Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

Virological Profile of People Living with HIV after 12 Months of Treatment with Dolutegravir in Kinshasa

Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log10 RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.

Contributions of the Measles Follow-Up Vaccination Campaign to Improving the Vaccination Coverage of Children Aged 6 - 59 Months in the Democratic Republic of the Congo in 2019

Background: In accordance with its measles elimination strategic plan 2012-2020, the Democratic Republic of the Congo (DRC) organized a follow-up vaccination campaign against measles from October to December 2019 in 26 provinces. This study aims to establish the contribution of this supplementary vaccination campaign to protecting children against measles. Methods: The survey was carried out in November 2020 among households of the DRC, according to the 2018 revised version of the World Health Organization’s stratified cluster sampling method, using multiple stage sampling. It targeted 280 children aged 6 - 59 months per stratum or province, with 10 children in each of the 28 selected clusters. Data collection using tablets with centralized and real-time data processing was preceded by enumeration to refine the household sampling frame. Clusters and households were selected by random draw. Data collected with CS Pro 7 software were analyzed with SPSS, Epi info 7 and Excel software to determine indicators and make before-after comparisons using the McNemar test, at a precision threshold of 5%. Results: Of the 8535 surveyed children, 89.5% were vaccinatedduring the follow-up campaign and 81.6% were vaccinated before. Only 3.7% had correctly completed campaign vaccination cards. Estimated vaccination coverage increased from 80.8% before the campaign to 92.6% after the campaign (p 0.001). Vaccination coverage after campaign against measles improved in all provinces (p < 0.001) except Bas-Uele and Maniema. Thirteen provinces reached the national coverage target of 95%, compared to five before the campaign. The proportion of zero-dose children dropped significantly after this campaign from 19.2% to 7.4% (p 0.001), and even fell below 1% in six provinces. Conclusion: This measles vaccination campaign improved overall vaccination coverage by 10% and reached more unvaccinated children. Efforts must continue to improve the retention of vaccination card, the adherence of unvaccinated children and the effectiveness of routine vaccination.

Epidemiological Characteristics and Risk Factors of the Pertussis in Infants < 12 Months of Age in Tianjin, China

The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence of infants was 104.66/100,000, which was 118 times higher than in other age groups （P 〈 0.001）. The primary type of pertussis simultaneously presented in households was adult-to-infant （70.51%）. The parents were identified as the source of infection in 80.18% of cases for infants. The positive rate of placental antibody transfer was 31.06% and 3.13% for 3-month-old infants. Infants presented the highest age-specific pertussis incidence. The most important reason was parents were the important sources of infection, and secondly the lower level of antibodies in neonates and the rapid waning of maternal antibody titer.

Effects of water-aging for 6 months on the durability of a novel antimicrobial and protein-repellent dental bonding agent

Biofilms at the tooth-restoration bonded interface can produce acids and cause recurrent caries. Recurrent caries is a primary reason for restoration failures. The objectives of this study were to synthesize a novel bioactive dental bonding agent containing dimethylaminohexadecyl methacrylate(DMAHDM) and 2-methacryloyloxyethyl phosphorylcholine(MPC) to inhibit biofilm formation at the tooth-restoration margin and to investigate the effects of water-aging for 6 months on the dentin bond strength and protein-repellent and antibacterial durability. A protein-repellent agent(MPC) and antibacterial agent(DMAHDM) were added to a Scotchbond multi-purpose(SBMP) primer and adhesive. Specimens were stored in water at 37 °C for 1, 30, 90, or 180 days(d).At the end of each time period, the dentin bond strength and protein-repellent and antibacterial properties were evaluated. Protein attachment onto resin specimens was measured by the micro-bicinchoninic acid approach. A dental plaque microcosm biofilm model was used to test the biofilm response. The SBMP + MPC + DMAHDM group showed no decline in dentin bond strength after water-aging for 6 months, which was significantly higher than that of the control(P < 0.05). The SBMP + MPC + DMAHDM group had protein adhesion that was only 1/20 of that of the SBMP control(P < 0.05). Incorporation of MPC and DMAHDM into SBMP provided a synergistic effect on biofilm reduction. The antibacterial effect and resistance to protein adsorption exhibited no decrease from 1 to 180 d(P > 0.1). In conclusion, a bonding agent with MPC and DMAHDM achieved a durable dentin bond strength and long-term resistance to proteins and oral bacteria. The novel dental bonding agent is promising for applications in preventive and restorative dentistry to reduce biofilm formation at the tooth-restoration margin.

A Case-Control Study on Leisure Time Physical Activity (LTPA) during the Last Three Months of Pregnancy and Foetal Outcomes in Italy

The association between Leisure Time Physical Activity (LTPA) during pregnancy and foetal outcomes has been extensively investigated. However, epidemiological studies specifically referred to LPTA in the last months of pregnancy are scarce. We evaluated the association between LPTA and the risk of both preterm delivery and small for gestational age (SGA) during the last three months of pregnancy in Italy. A nationwide case-control study was performed in nine Italian cities. A total of 299 preterm delivery, 364 SGA and 855 controls were enrolled in the study. A self-administered questionnaire was used to assess socio-demographic variables, medical and reproductive history, life-style habits and LTPA referred to the last three months of pregnancy. Univariate and multivariate regression analyses were performed in order to estimate Odds ratios and 95% CI. LTPA during the last three months of pregnancy decreases the risk of preterm delivery (adjusted OR = 0.56;95% CI 0.39 - 0.79). Among the different types of physical activity, walking, the most frequently referred activity, appears significantly protective against preterm delivery (adjusted OR = 0.53;95% CI 0.36 - 0.81). Moreover, a small protective effect of walking was evidenced against SGA (adjusted OR = 0.72;95% CI 0.51 - 1.00). In conclusion, a mild physical activity such as walking in the last three months of pregnancy seems to reduce the risk of preterm delivery and, at a lesser extent, of SGA, confirming the beneficial effects of physical activity along the whole pregnancy.

The Labors of the Months and the Zodiac Signs in the Cathedral of Otranto： An Iconographical Interpretation of the Symbols of Labor and Time

In 1163, Archbishop Gionata, Abbot of the Monastery of San Nicola of Casole in Puglia （Apulia）, commissioned Pantaleone, a learned monk and artist from the monastery, to decorate the pavement of the cathedral of Otranto with mosaics. This Italian Romanesque cathedral was dedicated to Santa Maria Annunziata or Saint Mary of The Annunciation. In the interior, the floor design in the shape of a tree contains an elaborate biblical program. The encyclopedic narrative of the mosaic symbolically unveils the meaning of the Tree of Life. The ieonography of the pavement＇s program combines biblical and pagan narratives evolving from a natural realm into a heavenly realm. The natural realm begins at the church＇s entrance with the symbolism of the earth-the roots of a tree-expanding through the nave and transept via the tree＇s trunk and its branches, culminating in the apse, at the end of the church, with the foliage oftbe top of the tree. This natural realm meets with the heavenly realm in two ways： at the crossing of the church or at the sacrificial altar, and at the apse of the church. Before reaching the altar or holy area, between the natural realm and the heavenly realm, the zodiac signs with the labors of the months are depicted.

An investigation and analysis of the export earnings of 100 foreign trade enterprises in the first five months of this year

In order to understand the export situation faced by Chinese foreign trade enterprises and learn about their difficulties and problems in this regard, the China Association of Foreign Trade and Economic Cooperation Enterprises carried

Months backward test:A review of its use in clinical studies

AIM: To review the use of the Months Backwards Test(MBT) in clinical and research contexts.METHODS: We conducted a systematic review of reports relating to the MBT based upon a search of Psych INFO and MEDLINE between January 1980 and December 2014. Only reports that specifically described findings pertaining to the MBT were included. Findings were considered in terms of rating procedures, testing performance, psychometric properties, neuropsychological studies and use in clinical populations.RESULTS: We identified 22 data reports. The MBT is administered and rated in a variety of ways with very little consistency across studies. It has been used to assess various cognitive functions including focused and sustained attention as well as central processingspeed. Performance can be assessed in terms of the ability to accurately complete the test without errors("MB accuracy"), and time taken to complete the test("MB duration"). Completion time in cognitively intact subjects is usually < 20 s with upper limits of 60-90 s typically applied in studies. The majority of cognitively intact adults can complete the test without error such that any errors of omission are strongly suggestive of cognitive dysfunction. Coverage of clinical populations, including those with significant cognitive difficulties is high with the majority of subjects able to engage with MBT procedures. Performance correlates highly with other cognitive tests, especially of attention, including the digit span backwards, trailmaking test B, serial threes and sevens, tests of simple and complex choice reaction time, delayed story recall and standardized list learning measures. Test-retest and inter-rater reliability are high(both > 0.90). Functional magnetic resonance imaging studies comparing the months forward test and MBT indicate greater involvement of more complex networks(bilateral middle and inferior frontal gyri, the posterior parietal cortex and the left anterior cingulate gyrus) for backwards cognitive processing. The MBT has been usefully applied to the study of a variety of clinical presentations, for both cognitive and functional assessment. In addition to the assessment of major neuropsychiatric conditions such as delirium, dementia and Mild Cognitive Impairment, the MBT has been used in the assessment of concussion, profiling of neurocognitive impairments in organic brain disorders and Parkinson's disease, prediction of delirium risk in surgical patients and medication compliance in diabetes. The reported sensitivity for acute neurocognitive disturbance/delirium in hospitalised patients is estimated at 83%-93%. Repeated testing can be used to identify deteriorating cognitive function over time.CONCLUSION: The MBT is a simple, versatile tool that is sensitive to significant cognitive impairment. Performance can be assessed according to accuracy and speed of performance. However, greater consistency in administration and rating is needed. We suggest two approaches to assessing performance- a simple(pass/fail) method as well as a ten point scale for rating test performance(467).

Neglected corticospinal tract injury for 10 months in a stroke patient

The corticospinal tract（CST）is an essential motor pathway in the human brain：particularly,it is essential for fine hand movements（Jang,2014）.Stroke patients can show more severe weakness when a partial injury of the CST is combined with apraxia.

Industrial Profits Decreased in the First Ten Months of 2019

Import and export In January-October 2019,China’s total import and export value reached USD 3.74 trillion,with a decrease of 2.5%year-on-year (the same as below).The exports were USD 2.04trillion,with a decrease of 0.2%,and the imports were USD 1.70 trillion,with a decrease of 5.1%.The trade surplus was USD 340.29 billion,increasing by 34.9%.

THE CHARACTERISTICS OF 500 hPa GEOPOTENTIAL AND SST FIELD OF EXTREMELY SEVERE COLD MONTHS IN SOUTH CHINA WINTER

The region of south China is sometimes subject to major climatic catastrophes in winter. To have a clear understanding, the time in which extremely severe cold months occur in the south China wintertime over the past 45 years are determined and characteristics of the 500-hPa geopotential fields and SST fields are studied for the simultaneous and preceding 6-month periods. Similarity exists in the 500-hPa geopotential fields between each current severely cold month, with the geopotential pattern of being high in the north, but low in the south, of Asian-Pacific region and meridional circulation developing. The work presents anomalies of the months with significant differences in the 500-hPa geopotential field of the previous periods. The SSTA is continuous in the distribution from each extremely severe cold winter month back to the 6 months leading up to it for the region of south China while the SST pattern is of El Ni?o in January and the preceding 1 ~ 6 months for equatorial eastern Pacific but of La Ni?a in February and December. It is concluded that the prediction of severely cold winter months are possible with the use of the geopotential field at 500 hPa and the SST fields for the months ahead of the target time.

THE CHARACTERISTICS OF GENERAL CIRCULATION, POLAR ICE AND SNOW DAYS / COVER OF EXTREMELY SEVERE COLD MONTHS IN SOUTH CHINA WINTER

The work has made a statistic study of the variations of extremely severe cold winter months in the south of China and general circulation and external forcing factors in preceding periods. The result shows that from the current month to the preceding March the subtropical high in the west Pacific is persistently weak or located more to the east and south. When the summer monsoon is weak in East Asia in the year before, the winter monsoon will be strong in the current year in which the extremely severe cold month occurs. The Asian polar vortex expands in the preceding July, August and September and the current winter. The Tibetan Plateau has fewer days of snow cover in the November and December before the cold month occurs. There is less snow in the Tibetan Plateau in the preceding winter / spring of each extremely severe cold month. There are more polar ice in the polar Region Ⅳ for the 11 months before the current February, especially the previous March through August, and in Region Ⅱin January ~ November before the current cold month of December but less ice in Region Ⅲ in March ~ August.

Overall National Economy Maintained Stable in the First Two Months

In the first two months of 2019,the economy performed within the reasonable range and maintained a generally stable and growing momentum;a positive trend has gradually been unveiled.The service industry grew steadily and the modern service industry developed fast In the first two months, the Index of Services Production increased by 7.3%year on year, maintaining the same speed as in December 2018.

Study on the chemical composition of Nauclea officinalis in different months of the same year and different growth years

Objective:Based on the quality analysis of Nauclea officinalis in different growth years and different months in the same year,the most suitable harvest year and the specific month in the same year were determined according to the evaluation of the active components in the stem of medicinal parts of Nauclea officinalis.Methods:LC-MS/MS method was used to investigate the quality of Nauclea officinalis from different growth years and different months in the same year,mainly including the content determination of the active ingredients in the medicine.Results:With the prolongation of production life,the content of active ingredients in stem of Nauclea officinalis increased continuously.After reaching a certain number of years,the content of active ingredients increased little;In the middle of the same year,from mid-October to mid-June of the next year,the content of iso-vincin lactam was relatively high,especially between the end of March and the end of May.The content was high and stable,and the highest point was the stem sample collected in May.Conclusion:The content of each component in the stem of Nauclea officinalis with a growth life of more than 5 years has reached a relatively high and stable level.Nauclea officinalis with a growth life of more than 5 years should be collected as raw materials for medicinal materials.The month with high and stable content of isocyanoside lactam,namely May of each year,was taken as the best harvest time of gallbladder in one year.The best harvest time was from mid-October to mid-June of the next year,or from March to May of each year.

PRESENT SITUATION OF BREAST-FEEDING AND COMPLEMENTARY FEEDING AND THEIR INFLUENCE ON GROWTH OF CHILDREN UNDER 36 MONTHS IN WESTERN CHINA

Objective To find out the present situation of complementary feeding, breast-feeding and children nutrition, and further explore the relationship between them. Methods Random sampling was adopted and 7302 pairs or mothers and their children under 36 months were investigated by means or questionnaires. Results Breast- feeding rate was 96. 8%,but exclusive breast-feeding rate was only 37.6%. Breast-feeding rate over 12 months was 34.7%,breast-feeding rate over 24 months was only 15. 8%. Timely sucking rate was 8.4%, 19. 2% of children had too early complementary feeding, 26.8% had too late,and 43.1% had appropriate feeding. To the children over 6 months, the feeding rates or meat and eggs per week were 36.3% and 49.3%,respectively. The stunting-rate was 24.0%, underweight-rate 22.1%,and wasting-rate 8.9%. The incidence rate of iron deficiency anemia (IDA) was 23.3%. Multivariable analysis showed that growth of children was associated with diet diversity,intake frequency of eggs and meat, too early complementary feeding,prolonged breast-feeding and diarrhea, etc. Conclusion In rural areas of western China,breast-feeding has been fundamentally popularized,however,the unfit complementary feeding and malnutrition of children under 36 months are common and serious,important complementary feeding recommen- dations and good hygiene condition are strongly needed.

Trend of <i>Cryptosporidium</i>Infection among Children below 24 Months in an Informal Urban Settlement, Kenya

Cryptosporidium infection is estimated to cause 2.9 million diarrheal cases yearly among children aged under 24 months in sub-Saharan Africa. Studies have shown long-term climatic variations can affect infectious diseases. The burden of cryptosporidiosis in rural areas of sub-Saharan Africa is well characterized. However, the trend of Cryptosporidium infection is not known, especially in informal urban settings. This study therefore sought to determine cryptosporidiosis trends, and further explore the association between year and Cryptosporidium infection among children below 24 months in Kibera urban informal settlement in Kenya. Data collected by the Kenya Medical Research Institute longitudinal study in Tabitha clinic in Kibera from 2009 to 2015 were used. At least 3000 children aged < 24 months receive free health care at the clinic. In the longitudinal study, children presenting with diarrhea were eligible for stool sample collection (n = 477), out of which 421 stool samples were tested using TaqMan™ Array Card (TAC) polymerase chain reaction panel that included a target for Cryptosporidium genus. Data for the 421 children were included in the analysis. Logistic regression was used to explore the difference between the seven years and cryptosporidiosis. Overall, the pooled data indicated that 23.5% of the children who were tested had Cryptosporidium infection, with the highest proportions of Cryptosporidium-positive cases observed in 2015 (45.2%). The logistic regression results also indicated that children who were tested in the year 2015 were more likely to have Cryptosporidium infection (OR = 3.39;95% CI: 1.44 - 7.96;p = 0.005) than those in 2009. Watery stool was also found to be an important symptom of cryptosporidiosis. There was a high prevalence of Cryptosporidium infection among young children, especially in the most recent year. Routine testing of Cryptosporidium infection using molecular methods, constant monitoring and identification of the infection sources is therefore necessary towards reducing the disease burden in the low resource settings.

Data Watch on China's Foreign Trade and Investment in the First Ten Months of 2011

China’s foreign trade in the first ten months of 2011 According to statistics of the Customs, China’s exports and imports in the first ten months of the year reached $2.97538 trillion, up 24.3% over the same period last year, 12 percentage

THE CALENDAR SYNCHRONIZATION AND INTERCALARY MONTHS IN UMMA,PUZRIS-DAGAN,NIPPUR,LAGAS AND UR DURING THE UR Ⅲ PERIOD

In my article in JAC 15,I discuss“the Mada calendar”of Puzri-Dagan of the UrⅢ period.This calendar started from the month iti-ma-d-k while its alternatecycle“the Akiti Calendar”started from the month iti-ki-ti(vi).The Akiticalendar was only used for three whole and two half years(ulgi 44’viii’-xii',45’-47’,48’i’-vii’)during the Mada years of ulgi 45/i to ulgi 48/xii.It wasonly used by the main office of Puzri-Dagan.