A survey of knowledge level about pediatric oral/dental health among pediatricians

Pediatricians play a central role in children�s health care and are the first line of care for oral/dental conditions. The level of pediatrician knowledge about oral/dental health is not accurately determined. In this cross-sectional study, a previously adapted questionnaire was used to evaluate the level of oral/ dental health knowledge among pediatricians affiliated with medical universities in Tehran, Iran. The data were summarized through descriptive statistics and central index tests. In this study, 263 pediatricians (49.4 male) completed the questionnaire. The mean age was 43.9 years. Only 17 individuals (6.5) had completed a course of oral/dental health during their residency. The mean score was 5.9 ± 1.7. Questionnaire scores were similar between male and female pediatricians. Time from graduation and completion of an oral/dental health course was not associated with better performance according to the questionnaire. The level of knowledge about oral/dental health among pediatricians is inadequate. Most pediatricians have not completed a training course on this matter. These findings highlight the need for integrated training programs to improve pediatrician knowledge about oral/dental health. © 2021, Institute of Medico-Legal Publications. All rights reserved

Evaluation of coronary stents: a review of types, materials, processing techniques, design, and problems

In the world, one of the leading causes of death is coronary artery disease (CAD). There are several ways to treat this disease, and stenting is currently the most appropriate way in many cases. Nowadays, the use of stents has rapidly increased, and they have been introduced in various models, with different geometries and materials. To select the most appropriate stent required, it is necessary to have an analysis of the mechanical behavior of various types of stents. The purpose of this article is to provide a complete overview of advanced research in the field of stents and to discuss and conclude important studies on different topics in the field of stents. In this review, we introduce the types of coronary stents, materials, stent processing technique, stent design, classification of stents based on the mechanism of expansion, and problems and complications of stents. In this article, by reviewing the biomechanical studies conducted in this field and collecting and classifying their results, a useful set of information has been presented to continue research in the direction of designing and manufacturing more efficient stents, although the clinical-engineering field still needs to continue research to optimize the design and construction. The optimum design of stents in the future is possible by simulation and using numerical methods and adequate knowledge of stent and artery biomechanics

Has decentralisation affected child immunisation status in Indonesia?

Background: The past two decades have seen many countries, including a number in Southeast Asia, decentralising their health system with the expectation that this reform will improve their citizens’ health. However, the consequences of this reform remain largely unknown. Objective: This study analyses the effects of fiscal decentralisation on child immunisation status in Indonesia. Design: We used multilevel logistic regression analysis to estimate these effects, and multilevel multiple imputation to manage missing data. The 2011 publication of Indonesia's national socio-economic survey (Susenas) is the source of household data, while the Podes village census survey from the same year provides village-level data. We supplement these with local government fiscal data from the Ministry of Finance. Results: The findings show that decentralising the fiscal allocation of responsibilities to local governments has a lack of association with child immunisation status and the results are robust. The results also suggest that increasing the number of village health centres (posyandu) per 1,000 population improves probability of children to receive full immunisation significantly, while increasing that of hospitals and health centres (puskesmas) has no significant effect. Conclusion: These findings suggest that merely decentralising the health system does not guarantee improvement in a country's immunisation coverage. Any successful decentralisation demands good capacity and capability of local governments

System-level determinants of immunization coverage disparities among health districts in Burkina Faso: a multiple case study

<p>Abstract</p> <p>Background</p> <p>Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso.</p> <p>Methods</p> <p>A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team.</p> <p>Results</p> <p>The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks).</p> <p>Conclusion</p> <p>The discourse on factors that determine the performance or breakdown of local health care systems in lower and middle income countries remains largely concentrated on technocratic and financial considerations, targeting institutional reforms, availability of resources, or accessibility of health services. The leadership role of those responsible for the district, and more broadly, of those we label "the human factor", in the performance of local health care systems is mentioned only marginally. This study shows that strong and committed leadership promotes an effective mobilization of teams and creates the conditions for good performance in districts, even when they have only limited access to supports provided by external partners.</p> <p>Abstract in French</p> <p>See the full article online for a translation of this abstract in French.</p

Syntheses, crystal structures, and antibacterial activities of two cobalt(III) complexes.

Syntheses, structures, and antimicrobial activities of cobalt(III) complexes with two tetradentate Schiff-base ligands, (BA)2en = bis(benzoylacetone)ethylenediimine dianion and (acac)2en = bis(acetylacetone)ethylenediimine dianion, and two axial pyridines (py) have been investigated. These complexes were characterized by FT-IR, 1H-NMR, UV-Vis spectroscopy, and elemental analysis. The crystal structures of the complexes were determined by X-ray crystallography. Single-crystal X-ray diffraction analyses revealed that both complexes have distorted octahedral environments, Schiff-base ligand coordinates cobalt in four equatorial positions, and the two axial positions are occupied by pyridines. The pyridines and Schiff-base ligands are involved in N–H···O hydrogen bonds with perchlorate. Biological activities of the ligands and metal complexes have been studied on Staphylococcus aureus, Escherichia coli, and Bacillus subtilis by the well diffusion method. The activity data show the metal complexes to be more potent than the parent ligand against two bacterial species

On the Optimal Design of Convolutional Neural Networks for Earth Observation Data Analysis by Maximization of Information Extraction

Although deep learning architectures are nowadays used in several research fields where automatized investigation of large scale datasets is required, the intrinsic mechanisms of deep learning networks are not fully understood yet. In this paper, a new approach for characterizing how information is processed within convolutional neural networks (CNNs) is introduced. Taking advantage of an analysis based on information theory, we are able to derive an index that is associated with the degree of maximum information extraction a CNN can obtain under ideal circumstances as a function of its hyperparameters setup and of the data to be explored. Experimental results on remote sensing datasets show the robustness of our approach. The outcomes of our analysis can be used to optimize the design of CNNs and maximize the information that can be obtained for the considered problem

Equilibrium studies of 2,2'-(5-bromo-6-methylpyrimidine-2,4-diyl)bis(azanediyl)dipropanoic acid with some transition-metal ions in aqueous solution

The stability constants of the 1:1 complexes formed between M2+ (M2+: Mn2+, Ni2+, Cu2+, or Cd2+) and BMADA2- (BMADA: 2,2'-(5-bromo-6-methylpyrimidine-2,4 diyl)bis(azanediyl)dipropanoic acid) were determined by potentiometric pH titration in aqueous solution (I = 0.1 mol L-1, NaNO3, 25 °C). The stability of the binary M - BMADA complexes is determined by the basicity of the carboxyl or amino groups. All the stability constants reported in this work exhibit the usual trend, and the order obtained was Mn2+ Cd2+. The observed stability order for BMADA approximately follows the Irving - Williams sequence. In the M - BMADA complexes, the M ion is able to form a macrochelate via the pyrimidine group of BMADA