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.

Vaccination for solid organ transplanted patients:Recommendations,efficacy,and safety

Solid organ transplant recipients face unique challenges in managing their im-munosuppressed status,making vaccination a critical consideration.This review aimed to comprehensively analyze current recommendations,evaluate the effi-cacy of vaccinations in this population,and assess safety concerns.We explored the latest evidence on vaccine types,timing,and potential benefits for transplant patients,highlighting the importance of individualized approaches for routinely used vaccines as well as coronavirus disease 2019 vaccines.By synthesizing avai-lable data,this review underscored the pressing need to optimize vaccination strategies,ensuring that transplant recipients can obtain the full protection against many pathogens while minimizing risks associated with their post-transplant immunosuppression.

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.

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects,health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745(Sb) and Lactobacillus rhamnosus GG(LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of(with the indicated strains): antibiotic-associated diarrhea(LGG or Sb); Clostridium difficile-induced diarrhea(Sb); nosocomial diarrhea(LGG); infantile colic(L reuteri) and as adjunct treatment of Helicobacter pylori(Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological,socioeconomical and health system conditions,similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.

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.

Does knowledge of physical activity recommendations increase physical activity among Chinese college students？ Empirical investigations based on the transtheoretical model

Background: Based on the transtheoretical model, the current study investigated whether awareness of physical activity(PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students.Methods: In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations,PA stage distribution, and self-reported PA level were surveyed. Pearson's χ2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups,students' PA stages and PA level were examined before the test and then 4 months post-test. Mc Nemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention.Results: Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior(χ~2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations(t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test(χ~2(1) = 112.06, p < 0.001; χ~2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed(t(139) < 1, p = 0.89).Conclusion: The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.

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.

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.

Revising Nitrogen Recommendations for Wheat in Response to the Need for Support of Variable-Rate Nitrogen Application

Sampling studies in North Dakota conducted from 1994 to 2003 showed that variable-rate N application could be practically directed with zone soil sampling. Results from variable-rate N studies using zone soil sampling were often less than rewarding due in part to the use of a whole-field predicted yield-based formula for developing the N recommendation in each zone. Nitrogen rate studies on spring wheat and durum were established in 2005 through 2009 with the objective to reexamine N recommendations and construct a new system if necessary. The results of the study and archived wheat N response data showed that the state should be divided into three separate N response regions. Within each region historic yields from low to high productivity were defined. The gross N rate was determined using the return-to-N concept developed in the US corn-belt states but with additional consideration for wheat protein value The gross N rate is then modified by credits for previous crop, soil test N from zone soil sampling, tillage systems, excessive straw from the previous year, relative susceptibility to nitrate leaching or denitrification. Finally, the user is encouraged to use common sense and consider whether particular fields have characteristics that require more or less N fertilizer than suggested by the recommendation formulas.

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.

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.

Review,assessment and recommendations on environmental policies in Western China

Reviewing the existing environmental policies in Western China,we find that:in time sequence,the characteristics of China's western environmental policies shift from"development drive governance"to the full implementation of environmental protection and construction;and in spatial sequence,the ecological,social,and economic development of Western China reach to coordination through the nature reserve setting,ecological migrants,fiscal transfer payment and differentiated ecological environmental policies.Due to the implementation of the policies and projects,environmental degradation trends in the western ecological environment were alleviated significantly,the living conditions of farmers and herdsmen were improved,and many successful experiences were explored.However,future ecological environmental construction in Western China requires further improvement in integrated planning,eco-compensation mechanism,and policy assessment.This paper concludes with specific recommendations such as drawing up ecological environment construction planning,strengthening environmental law enforcement and incentive mechanisms,improving policy assessment and scientific support,enhancing environmental protection capacity,improving eco-compensation mechanism,and refining the environmental policies for key areas.

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.

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.