Search results for: evaluation of entrepreneurship education (EE) curriculum

Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: Mauricio E. Cruz, Ilse Cervantes, Manuel J. Fabela

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The evaluation of the maneuverability of road vehicles is generally carried out through the use of specialized computer programs due to the advantages they offer compared to the experimental method. These programs are based on purely geometric considerations of the characteristics of the vehicles, such as main dimensions, the location of the axles, and points of articulation, without considering parameters such as weight distribution and magnitude, tire properties, etc. In this paper, we address the problem of maneuverability in a semi-trailer truck to navigate urban streets, maneuvering yards, and parking lots, using the Ackerman principle to propose a kinematic model that, through geometric considerations, it is possible to determine the space necessary to maneuver safely. The model was experimentally validated by conducting maneuverability tests with an articulated vehicle. The measurements were made through a GPS that allows us to know the position, trajectory, and speed of the vehicle, an inertial motion unit (IMU) that allows measuring the accelerations and angular speeds in the semi-trailer, and an instrumented steering wheel that allows measuring the angle of rotation of the flywheel, the angular velocity and the torque applied to the flywheel. To obtain the steering angle of the tires, a parameterization of the complete travel of the steering wheel and its equivalent in the tires was carried out. For the tests, 3 different angles were selected, and 3 turns were made for each angle in both directions of rotation (left and right turn). The results showed that the proposed kinematic model achieved 95% accuracy for speeds below 5 km / h. The experiments revealed that that tighter maneuvers increased significantly the space required and that the vehicle maneuverability was limited by the size of the semi-trailer. The maneuverability was also tested as a function of the vehicle load and 3 different load levels we used: light, medium, and heavy. It was found that the internal turning radii also increased with the load, probably due to the changes in the tires' adhesion to the pavement since heavier loads had larger contact wheel-road surfaces. The load was found as an important factor affecting the precision of the model (up to 30%), and therefore I should be considered. The model obtained is expected to be used to improve maneuverability through a robust control system.

Keywords: articuled vehicle, experimental validation, kinematic model, maneuverability, semi-trailer truck

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Authors: Zeinabossadat Hosseini, Fateme Qorbani

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The universal community has suffered from the lack of a sustainable and prosperous civilization in the world, and human distance from religious doctrines exposes the civilization of society to decline and collapse. To build a sustainable Islamic civilization, it is essential to understand and strengthen the core foundations of this subject. Islam, which claims to be integral in ensuring human prosperity and the creation of a new Islamic civilization, it can only develop this civilization if it has the necessary foundations. On the other hand, the family is one of the most important and effective foundations for effective individual and community life, and according to the influential role of the family on human behavioral and cognitive domains, it is impossible to define and explain the development of Islamic civilization without regard to the family category. The family can be effective in this important matter through its direct and indirect role in the education of individuals, and its members have the highest interaction and impact on each other. Development of the teachings of Islam in the form of verses and traditions can guide people towards the Islamic lifestyle and thus Islamic civilization and the Pure life (Tayyibah life-Al-Nahl/97). This article provides a descriptive-analytical approach to the conclusion that modern Islamic civilization promises the prosperity of the world and the hereafter. It will bring peace and prosperity to the world as well as advancement, fight against poverty, unity, and solidarity of Muslims, preservation of human dignity, as well as the growth of spirituality. It can also be deduced that the foundations of Islamic civilization in Qur'anic Tayyibah life and in today's term, the Islamic lifestyle, can be identified and implemented in the family structure, And the components of this blissful life can be found in this focus. The Tayyibah life will be realized by relying on the right faith and practice, paying attention to the rulings, divine command mentioned in the verses, as well as the traditions, altruism, nurturing a commitment to the community.

Keywords: family, development of modern Islamic civilization, quranic lifestyle, Tayyibah life

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Authors: Nalan Hakime Nogay

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Childhood obesity is a significant health issue that is currently on the rise all over the world. In recent years, the relationship between childhood obesity and cardiovascular disease risk has been pointed out. The purpose of this study is to evaluate the relationship between some of the anthropometric indicators and blood lipid levels in adolescents. The present study has been conducted on a total of 252 adolescents -200 girls and 52 boys- within an age group of 12 to 18 years. Blood was drawn from each participant in the morning -after having fasted for 10 hours from the day before- to analyze their total cholesterol, HDL, LDL and triglyceride levels. Their body weight, height, waist circumference, subscapular skinfold thicknesses and triceps skinfold thicknesses measurements were taken and their individual waist/height ratios, BMI and body fat ratios were calculated. The blood lipid levels of the participants were categorized as acceptable, borderline and high in accordance with the 2011 Expert Panel Integrated Guidelines. The body fat ratios, total blood cholesterol and HDL levels of the girls were significantly higher than the boys whereas their waist circumference values were lower. The triglyceride levels, total cholesterol/HDL, LDL/HDL, triglyceride/HDL ratios of the group with the BMI ≥ 95 percentile ratio (the obese group) were higher than the groups that were considered to be overweight and normal weight as per their respective BMI values, while the HDL level of the obese group was lower; a fact that was found to be statistically significant. No significant relationship could be established, however, between the total blood cholesterol and LDL levels with their anthropometric measurements. The BMI, waist circumference, waist/height ratio, body fat ratio and triglyceride level of the group with the higher triglyceride level ( ≥ 130mg/dl) were found to be significantly higher compared to borderline (90-129 mg/dl) and the normal group (< 90 mg/dl). The BMI, waist circumference, waist/height ratio values of the group with the lower HDL level ( < 40 mg/dl) were significantly higher than the normal ( > 45 mg/dl) and borderline (40-45 mg/dl) groups. All of the anthropometric measurements of the group with the higher triglyceride/HDL ratio ( ≥ 3) were found to be significantly higher than that of the group with the lower ratio (< 3). Having a high BMI, waist/height ratio and waist circumference is related to low HDL and high blood triglyceride and triglyceride/HDL ratio. A high body fat ratio, on the other hand, is associated with a low HDL and high triglyceride/HDL ratio. Tackling childhood and adolescent obesity are important in terms of preventing cardiovascular diseases.

Keywords: adolescent, body fat, body mass index, lipid profile

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Authors: Hadjer Chellia

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The study explores the phenomenon of second language use in a migratory setting and uses the case of Algerian international students in Scotland, United Kingdom. The linguistic history of Algeria reveals that French language has a high status among the Algerians’ verbal repertoires and Algerian English students consider it as a language of prestige. With mobility of some of these students towards Scotland -in the guise of internationalization of higher education, mobility and exchange programs, the transition was deemed to bring more complexity to their pre-migratory linguistic repertoires and resulted into their French language- being endangered and threatened by a potential shift to English. The study employed semi-structured interviews among six Ph.D. ethnically related students, and the main aim behind that is to explore their current experiences with regards to French language use and to provide an account of the factors which assist in shifting to English as a second language instead. The six participants identified in interviews were further invited to focus group sessions based on an in-group interaction fashion to discuss different topics using heritage languages. This latter was opted for as part of the methodology as a means to observe their real linguistic practice and to investigate the link between behaviors and previous perceptions. The findings detect a variety of social, individual and socio-psychological factors that would contribute in refining the concept of language shift among newly established émigré communities with short stay vis a vis the linguistic outcomes of immigrants with long stay, across generational basis that was –to some extent-the focus of previous research on language shift. The results further reveal a mismatch between students' perceptions and observed behaviors. The research is then largely relevant to international students’ sociolinguistic experience of study abroad.

Keywords: complexity, mobility, potential shift, sociolinguistic experience

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Authors: S. O. Ayansina, R. A. Oyeyinka, K. K. Bolarinwa

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There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. This study was designed to examine farmers’ involvement in public and private extension services in southwestern Nigeria, specifically to explore the farmers’ participation in the two types of organizations involved. It also evaluates the performances of personnel in the organizations. A multi-stage random sampling technique was used to select 30 respondents from each of the three selected organizations in Ogun, Osun and Oyo states in Southwestern Nigeria. Data was collected with interview schedule and analyzed both at descriptive and inferential levels. Kruskal Wallis one-way Analysis of variance was used to test the differences between the participation of beneficiaries who are farmers under the public and private extension services and the level of benefit accrued to them from the various extension organizations involved in the study. Results revealed that private extension organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2 = 0.709) S no significant difference between farmers’ participation in the extension services of public and private organizations but however showed significant difference (X2 =12.074) in the benefits achieved by respondents in the two organizations. These include: increased quantity of crop produced, farm income, skill acquisition, and improved education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly privatization in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots in production, processing and marketing of agricultural produce.

Keywords: public and private involvement, extension services, farmers' participation

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Umporn Wutchana

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An open ended problem and unstructured interview had been used to explore students’ conceptual and procedural understanding of vector components. The open ended problem had been designed based on research instrument used in previous physics education research. Without physical context, we asked students to find out magnitude and draw graphical form of vector components. The open ended problem was given to 211 first year students of faculty of science during the third (summer) semester in 2014 academic year. The students spent approximately 15 minutes of their second time of the General Physics I course to complete the open ended problem after they had failed. Consequently, their responses were classified based on the similarity of errors performed in the responses. Then, an unstructured interview was conducted. 7 students were randomly selected and asked to reason and explain their answers. The study results showed that 53% of 211 students provided correct numerical magnitude of vector components while 10.9% of them confused and punctuated the magnitude of vectors in x- with y-components. Others 20.4% provided just symbols and the last 15.6% gave no answer. When asking to draw graphical form of vector components, only 10% of 211 students made corrections. A majority of them produced errors and revealed alternative conceptions. 46.5% drew longer and/or shorter magnitude of vector components. 43.1% drew vectors in different forms or wrote down other symbols. Results from the unstructured interview indicated that some students just memorized the method to get numerical magnitude of x- and y-components. About graphical form of component vectors, some students though that the length of component vectors should be shorter than those of the given one. So then, it could be combined to be equal length of the given vectors while others though that component vectors should has the same length as the given vectors. It was likely to be that many students did not develop a strong foundation of understanding in vector components but just learn by memorizing its solution or the way to compute its magnitude and attribute little meaning to such concept.

Keywords: graphical vectors, vectors, vector components, misconceptions, alternative conceptions

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Authors: Hurgesa Hundera, Samuel Shibeshibikeko, Tarike Daba, Tesfaye Ganamo

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The study aimed at examining the ongoing adaptation strategies used by smallholder farmers in response to climate variability in Boset district. It also assessed the socioeconomic factors that influence the choice of adaptation strategies of smallholder farmers to climate variability risk. For attaining the objectives of the study, both primary and secondary sources of data were employed. The primary data were obtained through a household questionnaire, key informant interviews, focus group discussions, and observations, while secondary data were acquired through desk review. Questionnaires were distributed and filled by 328 respondents, and they were identified through systematic random sampling technique. Descriptive statistics and binary logistic regression model were applied in this study as the main analytical methods. The findings of the study reveal that the sample households have utilized multiple adaptation strategies in response to climate variability, such as cropping early mature crops, planting drought resistant crops, growing mixed crops on the same farm lands, and others. The results of the binary logistic model revealed that education, sex, age, family size, off farm income, farm experience, access to climate information, access to farm input, and farm size were significant and key factors determining farmers’ choice of adaptation strategies to climate variability in the study area. To enable effective adaptation measures, Ministry of Agriculture and Natural Resource, with its regional bureaus and offices and concerned non–governmental organizations, should consider climate variability in their planning and budgeting in all levels of decision making.

Keywords: adaptation strategies, boset district, climate variability, smallholder farmers

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Authors: Susanne Manes, Anni Glaeser, Katharina Wick, Bernhard Strauss, Uwe Berger

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Introduction: Over the last decades growing rates of mental health concerns among children and adolescents have been observed. At the same time, physical well-being of children and adolescents becomes increasingly impaired as well. Schools play an important role in preventing mental and physical disorders and in promoting well-being. Self-esteem, as well as social integration, are vital influence factors for mental and physical well-being. The purpose of this study was to develop and evaluate the program 'VorteilJena' for secondary schools in Germany focusing on self-esteem and social integration to improve mental and physical well-being. Method: The school-based health promotion program was designed for students in 5th grade and higher. It consists of several short pedagogical exercises instructed by a teacher and were integrated into the regular class over the course of ten weeks. The exercises focused on fostering social integration using either tasks improving team spirit or exercises that increase tolerance and sense of belonging. Other exercises focused on strengthening the self-esteem of the students. Additionally, the program included a poster exhibition titled 'Belonging' which was put up in the school buildings. The exhibition comprised ten posters which addressed relevant risk factors and resources related to social integration and self-esteem. The study was a randomized controlled sequential study with a pre and post measurement conducted in ten German schools. A total of 1642 students (44% male) were recruited. Their age ranged from 9 to 21 years (M=12.93 years; SD= 2.11). The program was conducted in classes ranging from 5th to 12th grade. Results: The program improved wellbeing, self-esteem and social integration of the involved students compared to the control group. Differential effects depending on implementation rates or age of the students will be analyzed. Moreover, implications for future school-based health promotion programs targeting self-esteem and social integration will be discussed. Conclusion: Social integration considerably influences self-esteem and well-being of students and can be targeted by school-based programs including short and modest exercises. Since a sufficient implementation of health promotion programs is essential, the present program due to its practicability represents a good opportunity to install health promotion focusing on social integration in schools.

Keywords: social integration, well-being, health promotion in schools, self-esteem

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Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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Authors: Bibire Abdulkareem Hussein

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Job satisfaction and motivation are considered as major tools in sustaining institutional development, they are also the machinery used to achieve an institutional goals and objectives. However, it has been observed that some institutions failed in motivating and stimulating their workers; in contrast, workers may be motivated but not satisfied with the job and failed to perform efficiently and effectively. It is hoped that the study of this nature would be of significance value to all stakeholders in education specifically, lecturers in higher institutions in Nigeria. Also it significances will enhance lecturers’ effectiveness and performance in discharging their duties. It is against this backdrop that, this study investigated whether job satisfaction and motivation predict lecturers’ effectiveness in Nigeria Police Academy, Wudil, KanoState. The correlational research method was adopted for the study while purposive sampling technique was used to choose the institution and the sampled lectures (70). Simple random sampling technique was used to select one hundred cadets across the academy. Two instruments were used to elicit information from both lecturers and cadets. These were job satisfaction and motivation; and lecturers’ effectiveness Questionnaires. The instruments were subjected to pilot testing and found to have reliability coefficient of 0.69 and 0.71 respectively. The results of the study revealed that there was a significance relationship among job satisfaction, motivation and lecturers effectiveness in Nigeria Police Academy, Job satisfaction had a Beta weight (β) of .125, t = 3.253, p<0.05, Job motivation had a Beta weight (β) of .185, t = 3.849, p<0.05. There was a significance relationship between job satisfaction and lecturers’ effectiveness in Nigeria Police Academy the cal r is 0.21 while the crt r is 0.19. at p<0.05 and; there was a significance relationship between job motivation and lecturers effectiveness in Nigeria Police Academy the cal r is 0.20 while the crt r is 0.19 at p<0.05This study therefore concluded that there was a significance relationship among job satisfaction, motivation and lecturers effectiveness in Nigeria Police Academy s,In view of the findings of this study, the paper recommends that lecturers should be more pro-active and more effective in their primary assignment (teaching) in order to make meaningful impacts and inputs in the life of cadets and boost the standard of the academy. In the same vein, it is recommended that management should intensify efforts to improve lecturers’ welfares by providing more motivational techniques to enhance more productivity.

Keywords: academy, lecturers effectiveness, motivation, satisfaction

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Authors: Yogesh Rai, Saurabh Singh, Sanjay Pandey, Dhananjay K. Sah, B. G. Roy, B. S. Dwarakanath, Anant N. Bhatt

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One of the most common signatures of highly malignant gliomas is their capacity to metabolize more glucose to lactic acid than normal brain tissues, even under normoxic conditions (Warburg effect), indicating that aerobic glycolysis is constitutively upregulated through stable genetic or epigenetic changes. However, oxidative phosphorylation (OxPhos) is also required to maintain the mitochondrial membrane potential for tumor cell survival. In the process of tumorigenesis, tumor cells during fastest growth rate exhibit both high glycolytic and high OxPhos. Therefore, metabolically reprogrammed cancer cells with combination of both aerobic glycolysis and altered OxPhos develop a robust metabolic phenotype, which confers a selective growth advantage. In our study, we grew the high glycolytic BMG-1 (glioma) cells with continuous exposure of mitochondrial uncoupler 2, 4, dinitro phenol (DNP) for 10 passages to obtain a phenotype of high glycolysis with enhanced altered OxPhos. We found that OxPhos modified BMG (OPMBMG) cells has similar growth rate and cell cycle distribution but high mitochondrial mass and functional enzymatic activity than parental cells. In in-vitro studies, OPMBMG cells showed enhanced invasion, proliferation and migration properties. Moreover, it also showed enhanced angiogenesis in matrigel plug assay. Xenografted tumors from OPMBMG cells showed reduced latent period, faster growth rate and nearly five folds reduction in the tumor take in nude mice compared to BMG-1 cells, suggesting that robust metabolic phenotype facilitates tumor formation and growth. OPMBMG cells which were found radio-resistant, showed enhanced radio-sensitization by 2-DG as compared to the parental BMG-1 cells. This study suggests that metabolic reprogramming in cancer cells enhances the potential of migration, invasion and proliferation. It also strengthens the cancer cells to escape the death processes, conferring resistance to therapeutic modalities. Our data also suggest that combining metabolic inhibitors like 2-DG with conventional therapeutic modalities can sensitize such metabolically aggressive cancer cells more than the therapies alone.

Keywords: 2-DG, BMG, DNP, OPM-BMG

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: M. A. Hashem, I. Jahan

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The experiment was conducted to find out the effect of different levels of Pomegranate (Punica granatum) extract and synthetic antioxidant BHA (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs in order to make functional food. For this purpose, ground beef samples were divided into five treatment groups. They were treated as control group, 0.1% synthetic antioxidant group, 0.1%, 0.2% and 0.3% pomegranate extract group as T1, T2, T3, T4 and T5 respectively. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value (POV) and microbiological examination were determined in order to evaluate the effect of pomegranate extract as natural antioxidant and antimicrobial activities compared to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE and Ash content were decreased significantly (p<0.05) at different treatment levels. FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability decreased significantly (p<0.05) at different days of intervals. Raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels and at different days of intervals comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS value and microbial analysis it can be concluded that pomegranate extract at 0.1%, 0.2% and 0.3% can be used instead of synthetic antioxidant BHA in beef meatballs. On the basis of sensory evaluation, nutrient quality, physicochemical properties, biochemical analysis and microbial analysis 0.3% Pomegranate extract can be recommended for formulation of value added beef meatball enriched with natural antioxidant.

Keywords: antioxidant, pomegranate, BHA, value added meat products

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Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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Authors: Débora P. Jaeschke, Eduardo A. Merlo, Rosane Rech, Giovana D. Mercali, Ligia D. F. Marczak

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Carotenoids are high value added pigments that can be alternatively extracted from some microalgae species. However, the application of carotenoids synthetized by microalgae is still limited due to the utilization of organic toxic solvents. In this context, studies involving alternative extraction methods have been conducted with more sustainable solvents to replace and reduce the solvent volume and the extraction time. The aim of the present work was to evaluate the extraction time of carotenoids from the microalgae Heterochlorella luteoviridis using moderate electric field (MEF) as a pre-treatment to the extraction. The extraction methodology consisted of a pre-treatment in the presence of MEF (180 V) and ethanol (25 %, v/v) for 10 min, followed by a diffusive step performed for 50 min using a higher ethanol concentration (75 %, v/v). The extraction experiments were conducted at 30 °C and, to keep the temperature at this value, it was used an extraction cell with a water jacket that was connected to a water bath. Also, to enable the evaluation of MEF effect on the extraction, control experiments were performed using the same cell and conditions without voltage application. During the extraction experiments, samples were withdrawn at 1, 5 and 10 min of the pre-treatment and at 1, 5, 30, 40 and 50 min of the diffusive step. Samples were, then, centrifuged and carotenoids analyses were performed in the supernatant. Furthermore, an exhaustive extraction with ethyl acetate and methanol was performed, and the carotenoids content found for this analyses was considered as the total carotenoids content of the microalgae. The results showed that the application of MEF as a pre-treatment to the extraction influenced the extraction yield and the extraction time during the diffusive step; after the MEF pre-treatment and 50 min of the diffusive step, it was possible to extract up to 60 % of the total carotenoids content. Also, results found for carotenoids concentration of the extracts withdrawn at 5 and 30 min of the diffusive step did not presented statistical difference, meaning that carotenoids diffusion occurs mainly in the very beginning of the extraction. On the other hand, the results for control experiments showed that carotenoids diffusion occurs mostly during 30 min of the diffusive step, which evidenced MEF effect on the extraction time. Moreover, carotenoids concentration on samples withdrawn during the pre-treatment (1, 5 and 10 min) were below the quantification limit of the analyses, indicating that the extraction occurred in the diffusive step, when ethanol (75 %, v/v) was added to the medium. It is possible that MEF promoted cell membrane permeabilization and, when ethanol (75 %) was added, carotenoids interacted with the solvent and the diffusion occurred easily. Based on the results, it is possible to infer that MEF promoted the decrease of carotenoids extraction time due to the increasing of the permeability of the cell membrane which facilitates the diffusion from the cell to the medium.

Keywords: moderate electric field (MEF), pigments, microalgae, ethanol

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Authors: Brock Buckingham, Zhe Lin, Wenxuan Guo

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Accurate elevation data is critical in deriving topographic attributes for the precision management of crop inputs, especially water and nutrients. Traditional ground-based elevation data acquisition is time consuming, labor intensive, and often inconvenient at the field scale. Various unmanned aerial systems (UAS) provide the capability of generating digital elevation data from high-resolution images. The objective of this study was to compare the performance of two UAS with different global positioning system (GPS) receivers in determining elevation at the field scale. A DJI Phantom 4 Pro and a DJI Phantom 4 RTK(real-time kinematic) were applied to acquire images at three heights, including 40m, 80m, and 120m above ground. Forty ground control panels were placed in the field, and their geographic coordinates were determined using an RTK GPS survey unit. For each image acquisition using a UAS at a particular height, two elevation datasets were generated using the Pix4D stitching software: a calibrated dataset using the surveyed coordinates of the ground control panels and an uncalibrated dataset without using the surveyed coordinates of the ground control panels. Elevation values for each panel derived from the elevation model of each dataset were compared to the corresponding coordinates of the ground control panels. The coefficient of the determination (R²) and the root mean squared error (RMSE) were used as evaluation metrics to assess the performance of each image acquisition scenario. RMSE values for the uncalibrated elevation dataset were 26.613 m, 31.141 m, and 25.135 m for images acquired at 120 m, 80 m, and 40 m, respectively, using the Phantom 4 Pro UAS. With calibration for the same UAS, the accuracies were significantly improved with RMSE values of 0.161 m, 0.165, and 0.030 m, respectively. The best results showed an RMSE of 0.032 m and an R² of 0.998 for calibrated dataset generated using the Phantom 4 RTK UAS at 40m height. The accuracy of elevation determination decreased as the flight height increased for both UAS, with RMSE values greater than 0.160 m for the datasets acquired at 80 m and 160 m. The results of this study show that calibration with ground control panels improves the accuracy of elevation determination, especially for the UAS with a regular GPS receiver. The Phantom 4 Pro provides accurate elevation data with substantial surveyed ground control panels for the 40 m dataset. The Phantom 4 Pro RTK UAS provides accurate elevation at 40 m without calibration for practical precision agriculture applications. This study provides valuable information on selecting appropriate UAS and flight heights in determining elevation for precision agriculture applications.

Keywords: unmanned aerial system, elevation, precision agriculture, real-time kinematic (RTK)

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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Despite the advancement of radiation-free interventions in the gastrointestinal and hepatobiliary fields, endoscopy and endoscopic retrograde cholangiopancreatography (ERCP) remain indispensable procedures that necessitate radiation exposure. ERCP, in particular, relies heavily on radiation-guided imaging to ensure precise delivery of therapy. Meanwhile, interventional radiology (IR) procedures also utilize imaging modalities like X-rays and CT scans to guide therapy, often under local anesthesia via small needle insertion. However, the complexity of these procedures raises concerns about radiation exposure to healthcare professionals, including nurses, who play a crucial role in these interventions. This study aims to assess the radiation exposure to the hands and fingers of nurses 1 and 2, who are directly involved in ERCP procedures utilizing (TLD-100) dosimeters at the Gastrointestinal Endoscopy department of a clinic in Shiraz, Iran. The dosimeters were initially calibrated using various phantoms and then a group was prepared and used over a two-month period. For personal equivalent dose measurement, two TLD chips were mounted on a finger ring to monitor exposure to the hands and fingers. Upon completion of the monitoring period, the TLDs were analyzed using a TLD reader, showing that Nurse 1 received an equivalent dose of 298.26 µSv and Nurse 2 received an equivalent dose of 195.39 µSv. The investigation revealed that the total radiation exposure to the nurses did not exceed the annual limit for occupational exposure. Nevertheless, it is essential to prioritize radiation protection measures to prevent potential harm. The study showed that positioning staff members and placing two nurses in a specific location contributed to somehow equal doses. To reduce exposure further, we suggest providing education and training on radiation safety principles, particularly for technologists.

Keywords: dose measurement, ERCP, interventional radiology, medical imaging

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Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

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This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

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Authors: Konrad Pietrykowski, Michal Bialy, Pawel Karpinski, Radoslaw Maczka

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The nozzle is an element of the rocket engine in which the conversion of the potential energy of gases generated during combustion into the kinetic energy of the gas stream takes place. The design parameters of the nozzle have a decisive influence on the ballistic characteristics of the engine. Designing a nozzle assembly is, therefore, one of the most responsible stages in developing a rocket engine design. The paper presents the results of the simulation of three types of rocket propulsion nozzles. Calculations were made using CFD (Computational Fluid Dynamics) in ANSYS Fluent software. The next types of nozzles differ in shape. The analysis was made of a conical nozzle, a bell type nozzle with a conical supersonic part and a bell type nozzle. Calculation results are presented in the form of pressure, velocity and kinetic energy distributions of turbulence in the longitudinal section. The courses of these values along the nozzles are also presented. The results show that the cone nozzle generates strong turbulence in the critical section. Which negatively affect the flow of the working medium. In the case of a bell nozzle, the transformation of the wall caused the elimination of flow disturbances in the critical section. This reduces the probability of waves forming before or after the trailing edge. The most sophisticated construction is the bell type nozzle. It allows you to maximize performance without adding extra weight. The bell type nozzle can be used as a starter and auxiliary engine nozzle due to its advantages. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).

Keywords: computational fluid dynamics, nozzle, rocket engine, supersonic flow

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Authors: Sheng-Yu Lee

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Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

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Authors: Kumiko Inagaki

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In recent, years, Japanese universities have begun to face a dilemma: more than half of all high school graduates go on to attend an institution of higher learning, overwhelming Japanese universities accustomed to small student bodies. These universities have been forced to embrace qualitative changes to accommodate the increased number and diversity of students who enter their establishments, students who differ in their motivations for learning, their levels of eagerness to learn, and their perspectives on the future. One of these changes is an increase in awareness among Japanese educators of the importance of active learning, which deepens students’ understanding of course material through a range of activities, including writing, speaking, thinking, and presenting, in addition to conventional “passive learning” methods such as listening to a one-way lecture. 　The purpose of this study is to examine the effectiveness of the teaching method adapted to improve active learning. A teaching method designed to promote active learning was implemented in a social science course at one of the most popular universities in Japan. A questionnaire using a five-point response format was given to students in 2,305 courses throughout the university to evaluate the effectiveness of the method based on the following measures: ① the ratio of students who were motivated to attend the classes, ② the rate at which students learned new information, and ③ the teaching method adopted in the classes. The results of this study show that the percentage of students who attended the active learning course eagerly, and the rate of new knowledge acquired through the course, both exceeded the average for the university, the department, and the subject area of social science. In addition, there are strong correlations between teaching method and student motivation and between teaching method and knowledge acquisition rate. These results indicate that the active learning teaching method was effectively implemented and that it may improve student eagerness to attend class and motivation to learn.

Keywords: active learning, Japanese university, teaching method, university education

Procedia PDF Downloads 181

Authors: Christian Neunzig, Simon Fahle, Jürgen Schulz, Matthias Möller, Bernd Kuhlenkötter

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Digitalisation in production technology is a driver for the application of machine learning methods. Through the application of predictive quality, the great potential for saving necessary quality control can be exploited through the data-based prediction of product quality and states. However, the serial use of machine learning applications is often prevented by various problems. Fluctuations occur in real production data sets, which are reflected in trends and systematic shifts over time. To counteract these problems, data preprocessing includes rule-based data cleaning, the application of dimensionality reduction techniques, and the identification of comparable data subsets to extract stable features. Successful process control of the target variables aims to centre the measured values around a mean and minimise variance. Competitive leaders claim to have mastered their processes. As a result, much of the real data has a relatively low variance. For the training of prediction models, the highest possible generalisability is required, which is at least made more difficult by this data availability. The implementation of a machine learning application can be interpreted as a production process. The CRoss Industry Standard Process for Data Mining (CRISP-DM) is a process model with six phases that describes the life cycle of data science. As in any process, the costs to eliminate errors increase significantly with each advancing process phase. For the quality prediction of hydraulic test steps of directional control valves, the question arises in the initial phase whether a regression or a classification is more suitable. In the context of this work, the initial phase of the CRISP-DM, the business understanding, is critically compared for the use case at Bosch Rexroth with regard to regression and classification. The use of cross-process production data along the value chain of hydraulic valves is a promising approach to predict the quality characteristics of workpieces. Suitable methods for leakage volume flow regression and classification for inspection decision are applied. Impressively, classification is clearly superior to regression and achieves promising accuracies.

Keywords: classification, CRISP-DM, machine learning, predictive quality, regression

Procedia PDF Downloads 129

Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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Authors: Temesgen Sidamo, Prakruti S. Rao, Eleni Akllilu, Workineh Shibeshi, Yumi Park, Yong-Soon Cho, Jae-Gook Shin, Scott K. Heysell, Stellah G. Mpagama, Ephrem Engidawork

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The fluoroquinolones (FQs) are used off-label for the treatment of multidrug-resistant tuberculosis (MDR-TB), and for evaluation in shortening the duration of drug-susceptible TB in recently prioritized regimens. Within the class, levofloxacin (LFX) and moxifloxacin (MXF) play a substantial role in ensuring success in treatment outcomes. However, sub-therapeutic plasma concentrations of either LFX or MXF may drive unfavorable treatment outcomes. To the best of our knowledge, the pharmacokinetics of LFX and MXF in Ethiopian patients with MDR-TB have not yet been investigated. Therefore, the aim of this study was to develop a population pharmacokinetic (PopPK) model of levofloxacin (LFX) and moxifloxacin (MXF) and assess the percent probability of target attainment (PTA) as defined by the ratio of the area under the plasma concentration-time curve over 24-h (AUC0-24) and the in vitro minimum inhibitory concentration (MIC) (AUC0-24/MIC) in Ethiopian MDR-TB patients. Steady-state plasma was collected from 39 MDR-TB patients enrolled in the programmatic treatment course and the drug concentrations were determined using optimized liquid chromatography-tandem mass spectrometry. In addition, the in vitro MIC of the patients' pretreatment clinical isolates was determined. PopPK and simulations were run at various doses, and PK parameters were estimated. The effect of covariates on the PK parameters and the PTA for maximum mycobacterial kill and resistance prevention was also investigated. LFX and MXF both fit in a one-compartment model with adjustments. The apparent volume of distribution (V) and clearance (CL) of LFX were influenced by serum creatinine (Scr), whereas the absorption constant (Ka) and V of MXF were influenced by Scr and BMI, respectively. The PTA for LFX maximal mycobacterial kill at the critical MIC of 0.5 mg/L was 29%, 62%, and 95% with the simulated 750 mg, 1000 mg, and 1500 mg doses, respectively, whereas the PTA for resistance prevention at 1500 mg was only 4.8%, with none of the lower doses achieving this target. At the critical MIC of 0.25 mg/L, there was no difference in the PTA (94.4%) for maximum bacterial kill among the simulated doses of MXF (600 mg, 800 mg, and 1000 mg), but the PTA for resistance prevention improved proportionately with dose. Standard LFX and MXF doses may not provide adequate drug exposure. LFX PopPK is more predictable for maximum mycobacterial kill, whereas MXF's resistance prevention target increases with dose. Scr and BMI are likely to be important covariates in dose optimization or therapeutic drug monitoring (TDM) studies in Ethiopian patients.

Keywords: population PK, PTA, moxifloxacin, levofloxacin, MDR-TB patients, ethiopia

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Authors: Farzana Esmailkassam, Usakorn Kunanuvat, Zahraa Mohammed Ali

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Objective: The key barrier in Clozapine treatment of treatment-resistant schizophrenia (TRS) includes frequent bloods draws to monitor neutropenia, the main drug side effect. WBC and ANC monitoring must occur throughout treatment. Accurate WBC and ANC counts are necessary for clinical decisions to halt, modify or continue clozapine treatment. The CSAN Pronto point-of-care (POC) analyzer generates white blood cells (WBC) and absolute neutrophils (ANC) through image analysis of capillary blood. POC monitoring offers significant advantages over central laboratory testing. This study evaluated the performance of the CSAN Pronto against the Beckman DxH900 Hematology laboratory analyzer. Methods: Forty venous samples (EDTA whole blood) with varying concentrations of WBC and ANC as established on the DxH900 analyzer were tested in duplicates on three CSAN Pronto analyzers. Additionally, both venous and capillary samples were concomitantly collected from 20 volunteers and assessed on the CSAN Pronto and the DxH900 analyzer. The analytical performance including precision using liquid quality controls (QCs) as well as patient samples near the medical decision points, and linearity using a mix of high and low patient samples to create five concentrations was also evaluated. Results: In the precision study for QCs and whole blood, WBC and ANC showed CV inside the limits established according to manufacturer and laboratory acceptability standards. WBC and ANC were found to be linear across the measurement range with a correlation of 0.99. WBC and ANC from all analyzers correlated well in venous samples on the DxH900 across the tested sample ranges with a correlation of > 0.95. Mean bias in ANC obtained on the CSAN pronto versus the DxH900 was 0.07× 109 cells/L (95% L.O.A -0.25 to 0.49) for concentrations <4.0 × 109 cells/L, which includes decision-making cut-offs for continuing clozapine treatment. Mean bias in WBC obtained on the CSAN pronto versus the DxH900 was 0.34× 109 cells/L (95% L.O.A -0.13 to 0.72) for concentrations <5.0 × 109 cells/L. The mean bias was higher (-11% for ANC, 5% for WBC) at higher concentrations. The correlations between capillary and venous samples showed more variability with mean bias of 0.20 × 109 cells/L for the ANC. Conclusions: The CSAN pronto showed acceptable performance in WBC and ANC measurements from venous and capillary samples and was approved for clinical use. This testing will facilitate treatment decisions and improve clozapine uptake and compliance.

Keywords: absolute neutrophil counts, clozapine, point of care, white blood cells

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Authors: Vidhya R

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The claim of feminists that women are made and not born is neither to set women on par with men nor to discriminate one from the other, but to establish and reiterate the fact that both the sexes have to understand, recognize and appreciate each other’s ability and responsibility thus to contribute to the peaceful co-existence of both, leading to the creation of a better and brave new world, which is neither patriarchal nor matriarchal. But history has repeatedly recorded the relegation of women to the secondary position consummated through the highly biased cultural, ritualistic and customary practices across the globe. In Africa, bracing herself against many odds through generations, the African woman who has been facing multiple jeopardy promulgated by racial, cultural, economic and gender discrimination has slowly started moving from the margins towards the center. The African woman was able to undertake the journey from the margins to the center bravely only because of her grit, grace, courage, confidence, and spirituality. This journey has resulted in the metamorphosis of the African woman’s psyche. Economic independence fortified with education has empowered the African woman. The various stages of metamorphosis are well delineated in the works of the contemporary Nigerian writer Chimamanda Ngozi Adichie. The objective of this research paper is to study the above said metamorphosis, the female protagonists undergo in Adichie’s novels. The approaches on which the study is based on are the Africana Womanist theory propounded by Clenora Hudson –Weems and African feminism of Carole Boyce Davies. The findings of this study lead towards establishing the proposition that the emergence and evolution of the Nigerian woman has resulted in the birth of a new breed of women – the Emphatic Female, manifested in the power packed portrayal of the female protagonists of Purple Hibiscus, Half of a Yellow Sun and Americanah by Chimamanda Ngozi Adichie.

Keywords: Africana womanism, African feminism, chimamanda ngozi adichie, metamorphosis, the emphatic female

Procedia PDF Downloads 331