Kwentong Pambata: Interactive Storybook for Filipino Fables, Legends, Parables and Short Stories

This paper focused on the development and evaluation of a mobile application in which children could interact, be entertained, and especially be educated at the same time. It was mainly designed for children, parents/guardians, and teachers as well. The interactive storybook which was created was different from those available in the market.  Kwentong Pambata is a children’s storybook application designed for Android devices that features Filipino legends, fables, parables and short stories designed for Filipino children and children all over the world. It portrays Filipino values, traditions and character which contains moral lesson at the end of each story that would educate children’s view in life, their characters, moral uprightness, and values. It is a storybook which contains fun pictures, texts, and sounds that kids will truly enjoy. The goal of the study is to develop an Android application that children could interact, learn, read, be entertained, improve and develop children’s imagination and comprehension skills at an early age, and to promote Filipino stories and moral values. Kwentong Pambata application was developed using ActionScript 3.0. and Adobe Flash CS5.5. The application has 3 different language translations such as Filipino, English, and Mandarin. The proponents used ADDIE model for the development of the application. After the development, the application was evaluated. The total number of 40 respondents which were selected through probability sampling is used for the evaluation process. The application was evaluated according to its Usability, Reliability, Efficiency and Graphical User Interface (GUI).  The evaluation questionnaire showed that the application was rated as very satisfactory with the help of the respondents and was improved throughout its revisions

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570