Search results for: differential outcomes

Authors: Monika Rawat, Rahul Kumar

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Input output Buffer Information Specification (IBIS) models are used for describing the analog behavior of the Input Output (I/O) buffers of a digital device. They are widely used to perform signal integrity analysis. Advantages of using IBIS models include simple structure, IP protection and fast simulation time with reasonable accuracy. As design complexity of driver and receiver increases, capturing exact behavior from transistor level model into IBIS model becomes an essential task to achieve better accuracy. In this paper, an improvement in existing methodology of generating IBIS model for complex I/O interfaces such as Inter-Integrated Circuit (I2C) and Low Voltage Differential Signaling (LVDS) is proposed. Furthermore, the accuracy and computational performance of standard method and proposed approach with respect to SPICE are presented. The investigations will be useful to further improve the accuracy of IBIS models and to enhance their wider acceptance.

Keywords: IBIS, signal integrity, open-drain buffer, low voltage differential signaling, behavior modelling, transient simulation

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Authors: J. P. Chollom, G. M. Kumleng, S. Longwap

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The search for higher order A-stable linear multi-step methods has been the interest of many numerical analysts and has been realized through either higher derivatives of the solution or by inserting additional off step points, supper future points and the likes. These methods are suitable for the solution of stiff differential equations which exhibit characteristics that place a severe restriction on the choice of step size. It becomes necessary that only methods with large regions of absolute stability remain suitable for such equations. In this paper, high order block implicit multi-step methods of the hybrid form up to order twelve have been constructed using the multi-step collocation approach by inserting one or more off step points in the multi-step method. The accuracy and stability properties of the new methods are investigated and are shown to yield A-stable methods, a property desirable of methods suitable for the solution of stiff ODE’s. The new High Order Block Implicit Multistep methods used as block integrators are tested on stiff differential systems and the results reveal that the new methods are efficient and compete favourably with the state of the art Matlab ode23 code.

Keywords: block linear multistep methods, high order, implicit, stiff differential equations

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Authors: Muath Awadalla, Maen Awadallah

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Banking sector covers different activities including lending money to customers. However, it is commonly known that customers pay money they have borrowed including an added amount called interest. Compound interest rate is an approach used in determining the interest to be paid. The instant compounded amount to be paid by a debtor is obtained through a differential equation whose main parameters are the rate and the time. The rate used by banks in a country is often defined by the government of the said country. In Switzerland, for instance, a negative rate was once applied. In this work, a new approach of modeling the compound interest is proposed using Hadamard fractional derivative. As a result, it appears that depending on the fraction value used in derivative the amount to be paid by a debtor might either be higher or lesser than the amount determined using the classical approach.

Keywords: compound interest, fractional differential equation, hadamard fractional derivative, optimization

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Authors: Ramzi B. Albadarneh

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In this paper, we use the new definition of fractional derivative called conformable fractional derivative to derive some finite difference formulas and its error terms which are used to solve fractional differential equations and fractional partial differential equations, also to derive fractional Euler method and its error terms which can be applied to solve fractional differential equations. To provide the contribution of our work some applications on finite difference formulas and Euler Method are given.

Keywords: conformable fractional derivative, finite difference formula, fractional derivative, finite difference formula

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Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis

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Authors: Yuan Liu, Hongyun Liu

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Teacher-student relationship plays an important role on facilitating students’ learning behavior, school engagement, and academic outcomes. It is believed that good relationship will enhance the human agency—the intrinsic motivation—mainly through the strengthening of autonomic support, feeling of relatedness, and the individual’s competence to increase the academic outcomes. This is in line with self-determination theory (SDT), which generally views that the intrinsic motivation imbedded with human basic needs is one of the most important factors that would lead to better school engagement, academic outcomes, and well-being. Based on SDT, the present study explored the relation of among teacher-student relationship (teacher’s encouragement, respect), students’ motivation (extrinsic and intrinsic), and achievement outcomes. The study was based on a large scale academic assessment and questionnaire survey conducted by the Center for Assessment and Improvement of Basic Education Quality in Mainland China (2013) on Grade 8 students. The results indicated that intrinsic motivation mediated the relation between teacher-student relationship and academic achievement outcomes.

Keywords: teacher-student relationship, intrinsic motivation, academic achievement, mediation

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Authors: Malika El Kyal, Ahmed Machmoum

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We prove the superlinear convergence of asynchronous multi-splitting methods applied to differential equations. This study is based on the technique of nested sets. It permits to specify kind of the convergence in the asynchronous mode.The main characteristic of an asynchronous mode is that the local algorithm not have to wait at predetermined messages to become available. We allow some processors to communicate more frequently than others, and we allow the communication delays to be substantial and unpredictable. Note that synchronous algorithms in the computer science sense are particular cases of our formulation of asynchronous one.

Keywords: parallel methods, asynchronous mode, multisplitting, ODE

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Authors: Rizwan Rizwan

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This paper provides an overview of Federated Learning (FL) and its application in enhancing data security, privacy, and efficiency. FL utilizes three distinct architectures to ensure privacy is never compromised. It involves training individual edge devices and aggregating their models on a server without sharing raw data. This approach not only provides secure models without data sharing but also offers a highly efficient privacy--preserving solution with improved security and data access. Also we discusses various frameworks used in FL and its integration with machine learning, deep learning, and data mining. In order to address the challenges of multi--party collaborative modeling scenarios, a brief review FL scheme combined with an adaptive gradient descent strategy and differential privacy mechanism. The adaptive learning rate algorithm adjusts the gradient descent process to avoid issues such as model overfitting and fluctuations, thereby enhancing modeling efficiency and performance in multi-party computation scenarios. Additionally, to cater to ultra-large-scale distributed secure computing, the research introduces a differential privacy mechanism that defends against various background knowledge attacks.

Keywords: federated learning, differential privacy, gradient descent strategy, convergence, stability, threats

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Authors: Somar Boubou, Tatsuo Narikiyo, Michihiro Kawanishi

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In this work, we address the problem of 3D object recognition with depth sensors such as Kinect or Structure sensor. Compared with traditional approaches based on local descriptors, which depends on local information around the object key points, we propose a global features based descriptor. Proposed descriptor, which we name as Differential Histogram of Normal Vectors (DHONV), is designed particularly to capture the surface geometric characteristics of the 3D objects represented by depth images. We describe the 3D surface of an object in each frame using a 2D spatial histogram capturing the normalized distribution of differential angles of the surface normal vectors. The object recognition experiments on the benchmark RGB-D object dataset and a self-collected dataset show that our proposed descriptor outperforms two others descriptors based on spin-images and histogram of normal vectors with linear-SVM classifier.

Keywords: vision in control, robotics, histogram, differential histogram of normal vectors

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Authors: Helmi Temimi

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In this paper, we study the super-convergence properties of the discontinuous Galerkin (DG) method applied to one-dimensional mth-order ordinary differential equations without introducing auxiliary variables. We found that nth−derivative of the DG solution exhibits an optimal O (hp+1−n) convergence rates in the L2-norm when p-degree piecewise polynomials with p≥1 are used. We further found that the odd-derivatives and the even derivatives are super convergent, respectively, at the upwind and downwind endpoints.

Keywords: discontinuous, galerkin, superconvergence, higherorder, error, estimates

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Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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Authors: Gleda Kutrolli, Maksi Kutrolli, Etjon Meco

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SARS-CoV-2 virus is currently one of the most infectious pathogens for humans. It started in China at the end of 2019 and now it is spread in all over the world. The origin and diffusion of the SARS-CoV-2 epidemic, is analysed based on the discussion of viral phylogeny theory. With the aim of understanding the spread of infection in the affected countries, it is crucial to modelize the spread of the virus and simulate its activity. In this paper, the prediction of coronavirus outbreak is done by using SIR model without vital dynamics, applying different numerical technique solving ordinary differential equations (ODEs). We find out that ABM and MRT methods perform better than other techniques and that the activity of the virus will decrease in April but it never cease (for some time the activity will remain low) and the next cycle will start in the middle July 2020 for Norway and Denmark, and October 2020 for Sweden, and September for Finland.

Keywords: forecasting, ordinary differential equations, SARS-COV-2 epidemic, SIR model

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Authors: Lina Wu, Ye Li, Jia Liu

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We are interested in solving Liouville-type problems to explore constancy properties for maps or differential forms on Riemannian manifolds. Geometric structures on manifolds, the existence of constancy properties for maps or differential forms, and energy growth for maps or differential forms are intertwined. In this article, we concentrate on discovery of solutions to Liouville-type problems where manifolds are Euclidean spaces (i.e. flat Riemannian manifolds) and maps become real-valued functions. Liouville-type results of vanishing properties for functions are obtained. The original work in our research findings is to extend the q-energy for a function from finite in L^q space to infinite in non-L^q space by applying p-balanced technique where q = p = 2. Calculation skills such as Hölder's Inequality and Tests for Series have been used to evaluate limits and integrations for function energy. Calculation ideas and computational techniques for solving Liouville-type problems shown in this article, which are utilized in Euclidean spaces, can be universalized as a successful algorithm, which works for both maps and differential forms on Riemannian manifolds. This innovative algorithm has a far-reaching impact on research work of solving Liouville-type problems in the general settings involved with infinite energy. The p-balanced technique in this algorithm provides a clue to success on the road of q-energy extension from finite to infinite.

Keywords: differential forms, holder inequality, Liouville-type problems, p-balanced growth, p-harmonic maps, q-energy growth, tests for series

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Authors: Gilbert Makanda

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The problem of the teaching of mathematics is studied using differential equations. A mathematical model for knowledge acquisition in mathematics is developed. In this study we adopt the mathematical model that is normally used for disease modelling in the teaching of mathematics. It is assumed that teaching is 'infecting' students with knowledge thereby spreading this knowledge to the students. It is also assumed that students who gain this knowledge spread it to other students making disease model appropriate to adopt for this problem. The results of this study show that increasing recruitment rates, learning contact with teachers and learning materials improves the number of knowledgeable students. High dropout rates and forgetting taught concepts also negatively affect the number of knowledgeable students. The developed model is then solved using Matlab ODE45 and \verb"lsqnonlin" to estimate parameters for the actual data.

Keywords: differential equations, knowledge acquisition, least squares, dynamical systems

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Authors: F. Waffo Tchuimmo, G. S. Kwandio Dongoua, C. U. Yves Mbono Samba, O. Dafounansou, L. Nana

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The strength criterion is an important condition of great interest to guarantee the stability of the structural elements. The present work is based on the study of the free vibration of Euler’s Bernoulli column of equal strength in compression while considering its own weight and the axial load in compression and tension subjected to symmetrical boundary conditions. We use the differential quadrature method to investigate the first fifth naturals frequencies parameters of the column according to the different forms of geometrical sections. The results of this work give help in making a judicious choice of type of cross-section and a better boundary condition to guarantee good stability of this type of column in civil constructions.

Keywords: free vibration, equal strength, self-weight, tip force, differential quadrature method

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Authors: Jamaludin Jamaludin, Suparji Suparji, Lilik Anifah, I. Gusti Putu Asto Buditjahjanto, Eppy Yundra

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Learning media is an important and main component in the learning process. By using currently available media, cadets still have difficulty understanding how the piston engine works, so they are not able to apply these concepts appropriately. This study aims to examine the development of interactive media for piston engine courses in order to improve student learning outcomes. The research method used is a literature study of several articles, journals and proceedings of interactive media development results from 2010-2020. The results showed that the development of interactive media is needed to support the learning process and influence the cognitive abilities of students. With this interactive media, learning outcomes can be improved and the learning process can be effective.

Keywords: interactive media, learning outcomes, learning process, literature study

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Authors: S. S. Abas, Y. M. Yatim

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In this paper the unsteady, slender, symmetric dry patch in an infinitely wide and thin liquid film of Newtonian fluid draining under gravity down an inclined plane in the presence of strong surface-tension effect is considered. A similarity transformation, named a travelling-wave similarity solution is used to reduce the governing partial differential equation into the ordinary differential equation which is then solved numerically using a shooting method. The introduction of surface-tension effect on the flow leads to a fourth-order ordinary differential equation. The solution obtained predicts that the dry patch has a quartic shape and the free surface has a capillary ridge near the contact line which decays in an oscillatory manner far from it.

Keywords: dry patch, Newtonian fluid, similarity solution, surface-tension effect, travelling-wave, unsteady thin-film flow

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Authors: Surendra Kumar Patel

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Disability is not just a health problem; it is a complex phenomenon, reflecting the interaction between features of a person’s age and physiology. Population ageing is a major demographic issue for India in the 21st century. Older population of India constituted 8% of total population, while 5.19% has affected by disability of older age group. Objective of the present research paper is to examine the state wise differential in disability among 60+ population and to access the health care of disabled population especially the 60+ disabled persons. The data sources of the present paper are census 2001 and 2011. For analyzing the state wise differentials by disability types and comparative advantage of data, rate, ratio, and percentage have been used. The Standardized Index of Diversity of Disability (SIDD) studies differential and diversity in disability. The results show that there are 5.19% persons have disability among 60+ population and sex differential not very significant, as it is 5.3 % of male and 5.05% in female in India but place of residence shows significant variation from 2001 to 2011 census. There is huge diversity in disability prevalence among 60+ in India, highest in Sikkim followed by Rajasthan, approximately, they comprise 11%, and the lowest found in Tamil Nadu as 2.53%. This huge gap in prevalence percentage shows the health care needs of highly prevailing states.

Keywords: disability, Standardized Index of Diversity of Disability (SIDD), differential and diversity in disability, 60+ population

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Authors: Zulfiqar Ali, Umar Saleem, Muhammad Junaid, Rizwan Tahir

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Gulzar Mahal is a heritage site located in the city of Bahawalpur, Pakistan. The site is under a process of degradation, as cracks are appearing on the walls, roofs, and floor around the building due to differential settlement. To preserve the integrity of the structure, a geotechnical distress evaluation was carried out to evaluate the causal factors and recommend remediation measures. The research involved the characterization of the problematic soil and analysis of the observed distress with respect to the geotechnical properties. Both conventional lab and field tests were used in conjunction with the unconventional techniques like; Electrical Resistivity Tomography (ERT) and FEA. The temporal, geophysical and geotechnical evaluations have concluded that the foundation soil over the past was subjected to variations in the land use, poor drainage patterns, overloading and fluctuations in groundwater table all contributing to the differential settlements manifesting in the form of the visible shear crack across the length and breadth of the building.

Keywords: differential settlement, distress evaluation, finite element analysis, Gulzar Mahal

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Authors: Aleksandra Bogdanovic, Milicat Tošić Radev, Tatjana Stefanovic Stanojevic

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The aim behind this study was to first analyze the nature and the extent of childhood trauma and existing maladaptive outcomes (internalized and externalized problems and dissociation) among adolescents in the foster system and then analyze the possibility of using traumatic experiences to predict the aforementioned outcomes of childhood trauma. The sample consists of 121 respondents, children, and youths in the care of child protective services, without adequate parental care, residing in temporary foster care families on the territory of Serbia, aged between 11 and 18. The respondents filled out the Childhood Trauma Questionnaire – CTQ, Relationship Questionaire – Clinical version RQ-CV, the Dissociative experience scale for adolescents, A-DES and the Child behavior checklist – youth self-report. The results of the analyses have indicated that physical and emotional neglect are the most frequent forms of maltreatment in early childhood, with a relatively high prevalence of the other individual forms of trauma. Early childhood trauma statistically significantly predicted all the analyzed maladaptive outcomes, explaining approximately 20% of the variance of internalized and externalized problems and dissociation. Recommendations are given for future studies.

Keywords: trauma, maladaptive outcomes, disorganization, dissociation

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Authors: Khairil Iskandar Othman, Nadhirah Kamal, Zarina Bibi Ibrahim

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Block methods for solving stiff systems of ordinary differential equations (ODEs) are based on backward differential formulas (BDF) with PE(CE)2 and Newton method. In this paper, we introduce Modified Newton as a new strategy to get more efficient result. The derivation of BBDF using modified block Newton method is presented. This new block method with predictor-corrector gives more accurate result when compared to the existing BBDF.

Keywords: modified Newton, stiff, BBDF, Jacobian matrix

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Authors: Yilmaz Simsek

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In this paper, we study the Bernstein-type basis functions with their generating functions. We give various properties of these polynomials with the aid of their generating functions. These polynomials and generating functions have many valuable applications in mathematics, in probability, in statistics and also in mathematical physics. By using the Bernstein-Galerkin and the Bernstein-Petrov-Galerkin methods, we give some applications of the Bernstein-type polynomials for solving high even-order differential equations with their numerical computations. We also give Bezier-type curves related to the Bernstein-type basis functions. We investigate fundamental properties of these curves. These curves have many applications in mathematics, in computer geometric design and other related areas. Moreover, we simulate these polynomials with their plots for some selected numerical values.

Keywords: generating functions, Bernstein basis functions, Bernstein polynomials, Bezier curves, differential equations

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Authors: Twarakavi Venkata Suresh Kumar, Sailaja Kumar, B. Eswara Reddy

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In a world of tremendous technical developments, effective and efficient higher education has always been a major challenge. The rising number of educational institutions have made it mandatory for healthy competitions among the institutions. To evaluate the qualitative competence of these educations institutions in engineering and technology and related disciplines, an efficient assessment technique in internal and external quality has to be followed. To achieve this, the curriculum is to be developed into courses, and each course has to be presented in the form teaching lesson plan consisting of topics and session outcome known as Course Outcomes (COs), that easily map into different Programme Outcomes (POs). The major objective of these methodologies is to provide quality technical education to its students. Detailed clear weightage in CO-PO mapping helps in proper measurable COs and to devise the POs attainment is an important issue. This ensures in assisting the achievement of the POs with proper weightage to POs, and also improves the successive curriculum development. In this paper, we presented a methodology for mapping CO and PO considering the key elements supported by each PO. This approach is useful in evaluating the attainment of POs which is based on the attainment of COs using the existing data from students' marks taken from various test items. Such direct assessment tools are used to measure the degree to which each student has achieved each course learning outcome by the completion of the course. Hence, these results are also useful in measuring the PO attainment for improving the programme vision and mission.

Keywords: attainment, course outcomes, programme outcomes, educational institutions

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Authors: Michael Airton

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This case study examines the development of a new service delivery model for prisons that focuses on using NGO’s to provide more effective case management and post release support functions. The model includes the co-design of the service delivery model and innovative commercial agreements that encourage embedded service providers within the prison and continuity of services post release with outcomes based payment mechanisms. The collaboration of prison staff, probation and parole officers and NGO’s is critical to the success of the model and its ability to deliver value and positive outcomes in relation to desistance from offending.

Keywords: collaborative service delivery, desistance, non-government organisations, post release support services

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Authors: Jiwon Park, Jihae Hur, Kukjae Kim, Hansoo Kim

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In this study, outriggers, which are horizontal structures connecting a building core to distant columns to increase the lateral stiffness of a tall building, are used to reduce differential axial shortening in a tall building. Therefore, the outriggers in tall buildings are used to serve the dual purposes of reducing the lateral displacement and reducing the differential axial shortening. Since the location of the outrigger greatly affects the effectiveness of the outrigger in terms of the lateral displacement at the top of the tall building and the maximum differential axial shortening, the optimum locations of the dual-purpose outriggers can be determined by an optimization method. Because the floors where the outriggers are installed are given as integer numbers, the conventional gradient-based optimization methods cannot be directly used. In this study, a piecewise quadratic interpolation method is used to resolve the integrality requirement posed by the optimum locations of the dual-purpose outriggers. The optimal solutions for the dual-purpose outriggers are searched by linear scalarization which is a popular method for multi-objective optimization problems. It was found that increasing the number of outriggers reduced the maximum lateral displacement and the maximum differential axial shortening. It was also noted that the optimum locations for reducing the lateral displacement and reducing the differential axial shortening were different. Acknowledgment: This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science and ICT (NRF-2017R1A2B4010043) and financially supported by Korea Ministry of Land, Infrastructure and Transport(MOLIT) as U-City Master and Doctor Course Grant Program.

Keywords: concrete structure, optimization, outrigger, tall building

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Authors: Eugene Stepanov, Arcady Ponosov

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To model gene regulatory networks one uses ordinary differential equations with switching nonlinearities, where the initial value problem is known to be well-posed if the trajectories cross the discontinuities transversally. Otherwise, the initial value problem is usually ill-posed, which lead to theoretical and numerical complications. In the presentation, it is proposed to apply the theory of hybrid dynamical systems, rather than switched ones, to regularize the problem. 'Hybridization' of the switched system means that one attaches a dynamic discrete component ('automaton'), which follows the trajectories of the original system and governs its dynamics at the points of ill-posedness of the initial value problem making it well-posed. The construction of the automaton is based on the classification of the attractors of the specially designed adjoint dynamical system. Several examples are provided in the presentation, which support the suggested analysis. The method can also be of interest in other applied fields, where differential equations contain switchings, e.g. in neural field models.

Keywords: hybrid dynamical systems, ill-posed problems, singular perturbation analysis, switching nonlinearities

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Authors: Ankita Shukla, Tiratha Raj Singh

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Colorectal cancer (CRC) imposes serious mortality burden worldwide and it has been increasing for past consecutive years. Continuous efforts have been made so far to diagnose the disease condition and to identify the root cause for it. In this study, we performed the pathway level as well as the differential gene expression studies for CRC. We analyzed the gene expression profile GSE24514 from Gene Expression Omnibus (GEO) along with the gene pathways involved in the CRC. This analysis helps us to understand the behavior of the genes that have shown differential expression through their targeted pathways. Pathway analysis for the targeted genes covers the wider area which therefore decreases the possibility to miss the significant ones. This will prove to be beneficial to expose the ones that have not been given attention so far. Through this analysis, we attempt to understand the various neighboring genes that have close relationship to the targeted one and thus proved to be significantly controlling the CRC. It is anticipated that the identified hub and neighboring genes will provide new directions to look at the pathway level differently and will be crucial for the regulatory processes of the disease.

Keywords: mismatch repair, microsatellite instability, carcinogenesis, morbidity

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Authors: Priyanka Ghosh, Priti Kumar Roy

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Every year a considerable number of people die due to methyl alcohol poisoning, in which most of them die even before proper treatment. This work gives a simple and cheap first aid to those affected individuals by the administration of activated charcoal. In this article, we emphasise on the adsorption capability of activated charcoal for the treatment of poisoning and use an impulsive differential equation to study the effect of activated charcoal during adsorption. We also investigate the effects of various parameters on the adsorption which are incorporated in the model system.

Keywords: activated charcoal, adsorption, impulsive differential equation, methanol poisoning

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Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

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Authors: Tamer Mesallam, Medhat Yousef, Ayna Almasaad

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BACKGROUND: Cochlear implantation (CI) in children with additional disabilities can be a fundamental and supportive intervention. Although, there may be some positive impacts of CI on children with multiple disabilities such as better outcomes of communication skills, development, and quality of life, the families of those children complain from the post-implant habilitation efforts that considered as a burden. OBJECTIVE: To investigate the outcomes of CI children with different co-disabilities through using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS) as outcome measurement tools. METHODS: The study sample comprised 25 hearing-impaired children with co-disability who received cochlear implantation. Age and gender-matched control group of 25 cochlear-implanted children without any other disability has been also included. The participants' auditory skills and speech outcomes were assessed using MAIS and MUSS tests. RESULTS: There was a statistically significant difference in the different outcomes measure between the two groups. However, the outcomes of some multiple disabilities subgroups were comparable to the control group. Around 40% of the participants with co-disabilities experienced advancement in their methods of communication from behavior to oral mode. CONCLUSION: Cochlear-implanted children with multiple disabilities showed variable degrees of auditory and speech outcomes. The degree of benefits depends on the type of the co-disability. Long-term follow-up is recommended for those children.

Keywords: children with disabilities, Cochlear implants, hearing impairment, language development

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