Estudi de la predicció del descentrament del tractament ortoqueratològic en funció del mapa topogràfic d'elevació pre-ortoqueratologia

Objectiu: Investigar les causes del descentrament de la lent d'ortoqueratologia (orto-k) i l'associació amb els paràmetres topogràfics corneals previs al tractament. Fer la recerca bibliogràfica sobre els articles que han fet estudis concretament sobre les causes del descentrament de la lent. Metodologia: Per realitzar el treball s’ha fet una recerca bibliogràfica en bases de dades, principalment a PubMed, Sciencedirect i Web of Science. S’han buscat els articles sobre les causes del descentrament de la lent d’ortoqueratologia. Només s’han trobat 7 articles, s’ha mirat el procediment de mesurar el grau i direcció del descentrament en cada article. S’ha trobat la relació entre el descentrament i els paràmetres corneals que poden influir en aquest procés. Resultats: A tots els articles van calcular el descentrament de la mateixa manera, comparant el mapa diferencial d'elevació de la còrnia pre i post ortoqueratologia. En tots els estudis, el descentrament més trobat va ser cap al quadrant inferotemporal de la còrnia. Les causes més influents van ser l’alta toricitat corneal, l’asfericitat corneal (Q), l’alta magnitud de l’error refractiu i l’asimetria corneal. Conclusions: El descentrament de la lent és un fenomen comú de l'ortoqueratologia, que passa principalment cap al quadrant inferotemporal de la còrnia i a la majoria dels casos és moderada i acceptable. La magnitud i la direcció d’aquest descentrament de la lent es poden predir pel mapa d'elevació i pels paràmetres topogràfics de la còrnia.Objetivo: Investigar las causas del descentramiento de la lente de la ortoqueratología (orto-k) y la asociación con los parámetros topográficos corneales previos al tratamiento. Realizar la búsqueda bibliográfica sobre los artículos que han realizado estudios concretamente sobre las causas del descentramiento de la lente. Metodología: Para realizar el trabajo se ha hecho una búsqueda bibliográfica en bases de datos, principalmente en PubMed, Sciencedirect y Web of Science. Se han buscado los artículos sobre las causas del descentramiento de la lente de ortoqueratología, en la que sólo se han encontrado 7 artículos. A continuación se ha mirado el procedimiento de medir el grado y dirección del descentramiento en cada artículo y se ha encontrado la relación entre el descentramiento y los posibles parámetros corneales que pueden influir en este proceso. Resultados: En todos los artículos, calcularon el descentramiento de la misma forma, comparando el mapa diferencial de elevación de la córnea pre y post-ortoqueratología. En todos los estudios, el descentramiento más hallado fue hacia el cuadrante inferotemporal de la córnea. Las causas que más influyeron fueron la alta toricidad corneal, la asfericidad corneal (Q), la alta magnitud del error refractivo y la asimetría corneal. Conclusiones: El descentramiento de la lente es un fenómeno común en la ortoqueratología, que se da principalmente hacia el cuadrante inferotemporal de la córnea y en la mayoría de los casos es moderada y aceptable. La magnitud y dirección de este descentramiento de la lente se pueden predecir por el mapa de elevación y por los parámetros topográficos de la córnea.Objective: To Investigate the causes of orthokeratology lens decentralization (ortho-k) and its association with prior treatment corneal topographic parameters. To perform bibliographic research on articles that have specifically studied the causes of lens decentralization. Methodology: To perform the work, a bibliographic search was carried out in databases, mainly in PubMed, Sciencedirect and Web of Science. The articles on the causes of orthokeratology lens decentration were searched, in which only 7 articles were found. Afterward, the procedure for measuring the degree and direction of decentration in each article was also studied. In the continuation of the project the possible relation between the decentration and the corneal parameters that may influence lens centration. Results: In all the articles that have been studied during this research work authors calculated the decentration in the same way, comparing the differential map of corneal elevation pre and post orthokeratology. In all studies, the most common decentration was toward the inferotemporal quadrant of the cornea. The most influential causes were high corneal toricity, corneal asphericity (Q), high magnitude of refractive error, and corneal asymmetry. Conclusions: Lens decentration is a common phenomenon in orthokeratology, which occurs mainly in the inferotemporal quadrant of the cornea and in most cases is moderate and acceptable. The magnitude and direction of this lens offset can be predicted by the elevation map and topographic parameters of the cornea

Using technology acceptance model to measure the use of social media for collaborative learning in Ghana

In this Digital era, thousands of teens in the universities use social network sites; it has become a way of life. Social Media Usage has recently received numerous debates in its impact on academics, with its advent, communities have become link to each other, but the lecture room still remains quite isolated, from other teachers, students, and a host of others who could potentially enhance learning. This study aimed at investigating the impact of social media usage on students’ academic performance through collaborative learning among university students in Ghana. Based Davis, Bagozzi & Warshaw (1989), Technology Acceptance Model (TAM), a conceptual framework was adopted for the study. To achieve the objectives, a quantitative data analysis method was employed. A total of 200 students were randomly surveyed for the study. Regression analysis revealed that, Interaction with peers, perceived ease of use and perceived usefulness had a significant positive relationship with collaborative learning. Furthermore, results suggested that there exist a significant mediation effects on the relationship between social media usage dimensions and academic performance. TAM does not take into account environment or economic factors that may influence a person’s intention to perform a behavior. The study recommends a clear mobile learning methodologies, rules and policies for integrating student activities on social media into their final gradesPeer Reviewe

Barriers to Innovation and Public Policy in Sub-Sahara Africa

Countries in sub-Sahara Africa are increasingly becoming aware of the role of Science, Technology and Innovation (STI) in lifting the region from the doldrums of poverty and deprivation. This is necessary if the continent aims to add value to its raw material in order to remain competitive in the global market and at the same time diversify the structure of its economies.  This paper aims to explore policies on STI implemented across countries in the region and how these policies have managed to change the status quo and ultimately led to building technological capability economies to enhance the wellbeing of the region.The paper primarily focuses on countries within sub-Sahara Africa excluding North Africa and the Middle East. However, comparisons are occasionally drawn from certain countries in the west and emerging economies.The paper systematically reviews national science, technology and innovation plans of selected countries in sub-Sahara Africa. Other secondary sources included credible journal articles, commentary, webpages, working papers and reports published on the selected countries.Empirical evidence gathered from secondary sources indicate that governments in the region have built public organizations and institutions to support STI. Yet technology-capability indicators available illustrates the results are far from expectation. The paper further discusses the barriers faced by governments in the design and implementation of STI policies that have led to the ensuing situation.In the face of the significant progress in setting up institutional frameworks across countries in the region leading to the adoption of a systemic approach, the ensuing results of STI policies in the region is marginal as evidenced in the indicators. Human and financial resources devoted to them are in shortfall. We admonish countries in the region to take all the necessary steps to develop national evaluation and STI data stand. The success of this approach will be contingent on the region first of all being able to evolve a specific conceptual and methodological tools for monitoring and assessing STI policies. Area of financing STI policies have to be reconsidered. Tax incentives and havens for technology related businesses ought to be given priority to augment already existing instruments such as export-led instruments. Keywords: Barriers; Sub-Sahara Africa; Policy, Science and Technology and Innovation (STI); Entrepreneurship

Penentuan Prioritas Rehabilitasi Perkerasan Lentur untuk Efisiensi Penambangan Material di Kendari

Pavement with poor performance results in lower speeds resulting in increased pollution and vehicle maintenance costs. The number of roads are not proportional to the allocation of funds for maintaining and managing the road network. According to its characteristics, the performance of the road network would be decreased that indicated by pavement deterioration. This study aims to predict the rate of performance degradation, to know the optimal time of treatment segment/road segment and to determine the priority of treatment. Delayed pavement treatment will likely require more material, which will result in the exploitation of rock mines. This study covers a detailed performance assessment using Pavement Condition Index (PCI) method, it was done three times with 4 and 3 month time interval. This study was conducted on five streets in Kendari City with varios Average Annual Daily Traffic (AADT) and existing conditions. From the result of PCI value, regression analysis was used since it was suitable with performance decreation characteristic to find out the relationship of PCI value and the time. Treatment strategy are arranged based on critical PCI method. The treatment costs were calculated by using the Bina Marga unit price analysis which was then projected to be the penalty cost. Priority of treatment were calculated by Simple Additive Weighting (SAW) method. From regression analysis obtained pavement with excellent rating gave longer time prediction than the lower rating. The treatment strategy divides five streets into 11 segments. From SAW analysis, obtained priority sequence of rehabilitation implementation for the first year: Boulevard street segment-1, Supu-Yusuf street segment-2, Supu-Yusuf segment-1, Balaikota-1 street; for the second year: Boulevard segment-2, Abunawas segment-2; Supu-Yusuf street segment-3, and third year: Boulevard segment-3, Buburanda segment-2, Buburanda street segment-1.Keywords: pavement, PCI, decreation rate, rehabilitationABSTRAKKinerja perkerasan yang buruk menyebabkan rendahnya kecepatan yang berakibat pada meningkatnya polusi dan biaya perawatan kendaraan. Namun jumlah jalan tidak sebanding dengan alokasi dana untuk memelihara dan mengelola jaringan jalan. Menurut karakteristik, kinerja jaringan jalan akan menurun yang ditunjukkan oleh kemunduran perkerasan. Penelitian ini bertujuan untuk memprediksi laju penurunan kinerja, untuk mengetahui waktu optimal segmen perawatan / segmen jalan dan untuk menentukan prioritas perawatan. Perawatan perkerasan yang tertunda cenderung akan membutuhkan material lebih banyak, yang akan mengakibatkan ekploitasi tambang batuan. Penelitian ini mencakup penilaian kinerja rinci menggunakan metode Pavement Condition Index (PCI), dilakukan tiga kali dengan interval waktu 4 dan 3 bulan. Penelitian ini dilakukan di lima jalan di Kota Kendari dengan varios Lalu Lintas Harian Rata-Rata Tahunan (AADT) dan kondisi yang ada. Dari hasil nilai PCI, analisis regresi digunakan karena sesuai dengan karakteristik penurunan kinerja untuk mengetahui hubungan nilai PCI dan waktu. Strategi perawatan disusun berdasarkan metode PCI kritis. Biaya perawatan dihitung dengan menggunakan analisis harga unit Bina Marga yang kemudian diproyeksikan menjadi biaya penalti. Prioritas perawatan dihitung dengan metode Simple Additive Weighting (SAW). Dari analisis regresi diperoleh perkerasan dengan peringkat sangat baik memberikan prediksi waktu yang lebih lama daripada peringkat yang lebih rendah. Strategi perawatan membagi lima jalan menjadi 11 segmen. Dari analisis SAW, diperoleh urutan prioritas pelaksanaan rehabilitasi untuk tahun I: jalan Boulevard segmen-1, jalan Supu-Yusuf segmen-2, Supu-Yusuf segmen-1, jalan Balaikota-1; untuk tahun II: Boulevard segmen-2, Abunawas segmen-2; Jalan Supu-Yusuf ruas-3, dan tahun ketiga: Boulevard ruas-3, Buburanda ruas-2, Ruas jalan Buburanda-1.Kata kunci: Trotoar, PCI, Tingkat Penurunan, Rehabilitasi 

Hydroxypropyl cellulose-based orally disintegrating films of promethazine HCl for the treatment of motion sickness

Purpose: To prepare and characterize orally disintegrating films (ODFs) of promethazine hydrochloride (HCl) for prompt treatment of motion sickness.Methods: Films were prepared by solvent casting method using hydroxypropyl cellulose (HPC) as film former and glycerin as plasticizer along with a saliva stimulating and sweetening agent. Nine different film formulations were prepared and evaluated for their characteristics including thickness, disintegration time, tensile strength and drug release behavior.Results: The prepared films were transparent and slightly sticky in nature with thickness that ranged from 0.22 mm to 0.29 mm and tensile strength of 0.56 N/cm² to 2.49 N/cm². The disintegration time of film formulations ranged from 26.3 to 52.7 s and a majority of formulations released approx. 80 % of the drug within 10 min with a non-Fickian diffusion pattern.Conclusion: The study concludes that the orally disintegrating films of promethazine HCl can be prepared using HPC as film former.Key words: Orally disintegrating films, Promethazine, Solvent casting, Motion sicknes

The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis

BackgroundThe existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.AimTo investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.MethodologyThe PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.ResultsTuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60–0.96, p < 0.001). Heterogeneity observed among included studies was moderate (I2 = 38%). No significant change was observed in the results after sub-group analysis by study design (HR 0.81, 95% CI: 0.61–0.96, p < 0.000). In the case of treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27–0.67, p < 0.001).ConclusionThe results showed that DM had a significant impact on the emergence of MDR-TB in TB-diabetes comorbid patients as compared to TB-non-DM patients. DM enhanced the risk of TB treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression

Effect of 3 Days of Oral Azithromycin on Young Children With Acute Diarrhea in Low-Resource Settings A Randomized Clinical Trial

Importance: World Health Organization (WHO) guidelines do not recommend routine antibiotic use for children with acute watery diarrhea. However, recent studies suggest that a significant proportion of such episodes have a bacterial cause and are associated with mortality and growth impairment, especially among children at high risk of diarrhea-associated mortality. Expanding antibiotic use among dehydrated or undernourished children may reduce diarrhea-associated mortality and improve growth. Objective: To determine whether the addition of azithromycin to standard case management of acute nonbloody watery diarrhea for children aged 2 to 23 months who are dehydrated or undernourished could reduce mortality and improve linear growth. Design, Setting, and Participants: The Antibiotics for Children with Diarrhea (ABCD) trial was a multicountry, randomized, double-blind, clinical trial among 8266 high-risk children aged 2 to 23 months presenting with acute nonbloody diarrhea. Participants were recruited between July 1, 2017, and July 10, 2019, from 36 outpatient hospital departments or community health centers in a mixture of urban and rural settings in Bangladesh, India, Kenya, Malawi, Mali, Pakistan, and Tanzania. Each participant was followed up for 180 days. Primary analysis included all randomized participants by intention to treat. Interventions: Enrolled children were randomly assigned to receive either oral azithromycin, 10 mg/kg, or placebo once daily for 3 days in addition to standard WHO case management protocols for the management of acute watery diarrhea. Main Outcomes and Measures: Primary outcomes included all-cause mortality up to 180 days after enrollment and linear growth faltering 90 days after enrollment. Results: A total of 8266 children (4463 boys [54.0%]; mean [SD] age, 11.6 [5.3] months) were randomized. A total of 20 of 4133 children in the azithromycin group (0.5%) and 28 of 4135 children in the placebo group (0.7%) died (relative risk, 0.72; 95% CI, 0.40-1.27). The mean (SD) change in length-for-age z scores 90 days after enrollment was -0.16 (0.59) in the azithromycin group and -0.19 (0.60) in the placebo group (risk difference, 0.03; 95% CI, 0.01-0.06). Overall mortality was much lower than anticipated, and the trial was stopped for futility at the prespecified interim analysis. Conclusions and Relevance: The study did not detect a survival benefit for children from the addition of azithromycin to standard WHO case management of acute watery diarrhea in low-resource settings. There was a small reduction in linear growth faltering in the azithromycin group, although the magnitude of this effect was not likely to be clinically significant. In low-resource settings, expansion of antibiotic use is not warranted. Adherence to current WHO case management protocols for watery diarrhea remains appropriate and should be encouraged. Trial Registration: ClinicalTrials.gov Identifier: NCT03130114.publishedVersionPeer reviewe

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries