Analytical Study Research Articles

Learning analytics: A comparison of western, educated, industrialized, rich, and democratic (WEIRD) and non-WEIRD research

We examined how Learning Analytics literature represents participants from diverse societies by comparing the studies published with samples from WEIRD (Western, Industrialized, Rich, Democratic) nations versus non-WEIRD nations. By analyzing the Learning Analytics studies published during 2015-2019 (N = 360), we found that most of the studies were on WEIRD samples, with at least 58 percent of the total studies on WEIRD samples. Through keyword analysis, we found that the studies on WEIRD samples’ research topics focused on self-regulated learning and feedback received in learning environments. The studies on non-WEIRD samples focused on the collaborative and social nature of learning. Our investigation of the analysis tools used for the studies suggested the limitations of some software in analyzing languages in diverse countries. Our analysis of theoretical frameworks revealed that most studies on both WEIRD and non-WEIRD samples did not identify a theoretical framework. The studies on WEIRD and non-WEIRD samples convey the similarities of Learning Analytics and Educational Data Mining. We conclude by discussing the importance of integrating multifaceted elements of the participant samples, including cultural values, societal values, and geographic areas, and present recommendations on ways to promote inclusion and diversity in Learning Analytics research.

Role of Fiber Addition in GFRP-Reinforced Slender RC Columns under Eccentric Compression: An Experimental and Analytical Study

Role of Fiber Addition in GFRP-Reinforced Slender RC Columns under Eccentric Compression: An Experimental and Analytical Study

Contribution of Closed Ties to Shear Strength of GFRP-Reinforced Precast Concrete Tunnel Lining Segments: Experimental and Analytical Study

Contribution of Closed Ties to Shear Strength of GFRP-Reinforced Precast Concrete Tunnel Lining Segments: Experimental and Analytical Study

Time-varying compressive properties and constitutive model of EPDM rubber materials for tunnel gasketed joint

The stress relaxation of ethylene propylene diene monomer (EPDM) rubber material in a compressed state significantly increases the risk of water leakage at tunnel precast segmental joints. Additionally, EPDM rubber gaskets typically experience a complex precompression strain state, further complicating the prediction of long-term stress relaxation. Therefore, it is imperative to propose a novel constitutive model that realistically reflects the stress relaxation of rubber with arbitrary precompression strain, providing a reference for the long-term waterproof design of shield tunnels. In this study, the time-varying properties of EPDM rubber at material level were studied in detail. At first, a comprehensive set of accelerated aging tests were conducted on EPDM rubber samples with varying precompression strains. The hardening effect of rubber without precompression and the stress relaxation effect of rubber with precompression were explored. The time-varying law and mechanism governing rubber properties under these two effects were analyzed. Subsequently, a conversion relationship between the EPDM rubber test conditions and the actual service time was established. The predicted hardening coefficient for uncompressed EPDM after 100 years is 1.468, whereas the relaxation coefficient for compressed EPDM is 0.359. Comparative analysis revealed that the compression set index do not consider the beneficial effects of hardening, resulting in a 54.1% overestimation of the design water pressure. Finally, the analytical study on the constitutive model of EPDM rubber material was carried out. The error in compression curve for unaged sample obtained from empirical formulas exceeded three times that of the analytical model, underscoring the need to study time-varying constitutive models. An interpolation method was employed to extend the test curve, leading to the development of a new constitutive model that represents the stress relaxation characteristics of EPDM materials under arbitrary precompression strain states. By combining the proposed constitutive model with the timetemperature conversion relationship, the time-varying expressions of the constitutive parameters for relaxation and hardening effects during the service life were derived. In comparison with existing models, the proposed model demonstrates wider applicability, effectively captures the time-varying characteristics of EPDM materials under arbitrary precompression strains, offering an efficient approach for studying the long-term stress relaxation prediction of rubber gaskets in shield tunnels under complex precompression strain states.

Corrélation entre la réfraction et la longueur axiale du sujet Albinos

To investigate the relationship between refraction and ocular axial length in albinos. A cross-sectional, analytical study was carried out from June to November 2021 at the Central Hospital of Yaounde (Cameroon), which included consenting albino subjects aged over 15years. All subjects underwent visual acuity testing, axial length measurements and objective refraction under cycloplegia. We included 51 albino subjects. The mean age was 26.06±9.47years, and the sex ratio was 0.5. Type 2 oculocutaneous albinism (OCA2) was predominant, representing 82.4% of cases. The mean uncorrected visual acuity was 0.93±0.25 logMAR, and the most common ametropia was myopic astigmatism (52.9%). The mean axial length was 24.65±2.54mm with extremes of 21.54 and 30.33mm. Eyes with myopia and myopic astigmatism had significantly longer axial lengths than those with hyperopic and mixed astigmatism. A strong, significant negative correlation (r=-0.93; P˂0.001) between the spherical component of the refraction and axial length was found. The spherical component of the refraction decreases significantly with increasing axial length in albinos.

National survey for pediatricians in Argentina: Vaccination in daily practice, perception of knowledge and barriers.

Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatricians play a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catch- up vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceived themselves as more trained. Multiple barriers associated with access to vaccination were identified.

POSTTRAUMATIC STRESS DISORDER AND PSYCHOSOCIAL RISK FACTORS IN FIRST RESPONSE WORKERS TO EMERGENCIES. MIXED METHOD.

First responders to emergencies are exposed to various risks, including psychosocial risk factors. Caring for patients in critical situations, experiencing traumatic events, and working under highly complex conditions increase their probability of developing mental disorders, such as posttraumatic stress disorder (PTSD). The objective of the study was to determine the relationship between PTSD and psychosocial risk factors and to understand the experiences of the disorder in this population. An explanatory sequential mixed method research design was used. The quantitative phase was an analytical cross-sectional observational study (n = 193), and the qualitative phase was phenomenological (n = 5). The psychosocial risk factors that best explained the presence of PTSD symptoms were the influence of non-work conditions on work, religion, emotional avoidance, and professional support as individual factors related to coping strategies. Individual factors such as coping strategies were determining factors that explained the symptoms of PTSD, and the influence of non-work conditions on work. It was identified that the demands of the job and the organizational factors, such as leadership style and lack of institutional support, generate anguish in workers and affect their ability to regulate their emotions when exposed to critical incidents.

Risk factors for acute kidney injury in patients hospitalized with COVID-19.

Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02-1.04), male sex (OR 2.13; 95% CI 1.49-3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04-2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06-4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00-1.03), ICU admission (OR 1.81; 95% CI 1.04-3.16), and vasopressor support (OR 7.46; 95% CI 3.34-16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84-0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98-0.99) could be protective factors. A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

Syndromes coronaires aigus au cours du diabète : étude comparative entre patients diabétiques et non diabétiques en milieu urbain sénégalais

IntroductionDiabetes Mellitus is a strong cardiovascular risk factor in which acute coronary syndromes (ACS) are thought to have a particular feature. We aimed to determine the characteristics of acute coronary syndromes in diabetics compared with non-diabetics patients. Patients and methodsWe carried out a prospective, descriptive and analytical study comparing diabetic and non-diabetic patients admitted for acute coronary syndrome to the cardiology department of Idrissa Pouye general hospital over a period of one year by studying socio-demographic, clinical, paraclinical, therapeutic and evolutionary parameters. We performed a multivariable logistic regression analysis to identify factors associated with chest pain and triple vessels disease. ResultsOur study included 139 patients, 61 with diabetes (44%) and 78 without diabetes (56%). Among diabetics, there was a predominance of women (p = 0.0001) in contrast to non-diabetics. The mean age was 62.7 ± 10.8 years in diabetics and 56.9 ± 13.5 years in non-diabetics (p = 0.006). Chest pain was found in 88.5% of diabetics and 97.4% of non-diabetics (p = 0.03). The mean HbA1c in diabetics was 9.4 ± 3.3%. ST elevation acute coronary syndrome was predominant in both groups. The mean GRACE score was 147 ± 29 in diabetics and 132 ± 28 in non-diabetics (p = 0.003). In multivariable analysis, only diabetes was associated with triple vessels disease (aOR (IC à 95%): 2,60 (1.29–6.83); p = 0.042). A total of 31% of diabetics and 43% of nondiabetics undergoes cardiac revascularization. There was no difference between the two groups in terms of complications. The mortality was 6.6% and 3.8% respectively among diabetics and non-diabetics (p = 0.49). ConclusionAccording to our study, diabetes is frequently encountered during acute coronary syndromes. It also shows that diabetics are more likely to be female and older, with more atypical symptoms and more severe coronary disease.

Effect of perineal massage and gentle techniques on perineal rupture in primigravida maternity mothers

Background: Perineal rupture is a tear that occurs when a baby is born, either spontaneously or by using tools/actions. Preventive efforts can be made to reduce the risk of perineal rupture by massaging the perineum and using good pressure techniques during labor. Objective: To determine the effect of perineal massage techniques and pressure on perineal rupture in primigravida mothers who give birth. Method: This research uses experimental research methods; this type of research is quantitative with a pretest-posttest research design with a control group and an analytical study design with a retrospective approach. The total research sample required was 30 primigravidas, with details, namely 15 people from the perineal massage group and 15 from the gentle technique. Sampling was taken using an accidental sampling technique, where subjects were selected as research samples based on cases/respondents who happened to be available in a place according to the context. Results: research results of primigravid mothers who experienced perineal rupture in the perineal massage group were two people (20%), and in the menstrual technique group, there were eight people (80%), based on the results of data analysis using the Wilcoxon test, the p-value was obtained. In the perineal massage group, it was 0.000; in the gentle technique group, it was 0.005. Conclusion: It can be concluded that perineal massage is more effective than gentle techniques in preventing perineal rupture in primigravida mothers. To ensure the effectiveness of the chosen method, it is advisable to consult with medical personnel experienced in this field and follow the recommendations and protocols approved by the relevant health authorities. In addition, careful monitoring and care during labor is also essential to minimize the risk of perineal rupture.

Abdominal emergency laparoscopy: Addressing anesthetic concerns for abdominal emergency surgery

Introduction: CO2 insufflation during laparoscopic procedures leads to respiratory changes, making general anesthesia during laparoscopy considered high-risk anesthesia. In an emergency context, this risk is likely heightened. The objective of our study is to evaluate the role of anesthesia during laparoscopy in non-traumatic emergency abdominal surgery. Materials and Methods: Descriptive and prospective study conducted between February 2018 and October 2021, involving 337 patients undergoing laparoscopic surgery for non-traumatic acute abdominal emergencies. Results: Of the 337 patients operated on, 190 were female (56.4%) and 147 were male (43.6%), with a mean age of 38 years ± 15 years (range 15-82 years). Comorbidities were noted in 109 patients (32.3%), with 39 patients (11.6%) having multiple concomitant comorbidities. Our patients were classified as ASA I in 74.8% (252 patients), ASA II in 22% (74 patients), and ASA III in 3.3% (11 patients). Perioperative morbidity and mortality related to anesthesia were nil. During the analytical study, we found no correlation between anesthesia duration and perioperative and postoperative morbidity and mortality (p value: 0.082) and no relationship between ASA stage and postoperative morbidity (p value = 0.392, chi-square test). Conclusion: Emergency abdominal surgery via laparoscopy is feasible and safe from an anesthetic standpoint.

Relationship between body mass index and degree of adult psoriasis

Because of the current inconsistencies in the association between body mass index (BMI) and psoriasis severity, this study aimed to determine aforementioned association. This analytical observational study was conducted in a private hospital in West Java between August and December 2023 using data from medical records of 108 psoriasis cases recruited by simple random sampling. Data were collected on demographic characteristics (age, gender), BMI, and psoriasis severity. BMI was divided into categories following the WHO Asia Pacific region classification. Psoriasis severity was categorized as mild, moderate, and severe, and determined by means of Psoriasis Area and Severity Index (PASI) scores. Data were analyzed by independent t test and Chi-squared tests. Mean age (± SD) of psoriasis subjects was 40.1 ±12.4 years, the most frequent gender was female with 73 (67.6%) subjects, and mean BMI was 25.2 ± 3.3 kg/m2. Fifty-six (51.9%) subjects were obese according to BMI, 24 (22.2%) subjects were overweight, and 28 (25.9%) subjects were of normal weight. A total of 47 (43.5%) subjects had severe psoriasis, followed by moderate psoriasis in 36 (33.3%) subjects, and mild psoriasis in 25 (23.1%) subjects. There was no significant correlation of BMI with psoriasis severity in subjects of productive age (p = 0.249). Healthy lifestyle and weight control are necessary in the management strategy of persons with psoriasis, because of the high prevalence of persons with psoriasis and obesity.

Is primary biliary cholangitis still a challenge? Experience of Hassan II University Hospital FES Morocco

Introduction: Primary biliary cholangitis is a chronic autoimmune hepatopathy and the leading cause of intrahepatic cholestasis. Treatment is mainly based on ursodesoxycholic acid. The aim of our work is to study the epidemiological, clinical and evolutionary profile of PBC, and to determine the factors predictive of a poor response to UDCA in our context. Materials and methods: This is a retrospective descriptive and analytical study of all cases of PBC followed in our training program from June 2012 to February 2023. Results: We recorded all clinical, diagnostic, therapeutic and evolutionary aspects of 70 cases of PBC. Ninety-two percent ( n= 65) were women. The mean age was 57.3 [24-83] years. The circumstances of discovery were dominated by pruritus, and jaundice. M2-type anti-mitochondrial antibodies were positive in 91.4% of cases. 52.14% of cases had associated autoimmune diseases. Treatment was based on UDCA in all cases, combined with corticosteroids and immunosuppressants for patients with overlap syndrome. A biochemical response after one year of treatment according to Paris II criteria was found in 62.85% (44 cases). In univariate analysis, the factors associated with poor response to treatment were : Discovery of cirrhosis at diagnosis , Decompensated cirrhosis , presence of overlap syndrome , poor compliance with UDCA due to non-availability of medication , initial bilirubin level above 30 mg/l , hypoalbuminemia below 35 g/l. Conclusion: Our study shows the frequency of cirrhosis in PBC, which may explain the low response rate to UDCA, a drug that remains difficult to obtain in our Moroccan context, making prognosis poor and management difficult.

Psychological impact of the covid -19 pandemic on school age children

Introduction: The psychological impact of the COVID-19 pandemic on the general population has been widely studied. However, few studies have been carried out on children, even though they are experiencing a difficult situation and major stress that may expose them to significant psychological suffering. We are interested in how children perceive these emotional changes during the confinement associated with the COVID-19 pandemic. The aim is to understand the impact of the pandemic and containment on children. To do this, we assessed the prevalence of depression, anxiety and perceived post-traumatic stress in school-age children, looking for factors associated with these psychopathological dimensions with a view to better management and intervention to reduce the possible negative effects of this situation. Methodology: This is a cross-sectional study based on gathering information from all primary school pupils in Fez, who responded freely and voluntarily. The study was carried out over a period of two months, from June 2020 to August 2020, using an online self-questionnaire and psychometric evaluation scales: QIPS, CDI, CRIES-13. Results: 330 students met our inclusion criteria. The mean age of our participants was 8.68 ± 1.94 years, with a minimum of 6 years and a maximum of 12 years. There was a slight female predominance, with 168 girls (50.9%) and 162 boys (49.1%). Most of the pupils (95.2%) lived in urban areas, 92.7% of the children had married parents, and 64.5% of our participants had parents with a university education. Almost half of the children had a family income of more than Dhs10,000 per month. Only 2.1% of the children had a psychiatric history, 16.7% of the children had a history of somatic illness, 22.1% of the participants had a family psychiatric history, 11.2% of our participants had experienced a stressful event in their lives and 22.1% had parents who had previously experienced a stressful event. Evaluation of the CRIES-13 scale showed that 39.4% had a positive score of over 30 in favour of significant symptoms of post-traumatic stress disorder, a probable depressive state (CDI score>15) was revealed in 26.1% of the children, and with regard to anxiety disorder, the mean score in our sample was 32.27 (±8.147) with a median of 29. The analytical study showed a statically significant relationship between certain socio-demographic characteristics, namely: parents' low level of education, living with divorced parents, low monthly family income and negative psychological impact during the pandemic. On the other hand, female gender was correlated with the occurrence of anxiety. Our study also revealed other correlations, notably between the presence of a personal history of psychiatric or somatic illness and the occurrence of depression, family psychiatric history, and the experience of a stressful event by the child and parents were factors strongly associated with the three psychological disorders studied. Factors related to the child's lifestyle, such as the practice of physical activity at home, a daily study period of less than 2 hours, and dissatisfaction with distance learning, were associated with psychological distress during confinement. In addition, certain personality traits seemed to be implicated in the worsening of this condition during confinement: the presence of a relative with covid-19, the child's knowledge of the pandemic, and the fear that the pandemic would continue. Conclusion: The COVID-19 pandemic has had a severe impact on the general public, particularly children, psychological interventions identifying and targeting children at risk are urgently needed, and future studies are warranted to design and evaluate the effectiveness of interventions.

Epidemiological, clinical and biological profile of COVID-19 in patients hospitalized at the Avicenne Military Hospital in Marrakech

In late December 2019, a series of cases of viral pneumonia caused by a novel coronavirus emerged in Wuhan, China, and quickly spread to all continents. This coronavirus, identified in respiratory tract samples, was named SARS-CoV-2 for Severe Acute Respiratory Syndrome Coronavirus-2 by the ICTV (International Committee on Taxonomy of Viruses). The disease it causes was designated COVID-19 for Coronavirus Disease 2019 by the Word Health Organization. Most often, SARS-CoV-2 infection is responsible for a mild or moderate form, with the most typical clinical presentation being that of a febrile respiratory infection with dry cough, dyspnea, fatigue, and myalgia. Approximately 10-15% of cases are severe, and 5% are critical. Cases of reinfection have been described. Treatment for COVID-19 is currently symptomatic, relying on supportive care. The present study aims to investigate the demographic, clinical, and diagnostic aspects, as well as the study of risk factors associated with SARS-CoV-2 infection among 318 patients admitted to the Avicenne Military Hospital in Marrakech during the first wave of the pandemic. This is a retrospective descriptive and analytical study involving 318 cases of SARS-CoV-2 infection, diagnosed at the microbiology-virology department, and followed up in various non-intensive care units of the Avicenna Military Hospital in Marrakech, during the period of the first wave of the epidemic in Morocco, schematically between March 22, 2020, and July 19, 2020. For patients who developed pneumonia, 20% were diabetic and 13.3% were hypertensive. A quarter of patients with pneumonia experienced desaturation upon admission. In the multivariate logistic regression model, risk factors associated with the development of pneumonia and the various disease outcomes included advanced age and absence of a history of contact with a confirmed case. In the univariate analysis, hyperleukocytosis, neutrophilia, lymphopenia, eosinopenia, anaemia, hyperferritinaemia with elevated aspartate aminotransferase, hyponatraemia and fasting hyperglycaemia were significantly associated with a higher risk of an unfavourable outcome. Patients who presented with pneumonia on admission had an unfavourable outcome during their hospitalisation compared with patients who did not develop pneumonia. The statistically significant risk factors associated with an unfavourable outcome were advanced age (>60 years) with p <0. 001: OR=1.194; 95%IC= [1.114-1.278], absence of contact with a confirmed case (p <0.001 : OR= 43.138; 95%IC= [8.893-209.263]), presence of comorbidity (P<0.001 : OR=11. 503; 95%CI= [3,306-40,028]), mainly diabetes (P<0.001: OR=16,971; 95%CI= [4,267-67,504]) and arterial hypertension (P<0.001: OR=18,812; 95%CI= [3,977-88,954]). The study of the epidemiological, clinical and biological characteristics of COVID 19 at the Avicenne military hospital in Marrakech has enabled us to gain a better understanding of the profile of our patients with SARS-CoV-2 infection, and then to detect shortcomings in terms of prophylaxis, diagnosis and management, in order to be able to provide the necessary solutions aimed at further improving the quality of care for this population.

Analytical observational study of salmonella PCR and its comparison with routine laboratory parameters in cases of enteric fever in tertiary care hospital in central India

Background Enteric fever, predominantly caused by Salmonella enterica serotype Typhi, remains a significant global health concern, particularly in resource-limited settings. The diagnostic landscape for enteric fever relies on traditional methods such as the Widal test and blood culture, each with inherent limitations regarding sensitivity and turnaround time. Methods The study will employ an Analytical Observational Study design conducted at Acharya Vinoba Bhave Rural Hospital in central India over a two-year period. Participants will include adults above 18 years admitted to the ward or Intensive Care Unit (ICU) with acute febrile illnesses. Inclusion criteria encompass a wide age range, ensuring a diverse study population. Peripheral blood samples will be collected for Salmonella PCR, Widal testing, and blood culture. Dot-PCR for Typhi will be employed, and DNA extraction will follow strict protocols. Data will be systematically recorded, and statistical analyses, including sensitivity, specificity, and comparative assessments, will be conducted to evaluate diagnostic performance. Expected Outcome It is anticipated that Salmonella PCR will exhibit superior sensitivity and specificity compared to traditional diagnostic methods, offering a more rapid and accurate identification of enteric fever cases. The study aims to contribute valuable evidence supporting the incorporation of Salmonella PCR into routine diagnostic algorithms, potentially revolutionizing the approach to enteric fever diagnosis. Moreover, insights gained from the study are expected to inform clinical practices, enhance patient management, and potentially reduce the economic burden associated with misdiagnosis or delayed diagnosis of enteric fever. The outcomes of this research are poised to impact public health strategies, providing a foundation for more effective and efficient diagnostic protocols in the context of enteric fever.

Characteristics associated with the intention to complete advance directives and end-of-life preferences in Brazilians with heart failure.

To identify characteristics associated with an intention to complete advance directives (ADs) and end-of-life treatment preferences for outpatients with heart failure (HF). A cross-sectional, analytical study. Sociodemographic and clinical data were collected from 108 patients with HF in an outpatient clinic in São Paulo, SP, Brazil. Quality of life (QoL) was assessed using the Minnesota Living with Heart Failure Questionnaire; knowledge about HF and the intention to complete ADs were assessed using a script. The relationships among variables were assessed through the chi-square and Mann-Whitney tests, with p<0.05 considered significant. The intention to complete ADs was significantly associated with reporting adherence to pharmacological recommendations (99% vs. 88.1%, p=0.02), worse QoL (29.7±18.2 vs. 20.9±11.0; p=0.0336), perceived knowledge about HF (89.7% vs. 63.6%, p=0.0495), not wishing the healthcare providers would decide about treatment (27.3% vs. 2.15, p=0.0026), and considering ADs useful (91.8% vs. 27.3%, p<0.001). End-of-life treatment preferences included living as long as possible (50.5%), not being sedated (37.1%), and staying close to family and friends for as long as possible (32.0%). Characteristics associated with an intention to complete ADs and end-of-life treatment preferences were identified in patients with HF. These results can help facilitate patients' completion of their ADs or activate their intention to maximize opportunities to exercise autonomy.

Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania

BackgroundUnsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion.ObjectivesTo assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region.MethodologyIt is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics.ResultsThe practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion.ConclusionThe majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone’s attitude towards unsafe abortion.

Analytical validation of the Mindray CL1200i analyzer high sensitivity cardiac troponin I assay: MERITnI study.

This study performed an analytical validation study of the Mindray high-sensitivity cardiac troponin I (hs-cTnI) assay addressing limit of blank (LoB), limit of detection (LoD), precision, linearity, analytical specificity and sex-specific 99th percentile upper reference limits. LoB, LoD, precision, linearity and analytical specificity were studied according to Clinical and Laboratory Standards Institute. We used one reagent lot and one CL1200i analyzer. Skeletal troponin I and T, cardiac troponin T, troponin C, actin, tropomyosin, myosin light chain, myoglobin and creatine kinase (CK-MB) were studied for cross-reactivity. Interference with biotin was examined. Lithium heparin samples (one freeze thaw cycle) from healthy males and females were measured to determine the 99th percentiles by using the non-parametric method. Analyses were performed before and after excluding subjects with clinical conditions and/or increased surrogate biomarkers. The Mindray hs-cTnI assay met criteria to be considered as a hs-cTn assay. LoB and LoD was <0.1 ng/L and 0.1 ng/L, respectively. Repeatability had a coefficient of variation 1.2-3.8 %, and within-laboratory imprecision 1.7-5.0 %. The measuring interval ranged from 1.1 to 28,180 ng/L. The analytical specificity was clinically acceptable for the interferents studied. After exclusions, the 99th percentile URLs obtained were 10 ng/L overall, 5 ng/L for females and 12 ng/L for males. Analytical observations of the Mindray hs-cTnI assay demonstrated excellent LoB, LoD, precision, linearity and analytical specificity, that were in alignment with the manufacturer's claims and regulatory guidelines for hs-cTnI. The assay is suitable for clinical investigation for patient-oriented studies.

Effectiveness of Mannitol Use on Clinical Outcomes of Severe Traumatic Brain Injury Patients

Background Head injuries are considered as a silent epidemic due to the high incidence rate throughout the world. The main cause of morbidity and mortality in patients with head injury is cerebral edema which is defined as abnormal fluid accumulation in the brain parenchyma. Mannitol is a hyperosmolar solution given to reduce fluid volume in the brain. Increased high intracranial pressure can affect prognosis and can be evaluated by assessing clinical outcomes in patients with severe traumatic brain injury using the Glasgow Outcome Discharge Scale (GODS) instrument. Methods Observational analytical study with a cross sectional design on 50 patients with severe traumatic brain injury at dr. Zainoel Abidin General Hospital Banda Aceh to determine the effect of mannitol use on the clinical outcomes of severe traumatic brain injury patients which used t test analysis. Results The mean value of the group that received mannitol had a higher GODS score than the group that did not receive mannitol. The results of the T test between groups obtained a p value of 0.000 which is smaller than 0.05, so it can be concluded that the use of mannitol has an effect on the GODS score in Severe traumatic brain injury patients. The results showed that the mean GODS value in patients who received mannitol was higher than those who did not receive mannitol. Conclusion This concludes that the administration of mannitol is effective in improving the clinical outcomes of patients with severe traumatic brain injury at dr. Zainoel Abidin General Hospital Banda Aceh.