GFANC-RL: Reinforcement Learning-based Generative Fixed-filter Active Noise Control.

The recent Generative Fixed-filter Active Noise Control (GFANC) method achieves a good trade-off between noise reduction performance and system stability. However, labelling noise data for training the Convolutional Neural Network (CNN) in GFANC is typically resource-consuming. Even worse, labelling errors will degrade the CNN's filter-generation accuracy. Therefore, this paper proposes a novel Reinforcement Learning-based GFANC (GFANC-RL) approach that omits the labelling process by leveraging the exploring property of Reinforcement Learning (RL). The CNN's parameters are automatically updated through the interaction between the RL agent and the environment. Moreover, the RL algorithm solves the non-differentiability issue caused by using binary combination weights in GFANC. Simulation results demonstrate the effectiveness and transferability of the GFANC-RL method in handling real-recorded noises across different acoustic paths.2.

The influence of the perception, attitude, and level of trust on the uptake of COVID-19 vaccinations among pregnant women attending antenatal care clinic in mbeya urban, Tanzania.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has been associated with adverse effects and death among people with low immunity, including pregnant women. Despite introducing the vaccine as the proper means to curb the spread of the pandemic, vaccine uptake is still low. This study assessed the influence of perception, attitude, and trust toward COVID-19 vaccine uptake among pregnant women attending Antenatal Care Clinics. METHODS: A cross-sectional study design was used, utilizing a quantitative approach with a cross-sectional analytical design conducted in Mbeya urban, distribution of sample size during data collection based on client's volume at three government health facilities (one tertiary health facility, one secondary health facility, and one primary health facility) in Mbeya Urban, Tanzania. Data were collected from 333 pregnant women who attended ANC during the data collection period using a questionnaire with closed-ended questions administered to respondents face-to-face. Data cleaning and analysis were done using Excel and Stata/SE 14.1 software for bivariate and multivariate data; Pearson's chi-squire and Fisher's test were used to analyze the independent determinants of COVID-19 vaccine uptake. RESULTS: The proportion of pregnant women vaccinated with the COVID-19 vaccine was 27%. There was a statistically significant association between the respondents' vaccine uptake with primary education and < 5 work experience to vaccine uptake P = 0.015 (AOR = 6.58; 95% CI; 1.45-29.85), and P = 0.046 (AOR = 2.45; 95% CI; 1.02-5.89) respectively. The association of attitude influence to COVID-19 vaccine uptake was statistically significant (acceptance of vaccine due to its availability, vaccine acceptance for protection against COVID-19 pandemic to respondent and her baby, experience from other vaccines) was statistically significant at P = 0.011 (AOR = 4.43; 95% CI; 1.41-13.93), P = 0.001 (AOR = 45.83; 95% CI; 18.6-112.89) respectively. The level of trust in the COVID-19 vaccine influenced respondents' association with vaccine uptake in the 2nd and 3rd trimesters of pregnancy (P = 0.633 (AOR = 1.23; 95% CI; 0.53-2.48), respectively. CONCLUSION: Pregnant women's positive attitude and trust in the COVID-19 vaccine influenced them to uptake it; our conclusion supports the WHO guidelines that the COVID-19 vaccine should be administered to pregnant women since it is a safer means to curb COVID-19 pregnancy-related complications.

Case report of an abdominal wet gangrene caused by Acidaminococcus.

The Acidaminococcus genus is a part of the normal flora in gastrointestinal tract. It is a strictly anaerob Gram-negative coccus that is rarely pathogenic. We report the case of a 58-year-old man, who presented to surgery department A of the Charles Nicolle hospital, complaining of a wide inflammatory lesion in the anterior abdominal wall evolving for two weeks. Patient's anamnestic data included smoking, hypertension, and diabetes mellitus with poor compliance. The patient underwent flattening with excision of necrotic tissues and surgical drainage using a DELBET blade. Empirical antibiotic therapy with imipenem 1gx3/d, teicoplanin 400 mg 1 inj x2/d and gentamicin 400 mg 1 inj/d was administered pending bacteriological results. The bacteriological examination of a sample of necrotic tissue, after 72 h of incubation at 37 °C in anaerobic atmosphere, was able to detect a Gram-negative coccus, that the VITEK2 ANC system identified as Actinomyces canis with an accuracy of 80%. Whole genome sequencing was subsequently performed, that identified Acidaminococcus sp. AM33-14BH and demonstrated the following resistance genes: cfxa, tet(X) and tet(Q). An antibiogram for anaerobes was performed showing that the strain was resistant to amoxicillin but sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ertapenem, imipenem, meropenem and rifampin. Patient's condition improved after treatment with imipenem for 2 weeks, followed by oral amoxicillin-clavulanic acid for 16 days.This work highlights the role of molecular biology in the diagnosis of infections caused by anaerobes. Although the Vitek 2 ANC card provides rapid and acceptable identification of the most common anaerobic bacteria, improvements are needed for the identification of bacteria in the genera Acidaminococcus and Actinomyces.

Evaluation of the incidence, predictors, risk assessment scores and outcomes of thromboembolism in a cohort of Egyptian NHL patients - Real World Experience.

Non-Hodgkin's Lymphoma (NHL) is the most common subtype of lymphoma. The incidence of venous thromboembolism (VTE) in aggressive NHL was estimated recently to be 11%. Several risk assessment scores and factors are available to help identify cancer patients at risk for developing VTE. Patients with a pathologically confirmed diagnosis of NHL were identified at the Oncology Center of Mansoura University. The study included 777 patients: 719 with DLBCL-NOS, 26 with Anaplastic-B-cell, and 32 with T-cell-rich-NHL. Data were retrospectively collected from electronic medical records, including clinical, radiological, and laboratory information related to VTE and NHL. The median age at NHL diagnosis was 53 years, (range: 18-98). There was a male predominance, 51.4% of the cases. At initial lymphoma diagnosis, VTE was identified in 46 (5.9%) patients, and 61 (7.9%) patients experienced VTE while undergoing chemotherapy. According to logistic regression analysis, a PS (performance status) ≥ 2, bulky lesions, and mediastinal masses were significant predictors of VTE at presentation, with P-values of 0.022, 0.002, and < 0.001, respectively. Meanwhile, NHL patients who developed VTE during chemotherapy had significantly poorer PS, higher absolute neutrophilic counts (ANC), neutrophil/lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lactate dehydrogenase (LDH) levels than lymphoma patients without VTE, with P-values of 0.003,  0.034, 0.049, 0.01 and 0.007, respectively, as determined by multivariate analysis. The ROC curve identified the cut-off values of 4.875 × 109/L for ANC, 2.985 for NLR, 144.85 for PLR, and 417.5 U/L for LDH as potential markers for predicting VTE in NHL patients. Patients with a PS ≥ 2 and values exceeding these cut-offs for ANC, NLR, and PLR experienced significantly higher incidences of VTE than other groups, with P-values of 0.003, < 0.001, < 0.001, and < 0.001, respectively. At the end of the follow-up, the overall survival was significantly shortened by VTE occurring during chemotherapy, hypoalbuminemia,  intermediate-high and high international prognostic index (IPI) scores (intermediate-high and high), responses other than CR and relapse, all with P-values < 0.05. ECOG PS and Inflammatory markers such as NLR, PLR, and neutrophilic count could serve as predictors of the development of thrombotic events in patients with NHL-DLBCL. Additionally, the occurrence of VTE during chemotherapy is an independent poor prognostic marker for overall survival (OS).

In Vivo Monitoring of Nucleophagy in Caenorhabditis elegans.

The autophagy-lysosomal pathway enables the controlled degradation of cellular contents. Nucleophagy is the selective autophagic recycling of nuclear components upon delivery to the lysosome. Although methods to monitor and quantify autophagy as well as selective types of autophagy have been developed and implemented in cells and in vivo, methods monitoring nucleophagy remain scarce. Here, we describe a procedure to monitor the autophagic engagement of an endogenous nuclear envelope component, i.e., ANC-1, the nematode homologue of the mammalian Nesprins in vivo, utilizing super-resolution microscopy.

Assessing the relationship of agger nasi pneumatization to the lacrimal sac: a dynamic computed tomography-dacryocystography analysis.

Background: An understanding of the anatomical structure is crucial for completing successful endoscopic dacryocystorhinostomy (DCR) surgery. This study aimed to precisely delineate the spatial relationship between the lacrimal sac and the agger nasi cell (ANC) and evaluate the impact of ANC on surgical strategies in endoscopic DCR. Methods: This retrospective cross-sectional study included 110 Han Chinese patients diagnosed with unilateral primary acquired nasolacrimal duct obstruction (PANDO) from January 2021 to June 2023. This study was conducted in Eye, Ear, Nose, and Throat Hospital of Fudan University and involved inpatient participants who were scheduled for DCR surgery under general anesthesia. Patients were consecutively enrolled. The patients underwent preoperative computed tomography-dacryocystography (CT-DCG), and contrast-enhanced images were used to locate the positions of the lacrimal sac and the common canaliculus. A dynamic approach was adopted to analyze the multiplanar CT imaging, facilitating a detailed assessment of the morphology of the lacrimal drainage system and potential overlap of the lacrimal sac. Patient ages and measured values are presented as the mean ± standard deviation, which were measured three times by the same observer and averaged for statistical analysis. Results: The prevalence of ANC in this study was 90.9% (100/110). Dynamic examination revealed that only 42.7% (47/110) of ANCs appeared as discrete cells, while the majority were connected to nearby sinus openings. Spatial analysis showed that in 57 out of 110 cases, ANCs were situated below the common canaliculus and not posterior to the lacrimal sac, indicating an overlap rate of 51.8%. Notably, our dynamic approach identified five critical cases of overlap below the level of the common canaliculus, which might have been missed by prior studies that used different methodologies. Conclusions: More than half of the ANCs exhibited overlap with the lacrimal sac, suggesting a significant proportion may necessitate opening during endoscopic DCR procedures. ANCs are often interconnected with adjacent nasal sinuses, necessitating careful consideration in the decision to open the ANCs during surgery. The dynamic evaluation employed in CT-DCG effectively assessed the extent of ANC coverage over the lacrimal sac.

High peripheral neutrophil and monocyte count distinguishes renal cell carcinoma from renal angiomyolipoma and predicts poor prognosis of renal cell carcinoma.

Background: The presence of peripheral inflammatory cells has been linked to the prognosis of cancer. This study aims to investigate the distinct roles of absolute neutrophil count (ANC) and absolute monocyte count (AMC) in differentiating renal cell carcinoma (RCC) from renal angiomyolipoma (RAML), as well as their prognostic significance in RCC. Methods: We conducted a comprehensive analysis of peripheral immune cell data, clinicopathological data, and tumor characteristics in patients diagnosed with RCC or RAML from January 2015 to December 2021. Receiver operating characteristic (ROC) curves, as well as univariate and multivariate analyses, were employed to assess the diagnostic utility of AMC and ANC in differentiating between RCC and RAML. Kaplan-Meier curve analysis was used to study the survival of RCC patients with different AMC and ANC. The prognostic value of AMC and ANC in RCC was investigated using COX univariate and multivariate analysis. The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases were used for bioinformatic correlation analysis. Results: A total of 1120 eligible patients were included in the study. The mean preoperative AMC and ANC in patients with RCC were found to be significantly higher compared to those in patients with RAML (P = 0.001 and P < 0.001, respectively). High preoperative AMC and ANC significantly correlated with smoking history, tumor length, gross hematuria, and high T Stage, N stage, and pathological grade. In multivariate analyses, an ANC> 3.205 *10^9/L was identified to be independently associated with the presence of RCC (HR = 1.618, P = 0.008). High AMC and ANC were significantly associated with reduced OS and PFS (P < 0.05), and ANC may be an independent prognostic factor. Public database analysis showed that signature genes of tumor-associated macrophages (TAMs) and tumor-associated neutrophils (TANs) were highly expressed in ccRCC. Conclusions: Elevated preoperative ANC and AMC can distinguish RCC from RAML and predict poor prognosis in patients with RCC. Furthermore, the signature genes of TAMs and TANs exhibit high expression levels in clear cell RCC.

Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022-2023.

INTRODUCTION: Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy. METHODS: We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata. RESULTS: Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women's higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births. DISCUSSION: Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women's social status.

Level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia: new WHO-recommended ANC 8+ model.

Background: To fully realize the life-saving and health-promoting benefits of antenatal care (ANC), the latest World Health Organization (WHO) recommendations call for pregnant women to have at least eight contacts with skilled healthcare providers. This increased number of recommended ANC visits represents a shift toward a more comprehensive, individualized approach to prenatal care. The focus is on health promotion, disease prevention, and the early detection and management of complications during pregnancy. However, in sub-Saharan African countries, including Ethiopia, the coverage rate for this level of recommended antenatal care is only 58%. Given this relatively low utilization, identifying the key risk factors that prevent adequate antenatal care would have significant implications for increasing overall ANC uptake in these regions. Objective: The aim of the present study was to assess the level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia in 2023 using the new WHO-recommended ANC 8+ model. Methods: An institution-based cross-sectional study was conducted among 416 mothers who were enrolled between 1 December 2022 and 30 January 2023. The total sample size was allocated proportionately to the number of women who delivered at each public health facility. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using SPSS Version 26. Statistical significance was determined at a p-value <0.05. Results: In this study, the level of optimal antenatal care was 41% [95% confidence interval (CI): 37-45.3]. The associated factors with optimal antenatal care were the presence of pregnancy danger signs [adjusted odds ratios (AOR) = 4.1, 95% CI: 1.87-8.82], having bad obstetric history (AOR = 3.90, 95% CI: 1.94-7.83), antenatal contact at hospital (AOR = 5.11, 95% CI: 2.28-11.21), having good knowledge about antenatal care (AOR = 2.26, 95% CI: 1.15-4.44), women's high decision-making power (AOR = 3.9, 95% CI: 1.2-7.63), and male partner involvement (AOR = 2.0, 95% CI: 1.04-3.78) were positively associated with optimal antenatal care utilization. Conclusion: The level of optimal antenatal follow-up is still low. Therefore, it is crucial to provide more information during the antenatal contacts to lower the rate of women discontinued from antenatal care.

The risk factors of infant mortality in Somalia: evidence from the 2018/2019 Somali health & demographic survey.

BACKGROUND: Globally, infant mortality is one of the major public health threats, especially in low-income countries. The infant mortality rate of Somalia stands at 73 deaths per 1000 live births, which is one of the highest infant death rates in the region as well as in the world. Therefore, the aim of this study was to ascertain the risk factors of infant mortality in Somalia using national representative data. METHOD: In this study, data from the Somali Health and Demographic Survey (SHDS), conducted for the first time in Somalia in 2018/2019 and released in 2020, were utilized. The analysis of the data involved employing the Chi-square test as a bivariate analysis. Furthermore, a multivariate Cox proportional hazard model was applied to accommodate potential confounders that act as risk factors for infant death. RESULTS: The study found that infant mortality was highest among male babies, multiple births, and those babies who live in rural areas, respectively, as compared to their counterparts. Those mothers who delivered babies with small birth size and belonged to a poor wealth index experienced higher infant mortality than those mothers who delivered babies with average size and belonged to a middle or rich wealth index. Survival analysis indicated that mothers who did use ANC services (HR = 0.740; 95% CI = 0.618-0.832), sex of the baby (HR = 0.661; 95% CI = 0.484-0.965), duration of pregnancy (HR = 0.770; 95% CI = 0.469-0.944), multiple births (HR = 1.369; 1.142-1.910) and place of residence (HR = 1.650; 95% CI = 1.451-2.150) were found to be statistically significantly related to infant death. CONCLUSION: The study investigated the risk factors associated with infant mortality by analyzing data from the first Somali Health and Demographic Survey (SHDS), which included a representative sample of the country's population. Place of residence, gestational duration, infant's gender, antenatal care visits, and multiple births were identified as determinants of infant mortality. Given that infant mortality poses a significant public health concern, particularly in crisis-affected countries like Somalia, intervention programs should prioritize the provision of antenatal care services, particularly for first-time mothers. Moreover, these programs should place greater emphasis on educating women about the importance of receiving antenatal care and family planning services, in order to enhance their awareness of these vital health services and their positive impact on infant survival rates.

Knowledge and utilization of iodized salt among expectant mothers in Harar City's public health facilities: a multicenter study in Eastern Ethiopia.

BACKGROUND: Insufficient iodine intake during pregnancy can result in abortion, stillbirths, neonatal mortality, cretinism and permanent cognitive impairment. Even although iodized salt is widely accessible in Ethiopia, pregnant women still experience persistent problems related to iodine deficiency disorders. METHODS: A facility-based cross-sectional study was conducted among randomly selected 573 pregnant women who were attending antenatal care services at public health facilities. Bivariate and multivariable logistic regression models were used, and independent predictors were determined based on adjusted ORs with 95% CIs and p<0.05. RESULTS: Knowledge and practice of pregnant women on iodized utilization were 35.6% (95% CI 31.8 to 39.6%) and 37.7% (95% CI 32.1 to 42.9%), respectively. Living in urban areas (adjusted OR [AOR]=1.976, 95% CI 1.136 to 3.435) and having a higher level of education (AOR=2.018, 95% CI 1.037 to 3.930) were associated with having adequate knowledge. Having a diploma or higher education (AOR=2.684, 95% CI 1.137 to 6.340) and adequate knowledge about iodized salt utilization (AOR=2.095, 95% CI 1.273 to 3.447) were significantly associated with good practice. CONCLUSIONS: The current study highlights the level of knowledge and practices of pregnant women on iodized salt. It emphasizes the necessity for targeted programs about the benefits of iodized salt and how to use it correctly, particularly for those with low literacy levels and those living in rural areas.

Only 9% of mothers have eight and more ANC visit in 14 sub-saharan African countries; evidence from the most recent DHS 2018-2023: a multilevel analysis.

BACKGROUND: The world health organization's global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes. METHOD: The most recent 2018-2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits. RESULT: The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76-9.13) ranging from 3.66% (95% CI: 3.54-3.79) in Gabon to 18.92% (95% CI: 18.67-19.17) in Nigeria. The multilevel analysis shows that maternal age (40-44, AOR;2.09, 95%CI: 1.75-2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07-1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16-1.38), wealth status(AOR;1.65, 95%CI; 1.50-1.82), media exposure (AOR;1.20, 95%CI; 1.11-1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05-1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07-1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49-5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30-1.56), urban place of residence (AOR;1.33, 95%CI; 1.22-1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53-0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75-0.86) and survey year (AOR;0.47, 95%CI; 0.34-0.65) were factors negatively associated with having eight and more ANC visits. CONCLUSION: In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices.

Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia.

BACKGROUND: Southern African countries have the largest global burden of HIV and syphilis, with a high prevalence among women of reproductive age. Although antenatal screening is standard of care, syphilis screening has generally lagged behind HIV screening. We aimed to evaluate the performance and operational characteristics of two commercial dual HIV/syphilis point-of-care tests (POCTs) for simultaneous maternal HIV/syphilis screening. METHODS: A clinic-based evaluation of dual HIV/syphilis POCTs (SD Bioline and Chembio) was conducted at five primary healthcare centres (PHCs) in South Africa and Zambia. POCT results using capillary fingerprick blood were compared to reference laboratory syphilis and HIV serological assays. RESULTS: Three thousand four hundred twelve consenting pregnant women aged ≥ 18 years were enrolled. The prevalence of treponemal antibody seropositivity and HIV infection ranged from 3.7 to 9.9% (n = 253) and 17.8 to 21.3% (n = 643), respectively. Pooled sensitivity for syphilis compared to the reference assay was 66.0% (95%CI 57.7-73.4) with SD Bioline and 67.9% (95%CI 58.2-76.3) with Chembio. Pooled specificity for syphilis was above 98% with both POCTs. The sensitivities of SD Bioline and Chembio assays were 78.0% (95%CI 68.6-85.7) and 81.0% (95%CI 71.9-88.2), respectively compared to an active syphilis case definition of treponemal test positive with a rapid plasma reagin titre of ≥ 8. The negative predictive values (NPVs) based on various prevalence estimates for syphilis with both assays ranged from 97 to 99%. The pooled sensitivity for HIV was 92.1% (95%CI 89.4-94.2) with SD Bioline; and 91.5% (95%CI 88.2-93.9) with Chembio. The pooled specificities for HIV were 97.2% (95%CI 94.8-98.5) with SD Bioline and 96.7% (95%CI 95.1-97.8) with Chembio. The NPV based on various prevalence estimates for HIV with both assays was approximately 98%. Most participating women (91%) preferred dual POCTs over two single POCTs for HIV and syphilis, and healthcare providers gave favourable feedback on the utility of both assays at PHC level. CONCLUSIONS: Based on the need to improve antenatal screening coverage for syphilis, dual HIV/syphilis POCTs could be effectively incorporated into antenatal testing algorithms to enhance efforts towards elimination of mother-to-child transmission of these infections.

The African National Congress's factionalism and targeted killings as risks to human security in KwaZulu-Natal province.

A prevalence of political violence and political assassinations characterised post-1994 South Africa. These politically motivated killings appeared to be dominant in the controversial KwaZulu-Natal (KZN) province. Political killings in South Africa started as a form of inter-party warfare, especially during the transition to democracy, when the two rivals, the African National Congress (ANC) and the Inkatha Freedom Party (IFP), fought each other for some areas of Gauteng and KwaZulu-Natal provinces. However, following the dominance of the ANC in the KZN Province, members of the ruling party fought each other for positions in government and political party structures. Considering this, the article analyses the crisis of factionalism by examining the ANC's intra-party tensions and targeted killings, and how this poses a risk to human security in KZN. Methodologically, the article employs a qualitative literature assessment and content analysis is used to delve into the impact of intra-party tensions and targeted killings on human security in the KZN province. Contribution: In quest for curbing the crisis of factionalism in the ruling ANC, the article recommends that the ANC needs to re-visit its leadership selection as these killings have seemingly happened during leadership selection, which leads to ruthless competition of positions in government and party structures. Members of the ruling party need to identify themselves as one, as opposed to belonging to different factional groups within the party. Failure by the ruling party to address divisions within the organisation shall result in more fatal killings resulting from competition for positions and resources.

Application of an improved wide-narrow-band hybrid ANC algorithm in a large commercial vehicle cabine.

In recent years, active noise reduction technology has become a research hotspot. However, most active noise reduction technologies are developed based on passenger vehicles and are not implemented in large commercial vehicles. The large commercial vehicle sound field space is large, the traditional active noise reduction method is difficult to implement. In order to explore this problem, this paper proposes an improved active noise control method for commercial vehicles: (1) based on the traditional notch filter, a notch FxLMS algorithm based on speed smoothing is proposed; (2) on the basis of the traditional wire-narrowband hybrid ANC algorithm, the reference signal weighting technology is introduced into the wide-band subsystem, and the notch FxLMS algorithm based on speed smoothing is used as the narrowband subsystem, so as to propose an improved wire-narrowband hybrid ANC algorithm. With the help of MATLAB, the simulation model of the designed algorithm is established, and the collected commercial vehicle test noise data is used as the reference signal to simulate and verify the proposed algorithm. The results show that the proposed method has certain practicability.

Exploring the burden of postpartum depression in urban Bangladesh: Prevalence and its associations with pregnancy-related factors from a cross-sectional study.

Background and Aims: Postpartum depression (PPD) is a globally recognized public health concern, yet research focusing on women in urban areas of Bangladesh remains unexplored. This study aimed to address this research gap by investigating the prevalence and associated factors of PPD within the first 2 years after childbirth. Methods: A cross-sectional study was conducted, enrolling 259 women (26.66 ± 4.57 years) residing in urban areas who were attending healthcare delivery centers. Sociodemographic factors, child-related issues, pregnancy-related complications, and PPD using the Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data analysis involved the application of χ 2 tests and logistic regression analysis using SPSS software. Results: This study found a 60.6% prevalence of PPD using a cutoff of 10 (out of 30) on the EPDS scale. Logistic regression analysis identified several significant factors associated with PPD, including high monthly family income (odds ratio [OR] = 47.51, 95% confidence interval [CI]: 8.34-270.54, p < 0.001), income dissatisfaction (OR = 14.28, 95% CI: 4.75-42.87, p < 0.001), up to two gravidities (OR = 2.94, 95% CI = 1.25-6.90, p = 0.013), pregnancy-related complications (OR = 2.70, 95% CI = 1.05-6.96, p = 0.039), increased antenatal care visits, and higher childbirth expenses. Conclusion: This study underscores the high prevalence of PPD among urban mothers in Bangladesh. The identified risk factors emphasize the need for targeted mental health initiatives, specifically tailored to support the vulnerable group. Implementing such initiatives can effectively address the challenges posed by PPD and enhance the well-being of postpartum women in urban areas.

HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.

Background: In countries with limited resources, including Ethiopia, HIV is diagnosed using a rapid serological test, which does not detect the infection during the window period. Pregnant women who test negative for HIV on the first test may seroconvert throughout pregnancy. Women who are seroconverted during pregnancy may not have received interventions, as they are considered HIV-negative unless they are retested for HIV at the end of their pregnancy. Due to limited data on HIV seroconversion, this study aimed to measure the extent of HIV seroconversion and to identify associated factors among seronegative pregnant women attending ANC in Ethiopia. Methods: Institution-based cross-sectional study was conducted among HIV-negative pregnant women attending the ANC in Ethiopia between June and July 2020. Socio-demographic, clinical, and behavioral data were collected through face-to-face questionnaires and participants' records review. HIV retesting was performed to determine the current HIV status of pregnant women. The data collected were entered into Epi data version 4.4.1 and were exported and analyzed by SPSS version 25. A p-value < 0.25 in the bivariate analysis was entered into multivariable logistic regression analysis and a p-value of < 0.05 was considered statistically significant. Result: Of the 494 pregnant women who tested negative for HIV on their first ANC test, six (1.2%) tested positive on repeat testing. Upon multivariable logistic regression, pregnant women who have had a reported history of sexually transmitted infections [AOR = 7.98; 95% CI (1.21, 52.82)], participants' partners reported travel history for work frequently [AOR = 6.00; 95% CI (1.09, 32.99)], and sexually abused pregnant women [AOR = 7.82; 95% CI (1.194, 51.24)] were significantly associated with HIV seroconversion. Conclusion: The seroconversion rate in this study indicates that pregnant women who are HIV-negative in early pregnancy are at an ongoing risk of seroconversion throughout their pregnancy. Thus, this study highlights the benefit of a repeat HIV testing strategy in late pregnancy, particularly when the risk of seroconversion or new infection cannot be convincingly excluded. Therefore, repeated testing of HIV-negative pregnant women in late pregnancy provides an opportunity to detect seroconverted pregnant women to enable the timely use of ART to prevent mother-to-child transmission of HIV infection.

A Feedback Active Control Approach to Road Noise Based on a Single Microphone Sensor to Improve Automotive Cabin Sound Comfort.

Tire-road noise deteriorates the sound quality of a vehicle's interior and affects the driving safety and comfort. Obtaining low interior noise is a challenge for passenger car manufacturers. Traditional passive noise control (PNC) is efficient for canceling high frequency noise but not useful for low frequency noise, while active noise control (ANC), according to the residual error signal, can generate an anti-noise signal to reduce the original noise. Most research has focused on improving the control effect for a feedforward ANC system. However, this paper emphasizes a feedback ANC system based on a signal microphone sensor. There are two main contributions in this study to improve automotive cabin sound comfort. One is that the algorithm of the feedback ANC system using a single microphone sensor without a reference noise signal is proposed based on the Filtered-x Least Mean Square method. The other is that the algorithm applies additive random noise online to estimate the secondary path model. A simulation was implemented based on measured real road noise data, and the simulation results indicate that the proposed feedback ANC system with the single microphone sensor can effectively attenuate road noise. This study shows the feasibility of applying a feedback ANC system in automobiles to increase the cabin sound quality.

Coverage and determinants of HIV testing and counseling services among mothers attending antenatal care in sub-Saharan African countries: a multilevel analysis.

BACKGROUND: HIV/AIDS is one of the top global public health threats that causes significant cases, deaths, and socioeconomic impact. Even though both HIV testing and counseling are identified as essential HIV interventions during pregnancy, large population-representative data shows that service coverage and determinants are limited. Therefore, this study aimed to assess the coverage and determinants of HIV testing and counseling services among pregnant mothers attending antenatal care services in sub-Saharan African countries using different nationwide data. METHODS: This study was conducted on large national-representative data from the Demographic Health Survey (DHS) using multilevel analysis. Data extraction, cleaning, coding, and statistical analysis were performed using STATA version 17. Weighting was used to ensure the representativeness of the sample and to obtain reliable estimates and standard errors. The multivariable multilevel logistic regression model was used to identify the determinants of HIV testing and counseling during the antenatal care visit. Adjusted odds ratios with 95% confidence intervals were used to measure statistical significance. RESULTS: A total of 83,584 women attending antenatal care were included in this study. HIV testing and counseling coverage in sub-Saharan Africa was found to be 62.87% with a 95% CI of 62.54-63.19%. The HIV testing and counseling determinants included being in the age group of 35-49 (AOR = 1.64; 95% CI: 1.46-1.83), secondary and above education levels (AOR = 1.50; 95% CI: 1.39-1.60), having at least four ANC visits (AOR = 1.85; 95% CI: 1.68-2.02), living in an urban area (AOR = 1.40; 95% CI: 1.30-1.52), and living in countries such as Rwanda (AOR = 6.19; 95% CI: 5.19-7.38) and Mauritania (AOR = 0.02; 95% CI: 0.01-0.03). CONCLUSION: This study revealed that HIV testing and counseling coverage was 62.87% in sub-Saharan Africa. Factors affecting the HIV testing and counseling coverage were age, education, frequency of antenatal care visits, residence area, and living in Rwanda and Mauritania. Therefore, to increase HIV testing and counseling coverage in sub-Saharan Africa, policymakers on maternal health and other stakeholders should work with an integrated approach with other sectors and give prior attention to modifiable factors such as promoting women's education and the comprehensiveness of antenatal care follow-up services during the follow-up.

Antenatal Care Practices: A Population-Based Multicenter Study from Saudi Arabia.

Background: Antenatal care (ANC) is the care women receive during pregnancy before birth and represents a cornerstone of maternal and child health. Previously, Saudi women faced various barriers to practicing ANC, including challenges related to transportation, low maternal education, poor communication with healthcare centers, and incorrect maternal beliefs. In line with Saudi Vision 2030, this multicenter cross-sectional study aimed to investigate the timing of ANC contact, coverage of service utilization in public hospitals among Saudi mothers, sociodemographic factors and antenatal health care utilization, and beliefs about prenatal vitamins, and supplement use among pregnant Saudi women. Methods: Data was collected from 1230 pregnant women across 11 Ministry of Health (MOH) facilities. The study assessed the timing of ANC initiation, beliefs about prenatal vitamins, and the use of folic acid, calcium, and iron during pregnancy. Chi-square tests were employed to analyze associations between variables. Results: The findings revealed that 14.55% of participants initiated ANC within the first 8 weeks of pregnancy, with 85.44% starting later. However, the majority 88.78% received prenatal care during pregnancy, regardless of the timing of ANC initiation. Beliefs about prenatal vitamins varied, with 20.08% agreeing that prenatal vitamins were only indicated for malnourished mothers, 72.35% disagreeing, and 7.56% uncertain. Moreover, 51.30% believed ANC should begin before pregnancy, 29.83% after pregnancy confirmation, and 13.57% during the first trimester, with no significant correlation between beliefs and ANC timing. Regarding prenatal care, 95.20% would recommend starting prenatal care with every pregnancy, regardless of the timing of their own ANC initiation. Conclusion: This study offers a comprehensive analysis of factors impacting late ANC contact and inadequate ANC contacts among pregnant Saudi women. These findings contribute to the broader understanding of ANC practices among Saudi women and underscore the importance of considering various determinants for tailored interventions and health education programs.