Search results for: flight test data

Authors: Dilek Dede

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This study aims at scrutinized the dilemma between education place and working place with professional socialization dimension over the beginning teachers in Turkey is to be found the solution for the dilemma in Turkey. The research question is that how can be explained the gap between education place and working place for beginning teachers in Turkey. That expected to contribute to literature with the solutions for shorting the gap between working area and education area of the teaching profession in Turkey case. The study is constructed in two section. Firstly, socialization of the teaching profession and teaching modules have been discussed through the profession, education, working place indicators. In the second section, Secondly, two educational specialists from Turkey has been interviewed about their observation on trainee teachers compelling to participate the class for candidate teachers after university grade. Then, the dilemma between education area and working area of the teaching profession has been detected by of semi-structured and in-depth interviews, the literature on the relationality of institutions and regulation is discussed. The following outcomes have been accessed in accordance with the data set and literature linkage axis: Firstly, teachers coming from the distinctive programmes as an educational background. Hence, teachers who pertain to distinctive cultures work in the same environment. That cause cultural conflicts and complication of socialization of profession. Secondly, the insufficient partnership between schools and universities besides, the education classes lead to a struggle of culture among these two institutions. Thirdly, the education classes are designed as bureaucratic form instead of coalescence between head teachers and trainee teachers around a common culture. That become deep the dilemma. In conclusion, on condition that applied-oriented education that advocates in-service learning is promoted and this programme is supported with well-structured the in-service training through the partnership of universities and schools, the gap between the working-area and education-area might be shortened.

Keywords: beginning teachers, construction of a common, social mobilization in the teaching profession, teacher training institution, the relationality of the regulations and institutions

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Authors: Muhammad Nasar-u-Minallah, Dagmar Haase, Salman Qureshi

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In a rapidly growing developing country cities are becoming more urbanized leading to modifications in urban climate. Rapid urbanization, especially unplanned urban land expansion, together with climate change has a profound impact on the urban settlement and urban thermal environment. Cities, particularly Pakistan are facing remarkably environmental issues and uneven development, and thus it is important to strengthen the investigation of urban environmental pressure brought by land-use changes and urbanization. The present study investigated the long term modification of the urban environment by urbanization utilizing Spatio-temporal dynamics of land-use change, urban population data, urban heat islands, monthly maximum, and minimum temperature of thirty years, multi remote sensing imageries, and spectral indices such as Normalized Difference Built-up Index and Normalized Difference Vegetation Index. The results indicate rapid growth in an urban built-up area and a reduction in vegetation cover in the last three decades (1990-2020). A positive correlation between urban heat islands and Normalized Difference Built-up Index, whereas a negative correlation between urban heat islands and the Normalized Difference Vegetation Index clearly shows how urbanization is affecting the local environment. The increase in air and land surface temperature temperatures is dangerous to human comfort. Practical approaches, such as increasing the urban green spaces and proper planning of the cities, have been suggested to help prevent further modification of the urban thermal environment by urbanization. The findings of this work are thus important for multi-sectorial use in the cities of Pakistan. By taking into consideration these results, the urban planners, decision-makers, and local government can make different policies to mitigate the urban land use impacts on the urban thermal environment in Pakistan.

Keywords: land use, urban environment, local climate, Lahore

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Elaine Wong

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This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

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Authors: Gampel Alexander, Mazzuchi Thomas, Sarkani Shahram

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The cybersecurity landscape is constantly evolving, and organizations must adapt to the changing threat environment to protect their assets. The implementation of the NIST Risk Management Framework (RMF) has become critical in ensuring the security and safety of industrial control and automation systems. However, cybersecurity professionals are facing challenges in implementing RMF, leading to systems operating without authorization and being non-compliant with regulations. The current approach to RMF implementation based on business practices is limited and insufficient, leaving organizations vulnerable to cyberattacks resulting in the loss of personal consumer data and critical infrastructure details. To address these challenges, this research proposes a Model-Based Systems Engineering (MBSE) approach to implementing cybersecurity controls and assessing risk through the RMF process. The study emphasizes the need to shift to a modeling approach, which can streamline the RMF process and eliminate bloated structures that make it difficult to receive an Authorization-To-Operate (ATO). The study focuses on the practical application of MBSE in industrial control and automation systems to improve the security and safety of operations. It is concluded that MBSE can be used to solve the implementation challenges of the NIST RMF process and improve the security of industrial control and automation systems. The research suggests that MBSE provides a more effective and efficient method for implementing cybersecurity controls and assessing risk through the RMF process. The future work for this research involves exploring the broader applicability of MBSE in different industries and domains. The study suggests that the MBSE approach can be applied to other domains beyond industrial control and automation systems.

Keywords: authorization-to-operate (ATO), industrial control systems (ICS), model-based system’s engineering (MBSE), risk management framework (RMF)

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Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Janet Wing-Chong Wai, Alex Chiu-Wing Lee, Hailey Hoi-Ching Tsang, Jeffrey Chiu, Kwok-Wing Tang

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Background: Mammography has limited sensitivity and specificity though it is the primary imaging technique for detection of early breast cancer. Ultrasound imaging and contrast-enhanced MRI are useful adjunct tools to mammography. The advantage of breast MRI is high sensitivity for invasive breast cancer. Therefore, indications for and use of breast magnetic resonance imaging have increased over the past decade. Objectives: 1. Cases demonstration on different indications for breast MR imaging. 2. To review of the common artifacts and pitfalls in breast MR imaging. Materials and Methods: This is a retrospective study including all patients underwent dynamic contrast-enhanced breast MRI examination in our centre, performed from Jan 2011 to Dec 2017. The clinical data and radiological images were retrieved from the EPR (electronic patient record), RIS (Radiology Information System) and PACS (Picture Archiving and Communication System). Results and Discussion: Cases including (1) Screening of the contralateral breast in patient with a new breast malignancy (2) Breast augmentation with free injection of unknown foreign materials (3) Finding of axillary adenopathy with an unknown site of primary malignancy (4) Neo-adjuvant chemotherapy: before, during, and after chemotherapy to evaluate treatment response and extent of residual disease prior to operation. Relevant images will be included and illustrated in the presentation. As with other types of MR imaging, there are different artifacts and pitfalls that can potentially limit interpretation of the images. Because of the coils and software specific to breast MR imaging, there are some other technical considerations that are unique to MR imaging of breast regions. Case demonstration images will be available in presentation. Conclusion: Breast MR imaging is a highly sensitive and reasonably specific method for the detection of breast cancer. Adherent to appropriate clinical indications and technical optimization are crucial for achieving satisfactory images for interpretation.

Keywords: MRI, breast, clinical, cancer

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Authors: Altilio Rosa, Chirico Francesco, Foglia Goffredo

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In recent years, the number of Unmanned Aerial Vehicles (UAVs) has significantly increased. The rapid development of commercial and recreational drones makes them an important part of our society. Despite the growing list of their applications, these vehicles pose a huge threat to civil and military installations: detection, classification and neutralization of such flying objects become an urgent need. Radar is an effective remote sensing tool for detecting and tracking flying objects, but scenarios characterized by the presence of a high number of tracks related to flying birds make especially challenging the drone detection task: operator PPI is cluttered with a huge number of potential threats and his reaction time can be severely affected. Flying birds compared to UAVs show similar velocity, RADAR cross-section and, in general, similar characteristics. Building from the absence of a single feature that is able to distinguish UAVs and birds, this paper uses a multiple features approach where an original feature selection technique is developed to feed binary classifiers trained to distinguish birds and UAVs. RADAR tracks acquired on the field and related to different UAVs and birds performing various trajectories were used to extract specifically designed target movement-related features based on velocity, trajectory and signal strength. An optimization strategy based on a genetic algorithm is also introduced to select the optimal subset of features and to estimate the performance of several classification algorithms (Neural network, SVM, Logistic regression…) both in terms of the number of selected features and misclassification error. Results show that the proposed methods are able to reduce the dimension of the data space and to remove almost all non-drone false targets with a suitable classification accuracy (higher than 95%).

Keywords: birds, classification, machine learning, UAVs

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Authors: Daniela Prado, Lexi Frankel, Amalia Ardeljan, Lokesh Manjani, Matthew Cardeiro, Omar Rashid

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Background: Clostridium difficile (C. diff) is a gram-positive bacterium that is known to cause life-threatening diarrhea and severe inflammation of the colon. It originates as an alteration of the gut microbiome and can be transmitted through spores. Recent studies have shown a high association between the development of C. diff in cancer patients due to extensive hospitalization. However, research is lacking regarding C. diff’s association in the causation or prevention of cancer. The objective of this study was to therefore assess the correlation between Clostridium difficile infection (CDI) and the incidence of bone cancer. Methods: This retrospective analysis used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with C. diff using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Standard statistical methods were used. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 78863 patients in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bone cancer was 659 patients (0.835%) in the C. diff group compared to 1941 patients (2.461%) in the control group. The difference was statistically significant by a P-value < 2.2x10^-16 with an odds ratio (OR)= 0.33 (0.31-0.37) with a 95% confidence interval (CI). Treatment for CDI was analyzed for both C. diff infected and noninfected populations. 91 out of 16,676 (0.55%) patients with a prior C. diff infection and treated with antibiotics were compared to the control group were 275 out of 16,676 (1.65%) patients with no history of CDI and received antibiotic treatment. Results remained statistically significant by P-value <2.2x10-16 with an OR= 0.42 (0.37, 0.48). and a 95% CI. Conclusion: The study shows a statistically significant correlation between C. diff and a reduced incidence of bone cancer. Further evaluation is recommended to assess the potential of C. difficile in reducing bone cancer incidence.

Keywords: bone cancer, colitis, clostridium difficile, microbiome

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Authors: Hare Krishna Doley

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Drawing upon empirical data, this paper tries to examine how ethnic groups like Ahom, Moran, Motok, and Chutia creates and recreates ethnic boundaries while making claims for recognition as Scheduled Tribes (STs) under the Sixth Schedule of the Constitution of India, in the state of Assam. Underlying such claim is the distinct identity consciousness amongst these groups as they assert themselves originally as tribe drawing upon primordial elements. For them, tribal identity promises social justice and give credence to their claims of indigeneity while preserving their exclusivity within the multifarious society of Assam. Having complex inter-group relationships, these groups under study displays distinct as well as overlapping identities, which demonstrate fluidity of identities across groups while making claims for recognition. In this process, the binary of ‘us’ and ‘them’ are often constructed amongst these groups, which are in turn difficult to grasp as they share common historical linkages. This paper attempts to grapple with such complex relationships the studied groups and their assertion as distinct cultural entities while making ethnic boundaries on the basis of socio-cultural identities. Such claims also involve frequent negotiation with the Sate as well as with other ethnic groups, which further creates strife among indigenous groups for tribal identity. The paper argues that identity consciousnesses amongst groups have persisted since the introduction of resource distribution on ethnic lines; therefore, issues of exclusive ethnic identity in the state of Assam can be contextualised within the colonial and post-colonial politics of redrawing ethnic and spatial boundaries. Narrative of the ethnic leaders who are in the forefront of struggle for ST status revealed that it is not merely to secure preferential treatment, but it also encompasses entitlement to land and their socio-cultural identity as aboriginal. While noting the genesis of struggle by the ethnic associations for ST status, this paper will also delineate the interactions among ethnic groups and how the identity of tribe is being performed by them to be included in the official categories of ST.

Keywords: ethnic, identity, sixth schedule, tribe

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Authors: Espinosa Carlos, Nobrega Doris

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Children are at high risk for lead (Pb) exposure. The objective of this study was to identify risk factors that contribute to high blood lead (PbB) levels in Venezuelan children. The concentration of PbB was determined in 60 children (ages 4-9 years old), coming from the Michelena sector, Valencia District, Carabobo State. The relationship between these concentrations and socio-economical parameters (A: high quality life; B: fair quality life; C: critic poverty), Pb levels of faucet water (Pb-water) and dust Pb levels of floor (Pb-dust) of their houses, was established. Living areas were classified according to sectors and socio-economical status. Forty [40=66.7%] children resulted with PbB levels above the permissible concentration (LAPC). Average PbB was not significantly higher than the permissible levels. Odds ratio proved that children from status C are 7.28 times more likely to have LAPC of PbB than the ones coming from A or B. Thirty-four percent (34%) of the children with LAPC come from status C which could be considered the most critical status from the exposure risk point of view. The 76,3% of the sampled houses reported VSLP of Pb-water, being the Pb-water average in 35 ± 25.5 ug/L. This average significantly went superior to the permissible limit established by Venezuela and international organisms (10 ug/L). When grouping the results of PbB and Pb-water by sex, were that 50,8% of the children who presented/displayed VSLP of Pb-water and PbB. Was a significant relation (p ≤ 0.05), between masculine sex and the VSLP of PbB and Pb-water (x² = 3,672). In relation to the Pb-Dust analyses, were not statistically significant differences with respect to their permissible limit value (40 ug/pie²). This study shows that by correlating geographical and health data, we can identify 'high risk' areas, leading to a proactive public health action. The results of this study are excellent, in order to take preventive measures for the care from the health. Later studies are suggested predicting main to determine of more conclusive form of levels elevated of PbB in the investigated population.

Keywords: demographic, lead, risk, socio-economical status

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Authors: Tadesse Menjetta, Daniel Dana, Serkadis Debalke

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Schistosomiasis/Bilharziasis is one of the neglected tropical parasitic diseases caused by different species of genus Schistosoma. Among the species, S. mansoni (causative agents of intestinal schistosomiasis) is one of the causes of severe intestinal parasitic infections with high public and medical importance in Ethiopia. There is a scarcity of information about the status of S. mansoni infection among the fisherman in our study area and in the country at large. Therefore, this study was designed to determine the prevalence and risk factors of S.mansoni infection among fishermen at Lake Hawassa, southern Ethiopia. A cross-sectional study was conducted among the fishermen from April to June 2013 in Hawassa, Southern Ethiopia. A total of 243 fishermen were included by systematic sampling from the lists of the fishermen members in the registration book of fishermen associations in the Hawassa Town. Data on socio-demographic features and risk factors were collected by using semi-structured questionnaires. Stool samples were collected and processed using Kato-Katz thick smear techniques and examined between 30- 40 minute for hookworm and after 24 hours for S. mansoni and other soil-transmitted helminths (STHs). The overall prevalence of S.mansoni among the fishermen was 29.21% (71/243), and the mean intensity of infection was 158.88 egg per gram (EPG). The prevalence of intestinal helminths including S. mansoni was 69.54% (169/243). Moreover, the prevalence of soil-transmitted helminths (STHs) was 40.74% (99/243), 35.80% (87/243) and 5.76% (14/243) for A. lumbricoides, T. trichiura and hookworm species, respectively. Almost similar prevalence of S.mansoni, 31.82%, 31.75%, 31.94% were recorded in age groups of 15-19, 20-24 and 25-29 years, respectively. Fishermen who are swimming always were 2.92 times [95% CI: 1.554, 5.502] more likely to acquire S. mansoni infection than other water contacting habit of the study participants. The results of the current investigation indicated the moderate endemicity of S. mansoni among the fishermen at Lake Hawassa, southern Ethiopia. Fishermen could be the potential risk group for S. mansoni infection and might be responsible for the transmission of S. mansoni to other segments of the communities. Since the high prevalence of STH was recorded among the fishermen, integrated prevention and control strategies from different sectors might be important to tackle the problem.

Keywords: S. mansoni, soil transmitted helminths, fishermen, Lake Hawassa, Ethiopia

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Authors: Ambrish Tiwari, Sudhasini Panda, Archana Singh, Kalpana Luthra, S. K. Sharma

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Introduction: On the basis of available literature we know that various host factors play a role in outcome of Tuberculosis (TB) infection by modulating innate immunity. One such factor is Inducible Nitric Oxide Synthase enzyme (iNOS) which help in the production of Nitric Oxide (NO), an antimicrobial agent. Expression of iNOS is in control of various host factors in which Vitamin D along with its nuclear receptor Vitamin D receptor (VDR) is one of them. Vitamin D along with its receptor also produces cathelicidin (antimicrobicidal agent). With this background, we attempted to investigate the levels of Vitamin D and NO along with their associated molecules in tuberculosis patients and household contacts as compared to healthy controls and assess the implication of these findings in susceptibility to tuberculosis (TB). Study subjects and methods: 100 active TB patients, 75 household contacts, and 70 healthy controls were taken. VDR and iNOS mRNA levels were studied using real-time PCR. Serum VDR, cathelicidin, iNOS levels were measured using ELISA. Serum Vitamin D levels were measured in serum samples using chemiluminescence based immunoassay. NO was measured using colorimetry based kit. Results: VDR and iNOS mRNA levels were found to be lower in active TB group compared to household contacts and healthy controls (P=0.0001 and 0.005 respectively). The serum levels of Vitamin D were also found to be lower in active TB group as compared to healthy controls (P =0.001). Levels of cathelicidin and NO was higher in patient group as compared to other groups (p=0.01 and 0.5 respectively). However, the expression of VDR and iNOS and levels of vitamin D was significantly (P < 0.05) higher in household contacts compared to both active TB and healthy control groups. Inference: Higher levels of Vitamin D along with VDR and iNOS expression in household contacts as compared to patients suggest that vitamin D might have a protective role against TB which prevents activation of the disease. From our data, we can conclude that decreased vitamin D levels could be implicated in disease progression and we can use cathelicidin and NO as a biomarker for early diagnosis of pulmonary tuberculosis.

Keywords: vitamin D, VDR, iNOS, tuberculosis

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Authors: Junaid Mahmood Alam

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Revalidating and harmonizing clinical chemistry analytical principles and optimizing methods through quality control programs and assessments is the preeminent means to attain optimal outcome within the clinical laboratory services. Present study reports revalidation of our existing IFCC regularized analytical methods, particularly hepatic and thyroid function tests, by optimization of precision analyses and processing through external and internal quality assessments and regression determination. Parametric components of hepatic (Bilirubin ALT, γGT, ALP), cardiac (LDH, AST, Trop I) and thyroid/pituitary (T3, T4, TSH, FT3, FT4) function tests were used to validate analytical techniques on automated chemistry and immunological analyzers namely Hitachi 912, Cobas 6000 e601, Cobas c501, Cobas e411 with UV kinetic, colorimetric dry chemistry principles and Electro-Chemiluminescence immunoassay (ECLi) techniques. Process of validation and revalidation was completed with evaluating and assessing the precision analyzed Preci-control data of various instruments plotting against each other with regression analyses R2. Results showed that: Revalidation and optimization of respective parameters that were accredited through CAP, CLSI and NEQAPP assessments depicted 99.0% to 99.8% optimization, in addition to the methodology and instruments used for analyses. Regression R2 analysis of BilT was 0.996, whereas that of ALT, ALP, γGT, LDH, AST, Trop I, T3, T4, TSH, FT3, and FT4 exhibited R2 0.998, 0.997, 0.993, 0.967, 0.970, 0.980, 0.976, 0.996, 0.997, 0.997, and R2 0.990, respectively. This confirmed marked harmonization of analytical methods and instrumentations thus revalidating optimized precision standardization as per IFCC recommended guidelines. It is concluded that practices of revalidating and harmonizing the existing or any new services should be followed by all clinical laboratories, especially those associated with tertiary care hospital. This is will ensure deliverance of standardized, proficiency tested, optimized services for prompt and better patient care that will guarantee maximum patients’ confidence.

Keywords: revalidation, standardized, IFCC, CAP, harmonized

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Authors: Ceyda Okudu, Secil Eroglu, Khandakar A. S. M. Saadat, Sibel O. Balci

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Ring Finger Protein 2 (RNF2) is a member of polycomb repressive complex 1 (PRC1), which is one of the epigenetic regulators in the genome. When RNF2 combines with other PRC1 members, it mediates the mono-ubiquitination of Histon2A (H2A). In breast cancer, RNF2 is commonly overexpressed, and also it promotes metastasis and invasion in other aggressive tumors like melanoma, prostate, and hepatocarcinoma. The role of RNF2 in the metastasis and invasion of breast cancer has not yet been elucidated. Our aim is to observe the role of RNF2 in metastasis and invasion in this study by miRNA mediated RNF2 gene silencing in breast cancer cell lines. We selected miRNAs, targeting to RNF2 by searching online databases. miR-17-5p, miR20a-5p, and miR-106b-5p were transfected to breast cancer cell lines (MCF-7, MDA-MB-231, SK-BR-3, and ZR-75-1), and also we used normal breast epithelial cell line (hTERT-HME1) to compare RNF2 gene expression level. After 48-72 hours post-transfection, mRNAs were isolated from the cells, and gene expressions were measured by RT-qPCR after from cDNA syntheses. We observed that RNF2 was highly expressed in SK-BR-3 and MDA-MB-231 cell lines opposite to MCF-7 and ZR-75-1 cell lines. RNF2 was downregulated 5, 5 and 7 fold by miR17-5p, miR20a-5p and miR106b-5p respectively in MCF-7. However, in SK-BR-3 and ZR-75-1 cell lines, miRNAs did not affect significantly RNF2 gene expression level. miR20a-5p decreased RNF2 3 fold and miR17-5p and miR106b-5p did not affect MDA-MB-231. After gene expression analysis, we performed metastasis and invasion assay in MCF-7 cells. For metastasis, we used both wound healing assay and Transwell Cell Migration Assay, and we used Transwell Cell Invasion Assay for invasion. The data of this assay showed that miR17-5p and miR20a-5p decreased both invasion and metastasis level, but miR106b-5p has no effect. We would like to conclude that RNF2 can be targeted by miR17-5p, miR20a-5p and miR106b-5p in MCF-7 cells and also RNF2, which is one of the upregulated genes in aggressive tumor, can be decreased by using these miRNAs. In future, we would like to confirm these results at the protein level and also whether these miRNAs are direct target of RNF2 or not.

Keywords: breast cancer, epigenetic, microRNAs, RNF2

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Authors: Liana Gomide, Juliana Rodrigues

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The morphology of the foot defines its mode of operation and a biomechanical reform indispensable for a symmetrical distribution of plantar pressures in order not to overload some of its components in isolation. High plantar pressures at specific points in the foot may be a causal factor in several orthopedic disorders that affect the feet such as pain and stress fracture. With digital baro-podometry equipment one can observe an intensity of pressures along the entire foot and quantify some of the movements, such as a subtalar pronation present in the midfoot region. Although, they are involved in microtraumas. In clinical practice, excessive movement has been limited with the use of different taping techniques applied on the plantar arch. Thus, the objective of the present study was to analyze and compare the influence of the inelastic and elastic taping on the distribution of plantar pressure of runners pronators. This is a randomized clinical trial and blind-crossover. Twenty (20) male subjects, mean age 33 ± 7 years old, mean body mass of 71 ± 7 kg, mean height of 174 ± 6 cm, were included in the study. A data collection was carried out by a single research through barop-odometry equipment - Tekscan, model F-scan mobile. The tests were performed at three different times. In the first, an initial barop-odometric evaluation was performed, without a bandage application, with edges at a speed of 9.0 km/h. In the second and third moments, the inelastic or elastic taping was applied consecutively, according to the definition defined in the randomization. As results, it was observed that both as inelastic and elastic taping, provided significant reductions in contact pressure and peak pressure values when compared to the moment without a taping. However, an elastic taping was more effective in decreasing contact pressure (no bandage = 714 ± 201, elastic taping = 690 ± 210 and inelastic taping = 716 ± 180) and no peak pressure in the midfoot region (no bandage = 1490 ± 42, elastic taping = 1273 ± 323 and inelastic taping = 1487 ± 437). It is possible to conclude that it is an elastic taping provided by pressure in the middle region, thereby reducing the subtalar pronunciation event during the run.

Keywords: elastic taping, inelastic taping, running, subtalar pronation

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Authors: M. Ntšolo, D. Kalumba, N. Lefu, G. Letlatsa

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Rock mass damage due to shear tectonic activity has been investigated largely in geoscience where fluid transport is of major interest. However, little has been studied on the effect of shear zones on rock mass behavior and its impact on stability of rock slopes. At Letšeng Diamonds open pit mine in Lesotho, the shear zone composed of sheared kimberlite material, calcite and altered basalt is forming part of the haul ramp into the main pit cut 3. The alarming rate at which the shear zone is deteriorating has triggered concerns about both local and global stability of pit the walls. This study presents the numerical modelling of the open pit slope affected by shear zone at Letšeng Diamond Mine (LDM). Analysis of the slope involved development of the slope model by using a two-dimensional finite element code RS2. Interfaces between shear zone and host rock were represented by special joint elements incorporated in the finite element code. The analysis of structural geological mapping data provided a good platform to understand the joint network. Major joints including shear zone were incorporated into the model for simulation. This approach proved successful by demonstrating that continuum modelling can be used to evaluate evolution of stresses, strain, plastic yielding and failure mechanisms that are consistent with field observations. Structural control due to geological shear zone structure proved to be important in its location, size and orientation. Furthermore, the model analyzed slope deformation and sliding possibility along shear zone interfaces. This type of approach can predict shear zone deformation and failure mechanism, hence mitigation strategies can be deployed for safety of human lives and property within mine pits.

Keywords: numerical modeling, open pit mine, shear zone, slope stability

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Authors: Mohammad Altaf Hossain

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A growing body of literature in urban studies has presented that urban precarity has been a lived experience for low-income groups of people in the cities of the Global South. It does not necessarily mean that cities in the Global North, where advanced capitalist economies exist, avoided the adverse realities of urban precarity. As a multifaceted condition, it creates other associated precariousness in lives -for example, economic deprivation, mental stress, and housing precarity. The interrelations between urbanity and precarity have been ubiquitous regardless of the developed and developing countries. People, mainly manual labourers with low incomes, go through uncertainties in every aspect of life. By analysing qualitative data and embracing structure-agency interaction, this paper intends to present how Bangladeshi migrants experience housing precarity in Dublin. Continued population growth and political economy factors such as labour market inequality, financialisation of the private rental sector, and the impact of cuts to government funding for social housing provision are combined to produce a housing supply crisis, affordability, and access in the city. As a result, low-income people practice informality in securing jobs and housing. The macro-structural components of this analysis include the Irish housing policy, the European labour market, the immigration policy, and the financialised housing market. The micro-structural components of South Asian communities’ experiences include social networks and social class. Access to social networks and practices of informality play a significant role in enabling them to negotiate urban precarity, including housing crises and income insecurity. In some cases, the collective agency of ethnic diaspora communities plays a vital role in negotiating with structural constraints.

Keywords: housing precarity, housing pathways, migration, agency, Dublin

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Authors: Anshika Kankane, Dongshik Kang

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Marine debris has a significant influence on coastal environments, damaging biodiversity, and causing loss and damage to marine and ocean sector. A functional cost-effective and automatic approach has been used to look up at this problem. Computer vision combined with a deep learning-based model is being proposed to identify and categorize marine debris of seven kinds on different beach locations of Japan. This research compares state-of-the-art deep learning models with a suggested model architecture that is utilized as a feature extractor for debris categorization. The model is being proposed to detect seven categories of litter using a manually constructed debris dataset, with the help of Mask R-CNN for instance segmentation and a shape matching network called HOGShape, which can then be cleaned on time by clean-up organizations using warning notifications of the system. The manually constructed dataset for this system is created by annotating the images taken by fixed KaKaXi camera using CVAT annotation tool with seven kinds of category labels. A pre-trained HOG feature extractor on LIBSVM is being used along with multiple templates matching on HOG maps of images and HOG maps of templates to improve the predicted masked images obtained via Mask R-CNN training. This system intends to timely alert the cleanup organizations with the warning notifications using live recorded beach debris data. The suggested network results in the improvement of misclassified debris masks of debris objects with different illuminations, shapes, viewpoints and litter with occlusions which have vague visibility.

Keywords: computer vision, debris, deep learning, fixed live camera images, histogram of gradients feature extractor, instance segmentation, manually annotated dataset, multiple template matching

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Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

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Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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Authors: Xiaoqin Wang, Li Yin

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Background and purpose: In many practices, one estimates causal effects arising from a complex stochastic process, where a sequence of treatments are assigned to influence a certain outcome of interest, and there exist time-dependent covariates between treatments. When covariates are plentiful and/or continuous, statistical modeling is needed to reduce the huge dimensionality of the problem and allow for the estimation of causal effects. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to conduct the modeling via point effects. The purpose of the work is to study the modeling of these causal effects via point effects. Challenges and solutions: The time-dependent covariates often have influences from earlier treatments as well as on subsequent treatments. Consequently, the standard parameters – i.e., the mean of the outcome given all treatments and covariates-- are essentially all different (null paradox). Furthermore, the dimension of the parameters is huge (curse of dimensionality). Therefore, it can be difficult to conduct the modeling in terms of standard parameters. Instead of standard parameters, we have use point effects of treatments to develop likelihood-based parametric approach to the modeling of these causal effects and are able to model the causal effects of a sequence of treatments by modeling a small number of point effects of individual treatment Achievements: We are able to conduct the modeling of the causal effects from a sequence of treatments in the familiar framework of single-point causal inference. The simulation shows that our method achieves not only an unbiased estimate for the causal effect but also the nominal level of type I error and a low level of type II error for the hypothesis testing. We have applied this method to a longitudinal study of COVID-19 mortality among Scandinavian countries and found that the Swedish approach performed far worse than the other countries' approach for COVID-19 mortality and the poor performance was largely due to its early measure during the initial period of the pandemic.

Keywords: causal effect, point effect, statistical modelling, sequential causal inference

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Authors: Amessalu Atenafu Gelaw, Nele Rath

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Currently, laser hardening process is becoming among the most efficient and effective hardening technique due to its significant advantages. The source where heat is generated, the absence of cooling media, self-quenching property, less distortion nature due to localized heat input, environmental friendly behavior and less time to finish the operation are among the main benefits to adopt this technology. This day, a variety of injection machines are used in plastic, textile, electrical and mechanical industries. Due to the fast growing of composite technology, fiber reinforced polymer matrix becoming optional solution to use in these industries. Due, to the abrasion nature of fiber reinforced polymer matrix composite on the injection components, many parts are outdated before the design period. Niko, a company specialized in injection molded products, suffers from the short lifetime of the injection nozzles of the molds, due to the use of fiber reinforced and, therefore, more abrasive polymer matrix. To prolong the lifetime of these molds, hardening the susceptible component like the injecting nozzles was a must. In this paper, the laser hardening process is investigated on Unimax, a type of stainless steel. The investigation to get optimal results for the nozzle-case was performed in three steps. First, the optimal parameters for maximum possible hardenability for the investigated nozzle material is investigated on a flat sample, using experimental testing as well as thermal simulation. Next, the effect of an inclination on the maximum temperature is analyzed both by experimental testing and validation through simulation. Finally, the data combined and applied for the nozzle. This paper describes possible strategies and methods for laser hardening of the nozzle to reach hardness of at least 720 HV for the material investigated. It has been proven, that the nozzle can be laser hardened to over 900 HV with the option of even higher results when more precise positioning of the laser can be assured.

Keywords: absorptivity, fiber reinforced matrix, laser hardening, Nd:YAG laser

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Authors: Archana Soni, Arvind Mittal, Manmohan Kapshe

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Energy has been recognized as one of the key inputs for the economic growth and social development of a country. High economic growth naturally means a high level of energy consumption. However, in the present energy scenario where there is a wide gap between the energy generation and energy consumption, it is extremely difficult to match the demand with the supply. India being one of the largest and rapidly growing developing countries, there is an impending energy crisis which requires immediate measures to be adopted. In this situation, the concept of Energy Intensity comes under special focus to ensure energy security in an environmentally sustainable way. Energy Intensity is defined as the energy consumed per unit output in the context of industrial energy practices. It is a key determinant of the projections of future energy demands which assists in policy making. Energy Intensity is inversely related to energy efficiency; lesser the energy required to produce a unit of output or service, the greater is the energy efficiency. Energy Intensity of Indian manufacturing industries is among the highest in the world and stands for enormous energy consumption. Hence, reducing the Energy Intensity of Indian manufacturing industries is one of the best strategies to achieve a low level of energy consumption and conserve energy. This study attempts to analyse the factors which influence the Energy Intensity of Indian manufacturing firms and how they can be used to reduce the Energy Intensity. The paper considers six of the largest energy consuming manufacturing industries in India viz. Aluminium, Cement, Iron & Steel Industries, Textile Industries, Fertilizer and Paper industries and conducts a detailed Energy Intensity analysis using the data from PROWESS database of the Centre for Monitoring Indian Economy (CMIE). A total of twelve independent explanatory variables based on various factors such as raw material, labour, machinery, repair and maintenance, production technology, outsourcing, research and development, number of employees, wages paid, profit margin and capital invested have been taken into consideration for the analysis.

Keywords: energy intensity, explanatory variables, manufacturing industries, PROWESS database

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Authors: Morenike Abimbola Adeleye, Anthony Temidayo Bolarinwa

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The genesis of talc bodies around Wonu, Ibadan-Apomu area, southwestern Nigeria, has been speculative due to inadequate compositional data on the talc and the mafic-ultramafic protoliths. Petrography, morphology, using scanning electron microscope, mineral chemistry, X-ray diffraction, and major, trace and rare-earth element compositions of the talc and the mafic-ultramafic in the area were undertaken with a view to determine the genesis of the talc bodies. Fine-grained amphibolite and lherzolite are the major mafic-ultramafic rocks in the study area. The amphibolite is fine-grained, composed of amphiboles, pyroxenes plagioclase, K-feldspar, ilmenite, magnetite, and garnet. The lherzolite and talc are composed of olivines, pyroxenes, amphiboles, and plagioclase. Alteration minerals include serpentine, amesite, talc, Cr-bearing clinochlore, and ferritchromite. Cr-spinel, pyrite, and magnetite are the accessory minerals present. Alteration of olivines, pyroxenes, and amphiboles to talc and chlinochlore; and spinel to ferritchchromite by hydrothermal (H₂O-CO₂-Cl-HF) fluids, provided by the granitic intrusions in the area, showed retrograde metasomatism of amphibolites to greenschist facies at 500-550ºC. This led to the formation of talc, amesite, anthophyllite, actinolite, and tremolite. The Al₂O₃-Fe₂O₃+TiO₂-MgO discrimination diagram suggests tholeiitic protolith for the amphibolite and komatitic protolith for the lherzolite. The lherzolite has flat rare-earth element patterns typical of komatiites and dunites. The Al₂O₃/TiO₂ ratios, Ce/Nb vs. Th/Nb, Cr-TiO₂, TiO₂ vs. Al₂O₃, and Nd vs. Nb discrimination diagrams indicated that the talcs are from two-parent sources: altered metacarbonates and tholeiitic basalts (amphibolites) to komatitic basalts (lherzolites).

Keywords: amphibolites, lherzolites, talc, komatiite

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Authors: Ruth Nsibirano

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Online mode of delivery in higher institutions of learning, popularly known in some circles as e-Learning or distance education is a new phenomenon that is steadily taking root in African universities but specifically at Makerere University. For slightly over a decade, the Department of Open and Distance Learning has been offering the first generation mode of distance education. In this, learning and teaching experiences were based on the use of hard copy materials circulated through postal services in a rather correspondence mode. There were more challenges to this including high dropout rates, limited support to the learners and sustainability issues. Fortunately, the Department was supported by the Norwegian Government through a NORHED grant to “leapfrog” to the fifth generation of distance education that makes more use of educational technologies and tools. The capacity of faculty staff was gradually enhanced through a series of training to handle the upgraded structure of fifth generation distance education. The trained staff was then tasked to develop modules befitting an online delivery mode, for use on the program. This paper will present attitudes, experiences of the course writers with a view of sharing the good practices that enabled them leap from e-faculty trainees to distinct online course writers. This perspective will hopefully serve as building blocks to enhance the capacity of other upcoming distance education programs in low capacity universities and also promote the uptake of e-Education on the continent and beyond. Methodologically the findings were collected through individual interviews with the 30 course writers. In addition, semi structured questionnaires were designed to collect data on the profile, challenges and lessons from the writers. Findings show that the attitudes of course writers on project supported activities are so much tagged to the returns from their committed efforts. In conclusion, therefore, it is strategically useful to assess and selectively choose which individual to nominate for involvement at the initial stages.

Keywords: distance education, online course content, staff attitudes, best practices in online learning

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Authors: Juan José Mesas, Luis Sainz

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The motivation for the development of this paper lies in the need for energy networks to reduce losses, improve performance, optimize their operation and try to benefit from the interconnection capacity with other networks enabled for other energy carriers. These interconnections generate interdependencies between some energy networks and others, which requires suitable models and methods for their analysis. Traditionally, the modeling and study of energy networks have been carried out independently for each energy carrier. Thus, there are well-established models and methods for the steady-state analysis of electrical networks, gas networks, and thermal networks separately. What is intended is to extend and combine them adequately to be able to face in an integrated way the steady-state analysis of networks with multiple energy carriers. Firstly, the added value of multi-energy networks, their operation, and the basic principles that characterize them are explained. In addition, two current aspects of great relevance are exposed: the storage technologies and the coupling elements used to interconnect one energy network with another. Secondly, the characteristic equations of the different energy networks necessary to carry out the steady-state analysis are detailed. The electrical network, the natural gas network, and the thermal network of heat and cold are considered in this paper. After the presentation of the equations, a particular case of the steady-state analysis of a specific multi-energy network is studied. This network is represented graphically, the interconnections between the different energy carriers are described, their technical data are exposed and the equations that have previously been presented theoretically are formulated and developed. Finally, the two iterative numerical resolution methods considered in this paper are presented, as well as the resolution procedure and the results obtained. The pros and cons of the application of both methods are explained. It is verified that the results obtained for the electrical network (voltages in modulus and angle), the natural gas network (pressures), and the thermal network (mass flows and temperatures) are correct since they comply with the distribution, operation, consumption and technical characteristics of the multi-energy network under study.

Keywords: coupling elements, energy carriers, multi-energy networks, steady-state analysis

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Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra

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Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatment

Keywords: very young, breast cancer, outcome, developing country, India

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Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

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Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

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Authors: Franco Miguel Nodado, Adrienne Marie Bugayong Janagap, Allen Claire Arances, Kirsten Anne Gerez, Frances Catherine Rosario, Charise Alvyne Samaniego, Matt Andrew Secular, Rommel Gestuveo, Marilyn Sumayo, Joseph Arbizo, Philip Ian Padilla

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COVID-19 pandemic adversely affected the delivery of health care services, but its impacts on Maternal, Newborn, Child Health and Nutrition (MNCHN) programs in rural municipalities in the Philippines remains understudied. Thus, this study explored the effects of the pandemic on MNCHN indicators in the municipalities of Miagao, Iloilo and Sibunag, Guimaras. A cross-sectional design was employed to compare the MNCHN indicators before and during the pandemic, and between Miagao and Sibunag. Key informant interviews (KII) were performed to identify the factors affecting access to MNCHN programs. During the pandemic, Miagao had a significant increase in positive outcomes of eight out of ten maternal health indicators, while Sibunag showed a significant decrease in six indicators. For child health and nutrition, Miagao obtained significant improvements in five of seven indicators, while Sibunag showed a significant increase in positive outcomes for six. KII data showed that the primary concern of mothers in Miagao is accessibility, while mothers in Sibunag raised concerns on accessibility, availability, and affordability of these MNCHN services. Miagao MHO employed various strategies such as telemedicine, activation of barangay health workers, and decentralization of health services to Barangay Health Centers, which can explain the improvements in MNCHN indicators. Sibunag also decentralized its health services, but its limited resources might have led them to prioritize child health and nutrition services. The findings suggest that the impacts of the COVID-19 pandemic on MNCHN depend on local health measures employed by the municipality, while telemedicine is a very useful tool in mitigating the negative effects of disrupted health services.

Keywords: maternal, child, COVID-19, Miagao, Sibunag, nutrition

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