Federal Ministry Research Articles

A Parameter Identification Approach towards Hemodynamics based on Capnography

Research question Pulse detection decisions during cardiopulmonary resuscitation (CPR) are commonly augmented by end-tidal CO2-concentration (etCO2) levels and trend as etCO2 is a surrogate measure of systemic blood flow during (CPR)1. However, ventilatory and circulatory parameters influence the interpretability of etCO2 heavily. Recently developed methods of continuous cardiac output measurement based on capnography are not applicable during CPR due to the required controlled ventilation settings2. In this study, a parameter identification for a model of CO2 transport during resuscitation is used to estimate cardiac output based on capnography and tidal flow. Methodology After development of a compartmental ordinary differential equation (ODE) model to represent CO2 transport during CPR, parameters such as airway dead space and the level of systemic perfusion are estimated by a multishooting parameter identification approach3. To evaluate the method, tests are conducted on experimental data from a porcine model (approved by an ethics committee vote of the Austrian Federal Ministry of Education, Science and Research (GZ: 2021-0.895.386)). The estimated level of systemic perfusion is compared visually to invasively measured mean arterial pressure due to a lack of continuous cardiac output measurements as a ground truth. Results For exemplary data from a female pig (weight 50.4 kg), airway resistance was estimated to 20.8 hPa s /L, compliance: 25.2 mL/hPa, and dead space: 109 mL. Changes in cardiac output can be identified qualitatively as shown in Fig. 1. Conclusion A validated, simple ODE model for CO2 extraction during CPR could contribute quantifying the impact of ventilatory parameters on etCO2 and elucidate CO2 production, storage and transport during cardiac arrest. Assumptions on CO2 production during cardiac arrest and redistribution in the body, and the lacking cardiac output measurements complicate the analysis. Conflicts of Interest All authors have no conflict of interest to declare.

Stabilizing time and its predictors among 1-59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study.

Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting. Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis. From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221-0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568-13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094-3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065-2.071) were identified as significant predictors of stabilizing time. All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.

The Impact of Passive Social Media Viewers in Influence Maximization

A frequently studied problem in the context of digital marketing for online social networks is the influence maximization problem that seeks for an initial seed set of influencers to trigger an information propagation cascade (in terms of active message forwarders) of expected maximum impact. Previously studied problems typically neglect that the probability that individuals passively view content without forwarding it is much higher than the probability that they forward content. Considering passive viewing enables us to maximize more natural (social media) marketing metrics, including (a) the expected organic reach, (b) the expected number of total impressions, or (c) the expected patronage, all of which are investigated in this paper for the first time in the context of influence maximization. We propose mathematical models to maximize these objectives, whereby the model for variant (c) includes individual’s resistances and uses a multinomial logit model to model customer behavior. We also show that these models can be easily adapted to a competitive setting in which the seed set of a competitor is known. In a computational study based on network graphs from Twitter (now X) and from the literature, we show that one can increase the expected patronage, organic reach, and number of total impressions by 36% on average (and up to 13 times in particular cases) compared with seed sets obtained from the classical maximization of message-forwarding users. History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms—Discrete. Funding: This work was supported by the Federal Ministry of Education, Science and Research of Austria and by the Austrian Agency for International Mobility and Cooperation in Education, Science and Research [Reference ICM-2019-13384]. Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2023.0047 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2023.0047 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .

Evaluating Public Procurement's Challenges in Nigeria's Construction Industry

The article explores the challenges faced by public project management in Nigeria, focusing on the procurement process and its potential improvements. The research used a survey and descriptive design, collecting data from 125 procurement offices and federal Ministry of Works professionals. The study found that poor risk management, dark purchasing, corruption, and lack of transparency were the top issues, with a mean score of 4.96. The study also found that the procurement process and industry, economy, and project quality had a joint influence on the dependent variables. The study rejected the null hypothesis, stating that the procurement process significantly impacts the industry, economy, and project quality in Nigeria. The research recommends implementing measures to improve the procurement process and punishing offenders to reduce fraud. The study concludes that the procurement process in Nigeria significantly impacts the industry, economy, and project quality.

Windows of opportunity in integrating mental health into care of neglected tropical diseases: the Nigeria experience.

In this invited commentary, the Mental Health and the Neglected Tropical Diseases(NTDs) Program leads in the Nigerian Federal Ministry of Health and Social Welfare share the opportunities that have arisen from recent global progress in normative guidance and political interest in the intersection of mental health and NTDs. They describe the new collaboration that has taken place between their programs, e.g. contributing to the World Health Organization Essential Care Package for Mental Health, Stigma and NTDs and integration of mental health for the first time into the new National NTD Masterplan.

Quality and sustainability of Ethiopia's national surgical indicators.

In 2015, the Ethiopian Federal Ministry of Health (FMOH) developed the Saving Lives through Safe Surgery (SaLTS) initiative to improve national surgical care. Previous work led to development and implementation of 15 surgical key performance indicators (KPIs) to standardize surgical data practices. The objective of this project is to investigate current practices of KPI data collection and assess quality to improve data management and strengthen surgical systems. The first portion of the study documented the surgical data collection process including methods, instruments, and effectiveness at 10 hospitals across 2 regions in Ethiopia. Secondly, data for KPIs of focus [1. Surgical Volume, 2. Perioperative Mortality Rate (POMR), 3. Adverse Anesthetic Outcome (AAO), 4. Surgical Site Infection (SSI), and 5. Safe Surgery Checklist (SSC) Utilization] were compared between registries, KPI reporting forms, and the DHIS2 (district health information system) electronic database for a 6-month period (January-June 2022). Quality was assessed based on data completeness and consistency. The data collection process involved hospital staff recording data elements in registries, quality officers calculating KPIs, completing monthly KPI reporting forms, and submitting data into DHIS2 for the national and regional health bureaus. Data quality verifications revealed discrepancies in consistency at all hospitals, ranging from 1-3 indicators. For all hospitals, average monthly surgical volume was 57 cases, POMR was 0.38% (13/3399), inpatient SSI rate was 0.79% (27/3399), AAO rate was 0.15% (5/3399), and mean SSC utilization monthly was 93% (100% median). Half of the hospitals had incomplete data within the registries, ranging from 2-5 indicators. AAO, SSC, and SSI were commonly missing data in registries. Non-standardized KPI reporting forms contributed significantly to the findings. Facilitators to quality data collection included continued use of registries from previous interventions and use of a separate logbook to document specific KPIs. Delayed rollout of these indicators in each region contributed to issues in data quality. Barriers involved variable indicator recording from different personnel, data collection tools that generate false positives (i.e. completeness of SSC defined as paper form filled out prior to patient discharge) or missing data because of reporting time period (i.e. monthly SSI may miss infections outside of one month), inadequate data elements in registries, and lack of standardized monthly KPI reporting forms. As the FMOH introduces new indicators and changes, we recommend continuous and consistent quality checks and data capacity building, including the use of routinely generated health information for quality improvement projects at the department level.

Abstract 2553: Functional precision medicine as a valid tool in glioblastoma clinical practice

Abstract Background: Glioblastoma remains a formidable therapeutic challenge, necessitating innovative strategies such as functional precision medicine (FPM). FPM offers personalized treatment by utilizing high-throughput screening of 10-100 compounds on patient-derived tumor cells (PDCs), assessing both efficacy and relative sensitivity, with results reported to the molecular tumor board within 2 weeks. The focus of this study is the cross-laboratory validity of this approach in glioblastoma, an essential step towards confirming FPM's consistency and potential as a game-changing tool in personalized cancer treatment. Methods: Patient-derived tumor cells from glioblastoma cases were cultured for 3-7 days followed by automated high-throughput screening. The drug library contained ~80 compounds, including specific numbers of cytotoxic and targeted drugs. Drug response curves informed the calculation of sensitivity scores, which were compared to the AimedBio reference library to identify potentially effective drug candidates for a given patient. Additionally, corresponding tumor tissues were analyzed through panel sequencing of 50 glioma-related genes. Results: A total of >50 patients with glioblastoma were included, with subgroups from CBmed, Austria, and AimedBio, South Korea. PDC cultures were successful in over 90% of cases, and informative high-throughput drug screening results were obtained. Integration of drug response with genetic tumor profiles yielded testable treatment candidates. Additionally, transcontinental shipping and re-screening of PDCs yielded comparable results, affirming the robustness of the method. Conclusion: This study establishes and validates high-throughput drug screening platforms specifically tailored for functional precision medicine, utilizing glioblastoma as a model. The findings reveal a high degree of validity in the drug screening results, reinforced by the excellent performance of both technical and biological replicates. Such success not only lays a solid foundation for further academic and pharmaceutical collaborations but also opens the path for regulatory approval, bringing the platforms one step closer to clinical implementation. Funding: K1 COMET Competence Centre CBmed, funded by the Federal Ministry of Transport, Innovation and Technology; the Federal Ministry of Science, Research and Economy, Land Steiermark (Dep. 12, Business and Innovation), the Styrian Business Promotion Agency (SFG), and the Vienna Business Agency. COMET is executed by the Austrian Research Promotion Agency (FFG). Citation Format: Nam-Gu Her, Adelheid Woehrer, Gi Ju Lee, Seung Yoon Hyun, Jae Woo Ahn, Ji Soo Kang, Ryu I Hwang, Amin El-Heliebi, Barbara Prietl, Stefanie Stanzer, Thomas R. Pieber, Do-Hyun Nam. Functional precision medicine as a valid tool in glioblastoma clinical practice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2553.

COVID-19 surveillance report for Sudan, 2020 to 2021

BackgroundFollowing the World Health Organization declaration, COVID-19 was first appearance in Sudan was in March 2020. Cases were reported to the Sudan Federal Ministry of Heath through the surveillance system from different sources. This study used surveillance data from 2020 to 2021 to describe the epidemiologic patterns of COVID-19 occurrence in Sudan and provide insight for better preparedness and response. MethodsThrough a retrospective descriptive study, COVID19 cases records obtained from the national surveillance line-list in Surveillance and Information Directorate in Federal Ministry of Health. The analysis of data was done with SPSS version 21. Descriptive analysis done by frequencies and percentages, and further analysis through performing multivariate logistic regression. ResultsOut of 48,545 suspected cases tested for COVID-19 using RT-PCR, 27,453 (56.5%) tested positive with case fatality ratio of 6.5%. Higher death rate among elderly (78% > 60-year-old) and males (70.1%). From the reported cases, 53.8% showed no symptoms, while the common symptoms among symptomatic patients were; fever (26.4%), cough (19.1%), shortness of breath (16.8%) with small proportion (4.5%) reported loss of smell and taste. Specific states, Khartoum, Gezira and Red Sea showed highest prevalence. The disease peaked four times during 2020–2021, with a proposed alert threshold of 200–250 cases per week acting as an explosion point nationwide. ConclusionsThe high case fatality rate in the country requires further analysis, as well as the high proportion of asymptomatic infection. This will be ensured by improving the quality and completeness of surveillance data. A proposed threshold of 200–250 cases per week should be an alert to augment the measures of controlling the pandemic over the country, including providing enough supplies to decrease mortality.

Evaluation of Noise Pollution Level in Selected Sawmill Factories in Port Harcourt and Environs, Rivers State, Nigeria

Evaluation of noise pollution level has been carried out in in some selected Sawmill factories in Port Harcourt and environs using noise level and frequency meters in seven locations. The mean values of maximum and minimum sound levels in Mile2, Mile3, Marine base, Oluwood were 81.98±0.43 and 79.28±2.00, 82.450±0.66 and 80.28±0.80, 81.50±4.73 and 74.75±1.10, 81.40±0.40 and 78.03±2.02 respectively. Also the mean values of maximum and minimum sound levels at Igwuruta, Rumosi, Rumuji were found to be 82.00±0.64 and 79.40±2.00, 81.53±0.60 and 78.66±1.63, 81.78±0.40 and 77.95±1.86 respectively. The average noise equivalent (Leq) ranged from 77.20 to 82.25 dB whereas the average noise pollution level (Lnp) ranged from 96.13 to 101.23 dB. Therefore, the indication is that the Sawmill at Igwuruta has the highest average Lnp whereas Rumuosi has the least average when compared with the recommend permissible value by the Nigerian Federal Ministry of Environment (FMEnv). This study has determined the noise level generated in study area through set objectives which included but not limited to measuring the sound level, investigating noise some meters away from the source and of course comparing results with best known standards. The results therefore suggested that the noise level is high at the saw mills and the day exposure to this unwanted sound could threaten the health of the factory workers and the residents at proximity to the noise sources.

GAA-FGF14 disease: defining its frequency, molecular basis, and 4-aminopyridine response in a large downbeat nystagmus cohort

BackgroundGAA-FGF14 disease/spinocerebellar ataxia 27B is a recently described neurodegenerative disease caused by (GAA)≥250 expansions in the fibroblast growth factor 14 (FGF14) gene, but its phenotypic spectrum, pathogenic threshold, and evidence-based treatability remain to be established. We report on the frequency of FGF14 (GAA)≥250 and (GAA)200-249 expansions in a large cohort of patients with idiopathic downbeat nystagmus (DBN) and their response to 4-aminopyridine. MethodsRetrospective cohort study of 170 patients with idiopathic DBN, comprising in-depth phenotyping and assessment of 4-aminopyridine treatment response, including re-analysis of placebo-controlled video-oculography treatment response data from a previous randomised double-blind 4-aminopyridine trial. FindingsFrequency of FGF14 (GAA)≥250 expansions was 48% (82/170) in patients with idiopathic DBN. Additional cerebellar ocular motor signs were observed in 100% (82/82) and cerebellar ataxia in 43% (35/82) of patients carrying an FGF14 (GAA)≥250 expansion. FGF14 (GAA)200-249 alleles were enriched in patients with DBN (12%; 20/170) compared to controls (0·87%; 19/2,191; OR, 15·20; 95% CI, 7·52 to 30·80; p<0·0001). The phenotype of patients carrying a (GAA)200-249 allele closely mirrored that of patients carrying a (GAA)≥250 allele. Patients carrying a (GAA)≥250 or a (GAA)200-249 allele had a significantly greater clinician-reported (80%, 33/41 vs 31%, 5/16; RR, 2·58; 95% CI, 1·23 to 5·41; Fisher’s exact test, p=0·0011) and self-reported (59%, 32/54 vs 11%, 2/19; RR, 5·63; 95% CI, 1·49 to 21·27; Fisher’s exact test, p=0·00033) response to 4-aminopyridine treatment compared to patients carrying a (GAA)<200 allele. Placebo-controlled video-oculography data, available for four patients carrying an FGF14 (GAA)≥250 expansion, showed a significant decrease in slow phase velocity of DBN with 4-aminopyridine, but not placebo. InterpretationThis study confirms that FGF14 GAA expansions are a frequent cause of DBN syndromes. It provides preliminary evidence that (GAA)200-249 alleles might be pathogenic. Finally, it provides large real-world and preliminary piloting placebo-controlled evidence for the efficacy of 4-aminopyridine in GAA-FGF14 disease. FundingThis work was supported by the Clinician Scientist program "PRECISE.net" funded by the Else Kröner-Fresenius-Stiftung (to CW, AT, and MSy), the grant 779257 “Solve-RD” from the European’s Union Horizon 2020 research and innovation program (to MSy), and the grant 01EO 1401 by the German Federal Ministry of Education and Research (BMBF) (to MSt). This work was also supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) N° 441409627, as part of the PROSPAX consortium under the frame of EJP RD, the European Joint Programme on Rare Diseases, under the EJP RD COFUND-EJP N° 825575 (to MSy, BB and – as associated partner – SZ), the NIH National Institutes of Neurological Disorders and Stroke (grant 2R01NS072248-11A1 to SZ), the Fondation Groupe Monaco (to BB), and the Montreal General Hospital Foundation (grant PT79418 to BB). The Care4Rare Canada Consortium is funded in part by Genome Canada and the Ontario Genomics Institute (OGI-147 to KMB), the Canadian Institutes of Health Research (CIHR GP1-155867 to KMB), Ontario Research Fund, Genome Quebec, and the Children’s Hospital of Eastern Ontario Foundation. The funders had no role in the conduct of this study.

Serological Responses to Trachoma Antigens prior to the Start of Mass Drug Administration: Results from Population-Based Baseline Surveys, North Darfur, Sudan.

After years of programmatic inaccessibility, in 2019-2020 the Sudan Federal Ministry of Health Trachoma Control Program conducted population-based trachoma surveys in three localities (districts) in North Darfur state, Sudan. These baseline surveys were to determine the prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years and to further use serological markers to understand the historical trachoma burden within this mass drug administration (MDA)-naive area. Trained and certified graders collected trachoma clinical data, and trained nurses collected dried blood spot (DBS) samples. The DBSs were assayed on a multiplex bead array for antibody responses to the Chlamydia trachomatis antigens Pgp3 and CT694. Across the three localities, 3,613 individuals aged 1-9 years and 3,542 individuals aged ≥15 years were examined for clinical signs, and 8,322 DBSs were collected. The prevalence of TF among children aged 1-9 years was endemic (≥5%) in two localities (El Seraif, 15.6%, and Saraf Omrah, 11.0%) and below the TF elimination threshold (<5%) in the third (Kotom, 1.4%). The Pgp3 seroprevalence among children aged 1-9 years was 34.1% in El Seraif, 35.0% in Saraf Omrah, and 11.0% in Kotom. Locality prevalence results were similar for Pgp3 and CT694. Seroprevalence increased with age in all three localities. Serological data collected within these surveys demonstrate that all three localities have had a long history of exposure to Chlamydia trachomatis and that two of the three localities require MDA to reach elimination as a public health problem threshold.

Service Quality Implications of Long Periods of Consecutive Working Days: An Empirical Study of Neonatal Intensive Care Nursing Teams

Problem definition: We examine the effects of prolonged consecutive working days without breaks on care quality and explore its association with daily staffing levels in neonatal intensive care nursing teams. Academic/practical relevance: Healthcare organizations typically base staffing guidelines on safe daily metrics like nurse-to-patient ratios. However, in response to unforeseen demand spikes or staff shortages, managers often depend on staff working additional consecutive days to bridge staffing gaps. This approach, although addressing immediate staffing needs, can inadvertently impact care quality and safety, potentially undermining the benefits of higher staffing levels. Methodology: Using longitudinal data from 62 German neonatal units, we analyze the effect of nursing teams’ consecutive working days on the time from admission to full enteral feeding for 847 low-birth-weight babies, considering nurse-to-patient ratios and patient complexity. Results: Longer consecutive working periods harmfully affect care quality, especially during staffing shortages. The detrimental impact on days with low staffing is particularly pronounced in patients with less complex medical needs. Limiting the team-average number of consecutive working days to two days would have reduced the time to full enteral feeding in our study by 6.4%. Shifting from half a day less to half a day more than the average number of consecutive working days has an impact equal to 20% of the difference in time taken to reach full enteral feeding between low- and high-birth-weight babies. Managerial implications: Limiting consecutive working days could significantly improve intensive care outcomes. Management should monitor consecutive working days alongside daily staffing levels. Policy makers should consider introducing limits on the number of consecutive working days for intensive care nurses. Funding: This work was supported by the Federal Ministry of Education and Research in Germany [Grant 01GY1152]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0021 .

Influence of Calcium Carbide Residue on Corn Stalk Ash Stabilized Lateritic Soil for Highway Pavement Construction

The most common binder used for roads and buildings is cement, and its annual production rate is rising at an unprecedented rate, which has significant negative effects on the environment. This research investigated the effect of a varying percentage of Calcium Carbide Residue (CCR) and Corn Stalk Ash (CSA) samples on lateritic soils. A total of 25 mixture samples of CCR and CSA were prepared and mixed with lateritic soils to evaluate the mechanical and strength properties according to the Standard for transportation materials and methods of sampling and testing, AASHTO. The results showed that CCR has the property that reacts with CSA which is a good pozzolana yielding a product similar to the cement hydration process. Particle size analysis, Atterberg limits, Specific gravity, Compaction, and California Bearing Ratio were developed for each test sample, and the corresponding optimum mixtures were determined for the general specification for roads and bridges. Tests showed that in comparison to the control sample, there is an increase in the Atterberg limits properties with a decrease in the compaction properties and an increase in the CBR values upon the addition of 8% CCR and 2.5% CSA mixture before soaking and after soaking for 24 hours respectively which falls within the guidelines of the Nigerian Federal Ministry of Highways and Transportation (1997). Similarly, CCR was found to be advantageous for use as an activator with CSA to stabilized soil as a sub-base material in Highway Pavement Construction.

ADOPTION OF SORGHUM NATIONAL INTEGRATED SOLUTIONS TECHNICAL PACKAGE BY RAINFED FARMERS, GEZIRA, SUDAN

The effect of climate change on African agriculture represents a major challenge to continental agricultural development including food security, nutrition and management. In Sudan, the yield of rainfed crops is characterized by high variability in the yield due to the high variability in seasonal rainfall and does not exceed two sacs/feddan because the rainfed farmers were adopted low input rainfed agriculture as a risk management option which led to reduce in the yield per unit of land and water. The Federal Ministry of Agriculture has designed and financed a special programme for the traditional the rainfed sector of the country called Integrated Solutions Programme as the main adaptation strategy for the 2014/ 2020 growing seasons to diversify and increase production and productivity of crops cultivated in traditional rainfed areas in each State of the country such as sorghum, sesame, millet and sunflower. This programme was implemented by the Administration of Agricultural Extension and Technology Transfer in each State in collaboration with Agricultural Research Corporation (ARC) and the Agricultural Bank of Sudan. Field survey was used to collect data from 50 rainfed farmers participated in the programme and an equal number from non- participant farmers from the study area were selected (for comparison) using the simple random sampling technique. A close ended questionnaire was constructed and the personal interview technique was used to administer the questionnaire. The collected data were coded, fed to computer and statistically analyzed using (SPSS), discussed interpreted using descriptive statistics and chi-square test. The results showed that the participant farmers adopted the programme components. The majority of chi-square test results revealed no significant association between farmer`s adoption of the programme components and participation in the programme and also no significant association between farmer`s adoption of the programme components and the selected socio-economic characteristics of the respondent farmers. From this study, it can be concluded that the NISP are very effective agricultural extension policy that can be applied in the rainfed sector of the country, which will help rainfed farmers to increase their income through their participation in various activities of the programme. The study recommends that NISP should become the main national policy specially designed for the agricultural rainfed sector of the country, the needed agricultural inputs should be available at a reasonable price, the curriculum of NISP should be updated and developed regularly to solve the constraints that might face the programme, in-service training should be organized for agricultural extension officers on various aspects related to the rainfed sector, various means for conduction the programme should be available, Further agricultural extension research should be conducted

Clinical Supervision for Quality Education Delivery in Public Schools in Nigeria

This paper discussed clinical supervision for quality education delivery in public schools in Nigeria. Clinical supervision is a formal process of professional support and learning that enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice, and enhance consumer protection and safety of care in complex clinical situations. Clinical supervision stands as the cornerstone of educational excellence in Nigerian public schools, offering a dynamic and transformative approach to elevate the quality of education delivery. The paper emphasized that clinical supervision can bring about quality education delivery in several key aspects which include: Professional Growth and Development, Contextual Adaptation, Innovative Pedagogies and Technology Integration, Quality Assurance and Standardization, Professional Collaboration and Peer Learning, Emotional and Social Well-being, Observation and Feedback, Assessment of Teacher Competencies and Reflective practices. Also, identified the impacts of clinical supervision on quality education delivery, which includes: Enhanced Teaching Practices, Professional Development, Increased Teacher Self-Efficacy, Alignment with Standards, Retention and Job Satisfaction, Technology Integration, Positive Student Outcomes, Promotion of Reflective Practice, Enhanced Collaboration, Leadership Development and Quality Assurance. It therefore concluded that clinical supervision emerges not merely as a pedagogical process but as a transformative force poised to elevate the landscape of education delivery in public schools across Nigeria. The paper likewise made some outstanding suggestions that; School Administrators should clearly define the objectives of clinical supervision, outlining specific goals for professional development, teaching improvement, and student outcomes. This clarity provides a roadmap for both supervisors and educators. Finally, Federal ministry of education should offer regular professional development opportunities aligned with the needs identified through clinical supervision. Provide access to workshops, training sessions, and resources to enhance educators' skills and knowledge.

Investigation of HIFU beam propagation through acoustic holograms in water

We investigated variations in the HIFU beam of a clinical system as it traverses acoustic holograms—small artificial objects of different types—within a tank that was filled in with the degassed deionized water. The pressure distribution within the HIFU beam was assessed in multiple planes perpendicular to the beam axis. The ultrasound transducer with the focal length of 14 cm inside the Sonalleve table top (Profound Medical, Mississauga, ON, Canada) generated the focusing ultrasonic beam, which propagated through the water. Each hologram was positioned 3 cm below the focal plane, with precise adjustments of positions and angles for each measurement. Pressure measurements were conducted using the needle hydrophone HNA-0400 (ONDA Corp, Sunnyvale, CA, USA) mounted on a 3D positioning system. The motors of the positioning system were controlled, and pressure values were recorded using a GUI generated in LabVIEW. The displacement step created by the motors on each axis was 0.01 mm. The properties of the holograms were reconstructed, considering the experimental data obtained. Our findings demonstrated that the shape, size, elasticity, and placement of each acoustic hologram significantly influenced the observed field pattern. This work was supported by the German Federal Ministry of Education and Research (“MR-HIFU-Pancreas”, FKZ:13GW0364D).

Die Reform der Rüstungsbeschaffung

Abstract Due to the duration of military procurements, it is economically necessary to streamline the Bundeswehr’s procurement process. It seems sensible to standardise armaments planning and procurement under the political leadership of the Federal Ministry of Defence, while the downstream procurement and operational processes should be organised on a market economy basis. This will ensure that the economic requirements for the public good of “external security” can be met in the long term.

Spatial variations and determinants of iron containing foods consumption among 6–23 months old children in Ethiopia: spatial, and multilevel analysis

Consuming foods high in iron benefits metabolic processes as well as the development of the neonatal and fetal brain. Despite the significance of eating foods high in iron for public health, Ethiopian practices are still limited when compared to the World Health Organization's (WHO) assessment of its consumption of such foods. This study used the Ethiopia Demographic and Health Survey (EDHS) to evaluate the consumption of iron-rich foods, regional clustering, and related characteristics among children aged 6–23 months. The information was taken from the typical EDHS 2019 dataset, which included a weighted sample of 1572 young children aged 6–23 months old in total. Utilizing Kuldorff's SaTScan version 9.6 software, spatial scan statistics were produced. Software from ArcGIS 10.8 was used to display the regional distribution of inadequate consumption of foods high in iron. Utilizing multilevel or mixed effects logistic regression analysis, the associated determinants for a healthy diet rich in foods containing iron were found. In the final model, a P-value of < 0.05 was announced as a statistical significance variable. Overall, in Ethiopia, children aged 6–23 months consumed iron-rich foods at a rate of 27.14% (95% CI 24.99–29.39). Poor intake of foods heavy in iron is concentrated in Ethiopia's regional states of Afar, a sizable portion of Amhara, Oromia, Tigray, Somali, Gambela, and SNNPS. Primary and secondary education (AOR = 1.73, CI 95%: 1.23, 2.41), and (AOR = 1.97,CI 95%: 1.25, 3.10), having ≥ 2 under five children, and current status of breastfeeding (AOR = 0.62 (CI 95%: 0.45, 0.84), and (AOR = 0.32, CI 95%: 0.23, 0.44), giving birth at health facilities (AOR = 1.51, CI 95%: 1.06, 2.13),being from Afar and Somali regions (AOR = 0.39, 95%: 0.17, 0.93), and (AOR = 0.26, CI 95%: 0.10, 0.69) have shown statistically significant association with the outcome variable respectively. In Ethiopia, providing high-iron meals and supplements to under-2-year-old children represents minimal, but persistent, public health expenses. Based on the identified determinants, the Ethiopian federal ministry of health and other stakeholders should pay special attention to the locations designated as hot spots for maternal and child health service enhancement to promote the consumption of iron-rich meals among children aged 6–23 months.

Quality Management Techniques and Performance of Oil Servicing Companies In Rivers State, Nigeria

To succeed in the volatile environment of the oil industry, oil servicing firms rely on technical change, heavy investment in high technology and intellectual capital to sustain performance and attain competitive advantage. Hence, the research on Quality Management Techniques and Performance of Oil Servicing Companies in Rivers State, Nigeria. The population of the study comprised of all the thirty (30) oil servicing companies in Rivers State as at 31 December, 2021 as culled from the Federal Ministry of Petroleum Resources of Nigeria. Correlation Analysis Pearson’s Product Moment Correlation (PPMC) and Factor Analysis was used to analyse the data collected. From the Pearson correlation (PC) Coefficient result displayed in table 4.4, it was discovered that quality audit has a positive statistically significant relationship with customer service delivery of oil servicing companies in Rivers State. Keywords: Quality management, Techniques, Sustained Performance, Nigeria

Evaluation of all-cause mortality and cardiovascular safety in patients receiving chimeric antigen receptor T cell therapy: a prospective cohort study

Assessment of cardiovascular risk is critical for patients with cancer. Previous retrospective studies suggest potential cardiotoxicity of CAR T cell therapies. We aimed to prospectively assess cardiotoxicity and the predictive value of cardiac biomarkers and classical risk factors (age, cardiac function, diabetes, arterial hypertension, smoking) for cardiac events and all-cause mortality (ACM). In this prospective cohort study, all patients treated with CAR T cell constructs (axi-cel, tisa-cel, brexu-cel, ide-cel, or the 3rd generation CAR HD-CAR-1) from Oct 1, 2018, to Sept 30, 2022at the University Hospital Heidelberg were included. Surveillance included cardiac assessment with biomarkers (high-sensitive Troponin T (hs-cTnT), N-terminal brain natriuretic peptide (NT-proBNP)), 12-lead-ECG, and 2D echocardiography. ACM was defined as the primary study endpoint, while cardiotoxicity, defined by clinical syndromes of heart failure or decline in ejection fraction, served as a secondary endpoint. Overall, 137 patients (median age 60, range 20-83, IQR 16), were included in the study. 46 patients died during the follow up period (median 0.75 years, range 0.02-4.33, IQR 0.89) 57 month, with a median survival of 0.57 years (range 0.03-2.38 years, IQR 0.79). A septal wall thickness above 11mm (HR 2.48, 95%-CI=1.10-5.67, p=0.029) was associated with an increased risk of ACM, with a trend seen for reduced left ventricular ejection fraction prior to therapy (LVEF <40%; HR 9.17, 95%-CI=1.30-183.11, p=0.051). Secondary endpoint was reached by 93 patients while no baseline parameter was able to predict an elevated risk. However, hs-cTnT change from baseline of 50% or more during the first 14 days after CAR infusion predicted ACM (HR 3.81, 95%-CI=1.58-9.45; p=0.003). None of the baseline characteristics was able to predict the incidence of cardiac events. Reduced pre-lymphodepletion ejection fraction and early post-infusion biomarker kinetics may be associated with increased ACM and cardiotoxicity events. These findings may help to identify patients who could benefit from intensified cardio-oncological surveillance. The German Center for Cardiovascular Research, German Research Foundation, and the Federal Ministry of Education and Research.