The use of oral human immunodeficiency virus pre-exposure prophylaxis in pregnant and lactating women in sub-Saharan Africa:considerations,barriers,and recommendations

In sub-Saharan Africa(SSA),63%of new human immunodeficiency virus(HIV)infections in 2021 were among women,particularly adolescent girls,and young women.There is a high incidence of HIV among pregnant and lactating women(PLW)in SSA.It is estimated that the risk of HIV-acquisition during pregnancy and the postpartum period more than doubles.In this article,we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis(PrEP),considerations for initiating PrEP in PLW,the barriers to initiating and adhering to PrEP among them and suggest recommendations to address these barriers.Tenofovir/emtricitabine,the most widely used combination in SSA,is safe,clinically effective,and cost-effective among PLW.Any PLW who requests PrEP and has no medical contraindications should receive it.PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons,including personal,pill-related,and healthcare facility-related issues.To address the barriers,we recommend an increased provision of information on PrEP to the women and the communities,increasing and/or facilitating access to PrEP among the PLW,and developing strategies to increase adherence.

Chest Radiography: General Practitioners’ Compliance with Recommendations

Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.

Enhancing Multicriteria-Based Recommendations by Alleviating Scalability and Sparsity Issues Using Collaborative Denoising Autoencoder

A Recommender System(RS)is a crucial part of several firms,particularly those involved in e-commerce.In conventional RS,a user may only offer a single rating for an item-that is insufficient to perceive consumer preferences.Nowadays,businesses in industries like e-learning and tourism enable customers to rate a product using a variety of factors to comprehend customers’preferences.On the other hand,the collaborative filtering(CF)algorithm utilizing AutoEncoder(AE)is seen to be effective in identifying user-interested items.However,the cost of these computations increases nonlinearly as the number of items and users increases.To triumph over the issues,a novel expanded stacked autoencoder(ESAE)with Kernel Fuzzy C-Means Clustering(KFCM)technique is proposed with two phases.In the first phase of offline,the sparse multicriteria rating matrix is smoothened to a complete matrix by predicting the users’intact rating by the ESAE approach and users are clustered using the KFCM approach.In the next phase of online,the top-N recommendation prediction is made by the ESAE approach involving only the most similar user from multiple clusters.Hence the ESAE_KFCM model upgrades the prediction accuracy of 98.2%in Top-N recommendation with a minimized recommendation generation time.An experimental check on the Yahoo!Movies(YM)movie dataset and TripAdvisor(TA)travel dataset confirmed that the ESAE_KFCM model constantly outperforms conventional RS algorithms on a variety of assessment measures.

Towards machine-learning-driven effective mashup recommendations from big data in mobile networks and the Internet-of-Things

A large number of Web APIs have been released as services in mobile communications,but the service provided by a single Web API is usually limited.To enrich the services in mobile communications,developers have combined Web APIs and developed a new service,which is known as a mashup.The emergence of mashups greatly increases the number of services in mobile communications,especially in mobile networks and the Internet-of-Things(IoT),and has encouraged companies and individuals to develop even more mashups,which has led to the dramatic increase in the number of mashups.Such a trend brings with it big data,such as the massive text data from the mashups themselves and continually-generated usage data.Thus,the question of how to determine the most suitable mashups from big data has become a challenging problem.In this paper,we propose a mashup recommendation framework from big data in mobile networks and the IoT.The proposed framework is driven by machine learning techniques,including neural embedding,clustering,and matrix factorization.We employ neural embedding to learn the distributed representation of mashups and propose to use cluster analysis to learn the relationship among the mashups.We also develop a novel Joint Matrix Factorization(JMF)model to complete the mashup recommendation task,where we design a new objective function and an optimization algorithm.We then crawl through a real-world large mashup dataset and perform experiments.The experimental results demonstrate that our framework achieves high accuracy in mashup recommendation and performs better than all compared baselines.

Tacrolimus and mycophenolate mofetil as second-line treatment in autoimmune hepatitis:Is the evidence of sufficient quality to develop recommendations?

BACKGROUND The standard management of autoimmune hepatitis(AIH)is based on corticosteroids,alone or in combination with azathioprine.Second-line treatments are needed for patients who have refractory disease.However,high-quality data on the alternative management of AIH are scarce.AIM To evaluate the efficacy and safety of tacrolimus and mycophenolate mofetil(MMF)and the quality of evidence by using the Grading of Recommendations Assessment,Development and Evaluation approach(GRADE).METHODS A systematic review and meta-analysis of the available data were performed.We calculated pooled event rates for three outcome measures:Biochemical remission,adverse events,and mortality,with their corresponding 95%confidence intervals(CI).RESULTS The pooled biochemical remission rate was 68.9%(95%CI:60.4-76.2)for tacrolimus,and 59.6%(95%CI:54.8-64.2)for MMF,and rates of adverse events were 25.5%(95%CI:12.4-45.3)for tacrolimus and 24.1%(95%CI:15.4-35.7)for MMF.The pooled mortality rate was estimated at 11.5%(95%CI:7.1-18.1)for tacrolimus and 9.01%(95%CI:6.2-12.8)for MMF.Pooled biochemical remission rates for tacrolimus and MMF in patients with intolerance to standard therapy were 56.6%(CI:43.4-56.6)vs 73.5%(CI:58.1-84.7),and among non-responders were 59.1%(CI:48.7-68.8)vs 40.8%(CI:32.3-50.0),respectively.Moreover,the overall quality assessments using GRADE proved to be very low for all our outcomes in both treatment groups.CONCLUSION Tacrolimus and MMF are in practice considered effective for patients with AIH who are non-responders or intolerant to first-line treatment,but we found no high-quality evidence to support this statement.

Screening for scoliosis-New recommendations,old dilemmas,no straight solutions

This opinion review considers the prevailing question of whether to screen or notto screen for adolescent idiopathic scoliosis. New and improved standards ofpeople-oriented care and person-centredness, as well as improved principles ofpreventive screening and guideline development, have been postulated andimplemented in health care systems and cultures. Recommendations addressingscreening for scoliosis differ substantially, in terms of their content, standards ofdevelopment and screening principles. Some countries have discontinued issuingrecommendations. In the last decade, a number of updated and newrecommendations and statements have been released. Systematically developedguidelines and recommendations are confronted by consensus and opinion-basedstatements. The dilemmas and discrepancies prevail. The arguments concentrateon the issues of the need for early detection through screening in terms of theeffectiveness of early treatment, on costs and cost-effectiveness issues, scientificand epidemiologic value of screenings, and the credibility of the sources ofevidence. The problem matter is of global scale and applies to millions of people.It regards clinical and methodological dilemmas, but also the matter of vulnerableand fragile time of adolescence and, more generally, children’s rights. Thedecisions need to integrate people’s values and preferences – screening tests needto be acceptable to the population, and treatments need to be acceptable forpatients. Therefore we present one more crucial, but underrepresented in thediscussion, issue of understanding and implementation of the contemporaryprinciples of person-centred care, standards of preventive screening, andguideline development, in the context of screening for scoliosis.

Problems in Development of Rural E- commerce and Logistics and Recommendations

Rural e-commerce and logistics development is of great significance to promote rural economic development and increase farmers' income. This paper analyzed existing problems in development of rural e-commerce and logistics in China,mainly including objective restriction of rural e-commerce and logistics by economic level,relatively backward capital construction facilities,lack of logistics information service platform,and insufficient professional personnel,and shortage of rural logistics professional personnel,and weak financial support of government. On the basis of these problems,it came up with pertinent recommendations from government,enterprises,and rural areas.

Advantages and Disadvantages of Fragmented Learning and Recommendations

The development of information technology has changed people's learning methods. Fragmented learning,as an informal learning method,has become an important way to accept new knowledge and learn new technologies. Through analyzing the connotation,characteristics,and advantages and disadvantages of fragmented learning,this paper came up with reasonable recommendations for fragmented learning. To truly become systematic and holistic knowledge,fragmented knowledge must be explored,understood,integrated and internalized. This paper is expected to play an important guiding role in building a lifelong learning society.

Fenofibrate for the prevention of progression of non-proliferative diabetic retinopathy:review,consensus recommendations and guidance for clinical practice

The prevalence of diabetic retinopathy(DR),and associated morbidity is high in the Asia-Pacific region.Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR,especially in patients with cardiovascular risk,and pre-existing mild-to-moderate DR.Fenofibrate has also been found to reduce maculopathy,and the need for laser treatment in these patients.Considering these benefits of fenofibrate,a group of experts from the fields of endocrinology and ophthalmology convened in May 2017,to discuss on the the mechanism of action,and clinical efficacy of fenofibrate in DR.The findings from key clinical studies on fenofibrate in DR were reviewed by the experts,and consensus statements were derived to define the role of fenofibrate in the prevention and treatment of DR.The statements were rated based on the GRADE criteria.An algorithm was also developed for the screening and treatment of DR in patients with type 2 diabetes(T2D),and the place of fenofibrate was defined in the algorithm.The expert recommendations,and the algorithm provided in this review will serve as a guide to the clinicians to reconsider the adjunctive use of fenofibrate for preventing the progression of DR in selected T2D patients.

Role of Nanfan Base and Recommendations about Construction and Management

This paper first analyzes the important role of Nanfan Base in China: " accelerator" for breeding new varieties of crops; " unallocated store" to ensure the varieties for agricultural production; " lightning rod" to ensure the quality and safety of seeds; " big stage" for variety and technical exchanges and cooperation; " big school" for cultivating seed industry technology talents; " booster" for promoting local economic development. Then it points out the main problems about Nanfan Base and finally sets forth the relevant recommendations.

Moving forward on the pathway of cell-based therapies in ischemic heart disease and heart failure-time for new recommendations?

Although substantial advances have been made in treating ischemic heart disease and subsequent heart failure, the overall morbidity and mortality from these conditions remain high. Stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation. Various cell types have been tested in the clinical arena, proving consistent safety results. As for efficiency outcomes, contradictory findings have been reported, partly due to inconsistency in study protocols but also due to poor survival, engraftment and differentiation of transplanted cells in the hostile milieu of the ischemic host tissue. Studies have varied in terms of route of delivery, type and dose of implanted stem cells, patient selection and randomization, and assessment of therapeutic effect. Founded on the main achievements and challenges within almost 20 years of research, a number of official documents have been published by leading experts in the field. Core recommendations have focused on developing and optimizing effective strategies to enrich cell retention and their regenerative potential. Issued consensus and position papers have stemmed from an unmet need to provide a harmonized framework for future research, resulting in improved therapeutic application of cell-based therapies for cardiac regeneration and repair.

Analysis of Problems and Policy Recommendations for the Third-party Evaluation in the Present Poverty Alleviation

The introduction of third-party evaluation system and the implementation of third-party evaluation system in poverty alleviation is a major innovation in the targeted poverty alleviation work in China.In order to improve the third-party evaluation mechanism,further improve the efficiency of third-party evaluation,and enhance the effectiveness of targeted poverty alleviation,this paper analyzes and summarizes the main problems existing in the current third-party evaluation practice.In view of the related problems,this paper puts forward the corresponding policy recommendations,which are believed to play a positive role in further promoting the development and improvement of the third-party evaluation of getting rid of poverty.

Current Situation and Management Recommendations about Betel Nut Planting in Hainan

The betel nut planting area and yield in Hainan have reached 94000 ha and 231000 t,respectively.There are some problems in betel nut planting such as dispersed cultivation,irrational planting layout,excessively dense planting and serious betel nut yellow leaf disease.For the sustainable development of Hainan betel nut,it is necessary to focus on building the disease-resistant betel nut plantation,so as to prevent and control the occurrence and spread of betel nut yellow leaf disease;transform the low-yield betel nut plantation,and strengthen betel nut production management,in order to improve betel nut yield and promote sustainable development of betel nut industry.

Implications and Recommendations for Rural Revitalization Strategy Based on Domestic and Foreign Experience

The 19th National Congress of the Communist Party of China formulated a major deployment of the rural revitalization strategy from the overall situation of the national cause,and took the rural revitalization strategy as the general gripper of the work of " agriculture,farmers and rural areas". This has important practical significance for realizing agricultural modernization. Through selecting several typical countries,this paper analyzes and introduces the historical experience of rural revitalization. Finally,it comes up with some recommendations and implications.

Existing Problems of Agricultural Development in China and Recommendations

In 2012,China's total grain yield reached 590 million tons and realized nine consecutive years of growth. This is huge historic achievement of China and also rare in development history of world agriculture. However,at the same time of making great achievements,China's agriculture is still confronted with many problems. On the basis of extensive survey,it pointed out 10 outstanding problems: farmland,labor,livestock power,water conservancy,input,agricultural disaster,ecological and environmental problem,waste of resources,economic scale and economic benefits. These problems have brought great adverse influence on China's agricultural development. In view of these problems,to realize sustainable,stable and healthy development of agriculture in the new period,it came up with following recommendations:( i)deepening the understanding;( ii) enforcing laws strictly;( iii) enhancing training;( iv) increasing benefits;( v) saving resources;( vi) protecting environment;( vii) developing science and technology;( viii) consolidating foundation.

Current Situation and Development Recommendations for Betel Nut Processing in Hainan Province

Hainan's betel nut processing industry continues to develop,and the yield has reached 231000 t. There are some problems in betel nut industry such as unreasonable initial processing layout,processing capacity surplus,and deep processing industry lag. It is suggested that we should guide the initial processing layout of betel nut according to local conditions,and carry out overall deep processing planning of betel nut; support betel nut deep processing plant in the main producing areas,establish betel nut initial processing and deep processing serial production line,and develop new betel nut product; build betel nut production,processing,transport and marketing information database and market information early warning mechanism,and improve betel nut processing information service platform to timely provide information services and continuously develop betel nut industry.

Evaluation of Soil Potassium Test to Improve Fertilizer Recommendations for Corn

The soil potassium (K) test methodology is under increased evaluation due to the soil sample drying effect, temporal variations of test results and inconsistent crop response to applied K fertilizers. Ten on-farm trials were conducted in 2014 in eastern North Dakota to determine the corn response to different K-fertilizer rates and to assess the variation of soil K test levels between air-dried (KDry) and field moist (KMoist) soil samples during the corn growing season. Significant differences were observed between KDry and KMoist soil K test results. The ratio of KDry/KMoist showed high correlation with cation exchange capacity (r = 0.63, p < 0.10), Organic matter (r = 0.61, p < 0.10) and (Ca + Mg)/K ratio (r = 0.64, p < 0.10) from the 1 M ammonium acetate extractant, while pH, electrical conductivity, clay (%), and soil moisture showed non-significant correlation. On average, KDry resulted in higher soil K test levels than KMoist and pattern of deviation was different for surface and sub-surface soil samples. Soil K analysis of samples collected during the fall and spring showed large enough variations to affect the soil test interpretation category which was used to make fertilizer recommendations. Corn yield increased significantly with applied K fertilizer at only three out of 8 sites with beginning K levels below the current critical level of 150 ppm, and one response was at a site with K level above the critical level. Therefore, use of either the KDry or KMoist method alone may not be adequate to predict K response in some North Dakota soils.

Present Situation and Recommendations on the Development of Dalbergia odorifera in Hainan

Dalbergia odorifera is particularly scarce,and the D. odorifera furniture and commercial raw materials on the market are mainly old furniture and agricultural tools,as well as commercially collected D. odorifera logs. The logs and high-grade furniture made from D. odorifera are extremely expensive. It takes several decades for D. odorifera to grow into wood. At present,there is only a small area of newly planted and regenerated forest,and the planting area of D. odorifera is about 15 000 ha in Hainan Island,distributed in the low altitude area of Hainan Island. It is suggested that Hainan D. odorifera island should be built through the transformation of low-yielding forest land,the use of wasteland and marginal cultivated land,land around houses,green belt and roadside land for the cultivation of D. odorifera,and the development area can be up to 100 000-150 000 ha. It is necessary to mobilize farmers to revitalize the rural green economy,plant D. odorifera,beautify the environment,and increase the economic resources of rural trees; actively publicize the legal nature and obligation of D. odorifera protection,and create a strong atmosphere for each family to plant and protect D. odorifera.

THE SCIENTIFIC BASE OF ICRP RECOMMENDATIONS IS IT CHANGING? CAN WE STRENGTHEN IT?

１ＩｎｔｒｏｄｕｃｔｉｏｎＩＣＲＰｒｅｃｏｍｍｅｎｄａｔｉｏｎｓｉｎｒａｄｉａｔｉｏｎｐｒｏｔｅｃｔｉｏｎｈａｖｅａｌｗａｙｓｄｅｐｅｎｄｅｄｏｎａｂｌｅｎｄｏｆｂａｃｋｇｒｏｕｎｄｓｃｉｅｎｃｅａｎｄｊｕｄｇｅｍｅｎｔ．ＩｎｔｈｅｃｏｕｒｓｅｏｆＩ...

International mechanism for loss and damage from climate change:recommendations for related work in China

Loss and damage(L&D) from climate change has threatened the sustainable development of humankind,while the progress of mitigative and adaptive measures carried out under the international multilateral framework has been slow.The scientific community and policymakers have placed increasing emphasis on the international L&D response mechanism as a potential direct solution.This paper reviewed the origins of such a mechanism,with an in-depth analysis of the related connotations.A review of the existing situation in China on work related to L&D arising from climate change was conducted,followed by a summary of the findings.Finally,measures and recommendations to improve China's efforts were proposed in this issue.