoin and other cryptocurrencies due to the rapid growth of this recent technology. For computer experts and individuals looking for a method to supplement their income, cryptocurrency mining has become a big source of anxiety. Mining is a way of resolving mathematical problems based on the processing capacity and speed of the computers employed to solve them in return for the digital currency incentives. Herein, we have illustrated benefits of utilizing GPUs (graphical processing units) for cryptocurrency mining and compare two methods, namely overclocking and undervolting, which are the superior techniques when it comes to GPU optimization. The techniques we have used in this paper will not only help the miners to gain profits while mining cryptocurrency but also solve a major flaw; in order to mitigate the energy and resources that are consumed by the mining hardware, we have designed the mining hardware to simultaneously run longer and consume much less electricity. We have also compared our techniques with other popular techniques that are already in existence with respect to GPU mining.publishedVersio

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Trophic analysis of a historical network reveals temporal information

Trophic analysis exposes the underlying hierarchies present in large complex systems. This allows one to use data to diagnose the sources, propagation paths, and basins of influence of shocks or information among variables or agents, which may be utilised to analyse dynamics in social, economic and historical data sets. Often, the analysis of static networks provides an aggregated picture of a dynamical process and explicit temporal information is typically missing or incomplete. Yet, for many networks, particularly historical ones, temporal information is often implicit, for example in the direction of edges in a network. In this paper, we show that the application of trophic analysis allows one to use the network structure to infer temporal information. We demonstrate this on a sociohistorical network derived from the study of hadith, which are narratives about the Prophet Muhammad’s actions and sayings that cite the people that transmitted the narratives from one generation to the next before they were systematically written down. We corroborate the results of the trophic analysis with a partially specified time labelling of a subset of the transmitters. The results correlate in a manner consistent with an observed history of information transmission flowing through the network. Thus, we show that one may reconstruct a temporal structure for a complex network in which information diffuses from one agent to another via social links and thus allows for the reconstruction of an event based temporal network from an aggregated static snapshot. Our paper demonstrates the utility of trophic analysis in revealing novel information from hierarchical structure, thus showing its potential for probing complex systems, particularly those with an inherent asymmetry

MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral breast cancer in patients undergoing MRI mammography for the evaluation of a malignant breast lesion. Materials and Methods: A total of 294 patients with recently diagnosed breast cancer who underwent MRI of the breast were evaluated for lesions in the opposite breast. Results: The incidence of synchronous contralateral malignancy detected by preoperative MRI mammography done for evaluation of extent of disease was 4.1%. Conclusion: Preoperative breast MRI may detect clinically and mammographically occult synchronous contralateral cancer, and can help the patient avoid an additional second surgery or a second course of chemotherapy later; also, as theoretically these lesions are smaller, there may be a survival benefit as well

Paraquat and psychological stressor interactions as pertains to Parkinsonian co-morbidity

A number of epidemiological and experimental studies have implicated the non-selective herbicide, paraquat, in the development of sporadic Parkinson's disease (PD). While preclinical research has focused mainly on elucidating the nigrostriatal effects of paraquat, relatively little data are available concerning non-motor brain systems and inflammatory immune processes (which have been implicated in PD). Hence, in the present study, we sought to take a multi-system approach to characterize the influence of paraquat upon extra-nigrostriatal brain regions, as well ascertain whether the impact of the pesticide might be enhanced in the context of chronic intermittent stressor exposure. Our findings support the contention that paraquat itself acted as a systemic stressor, with the pesticide increasing plasma corticosterone, as well as altering neurochemical activity in the locus coeruleus, paraventricular nucleus of the hypothalamus, nucleus accumbens, dorsal striatum, and central amygdala. However, with the important exception striatal dopamine turnover, the stressor treatment did not further augment these effects. Additionally, paraquat altered inter-cytokine correlations and, to a lesser extent, circulating cytokine levels, and concomitant stress exposure modulated some of these effects. Finally, paraquat provoked significant (albeit modest) reductions of sucrose preference and weight gain, hinting at possible anhendonic-like or sickness responses. These data suggest that, in addition to being a well known oxidative stress generator, paraquat can act as a systemic stressor affecting hormonal and neurochemical activity, but largely not interacting with a concomitant stressor regimen