Developments in statistical evaluation of clinical trials

This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches

Reliability-based design optimization with Cross-Entropy method

Implementation of the Cross-entropy (CE) method to solve reliability-based design optimization (RBDO) problems was investigated. The emphasis of this implementation method was to solve independently both the reliability and optimization sub-problems within the RBDO problem; therefore, the main aim of this study was to evaluate the performance of the Cross-entropy method in terms of efficiency and accuracy to solve RBDO problems. A numerical approach was followed in which the implementation and preparation of the CE algorithm for the numerical modelling and simulations were performed on the high level language, MATLAB (R2014a and R2013b). The CE algorithm was prepared for reliability analysis and further developed to account for optimization problems. The CE method was initially validated on an academic RBDO problem within an analytical solution and the necessary parameter study of the CE algorithm was conducted. In the meantime, the efficiency and accuracy of the CE method were evaluated in comparison with existing reliability and optimization methods. Finally, the developed algorithm was examined and evaluated on an RBDO problem of a practical design of a laterally loaded monopile foundation for offshore wind turbines

Synthesis of adjacent-bridged benzo-annelated cyclam and studies of mono- and di-benzo-annelated cyclam derivatives

A new synthetic methodology for the preparation of a novel adjacent-bridged benzoannelated cyclam is presented. This methodology utilizes reductive ring expansion followed by deallylation to give the desired adjacent-bridged benzo-annelated cyclam. This novel ligand is designed to complex metal cations with a trans coordination geometry. Derivatives of this ligand can be prepared by attaching pendant arms on the nitrogens which can aid as coordinating arms and linkers for potential use of this ligand as bifunctional chelator (BFC). Coupling chemistry studies have been carried out in an attempt to increase the lipophilicity of a dibenzo-annelated tetracyclic bisaminal and to functionalize at the para positions to provide a site for bio-conjugation

Enhancing Digital Information Interoperability And User Interaction Among Ethiopian Higher Education Digital Libraries

When currently some Ethiopian Higher Educations are implementing digital libraries for their actual clients and interoperability is one of the advancement features of digital libraries, extending this service is this study purpose. Therefore this study identifies Ethiopian Higher Education Digital Libraries tools they used; service they provide as well as identifies stakeholders, developers and end users so that discussing three interoperability approaches used by digital libraries. Because of simplicity and suited for current EHIDLs over other protocols OAI-PMH metadata harvesting approach is deployed to EHIDL. Thus first we proposed EHIDL-AP metadata schema; then for DSpace and Greenstone digital library tools demonstration about how to use EHIDL-AP schema and implement data provider also presented; those metadata created by those institutions service provider using PKP OHS tools will harvest, normalize and make available for EHIDL users. Service provider (federated system) of EHIDL architecture, installation overview, adding EHIDL-AP schema, adding data providers, harvesting metadata, searching and browsing functions also discussed. Finally the study conclusions presented with a long side of recommendations for future works to be done to maximize the semantic level of interoperability among EHIDLs

Impact of Collaborative Master Degree in Nurse Practitioner & Nurse Anesthesia Education Programs a Case of Eritrea

Moreover, the anesthesia program improved the quality of anesthesia practice at the National Referral Teaching Hospitals. Therefore, the Asmara College of Health Sciences has proved the effectiveness and benefits of running graduate education programs in partnership with stronger universities. Practice Implication: Policy makers who are leading the national tertiary education institutions in Eritrea should strongly support the colleges and institutes to create partnerships to run graduate programs to strengthen faculty capacity and prevent brain drain in the country, which is the biggest national challenge. The School of Nursing (SoN) at Asmara College of Health Sciences (ACHS) suffered from a lack of qualified teaching faculty as well as teaching infrastructure both of which posed a major obstacle to producing competent graduates. To solve the problem, the ACHS sent BSc graduates to the United States and other countries to earn their Masters degrees; however, none of them came back to the country

Midwifery Care Experiences of Mothers during Labor and Delivery at Orota Maternity National Referral Hospital in Asmara, Eritrea (2011)

In Eritrea normal pregnancy, labor, and postpartum care is mostly managed by nurse midwives. The purpose of this study was to explore midwifery care experiences of women and their families during childbirth at the Orota Maternity National Referral Hospital (OMNRH). The study was a cross sectional descriptive method that utilized both quantitative and qualitative techniques

Geochemical and petrographic studies of the volcano-tectonic evolution of northern Afar

Der äthiopische Afar-Manteldiapir ist einer der jüngsten Diapirstrukturen der Welt. Seit ca. 30 Mio Jahren fördert er große Mengen an Magmen an die Erdoberfläche und trägt damit zur Umgestaltung der sublithosphärischen ostafrikanischen Kruste bei. Aufgrund der komplexen geodynamischen Natur dieser Region existiert eine eindruckvolle petrologische Vielfalt. Die Laven umfassen ein Spektrum von Basaniten zu tholeiitischen Basalten und von Phonoliten zu Trachyten. Diese Arbeit präsentiert geochemische und petrographische Untersuchungen an 93 vulkanischen, hauptsächlich basaltischen, Gesteinen, die aus den nördlichen äthiopischen Flutbasalten und der nördlichen Afar-Störung, der Erta`Ale Vulkankette, stammen. Sie beinhaltet ebenso eine kinematische Analyse der nördlichen und zentralen Afar-Störung, von deren ursprünglichen Beginn bis zur heutigen Ozeanbodenspreizung. Das Gesteinsmaterial stammt aus zwei Feldkampagnen: die erste fand 2007 in Vulkaniten des äthiopischen Hochlands statt, die zweite, 2008/09, hatte die axialen Basalte der nördlichen Afar-Senke zum Ziel. Es konnten viele petrologisch unterscheidbare vulkanischen Sequenzen im nördlichen äthiopischen Plateau und in der Afar-Senke identifiziert werden. Die ältesten vulkanischen Gesteine des Afar-Manteldiapirs werden durch die titanreichen (HT) und die titanarmen (LT) Gruppen der oligozänen Flutbasalte repräsentiert. Es kam jedoch auf der äthiopischen Hochebene sporadisch zur Eruption von in der Zusammensetzung variirenden Magmaserien. Eine dieser vulkanischen Serien setzt sich aus den, in einer kurzen Zeitspanne ausgetretenen, Axum post-Trappvulkaniten zusammen, eines geochemisch komplexen und lithologisch differierenden Teils der nordwestlichen äthiopischen Flutbasalt-Provinz. Nach dem Höhepunkt der äthiopischen Flutbasalteruption konzentrierte sich die magmatische Aktivität hauptsächlich auf Schildvulkane der Hochebene und auf riftgesteuerte Spaltbasalte am Grund der Afar-Senke. Zur Zeit beschränken sich die vulkanischen Aktivitäten komplett auf die axialen Bereiche der Afar-Senke, welche die letzte Phase des Afar-Manteldiapirs darstellen. Alle vorhandenen Spurenelementdaten und Isotopenuntersuchungen zeigen, dass sowohl die Plateaubasalte (Ti-reich) des Diapirkopfes, wie auch die axialen Basalte des Diapirendes eine nicht unterscheidbare Quellregion (OIB-Typ) besitzen, welche von der abgereicherten Mantelquelle abweicht. Die Konzentration der sehr inkompatiblen Elemente kann jedoch zwischen den einzelnen basaltischen Abfolgen variieren, was auf einen Wechsel im Aufschmelzungsgrad und -tiefe der Quellregion hinweist. Andererseits zeigen tektonische und geophysikalische Untersuchungen, dass die Afar-Senke zu den reinen Ozeankrusten-Typen gehört. Die Krustendicke der nördlichen Afar-Senke geht nicht über 15 km hinaus, die Spreizungs-Geschwindigkeit entlang der aktiven Erta´Ale Senke beträgt ca. 12 mm/Jahr/100 km. Es liegt auf der Hand, daß der Boden der nördlichen Afar-Senke ein ozeanischer ist, da seine Ausdehnungsraten denen des Roten Meeres und des Golfs von Aden enstpricht. Allerdings bestätigen die geochemischen Ergebnisse, dass der Magmatismus immer noch aus dem Rest des Afar-Manteldiapirs resultiert.The Ethio-Afar mantle plume is one of the youngest plume structures on earth that continually pours significant amounts of magmatic products to the surface of the earth for the last 30 Ma or more and reshaping the sublithospheric crust of east Africa. As a result of the complex geodynamic nature of the region, the petrologic diversity is very significant, the lavas ranging from basanites to tholeiitic basalts and phonolites to trachytes. This thesis presents geochemical and petrographic investigations of 90 volcanic rocks, mainly basaltic, from both the northern Ethiopian flood basalts and northern Afar Depression, the Erta’Ale Range. It also incorporates the kinematic analysis of the northern and central Afar Depression from incipient breakup to seafloor spreading. Rock sampling was performed in two field seasons: the first was in 2007 from the Ethiopian highland volcanic rocks and the second in 2008/09 from the northern Afar Depression axial basalts. Many petrologically distinct volcanic sequences in the northern Ethiopian plateau as well as Afar Depression have been identified. The oldest volcanic rocks of the Afar mantle plume are represented by the high-Ti (HT) and low-Ti (LT) groups of the Oligocene flood basalts. However, compositionally distinct magmatic series have been sporadically erupted in the Ethiopian highlands. One of these volcanic sequences is comprised of the Axum post-trap volcanics, a geochemically complex and lithologically varied part of the northwestern Ethiopian flood basalt province that erupted during a narrow time span. After the peak activity of the Ethiopian flood basalts, magmatic activities were mainly concentrated in the form of shield volcanoes in the plateau area and/or rift triggered fissure basalts in the floor of the Afar Depression. At present, volcanic activities are entirely confined along the axial zones of the Afar Depression representing the last phase of the Afar mantle plume (plume tail). All available trace element data and isotopic investigations show that both the high-Ti plateau basalts (HT2) from the plume head and the axial zone basalts from the plume tail have indistinguishable source regions (OIB-type), which are different from the depleted mantle source. However, the concentrations of the highly incompatible elements vary from one basaltic suite to another, showing a variation in degree and depth of melting of the source region. Structural and geophysical investigations (in the literature), on the other hand, show that the nature of the Afar Depression is purely an oceanic crust-type. Crustal thickness of the northern Afar Depression does not exceed 15 km and spreading rate along the actively expanding Erta’Ale Depression is ~12 mm/yr/100 km. This, obviously, implies that the floor of the northern Afar Depression is oceanic crust, as its spreading rate being analogous to the rates of the Red Sea and Gulf of Aden rifts; on the other hand, geochemical results confirm that magmatism resulted from the tail of the Afar mantle plume

Knowledge ,Attitude, and Factors Affecting Practice of Partograph by Professional Birth Attendants

partograph to document the assessment of maternal and fetal condition that enables appropriate decision making it is not being used at OINRMH

Effects of combined conservation practices on soil and water quality in the Central Mississippi River Basin

Conventional cultivation of claypan soils leads to soil and water quality degradation because of high runoff and associated soil erosion. The Goodwater Creek Experimental Watershed, which is part of the USDA Agricultural Research Service Benchmark Conservation Effects Assessment Project, Watershed Assessment Studies, was established to address these issues. Plot studies have highlighted trade-offs between erosion control and herbicide or nutrient runoff. There is a need for long-term field-scale evaluation of combined practices that reduce sediment, nutrient, and herbicide losses by runoff. A 36 ha field located in Missouri was under a conventional corn (Zea mays L.)-soybean (Glycine max L.) system from 1993 to 2003 with fertilizer application and tillage prior to planting in the spring. A precision agriculture system defined by two main management zones was implemented from 2004 to 2014: Wheat (Triticum aestivum L.) and soybean in 60% of the field, and corn and soybean in the remaining 40%. The system included no-till, cover crops, atrazine split-applications based on weed pressure, variable rates of nitrogen (N), and variable rates of fall-applied phosphorus (P). The objective of this study was to compare runoff water quality from the two management systems, based on flow and load duration curves, cumulative distribution functions, and conclusions from replicated plot studies. The precision agriculture system did not affect annual runoff, but it did increase the frequency of low flows. Sediment losses were reduced by 87% as a result of no-till and cover crops. Atrazine and P losses were lower than expected, despite the lack of incorporation into the soil. Atrazine losses were possibly lower because of the wheat area acting as a buffer, greater atrazine adsorption and retention in the field, and faster decay. Dissolved P losses as a fraction of applied remained the same, likely because of greater adsorption and lower runoff risk when applying P. Finally, nitrate-N (NO3-N) losses decreased and resulted in an overall decrease of N losses despite a slight increase of ammonium-N (NH4-N) losses. Explanations includeincluded a greater soil water content, a different timing of N applications, and N uptake by cover crops. Building on these successes, an aspirational management system is proposed to further improve on the performance and practicality of the precision agriculture system