The ABCs of EBP: opportunities and challenges for evidence-based practice education in developing countries

The importance of embedding evidence-based practice as part curricula and practice is now well recognised in health disciplines. However, despite this recognition there continues to be ongoing challenges. Nowhere are these challenges more evident than in developing countries where a tsunami of challenges confronts health care stakeholders. This commentary sheds some light on opportunities and challenges for evidence-based practice education in developing counties

Y chromosome microdeletions in infertile male candidates for microfertilization

Uvod. Mikrodelecije Y hromozoma su, posle Klinefelterovog (Klinefelter) sindroma, najčešći genetski uzrok neplodnosti muškaraca. Cilj rada. Cilj istraživanja je bio da se utvrdi učestalost mikrodelecija Y hromozoma kod muškaraca s idiopatskom neplodnošću koji su kandidati za mikrofertilizaciju (Intracytoplasmic Sperm Injection - ICSI), kao i da se ispita korelacija genotipa i fenotipa kod bolesnika sa delecijama Y hromozoma. Metod rada. U studiju je prvobitno uključeno 160 odabranih muškaraca s malim brojem spermatozoida (manje od 5×106 spermatozoida po mililitru ejakulata), međutim, 40 muškaraca je isključeno iz daljeg ispitivanja (kod 10 ispitanika su utvrđeni citogenetski poremećaji, a kod 30 je dijagnostikovan jedan od poznatih uzroka neplodnosti). Kontrolnu grupu ispitanika činilo je 150 muškaraca koji su ostvarili očinstvo bar jednom u poslednje dve godine. Genomska DNK je izolovana iz periferne krvi 120 odabranih ispitanika, a postojanje ili izostanak delecija Y hromozoma analizirano je u dve multipleks reakcije lančanog umnožavanja (Polimerase Chain Reaction - PCR) korišćenjem odgovarajućih prajmera. Rezultati. Izostanak amplifikacije korišćenjem bar jednog para prajmera dokazan je kod 12 ispitanika (10%), dok u kontrolnoj grupi ispitanika nije dokazana nijedna delecija Y hromozoma. Od ukupno 12 otkrivenih delecija, kod devet ispitanika delecija je lokalizovana u regionu AZFc (75%), kod jednog ispitanika je otkrivena u regionu AZFa (8%), dok su kod dva ispitanika delecije zabeležene u regionu AZFbc (17%). Zaključak. Ispitivanje mikrodelecija Y hromozoma treba razmotriti kao važan elemenat genetskog savetovanja infertilnih parova u Srbiji. Odluka o primeni tehnika asistirane reprodukcije treba da bude zasnovana na rezultatima kliničkog pregleda, spermograma, kariotipa, endokrinih ispitivanja, kao i na rezultatima analize mikrodelecija Y hromozoma.Introduction Y chromosome microdeletions are the second most frequent genetic cause of male infertility after Klinefelter's syndrome. Objective The aim of the study was to determine the frequency of Y chromosome microdeletions in a group of infertile men with an idiophatic cause of infertility, candidates for microfertilization (Intra-cytoplasmic Sperm Injection - ICSI) in Serbia and to correlate genotype-phenotype in patients with Y chromosome microdeletions. METHOD One hundred and sixty patients with low sperm count (less than 5x106 spermatozoa/ml) were enrolled in the study. Forty patients were excluded from the study: ten because they were diagnosed with cytogenetic abnormality and thirty patients were diagnosed with other known causes of infertility. The control group consisted of 150 men who fathered at least one child in the last two years. Genomic DNA was extracted from peripheral blood samples and two multiplex polymerase chain reactions (PCR) analyses were performed using specific primers to confirm the presence or absence of Y chromosome microdeletions. Results Microdeletions were detected in 12 of 120 (10%) cases, while no deletions were detected in the control group. Of total number of 12 deletions, nine were detected in AZFc region (75%), one in AZFa (8%), and two in AZFbc (17%). Conclusion Testing for Y chromosome microdeletions should be considered as an important element in diagnosis and genetic counselling of infertile couples in Serbia. Decisions regarding the assisted reproduction should be made based on the detailed clinical, endocrinological and cytogenetic examinations, spermogram, presence or absence and type of AZF microdeletions and CFTR gene mutations

Detection, determination and monitoring of children with disabilities in the municipality of Foca

Problem detekcije, evidencije, praćenja i usmeravanja dece sa smetnjama u razvoju u Republici Srpskoj je kompleksan i do sada nije ostvarena institucionalizovana i stručna povezanost izme�����u zdravstva, dečje zaštite, školovanja i socijalne zaštite. Ovi problemi su doveli do: stagnacije u ranom otkrivanju dece ometene u razvoju a samim tim i kasnom uključivanju u odgovarajuće rehabilitacione programe; male obuhvaćenosti dece predškolskim vaspitanjem, osnovnoškolskim vaspitanjem i obrazovanjem kao i profesionalnim osposobljavanjem i zastoja u razvoju mreže institucija koje se bave decom ometenom u razvoju. Ovom problemu smo pristupili kroz naučno istraživački projekat „Detekcija, determinacija i prećenje dece ometene u razvoju na području Republike Srpske“ koji je odobrilo Ministarstvo nauke i tehnologije Republike Srpske. Ciljevi ovog istraživanja su: otkrivanje dece sa smetnjama u razvoju, njihovo evidentiranje i uspostavljanje mehanizma periodičnog praćenja. Za realizaciju prvog cilja ovog istraživanja izvršena je kvalitativna analiza aktuelne zakonske regulative Republike Srpske u kojoj se pominju deca sa smetnjama u razvoju: Zakon o socijalnoj zaštiti, Zakon o dečijoj zaštiti, Zakon o osnovnom obrazovanju i vaspitanju. Zakon o zdravstvenoj zaštiti i Pravilnik o razvrstavanju lica sa smetnjama u fizičkom i psihičkom razvoju. Na osnovu, obra�����nih podataka, na teritoriji Opštine Foča evidentirano je 37 dece sa smetnjama u razvoju sa Nalazom i mišljenjem stručne komisije. Od tog broja, 11 nalazi se u dve osnovne škole. Pored ove dece, u dve redovne škole u Foči nastavu poha�����a još 24 dece koja ispoljavaju smetnje u razvoju ali nemaju Rešenje Stručne Komisije. Reč je o deci koja ispoljavaju: Oštećenje glasa govora i jezika 12 (50%); Hronične bolesti 4 (16,66%); Oštećenje vida 3 (12,50%); Laka mentalna retardacija 3 (12,50%), Telesna oštećenja 1 (4,16%) i Poremećaj ponašanja 1 (4,16%).Problem of detection, keeping records, monitoring and guidance of children with disabilities in Republika Srpska is complex. Institutionalized and professional relationship between health, child welfare, education and social protection has not been established yet. These problems have led to: stagnation in the early detection of disabilities in children and therefore the late inclusion in the appropriate rehabilitation programs; low coverage of children with pre-school and primary education as well as professional training and delays in development of institutional network, which should involve institutions specialized in dealing with disabled children. We approached this problem through scientific research project “Detection, Determination and Monitoring of Children with Disabilities in Republika Srpska”, approved by the Ministry of Science and Technology, Republic of Serbia. The objectives of this research are: detection of children with developmental disabilities, their recording, and establishing of periodic monitoring. In order to finish the first objective of this research, quality analysis of the current legislation in Republika Srpska, regarding children with disabilities, was carried out. Those are: the Law on Social Protection, the Law on Child Protection, the Law on Primary Education, Health Care Law and Regulation regarding Classification of people with disabilities in the physical and mental development. Grounded on processed data, in the municipality of Foca, we recorded 37 children with disabilities with recorded opinion of expert committee. Out of those 37, eleven children were located in two elementary schools. In addition to these children, in two regular schools in Foca there are 24 children with disabilities, but without opinion of expert committee. Those are the children with: impairment of voice, speech or language 12 (50%), chronic disease 4 (16,66%), visual impairment 3 (12,50%), mild mental retardation 3 (12,50%), physical impairment 1 (4,16%) and behavioral disorders 1 (4,16%)

Detection, determination and monitoring of children with disabilities in the municipality of Foca

Problem detekcije, evidencije, praćenja i usmeravanja dece sa smetnjama u razvoju u Republici Srpskoj je kompleksan i do sada nije ostvarena institucionalizovana i stručna povezanost izme�����u zdravstva, dečje zaštite, školovanja i socijalne zaštite. Ovi problemi su doveli do: stagnacije u ranom otkrivanju dece ometene u razvoju a samim tim i kasnom uključivanju u odgovarajuće rehabilitacione programe; male obuhvaćenosti dece predškolskim vaspitanjem, osnovnoškolskim vaspitanjem i obrazovanjem kao i profesionalnim osposobljavanjem i zastoja u razvoju mreže institucija koje se bave decom ometenom u razvoju. Ovom problemu smo pristupili kroz naučno istraživački projekat „Detekcija, determinacija i prećenje dece ometene u razvoju na području Republike Srpske“ koji je odobrilo Ministarstvo nauke i tehnologije Republike Srpske. Ciljevi ovog istraživanja su: otkrivanje dece sa smetnjama u razvoju, njihovo evidentiranje i uspostavljanje mehanizma periodičnog praćenja. Za realizaciju prvog cilja ovog istraživanja izvršena je kvalitativna analiza aktuelne zakonske regulative Republike Srpske u kojoj se pominju deca sa smetnjama u razvoju: Zakon o socijalnoj zaštiti, Zakon o dečijoj zaštiti, Zakon o osnovnom obrazovanju i vaspitanju. Zakon o zdravstvenoj zaštiti i Pravilnik o razvrstavanju lica sa smetnjama u fizičkom i psihičkom razvoju. Na osnovu, obra�����nih podataka, na teritoriji Opštine Foča evidentirano je 37 dece sa smetnjama u razvoju sa Nalazom i mišljenjem stručne komisije. Od tog broja, 11 nalazi se u dve osnovne škole. Pored ove dece, u dve redovne škole u Foči nastavu poha�����a još 24 dece koja ispoljavaju smetnje u razvoju ali nemaju Rešenje Stručne Komisije. Reč je o deci koja ispoljavaju: Oštećenje glasa govora i jezika 12 (50%); Hronične bolesti 4 (16,66%); Oštećenje vida 3 (12,50%); Laka mentalna retardacija 3 (12,50%), Telesna oštećenja 1 (4,16%) i Poremećaj ponašanja 1 (4,16%).Problem of detection, keeping records, monitoring and guidance of children with disabilities in Republika Srpska is complex. Institutionalized and professional relationship between health, child welfare, education and social protection has not been established yet. These problems have led to: stagnation in the early detection of disabilities in children and therefore the late inclusion in the appropriate rehabilitation programs; low coverage of children with pre-school and primary education as well as professional training and delays in development of institutional network, which should involve institutions specialized in dealing with disabled children. We approached this problem through scientific research project “Detection, Determination and Monitoring of Children with Disabilities in Republika Srpska”, approved by the Ministry of Science and Technology, Republic of Serbia. The objectives of this research are: detection of children with developmental disabilities, their recording, and establishing of periodic monitoring. In order to finish the first objective of this research, quality analysis of the current legislation in Republika Srpska, regarding children with disabilities, was carried out. Those are: the Law on Social Protection, the Law on Child Protection, the Law on Primary Education, Health Care Law and Regulation regarding Classification of people with disabilities in the physical and mental development. Grounded on processed data, in the municipality of Foca, we recorded 37 children with disabilities with recorded opinion of expert committee. Out of those 37, eleven children were located in two elementary schools. In addition to these children, in two regular schools in Foca there are 24 children with disabilities, but without opinion of expert committee. Those are the children with: impairment of voice, speech or language 12 (50%), chronic disease 4 (16,66%), visual impairment 3 (12,50%), mild mental retardation 3 (12,50%), physical impairment 1 (4,16%) and behavioral disorders 1 (4,16%)

Hemorrhage control, infection prevention and application on anesthetics in exodontia of natal teeth

Introduction: The teeth that appear at the time of birth are called Natal teeth. The exact cause of its appearance is unknown, but possible causes for this condition include infections, trauma, hormonal stimulation etc. There is a possibility to aspirate the tooth and difficulty with feeding. Case report: A one day old baby born with teeth in the lower jaw was referred to our dental department, Thumbay Hospital, Dubai, UAE. The crown structure was attached to the gums with grade 2 mobility (Millers classification). The shell like crown was removed with a periodontal curette and care was taken not to injure the underlying tooth. Vitamin K injection 1mg IM was given in the anterolateral thigh 2hours before the procedure. Conclusion: The appearance of natal teeth is a rare case however it is not uncommon in the newborns. Extraction as the first treatment choice should be performed as soon as possible considering all possible complications. Vitamin K administration is a mandatory step in the treatment

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

Peer reviewe

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| < 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe