Hasil untuk "Office management"

Quan Wang, Zheng Zhu, Chao Gong et al.

Abstract Background E-cigarette taxation has been increasingly implemented worldwide as a fiscal and regulatory tool to curb consumption, generate revenue, and mitigate public health risks. However, the effectiveness of such policies remains uncertain, particularly given differences in tax structures, market dynamics, and consumer behaviors. This study systematically reviews and synthesizes evidence on the impact of e-cigarette taxation on governments, businesses, and consumers. Methods Following PRISMA guidelines, seven electronic databases and grey literature sources were utilized to identify relevant studies. Eligible studies included quantitative research on e-cigarette taxation policies. Data synthesis involved a narrative summary focusing on tax pass-through rates and elasticity. Meta-analysis calculated pooled odds ratios (OR) for e-cigarette usage between tax and no tax groups. Quality assessment was conducted using JBI Critical Appraisal Checklists. Results A total of 27 studies were included. The meta-analysis based on three US studies suggested a modest reduction in e-cigarette use among adults (OR: 0.89, 95% CI: 0.84–0.94) and youth aged 18–24 (OR: 0.87, 95% CI: 0.78–0.98). Notable heterogeneity in tax elasticity was observed, ranging from − 0.62 to − 0.02, suggesting inelastic demand in some cases. Limited evidence suggested that e-cigarette taxation can increase fiscal revenue, although the absolute amount remains small compared with traditional tobacco excise revenue. The pass-through rate ranged from 0.07 in China to 1.67 in the USA, highlighting differences in company pricing strategies and market responses. The ad valorem taxes had a lower pass-through rate and higher effect than specific taxes. Conclusions E-cigarette taxation impacts prices, sales, and consumption variably, influenced by tax policy specifics, market conditions, and stakeholder behavior. Coordinated tax design, aligned with broader regulatory and educational measures, is essential to enhance policy effectiveness and protect public health. Trial registration Prospero Registration Number CRD42023395112.

Rachael Sampson, Patricia Rojas Mendez, Viren Kaul

Background/Objectives: There is a paucity of research studying point-of-care ultrasound in the pregnant population, despite the rising incidence of maternal medical complications and, in particular, preeclampsia. This study sought to compare the inferior vena cava collapsibility index (IVC-CI) between patients with preeclampsia with severe features (PECS) and gestational age-matched controls and to assess whether pulse pressure (PP) correlates with IVC-CI in PECS. Methods: This was a prospective pilot study of patients recruited at an inpatient hospital and an outpatient office. The case group included admitted patients with a diagnosis of PECS considered to be stable for prolonged antepartum expectant management. One patient per gestational age week from 23 to 34 weeks with PECS was compared to a gestational age-matched patient without any form of preeclampsia and/or gestational hypertension. Patients on magnesium sulfate, those with multiple gestation, large-for-gestational age fetus, fetal growth restriction, polyhydramnios, oligohydramnios, and/or an anomalous fetus were excluded. Results: IVC-CI was significantly lower in the PECS group compared with controls (mean 20.1% vs. 48.3%, 95% CI = −0.40–−0.16, <i>p</i> < 0.001). There was an inverse relationship between IVC-CI and pulse pressure in patients with PECS. For each additional 1 mmHg in pulse pressure, the odds of having IVC-CI greater than 50% decreased by 13%. Conclusions: Patients with preeclampsia exhibit detectable changes in inferior vena cava diameter that can be assessed with bedside ultrasound and correlated with maternal PP. Future research should focus on validating these findings and exploring the clinical significance of these measurements.

Charlotte M. H. H. T. Bootsma-Robroeks, Charlotte M. H. H. T. Bootsma-Robroeks, Jessica D. Workum et al.

IntroductionThe integration of Large Language Models (LLMs) in Electronic Health Records (EHRs) has the potential to reduce administrative burden. Validating these tools in real-world clinical settings is essential for responsible implementation. In this study, the effect of implementing LLM-generated draft responses to patient questions in our EHR is evaluated with regard to adoption, use and potential time savings.Material and methodsPhysicians across 14 medical specialties in a non-English large academic hospital were invited to use LLM-generated draft replies during this prospective observational clinical cohort study of 16 weeks, choosing either the drafted or a blank reply. The adoption rate, the level of adjustments to the initial drafted responses compared to the final sent messages (using ROUGE-1 and BLEU-1 natural language processing scores), and the time spent on these adjustments were analyzed.ResultsA total of 919 messages by 100 physicians were evaluated. Clinicians used the LLM draft in 58% of replies. Of these, 43% used a large part of the suggested text for the final answer (≥10% match drafted responses: ROUGE-1: 86% similarity, vs. blank replies: ROUGE-1: 16%). Total response time did not significantly different when using a blank reply compared to using a drafted reply with ≥10% match (157 vs. 153 s, p = 0.69).DiscussionGeneral adoption of LLM-generated draft responses to patient messages was 58%, although the level of adjustments on the drafted message varied widely between medical specialties. This implicates safe use in a non-English, tertiary setting. The current implementation has not yet resulted in time savings, but a learning curve can be expected.Registration number19035.

S. Calgaro, I. Avagnina, A. Vettor et al.

BackgroundStunting is a major public health problem, especially in developing countries. In 2020, 37.5% of children under 5 years in Mozambique were stunted.ObjectivesThis study aims to describe the nutritional practices in a cohort of Mozambican children and to compare them with international recommendations. The secondary objective is to find differences between chronic malnourished (M) versus non-malnourished (NM) children and to detect factors related to malnutrition.MethodsA retrospective study was conducted, including children admitted to Beira Central Hospital in Mozambique, using a questionnaire focusing on early nutritional and complementary feeding (CF) practices. We compared the clinical and feeding characteristics of M and NM children and conducted logistic regression to identify factors associated with chronic malnutrition. Data management was performed using Microsoft Excel Office 365 and statistical analysis with Jamovi (version 2.3).ResultsA total of 103 children were studied (median age: 19 months). Seventy percent were exclusively breastfed, 56% continued breastfeeding during CF, but only 8% breastfed until 2 years of age. The introduction of CF occurred at a median age of 6 months, with the main reason being the baby’s crying. Sugar, salt, and sugary drinks were introduced before 1 year of age. At the time of the survey, 42% of the children’s diets were adequately varied. Statistical analysis showed that M children had statistically significant differences in birth weight percentile, were less likely to be breastfed, and consumed fewer dairy products than NM children. Multivariate logistic regression showed that risk factors for chronic malnutrition included HIV infection in both mother and child (OR: 7.5, 95% CI: 1.6–35.09), unaware initiation of CF (OR: 4.35, 95% CI: 1.45–13.05), and birth weight below the 10th percentile (OR: 3.26, 95% CI: 1.02–10.47). In contrast, early and frequent dairy consumption, as well as ongoing maternal breastfeeding during CF, were identified as protective factors.ConclusionIn our population, the percentage of children with a minimally acceptable diet was low. The use of human milk could be increased, and mistakes in CF practices could be corrected. Our findings highlight the need to raise awareness about the importance of breastfeeding and the timely introduction of appropriately composed CF. Increased attention should be given to children suffering from HIV, with lower birth weights, less breastfeeding, and lower dairy product consumption, in order to prevent malnutrition.

Bowen Zhang, Haojie Liang, Meining Lu et al.

Centrifugal pumps are essential to modern marine engineering systems for fluid transport. This study is to analyze the typical failure causes of sediment erosion and energy dissipation in a multi-stage centrifugal pump with different blade installation angles <i>α</i> using numerical simulation approach and on-site testing. Three different schemes with <i>α</i> = 0°, 10.85°, and 21.7° were designed. The installation angle of the blade influenced sediment erosion and energy dissipation through three key aspects: turbulent flow, particle motion, and wall roughness. Turbulent and friction dissipation, which are related to the blade angle and sediment erosion, are the leading causes of the pump failure. The symmetrical blade installation, turbulence intensity, particle impact velocity, and wall friction inside the unit were the highest, resulting in the most severe turbulence loss, wall loss, and sediment erosion under this scheme, with the maximum friction loss being 320 W·m⁻³·K⁻¹. Complex turbulence intensifies the intensity of particle motion, with the maximum sediment erosion rate <i>E</i> = 0.000052 kg·m⁻²·s⁻¹. Compared to Plan 1 and Plan 3, the performance can be improved by more than 20% and 23%, respectively. There was a positive correlation between the friction loss and erosion rate. The research presented in this study provides a novel perspective on the operation of a pump to prevent sediment erosion failure.

Youxin Wang, Daniel Q. Huang, Pingping Zhang et al.

Abstract Background & aims Pediatric metabolic dysfunction–associated steatotic liver disease (MASLD) is increasingly prevalent among children with overweight or obesity, yet its early diagnosis remains a major clinical challenge. This study aimed to identify circulating inflammatory proteins associated with MASLD and to develop a proteomic risk score (ProScore) to improve diagnostic accuracy. Methods In this cross-sectional study of 161 children (median age 8.5 years) with overweight or obesity, MASLD was assessed by vibration-controlled transient elastography, with 42 cases identified. Plasma concentrations of 92 inflammation-related proteins were quantified using a high-throughput proximity extension assay. The ProScore was compared with eleven conventional anthropometric/metabolic indices (WHtR, METS-IR, SPISE, PNFI, VAI, LAP, TyG, TyG-ALT, TyG-WC, TyG-WHtR, and TyG-BMI) and a genetic risk score (GRS). Six machine learning algorithms were employed and diagnostic performance was assessed using area under the curve (AUC) with fivefold cross-validation. Results Fifteen proteins were significantly associated with MASLD. A six-protein panel (FGF-21, CDCP1, CD244, OPG, Flt3L, MCP-1) achieved the highest diagnostic accuracy (AUC = 0.84), exceeding that of all conventional indices (AUC = 0.65–0.78; all P < 0.05). ProScore performance remained robust in school-based validation (AUC = 0.83), with no substantial improvement when combined with conventional indices. Diagnostic accuracy was higher in children with lower GRS (AUC = 0.92) than in those with higher GRS (AUC = 0.80; P = 0.003). Conclusions A proteomic signature of systemic inflammation provides accurate, non-invasive identification of MASLD in at-risk children, outperforming conventional metabolic and genetic tools, and may have utility in clinical and public health settings.

Gerhard Ortner, Betina Stur

Addisalem Workie Demsash, Milkias Dugassa Emanu, Agmasie Damtew Walle

Abstract Background In low-income countries, households’ food insecurity and the undernutrition of children are the main health problems. Ethiopia is vulnerable to food insecurity and undernutrition among children because its agricultural production system is traditional. Hence, the productive safety net program (PSNP) is implemented as a social protection system to combat food insecurity and enhance agricultural productivity by providing cash or food assistance to eligible households. So, this study aimed to explore spatial patterns of households’ insufficient cash or food receiving from PSNP, and identify its associated factors in Ethiopia. Methods The 2019 Ethiopian Mini Demographic and Health Survey dataset was used. A total of 8595 households were included in this study. Data management and descriptive analysis were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for spatial exploration and visualization. SaTScan version 9.5 software was used for spatial scan statistics reports. In the multilevel mixed effect logistic regression analysis, explanatory variables with a p-value of less than 0.05 were considered significant factors. Results Overall, 13.5% (95% CI: 12.81–14.27%) of the households’ level beneficiaries received cash or food from PSNP. The spatial distribution of households’ benficiaries received cash or food from PSNP was not random, and good access to cash or food from PSNP was detected in Addis Ababa, SNNPR, Amhara, and Oromia regions. Households’ heads aged 25–34 (AOR:1.43, 95% CI: 1.02, 2.00), 35–44 (AOR: 2.41, 95% CI: 1.72, 3.37), and > 34 (AOR: 2.54, 95% CI: 1.83, 3.51) years, being female (AOR: 1.51, 95% CI: 1.27,1.79), poor households (AOR: 1.91, 95% CI:1.52, 2.39), Amhara (AOR:.14, 95% CI: .06, .39) and Oromia (AOR:.36, 95% CI:.12, 0.91) regions, being rural residents (AOR:2.18, 95% CI: 1.21,3.94), and enrollment in CBHS (AOR: 3.34, 95% CI:2.69,4.16) are statistically significant factors. Conclusions Households have limited access to cash or food from the PSNP. Households in Addis Ababa, SNNPR, Amhara, and Oromia regions are more likely to receive benefits from PSNP. Encouraging poor and rural households to receive benefits from the PSNP and raise awareness among beneficiaries to use the benefits they received for productivity purposes. Stakeholders would ensure the eligibility criteria and pay close attention to the hotspot areas.

Mandzhikova Larisa B.

Introduction. The article discusses the history of the creation and organization of the activities of the Council of Kalmyk Administration, which carried out the administrative management of the Kalmyk steppe of the Astrakhan province in the period from 1836 to 1848. The Kalmyk Administration Council was guided in its work by the “Regulations on the Administration of the Kalmyk People” dated November 24, 1834, which regulated the structure of the governing body and the procedure for organizing work with documents. Studying the composition and content of documents created during the activities of the Council and stored in the archival fund I-3 “Council of the Astrakhan Kalmyk Administration” of the National Archive of the Republic of Kalmyk will allow for analysis and determination of the directions of its activities. The purpose of the article is to study the archival documents of the I-3 Foundation “Council of Kalmyk Administration” and to identify their source potential for studying the organization of activities of the body for governing the Kalmyk people, especially in the management of office work and document flow in pre-revolutionary Kalmykia. The purpose of the article is to study the archival documents of the I-3 Foundation “Council of Kalmyk Administration” and to identify their source potential for studying the organization of activities of the body for governing the Kalmyk people, especially in the management of office work and document flow in pre-revolutionary Kalmykia. Results. The documents created during the activities of the Kalmyk Administration Council are unique written sources for the study of the life of the Kalmyk people in pre-revolutionary Russia. In addition, these studies will allow us to study the procedure for organizing work with documents in Kalmykia and identify their compliance with all-Russian regulatory requirements in the field of office work and document management.

Arezoo Shafaati, Reza Valizade, Akbar Rahimi et al.

Extent AbstractIntroductionNew urbanization developments and the emergence of problems in the world have made the central cities of metropolitan areas more vulnerable to the adverse effects of urban development compared to other urban areas. Meanwhile, technological advances have accelerated the population change and increased urban populations. This volume of rapid urbanization has had a significant impact on ancient and historical textures. The ancient and historic cores of cities with a large population of mostly immigrants in recent years have been continually deformed and their textures have been eroded. Therefore, urban planners around the world are working to integrate models of urban development so as to meet the demands and expectations of today's world by integrating all aspects of urbanization.One of the new concepts to address the current challenges of cities in the field of urban planning is smart city development. The smart city is at the heart of the evolution of the 3rd millennium and means opening up of new concepts in urban planning, which combines real-world and virtual world capabilities to solve urban problems. One of the most important projects for the development of worn-out textures, on which planners and city officials have now focused, is the idea of infill development. This theory is one of the categories of urban smart growth and if it is applied correctly, the development of old and worn-out urban areas can be strengthened.Tabriz is one of the oldest residential centers of Iran and an important city in different natural, political, demographic, and other aspects. The metropolis needs several goals to refurbish and modernize the worn-out areas in the form of smart and infill developments so as to maintain its core pillars. One of these goals is providing the basis for optimal urban development and analyzing the infill development in the context of urban development. Prioritizing the indicators, providing sub-themes of the research subject, and identifying the key variables of interstate development policies were the goals of this research. MethodologyA smart city has 6 features: smart shifting, smart economy, smart environment, smart community, smart life, and smart government. In the present study, the subsets of each of these 6 key factors, along with the infill development factors, were studied by measuring their interactions in a matrix. In this regard, the current study intended to identify the priority areas for future planning by examining different aspects of urban smart development and infill development and propose optimal strategies for effectively implementing such developments. The structural equation modeling was utilized to investigate the research conceptual model in detail. For this purpose, the opinions of 50 experts were gathered.To estimate the impacts of smart growth and interdependent development, the researchers created a 53-by-53 matrix by taking into account 34 urban smart development subdivisions and 19 interdisciplinary development subsystems with regard to indigenous and territorial conditions within the system.The 50 experts were provided with the matrix in order to identify the impact of each subsystem in the system. DiscussionThe researchers prepared a questionnaire to determine the weights of the criteria, besides conducting a survey on the opinions of the 50 experts in Tabriz University and Municipality.A total of 53 criteria were identified in a table for the two main factors of smart development and interstate development. Then, by placing these factors in a 53-by-53 matrix, their effects on each other were determined after weighting them.After determining the degree of influence and effectiveness of each of the smart development and infill development factors in the worn-out areas of Tabriz City, the relationship between these factors were investigated using Micmac software. With respect to the bi-directional variables, there was only one factor -- land use compatibility -- related to infill development and the rest of the components were among the factors that affected smart development, indicating the importance of having such development in urban growth and development. The future of the city of Tabriz in different aspects, as well as the development of its worn-out urban textures in particular, could be tied to this kind of development. ConclusionThe current research was undertaken as the first step in studying the impacts of macroeconomic policies on sustainable development and infill development as two interrelated issues. Hence, new horizons were created for the smart development of the worn-out areas of Tabriz. The results showed the prominence of the 3 critical factors of technological infrastructure, creativity, and innovation and ultimately, social and corporate cohesion in the infill development of historic and worn-out areas.A look at the results clearly revealed the impact of urban smart development on infill development that inevitably need to be further explored in planning the developments of the burnt urban areas so as to achieve a comprehensive development. Keywords: urban smart development, infill development, regeneration, worn-out tissue, Tabriz City References- Alvarez, F. (2009). The future internet. Springer Heidelberg Dordrecht London New York.- Aly, S. S., & Attwa, Y. A. (2013). Infill development as an approach for promoting compactness of urban form. WIT Transactions on Ecology and The Environment, WIT Press.- American Planning Association (APA) (2006). Planning and urban design standards. New York: John Wiley and Sons, Inc.- Basova, S., & Stefancova, L. (2017). Creative and smart public spaces. International Journal of Liberal Arts and Social Science, 5(1), 17-33.- Caragliu, A., Bo, C. D., & Nijkamp, P. (2009). Smart cities in Europe. Third Central European Conference in Regional Science. CERS.- Chiroma, M. A., Isa, A. H., Gana, B. A., & Bogoro, A. G. (2017). A review of infill development strategies in Nigeria. Journal of Applied Sciences in Environmental Sanitation, 3(8), 46-59.- Farris, J. T. (2001). The barriers to using urban infill development to achieve smart growth. Journal of Housing Policy Debate, 12(1), 1-30.- Harrison, C., & Donnelly, I. A. (2012). A theory of smart cities. Retried from IBM Cor.- Kienitz, R. (2001). Models and guidelines for infill development. Maryland Department of Planning, Managing Maryland’s Growth.- Korczak, J., & Kijewska, K. (2019). Smart logistics in the development of smart cities. Transportation Research Procedia, 39, 201-211.- Kulpa, E., & Zamorano, L.(2015). How infill development can help stop urban sprawl. Retrieved from: http://thecityfix. com/blog/author/ekulpa/accessed on February 2016.- Ligmann-Zielinska, A., Church, R., & Jankowski, P. (2005) .Sustainable urban land use allocation with spatial optimization. In 8th ICA workshop on generalization and multiple representation (pp. 1-18).- Liu, L., Chen, W., Nie, M., Zhang, F., Wang, Y., He, A., … & Yan, G. (2016). Image cloud: Medical image processing as a service for regional healthcare in a hybrid cloud environment. Journal of Environmental Health and Preventive Medicine, 21(6), 563-571.- Loo, B. P. Y., Cheng, A. H. T., & Nocholas, S. L. (2017). Transit-oriented development on greenfield versus infill sites: Some lessons from Hong Kong. Journal of Landscape and Urban Planning, 167, 37-48.- Maccani, G., Donnellan, B., & Helfert, M. (2013). The development of a framework for sustainable connected cities for Dublin, Ireland. In: 18th International Sustainable Innovation Conference, Surrey, UK.- Mahesa, R., Yudoko, G., & Anggoro, Y. (2019). Dataset on the sustainable smart city development in Indonesia. Data in Brief, 25, 104098.- McConnell, V., & Wiley, K. (2010). Infill development: Perspectives and evidence from economics and planning. Discussion paper, JEL Classification Numbers: R11, R12, R14.- Meijer, A. (2013). Governing the smart city: Scaling-up the search for socio-techno synergy. Utrecht School of Governance. Utrecht University.- Merlin, L. A. (2018). The influence of infill development on travel behavior. Journal of Research in Transportation Economies, 67, 54-67.- Moudon, A. V. (1997). Urban morphology as an emerging interdisciplinary field. Journal of Urban Morphology, 1(1), 3-10.- Ooi, J. T., & Le, T. T. (2013). The spillover effects of infill developments on local housing prices. Journal of Regional Science and Urban Economics, 43(6), 850-861.- Smart Growth Network (SGN) (2002). About smart growth. Retrieved from: www.smartgrowth.org/about.- TGM Program Staff (2001). Commercial and mixed-use development. Oregon Transportation and Growth Management.- Titu, M., Viinikka, A., Kopperoninen, L., & Geneletti, D. (2018). Balancing urban green space and residential infill development: A spatial multi-criteria approach based on practitioner engagement. Journal of Environmental Assessment Policy and Management, 20(03), 1840004.- US Environmental Protection Agency. (2014). Attracting infill development in distressed communities: 30Strategies. Office of Sustainable Communities, Smart Growth Program. Retrieved from: www.epa.gov/smartgrowth.

Jonas A. Pramudita, Wataru Hiroki, Takuya Yoda et al.

Distal radial fractures exhibit various fracture patterns. By assuming that the strain distribution at the distal radius affects the diversification of the fracture pattern, a parameter study using the finite element model of a wrist developed from computed tomography (CT) images was performed under different loading conditions. The finite element model of the wrist consisted of the radius, ulna, scaphoid, lunate, triquetrum, and major carpal ligaments. The material properties of the bone models were assigned on the basis of the Hounsfield Unit (HU) values of the CT images. An impact load was applied to the scaphoid, lunate, and triquetrum to simulate boundary conditions during fall accidents. This study considered nine different loading conditions that combine three different loading directions and three different load distribution ratios. According to the analysis results, the strain distribution at the distal radius changed with respect to the change in the loading condition. High strain concentration occurred in regions where distal radius fractures are commonly developed. The direction and distribution of the load acting on the radius were considered to be factors that may cause variations in the fracture pattern of distal radius fractures.

Zhe Yang, Kun Jiang, Miaomiao Lou et al.

Abstract Background Health data from different specialties or domains generallly have diverse formats and meanings, which can cause semantic communication barriers when these data are exchanged among heterogeneous systems. As such, this study is intended to develop a national health concept data model (HCDM) and develop a corresponding system to facilitate healthcare data standardization and centralized metadata management. Methods Based on 55 data sets (4640 data items) from 7 health business domains in China, a bottom-up approach was employed to build the structure and metadata for HCDM by referencing HL7 RIM. According to ISO/IEC 11179, a top-down approach was used to develop and standardize the data elements. Results HCDM adopted three-level architecture of class, attribute and data type, and consisted of 6 classes and 15 sub-classes. Each class had a set of descriptive attributes and every attribute was assigned a data type. 100 initial data elements (DEs) were extracted from HCDM and 144 general DEs were derived from corresponding initial DEs. Domain DEs were transformed by specializing general DEs using 12 controlled vocabularies which developed from HL7 vocabularies and actual health demands. A model-based system was successfully established to evaluate and manage the NHDD. Conclusions HCDM provided a unified metadata reference for multi-source data standardization and management. This approach of defining health data elements was a feasible solution in healthcare information standardization to enable healthcare interoperability in China.

rifzul maulina

Stunting is one of the problems that can human development globally. East Java is one of the provinces that has a high prevalence of stunting. This shows the low quality of health services. The government is committed to reduce stunting rates through several health policies. The policy is in the form of a program launched by the Indonesian Ministry of Health (Kemenkes), namely the Healthy Indonesia Program with a Family Approach (PIS-PK), Provision of Supplementary Food and the First 1000 Days of Life (HPK). The purpose of this study was to evaluate the intervention program for the management of nutritional status of stunting under five with elements of input, process and output. This research is a qualitative research. The initial informants were determined by purposive sampling technique. The data collection method was through in-depth interviews, observation and documentation of 6 initial informants consisting of the head of the puskesmas, the coordinating midwife for Children and Mother Health, the nutrition coordinator, the village midwife, framework and some target mothers. Two triangulation informants consisting of the family health coordinator and the district health office nutrition coordinator. The results showed that at the input stage, the health workers involved still needed additional, there were no nutrition workers. In the process element, some of the programs were well implemented including the family approach through home visits by framework, healthy programs for pregnant women, exclusive breastfeeding, growth monitoring, supplementary feeding, giving vitamin A except for the taburia program. In the output element, the coverage of the prevalence of stunting in the Tajinan Public Health Center, Malang Regency in 2018 was 17.24%

Kirsten Fagerli, Janell Routh, W Thane Hancock et al.

<h4>Background</h4>In September 2009, the Machinga Integrated Antenatal Water Hygiene Kit Program began addressing problems of unsafe water, high infant mortality, and low antenatal care (ANC) attendance in Machinga District, Malawi. In March 2011, the supporting international non-governmental organization transitioned management of the program to the Machinga District Health Office (DHO). We evaluated maternal and HIV service use before and after program transition to the DHO.<h4>Methods</h4>We compared pre- and post-transition periods by examining data recorded in ANC and maternal registries in 15 healthcare facilities (HCFs) by proportion z-tests. We classified HCFs by size, using the median monthly patient volumes as the split for large or small facilities. We used logistic regression to evaluate changes in the use of ANC, maternal, and HIV services and their interactions with HCF size.<h4>Results</h4>The percentage of women attending their first ANC visit during the first trimester was similar in the pre-and post-transition periods (9.3% vs 10.2%). Although the percentage of women with ≥4 ANC visits was similar from pre- to post-transition (26.0% vs 24.8%), the odds increased among women in small facilities (OR: 1.37, 95% CI: 1.24-1.51), and decreased among women in large facilities (OR: 0.80, 95% CI: 0.75-0.85). Although a similar percentages of pregnant women were diagnosed with HIV in all HCFs in the pre- and post-transitions periods (6.4% vs 4.8%), a substantially larger proportion of women were not tested for HIV in large HCFs (OR: 6.34, 95% CI: 5.88-6.84). A larger proportion of women gave birth at both small (OR: 1.30, 95% CI: 1.16-1.45) and large HCFs (OR: 1.55, 95% CI: 1.43-1.67) in the post-transition vs. the pre-transition period.<h4>Conclusions</h4>The evaluation results suggest that many positive aspects of this donor-supported program continued following transition of program management from a non-governmental organization to a DHO.

Xuan Zhao, Qiang Yu, Man Yu et al.

We propose an electronic differential system (EDS) based on a wavelet controller for electric vehicle with dual-wheeled-motor front drive. According to an analysis of current electronic differential strategies and vehicle driving dynamics, a new electronic differential strategy model of equal power allocation is proposed, and based on an analysis of the mathematical model of an interior permanent magnet synchronous motor, a new current controller based on the discrete wavelet transform is proposed using vector control. Based on A&D5435 hardware-in-the-loop simulation system and Carsim/Simulink, the test and simulation platform of the electric vehicle with dual-wheeled-motor front drive are established, and a vehicle performance simulation and test are performed under various driving conditions. The test and simulation results show that the equal power allocation EDS based on a wavelet controller for a front-wheel independent-drive electric vehicle proposed in this article shows excellent differential effects, stability, robustness, and vehicle handling stability.

Yi-Rong Lin, Mei-Yao Wu, Jen-Huai Chiang et al.

Abstract Background Many patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan. Methods We analyzed a cohort of one million individuals randomly selected from the National Health Insurance Research Database in Taiwan. We included 46,337 subjects with newly diagnosed DUB (ICD-9-CM codes 626.8) from January 1, 1997 to December 31, 2010. The patients were categorized into TCM seekers and non-TCM seekers according to their use of TCM. Results Among the subjects, 41,558 (89.69%) were TCM seekers and 4,779 (10.31%) were non-TCM seekers. Patients who were younger tended to be TCM seekers. Most of the patients had also taken Western medicine, especially tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). More than half of TCM seekers (55.41%) received combined treatment with both Chinese herbal remedies and acupuncture. The most commonly used TCM formula and single herb were Jia-Wei-Xiao-Yao-San (Bupleurum and Peony Formula) and Yi-Mu-Cao (Herba Leonuri), respectively. The core pattern of Chinese herbal medicine for DUB patients consisted of Jia-Wei-Xiao-Yao-San, Xiang-Fu (Rhizoma Cyperi), and Yi-Mu-Cao (Herba Leonuri). Conclusions TCM use is popular among patients with DUB in Taiwan. Further pharmacological investigations and clinical trials are required to validate the efficacy and safety of these items.

Najme Heidarian, سلیمان محمدی لیمایی, علیرضا امیرتیموری

The aim of this study is to measure the technical and scale efficiencyes of forest nursery in Guilan, Mazandaran and gorgan Provinces using data envelopment analysis. In this study, data of 12 forest nursery during of 4 years (2010-2013) with two inputs (fixed costs and variable costs) and two outputs (number of plant production and revenue) was collected from General Office of Guilan natural resources, Shafaroud forest Company as well as Forest Rangeland and Watershed Managements Organization. CCR and BCC models were used in order to investigate the technical efficiency. DRS model was used in order to investigate the rate of return scale in efficiency. Results indicated that Shanderman, Jokandan, Peseson and Ghrogh nurserys was completely efficient (efficiency score were 1 or 100%). Furthermore, nurseries such as Kani, Safrabaste, pelambara, Shahr posht and Lakans had the lowest efficiency, respectively. This can be due to the nature of the input models and optimal management of nurseries in the input and output.

Stephanie eFryar-Williams, Stephanie eFryar-Williams, Stephanie eFryar-Williams et al.

The Mental Health Biomarker Project aimed to discover case-predictive biomarkers for functional psychosis. In a retrospective, cross-sectional study, candidate marker results from 67, highly-characterized symptomatic participants were compared with results from 67 gender and age matched controls. Urine samples were analysed for catecholamines, their metabolites and hydroxylpyrolline-2-one, an oxidative stress marker. Blood samples were analyzed for vitamin and trace element cofactors of enzymes in the catecholamine synthesis and metabolism pathways. Cognitive, auditory and visual processing measures were assessed using a simple 45 minute, office-based procedure. Receiver Operating Curve (ROC) and Odds Ratio analysis discovered biomarkers for deficits in folate, vitamin D and B6 and elevations in free copper to zinc ratio, catecholamines and the oxidative stress marker. Deficits were discovered in peripheral visual and auditory end-organ function, intra-cerebral auditory and visual processing speed and dichotic-listening performance. 15 ROC biomarker variables were divided into 5 functional domains. Through a repeated ROC process, individual ROC variables, followed by domains and finally the overall 15 set model, were dichotomously scored and tallied for abnormal results upon which it was found that ≥ 3 out of 5 abnormal domains achieved an AUC of 0.952 with a sensitivity of 84 per cent and a specificity of 90 percent. Six additional middle ear biomarkers in a 21 biomarker set increased sensitivity to 94% percent. Fivefold cross-validation yielded a mean sensitivity of 85% for the 15 biomarker set. Non-parametric regression analysis confirmed that ≥ 3 out of 5 abnormally scored domains predicted > 50% risk of case-ness whilst 4 abnormally-scored domains predicted 88% risk of case-ness and 100% diagnostic certainty was reached when all 5 domains were abnormally scored. These findings require validation in prospective cohorts and other mental illness states. They have potential for case-detection,-screening, -monitoring and targeted personalized management. They unmask unmet needs within the functional psychosis condition and suggest new biological understandings of psychosis phenomenology.

Chi-Shun Lien, Chi-Ping Huang, Chi-Jung Chung et al.

Z. Švec, K. Pavelka

The Orthophoto CR is produced in co-operation with the Land Survey Office and the Military Geographical and Hydrometeorological Office. The product serves to ensure a defence of the state, integrated crisis management, civilian tasks in support of the state administration and the local self-government of the Czech Republic as well. It covers the whole area of the Republic and for ensuring its up-to-datedness is reproduced in the biennial period. As the project is countrywide, it keeps the project within the same parameters in urban and rural areas as well. Due to economic reasons it can´t be produced as a true ortophoto because it requires large side and forward overlaps of the aerial photographs and a preparation of the digital surface model instead of the digital terrain model. Use of DTM without some objects of DSM for orthogonalization purposes cause undesirable image deformations in the Orthophoto. There are a few data sets available for forming a suitable elevation model. The principal source should represent DTMs made from data acquired by the airborne laser scanning of the entire area of the Czech Republic that was carried out in the years 2009-2013, the DMR4G in the grid form and the DMR5G in TIN form respectively. It can be replenished by some vector objects (bridges, dams, etc.) taken from the geographic base data of the Czech Republic or obtained by new stereo plotting. It has to be taken into account that the option of applying DSM made from image correlation is also available. The article focuses on the possibilities of DTM supplement for ortogonalization. It looks back to the recent transition from grid to hybrid elevation models, problems that occurred, its solution and getting some practical remarks. Afterwards it assesses the current state and deals with the options for updating the model. Some accuracy analysis are included.