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Batman, the caped crusader
\"A new collection featuring the legendary 1980s Batman epics \"Ten Nights of the Beast\" and \"A Death in the Family\", never before collected! This new collection of 1980s Batman tales includes the legendary story \"A Death in the Family,\" in which the Joker ends up killing the secon Robin, Jason Todd. It all begins with the story \"Ten Nights of the Beast,\" which introduced the deadly post-Soviet villain known as the KGBeast. Following that, a series of stories concerning organized crime in the streets of Gotham City leads into \"A Death in the Family,\" in which Robin follows a trail to find his birth mother, who is in cahoots with the Joker.\"-- Provided by publisher.
Book
Factors associated with changes in adequate antenatal care visits among pregnant women aged 15-49 years in Tanzania from 2004 to 2016
Background
Antenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits, and the trend has been fluctuating over time. An understanding of the factors that have been contributing to the fluctuating trend over years is pivotal in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania.
Methods
The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using Stata version 14. Categorical and continuous variables were summarized using descriptive statistics and weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate ANC visits. To determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016, multivariable Poisson decomposition analysis was done.
Results
The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62, 43 and 51% respectively. The increase in the proportion of women attaining adequate ANC from 2010 to 2015/16 was mainly, 66.2% due to changes in population structure, thus an improvement in health behavior. While 33.8% was due to changes in the mother’s characteristics. Early initiation of first ANC visit had contributed 51% of the overall changes in adequate ANC attendance in TDHS 2015/16 survey.
Conclusion
Early ANC initiation has greatly contributed to the increased proportion of pregnant women who attain four or more ANC visits overtime. Interventions on initiating the first ANC visit within the first twelve weeks of pregnancy should be a priority to increase proportion of women with adequate ANC visit.
Journal Article
Fertility trends by HIV status in a health and demographic surveillance study in Magu District, Tanzania, 1994–2018
Sub-Saharan Africa (SSA) has the highest fertility rates and highest HIV disease burden globally. However, it is not clear how the rapid expansion of anti-retroviral therapy (ART) for HIV has impacted the fertility gap between HIV-infected and uninfected women. We used data from a Health and Demographic Surveillance System (HDSS) in north-western Tanzania to explore trends in fertility rates and the relationship between HIV and fertility over the 25-year period.
From 1994 to 2018, births and population denominators from the HDSS population were used to obtain age-specific fertility rates (ASFRs) and total fertility rates (TFRs). HIV status was extracted from eight rounds of epidemiologic serological surveillances (1994-2017). Fertility rates by HIV status and in different levels of ART availability were compared over time. Independent risk factors for fertility changes were examined using Cox proportional hazard models.
There were 24,662 births from 36,814 women (15-49) who contributed a total of 145,452.5 Person-Years of follow-ups. The TFR declined from 6.5 births per woman in 1994-1998 to 4.3 births per woman in 2014-2018. The number of births per woman was 40% lower in women living with HIV than in HIV-uninfected women (4.4 vs. 6.7), although this difference narrowed over time. The fertility rate in HIV-uninfected women was 36% lower in 2013-2018 than in 1994-1998(age-adjusted HR = 0.641; 95% CI 0.613-0.673). In contrast, the fertility rate in women living with HIV was relatively unchanged over the same follow up period (age-adjusted HR = 1.099; 95% CI 0.870-1.387).
There was a notable fertility decline among women in the study area from 1994 to 2018. Fertility remained lower in women living with HIV than in HIV-uninfected women, but the difference continued to narrow over time. These results highlight the need for more research into fertility changes, fertility desire and family planning use in Tanzanian rural communities.
Journal Article
Batman, the Dark Knight detective
\"In these stories that immediately followed BATMAN: YEAR ONE, the Caped Crusader learns what kind of compromises he must make to be the hero that Gotham City truly needs. As he battles against the deadly Reaper, the city's first vigilante hero, Batman must work with the man who murdered his parents and a cadre of mob bosses to protect Gotham City.\"-- Provided by publisher.
Book
Comparison of survival analysis approaches to modelling age at first sex among youth in Kisesa Tanzania
Many studies analyze sexual and reproductive event data using descriptive life tables. Survival analysis has better power to estimate factors associated with age at first sex (AFS), but proportional hazards models may not be right model to use. This study used accelerated failure time (AFT) models, restricted Mean Survival time model (RMST) models, with semi and non-parametric methods to assess age at first sex (AFS), factors associated with AFS, and verify underlying assumptions for each analysis.
Self-reported sexual debut data was used from respondents 15-24 years in eight cross-sectional surveys between 1994-2016, and from adolescents' survey in an observational community study (2019-2020) in northwest Tanzania. Median AFS was estimated in each survey using non-parametric and parametric models. Cox regression, AFT parametric models (exponential, gamma, generalized gamma, Gompertz, Weibull, log-normal and log-logistic), and RMST were used to estimate and identify factors associated with AFS. The models were compared using Akaike information criterion (AIC) and Bayesian information criterion (BIC), where lower values represent a better model fit.
The results showed that in every survey, the Cox regression model had higher AIC and BIC compared to the other models. Overall, AFT had the best fit in every survey round. The estimated median AFS using the parametric and non-parametric methods were close. In the adolescent survey, log-logistic AFT showed that females and those attending secondary and higher education level had a longer time to first sex (Time ratio (TR) = 1.03; 95% CI: 1.01-1.06, TR = 1.05; 95% CI: 1.02-1.08, respectively) compared to males and those who reported not being in school. Cell phone ownership (TR = 0.94, 95% CI: 0.91-0.96), alcohol consumption (TR = 0.88; 95% CI: 0.84-0.93), and employed adolescents (TR = 0.95, 95% CI: 0.92-0.98) shortened time to first sex.
The AFT model is better than Cox PH model in estimating AFS among the young population.
Journal Article
Batman Knightfall omnibus
\"This classic storyline that led to the birth of a new Batman begins as the Dark Knight's greatest enemies have all simultaneously escaped from Arkham Asylum and are preying on Gotham City. With his city under siege, Batman pushes his body to its physical breaking point as he takes on the Joker, the Mad Hatter, Poison Ivy, Killer Croc, the Riddler and the Scarecrow, one after another. But things get much worse, when Bane, the man behind all of this madness, confronts an exhausted Batman and cripples him by breaking his back.\"-- Provided by publisher.
Book
Improvement of germination rate and hybridization to facilitate breeding of an industrial oil crop, Euphorbia lagascae Spreng
Background
The potential of plant-based sources of vernolic acid to provide agricultural producers with a market diversification opportunity and industrial manufacturers with a renewable, environmentally friendly chemical feedstock is immense. The herbaceous wild spurge or caper spurge (
Euphorbia lagascae
Spreng) is the most promising source of vernolic acid, containing an average oil content of 50%, of which around 60% is vernolic acid. Its seed yield ranges between 500 and 2000 kg ha
−1
, and a theoretical yield of 180 kg ha
−1
of pure vernolic acid is possible. The objective of this research was to characterize the flower and whole plant morphology so to allow for the development of a method to efficiently hybridize
E. lagasce
plants for breeding purposes.
Results
In this study, we have characterized the flower and whole plant morphology in detail, thereby, developing an efficient method for hybridization of
E. lagasce
to allow for its breeding and improvement as a novel oil crop. Such method was not described previously in the literature making it difficult to breed this crop. We believe that the method will be of great value to plant breeders working on optimizing the crop, particularly in terms of the development of non-shattering cultivars with enhanced germination potential.
Conclusions
The successful development of this crop through plant breeding could provide substantial economic benefits to farmers by offering them a new industrial oilseed crop. This research could prove invaluable in unlocking the potential of
E. lagasce
, and in turn, the potential of vernolic acid as a renewable, environmentally friendly source of chemical feedstock.
Journal Article
Morbidity and health seeking behavior among children and adolescents (0–19 years): a household survey assessment in Northwestern Tanzania
Background
Information on morbidity and health-seeking behavior beyond early childhood is crucial for planning evidence-based interventions. Currently, data is limited to children under five. This study introduces a method for estimating morbidity and health-seeking behavior in older children and adolescents (5–19 years) using women’s birth histories from a household survey in northwestern Tanzania, comparing it with data on children under five.
Methods
We conducted a household survey among women 15–49 years as part of the Magu Health and Demographic Surveillance from October 2020 to November 2021, including 16,896 children aged 0–19 living with their mothers. The study outcomes were the prevalence of reported illness in the last four weeks and health-seeking behavior, defined as visiting a health facility for recent illness. Modified Poisson regression analysis was performed, accounting for mothers as clusters and adjusting for child and mother characteristics. We compared the prevalence of recent illness and health-seeking behavior among older children and adolescents (5–19 years) with children under five within the same population.
Results
Morbidity presented as the prevalence of any illness decreased with age, from 26.1% in children under-five to 10.4% among adolescents aged 15–19. Health seeking behavior also decreased with age, from 48.2% in children under-five to nearly 30% among adolescents aged 15–19. Types of illnesses reported were similar across age groups, with Fever/Malaria accounting more than two-thirds, followed by respiratory tract illnesses. Higher illness prevalence was noted in rural areas for both age groups. Health seeking behavior was higher among mothers with secondary education and above for both children under-fives (APR:1.22;95% CI: 1.02, 1.47) and 5–19-year-olds (APR: 1.31; 95% CI:1.01, 1.70). Additionally, those with health insurance also reported higher health seeking behavior (APR: 1.38; 95% CI:1.07, 1.78), while lower for children in rural households (APR: 0.72; 95% CI:0.61, 0.83), for 5–19-year-olds.
Conclusions
Our findings on morbidity and health-seeking behavior demonstrate the importance of extending health monitoring beyond early childhood. The inequalities identified point to gaps in programming and health service delivery that require attention.
Journal Article
Prevalence and correlates of overweight and obesity among primary school children in Kilimanjaro, Tanzania
Prevalence of childhood overweight and obesity in low- and middle-income countries is on the rise. We focused on multiple factors which could influence body mass index.
A cross sectional school-based study was conducted in Moshi, Tanzania. Primary school children aged 9-11 years were recruited from 20 schools through a multistage sampling technique. Questionnaires were used to collect information on physical activity and diet by food frequency questionnaire. Height and weight measurements were taken and body mass index z scores for age and sex (BMIZ) calculated using the WHO AnthroPlus. Children were considered thin if BMIZ was <-2 standard deviations and overweight or obese if BMIZ was >1 SD. Information on school policies and environment was obtained from headteachers. Correlates of overweight and obesity were examined using a multinomial multilevel logistic regression.
A total of 1170 primary school children, of whom 636 (54%) were girls, were recruited from 20 schools. The prevalence of overweight and obesity was 15% overall (overweight 9% and obesity 6%) and most prevalent in urban areas (23%) and in private schools (24%). Moreover, thinness was found to be (10%) overall, most prevalent in rural areas (13%) and in government schools (14%). At school level, residing in urban (adjusted relative risk ratio [aRRR] 3.76; 95% confidence interval [CI] 2.49,5.68) and being in private school (aRRR 4.08; 95% CI 2.66,6.25) were associated with a higher risk of overweight and obesity while availability of playgrounds in schools (aRRR 0.68; 95% CI 0.47, 0.97) was associated with a lower risk of overweight and obesity. At home level, availability of sugary drinks (aRRR 1.52; 95% CI 1.01,2.28) was associated with a higher risk of overweight and obesity.
Overweight and obesity are common in private schools and in urban settings. Efforts should be taken to ensure availability of playgrounds in schools and encouraging children to engage in physical activities.
Journal Article