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Factors influencing the determination of dosing weight in the neonatal intensive care unit (NICU)

Midwifery care in The Gambia: A focus group study with clinical midwives, midwifery students, educators and leaders on how barriers and facilitators impact quality midwifery care

Objective The aim of this study is to explore the impact of barriers and facilitators on the quality of midwifery care in The Gambia, from the perspectives of clinical midwives, midwifery students, educators, and leaders. Methods A qualitative study based on focus group discussions with 29 clinical midwives, midwifery students, educators and leaders analysed with content analysis. The study was conducted in The Gambia. Results The analyses led to three main categories outlining barriers and facilitators for the quality of midwifery care: 1) the gap between theory and practice, 2) working in a harsh environment and 3) facilitating factors that can pave ways forward. The results are described in generic categories: 1a) national plans and facility-based guidelines, 1b) midwifery education, 1c) becoming a skilled midwife, 2a) scarcity of resources, 2b) encountering community barriers, 2c) midwives - a passionate but demotivated profession, 3a) positive assets for quality midwifery care, 3b) women in leadership as a tool for a motivated midwifery workforce and 3c) teamwork. Conclusions Addressing the gaps between theory and practice, and strengthening the incentives for midwives to remain in their profession are central for improved quality of midwifery care in The Gambia. Guaranteed employment after completing education, equal opportunities for men and women to become midwives and the significance of passion are assets which need to be carefully maintained within the health care system.

Usage of magnetic activated carbon as a potential adsorbent for aniline adsorption from wastewater

Investigation into the sero-molecular prevalence of Brucella melitensis in small ruminants in districts Mohmand and Charsadda Khyber Pakhtunkhwa Pakistan

Globally, ruminants contribute largely to the livelihood and supply of quality food for human consumption. However, small ruminants face numerous problems, including infectious diseases, in lower- and middle-income countries (LMIC). Brucellosis is one of the important zoonotic diseases affecting the range of animals caused by Brucella species, including Brucella abortus and Brucella mellitensis. Although brucellosis caused by B. mellitensis in small ruminants has never been reported in the study areas, its zoonotic importance can never be underestimated. Therefore, this study was designed to investigate the sero-molecular prevalence of B. mellitensis in small ruminants in districts Mohmand and Charsadda of Khyber Pakhtunkhwa, Pakistan. A total of 400 blood samples were collected from sheep and goats (n = 200 from each species) and analyzed by Rose Bengal precipitation test (RBPT), the indirect enzyme-linked immunosorbent assay (i-ELISA) and polymerase chain reaction (PCR). The findings of the study indicated 13.5% and 7% of sheep while 12.5% and 12.5% of goat’s samples by RBPT and (i-ELISA) respectively. The species-specific PCR confirmed B. abortus in 70% of sheep samples and 37.5% of goat’s samples and B. mellitensis in 25% of sheep and 62.5% of goat’s samples by targeting IS711. The findings of the study concluded that B. abortus and B. melitensis were circulating in sheep and goats with a higher prevalence in the study areas. This study detected the presence of B. mellitensis for the first time in small ruminants in the study areas.

Multiscale correlations between joint and tissue-specific biomechanics and anatomy in postmortem ovine stifles

Abstract Joint stability depends on various properties that include the bone anatomy, joint capsule geometry and stiffness, and soft tissues within. The multiscale biomechanical relationships between the whole joint and individual tissues are useful in estimating the physiological condition of the knee. To better understand these relationships, we evaluated multiple structural and mechanical parameters in healthy ovine stifles, specifically joint laxity, joint morphology, individual tissue T 2 * relaxation and mechanical properties of ligaments (ACL, PCL, MCL, LCL), patellar tendon, menisci, and cartilage. By combining mechanical testing at two length scales and magnetic resonance imaging (MRI) scans, we quantify the strength of correlation coefficients between measured metrics, among joint size, whole joint and individual tissue properties. We observe positive correlations between joint laxity forces and the inter-epicondylar distance. Further, the viscoelastic properties of the tendons and ligaments correlate positively with joint laxity forces; however, no such correlations were observed for the cartilage and menisci. We also found weak inverse correlation between tissue viscoelasticity and T 2 * for MCL; and positive correlations for cartilage and menisci, LCL and PCL respectively. These results provide useful insights into the role of individual tissues that are crucial in measuring whole joint responses as key indicators of knee health.

Nonlinear connectedness of conventional crypto-assets and sustainable crypto-assets with climate change: A complex systems modelling approach

Earlier studies used classical time series models to forecast the nonlinear connectedness of conventional crypto-assets with CO2 emissions. For the first time, this study aims to provide a data-driven Nonlinear System Identification technique to study the nonlinear connectedness of crypto-assets with CO2 emissions. Using daily data from January 2, 2019, to March 31, 2023, we investigate the nonlinear connectedness among conventional crypto-assets, sustainable crypto-assets, and CO2 emissions based on our proposed model, Multiple Inputs Single Output (MISO) Nonlinear Autoregressive with Exogenous Inputs (NARX). Intriguingly, the forecasting accuracy of the proposed model improves with the inclusion of exogenous input variables (conventional and sustainable crypto-assets). Overall, our results reveal that conventional crypto-assets exhibit slightly stronger connectedness with CO2 emissions compared to sustainable crypto-assets. These findings suggest that, to some extent, sustainable crypto-assets provide a solution to the environmental issues related to CO2 emissions. However, further improvements in sustainable crypto-assets through technological advances are required to develop more energy-efficient decentralised finance consensus algorithms, with the aim of reshaping the cryptocurrency ecosystem into an environmentally sustainable market.

A flexible way to study composites in ecology using structural equation modeling

Abstract Composites, which refer to weighted linear combinations of variables, are receiving increasing attention in the field of ecology. In practice, however, researchers relying on the common approaches to study composites encounter limitations in flexibly specifying composites with structural equation modeling (SEM). To enrich the researchers’ statistical toolbox and to flexibly model composites in structural equation models, we introduce the Henseler–Ogasawara (H–O) specification to the field of ecology. As we show in this paper, this approach can not only mimic the common approaches such as the one-step and two-step approaches, but also offers improvements. Compared to the two-step approach, the H–O specification explicitly models composites, i.e., it takes into account the formation of the composites and it allows modeling composites with free weights and with fixed weights, i.e., unknown-weight and fixed weight composites. Consequently, this specification allows for a more in-depth model assessment. Compared to the one-step approach, the H–O specification offers more modeling flexibility. For example, it allows researchers to specify the effects of other variables on a composite. Consequently, conceptual models can be more adequately represented by the statistical model using this specification. To demonstrate these advantages, we provide an ecological illustrative example including the R code to reproduce our results. Specifically, we present different H–O specifications and compare them statistically. Our analysis also shows that the specified model, closest to the conceptual model of the illustrative example does not adequately describe the data. Instead, a model that does not assume that all covariances between the components of the composites are accounted for by the composites fits the data well.

Force analysis of slope reinforced by Frame-Anchor-Support-Structure based on improved horizontal slice method

As a flexible support structure commonly used in slope stabilization and management, the Frame-Anchor-Support-Structure (FASS) is of great significance in studying the actual stress situation to ensure the safety of slopes. In this paper, based on the traditional horizontal slice method, utilizing the principle that the vertical slice method and the horizontal slice method share the same sliding surface, the inter-strip force between soil slices, the effect of the FASS, the effect of the slope-top uniform load, and the relationship between the vertical slice method and the horizontal slice method of the force conversion is considered at the same time. The improved horizontal slice method for the slope reinforced by the FASS is also proposed, and the force calculation formula for the slope reinforced by FASS is derived. By comparing and analyzing with the overall sliding wedge method, the reasonableness and accuracy of the calculation method of this paper are verified, and the variety rule of force on the slope reinforced by FASS under different loads is obtained. The results show that the combined force of lateral earth pressures on slopes calculated in this paper is smaller than that of the overall sliding wedge method, but the difference between the two is not significant (within 9% difference). The earth pressure strength of the slope, the shear stress of FASS on the sliding soil, and the vertical force strength and the shear stress of the stabilized soil on the sliding soil all show a distribution trend of small at both ends and large in the middle (about 1/3 of the position from the bottom of the slope). Moreover, the trend of the above forces does not vary with the slope-top uniform loads. The study results are informative for calculating and analyzing the forces on the slope reinforced by FASS.

Relationship between Schlemm’s canal incision length and the results of ab interno gonioscopy-assisted transluminal suture trabeculotomy

From tradition to progressiveness: Analyzing Thailand’s image on youtube amid post-cannabis legalization

This research examines the depiction of Thailand on YouTube subsequent to the nation’s decision to legalize recreational marijuana in June 2022. By analyzing 57 video clips recorded between March and September 2022, we investigate the evolution of Thailand’s digital image after the legalization of cannabis in the country. The outcomes of our study demonstrate a predominantly favorable account, highlighting the incorporation of marijuana into Thai society, its therapeutic capabilities, and its potential as a lucrative economic commodity. In intimate connection to elements of the social, physical, and cultural components, the emotional dimension developed as a prevailing theme. Thai residents and government officials were the main influencers in shaping the discussion, representing the prevailing public opinion in support of the choice to legalize marijuana. The prevailing media narratives, which included tourism, celebration, and policy, further emphasized the positive perspective on the advantages of legalizing marijuana. This research emphasizes the profound impact of substantial policy changes on a nation’s international reputation, with Thailand depicted as providing a distinctive combination of cultural heritage and contemporary elements.

Use of failure mode and effect analysis to improve the monoclonal antibody drugs management process in pharmacy intravenous admixture services

Customer segmentation in the digital marketing using a Q-learning based differential evolution algorithm integrated with K-means clustering

Effective and well-structured customer segmentation enables organizations to accurately identify and comprehend the distinct characteristics and needs of various customer groups, thereby facilitating the development of more targeted marketing strategies. Contemporary artificial intelligence technologies have emerged as the predominant tools for customer segmentation, owing to their robust capabilities in analyzing complex datasets and extracting profound customer insights. This paper proposes a customer segmentation framework within the realm of digital marketing, which integrates a reinforcement learning-based differential evolution algorithm with K-means clustering using dimensionality reduction techniques to address challenges in the customer segmentation process. Initially, a correlation matrix is used to identify redundant noise and multicollinear features within customer feature groups, and Principal Component Analysis is applied for denoising and dimensionality reduction to enhance the ability of the model to identify potential features. Subsequently, a parameter adaptive adjustment method based on Q-learning is proposed, which significantly augments the clustering performance of K-means. Ultimately, the effectiveness of the proposed method is validated using a Kaggle dataset, and the elbow method is employed to ascertain the optimal number of clusters. Based on the cluster category centers, the typical characteristics of different customer types are analyzed. Furthermore, four widely recognized machine learning methods are employed to classify the clustering results, achieving over 95% classification accuracy on the test set. The experimental results demonstrate that the proposed model exhibits a high degree of customer characteristic identification and segmentation, which not only enhances marketing efficiency and customer satisfaction but also fosters corporate profit growth through the strategic formulation of various marketing initiatives.

Clinical efficacy and safety study of vNOTES for benign ovarian tumors in obese patients

The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring: A systematic review and meta-analysis

Introduction Maternal tobacco smoking during pregnancy is a significant public health concern with potential long-lasting effects on child development. ADHD, a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, may be influenced by prenatal nicotine exposure. This systematic review and meta-analysis examine the association between maternal tobacco smoking during pregnancy and the risk of ADHD in offspring. Methods Following PRISMA guidelines, we searched databases including PubMed, Web of Science, Cochrane Central, Embase, Scopus, CINAHL, LILACS, SciELO, Allied and Complementary Medicine Database (AMED), ERIC, CNKI, HTA Database, Dialnet, EBSCO, LENS, and Google Scholar for studies up to November 1, 2024. We included peer-reviewed studies reporting quantitative effect size estimates for the association between maternal tobacco smoking and ADHD. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Results We identified 2,981 articles and included 55 studies (4,016,522 participants) in the analysis. The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring (pooled Odds Ratio (OR) = 1.71, 95% CI: 1.55-1.88; P < 0.001). Egger’s test indicated no publication bias (p = 0.204), but Begg’s test did (p = 0.042). By employing the trim and fill method, the revised OR was estimated to be 1.54 (95% CI: 1.40–1.70; P < 0.001). The OR were 2.37 (95% CI: 1.72–3.28; P < 0.001) in cross-sectional studies, 1.72 (95% CI: 1.49–2.00; P < 0.001) in case-control studies, and 1.53 (95% CI: 1.34–1.74; P < 0.001) in cohort studies. Meta-regression showed study design and study region significantly influenced heterogeneity (P < 0.10). Sensitivity and subgroup analyses confirmed the robustness of these findings. Conclusion This systematic review and meta-analysis demonstrate a significant association between maternal tobacco smoking during pregnancy and increased odds of ADHD in offspring. These findings highlight the need for prenatal care guidelines and tobacco smoking cessation programs for pregnant women to reduce ADHD risk and promote optimal neurodevelopmental outcomes. Future research should explore underlying mechanisms and potential confounders further.

Unilocular adipocyte and lipid tracer for immunofluorescent images

A comprehensive analysis of deep learning and transfer learning techniques for skin cancer classification

Investigation and evaluation of the efficiency of palm kernel oil extract for corrosion inhibition of brass artifacts

Abstract Brass (Cu–Zn alloy) used in the crescent of the Al-Maradani Mosque pulpit is subjected to corrosion under certain conditions, such as exposure to polluted air, oxidizing acids, and compounds containing sulphur or ammonia. This study aimed to evaluate the effectiveness of palm kernel oil extract (PKO) as a green corrosion inhibitor for protecting brass artifacts. The crescent was analyzed using metallographic microscopy, scanning electron microscopy (SEM) with energy-dispersive X-ray (EDX), and X-ray diffraction (XRD) to identify its alloy composition, microstructure and corrosion products. The analyses confirmed the crescent was made of a brass alloy (Cu–Zn) and formed by hammering, with corrosion layers composed primarily of cuprite and clinoatacamite, covered by dust containing calcite and quartz. The corrosion protection efficiency of the PKO was evaluated using brass coupons, simulating the artifact of the alloy. Electrochemical methods, including the open circuit potential (OCP), Tafel, and electrochemical impedance spectroscopy (EIS), were used to assess the performance of palm kernel oil on brass coupons at different concentrations (1, 3, 5, 7%). Electrochemical tests showed that corrosion inhibition efficiency increased with higher palm kernel oil concentrations, with the 7% concentration exhibiting the highest corrosion protection, up to 99.7%.

Impact of type 2 diabetes mellitus on results in the animal naming test in patients with and without liver cirrhosis

Introduction and objectives Diabetes mellitus is a common comorbidity in patients with cirrhosis and is associated with the development of hepatic encephalopathy (HE) and cognitive dysfunction. The simplified Animal Naming Test (S-ANT1) has been established for detecting minimal HE (MHE). It is currently unknown whether S-ANT1 results are affected by diabetes mellitus in patients with and without cirrhosis. Materials and methods This study analyzed data from 268 patients with cirrhosis without signs of HE ≥ 1. MHE was defined using the psychometric hepatic encephalopathy score (PHES). All patients were also tested with S-ANT1. 14 patients with diabetes mellitus and diabetic foot syndrome but no cirrhosis, as well as 37 healthy controls, were also tested with S-ANT1 and served as controls. Results Type 2 diabetes mellitus was present in 79 (29.5%) patients with cirrhosis and MHE according to PHES was detected in 81 (30.2%) patients. In the total cohort, results in S-ANT1 did not differ between patients with and without diabetes mellitus (19 vs. 20 animals, p = 0.108). In multivariable logistic regression analysis, the only variables independently associated with performance in S-ANT1 were PHES-MHE, school education, sodium, and age, while diabetes mellitus was not. Patients with diabetic foot syndrome but no cirrhosis performed poorer in S-ANT1 compared to healthy controls, while patients with cirrhosis and MHE performed poorer than patients with diabetic foot syndrome. Conclusion S-ANT1 seems to be usable for screening for MHE in patients with cirrhosis and type 2 diabetes mellitus, while one might be more cautious when interpreting results in patients with diabetes-related complications.

Dietary and lifestyle indices for hyperinsulinemia and odds of MAFLD in overweight and obese children and adolescents

Guinea grass (Megathyrsus maximus) agronomic performances in mixed cultivation using irrigation condition, North-Western Ethiopia

In this field experiment, the agronomic performance of Guinea grass was evaluated to assess the optimum planting spacing and harvesting age in mixed cultivation under irrigation conditions. These factors were arranged according to a 3*3 factorial setting, which was fitted to a randomized complete block design and replicated three times. This trial used three planting spaces (20, 30 and 40 cm) and harvesting ages (60, 90 and 120 days), grown in a mixed cropping system with Silver leaf desmodium using a furrow irrigation. The collected data includes plant height, leaves per plant, leaf length per plant, leaf to stem ratio, number of tillers per plant, number of roots per plant, root length per plant, and dry matter yield. The results of the study showed that age at harvest and planting space had a significant (P<0.001) effect on the morphological characteristics and dry matter yield of Guinea grass. The effect of these management practices was also affected the dry matter, crude protein and crude fiber contents of the grass. The maximum performances (high records) of the morphological characteristics and dry matter yield of Guinea grass were obtained by allocating a planting space of 40 cm and prolonging the harvesting period up to 120 days. However, harvesting at 90 days (11.48% of crude protein) resulted in the optimum nutritional contents. Therefore, in the area with irrigation facilities at midland agroecology, a planting space of 40 cm and a harvesting time of 90 days could be suggested through irrigation application in the study area and similar agro-ecologies.