Vaccinators' Perception of HPV Vaccination in the Saa Health District of Cameroon

Introduction: Cervical cancer is the second most prevalent cancer among women in Cameroon. In November 2020, the HPV vaccine was introduced into the expanded programme on immunisation. However, uptake of the vaccine has been slow in the Centre region as opposed to other regions in the country. We therefore sought to describe vaccinators' perception of HPV vaccination in Saa health district.Methods: A self-administered questionnaire with both open-ended and closed questions was used to assess the perception of HPV vaccination among 24 vaccinators from the Saa health district. Quantitative data were summarised as proportions while qualitative data were deductively and inductively coded and thematically analysed.Results: Most vaccinators (75%, n = 18) had a good knowledge about cervical cancer and HPV vaccination. Fourteen (58.3%, n = 14) vaccinators correctly reported the target group, number and spacing of doses for the HPV vaccine. Fourteen (58.3%) vaccinators favoured HPV vaccination while the others (n = 10) were sceptical. Sceptics felt manufacturers hadn't given enough proof of the safety of the vaccine and lacked confidence in government's assessment of the epidemiological situation. The COVID 19 pandemic, fear of infertility and the negative influence of social media were perceived as the main reasons for community hesitancy. Vaccinators criticised health authorities for failing to sensitise the population about the HPV vaccine before its introduction.Conclusion: Vaccinators' perceptions of HPV vaccination may influence the offer of HPV vaccination services. Measures to increase acceptance of HPV vaccination and ownership of the activity among vaccinators have to be put in place.

Effect of Zinc Supplement on Severity Of Acute Diarrhea Among Childern Under Five Years Of Age

According to World Health Organization (WHO) approximately four million children less than 5 years of age in Asia, Africa, and Latin America die annually from diarrhea; and 80% of these deaths occur in the first year of life. Objective: To see how a zinc supplement influences the severity of acute diarrhea in children under the age of five. Methods: In current study, we analyze the effect of zinc on diarrheal patients. Zinc was randomly assigned to diarrheal patients in different concentration 5 mg, 10 mg, 15 mg and 20 mg. There were two groups in our study, treatment and control group. Results: The results are presented in the form of descriptive and inferential statistics. In T1 (Treatment Group) number of Diarrhea patients < 1 Year of age were 16, 2-4 years of age were 45, 4-5 years of age and maximum no of patients in T1 < 2 year of age were 57. Number of male patients were 84 while female patients were 67 in T1.In T2 (Control Group) number of male patients were 92 while female patients were In T1 number of patients residing in urban area were 51 while rural were 100. In T2 number of urban were 69 while rural were 82.Number of patients stay in the hospital for one day were 67 ,15 for Four days and only 1 for seven days in T1. In T2 number of patients stay in the hospital for one day were 29, 17 for four days and only 6 for seven days. In T1 number of Patients with watery diarrhea were 87, Mucoid consistency of stool were 31,soft consistency of stool were 23 and formed consistency of stool were 9.In T2 watery diarrhea were 92,Mucoid consistency of stool were 25,soft consistency of stool were 31 and formed consistency of stool were 4. Frequency of stool significantly reduced (P<0.005) at 7th day of zinc treatment while consistency of stool was significantly improved (P<0.005) at day 3 and day 5 of zinc treatment. Children who received zinc supplements showed a marked improvement in all outcome measures, suggesting that this deficiency is amenable to correction by replacement.

Number of Sunspot Groups and Individual Sunspots Recorded by Tevel for the Period 1816–1836 in the Dalton Minimum

Cornelis Tevel made sunspot observations during the period 1816–1836, including the Dalton Minimum. In this work, the first revision of these observations since Wolf incorporated them into his database is presented. On the one hand, the number of individual sunspots from Tevel’s drawings was counted. This is of special interest for the sunspot number reconstruction because this kind of information is not as common in historical sunspot records as the number of groups. Thus, Tevel could be considered for the future reconstruction of the sunspot number index. On the other hand, the number of groups counted according to modern sunspot group classifications finding significant misinterpretations with the number of groups assigned to Tevel in the existing databases. Tevel was a relevant sunspot observer in the Dalton Minimum. In fact, he was the observer with the highest number of groups observed in Solar Cycles 6 and 7 according to the existing sunspot group number databases. According to the raw group number recount in this work, the maximum amplitudes for Solar Cycles 6 and 7 are, respectively, 27% and 7% lower than those previously determined. Moreover, Solar Cycle 6 is the weakest solar cycle since the Maunder Minimum after applying these new counts. Group counts from Tevel’s observations were compared with those from relevant contemporary astronomers, demonstrating that Schwabe and Tevel systematically recorded a higher number of groups than Flaugergues and Derfflinger. In addition, sunspot areas and positions recorded by Tevel should be used with caution for scientific purposes.

Minimizing Cost of Assembly of an Interrelated Dimensional Chain Product Using ABC Algorithm

Selective assembly is a method where components made with wider tolerance are grouped into a number of bins. Based on the best combination of the bin, the corresponding group components are randomly selected and matched together to make an assembly. Existing techniques focused on equal group number partitioning of components, equal probability, equal group width, and equal area methods to minimize either clearance variation or surplus parts using different optimization techniques. Mostly, simple assemblies with two or three components are worked by various authors in the literature without considering their original dimension by considering only their component’s tolerance. In the present work, components are classified into different unequal group numbers based on their tolerance values. The interrelated dimensional assemblies are made in a single stage by matching the parts based on the best bin combination obtained by the artificial bee colony algorithm. A simple linear assembly and a three-armed knuckle joint assembly are considered examples of problems to demonstrate the effectiveness of the proposed method by minimizing the manufacturing cost.

P-420 Pre-selected for an award: Uncomplicated oocyte donation pregnancies display elevated CD163 positive type 2 macrophage load in the decidua, which is associated with fetal-maternal HLA class II mismatches

Study question Do quantity and composition of decidual macrophages differ between uncomplicated oocyte donation (OD) pregnancies and non-OD in vitro fertilization (IVF) pregnancies? Summary answer OD placentas show higher decidual CD163 positive fraction within the total macrophage population compared to non-OD IVF placentas. What is known already The embryo of an OD pregnancy is completely allogeneic to the mother, which may lead to a bigger challenge for the maternal immune system to tolerize the fetus compared to autologous pregnancies. Placental macrophages may be essential in maintaining a healthy pregnancy. Macrophages can be classified into different categories based on phenotype and characteristics, in which type 2 macrophages are thought to exhibit immune suppressive activity. Study design, size, duration This retrospective case-control study included patients who delivered in the Leiden University Medical Center between January 1st 2006 and July 1st 2016. A total of 42 pregnancies were enrolled in this study, conceived by uncomplicated singleton OD pregnancies (n = 25) or non-OD IVF pregnancies (n = 17). Medical records were reviewed and clinical data were collected. Placental tissue samples were collected for immunohistochemical staining and blood samples were collected for HLA typing. Participants/materials, setting, methods Placentas were collected and immunohistochemically stained for CD14 (pan-macrophage marker) and CD163 (type 2 macrophage marker). The extent of staining was quantitated by digital image analysis software. To assess mismatching, maternal and fetal DNA was typed for HLA-A, -B, C, -DRB1, and -DQB1. Main results and the role of chance A significantly lower percentage of CD14 positive staining was observed in the decidua basalis of OD pregnancies compared to non-OD IVF pregnancies (p = 0.030). Consequently, the CD163/CD14 ratio in OD group was higher than in non-OD IVF group (p = 0.243). In the parietalis, OD pregnancies demonstrated a significantly higher percentage of CD163+ staining (p = 0.040) and a significantly higher CD163/CD14 ratio (p = 0.032) compared to non-OD IVF group. The reproducibility of this quantitative analysis was found to be high. OD group was separated into a syngeneic group (number of mismatches lower than half of the antigens per HLA locus) and an allogeneic group (number of mismatches higher than half of the antigens per HLA locus). Significant differences of CD163+ and CD163/CD14 ratio were found in the decidua parietalis when comparing the HLA-classII-allogeneic OD group with the non-OD IVF group (p = 0.047). This difference was not found for the HLA-class-II-syngeneic OD group. Limitations, reasons for caution Our study only focused on decidua basalis and parietalis, no other locations in the placentas. Larger sample size might be needed to verify the association between macrophages and HLA mismatches. Wider implications of the findings To our knowledge, this study is the first to quantify a higher CD163 positive M2 macrophages load within the total decidual macrophages of uncomplicated OD pregnancy compared to non-OD IVF pregnancies. Trial registration number not applicable

P–420 uncomplicated oocyte donation pregnancies display elevated CD163 positive type 2 macrophage load in the decidua, which is associated with fetal-maternal HLA class II mismatches

Study question Do quantity and composition of decidual macrophages differ between uncomplicated oocyte donation (OD) pregnancies and non-OD in vitro fertilization (IVF) pregnancies? Summary answer OD placentas show higher decidual CD163 positive fraction within the total macrophage population compared to non-OD IVF placentas. What is known already The embryo of an OD pregnancy is completely allogeneic to the mother, which may lead to a bigger challenge for the maternal immune system to tolerize the fetus compared to autologous pregnancies. Placental macrophages may be essential in maintaining a healthy pregnancy. Macrophages can be classified into different categories based on phenotype and characteristics, in which type 2 macrophages are thought to exhibit immune suppressive activity. Study design, size, duration This retrospective case-control study included patients who delivered in the Leiden University Medical Center between January 1st 2006 and July 1st 2016. A total of 42 pregnancies were enrolled in this study, conceived by uncomplicated singleton OD pregnancies (n = 25) or non-OD IVF pregnancies (n = 17). Medical records were reviewed and clinical data were collected. Placental tissue samples were collected for immunohistochemical staining and blood samples were collected for HLA typing. Participants/materials, setting, methods Placentas were collected and immunohistochemically stained for CD14 (pan-macrophage marker) and CD163 (type 2 macrophage marker). The extent of staining was quantitated by digital image analysis software. To assess mismatching, maternal and fetal DNA was typed for HLA-A, -B, C, -DRB1, and -DQB1. Main results and the role of chance A significantly lower percentage of CD14 positive staining was observed in the decidua basalis of OD pregnancies compared to non-OD IVF pregnancies (p = 0.030). Consequently, the CD163/CD14 ratio in OD group was higher than in non-OD IVF group (p = 0.243). In the parietalis, OD pregnancies demonstrated a significantly higher percentage of CD163+ staining (p = 0.040) and a significantly higher CD163/CD14 ratio (p = 0.032) compared to non-OD IVF group. The reproducibility of this quantitative analysis was found to be high. OD group was separated into a syngeneic group (number of mismatches lower than half of the antigens per HLA locus) and an allogeneic group (number of mismatches higher than half of the antigens per HLA locus). Significant differences of CD163+ and CD163/CD14 ratio were found in the decidua parietalis when comparing the HLA-classII-allogeneic OD group with the non-OD IVF group (p = 0.047). This difference was not found for the HLA-class-II-syngeneic OD group. Limitations, reasons for caution Our study only focused on decidua basalis and parietalis, no other locations in the placentas. Larger sample size might be needed to verify the association between macrophages and HLA mismatches. Wider implications of the findings: To our knowledge, this study is the first to quantify a higher CD163 positive M2 macrophages load within the total decidual macrophages of uncomplicated OD pregnancy compared to non-OD IVF pregnancies. Trial registration number Not applicable

A Pilot Study Investigating the effect of Glycemic Control on Electrodiagnostic Parameters in Type II Diabetic Patients

Background: Diabetes is a chronic metabolic abnormality due to either decreased secretion of insulin or decreased tissue sensitivity of insulin resulting in elevated blood glucose. Most common complication of diabetes is peripheral neuropathy. In this research project, we will be conducting a pilot study to observe the effect of glycaemic control on physiological functioning of nerve with the help of neurophysiological parameters, independent of duration of diabetes. Objectives: To investigate relationship of quality of glycemic control & severity of neurological changes. To find out whether glycemic control acts as an independent risk factor for progression of diabetic neuropathy despite the duration of diabetes. To validate the HBA1C at 10 for future longitudinal study to understand the association between glycemic control & progression of neuropathy. Methodology: 60 type II diabetic patients visiting diabetic OPD (Medicine) will participate in the study. The patients will be divided in to 2 groups of Group number 1 with (30 subjects) HBA1C < 10 and Group number 2 having (30 subjects) HBA1C >10. Electrodiagnostic study will be conducted on motor (tibial nerve) and sensory (sural nerve) will be performed in Neurophysiology lab. Neurophysiological parameters data of two groups will be analysed and compared. Expected Results: The pilot study will help to find out whether glycaemic control acts as a separate risk factor for progression of diabetic neuropathy despite duration of diabetes. Conclusion: This pilot study will help to establish the association between quality of glycaemic control and severity of neurological changes. Also, this will help to validate the HBA1C at 10 for further longitudinal study to know whether poor diabetes control is an independent risk factor associated to the severity of neuropathy in type II diabetes.

Information-Centric Blockchain Technology for the Smart Grid

This paper proposes an application of blockchain technology for securing the infrastructure of the modern power grid - an Information-Centric design for the blockchain network. In this design, all the transactions in the blockchain network are classified into different groups, and each group has a group number. A sender’s identity is encrypted by the control centre’s public key; energy data is encrypted by the subscriber’s public key, and by a receiver’s public key if this transaction is for a specific receiver; a valid signature is created via a group message and the group publisher’s private key. Our implementation of the design demonstrated the proposal is applicable, publisher’s identities are protected, data sources are hidden, data privacy is maintained, and data consistency is preserved.

AB0212 NON-ADHERENCE IN RHEUMATOLOGIC IMMUNE-MEDIATED DISEASES

Background:Patient adherence is a key determinant of treatment success in rheumatologic immune-mediated diseases. Available data about adherence to biological treatments and factors associated to non-adherence is limited in Spain. Moreover, no studies compare adherence between subcutaneous and oral drugs.Objectives:To evaluate non-adherence to prescribed subcutaneous biologicals and oral drugs in patients with rheumatologic immune-mediated diseases and to assess possible predictor factors associated to treatment non-adherence.Methods:Retrospective observational study including all patients with oral and subcutaneous treatment for rheumatologic immune-mediated diseases from 2017 to 2019 in the outpatient pharmaceutical care area from a tertiary university hospital. Non-adherence was evaluated by reviewing all scheduled drug-dispensing visits in the computerized application. We considered non-adherent every time that a patient missed at least one drug administration.Data collected: demographic, total patients and patient-treatments, total dispensing visits and route of administration for drug dispensed in every visit.We classified patients in adherent and non-adherent considering dispensing visits. Non-adherent group: number of dispensing visits, reasons for non-adherence, number of missed administrations per patient and drug and predictor factors for non-adherence.Results:783 patients included: 52.4(13.7) years; 427(54.5%) female; 164 (20.9%) smoker; 697 (89%) Caucasian.A total of 79 (10.1%) of 783 patients received more than one treatment.869 patient-treatments: 294 adalimumab (33.8%), 236 etanercept (27.2%), 78 golimumab (8.9%), 47 apremilast (5.4%), 39 certolizumab (4.5%), 34 secukinumab (3.9%), 30 tocilizumab (3.5%).9,197 dispensing visits. Route of administration: 6,406 subcutaneous (93.2%), 374 oral (6.8%).Non-adherence analysis: 2417 (26.3%) dispensing visits, reasons for non-adherence/ dispensing visits: 92 unjustified (97.5%), 33 infection (1.4%), 18 (surgery) 0.7%, 3 pregnancy (0.1%), 6 others (0.3%).Number of missed administrations/patient treatment: 675 patients missed at least one administration (77.7%).Mean 2.5 (±12.9) missed administrations.Number of missed administrations/drug: 9.9 baricitinib (±20.8), 15.8 tofacitinib (±31.2), 25.4 apremilast (±53.2).Predictor factors for non-adherence: ethnicity (p=0.015), treatment with golimumab (p=0.006), and tocilizumab (p=0.036). Age (p=0.072).Conclusion:- Non-adherence to the prescribed drug occurred in 77.7% of patients with rheumatologic immune-mediated diseases- Demographic factors such as ethnicity as well as golimumab and tocilizumab treatment, despite their different frequency of administration, were predictors for non-adherence- Route of administration did not influence non-adherence.Disclosure of Interests:None declared

Several Populations of Sunspot Group Numbers – Resolving a Conundrum

&lt;p&gt;The long-standing disparity between the sunspot number record and the Hoyt and Schatten (1998, H&amp;S) Group Sunspot Number series was initially resolved by the Clette et al. (2014) revision of the sunspot number and the group number series. The revisions resulted in a flurry of dissenting group number series while the revised sunspot number series was generally accepted. Thus, the disparity persisted and confusion reigned, with the choice of solar activity dataset continuing to be a free parameter. A number of workshops and follow-up collaborative efforts by the community have not yet brought clarity. We review here several lines of evidence that validate the original revisions put forward by Clette et al. (2014) and suggest that the perceived conundrum no longer need to delay acceptance and general use of the revised series. We argue that the solar observations constitute several distinct populations with different properties which explain the various discontinuities in the series. This is supported by several proxies: diurnal variation of the geomagnetic field, geomagnetic signature of the strength of the heliomagnetic field, and variation of radionuclides. The Waldmeier effect shows that the sunspot number scale has not changed over the last 270 years and a mistaken scale factor between observers Wolf and Wolfer explains the disparity beginning in 1882 between the sunspot number and the H&amp;S reconstruction of the group number. Observations with replica of 18th century telescopes (with similar optical flaws) validate the early sunspot number scale; while a reconstruction of the group number with monthly resolution (with many more degrees of freedom) validate the size of Solar Cycle 11 given by the revised series that the dissenting series fail to meet. Based on the evidence at hand, we urge the working groups tasked with producing community-vetted and agreed upon solar activity series to complete their work expeditiously.&lt;/p&gt;