Information systems and information technology (IS/IT) play an important role in supporting the organization to conduct its business processes. The research was conducted at the University of Satya Christian Wacana (S...Information systems and information technology (IS/IT) play an important role in supporting the organization to conduct its business processes. The research was conducted at the University of Satya Christian Wacana (SWCU). Business processes in perceived walking SWCU are not optimal in using IS/IT in the organization. The planning process/IT has not been done in all business units and SWCU does not have an Executive Information System that can help in the decision making process. The process of strategic planning of information systems and information technology using The Open Group Architecture Framework (TOGAF) has compiled a few methods of strategic planning. The results obtained by the study of the needs of IS/IT in SWCU generating application portfolio will be implemented in the institution.展开更多
Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and...Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, the cut-off point of a D-dimer level of 0.66 µg/ml significantly predicts postpartum hemorrhage with a sensitivity of 75% and specificity of 55%. For those who had no severe features the cut-off point was 0.53 µg/ml with a sensitivity of 95% and specificity of 53%, and for those who had severe features the cut-off point was 3.58 µg/ml with a sensitivity of 50% and specificity of 96%. Conclusion: D-dimer can be used to predict postpartum hemorrhage among pre-eclampsia, especially among those who have severe features. This shows that D-dimer has specificity in predicting PPH in women with pre-eclampsia and can be applied in clinical services to save women from maternal morbidity and mortality. Blood products such as fresh frozen plasma, platelets, and whole blood together with tranexamic acid should be readily available in women with pre-eclampsia especially those with severe features with a D-dimer level of 3.58 µg/ml and above during delivery as they are at high risk of developing PPH.展开更多
Visual Question Answering(VQA)is an interdisciplinary artificial intelligence(AI)activity that integrates com-puter vision and natural language processing.Its purpose is to empower machines to respond to questions by ...Visual Question Answering(VQA)is an interdisciplinary artificial intelligence(AI)activity that integrates com-puter vision and natural language processing.Its purpose is to empower machines to respond to questions by utilizing visual information.A VQA system typically takes an image and a natural language query as input and produces a textual answer as output.One major obstacle in VQA is identifying a successful method to extract and merge textual and visual data.We examine“Fusion”Models that use information from both the text encoder and picture encoder to efficiently perform the visual question-answering challenge.For the transformer model,we utilize BERT and RoBERTa,which analyze textual data.The image encoder designed for processing image data utilizes ViT(Vision Transformer),Deit(Data-efficient Image Transformer),and BeIT(Image Transformers).The reasoning module of VQA was updated and layer normalization was incorporated to enhance the performance outcome of our effort.In comparison to the results of previous research,our proposed method suggests a substantial enhancement in efficacy.Our experiment obtained a 60.4%accuracy with the PathVQA dataset and a 69.2%accuracy with the VizWiz dataset.展开更多
Background: Modern contraceptives are medical procedures that interfere with reproduction or acts of sexual intercourse. Moyo district contraceptive prevalence used by females aged 15 - 24 years is 6.03%, which is far...Background: Modern contraceptives are medical procedures that interfere with reproduction or acts of sexual intercourse. Moyo district contraceptive prevalence used by females aged 15 - 24 years is 6.03%, which is far from the national target. The low contraceptive use among this age group results in high school drops, unwanted pregnancy, early child marriage, and community disputes. Purpose: To evaluate barriers associated with the utilization of modern contraceptive methods used by females aged 15 - 24 years in Moyo district in Uganda. Methods: A cross-sectional design with mixed methods of quantitative and qualitative approaches was used. The reason for using a cross-sectional design is to measure the exposure and outcome variables at the same time. It’s relatively quick and inexpensive, and findings can be used to create an in-depth research study. Multistage sampling was used to draw 423 participants for quantitative and 23 participants were purposively selected for Qualitative study based on knowledge and experience, the results were analyzed using SPSS Version 20 and open code software and presented in the form of tables, pie charts, graphs, descriptive and inferential statistics. Results: The findings indicated marital status OR 3.193, P-Value 0.000 and CI (2.002 - 5.091), Family/Community influence OR 1.644, P-Value 0.019 and CI (1.084 - 2.493) and Cultural influence OR 2.004, P-Value 0.006 and CI (1.218 - 3.298) tend to be associated with using contraceptives. Desire for children OR 0.459, P-Value 0.002 and CI (0.279 - 0.756) and long waiting time OR 0.442, P-Value 0.003 and CI (0.258 - 0.756) tend to be not associated with the use of modern contraceptives. The findings of this study have shown both individual and socio-cultural factors contribute to the low utilization of modern contraceptives among females aged 15 - 24 years, and these need to be addressed with the involvement of different stakeholders.展开更多
Background: Orphans are potentially at greater risk of malnutrition because they are more likely to be extremely poor and receive less medical and social care. Children living in orphanages tend to be neglected and ma...Background: Orphans are potentially at greater risk of malnutrition because they are more likely to be extremely poor and receive less medical and social care. Children living in orphanages tend to be neglected and may be malnourished and they’re at risk of losing their full potential, with consequences to the child, nation and worldwide. Despite the nutritional concerns raised globally and in neighboring countries among these children, there exists an inadequate body of information about orphans’ nutritional status and feeding practices in Tanzania. This study aimed to assess the nutritional status, feeding practices and factors contributing to malnutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Study Objective: To assess the nutritional status, feeding practices and factors contributing to undernutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Methodology: This was an institution-based cross-sectional study conducted in selected orphanage Centre in the Arusha region. A representative sample size of 216 children aged 6 - 59 months in Arusha orphanages was selected to participate in the study. Multistaging sampling was used to select the study participants. Interviewer-administered questionnaires and anthropometric measurements were used during data collection. The data collected were entered, processed, and analyzed;continuous variables were summarized by use of mean and Standard deviation, while categorical variables were summarized by use of frequency, percentages and figures. Multivariable logistic regression was used to estimate the Odds Ratio with 95% CI and measure the strength of association between the outcomes with respect to selected independent variables. Variables with a p-value of less than 0.05 were considered statistically significant. Results: A total of 216 children from the orphanage Centre were involved in this study. Prevalence of Stunting, underweight and wasting among orphan children were 23.60%, 15.30% and 9.30%. The proportions of MDD and MMF were 89% and 99%. Children being on medication for any kind of illness during the survey (AOR: 7.9;95% CI: 1.95, 31.78), unmarried caregivers (AOR: 1.9;95% CI: 1.32, 10.86), fever 2 weeks before the survey (AOR: 2.9;95% CI: 1.09, 9.24) and orphanage Centre with more than 30 children (AOR: 1.8;95% CI: 1.08, 6.86) were found to be associated with undernutrition. Conclusion: In Arusha orphanages, the prevalence of stunting, underweight, and wasting among children exceeded WHO standards. Despite adequate feeding practices, the child’s illness, the number of children in the orphanage, and the marital status of caregivers were factors influencing the nutritional status of the orphans.展开更多
Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal ...Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal sepsis is the third leading cause of neonatal death, accounting for 25% of all deaths. The rising global threat of antimicrobial resistance and the rising burden of neonatal death due to neonatal sepsis have been of great concern and have delayed progress toward reaching SDG goal 3.2 by 2030. This study aims to determine the bacteriological profile, antibiotic susceptibility patterns, and predictors of bacteremia among neonates with clinical sepsis at KCMC Hospital in Northern Tanzania. Methodology: This study had a cross-sectional design conducted at KCMC Hospital, Northern Tanzania. The study population was neonates admitted to the neonatal unit at KCMC Hospital. Data were collected using questionnaires and blood cultures from neonates. Frequencies and proportions were used to summarize categorical variables, while continuous variables were summarized using mean and standard deviation. The frequencies and proportions of bacteria isolated and the antimicrobial susceptibility results were analyzed and compared using Pearson’s chi-square test and Fisher’s exact test where applicable. Modified Poisson regression model was used to determine factors associated with positive blood culture. Results: Out of 411 neonates with a clinical diagnosis of neonatal sepsis, 175 (42.9%) had positive blood cultures. Gram-positive bacteria were most frequently isolated at 52.3%, and gram-negative bacteria were 47.7%. Coagulase-negative Staphylococcus (30.7%) and Staphylococcus aureus (19.9%) were the predominant gram-positive isolates. Gram-negative isolates were Klebsiella spp 47 (26.7%), E. coli 10 (5.7%), and Citrobacter spp 10 (5.1%). The gram-positive isolates were sensitive to vancomycin, piperacillin/tazobactam, and ceftazidime, whereas the gram-negative were sensitive to amikacin, meropenem, and vancomycin. The study did not find statistically significant associations between clinical factors and positive blood cultures in bacteremia. Conclusion: Gram-positive bacteria are the dominant pathogens in early-onset and late-onset neonatal sepsis. High levels of resistance to ampicillin and ceftriaxone and moderate resistance to gentamycin were observed in both gram-positive and gram-negative bacteria. Gram-positive organisms exhibit better susceptibility rates to vancomycin and ciprofloxacin, while gram-negative micro-organisms are more sensitive to amikacin and meropenem. An effective initial treatment approach for neonatal sepsis would involve a combination of drugs.展开更多
This study proposed a new real-time manufacturing process monitoring method to monitor and detect process shifts in manufacturing operations.Since real-time production process monitoring is critical in today’s smart ...This study proposed a new real-time manufacturing process monitoring method to monitor and detect process shifts in manufacturing operations.Since real-time production process monitoring is critical in today’s smart manufacturing.The more robust the monitoring model,the more reliable a process is to be under control.In the past,many researchers have developed real-time monitoring methods to detect process shifts early.However,thesemethods have limitations in detecting process shifts as quickly as possible and handling various data volumes and varieties.In this paper,a robust monitoring model combining Gated Recurrent Unit(GRU)and Random Forest(RF)with Real-Time Contrast(RTC)called GRU-RF-RTC was proposed to detect process shifts rapidly.The effectiveness of the proposed GRU-RF-RTC model is first evaluated using multivariate normal and nonnormal distribution datasets.Then,to prove the applicability of the proposed model in a realmanufacturing setting,the model was evaluated using real-world normal and non-normal problems.The results demonstrate that the proposed GRU-RF-RTC outperforms other methods in detecting process shifts quickly with the lowest average out-of-control run length(ARL1)in all synthesis and real-world problems under normal and non-normal cases.The experiment results on real-world problems highlight the significance of the proposed GRU-RF-RTC model in modern manufacturing process monitoring applications.The result reveals that the proposed method improves the shift detection capability by 42.14%in normal and 43.64%in gamma distribution problems.展开更多
In the context of the new era,people’s material living standards have improved and the public’s demand for spiritual life experience is more vigorous,the hotel industry has also ushered in the development of the pea...In the context of the new era,people’s material living standards have improved and the public’s demand for spiritual life experience is more vigorous,the hotel industry has also ushered in the development of the peak period,and the demand for high-quality hotel management professionals is increasing.The cultivation of hotel management professionals needs to adapt to the transformation and upgrading of the hotel industry.Based on the study of the development status and new challenges faced by hotel management education in the new era,this article explores the logic and innovative practice of cultivating hotel management professionals from the aspects of strengthening the construction of hotel management disciplines,constructing new models of talent cultivation,reforming educational concepts,and reshaping the teaching content system.It aims to provide guidelines for the cultivation of hotel management professionals in Chinese universities.展开更多
Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
High-quality nursing care can greatly reduce the occurrence of nursing accidents and help patients maintain better physical and mental health.For patients with hypertension,special attention should be given to clinica...High-quality nursing care can greatly reduce the occurrence of nursing accidents and help patients maintain better physical and mental health.For patients with hypertension,special attention should be given to clinical nursing.Providing scientific medication guidance,along with psychological support,can improve their medication compliance and establish a good doctor-patient relationship,aiding in their faster recovery.Based on a review of relevant literature and the author's practical experience,this paper first analyzes the content and requirements of clinical nursing for hypertension,then discusses the main factors that restrict the effectiveness of clinical nursing for hypertension,and finally suggests improvements to the clinical nursing model for hypertension to serve as a reference for colleagues.展开更多
AIM: To investigate the role of opioid p-receptor subtype in opiate-induced constipation (OIC).METHODS: The effect of Ioperamide on intestinal transit was investigated in mice. Ileum strips were isolated from 12-w...AIM: To investigate the role of opioid p-receptor subtype in opiate-induced constipation (OIC).METHODS: The effect of Ioperamide on intestinal transit was investigated in mice. Ileum strips were isolated from 12-wk-old male BALB/c mice for identification of isometric tension. The ileum strips were precontracted with 1 μmol/L acetylcholine (ACh). Then, decrease in muscle tone (relaxation) was characterized after cumu- lative administration of 0.1-10μ~mol/L Ioperamide into the organ bath, for a concentration-dependent study. Specific blockers or antagonists were used for pretreat- ment to compare the changes in Ioperamide-induced relaxation.RESULTS: In addition to the delay in intestinal transit, Ioperamide produced a marked relaxation in isolated ileum precontracted with ACh, in a dose-dependent manner. This relaxation was abolished by cyprodime,a selective opioid p-receptor antagonist, but not modified by naloxonazine at a dose sufficient to block opioid μ-1 receptors. Also, treatment with opioid μ-1 receptor agonist failed to modify the muscle tone. Moreover, the relaxation by Ioperamide was attenuated by glibenclamide at a dose sufficient to block ATP-sensitive K^+ (KATP) channels, and by protein kinase A (PKA) inhibitor, but was enhanced by an inhibitor of phosphodiesterase for cyclic adenosine monophosphate (cAMP).CONCLUSION: Loperamide induces intestinal relaxa- tion by activation of opioid μ-2 receptors via the cAMP- PKA pathway to open KATp channels, relates to OIC.展开更多
Taking the minimum chip thickness effect,cutter deflection,and spindle run-out into account,a micro milling force model and a method to determine the optimal micro milling parameters were developed.The micro milling f...Taking the minimum chip thickness effect,cutter deflection,and spindle run-out into account,a micro milling force model and a method to determine the optimal micro milling parameters were developed.The micro milling force model was derived as a function of the cutting coefficients and the instantaneous projected cutting area that was determined based on the machining parameters and the rotation trajectory of the cutter edges.When an allowable micro cutter deflection is defined,the maximum allowable cutting force can be determined.The optimal machining parameters can then be computed based on the cutting force model for better machining efficiency and accuracy.To verify the proposed cutting force model and the method to determine the optimal cutting parameters,micro-milling experiments were conducted,and the results show the feasibility and effectiveness of the model and method.展开更多
In order to avoid the accuracy deterioration or tool damage caused by milling chatter, it is necessary to have an efficient and reliable diagnosis system that can on-line predict/detect the occur-rence of chatter. The...In order to avoid the accuracy deterioration or tool damage caused by milling chatter, it is necessary to have an efficient and reliable diagnosis system that can on-line predict/detect the occur-rence of chatter. The diagnosis/predicting system proposed is to on-line process and analysis the vi-bration signals of the milling machine measured by accelerometers. According to the analysis results, the system will be able to detect/predict the occurrence of the chatter. The diagnosis algorithm is, first, collecting both the normal signals and chatter signals from milling processes, and then, converting the signals through wavelet transform and fast Fourier transform (FFT). Since the converted chatter sig-nals exhibit different characteristics from the normal signals, through defining the characteristic val-ues, such as root-mean-square value, max value, and ratio of peak value to root-mean-square value, etc, a diagnosis reference library that contains the distribution of these characteristic values is built for diagnosis. When a diagnosis is executing, the characteristic value of the measured signals is con-trasted with the diagnosis reference. The approach index which shows the possibility of occurrence of milling chatter will, then, be calculated through the diagnosis system. Cutting experiments are con-ducted to verify the proposed diagnosis system. The results show the success of early chatter detecting for the system.展开更多
NaTaONcatalysts were synthesized by a hydrothermal(H) and a solid-state(S) methods in this study.The H-and S-NaTaONsamples were characterized by X-ray diffraction(XRD), scanning electron microscopy(SEM), trans...NaTaONcatalysts were synthesized by a hydrothermal(H) and a solid-state(S) methods in this study.The H-and S-NaTaONsamples were characterized by X-ray diffraction(XRD), scanning electron microscopy(SEM), transmission electron microscopy(TEM), UV–visible(UV–vis) diffuse reflectance spectroscopy, and photoluminescence(PL) spectroscopy. The XRD patterns of the H-and S-samples showed peaks indexed to the pure phase of perovskite NaTaOand minor peaks assignable to TaNat various synthesis temperatures. Substitution of oxygen by nitrogen ions causes the light absorption of the H-and S-NaTaONsamples to be extended to the 600–650 nm region, thus making the samples visible-light active. The NaTaONsamples exhibited photocatalytic activity for Hand Oevolution from aqueous methanol and silver nitrate solutions under visible-light irradiation. The UV–vis and PL spectra of the Hand S-catalysts revealed the presence of cationic vacancies and reduced metallic species, which acted as recombination centers. These results demonstrated that the preparation method plays a critical role in the formation of defect states, thereby governing the photocatalytic activity of the NaTaONcatalysts.展开更多
In a rectangular fluidized bed combustor, the tracer gas is injected continuously into the bed from a point source at the center of the distributor plate. In this study, a general governing equation is formulated for ...In a rectangular fluidized bed combustor, the tracer gas is injected continuously into the bed from a point source at the center of the distributor plate. In this study, a general governing equation is formulated for tracer gas dispersion in the bed. An analytical solution is derived to estimate the dispersion coefficients, Dxand Dy, in a horizontal plane. The concentration profiles at different sampling heights with various gas velocities are plotted.Subsequently, to estimate the dispersion coefficients, surface fitting of the obtained analytical solution to the experimental data is performed. The dispersion coefficients obtained from this model are compared with those of a conventional model. Additionally, the effect of walls, bed height and gas injection rate on the dispersion coefficients in a horizontal plane is investigated, and the effect of distributor design on the dispersion coefficients in a horizontal plane is investigated with different tracer positions. It is found that Dxand Dyare nearly equivalent at a lower tracer gas ratio of the injected gas to the total gas flow rate. It is also demonstrated that the effect of bed height on Dxis minor. This model is also able to estimate the dispersion coefficients in the case of a multihorizontal nozzle distributor.展开更多
Amyloid cross-seeding of different amyloid proteins is considered as a highly possible mechanism for exacerbating the transmissible pathogenesis of protein misfolding disease(PMDs)and for explaining a molecular link b...Amyloid cross-seeding of different amyloid proteins is considered as a highly possible mechanism for exacerbating the transmissible pathogenesis of protein misfolding disease(PMDs)and for explaining a molecular link between different PMDs,including Alzheimer disease(AD)and type 2 diabetes(T2D),AD and Parkinson disease(PD),and AD and prion disease.Among them,AD and T2D are the most prevalent PMDs,affecting millions of people globally,while Ab and hIAPP are the causative peptides responsible for AD and T2D,respectively.Increasing clinical and epidemiological evidences lead to a hypothesis that the cross-seeding of Ab and hIAPP is more biologically responsible for a pathological link between AD and T2D.In this review,we particularly focus on(i)the most recent and important findings of amyloid cross-seeding between Ab and hIAPP from in vitro,in vivo,and in silico studies,(ii)a mechanistic role of structural compatibility and sequence similarity of amyloid proteins(beyond Ab and hIAPP)in amyloid cross-seeding,and(iii)several current challenges and future research directions in this lessstudied field.Review of amyloid cross-seeding hopefully provides some mechanistic understanding of amyloidogenesis and inspires more efforts for the better design of next-generation drugs/strategies to treat different PMDs simultaneously.展开更多
文摘Information systems and information technology (IS/IT) play an important role in supporting the organization to conduct its business processes. The research was conducted at the University of Satya Christian Wacana (SWCU). Business processes in perceived walking SWCU are not optimal in using IS/IT in the organization. The planning process/IT has not been done in all business units and SWCU does not have an Executive Information System that can help in the decision making process. The process of strategic planning of information systems and information technology using The Open Group Architecture Framework (TOGAF) has compiled a few methods of strategic planning. The results obtained by the study of the needs of IS/IT in SWCU generating application portfolio will be implemented in the institution.
文摘Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, the cut-off point of a D-dimer level of 0.66 µg/ml significantly predicts postpartum hemorrhage with a sensitivity of 75% and specificity of 55%. For those who had no severe features the cut-off point was 0.53 µg/ml with a sensitivity of 95% and specificity of 53%, and for those who had severe features the cut-off point was 3.58 µg/ml with a sensitivity of 50% and specificity of 96%. Conclusion: D-dimer can be used to predict postpartum hemorrhage among pre-eclampsia, especially among those who have severe features. This shows that D-dimer has specificity in predicting PPH in women with pre-eclampsia and can be applied in clinical services to save women from maternal morbidity and mortality. Blood products such as fresh frozen plasma, platelets, and whole blood together with tranexamic acid should be readily available in women with pre-eclampsia especially those with severe features with a D-dimer level of 3.58 µg/ml and above during delivery as they are at high risk of developing PPH.
基金supported by the National Science and Technology Council,Taiwan(Grant number:NSTC 111-2637-H-324-001-).
文摘Visual Question Answering(VQA)is an interdisciplinary artificial intelligence(AI)activity that integrates com-puter vision and natural language processing.Its purpose is to empower machines to respond to questions by utilizing visual information.A VQA system typically takes an image and a natural language query as input and produces a textual answer as output.One major obstacle in VQA is identifying a successful method to extract and merge textual and visual data.We examine“Fusion”Models that use information from both the text encoder and picture encoder to efficiently perform the visual question-answering challenge.For the transformer model,we utilize BERT and RoBERTa,which analyze textual data.The image encoder designed for processing image data utilizes ViT(Vision Transformer),Deit(Data-efficient Image Transformer),and BeIT(Image Transformers).The reasoning module of VQA was updated and layer normalization was incorporated to enhance the performance outcome of our effort.In comparison to the results of previous research,our proposed method suggests a substantial enhancement in efficacy.Our experiment obtained a 60.4%accuracy with the PathVQA dataset and a 69.2%accuracy with the VizWiz dataset.
文摘Background: Modern contraceptives are medical procedures that interfere with reproduction or acts of sexual intercourse. Moyo district contraceptive prevalence used by females aged 15 - 24 years is 6.03%, which is far from the national target. The low contraceptive use among this age group results in high school drops, unwanted pregnancy, early child marriage, and community disputes. Purpose: To evaluate barriers associated with the utilization of modern contraceptive methods used by females aged 15 - 24 years in Moyo district in Uganda. Methods: A cross-sectional design with mixed methods of quantitative and qualitative approaches was used. The reason for using a cross-sectional design is to measure the exposure and outcome variables at the same time. It’s relatively quick and inexpensive, and findings can be used to create an in-depth research study. Multistage sampling was used to draw 423 participants for quantitative and 23 participants were purposively selected for Qualitative study based on knowledge and experience, the results were analyzed using SPSS Version 20 and open code software and presented in the form of tables, pie charts, graphs, descriptive and inferential statistics. Results: The findings indicated marital status OR 3.193, P-Value 0.000 and CI (2.002 - 5.091), Family/Community influence OR 1.644, P-Value 0.019 and CI (1.084 - 2.493) and Cultural influence OR 2.004, P-Value 0.006 and CI (1.218 - 3.298) tend to be associated with using contraceptives. Desire for children OR 0.459, P-Value 0.002 and CI (0.279 - 0.756) and long waiting time OR 0.442, P-Value 0.003 and CI (0.258 - 0.756) tend to be not associated with the use of modern contraceptives. The findings of this study have shown both individual and socio-cultural factors contribute to the low utilization of modern contraceptives among females aged 15 - 24 years, and these need to be addressed with the involvement of different stakeholders.
文摘Background: Orphans are potentially at greater risk of malnutrition because they are more likely to be extremely poor and receive less medical and social care. Children living in orphanages tend to be neglected and may be malnourished and they’re at risk of losing their full potential, with consequences to the child, nation and worldwide. Despite the nutritional concerns raised globally and in neighboring countries among these children, there exists an inadequate body of information about orphans’ nutritional status and feeding practices in Tanzania. This study aimed to assess the nutritional status, feeding practices and factors contributing to malnutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Study Objective: To assess the nutritional status, feeding practices and factors contributing to undernutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Methodology: This was an institution-based cross-sectional study conducted in selected orphanage Centre in the Arusha region. A representative sample size of 216 children aged 6 - 59 months in Arusha orphanages was selected to participate in the study. Multistaging sampling was used to select the study participants. Interviewer-administered questionnaires and anthropometric measurements were used during data collection. The data collected were entered, processed, and analyzed;continuous variables were summarized by use of mean and Standard deviation, while categorical variables were summarized by use of frequency, percentages and figures. Multivariable logistic regression was used to estimate the Odds Ratio with 95% CI and measure the strength of association between the outcomes with respect to selected independent variables. Variables with a p-value of less than 0.05 were considered statistically significant. Results: A total of 216 children from the orphanage Centre were involved in this study. Prevalence of Stunting, underweight and wasting among orphan children were 23.60%, 15.30% and 9.30%. The proportions of MDD and MMF were 89% and 99%. Children being on medication for any kind of illness during the survey (AOR: 7.9;95% CI: 1.95, 31.78), unmarried caregivers (AOR: 1.9;95% CI: 1.32, 10.86), fever 2 weeks before the survey (AOR: 2.9;95% CI: 1.09, 9.24) and orphanage Centre with more than 30 children (AOR: 1.8;95% CI: 1.08, 6.86) were found to be associated with undernutrition. Conclusion: In Arusha orphanages, the prevalence of stunting, underweight, and wasting among children exceeded WHO standards. Despite adequate feeding practices, the child’s illness, the number of children in the orphanage, and the marital status of caregivers were factors influencing the nutritional status of the orphans.
文摘Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal sepsis is the third leading cause of neonatal death, accounting for 25% of all deaths. The rising global threat of antimicrobial resistance and the rising burden of neonatal death due to neonatal sepsis have been of great concern and have delayed progress toward reaching SDG goal 3.2 by 2030. This study aims to determine the bacteriological profile, antibiotic susceptibility patterns, and predictors of bacteremia among neonates with clinical sepsis at KCMC Hospital in Northern Tanzania. Methodology: This study had a cross-sectional design conducted at KCMC Hospital, Northern Tanzania. The study population was neonates admitted to the neonatal unit at KCMC Hospital. Data were collected using questionnaires and blood cultures from neonates. Frequencies and proportions were used to summarize categorical variables, while continuous variables were summarized using mean and standard deviation. The frequencies and proportions of bacteria isolated and the antimicrobial susceptibility results were analyzed and compared using Pearson’s chi-square test and Fisher’s exact test where applicable. Modified Poisson regression model was used to determine factors associated with positive blood culture. Results: Out of 411 neonates with a clinical diagnosis of neonatal sepsis, 175 (42.9%) had positive blood cultures. Gram-positive bacteria were most frequently isolated at 52.3%, and gram-negative bacteria were 47.7%. Coagulase-negative Staphylococcus (30.7%) and Staphylococcus aureus (19.9%) were the predominant gram-positive isolates. Gram-negative isolates were Klebsiella spp 47 (26.7%), E. coli 10 (5.7%), and Citrobacter spp 10 (5.1%). The gram-positive isolates were sensitive to vancomycin, piperacillin/tazobactam, and ceftazidime, whereas the gram-negative were sensitive to amikacin, meropenem, and vancomycin. The study did not find statistically significant associations between clinical factors and positive blood cultures in bacteremia. Conclusion: Gram-positive bacteria are the dominant pathogens in early-onset and late-onset neonatal sepsis. High levels of resistance to ampicillin and ceftriaxone and moderate resistance to gentamycin were observed in both gram-positive and gram-negative bacteria. Gram-positive organisms exhibit better susceptibility rates to vancomycin and ciprofloxacin, while gram-negative micro-organisms are more sensitive to amikacin and meropenem. An effective initial treatment approach for neonatal sepsis would involve a combination of drugs.
基金support from the National Science and Technology Council of Taiwan(Contract Nos.111-2221 E-011081 and 111-2622-E-011019)the support from Intelligent Manufacturing Innovation Center(IMIC),National Taiwan University of Science and Technology(NTUST),Taipei,Taiwan,which is a Featured Areas Research Center in Higher Education Sprout Project of Ministry of Education(MOE),Taiwan(since 2023)was appreciatedWe also thank Wang Jhan Yang Charitable Trust Fund(Contract No.WJY 2020-HR-01)for its financial support.
文摘This study proposed a new real-time manufacturing process monitoring method to monitor and detect process shifts in manufacturing operations.Since real-time production process monitoring is critical in today’s smart manufacturing.The more robust the monitoring model,the more reliable a process is to be under control.In the past,many researchers have developed real-time monitoring methods to detect process shifts early.However,thesemethods have limitations in detecting process shifts as quickly as possible and handling various data volumes and varieties.In this paper,a robust monitoring model combining Gated Recurrent Unit(GRU)and Random Forest(RF)with Real-Time Contrast(RTC)called GRU-RF-RTC was proposed to detect process shifts rapidly.The effectiveness of the proposed GRU-RF-RTC model is first evaluated using multivariate normal and nonnormal distribution datasets.Then,to prove the applicability of the proposed model in a realmanufacturing setting,the model was evaluated using real-world normal and non-normal problems.The results demonstrate that the proposed GRU-RF-RTC outperforms other methods in detecting process shifts quickly with the lowest average out-of-control run length(ARL1)in all synthesis and real-world problems under normal and non-normal cases.The experiment results on real-world problems highlight the significance of the proposed GRU-RF-RTC model in modern manufacturing process monitoring applications.The result reveals that the proposed method improves the shift detection capability by 42.14%in normal and 43.64%in gamma distribution problems.
文摘In the context of the new era,people’s material living standards have improved and the public’s demand for spiritual life experience is more vigorous,the hotel industry has also ushered in the development of the peak period,and the demand for high-quality hotel management professionals is increasing.The cultivation of hotel management professionals needs to adapt to the transformation and upgrading of the hotel industry.Based on the study of the development status and new challenges faced by hotel management education in the new era,this article explores the logic and innovative practice of cultivating hotel management professionals from the aspects of strengthening the construction of hotel management disciplines,constructing new models of talent cultivation,reforming educational concepts,and reshaping the teaching content system.It aims to provide guidelines for the cultivation of hotel management professionals in Chinese universities.
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
文摘High-quality nursing care can greatly reduce the occurrence of nursing accidents and help patients maintain better physical and mental health.For patients with hypertension,special attention should be given to clinical nursing.Providing scientific medication guidance,along with psychological support,can improve their medication compliance and establish a good doctor-patient relationship,aiding in their faster recovery.Based on a review of relevant literature and the author's practical experience,this paper first analyzes the content and requirements of clinical nursing for hypertension,then discusses the main factors that restrict the effectiveness of clinical nursing for hypertension,and finally suggests improvements to the clinical nursing model for hypertension to serve as a reference for colleagues.
基金Supported by A grant from E-Da Hospital (in part)
文摘AIM: To investigate the role of opioid p-receptor subtype in opiate-induced constipation (OIC).METHODS: The effect of Ioperamide on intestinal transit was investigated in mice. Ileum strips were isolated from 12-wk-old male BALB/c mice for identification of isometric tension. The ileum strips were precontracted with 1 μmol/L acetylcholine (ACh). Then, decrease in muscle tone (relaxation) was characterized after cumu- lative administration of 0.1-10μ~mol/L Ioperamide into the organ bath, for a concentration-dependent study. Specific blockers or antagonists were used for pretreat- ment to compare the changes in Ioperamide-induced relaxation.RESULTS: In addition to the delay in intestinal transit, Ioperamide produced a marked relaxation in isolated ileum precontracted with ACh, in a dose-dependent manner. This relaxation was abolished by cyprodime,a selective opioid p-receptor antagonist, but not modified by naloxonazine at a dose sufficient to block opioid μ-1 receptors. Also, treatment with opioid μ-1 receptor agonist failed to modify the muscle tone. Moreover, the relaxation by Ioperamide was attenuated by glibenclamide at a dose sufficient to block ATP-sensitive K^+ (KATP) channels, and by protein kinase A (PKA) inhibitor, but was enhanced by an inhibitor of phosphodiesterase for cyclic adenosine monophosphate (cAMP).CONCLUSION: Loperamide induces intestinal relaxa- tion by activation of opioid μ-2 receptors via the cAMP- PKA pathway to open KATp channels, relates to OIC.
基金Project(NSC98-2221-E-033-047)supported by National Science Council
文摘Taking the minimum chip thickness effect,cutter deflection,and spindle run-out into account,a micro milling force model and a method to determine the optimal micro milling parameters were developed.The micro milling force model was derived as a function of the cutting coefficients and the instantaneous projected cutting area that was determined based on the machining parameters and the rotation trajectory of the cutter edges.When an allowable micro cutter deflection is defined,the maximum allowable cutting force can be determined.The optimal machining parameters can then be computed based on the cutting force model for better machining efficiency and accuracy.To verify the proposed cutting force model and the method to determine the optimal cutting parameters,micro-milling experiments were conducted,and the results show the feasibility and effectiveness of the model and method.
基金Selected from Proceedings of the 7th International Conference on Frontierof Design and Manufacturing(ICFDM’2006).
文摘In order to avoid the accuracy deterioration or tool damage caused by milling chatter, it is necessary to have an efficient and reliable diagnosis system that can on-line predict/detect the occur-rence of chatter. The diagnosis/predicting system proposed is to on-line process and analysis the vi-bration signals of the milling machine measured by accelerometers. According to the analysis results, the system will be able to detect/predict the occurrence of the chatter. The diagnosis algorithm is, first, collecting both the normal signals and chatter signals from milling processes, and then, converting the signals through wavelet transform and fast Fourier transform (FFT). Since the converted chatter sig-nals exhibit different characteristics from the normal signals, through defining the characteristic val-ues, such as root-mean-square value, max value, and ratio of peak value to root-mean-square value, etc, a diagnosis reference library that contains the distribution of these characteristic values is built for diagnosis. When a diagnosis is executing, the characteristic value of the measured signals is con-trasted with the diagnosis reference. The approach index which shows the possibility of occurrence of milling chatter will, then, be calculated through the diagnosis system. Cutting experiments are con-ducted to verify the proposed diagnosis system. The results show the success of early chatter detecting for the system.
基金the financial support from the Ministry of Science and Technology,Taiwan(MOST 104-2218-E-033-006-MY2)
文摘NaTaONcatalysts were synthesized by a hydrothermal(H) and a solid-state(S) methods in this study.The H-and S-NaTaONsamples were characterized by X-ray diffraction(XRD), scanning electron microscopy(SEM), transmission electron microscopy(TEM), UV–visible(UV–vis) diffuse reflectance spectroscopy, and photoluminescence(PL) spectroscopy. The XRD patterns of the H-and S-samples showed peaks indexed to the pure phase of perovskite NaTaOand minor peaks assignable to TaNat various synthesis temperatures. Substitution of oxygen by nitrogen ions causes the light absorption of the H-and S-NaTaONsamples to be extended to the 600–650 nm region, thus making the samples visible-light active. The NaTaONsamples exhibited photocatalytic activity for Hand Oevolution from aqueous methanol and silver nitrate solutions under visible-light irradiation. The UV–vis and PL spectra of the Hand S-catalysts revealed the presence of cationic vacancies and reduced metallic species, which acted as recombination centers. These results demonstrated that the preparation method plays a critical role in the formation of defect states, thereby governing the photocatalytic activity of the NaTaONcatalysts.
基金The financial support from the Ministry of Science and Technology under Grant MOST 105-3113-E-033-001
文摘In a rectangular fluidized bed combustor, the tracer gas is injected continuously into the bed from a point source at the center of the distributor plate. In this study, a general governing equation is formulated for tracer gas dispersion in the bed. An analytical solution is derived to estimate the dispersion coefficients, Dxand Dy, in a horizontal plane. The concentration profiles at different sampling heights with various gas velocities are plotted.Subsequently, to estimate the dispersion coefficients, surface fitting of the obtained analytical solution to the experimental data is performed. The dispersion coefficients obtained from this model are compared with those of a conventional model. Additionally, the effect of walls, bed height and gas injection rate on the dispersion coefficients in a horizontal plane is investigated, and the effect of distributor design on the dispersion coefficients in a horizontal plane is investigated with different tracer positions. It is found that Dxand Dyare nearly equivalent at a lower tracer gas ratio of the injected gas to the total gas flow rate. It is also demonstrated that the effect of bed height on Dxis minor. This model is also able to estimate the dispersion coefficients in the case of a multihorizontal nozzle distributor.
文摘Amyloid cross-seeding of different amyloid proteins is considered as a highly possible mechanism for exacerbating the transmissible pathogenesis of protein misfolding disease(PMDs)and for explaining a molecular link between different PMDs,including Alzheimer disease(AD)and type 2 diabetes(T2D),AD and Parkinson disease(PD),and AD and prion disease.Among them,AD and T2D are the most prevalent PMDs,affecting millions of people globally,while Ab and hIAPP are the causative peptides responsible for AD and T2D,respectively.Increasing clinical and epidemiological evidences lead to a hypothesis that the cross-seeding of Ab and hIAPP is more biologically responsible for a pathological link between AD and T2D.In this review,we particularly focus on(i)the most recent and important findings of amyloid cross-seeding between Ab and hIAPP from in vitro,in vivo,and in silico studies,(ii)a mechanistic role of structural compatibility and sequence similarity of amyloid proteins(beyond Ab and hIAPP)in amyloid cross-seeding,and(iii)several current challenges and future research directions in this lessstudied field.Review of amyloid cross-seeding hopefully provides some mechanistic understanding of amyloidogenesis and inspires more efforts for the better design of next-generation drugs/strategies to treat different PMDs simultaneously.