DEVELOPMENT OF CEREAL-BASED NUTRI BAR COMBINING WITH DIFFERENT LEVELS OF PARTIALLY SPROUTED CHICKPEAS FLOUR

Modern consumers prefer snacks not only to satisfy their hunger but also to provide themselves with essential nutrients. Nutri bar is a convenient and healthy ready-to-eat food which supplies balanced nutrients. The nutritional value of the bars depends heavily on their ingredients used. Cereal-legume complementation is one of the strategies to produce the nutri bar with good protein quality and therefore the present research was conducted to evaluate the effects of partially sprouted chickpea flour (PSCF) with high protein content and nutrients on physicochemical properties of cereal-based nutri bar. Five levels (0, 10, 20, 30 and 40%) of PSCF were combined with other ingredients based on 100% reducing cereals (wheat and oat). Physical and chemical properties were determined and sensory evaluation was assessed using 9 hedonic scales by 55 panelists. Nutri bar with 40% of PSCF was highest in crude protein (20.58%) and crude fiber content (8.91%) among the treatments. Although most of the physicochemical properties were good in 40% PSCF, the score of overall acceptability in sensory evaluation was highest in 20% PSCF. Therefore, PSCF can be successfully added up to 20% levels for high quality protein and balanced nutrients for manufacturing of cereal-based nutri bars

Assessment of a Machine Learning Framework for Sustainability Base

The Sustainability Base is a super‐green, government owned building that was inspired by NASA’s space exploration technology. There are thousands of sensors that are placed around the building for the purpose of automating certain processes as well as for data acquisition. The purpose of this project is to apply NuPIC, a machine learning framework based on the Cortical Learning Algorithm (CLA) to the data acquired from Sustainability Base in order to evaluate its performance metrics. First, data from the Sustainability Base will need to be analyzed in order to pick out the sensors (features) that would serve as good references for anomaly detection and adverse event prediction of the differential water pressure sensor. Then a training dataset (contains nominal values), validation dataset (contains anomalous values), and a test dataset (contains one anomaly) was constructed to use with NuPIC. The results generated by the Online Predictive Framework (OPF) of NuPIC when the test dataset is applied, will be used to evaluate its performance metrics (false alarm rate, missed detection rate, detection time)

Long-Term Management of Hepatitis C-Seropositive Subjects with AntiOxidant Biofactor (AOB®), a Fermented Food Supplement

The efficacy of AntiOxidant Biofactor (AOB(R)) for the management of apparently healthy subjects with chronic hepatitis C infection was investigated. A total of 60 subjects (35 males, 25 females) participated in the trial. AOB was given orally in 2 packs (3g per pack) 3 times per day. 17 subjects had taken AOB for 3 years, 31 subjects up to 2 years, and 41 subjects up to one year. The initial mean (SD) serum alamine aminotransferase (ALT) level was 46.3+/-35.4IU/L, and significant (p0.05, paired t-test) reductions in the mean serum ALT levels were observed at 6 months (38.6+/-21.5IU/L), 18 months (31.9+/-18.1IU/L), 2 years (31.2+/-14.6IU/L), and 3 years (28.0+/-15.9IU/L). Those presenting with high serum ALT levels (30 subjects) demonstrated significant levels (p0.05, paired t-test) of reduction in the mean serum ALT levels at 6, 12, 18, 24, and 36 months of treatment. No side effects were observed and the AOB treatment was well tolerated by all subjects

Spatial distribution, work patterns, and perception towards malaria interventions among temporary mobile/migrant workers in artemisinin resistance containment zone

BACKGROUND: Mobile populations are at a high risk of malaria infection and suspected to carry and spread resistant parasites. The Myanmar National Malaria Control Programme focuses on preventive interventions and vector control measures for the temporary mobile/migrant workers in Myanmar Artemisinin Resistance Containment Zones. METHODS: A prospective cross-sectional study was conducted in 2012 in Kawthaung and Bokepyin townships of Tanintharyi Region, Myanmar, covering 192 mobile/migrant aggregates. The objectives were to identify the spatial distribution of the mobile/migrant populations, and to assess knowledge, attitudes, perceptions, and practices concerning malaria prevention and control, and their preferred methods of interventions. The structure of the192 migrant aggregates was investigated using a migrant mapping tool. Individual and household information was collected by structured interviews of 408 respondents from 39 aggregates, supplemented by 12 in-depth interviews of health care providers, authorities, volunteers, and employers. Data were analyzed by triangulating quantitative and qualitative data. RESULTS: The primary reasons for the limitation in access to formal health services for suspected malaria within 24 hours were identified to be scattered distribution of migrant aggregates, variable working hours and the lack of transportation. Only 19.6% of respondents reported working at night from dusk to dawn. Among study populations, 73% reported a perceived risk of contracting malaria and 60% reported to know how to confirm a suspected case of malaria. Moreover, only 15% was able to cite correct antimalarial drugs, and less than 10% believed that non-compliance with antimalarial treatment may be related to the risk of drug resistance. About 50% of study population reported to seeking health care from the public sector, and to sleep under ITNs/LLINs the night before the survey. There was a gap in willingness to buy ITNs/LLINs and affordability (88.5% vs. 60.2%) which may affect their sustained and consistent use. Only 32.4% across all aggregates realized the importance of community participation in effective malaria prevention and control. CONCLUSIONS: Community-based innovative approaches through strong collaboration and coordination of multi-stakeholders are desirable for relaying information on ITNs/LLINs, rapid diagnostic test, and artemisinin combination therapy and drug resistance successfully across the social and economic diversity of mobile/migrant aggregates in Myanmar

Factors Associated With Age of Diagnosis Among Myanmar Children with Autism Spectrum Disorders

This study aimed to find out the average age of diagnosis, and factors associated with the age of diagnosis, among Myanmar children with Autism Spectrum Disorders. A cross-sectional descriptive study involving 84 children from two private special schools, namely New World and Light House. All children who were diagnosed as ASD, according to DSM-IV criteria, were involved in this study. Data was collected from the caregivers by face-to-face interviewing. Physical examinations and investigations were done as necessary. Results: A total of 84 children with ASD were included in this study. The mean age of diagnosis was 3.5 years old. The minimum age of diagnosis was 1 year old and the maximum was 6 years old. There were significant findings regarding factors associated with the age of diagnosis. A higher educational standard of the child’s father, and some autism specific signs such as lack of pointing out objects of interest, and poor response to name being called, were associated with an earlier age of diagnosis of autism spectrum disorders. The presence of persistent preoccupation with parts of objects, the presence of selective eating habits and comorbid conditions like epilepsy and global delay, had been found to delay the age of diagnosis of ASDs. This study revealed information regarding the age of diagnosis among Myanmar children with ASD, and factors associated with the age of diag-nosis. Although this study could not represent the whole population, due to its limitation in sampling size and study area, the findings will contribute to future research being done in different places, including urban, as well as rural areas, with larger populations, which would result in a later age of diagnosis. Identified discrepancies in the age of diagnosis based on certain socio-demographic and clinical variables highlight the need for coordinated strategies for early detection of autism spectrum disorders

A literature review exploring how health systems respond to acute shocks in fragile and conflict-affected countries

Understanding how health systems respond to shocks has become a pressing need to strengthen response efforts. With already fragmented and disrupted health services, fragile and conflict affected [FCA] countries are more vulnerable to shocks. Previous studies have focused more on conceptualizing health system resilience rather than how health systems [especially in FCA countries] respond to or are resilient to acute shocks. To understand how health systems in FCA countries respond to the shocks and what influence their responses, we conducted a review of the literature published between January 2011 and September 2021 on health system responses to acute shocks in FCA countries. We searched Medline, Embase, Scopus, Jester and Google Scholar – 60 empirical studies in FCA countries on response to sudden, extreme, and unanticipated shocks were included in the review. We found that health systems in FCA countries responded to acute shock using absorptive, adaptive, or transformative capacities. These capacities were mediated by four dimensions of context; knowledge, uncertainties, interdependence, and legitimacy. In addition, we identified the cross-cutting role of community involvement [and its self-evolving nature], frontline workers, and leadership capacity. To our knowledge, this is among the first reviews that focus on FCA country health systems responses to acute shock. By highlighting enabling and constraining factors to each type of capacity, this study provides important lessons and practical strategies from FCA countries on how to absorb, adapt and transform in response to acute shocks – thus promoting health system resilience globally

Cost effectiveness and resource allocation of Plasmodium falciparum malaria control in Myanmar: a modelling analysis of bed nets and community health workers.

BACKGROUND: Funding for malaria control and elimination in Myanmar has increased markedly in recent years. While there are various malaria control tools currently available, two interventions receive the majority of malaria control funding in Myanmar: (1) insecticide-treated bed nets and (2) early diagnosis and treatment through malaria community health workers. This study aims to provide practical recommendations on how to maximize impact from investment in these interventions. METHODS: A simple decision tree is used to model intervention costs and effects in terms of years of life lost. The evaluation is from the perspective of the service provider and costs and effects are calculated in line with standard methodology. Sensitivity and scenario analysis are undertaken to identify key drivers of cost effectiveness. Standard cost effectiveness analysis is then extended via a spatially explicit resource allocation model. FINDINGS: Community health workers have the potential for high impact on malaria, particularly where there are few alternatives to access malaria treatment, but are relatively costly. Insecticide-treated bed nets are comparatively inexpensive and modestly effective in Myanmar, representing a low risk but modest return intervention. Unlike some healthcare interventions, bed nets and community health workers are not mutually exclusive nor are they necessarily at their most efficient when universally applied. Modelled resource allocation scenarios highlight that in this case there is no "one size fits all" cost effectiveness result. Health gains will be maximized by effective targeting of both interventions

Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy.

Healthcare services are often provided to a country as a whole, though in many cases the available resources can be more effectively targeted to specific geographically defined populations. In the case of malaria, risk is highly geographically heterogeneous, and many interventions, such as insecticide-treated bed nets and malaria community health workers, can be targeted to populations in a way that maximises impact for the resources available. This paper describes a framework for geographically targeted budget allocation based on the principles of cost-effectiveness analysis and applied to priority setting in malaria control and elimination. The approach can be used with any underlying model able to estimate intervention costs and effects given relevant local data. Efficient geographic targeting of core malaria interventions could significantly increase the impact of the resources available, accelerating progress towards elimination. These methods may also be applicable to priority setting in other disease areas

Effectiveness of the SA 14-14-2 Live-Attenuated Japanese Encephalitis Vaccine in Myanmar

Myanmar is an endemic country for the Japanese encephalitis virus (JEV), and the SA-14-14-2 live-attenuated JEV vaccine was first introduced as a catch-up vaccination campaign in 2017. To determine the effectiveness of vaccination by means of neutralizing antibody titers against JEV, a cross-sectional descriptive study was conducted among five to 15-year-old monastic school children in Mandalay, Myanmar. A total of 198 students who had received vaccines were recruited, and single-time investigation of anti-JEV IgG and neutralizing antibodies against wild-type JEV were determined using anti-JEV IgG ELISA and plaque reduction neutralization tests (PRNT50). All students 100% (198/198) showed positive results on the anti-JEV IgG ELISA, and 87% (172/198) of the students had neutralizing antibodies against JEV six months after immunization. The geometric mean titers of both IgG antibodies and neutralizing antibodies increased with the participants’ age groups, and statistically significant differences in anti-JEV IgG titers were noted across age groups. In this study, we could not investigate the persistence of neutralizing antibodies as only single-time blood collection was done. This study, which is the first report of JEV vaccination among children in Myanmar, showed similar neutralizing antibody production rates among vaccinated individuals as did studies in other countries