•The use of convolutional neural networks (CNN) has grown in brain image analysis.•We review the deep CNNs applied to brain lesions, tissue and structure segmentation.•We discuss about ...pre-processing, data-preparation, architectures and post-processing.•Quantitative results are shown, pointing out pros and cons of reviewed architectures.
In recent years, deep convolutional neural networks (CNNs) have shown record-shattering performance in a variety of computer vision problems, such as visual object recognition, detection and segmentation. These methods have also been utilised in medical image analysis domain for lesion segmentation, anatomical segmentation and classification. We present an extensive literature review of CNN techniques applied in brain magnetic resonance imaging (MRI) analysis, focusing on the architectures, pre-processing, data-preparation and post-processing strategies available in these works. The aim of this study is three-fold. Our primary goal is to report how different CNN architectures have evolved, discuss state-of-the-art strategies, condense their results obtained using public datasets and examine their pros and cons. Second, this paper is intended to be a detailed reference of the research activity in deep CNN for brain MRI analysis. Finally, we present a perspective on the future of CNNs in which we hint some of the research directions in subsequent years.
Background. Today, complementary and alternative medicine (CAM) use is being routinely practiced by cancer patients worldwide. This study aimed at examining the prevalence of CAM use in patients with ...cancer and comparing the quality of life (QoL) in CAM users and nonusers. Methods. A cross-sectional study was employed on 195 cancer patients receiving chemotherapy at Gondar University Referral Hospital (GURH) chemotherapy center. Interviewer-administered questionnaires were used and the collected data were analyzed by the Statistical Package for the Social Sciences (SPSS) software version 21.0 for Windows. Results. 154 (79%) patients were found to be users of CAM. Educational status, average monthly income, disease stage, and comorbidity were strong predictors of use of CAM. The most commonly utilized types of CAM were traditional herbal based medicine (72.1%) and only 20.8% of patients discuss with their doctors CAM use. No significant difference was found in QoL between CAM users and nonusers except in financial difficulties ( p = 0.020 ). Conclusions. This study revealed a high rate of CAM use with very low disclosure rate to their health care providers. Health care providers should be open to discuss the use of CAM with their patients as it will lead to better health outcome.
Morphometric analysis is a quantitative measurement and mathematical analysis of landforms. It plays a significant role in understanding the geohydrological characteristics of a drainage basin in ...relation to the terrain feature and its flow patterns. It also helps to estimate the incidence of infiltration and runoff, and other related hydrological character of a watershed like erosion and sediment transport which has a strong implication for natural resource conservation. This study has attempted to quantify the morphometric characteristics of Guna- Tana watershed for proper implementation of soil and water conservation practices. ASTER (DEM) was used for extracting morphometric parameters. The watershed covers a total area of 3601.5 km2 and it has a basin length of 78.89 km. It has been tried to generate morphometric parameters which account basin drainage network, geometry, drainage texture, and relief characteristics together with hypsometric characteristics. The morphometric analysis of drainage density of the study watershed is 0.49 km/km2 which indicates the basin is highly permeable and result with better underground water storage capacity. Ruggedness number is 0.02 that implies the area is less prone to soil erosion. In addition, it has stream frequency of 0.32 and form factor 0.57 which indicates slightly elongated basin shape. Comparative analysis of its sub watersheds Gumara and Ribb was also undertaken. Therefore, practicing soil and water conservation in the watershed could enhance/strengthen the water storage capacity, prevent sediment loss and related natural resource from the watershed that rehabilitate its productivity.
In Ethiopia, soil erosion is a severe problem and a major cause of the decline of agricultural productivity. Interventions were taken by introducing soil and water conservation practices. However, ...the adoption of these practices is far below the expectation. The objective of this study was to examine factors affecting adoption of introduced soil and water conservation practices in Wereillu Woreda. Mixed research methods design was employed in order to conduct this study. Questionnaire, focus group discussion, in-depth interview and field observation were used to collect data. A binary logistic regression model was employed to analyze the collected data. The analysis result showed that sex of household heads, education status of household heads, access to extension services and training were positively correlated at significantly level with the adoption of the introduced soil and water conservation practices. On the other hand, the age of household heads, off-farm activity, and distance of farmlands from homesteads influenced the adoption of introduced soil and water conservation practices negatively. The finding depicts that the identified physical, socioeconomic, and institutional factors influence the adoption of soil and water conservation so, the Woreda Rural and Agricultural Development Office and other concerned bodies should consider these influential factors to enhance farmers’ adoption of introduced soil and water conservation practices and to promote agricultural productivity and environmental quality.
Located in the heart of the community and widely distributed geographically, community pharmacies provide a platform for a more proactive involvement in public health services. So far, little ...information has been gathered in Ethiopia on community pharmacists' level of involvement in public health services. The aim of the present study was, therefore, to document the level of involvement of community pharmacy professionals in the provision of public health services and the barriers to such involvement. This study employed a self-administered questionnaire based survey, which asked participants to indicate their frequency and level of involvement in providing public health services and their perceived barriers in providing such services. Surveys were undertaken from May to July, 2016 with 472 community pharmacy professionals working in community pharmacies in six cities of Amhara regional state of Ethiopia: Debre Markos, Gondar, Dessie, Bahir Dar, Woldya and Debre Birhan. Among 472 community pharmacy professionals approached, 412 (233 pharmacists and 179 pharmacy technicians) completed the survey with a response rate of 87.3%. Most respondents reported as being either "not at all involved" or "little involved" in counselling on smoking cessation (79.3%), and screening for hypertension (86.9%), diabetes (89.5%), and dyslipidemia (88.9%). On the other hand, they reported a higher level of involvement in the management and screening of infectious diseases (72.8%) and counseling with partners when initiating treatment for sexually transmitted diseases (68.9%). Lack of knowledge or clinical skills and lack of personnel or resources were the most commonly reported barrier for expanding such services. This survey revealed a low level of involvement of community pharmacists in public health services. In order to better integrate community pharmacies into future public health programs and optimize the contribution of community pharmacy professionals, interventions should focus on overcoming the identified barriers.
Abstract
Background
Non-prescription dispensing of antibiotics, one of the main sources of antibiotic misuse or over use, is a global challenge with detrimental public health consequences including ...acceleration of the development of antimicrobial resistance, and is facilitated by various intrinsic and extrinsic drivers. The current review aimed to systematically summarise and synthesise the qualitative literature regarding drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries.
Methods
Four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) and reference lists of the relevant articles were searched. The Joanna Briggs Institute’s Critical Appraisal Checklist for qualitative studies was used to assess the quality of included studies. The enhancing transparency in reporting the synthesis of qualitative research statement was used to guide reporting of results. Data were coded using NVivo 12 software and analysed using both inductive and deductive thematic analysis.
Results
A total of 23 articles underwent full text review and 12 of these met the inclusion criteria. Four main themes were identified in relation to facilitators of non-prescribed sale of antibiotics among community drug retail outlets: i) the business orientation of community drug retail outlets and tension between professionalism and commercialism; ii) customers’ demand pressure and expectation; iii); absence of or a lax enforcement of regulations; and iv) community drug retail outlet staff’s lack of knowledge and poor attitudes about antibiotics use and scope of practice regarding provision.
Conclusions
This review identified several potentially amendable reasons in relation to over the counter dispensing of antibiotics. To contain the rise of antibiotic misuse or over use by targeting the primary drivers, this review suggests the need for strict law enforcement or enacting new strong regulation to control antibiotic dispensing, continuous and overarching refresher training for community drug retail outlet staff about antibiotic stewardship, and holding public awareness campaigns regarding rational antibiotic use.
To assess accuracy and adherence of visual field (VF) home monitoring in a pilot sample of patients with glaucoma.
Prospective longitudinal feasibility and reliability study.
Twenty adults (median 71 ...years) with an established diagnosis of glaucoma were issued a tablet perimeter (Eyecatcher) and were asked to perform 1 VF home assessment per eye, per month, for 6 months (12 tests total). Before and after home monitoring, 2 VF assessments were performed in clinic using standard automated perimetry (4 tests total, per eye).
All 20 participants could perform monthly home monitoring, though 1 participant stopped after 4 months (adherence: 98% of tests). There was good concordance between VFs measured at home and in the clinic (r = 0.94, P < .001). In 21 of 236 tests (9%), mean deviation deviated by more than ±3 dB from the median. Many of these anomalous tests could be identified by applying machine learning techniques to recordings from the tablets' front-facing camera (area under the receiver operating characteristic curve = 0.78). Adding home-monitoring data to 2 standard automated perimetry tests made 6 months apart reduced measurement error (between-test measurement variability) in 97% of eyes, with mean absolute error more than halving in 90% of eyes. Median test duration was 4.5 minutes (quartiles: 3.9-5.2 minutes). Substantial variations in ambient illumination had no observable effect on VF measurements (r = 0.07, P = .320).
Home monitoring of VFs is viable for some patients and may provide clinically useful data.
•Twenty patients with glaucoma performed visual field assessments at home for 6 months.•The data were in good agreement with conventional measurements made in clinic.•Home monitoring may be viable and useful for some patients.•Practical concerns and future directions for home monitoring are also discussed.
Background. Complementary and alternative medicine (CAM) therapies are being widely used by hypertensive patients worldwide. However, evidences regarding CAM use by hypertensive patients in Ethiopia ...are limited. This study aimed at assessing prevalence and correlates of CAM use among hypertensive patients attending ambulatory clinic at Gondar University Referral Hospital (GURH), Ethiopia. Methods. A cross-sectional study was employed on 423 patients visiting GURH. Descriptive statistics and bivariate and multivariate logistic regression tools were used to analyze/come up with the prevalence and correlates of CAM use. Results. The prevalence of CAM use in our study was found to be 67.8% and herbal based medicine was the most commonly utilized CAM therapies. Majority of CAM users (70.2%) did not disclose CAM use for their physician. However, nearly half of CAM users (48.4%) were satisfied with the result of CAM use. Conclusions. The higher prevalence of CAM use among hypertensive patients coupled with a very low disclosure rate to their health care providers can have a marked potential to cause ineffective hypertensive management and adverse effects due to CAM use. Health care providers should be open to discussing the use of CAM with their patients as it will lead to better health outcome.
Soil erosion is a serious environmental problem arising from agricultural intensification and landscape changes. Improper land management coupled with intense rainfall has intricated the problem in ...most parts of the Ethiopian highlands. Soil loss costs a profound amount of the national GDP. Thus, quantifying soil loss and prioritizing areas for conservation is imperative for proper planning and resource conservation. Therefore, this study has modeled the mean soil loss and annual sediment yield of the Gumara watershed. Landsat 5 TM, Landsat 7ETM+, and Landsat 8 OLI were used for land use land cover (LULC) change analysis. Besides these, other datasets related to rainfall, digital soil map, Digital Elevation Model, reference land use, and cover (LULC) ground truth points were used to generate parameters for modeling soil loss. The watershed was classified into five major land-use classes (water body, cultivated land, grazing land, built-up and forest and plantation) using a maximum likelihood algorithm covering a period of the last 30 years (1988–2019). The mean annual soil loss and sediment yield were quantified using RUSLE, Sediment delivery ratio (SDR), and Sediment Yields models (SY). The analysis result unveils that within the past 30 years, the watershed has undergone significant LULC changes from forest & plantation (46.33%) and grazing land to cultivated land (31.59%) with the rate of −1.42km2yr-1 and -2.80km2yr-1 respectively. In the same vein, the built-up area has expanded to cultivated and grazing land. Subsequently, nearly 15% (207 km2) of the watershed suffered from moderate to very severe soil loss. On average, the watershed losses 24.2 t ha−1 yr−1 of soil and yields 2807.02 t ha−1 yr−1 sediment. Annually, the watershed losses 385,157 t ha−1 yr−1 soil from the whole study area. Among the admirative districts, Farta (Askuma, Giribi, Mahidere Mariam and Arigo kebeles), Fogera (Gazen Aridafofota and Gura Amba kebeles), East Este (Witimera kebele), and Dera (Gedame Eyesus and Deriana Wechit kebeles) districts which cover 50% of the watershed were found severely affected by soil erosion. Thus, to curve back this scenario, soil and water conservation practices should prioritize in the aforementioned districts of the watersheds.
Background. Community pharmacists are key healthcare professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to ...assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS) in Ethiopia. Methods. A cross-sectional survey was conducted by selecting pharmacy sites through stratified simple random sampling technique. Descriptive and inferential statistics were used to analyze the data. Results. Majority of respondents strongly agreed or agreed that AMS program is vital for the improvement of patient care. Almost all of respondents agreed that pharmacists can play a prominent role in AMS and infection prevention (93.2%, median = 5; IQR = 2–5). However, only 26.5% of respondents strongly agreed or agreed that AMS should be practiced at community pharmacy level (median = 4, IQR = 1–3) and more than half of community pharmacists (59.9%) often/always dispense antimicrobial without a prescription. Conclusion. The present study revealed positive perceptions and practices of community pharmacists towards antimicrobial stewardship. Yet, some weak areas like integration of AMS program in community pharmacies, the significance of interprofessional involvement, and dispensing of antimicrobials without a valid prescription still need improvement.
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