Population mortality before and during the COVID-19 epidemic in two Sudanese settings: a key informant study.

BACKGROUND: Population mortality is an important metric that sums information from different public health risk factors into a single indicator of health. However, the impact of COVID-19 on population mortality in low-income and crisis-affected countries like Sudan remains difficult to measure. Using a community-led approach, we estimated excess mortality during the COVID-19 epidemic in two Sudanese communities. METHODS: Three sets of key informants in two study locations, identified by community-based research teams, were administered a standardised questionnaire to list all known decedents from January 2017 to February 2021. Based on key variables, we linked the records before analysing the data using a capture-recapture statistical technique that models the overlap among lists to estimate the true number of deaths. RESULTS: We estimated that deaths per day were 5.5 times higher between March 2020 and February 2021 compared to the pre-pandemic period in East Gezira, while in El Obeid City, the rate was 1.6 times higher. CONCLUSION: This study suggests that using a community-led capture-recapture methodology to measure excess mortality is a feasible approach in Sudan and similar settings. Deploying similar community-led estimation methodologies should be considered wherever crises and weak health infrastructure prevent an accurate and timely real-time understanding of epidemics' mortality impact in real-time.

The Extent of Antibiotic Dispensing in Self-Medication Encounters in Sudan: A Simulated Patient Study Focusing on Cefixime Sale.

Background: Antibiotics play an important role in decreasing morbidity and mortality worldwide. However, inappropriate use of them by patients or healthcare professionals contributes to their resistance rendering them less efficacious. Community pharmacists (CPs) have a significant part in reducing antibiotic resistance. Therefore, this study aimed to investigate the dispensing of antibiotics without prescription in community pharmacies with an emphasis on cefixime dispensing. Methods: A cross-sectional, simulated patient (SP) study was conducted in the Khartoum locality. A total of 238 community pharmacies were randomly chosen using simple random sampling. One scenario of uncomplicated urinary tract infection was designed, and six female pharmacy students who were trained to act as SPs presented the scenario. Descriptive statistics were applied to report the study outcomes. Results: In the 238 pharmacy visits, at least one antibiotic was dispensed without a prescription in 69.3% of the simulated visits. Among the dispensed antibiotics, ciprofloxacin was the most dispensed antibiotic followed by cefixime representing 51.5% and 41.8%, respectively, of total dispensed antibiotics. Cefixime was dispensed as a first choice by CPs in 29% of the visits, and in the rest of the visits, only 37.3% of CPs refused to dispense cefixime after SP demand. Conclusion: The findings revealed a high rate of antibiotics dispensing without prescription by CPs in Khartoum state, and cefixime was obtained with ease before and after the patient's demand. Urgent corrective actions such as imposing strict regulations, monitoring pharmacists' practice, and endorsing educational programs for pharmacists are needed to prevent inappropriate antibiotic dispensing practices.

The combined effects of contextual predictability and noise on the acoustic realisation of German syllables.

Speakers tend to speak clearly in noisy environments, while they tend to reserve effort by shortening word duration in predictable contexts. It is unclear how these two communicative demands are met. The current study investigates the acoustic realizations of syllables in predictable vs unpredictable contexts across different background noise levels. Thirty-eight German native speakers produced 60 CV syllables in two predictability contexts in three noise conditions (reference = quiet, 0 dB and -10 dB signal-to-noise ratio). Duration, intensity (average and range), F0 (median), and vowel formants of the target syllables were analysed. The presence of noise yielded significantly longer duration, higher average intensity, larger intensity range, and higher F0. Noise levels affected intensity (average and range) and F0. Low predictability syllables exhibited longer duration and larger intensity range. However, no interaction was found between noise and predictability. This suggests that noise-related modifications might be independent of predictability-related changes, with implications for including channel-based and message-based formulations in speech production.

Effect of Rare-Earth Ions on the Optical and PL Properties of Novel Borosilicate Glass Developed from Agricultural Waste.

There is considerable attention devoted to the use of agricultural waste as a raw material substitute for commercial silica in the development of borosilicate glasses doped with rare earth oxides. Here, we present a novel structure for borosilicate glasses made from rice husk ash with a 25% molar ratio of extracted SiO2 and doped with neodymium (GRN) or dysprosium (GRD). Adding rare earth oxides to borosilicate glasses by the melt quenching method enhanced optical transmission due to the presence of their tetrahedral geometries. GRN samples showed few bands near zero, which constitutes good utility for band rejection filters in image devices, and the samples exhibited energy values ranging from 3.03 to 3.00 eV before and after gamma irradiation. Optical transmissions of GRD samples showed peaks at 25,974, 22,172, 13,333, 11,273, 9302, 7987, and 6042 cm-1. Deterioration in transmittance was observed when the investigated samples were exposed to irradiation doses of 20 and 50 kGy in the wavenumber range of 12,500 to 50,000 cm-1; however, different behaviors after irradiation with 50 kGy caused an increase in transparency in comparison to 20 kGy irradiation, which was pronounced for higher wavenumbers (greater than 12,500 cm-1). Photoluminescence emission and excitation spectra of the glass-doped Nd3+ (GRN) and glass-doped Dy3+ (GRD) samples were determined. GRD exhibited emission in the blue and yellow regions of the visible spectrum, which gave a white flash of light. Chromaticity coordinate (CIE) measurements of GRD samples indicated the origin of its luminous color relative to the standard white light region.

Chondrogenic differentiation of human umbilical cord blood-derived mesenchymal stem cells in vitro.

UNLABELLED: Different therapeutic techniques have been developed for regeneration of articular cartilage injuries, but none has provided an optimal solution to their treatment. Human umbilical cord blood-mesenchymal Stem Cells (HUCB-MSCs) have been considered as promising alternative cell source for cartilage repair. OBJECTIVES: Examining the success rate of MSCs isolation from HUCB as well as chondrogenic differentiation potential of HUCB-MSCs in vitro. MATERIALS AND METHODS: 32 UCB samples were collected, in addition to 5 bone marrow (BM) and 5 peripheral blood (PB) samples, taken as reference controls. Samples were used for mononuclear cells isolation from which MSCs were expanded under complete aseptic conditions, were verified morphologically and through the presence of CD44 and CD105, and absence of CD34. RESULTS: Success rate of UCB-MSCs isolation was (25%), a rate that was lower than those of PB (40%) and BM (80%). Accordingly, certain input parameters have been recommended for successful MSCs isolation from UCB. On selecting samples in which recommended parameters were fulfilled, success rate was increased to 72%. This was together with providing optimal experiment conditions; mainly type of expansion medium, success rate reached 80%. Then, successfully expanded MSCs were subjected to chondrogenic differentiation by culturing in pelleted micromass system in presence of transforming growth factor beta-1 and chondrogenic medium devoid of fetal bovine serum to evaluate their ability to undergo chondrogenesis. Differentiation was verified microscopically using special stains, and proved by reverse transcriptase-polymerase chain reaction for expression of aggrecan and collagen II genes. In conclusion, in vitro differentiation into chondrocytes is possible from HUCB-MSCs.