In Indonesia, home to the fourth-largest children-under-five population globally, the stunting prevalence is among the highest in Asia. The detrimental and irreversible impacts of stunting warranted the government to ...
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In Indonesia, home to the fourth-largest children-under-five population globally, the stunting prevalence is among the highest in Asia. The detrimental and irreversible impacts of stunting warranted the government to aim for stunting eradication by 2030, with community health workers (CHWs) at the forefront of the program. With over 1.5 million Indonesian CHWs conducting monthly growth monitoring and counseling, the critical importance and cost-effectiveness of CHWs in stunting management are clear. However, several implementation challenges continue to hinder their maximum potential. This includes unclear recruitment processes, the nonprofessional status of CHWs, unclear incentive schemes, research and funding constraints, and unclear role of stakeholders. This commentary examines the current involvement of CHWs in the Indonesian stunting program, the remaining issues, and recommendations to mitigate the identified challenges. Improvements in the recruitment process, recognition, and incentivization system, as well as cross-sectoral collaboration, particularly in evidence creation and policy-research continuum, are crucial in improving the current program and achieve the goal of stunting eradication.
Background There is increasing concern that a significant proportion of randomized controlled trials (RCTs) included in Cochrane reviews may not be trustworthy. Applying the Cochrane Pregnancy and Childbirth Trustwort...
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Background There is increasing concern that a significant proportion of randomized controlled trials (RCTs) included in Cochrane reviews may not be trustworthy. Applying the Cochrane Pregnancy and Childbirth Trustworthiness Screening Tool (CPC-TST) has already had a clinically important effect on several reviews published by the Cochrane Pregnancy and Childbirth Group. Objectives We wanted to assess the impact of removing untrustworthy RCTs from already-published Cochrane reviews on a defined clinical area (antenatal and postnatal nutritional interventions). Methods We applied the tool to 18 Cochrane reviews (374 RCTs). The tool had four domains: (i) is the research governance trustworthy; (ii) are the baseline characteristics trustworthy; (iii) is the study feasible; (iv) are the results plausible? When additional information was needed, authors were contacted using a standard template. At least two attempts were made to contact the authors. At the end of the evaluation process each study was classified as: (i) included (YES to all questions); (ii) excluded (retracted study); or (iii) awaiting classification (any NO to the questions). Results Ninety-three out of 374 included studies (25%) were reclassified as “excluded” or “awaiting classification.” The number of included RCTs was reduced in 14 out of 18 reviews. Six reviews (33%) were judged to require updating because of important differences in the Summary of Findings tables (direction and size of effects and/or GRADE ratings), conclusions, implication for practice, and/or implication for research. Conclusions Formal assessment of trustworthiness, and inclusion only of studies that satisfy prespecified criteria for trustworthiness, affect conclusions in a relatively large number of Cochrane reviews, with potentially important clinical implications for practice and research.
China's economy underwent a steady recovery in 2021. Investment grew steadily with structural improvement. Exports and imports surged while trade surplus expanded. On the other hand, although labor market conditio...
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China's economy underwent a steady recovery in 2021. Investment grew steadily with structural improvement. Exports and imports surged while trade surplus expanded. On the other hand, although labor market conditions improved, income distribution worsened, contributing to sluggish growth in consumption, whereas the gap between consumer price index and producer price index widened, and the profits of enterprises of different sizes diverged, which may go beyond how they are correlated with the locations of the enterprises in the chain of production and trade. While proper liquidity was maintained with prudent monetary policy, risk spillover rose in the financial system, particularly for small and medium-sized banks. Household and local government debts remained at relatively high levels, further dragging down growth in consumption and infrastructure investment. The “dual carbon” goals exerted downward pressure on near-term growth in trading off their long-term benefits. The economy also faced challenges in its external environment in the midst of the prolonged COVID-19 pandemic aboard, trade protectionism, and the readjustment of the global value chain. Moreover, excessive supervision and inadequate implementation disturbed China's economy, resulting in declined market vitality and confidence of market participants. Based on the Institute for Advanced Research-China Macroeconomic Model, the baseline real gross domestic product growth rate is projected to be 5.5% in 2022. Alternative scenario analyses and policy simulations are conducted, in addition to the benchmark forecast, to reflect the influences of various risks and possible favorable situations. The findings suggest that China should deepen reform and open up more comprehensively and initiatively, while special effort should be placed on providing accommodative policy and friendly public opinion environment, to facilitate steady growth and propel high-quality development. A comprehensive macroeconomic governance
Rate-enhancement of any isothermal, isobaric chemical synthesis conducted under resonant microwave (RM) irradiation versus the same process activated by conventional field-free heating has been attributed to a reducti...
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Rate-enhancement of any isothermal, isobaric chemical synthesis conducted under resonant microwave (RM) irradiation versus the same process activated by conventional field-free heating has been attributed to a reduction in activation enthalpy of the process. This report applies a unified process kinetic equation (UPKE) to demonstrate and characterize non-thermal microwave effects (NTME) on kinetics-enhancements observed in isothermal microwave-assisted chemical syntheses (IMACS). The UPKE, derived from a mesoscopic irreversible thermodynamic model, pinpoints that the rate of any high-affinity chemical reaction is effectively independent of the affinity of the process as described by the mass-action rate law. Energetically, activation enthalpy reduction observed in IMACS is considered the major NTME, which causes dominant process-rate enhancements. This NTME results from RM-induced enthalpy variation during the reaction: RM energy-input first promotes the molar enthalpy of the irradiated reactant(s) at temperature, which consequently motivates an activation enthalpy reduction for rate-enhancement. Conversely, frequency coefficient lowering is another common NTME occurring in IMACS, causing an adverse yet compensable setback to process-kinetics as predicted by the UPKE. Applicability of the UPKE-proposed rationale and methodology for IMACS kinetic characterization is fully confirmed by relevant data in the literature.
Improved durability, enhanced interfacial stability, and room temperature applicability are desirable properties for all-solid-state lithium metal batteries (ASSLMBs), yet these desired properties are rarely achieved ...
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Improved durability, enhanced interfacial stability, and room temperature applicability are desirable properties for all-solid-state lithium metal batteries (ASSLMBs), yet these desired properties are rarely achieved simultaneously. Here, in this work, it is noticed that the huge resistance at Li metal/electrolyte interface dominantly impeded the normal cycling of ASSLMBs especially at around room temperature (<30 °C). Accordingly, a supramolecular polymer ion conductor (SPC) with “weak solvation” of Li + was prepared. Benefiting from the halogen-bonding interaction between the electron-deficient iodine atom (on 1,4-diiodotetrafluorobenzene) and electron-rich oxygen atoms (on ethylene oxide), the O-Li + coordination was significantly weakened. Therefore, the SPC achieves rapid Li + transport with high Li + transference number, and importantly, derives a unique Li 2 O-rich SEI with low interfacial resistance on lithium metal surface, therefore enabling stable cycling of ASSLMBs even down to 10 °C. This work is a new exploration of halogen-bonding chemistry in solid polymer electrolyte and highlights the importance of “weak solvation” of Li + in the solid-state electrolyte for room temperature ASSLMBs.
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