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.

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.

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.

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.

Damage investigation of girder bridges under the Wenchuan earthquake and corresponding seismic design recommendations

An investigation of girder bridges on National Highway 213 and the Doujiangyan-Wenchuan expressway after the Wenchuan earthquake showed that typical types of damage included： span collapses due to unseating at expansion joints; shear key failure; and damage of the expansion joint due to the slide-induced large relative displacement between the bottom of the girder and the top of the laminated-rubber bearing. This slide, however, can actually act as a form of isolation for the substructure, and as a result, the piers and foundation of most of the bridges on state route 213 suffered minor damage. The exception was the Baihua Bridge, which suffered severe damage. Corresponding seismic design recommendations are presented based on this investigation.

Hormonal replacement therapy and aging: Asian practical recommendations on testosterone supplementation

<abstract>Profound and diffuse alterations in the production of gonadal and adrenal androgens as well as growth hormone are associated with aging. To convey this concept more appropriately, partial endocrine deficiency in the aging male (PEDAM) was introduced as a term for the phenomenon of hormonal alterations in the aging male. Hormones responsible for some of the manifestations associated with male aging are testosterone, growth hormone, dehydroepiansdrosterone (DHEA), melatonin, thyroid hormones and leptin. Of these, testosterone has been widely investigated and its beneficial and adverse effects on male bodily systems are relatively well established. However, a serious body of confusion and misunderstandings surrounding the diagnosis, treatment and monitoring of men suspected of having androgen deficiency has been raised. Therefore, it is timely to provide practical criteria for diagnosis and treatment to avoid misconception about the use of testosterone in the aging male. To provide an understanding and information of the issues, the following headings are summarized: (1) Important clinical consideration on testosterone supplementation in the aging male; (2) Asian practical recommendations on testosterone supplementation in the aging male.

Charging Pile Siting Recommendations via the Fusion of Points of Interest and Vehicle Trajectories

By mining of the requirements of lots of electric vehicle users for charging piles, this paper proposes the charging pile siting algorithm via the fusion of Points of Interest and vehicle trajectories. The proposed algorithm computes appropriate charging pile locations by: 1) mining user Points of Interest from social network; 2) mining parking sites of vehicle form GPS trajectories and 3) fusing the Points of Interest and parking sites together then clustering the fusions with our improved DBSCAN algorithm, whose clustering results indicates the final appropriate charging pile locations. Experimental results show that our proposed methods are more efficient than existing methods.

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.

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.

A GIS-Based Database Management Package for Fertilizer Recommendations in Paddy Fields

Over-use of fertilizer in paddy fields could lead to agro-environmental pollution. Therefore, the Paddy Fertilizer Recommendation System (PFRS) application package was designed to aid in the dissemination of fertilizer recommendations for paddy fields. PFRS utilized geographical information system (GIS) ActiveX Controls, enabling the user to select a location of interest linked to a spatial database of paddy field soil characteristics. The application package also incorporated different soil fertilizer recommendation methods, forming a relational database. The application's structure consisted primarily of building database queries using Standard Query Language (SQL) constructed during run-time, based on user provided spatial parameters of a selected location, the type of soil desired and paddy production criteria. PFRS, which was comprised of five modules including: File, View, Edit, Layer and Fertilizer/Model, provided the user with map-based fertilizer recommendations based on selected soil nutrient P and K map layers as well as N characteristics and land use maps.

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.

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.

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.

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.

Nitrogen Recommendations for Summer Maize in Northern China Using the N_min Test and Rapid Plant Tests

A field experiment with a split-plot design was carried out at Dongbeiwang Farm in Beijing Municipality to establish reliable N fertilizer recommendation indices for summer maize (Zea mays L.) in northern China using the soil Nmin (mineral N) test as well as the plant nitrate and SPAD (portable chlorophyll meter readings) tests. The results showed that Nmin sollwert (NS) 60 kg N ha-1 at the third leaf stage and N rate of 40 to 120 kg N ha-1 at the tenth leaf stage could meet the N requirement of summer maiz…

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.

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.

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.

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.

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.