Search results for: positive selection

Authors: Araceli Martinez Ortiz, Gillian U Bayne, Solomon Abraham

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This paper describes research led by faculty from three American universities and four Ethiopian universities on the delivery of professional leadership development for early-career female Ethiopian university instructors in the Science, Technology, Engineering, and Mathematics (STEM) fields. The objective was to carry out a case study focused on the impact of an innovative intervention program designed to assist in the empowerment and leadership development related to teaching effectiveness, scholarly activity participation, and professional service participation by female instructors. This research was conducted utilizing a case study methodology for the weeklong intervention and a survey to capture the voices of the leadership program participants. The data regarding insights into the challenges and opportunities for women in these fields is presented. The research effort project expands upon existing linkages between universities to support professional development and research effort in this region of the world. Findings indicate the positive reception of this kind of professional development by the participating women. Survey data also reflects the educational technology and cultural challenges professional women in STEM education face in Ethiopia as well as the global challenges of balancing family expectations with career development.

Keywords: women, STEM education, higher education, Ethiopia

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Authors: M. Qamarul Islam, Ergun Dogan, Mehmet Yazici

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There is a growing body of evidence that non-normal data is more prevalent in nature than the normal one. Examples can be quoted from, but not restricted to, the areas of Economics, Finance and Actuarial Science. The non-normality considered here is expressed in terms of fat-tailedness and asymmetry of the relevant distribution. In this study a skew t distribution that can be used to model a data that exhibit inherent non-normal behavior is considered. This distribution has tails fatter than a normal distribution and it also exhibits skewness. Although maximum likelihood estimates can be obtained by solving iteratively the likelihood equations that are non-linear in form, this can be problematic in terms of convergence and in many other respects as well. Therefore, it is preferred to use the method of modified maximum likelihood in which the likelihood estimates are derived by expressing the intractable non-linear likelihood equations in terms of standardized ordered variates and replacing the intractable terms by their linear approximations obtained from the first two terms of a Taylor series expansion about the quantiles of the distribution. These estimates, called modified maximum likelihood estimates, are obtained in closed form. Hence, they are easy to compute and to manipulate analytically. In fact the modified maximum likelihood estimates are equivalent to maximum likelihood estimates, asymptotically. Even in small samples the modified maximum likelihood estimates are found to be approximately the same as maximum likelihood estimates that are obtained iteratively. It is shown in this study that the modified maximum likelihood estimates are not only unbiased but substantially more efficient than the commonly used moment estimates or the least square estimates that are known to be biased and inefficient in such cases. Furthermore, in conventional regression analysis, it is assumed that the error terms are distributed normally and, hence, the well-known least square method is considered to be a suitable and preferred method for making the relevant statistical inferences. However, a number of empirical researches have shown that non-normal errors are more prevalent. Even transforming and/or filtering techniques may not produce normally distributed residuals. Here, a study is done for multiple linear regression models with random error having non-normal pattern. Through an extensive simulation it is shown that the modified maximum likelihood estimates of regression parameters are plausibly robust to the distributional assumptions and to various data anomalies as compared to the widely used least square estimates. Relevant tests of hypothesis are developed and are explored for desirable properties in terms of their size and power. The tests based upon modified maximum likelihood estimates are found to be substantially more powerful than the tests based upon least square estimates. Several examples are provided from the areas of Economics and Finance where such distributions are interpretable in terms of efficient market hypothesis with respect to asset pricing, portfolio selection, risk measurement and capital allocation, etc.

Keywords: least square estimates, linear regression, maximum likelihood estimates, modified maximum likelihood method, non-normality, robustness

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Authors: Ghazal Mortazavi, S. M. J. Mortazavi

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Although seems to be ultra-conservative, it has recently been suggested that whenever it is possible, pregnant women should postpone dental amalgam restorations to avoid the toxic effect of mercury on the foetus. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. As a strong positive correlation between maternal and cord blood mercury levels has been found in some studies, our findings regarding the effect of exposure to electromagnetic fields on the release of mercury from dental amalgam fillings lead us to this conclusion that pregnant women with dental amalgam fillings should limit their exposure to electromagnetic fields to prevent toxic effects of mercury in their foetuses.

Keywords: pregnancy, foetus, mercury release, dental amalgam, electromagnetic fields, MRI, mobile phones

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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Authors: Mae Genevieve G. Cheung, Michael G. Cuevas, Lovely Fe L. Cuison, Elijin P. Dai, Katrina Marie S. Duron, Azalea Damaris E. Encarnacion, May T. Magtoto, Gina C. Castro

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The present study aims to evaluate the effectiveness of aqueous and ethanolic leaf extracts of Blumea balsamifera in reducing obesity on diet-induced obese Sprague-Dawley rats. Aqueous and ethanolic leaf extracts were obtained by maceration and percolation, respectively, of air-dried, grinded leaves. The test animals were given a high fat diet (HFD) for 21 days, except for one negative control group fed with a standard diet (SD). The Blumea balsamifera extracts were given at doses of 300 mg/Kg and 600 mg/Kg for BBAE and BBEE groups, and the positive control group, Orlistat, was given at 21.6 mg/Kg dose. After 24 days of treatment, the statistical difference of parameters such as Lee’s index and lipid profile of each group before and after the treatment period were determined separately using Tukey’s test of two-way Analysis of Variance (ANOVA). The statistical results showed that the600mg/kg dose of BBAE and BBEE had greatly lowered the Lee’s index among the other doses while the 300 mg/Kg dose BBEE, 600 mg/Kg BBAE, and 300 mg/kg BBAE lowered the total cholesterol level, LDL level, and VLDL and total triglyceride level respectively. The extracts, however, lowered the HDL level which was also exhibited by the standard drug, Orlistat.

Keywords: adipocytes, adipogenesis, Blumea balsamifera, Lee’s index, obesity, Sambong

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Authors: Saranchuluun Otgon, Sugarmaa Myagmarjav, Khorolsuren Lkhagvasuren, Fabio Casati

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Background: Flourishing is a eudaimonic dimension of psychological well-being that has been associated with positive social and health-related outcomes. Determining the factors associated with health and well-being is important to the development of evidence-based intervention programs, policies, and action plans targeting the older adult population, especially in low- and middle-income countries, such as Mongolia, where evidence-based research on aging, health, and well-being is still scarce. This study makes important contributions to the study of well-being in later age and also to policy activities for the older population in Mongolia. Methods: We employed multiple regression models to predict the factors of flourishing using data from 304 older adults living in urban and rural Mongolia. Data is collected by the standardized and validated questionnaire adopted by Ed Diener. Results: The median score of the flourishing of urban and rural older adults in Mongolia was significantly different, 53 and 50, respectively. The sex (β = 2.52,p = 0.034), level of education(β = 0.94, p = 0.026), receive help for the activity of daily living (β = 2.16, p = 0.022) determine the flourishing of older adults living in a rural area, while self-reported health (β = 0.94, p = 0.026), the number of social activities, friends network determine to flourish of older adults living urban area. Conclusion: Older adults who live in urban areas have more psychological resources and strengths than those in rural areas. Determinants of flourishing are different in different settings. For instance, individual and family factors determine flourishing in rural areas, and social ties determine flourishing in urban areas.

Keywords: flourishing, predictors, older adults, Mongolia, psychological well-being

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Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

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Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Bahram Asghari Aghdam, Ali Mahjoub

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The purpose of this study is to evaluate the effect of emotional intelligence on the motivation and performance of East Azarbaijan the Red Crescent staff. In this study, EI is determined as the independent variable component of self awareness, self management, social awareness, and relations management, motivation and performance as dependent variables. The research method is descriptive-survey. In this study, simple random sampling method is used and research sample consists of 130 East Azarbaijan the Red Crescent staff that uses Cochran's formula 100 of them were selected and questionnaires were filled by them. Three types of questionnaires were used in this study for emotional intelligence, consisting of the Bradbury Travis and Jane Greaves standard questionnaire; and for motivation and performance a questionnaire is regulated by the researcher with help of professionals and experts in this field that consists of 33 questions about the motivation and 15 questions about performance and content validity were used to obtain the necessary credit. Reliability by using the Cronbach's alpha coefficient /948 was approved. Also, in this study to test the hypothesis of the Spearman correlation coefficient and linear regressions and determine fitness of variables' of structural equation modeling is used. The results show that emotional intelligence with coefficient /865, motivation and performance of in East Azerbaijan the Red Crescent employees has a positive effect. Based on Friedman Test ranking the most influence in motivation and performance of staff in respondents' opinion is in order of self-awareness, relations management, social awareness and self-management.

Keywords: emotional intelligence, self-awareness, self-management, social awareness, relations management, motivation, performance

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Authors: Sanusi Abubakar Sadiq, Rebecca William Chiwar

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Wildlife Park stands a chance of contributing to tourism development in different ways, but available infrastructure, and facilities required by visitors when they arrive, access road to the destination, and resources to facilitate positive experience are lacking in certain areas. The study set out to find out the need to develop Sumu Wildlife Park Bauchi State, to an international standard. The study focused on identifying the existing facilities and infrastructure at the park and to further identify the available resources used by visitors. In attempt to find out the impact of developing Sumu Wildlife Park and ways of filling the gap of the actual standard data were obtained from fifteen administrative staff of Sumu Wildlife Park, ten staff of Bauchi state Tourism Board and twenty-five residents of the community in Kafin Madaki, Bauchi. Relevant literature were reviewed in the study; data collected were organized and analyzed using Statistical Package of Social Sciences (SPSS), software for analysis. Findings revealed that though Sumu Wildlife Park has attractions to keep visitors patronage but has insufficient facilities to maintain visitors and has not been developed to an expected standard. The problem faced by the management of Sumu wildlife Park is lack of adequate facilities, infrastructure and resources. The need to develop Sumu Wildlife Park has enormous benefits in increasing patronage. Provision of more funds would help improve standard as there would be more activities within and around the park. Regular maintenance of those facilities protects the life span of the park.

Keywords: attractions, facilities, infrastructure, resources

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Authors: Debalkie Demissie Addisu, Ejigu Alemu Abebe, Tsegay Tensay Assefa

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This study examines the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics moderated by political skill. This study reports the responses of 321 respondents from six federal public service organizations in Ethiopia. A multi-stage random sampling procedure was employed to select the sampled federal public service organizations. To test hypotheses, the study employed structural equation modeling using AMOS version-26 software. The result revealed that all direct effects have a significant effect. Specifically, servant leadership has a positive effect on organizational citizenship behavior. Likewise, servant leadership has a negative effect on perceptions of organizational politics. Also, a perception of organizational politics has a negative effect on organizational citizenship behavior. Moreover, perceptions of organizational politics competitively mediated the effect of servant leadership on organizational citizenship behavior. As well, political skill moderated the effect of perceptions of organizational politics on organizational citizenship behavior but not the indirect effect. To the best of our knowledge, no one else employs perceptions of organizational politics as a mediating effect between servant leadership and organizational citizenship behavior. Furthermore, we are not aware of anyone else employing political skill as a moderating role in the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics.

Keywords: servant leadership, organizational citizenship behavior, perceptions of organizational politics, political skill, public service organization, Ethiopia

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Authors: İsmail Seçer, Taştan Seçer

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In this study, the effect of the group counseling on the victimhood perceptions of the primary school 7th and 8th grade students who are determined to be the subject of peer victimization and their dealing way with it was analyzed. The research model is Solomon Four Group Experimental Model. In this model, there are four groups that were determined with random sampling. Two of the groups have been used as experimental group and the other two have been used as control group. Solomon model is defined as real experimental model. In real experimental models, there are multiple groups consisting of subject which have similar characteristics, and selection of the subjects is done with random sampling. For this purpose, 230 students from Kültür Kurumu Primary School in Erzurum were asked to fill Adolescent Peer Victim Form. 100 students whose victim scores were higher and who were determined to be the subject of bullying were talked face to face and informed about the current study, and they were asked if they were willing to participate or not. As a result of these interviews, 60 students were determined to participate in the experimental study and four group consisting of 15 people were created with simple random sampling method. After the groups had been formed, experimental and control group were determined with casting lots. After determining experimental and control groups, an 11-session group counseling activity which was prepared by the researcher according to the literature was applied. The purpose of applying group counseling is to change the ineffective dealing ways with bullying and their victimhood perceptions. Each session was planned to be 75 minutes and applied as planned. In the control groups, counseling activities in the primary school counseling curricula was applied for 11 weeks. As a result of the study, physical, emotional and verbal victimhood perceptions of the participants in the experimental groups were decreased significantly compared to pre-experimental situations and to those in control group. Besides, it was determined that this change observed in the victimhood perceptions of the experimental group occurred independently from the effect of variables such as gender, age and academic success. The first evidence of the study related to the dealing ways is that the scores of the participants in the experimental group related to the ineffective dealing ways such as despair and avoidance is decreased significantly compared to the pre-experimental situation and to those in control group. The second evidence related to the dealing ways is that the scores of the participants in the experimental group related to effective dealing ways such as seeking for help, consulting social support, resistance and optimism is increased significantly compared to the pre-experimental situation and to those in control group. According to the evidence obtained through the study, it can be said that group counseling is an effective approach to change the victimhood perceptions of the individuals who are the subject of bullying and their dealing strategies with it.

Keywords: bullying, perception of victimization, coping strategies, ancova analysis

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Authors: Sanja Obradovic, Vladimir Stojanovic

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The purpose of this paper is to examine the attitudes of residents toward sustainable tourism development in the Bačko Podunavlje Biosphere Reserve (BPBR) in northwestern Serbia. BPBR is a part of 'the European Amazon', world's first five-country Transboundary UNESCO Biosphere Reserve 'Mura-Drava-Danube'. Sustainable tourism development requires the engagement of local residents. Within the initial stage of tourism development, it is important to address residents' attitudes from the early beginning, thus further involve the local community through all phases of development, which in return will largely influence overall success. Data were collected through in-person (face-to-face) questionnaire. The research also addresses the quality of the sustainable tourism attitude scale (SUS-TAS), perceived as an instrument to measure local communities' attitudes towards sustainable tourism development. SUS-TAS has seven variables, which are named as environmental sustainability, perceived social cost, long-term planning, perceived economic benefit, community center economy, ensuring visitor satisfaction, and maximizing community participation. Data were analyzed using SPSS. Findings indicate that residents have a positive attitude toward the development of sustainable tourism in the BPBR. They also recognized the importance of environmental sustainability and preservation for future generations. The study shows that BPBR has a very good community to support sustainable tourism activities in each area considered.

Keywords: biosphere reserve, local resident's attitude, sustainable tourism attitude scale, SUS-TAS, sustainable tourism

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Authors: Kalu Uka Orji, Nasiman Sapari, Khamaruzaman W. Yusof

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Exposure of galena (PbS), tealite (PbSnS2), and other associated minerals during mining activities release lead (Pb) and other heavy metals into the mining water through oxidation and dissolution. Heavy metal pollution has become an environmental challenge. Lead, for instance, can cause toxic effects to human health, including brain damage. Ex-mining pond water was reported to contain lead as high as 69.46 mg/L. Conventional treatment does not easily remove lead from water. A promising and emerging treatment technology for lead removal is the application of the electrocoagulation (EC) process. However, some of the problems associated with EC are systematic reactor design, selection of maximum EC operating parameters, scale-up, among others. This study investigated an EC process for the removal of lead from synthetic ex-mining pond water using a batch reactor and Fe electrodes. The effects of various operating parameters on lead removal efficiency were examined. The results obtained indicated that the maximum removal efficiency of 98.6% was achieved at an initial PH of 9, the current density of 15mA/cm2, electrode spacing of 0.3cm, treatment time of 60 minutes, Liquid Motion of Magnetic Stirring (LM-MS), and electrode arrangement = BP-S. The above experimental data were further modeled and optimized using a 2-Level 4-Factor Full Factorial design, a Response Surface Methodology (RSM). The four factors optimized were the current density, electrode spacing, electrode arrangements, and Liquid Motion Driving Mode (LM). Based on the regression model and the analysis of variance (ANOVA) at 0.01%, the results showed that an increase in current density and LM-MS increased the removal efficiency while the reverse was the case for electrode spacing. The model predicted the optimal lead removal efficiency of 99.962% with an electrode spacing of 0.38 cm alongside others. Applying the predicted parameters, the lead removal efficiency of 100% was actualized. The electrode and energy consumptions were 0.192kg/m3 and 2.56 kWh/m3 respectively. Meanwhile, the adsorption kinetic studies indicated that the overall lead adsorption system belongs to the pseudo-second-order kinetic model. The adsorption dynamics were also random, spontaneous, and endothermic. The higher temperature of the process enhances adsorption capacity. Furthermore, the adsorption isotherm fitted the Freundlish model more than the Langmuir model; describing the adsorption on a heterogeneous surface and showed good adsorption efficiency by the Fe electrodes. Adsorption of Pb2+ onto the Fe electrodes was a complex reaction, involving more than one mechanism. The overall results proved that EC is an efficient technique for lead removal from synthetic mining pond water. The findings of this study would have application in the scale-up of EC reactor and in the design of water treatment plants for feed-water sources that contain lead using the electrocoagulation method.

Keywords: ex-mining water, electrocoagulation, lead, adsorption kinetics

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Authors: Aditya Manna, Lalit Kumar Khanra, Shyamal Kumar Sarkar

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Introduction: Here in India almost 75% of cancer patient die a sad death of neglect due to lack of awareness about palliative care and low economic level. Surveys in India show that two third of cancer patient do not get proper care during the terminal phase of their life. Palliative care through volunteers can make a significant difference in this respect. Objective: To identify and try to solve, to the extent possible, the main difficulties in giving palliative care to the terminal cancer patients of the area. And evaluate the impact of volunteer’s direct care of palliative patients and their families. Methods: Feedback from patients and their relatives regarding the palliative care they receive from nursing home and from volunteers and compare the two. Also feedback from volunteers regarding their positive and negative experience while delivering palliative care service. Then evaluate the data to compare and improve the quality of service. Results: We carried out two studies. One study was undertaken in nursing home palliative care and another was in home setting by volunteers. Both studies were in adult palliative care services. Since January 2015, 496 cases were studied to enquire about their experience in both home based care and nursing home care. Both the studies fulfilled our quality appraisal criteria. One found that those families and patients who received home visits from volunteers were significantly more satisfied. The study highlighted the value of the role of volunteers in better satisfaction of patients and their families. Conclusions: Further research is needed to evaluate the role of volunteers in palliative care and how it can be delivered appropriately and effectively. We also wish to compare our findings with similar studies elsewhere.

Keywords: palliative care, terminal care, cancer, home care

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Authors: Pedro G. Morouço

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One utmost challenge in Tissue Engineering is the production of 3D constructs capable of mimicking the functional hierarchy of native tissues. This is well stated for osteochondral tissue due to the complex mechanical functional unit based on the junction of articular cartilage and bone. Thus, the aim of the present study was to develop a new additive manufacturing system coupling micro-extrusion with hydrogels printing. An integrated system was developed with 2 main features: (i) the printing of up to three distinct hydrogels; (ii) in coordination with the printing of a thermoplastic structural support. The hydrogel printing module was projected with a ‘revolver-like’ system, where the hydrogel selection was made by a rotating mechanism. The hydrogel deposition was then controlled by pressured air input. The use of specific components approved for medical use was incorporated in the material dispensing system (Nordson EDF Optimum® fluid dispensing system). The thermoplastic extrusion modulus enabled the control of required extrusion temperature through electric resistances in the polymer reservoir and the extrusion system. After testing and upgrades, a hydrogel modulus with 3 syringes (3cm3 capacity each), with a pressure range of 0-2.5bar, a rotational speed of 0-5rpm, and working with needles from 200-800µm was obtained. This modulus was successfully coupled to the extrusion system that presented a temperature up to 300˚C, a pressure range of 0-12bar, and working with nozzles from 200-500µm. The applied motor could provide a velocity range 0-2000mm/min. Although, there are distinct printing requirements for hydrogels and polymers, the novel system could develop hybrid scaffolds, combining the 2 moduli. The morphological analysis showed high reliability (n=5) between the theoretical and obtained filament and pore size (350µm and 300µm vs. 342±4µm and 302±3µm, p>0.05, respectively) of the polymer; and multi-material 3D constructs were successfully obtained. Human tissues present very distinct and complex structures regarding their mechanical properties, organization, composition and dimensions. For osteochondral regenerative medicine, a multiphasic scaffold is required as subchondral bone and overlying cartilage must regenerate at the same time. Thus, a scaffold with 3 layers (bone, intermediate and cartilage parts) can be a promising approach. The developed system may give a suitable solution to construct those hybrid scaffolds with enhanced properties. The present novel system is a step-forward regarding osteochondral tissue engineering due to its ability to generate layered mechanically stable implants through the double-printing of hydrogels with thermoplastics.

Keywords: 3D bioprinting, bone regeneration, cartilage regeneration, regenerative medicine, tissue engineering

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Authors: Samhani Ismail, Tahamina Begum, Faruque Reza, Zamzuri Idris, Hafizan Juahir, Jafri Malin Abdullah

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Holy Quran, a rhymed prosed scripture has a complete literary structure that exemplifies the peak of literary beauty. Memorizing of its verses could enhance one’s memory capacity and cognition while those who are listening to its recitation it is also believed that the Holy Quran alter brainwave producing neuronal excitation engaging with cognitive processes. 28 normal healthy subjects (male =14 & female = 14) were recruited and EEG recording was done using 128-electrode sensor net (Electrical Geosics, Inc.) with the impedance of ≤ 50kΩ. They listened to Sura Fatiha recited by Sheikh Qari Abdul Basit bin Abdus Samad. Arabic news and no sound were chosen as positive and negative control, respectively. The waveform was analysed by Fast Fourier Transform (FFT) to get the power in frequency bands. Bilateral frontal (F7, F8) and temporal region (T7, T8) showed decreased power significantly in alpha wave band in respondent stimulated by Sura Fatihah recitation reflects acoustic attention processing. However, decreased in alpha power in selective attention to memorized, and in familial but not memorized language, reveals the memorial processing in long-term memory. As a conclusion, Quranic recitation relates both cognitive element of memory and language in its listeners and memorizers.

Keywords: auditory stimulation, cognition, EEG, linguistic, memory, Quranic recitation

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Authors: Jelena S. Kiurski, Vesna S. Kecić, Snežana M. Aksentijević

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The identification and evaluation of organic and inorganic pollutants were performed in a flexographic facility in Novi Sad, Serbia. Air samples were collected and analyzed in situ, during 4-hours working time at five sampling points by the mobile gas chromatograph and ozonometer at the printing of collagen casing. Experimental results showed that the concentrations of isopropyl alcohol, acetone, total volatile organic compounds and ozone varied during the sampling times. The highest average concentrations of 94.80 ppm and 102.57 ppm were achieved at 200 minutes from starting the production for isopropyl alcohol and total volatile organic compounds, respectively. The mutual dependences between target hazardous and microclimate parameters were confirmed using a multiple linear regression model with software package STATISTICA 10. Obtained multiple coefficients of determination in the case of ozone and acetone (0.507 and 0.589) with microclimate parameters indicated a moderate correlation between the observed variables. However, a strong positive correlation was obtained for isopropyl alcohol and total volatile organic compounds (0.760 and 0.852) with microclimate parameters. Higher values of parameter F than F_critical for all examined dependences indicated the existence of statistically significant difference between the concentration levels of target pollutants and microclimates parameters. Given that, the microclimate parameters significantly affect the emission of investigated gases and the application of eco-friendly materials in production process present a necessity.

Keywords: flexographic printing, indoor air, multiple regression analysis, pollution emission

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Authors: Bang Haeyong

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Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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Authors: A. M. Isakhanyan, F. N. Tkhruni, N. N. Yakimovich, Z. I. Kuvaeva, T. V. Khachatryan

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Introduction: At present, the simbiotics based on different genera and species of lactic acid bacteria (LAB) and yeasts are used. One of the basic properties of probiotics is presence of antimicrobial activity and therefore selection of LAB and yeast strains for their co-cultivation with the aim of increasing of the activity is topical. Since probiotic yeast and bacteria have different mechanisms of action, natural synergies between species, higher viability and increasing of antimicrobial activity might be expected from mixing both types of probiotics. Endemic strains of LAB Enterococcus faecium БТK-64, Lactobaccilus plantarum БТK-66, Pediococcus pentosus БТK-28, Lactobacillus rhamnosus БТK-109 and Kluyveromyces lactis БТX-412, Saccharomycopsis sp. БТX- 151 strains of yeast, with probiotic properties and hight antimicrobial activity, were selected. Strains are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB and yeast strains were isolated from different dairy products from rural households of Armenia. The genotyping by 16S rRNA sequencing for LAB and 26S RNA sequencing for yeast were used. Combined cultivation of LAB and yeast strains was carried out in the nutrient media on the basis of milk whey, in anaerobic conditions (without shaker, in a thermostat at 37oC, 48 hours). The complex preparations were obtained by purification of cell free culture broth (CFC) broth by the combination of ion-exchange chromatography and gel filtration methods. The spot-on-lawn method was applied for determination of antimicrobial activity and expressed in arbitrary units (AU/ml). Results. The obtained data showed that at the combined growth of bacteria and yeasts, the cultivation conditions (medium composition, time of growth, genera of LAB and yeasts) affected the display of antimicrobial activity. Purification of CFC broth allowed obtaining partially purified antimicrobial complex preparation which contains metabiotics from both bacteria and yeast. The complex preparation inhibited the growth of pathogenic and conditionally pathogenic bacteria, isolated from various internal organs from diseased animals and poultry with greater efficiency than the preparations derived individually alone from yeast and LAB strains. Discussion. Thus, our data shown perspectives of creation of a new class of antimicrobial preparations on the basis of combined cultivation of endemic strains of LAB and yeast. Obtained results suggest the prospect of use of the partially purified complex preparations instead antibiotics in the agriculture and for food safety. Acknowledgments: This work was supported by the RA MES State Committee of Science and Belarus National Foundation for Basic Research in the frames of the joint Armenian - Belarusian joint research project 13РБ-064.

Keywords: co-cultivation, antimicrobial activity, biosafety, metabiotics, lactic acid bacteria, yeast

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Authors: Akbarov Elbek Elmurodovich

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Introduction: We are analyzing the topic of hemolytic anemia observed in patients after COVID-19 infection. The purpose of this research is to investigate the development of hemolytic anemia, identify its causes, and study treatment methods. Objective and Task: The goal of our research is to analyze the changes in blood occurring after COVID-19 infection and study the development of hemolytic anemia. Our main task is to analyze the results and assess subsequent changes in patients. Materials and Methods: The study was conducted among patients treated with a diagnosis of COVID-19 in the Department of Infectious Diseases at the TTA 1-Multiprofile Clinic from March to August 2023. Out of the 32 patients included, 16 were female, and 16 were male. Monitoring Blood Coagulation in Patients: The hemoglobin level of patients upon admission was initially measured using the URITEST-150 analyzer. The average for women was 110 g/l, and for men was 120 g/l. Over the course of 3 months, a decrease was observed: an average of 72 g/l in women (a decrease of up to 35%) and 84 g/l in men (a decrease of up to 30%). In the next 2 months, the positive dynamics of hemoglobin levels were observed, with an average increase to 93 g/l in women (>28%) and 112 g/l in men (>25%). Research Results: Hemolytic anemia developed in men within 5 months, reaching up to 112 g/l. In women, this process required a longer period, with the last month of observation (6 months) showing that women reached levels of up to 112 g/l, similar to men. Conclusion: Hemolytic anemia observed in patients after COVID-19 infection was monitored for 6 months (5 months in men, 6 months in women), reaching up to 112 g/l. The first 3 months after contracting COVID showed the period of development of anemia, and the subsequent 3 months indicated a stabilization period in patients.

Keywords: COVID, anemia, hemoglobin, tma, virus, viral infrection

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Authors: Mohit Taneja, Ravi Kiran, S. C. Bose

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Entrepreneurs’ role in achieving Sustainable development goals is crucial as the growth potential of any region depends upon the number and the success rate of entrepreneurial firms. This paper is an effort to examine the relationship between Sustainable growth (SG) with Entrepreneurial attitude (EA) and Entrepreneurial intention (EI) in the context of the Indian economy. The mediation effect of EI between EA and SG has been considered. Partial least square (PLS) –Structural Equation Model (SEM) software was used to design the framework. Students enrolled in entrepreneurship courses of higher educational institutes (HEI) of Punjab, Haryana, and the National Capital Region NCR were contacted for data collection. The National Institutional Ranking Framework (NIRF) framework was used in selecting HEIs and data collected from 589 students was considered for analysis. McGee’s multi-dimensional scale for measuring ESE and the scale of Linan & Chen for measuring EI & ES (SG) was used. Results highlight that EA has a strong impact on EI (p≤ 0.001) and EI has a positive and strong relationship with SG (ES) as β value for the same is 0.683 (p≤ 0.001). The current study also reflects the mediating effect of EI among EA and ES, as the results show that the combined β value of both EA and EI (i.e.0.684*0.683= 0.467) is more than the direct influence of EA on ES (β=0.265). EA, with the mediating effect of EI can enhance the opportunity for achieving SG, which suggests that in order to increase the venture success rate and to attain SG, emphasis should be given to EI along with EA. The study has been investigated in three regions of India. Future studies can be extended to other South Asian countries for generalization.

Keywords: entrepreneurship, sustainable growth, entrepreneurship intention, entrepreneurship attitude

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Authors: Praveenkumar Natarajan

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A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

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Authors: Vlad Andrei Raducanu, Mariana Lucia Angelescu, Ion Cinca, Vasile Danut Cojocaru, Doina Raducanu

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By using smart digital tools, such as generative design (GD) and digital fabrication (DF), problems of high actuality concerning resources optimization (materials, energy, time) can be solved and applications or products of free-form type can be created. In the new digital technology materials are active, designed in response to a set of performance requirements, which impose a total rethinking of old material practices. The article presents the design procedure key steps of a free-form architectural object - a column type one with connections to get an adaptive 3D surface, by using the parametric design methodology and by exploiting the properties of conventional metallic materials. In parametric design the form of the created object or space is shaped by varying the parameters values and relationships between the forms are described by mathematical equations. Digital parametric design is based on specific procedures, as shape grammars, Lindenmayer - systems, cellular automata, genetic algorithms or swarm intelligence, each of these procedures having limitations which make them applicable only in certain cases. In the paper the design process stages and the shape grammar type algorithm are presented. The generative design process relies on two basic principles: the modeling principle and the generative principle. The generative method is based on a form finding process, by creating many 3D spatial forms, using an algorithm conceived in order to apply its generating logic onto different input geometry. Once the algorithm is realized, it can be applied repeatedly to generate the geometry for a number of different input surfaces. The generated configurations are then analyzed through a technical or aesthetic selection criterion and finally the optimal solution is selected. Endless range of generative capacity of codes and algorithms used in digital design offers various conceptual possibilities and optimal solutions for both technical and environmental increasing demands of building industry and architecture. Constructions or spaces generated by parametric design can be specifically tuned, in order to meet certain technical or aesthetical requirements. The proposed approach has direct applicability in sustainable architecture, offering important potential economic advantages, a flexible design (which can be changed until the end of the design process) and unique geometric models of high performance.

Keywords: parametric design, algorithmic procedures, free-form architectural object, sustainable architecture

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Authors: Jennifer Bradley

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With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.

Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support

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Authors: Laurentius J. M. Rumokoy, Jimmy Posangi, Wisje Lusia Toar, Julio Lopez Aban

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The threat of pathogen infection agents to the neonates is a major health problem to the new born life livestock. Neonate losses became an important case in the world as well as in Indonesia. This condition can be triggered by an infection with nematode in conjunction with a failure of immunoglobulin passive transfer. The study was conducted to evaluate the role of the curcuma combined with IgG colostrum on the development of parasites in the gut of CD1 mice. Animal experiments were divided in four groups (G) based on the treatment: G1 (infection only); G2 (curcuma+infection), G3 (IgG + infection) and G4 (curcuma+IgG+infection). The parameters measured were EPG (eggs per gram) and female in the intestine. The results obtained showed that the treatment has no a significant influence on the number of eggs per gram of feces in the group infected compared to the control group without receiving IgG nor curcuma. However, the EGP response tended to decrease at day 6 in G3 and G4 with a minimum number at zero eggs. This performant showed that the immunoglobulin-G and curcuma substances could slightly decreased the number of eggs in animal infected with Strongyloides. The results obtained showed also that the treatment has no significant difference (P > 0.05) on female larva in the gut of MCD1 experimental. In other side, we found that the best performance to inhibit the female quantity in the gut was the treatment with IgG and infection of parasite in G3. In this treatment, the minimum number was five female only in the gut. The results described IgG response was better than the curcuma single use in reducing the female parasite in the gut. This positive response of IgG compared to other controls group was associated with the function of colostrum antibodies.

Keywords: parasites, livestock, curcuma, colostrums

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Authors: Zhihua Cao, Hongfei Zhao, Zhongneng Wu

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The development of polar-based agroforestry was necessary due to the influence of the timber market environment in China, which can promote the coordinated development of forestry and agriculture, and gain remarkable ecological, economic and social benefits. The main agroforestry models of the main poplar planting area in Huaibei plain and along the Yangtze River plain were carried out. 11 typical management models of poplar were selected to sum up: pure poplar forest, poplar-rape-soybean, poplar-wheat-soybean, poplar-rape-cotton, poplar-wheat, poplar-chicken, poplar-duck, poplar-sheep, poplar-Agaricus blazei, poplar-oil peony, poplar-fish, represented by M0-M10, respectively. 12 indexes related with economic, ecological and social benefits (annual average cost, net income, ratio of output to investment, payback period of investment, land utilization ratio, utilization ratio of light energy, improvement and system stability of ecological and production environment, product richness, labor capacity, cultural quality of labor force, sustainability) were screened out to carry on the comprehensive evaluation and analysis to 11 kinds of typical agroforestry models based on analytic hierarchy process (AHP). The results showed that the economic benefit of each agroforestry model was in the order of: M8 > M6 > M9 > M7 > M5 > M10 > M4 > M1 > M2 > M3 > M0. The economic benefit of poplar-A. blazei model was the highest (332, 800 RMB / hm²), followed by poplar-duck and poplar-oil peony model (109, 820RMB /hm², 5, 7226 RMB /hm²). The order of comprehensive benefit was: M8 > M4 > M9 > M6 > M1 > M2 > M3 > M7 > M5 > M10 > M0. The economic benefit and comprehensive benefit of each agroforestry model were higher than that of pure poplar forest. The comprehensive benefit of poplar-A. blazei model was the highest, and that of poplar-wheat model ranked second, while its economic benefit was not high. Next were poplar-oil peony and poplar-duck models. It was suggested that the model of poplar-wheat should be adopted in the plain along the Yangtze River, and the whole cycle mode of poplar-grain, popalr-A. blazei, or poplar-oil peony should be adopted in Huaibei plain, northern Anhui. Furthermore, wheat, rape, and soybean are the main crops before the stand was closed; the agroforestry model of edible fungus or Chinese herbal medicine can be carried out when the stand was closed in order to maximize the comprehensive benefit. The purpose of this paper is to provide a reference for forest farmers in the selection of poplar agroforestry model in the future and to provide the basic data for the sustainable and efficient study of poplar agroforestry in Anhui province, eastern China.

Keywords: agroforestry, analytic hierarchy process (AHP), comprehensive benefit, model, poplar

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Authors: Haiying Zong, Yi Yuan, Pengcheng Li

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Cadmium (Cd), one of the toxic heavy metals, has high solubility and mobility in agricultural soils and is readily taken up by roots and transported to the vegetative and reproductive organs which can cause deleterious effects on crop yield and quality. Excess Cd in plants can interfere with many metabolic processes, such as photosynthesis, transpiration, respiration or nutrients homeostasis. Generally, the main methods to reduce Cd accumulation in plants are to decrease the concentration of Cd in the soil solution through reduction of Cd influx into the soil system, site selection, and management practices. However, these approaches can be very costly and consume a lot of energy Therefore, it is critical to develop effective approaches to reduce the Cd concentration in plants. It is proved that chitooligosaccharide (COS) can enhance the plant's tolerance to abiotic stress including drought stress, salinity stress, and toxic metal stress. However, so far little information is known about whether foliar application with COS modulates Cd-induced toxicity in plants. The metal detoxification processes of plants treated with COS also remain unclear. In this study, edible rape (Brassica rapa L.), one of the most widely consumed leafy vegetables, was selected as an experimental mode plant. The effect of foliar application with COS on reducing Cd accumulation in edible rape was investigated. Moreover, Cd subcellular distribution pattern in response to Cd stress in the rape plant sprayed with COS was further tested in order to explore the potential detoxification mechanisms in plants. The results demonstrated that spraying COS at different concentrations (25, 50,100 and 200 mg L-1) possess diverse functions including growth-promoting,chlorophyll contents-enhancing, malondialdehyde (MDA) level-decreasing in leaves, Cd2+ concentration-decreasingin shoots and roots of edible rape under Cd stress. In addition, it was found that COS can also dramatically improve superoxide dismutase (SOD) activity, catalase (CAT) activity and peroxidase (POX) activity of edible rape leaves. The relievingeffect of COS was related to theconcentration and COS with 50-100 mg L-1 displayed the best activity. Furtherly, theexperiments results exhibitedthat COS could decrease the proportion of Cd in the organelle fraction of leaves by 40.1% while enhance the proportion of Cd in the soluble fraction by 13.2% at the concentration of 50 mg L-1. The above results showed that COS may have thepotential to improve plant resistance to Cd via promoting antioxidant enzyme activities and altering Cd subcellular distribution. All the results described here open up a new way to study the protection role of COS in alleviating Cd tolerance and lay the foundation for future research about the detoxification mechanism at subcellular level.

Keywords: chitooligosaccharide, cadmium, edible rape (Brassica rapa L.), subcellular distribution

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Authors: Musthaya Patchanee

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The aim of this research is to study potential factors relating to the decision of return migration of Myanmar migrant workers in Prachuap Khiri Khan Province by conducting a random sampling of 400 people aged between 15-59 who migrated from Myanmar. The information collected through interviews was analyzed to find a percentage and mean using the Stepwise Multiple Regression Analysis. The results have shown that 33.25% of Myanmar migrant workers want to return to their home country within the next 1-5 years, 46.25%, in 6-10 years and the rest, in over 10 years. The factors relating to such decision can be concluded that the scale of the decision of return migration has a positive relationship with a statistical significance at 0.05 with a conformity with friends and relatives (r=0.886), a relationship with family and community (r=0.782), possession of land in hometown (r=0.756) and educational level (r=0.699). However, the factor of property possession in Prachuap Khiri Khan is the only factor with a high negative relationship (r=0.-537). From the Stepwise Multiple Regression Analysis, the results have shown that the conformity with friends and relatives and educational level factors are influential to the decision of return migration of Myanmar migrant workers in Prachuap Khiri Khan Province, which can predict the decision at 86.60% and the multiple regression equation from the analysis is Y= 6.744+1.198 conformity + 0.647 education.

Keywords: decision of return migration, factors of return migration, Myanmar migrant workers, Prachuap Khiri Khan Province

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Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

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Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

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