Poor Monitoring Research Articles

Social development of children with disabilities in the integrated departments in Montenegro

Socialization is not just training an individual for social life and his future role in society, but it is very important for personality formation, which is formed through learning with certain characteristics, and thus becomes a member of one culture [1]. Conflicts in the family, inconsistent discipline, affective cold, parents' hostility, poor monitoring and non-inclusion of parents in the everyday life of a minor, but also his psychological and emotional state, as well as crime and alcoholism in the family can be important factors, causers and triggers of the appearance of delinquent behaviour. The research was conducted for the duration of one school year, and it is represented by the central, southern and northern regions of Montenegro, in integrated departments at regular schools (PI Primary school 'Ilija Kisic' Herceg Novi, PI Primary school 'Vuk Karadzic' Berane, PI Primary school 'Dusan Korac' Bijelo Polje, PI Primary school 'Njegos' Kotor, PI Primary school 'Bosko Buha' Pljevlja, PI Primary school 'Olga Golovic' Niksic and PI Primary school 'Yugoslavia' Bar. Starting from the nature, essence and importance of the defined problem, the subject of our study is focused on the social development of children with disabilities, as well as on the influence of social development on the presence of problematic behaviour. The most significant results of this research, and we think that they have an impact on the social development of the child are: the fact that 23% of children grew up, lived and formed a socio-emotional status with their parent, who was not in the marital union of another child's parent. Parent's education: the most frequent is secondary school with 45.5%, and the number of parents with non-completed primary school is relatively high with 14.5%. A significant number of parents of children with disabilities are unemployed (fathers 26.4%, mothers 60.0%). We can conclude that economic characteristic can be very unfavourable for the functioning of the family. Our research shows that there are quarrels between 51.8% of parents. Regarding the presence of psychological violence against children with disabilities, we have concluded that in 14.5% of children there are indications of experiencing some form of psychological violence. The quarrel between parents, as a serious disorder in the social and overall development of children with disabilities, are expressed as a problem in the amount of 23.6% and there are indications that they reach up to 33.7%. So we can say that the presence of this problem is high. It is not negligible that 40% of children with disabilities have an inadequate relation towards teachers.

Assessment of youths’ participation in activities of value chain development programme in Anambra state, Nigeria

The study assessed youths’ participation in activities of Value Chain Development Programme (VCDP) in Anambra State, Nigeria. A multi-stage sampling procedure was used to select 100 respondents. Data were collected from primary source through the use of validated questionnaire. Data were analysed using percentage, mean score and multiple linear regression. The findings showed that youths were mostly involved in rice production (M=2.88), rice processing (M= 2.72), cassava production (M= 2.68) and rice marketing (M= 2.05). Age, educational level, programme experience and annual income had positive significant influence on the extent of youth participation in the programme’s activities at 5% level. The VCDP beneficiaries had very high benefits in increased access to improved rice/cassava varieties, provision of agro-chemicals, increase in income, provision of all-weather feeder roads, adequate trainings on the improved technologies, increase in yield, and ease in marketing of produce. The major challenges identified were late/ untimely distribution of inputs, difficulty in payment of counterpart fund, poor monitoring and evaluation, high cost of production, fluctuation in prices of products, corruption and materialism among staff and poor off-taker implementation. The need for timely and adequate supply of agro-inputs and credits at subsidized rate by the service providers was one of the recommendations made.

The main factors of supplier-induced demand in health care: A qualitative study.

BACKGROUND:Induced demand is a major challenge for financing health promotion, whereby providers exploit patients' information gap to manipulate their demand for health care. The purpose of this study was to identify the factors associated with induced demand for health-care services in hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018.MATERIALS AND METHODS:In this qualitative study, semi-structured interviews were conducted with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze the data.RESULTS:Overall, 24 subthemes or factors were identified and classified into the health system, the insurer, health-care provider, and health-care recipient themes. Poor monitoring and control, the fee-for-service payment system, limited role of insurance companies, insufficient monitoring of insurance companies, the educational nature of our health centers, health-care providers' interests, and patients' information gap were some important factors in induced demand for health-care services.CONCLUSION:Our results showed that there are many factors that contribute to induced demand for health care. Given the four levels of factors identified in this study, health policymakers and managers must develop strategies at each level to reduce induced demand for health care.

Management of Solid Waste and Environmental Sustainability in Calabar Municipality Local Government Area

This study was designed to investigate the management of solid waste and environmental sustainability in Calabar Municipal Local Government Area. The three null hypotheses were formulated to guide the study. The estimated population of the study area is One Hundred and Ninety Thousand (190, 000). A stratified random sampling technique was used to sample hundred (100) respondents from six (6) locations in Calabar Municipal. A thirty (30) items structured questionnaire was the instrument used for data collection. The data collected was analyzed using Pearson product moment correlation technique which tested the hypothesis at 0.05 level of significance. The study revealed that there was a significant management of solid waste and environmental sustainability of Calabar Municipal. The study also revealed that there was a significant relationship among monitoring, recycling and incineration of solid waste on environmental sustainability in Calabar Municipal. Based on these findings, it is concluded that there is nor or poor monitoring, recycling and incineration and management of solid waste which pose health hazards to Calabar Municipal. It was recommended that the monthly environmental sanitation exercise would be re-introduced to both the resident dwellers and industries within the municipality government area.

Difficulties and Solutions for the Family Doctor Team in Preventing and Managing Public Health Emergencies: a Study Using the Value Chain Approach

Background: Currently, the family doctor team still faces many obstacles in managing public health emergencies as the gatekeeper. However, there is little research on the difficulties of family doctor teams in the prevention and management of public health emergencies. Objective: To explore the difficulties of family doctor teams in the prevention and management of public health emergencies, providing a theoretical basis and recommendations on ensuring the highly efficient performance of family doctor teams in preventing and managing the emergencies. Methods: Convenience sampling was used to select frontline healthcare workers from 25 primary healthcare institutions of Guangzhou to complete an online survey using a self-administered questionnaire conducted in June 2020 for investigating the implementation of essential public health services, essential medical services and prevention and management of public health emergencies in their hospitals between February and June 2020. Interviews were conducted with some of the healthcare workers who volunteered to be interviewed. Results: According to the questionnaire survey, during February to June 2020, of the 25 institutions, 19 had halted the delivery of some or all essential public health services, 6 had no capacities and channels to transfer suspected or confirmed COVID-19 cases to designated COVID-19 hospitals, 24 had implemented the emergency response plan for the COVID-19 pandemic, 10 had offered COVID-19-related health education, 9 had not set up the infectious diseases and public health emergencies reporting and managing system, 10 had not established the fever clinic, and 11 had operated all the clinics as usual. Value chain analysis of the interviews indicated that difficulties faced by the family doctor team in preventing and managing public health emergencies were: insufficient in-hospital support, unsuccessful communication and collaboration between hospitals or between the hospital and other institutions, poor monitoring and early warning effect of the COVID-19 pandemic, insufficient COVID-19-related health education, residents' unmet needs of essential medical services, inadequate emergency response infrastructure, lack of public health professionals, discrepancy between the construction of various information systems, inappropriate emergency procurement system. Conclusion: To make the community a solid fortress for the prevention and management of public health emergencies to ensure residents' health and safety, the authors suggest that efforts shall be made to address the barriers to the implementation of essential medical services first, then to solve issues existing in the implementation of auxiliary services. Copyright © 2021 by the Chinese General Practice.

Epidemiological Profile of Childbirth among Primiparous Women in Rural Areas of Tanganyika Province, Democratic Republic of Congo

Introduction: Sub-Saharan Africa remains one of the areas where maternal deaths are most prevalent. This situation is linked to a number of maternal risk factors including obstetric experience, age, disease history, socio-economic conditions and the quality of the health system. The objective of this study is to determine the epidemiological profile of childbirth in rural primiparous women. Methods: This is a multi-centre, retrospective and descriptive cross-sectional study among primiparous women in Moba (DR. Congo). The period from 2015 to 2016 was chosen. Epi Info 7 and Excel software were used for data analysis. Results: Of the 2644 deliveries selected for this study, 474 (17.9%) were among primiparous women. The average age of primiparous women was 18.4 ± 1.9 years (extremes 15 to 24 years). The majority of primiparous women were educated, married, housewives, with poor prenatal monitoring of pregnancies, having given birth by eutocic mode (53.6%) and vaginal route (92.0%). Maternal and early neonatal mortality was 0.8% and 1.7% respectively. This mortality only significantly (p < 0.05) concerned dystocic deliveries and the 18- to 21-year-old age group. Maternal age (p < 0.001), especially before the age of 18 (p < 0.000), and occupation (p < 0.01) significantly determine the mode of childbirth. Conclusion: The primiparous under 18 years of age presents risks of dystocic childbirth. Dystocia is responsible for several complications that can lead to maternal or neonatal death. Efforts should be made to discourage early pregnancy and improve the quality of obstetric care.

Control less, trust more: Parenting and externalising problems of adolescents

Previous research recognises poor parental monitoring, negative parental upbringing practices and insecure attachment as risk factors of great importance for understanding externalising problems in adolescence. The aim of the research is to understand the role that affective attachment to parents plays in the interpretation of the relationship between parental monitoring and upbringing practices with externalising problems of adolescents. A total of 507 adolescents (209 males and 298 females), aged between 15 to 18 filled the questionnaires. Through the use of structural equation modelling, trust in parents is revealed as important mediator with systematic effect that deserves further attention. It is found that trust in parents, especially in mothers, is a more potent mediator for explaining the link between positive parenting and parental monitoring with aggressive behaviour than with rule-breaking behaviour. Results are discussed in the light of the importance of parent-adolescent relationship for externalising problems in adolescence.

Markov Chain Neighborhood Sparse Preserving Graph Embedding Based on Tensor Factorization for Batch Process Monitoring

If the three-dimension data of batch process are unfolded the two-dimension data, some important information would lose, and outliers such as noise would lead to poor monitoring results. Therefore, a Markov chain neighborhood sparse preserving graph embedding algorithm based on tensor factorization (TMNSPGE) is proposed. Firstly, tensor factorization is used to directly process the three-dimension data in batch process, which can avoid the information loss. Secondly, by using the neighborhood preserving embedding algorithm and sparse manifold coding, the local linear relationship and local sparse manifold structure of data are preserved. On this basis, Markov chain analysis is introduced to construct a similar graph to make the data after dimensionality reduction have a certain probability interpretation. Finally, the statistics and control limits are determined to realize process monitoring. Numerical example and penicillin fermentation simulation process prove the effectiveness of TMNSPGE algorithm in batch process monitoring.

Experience in monitoring the educational activities of students

Today, digital technologies allow creating and operated a virtual (online) platform that facilitates synchronous and asynchronous interaction with available resources between all parties to the learning process. In distance or blended learning, students independently organize, control, direct and regulate their activities. At the same time, monitoring, in particular by the teacher, plays a crucial role in creating internal feedback and, thus, in adopting appropriate rules. However, students may have unsatisfactory self-regulated learning outcomes due to poor monitoring. Therefore, external feedback between all actors involved in the various electronic learning management platforms is important. The article analyzes the possibilities of monitoring the educational activities of students in the study of disciplines in the system of higher education for technical and economic specialties. The main components of the study and the possibility of obtaining information about the activity and success of student learning in the learning management systems Moodle and Microsoft Teams are considered. A detailed description of obtaining information about the student's actions on the page of the discipline in the Moodle system using the blocks "Action Reports" and "Monitoring" are presented. Opportunities for monitoring all active student groups with which the teacher works, using the Insights tab and other Microsoft Teams applications are presented. The mechanisms of obtaining statistical information about the work of students during classroom and extracurricular work are described.

Modified monitoring system of soil temperature based on ARM

The existing real-time monitoring system of soil temperature in underground buildings has the defect of poor monitoring accuracy. In order to solve the above problems, the real-time monitoring system of soil temperature in underground buildings is designed based on arm. The hardware of the real-time monitoring system for the soil temperature of underground building reclamation includes the temperature acquisition unit, arm processing unit and wireless transmission unit, and the software includes the upper computer monitoring module and the lower computer program module. Through the design of the hardware and software of the system, the operation of the real-time monitoring system for the soil temperature of underground building reclamation based on arm is realized. The experimental results show that compared with the existing real-time monitoring system, the designed real-time monitoring system based on ARM greatly improves the monitoring accuracy, which fully shows that the proposed real-time monitoring system based on arm has better monitoring performance. • The paper uses ARM to monitor the soil temperature of underground buildings. • Monitoring soil temperature through temperature acquisition units and other units. • Upper and lower computer modules can improve the accuracy of temperature monitoring. • The paper uses sensors and wireless serial ports to obtain and transmit information. • ARM processor can reduce power consumption, save costs, and has good performance.

"So sometimes, it looks like it's a neglected ward": Health worker perspectives on implementing kangaroo mother care in southern Malawi.

Kangaroo mother care (KMC) involves continuous skin-to-skin contact of baby on mother's chest to provide warmth, frequent breastfeeding, recognizing danger signs of illness, and early discharge. Though KMC is safe, effective and recommended by the World Health Organization, implementation remains limited in practice. The objective of this study is to understand barriers and facilitators to KMC practice at tertiary and secondary health facilities in southern Malawi from the perspective of health workers. This study is part of the "Integrating a neonatal healthcare package for Malawi" project in the Innovating for Maternal and Child Health in Africa initiative. In-depth interviews were conducted between May-Aug 2019 with a purposively drawn sample of service providers and supervisors working in newborn health at a large tertiary hospital and three district-level hospitals in southern Malawi. Data were analyzed using a thematic approach using NVivo 12 software (QSR International, Melbourne, Australia). A total of 27 nurses, clinical officers, paediatricians and district health management officials were interviewed. Staff attitudes, inadequate resources and reliance on families emerged as key themes. Health workers from Malawi described KMC practice positively as a low-cost, low-technology solution appropriate for resource-constrained health settings. However, staff perceptions that KMC babies were clinically stable was associated with lower prioritization in care and poor monitoring practices. Neglect of the KMC ward by medical staff, inadequate staffing and reliance on caregivers for supplies were associated with women self-discharging early. Though routine uptake of KMC was policy for stable low birthweight and preterm infants in the four hospitals, there were gaps in monitoring and maintenance of practice. While conceptualized as a low-cost intervention, sustainable implementation requires investments in technologies, staffing and hospital provisioning of basic supplies such as food, bedding, and KMC wraps. Strengthening hospital capacities to support KMC is needed as part of a continuum of care for premature infants.

Assessment of the performance of drought indices for explaining crop yield variability at the national scale: Methodological framework and application to Mozambique

Droughts are one of the most damaging and complex natural disasters in the world, and they frequently affect agricultural production. Drought monitoring is essential for decision-makers seeking to minimize the socio-economic impacts related to drought events. In this study, we propose a methodology to identify the most suitable drought indices and data sources for monitoring the impact of drought on crops. Mozambique is used as a case study, as it represents a challenging example because of its poor hydroclimatic monitoring network and a lack of disaggregated data for agricultural production. A total of seven standardized drought indicators (SPI, SPEI, SSI, SVCI, STCI, SVHI, and STWS) at different scales (1, 3, 6, and 12 months) were obtained from global databases and evaluated as possible predictors of the annual variability of agricultural yields at the national level. A statistical model of crop yields based on time series was used to measure the explanatory capacity of each index. SPEI and SSI were the most effective at detecting the country's historical drought records regardless of whether nationally averaged values or the percentages of area affected by drought (PAA) were used. However, PAA was found to be a more accurate predictor of variability in crop yields. The variability of most cereals (maize, millet and sorghum) was adequately explained by the PAA of SPEI-3, with that of other crops (cashew nuts, cassava, potatoes, tea, tobacco and vegetables) being explained by the PAA of SSI-12. Specific indicators were proposed for monitoring wheat and sugar cane. These results can directly support managers and decision makers in developing drought contingency plans in Mozambique. To further demonstrate the potential of this methodology, it should be tested in other regions with a greater availability of agricultural data, including spatial disaggregation.

Associative Imagery as a Strategy to Improve Destination Memory in Younger and Older Adults

Destination memory errors (inability to remember to whom information was shared) affects all ages, but older adults are particularly vulnerable due to poor source monitoring. Individuals may assume information was already shared when it was not or repeat previously shared information. The current study explored two mental imagery strategies (vivid imagery, visualizing context) to improve destination memory. Using a software program, younger and older adults told randomly generated facts to random celebrity faces. Participants were unaware of the upcoming memory tests. The control group did not use a strategy. The imagery group used vivid imagery to connect the fact and face (e.g., visualize Oprah on a dime to remember Oprah was told that dimes have 118 ridges). The context group visualized a provided context (e.g., grocery store) when telling a fact to a face. Assessments of performance on item memory (facts, faces) as well as destination memory (face-fact pairings) were counterbalanced. Results indicated an associative memory deficit among older adults, which was driven by a higher rate of false alarms. However, across all adults, the vivid imagery condition was more accurate than the control condition, and they demonstrated fewer false alarms. These findings suggest that older adults can use mental imagery to reduce false alarms and improve destination memory performance. Implications include reducing age stereotypes, improving conversations, and decreasing potentially dangerous situations (e.g., withholding important health information thinking it already was shared with a doctor).

Preventing maternal mortality in the United States: lessons from California and policy recommendations.

Maternal mortality remains a large concern in the United States (US), although other Western countries are making progress. In this scoping review, we identify four problems that may contribute to the maternal mortality burden in the US: inadequately investing in women's health, poor quality of care, increasing disparities, and poor data collection and monitoring of maternal health issues. Because maternal mortality is decreasing in California, we identify strategies implemented there that could improve maternal health outcomes nationwide: funding programs to address social determinants of maternal health; supporting health care strategies to improve maternal health (including national standards and goals for health care systems); and investing in maternal health monitoring and surveillance (including use of technology). We encourage researchers, practitioners, and policymakers to work together to develop evidence-based policies and practices to improve maternal health and reduce maternal. We conclude with recommendations for the United States and globally.

Time and Cost Planning of a Housing Construction Project Using Building Information Modelling

Conventional ways of building construction process lack proper task scheduling and planning of the project work at the site resulting in poor monitoring of the whole process. Building information modelling (BIM) creates a platform where all the information of every single element of the construction process can be virtually integrated. The integration of 3D elements of a building model with its scheduled time and cost parameters results in 5D BIM. This feature enables the visualization, scheduling, planning, and monitoring and clash detection of all pre- construction, construction and post-construction processes of a building. The present study used the information of a live project of a traditionally built residential building which was remodelled using 5D BIM technique. The purpose of this study was to compare and analyse the impact of 5D BIM on time and cost parameters of the live project.

An analysis of internal and external feedback in self-regulated learning activities mediated by self-regulated learning tools and open learner models

In self-regulated learning (SRL), students organize, monitor, direct, and regulate their learning. In SRL, monitoring plays a critical role in generating internal feedback and thus adopting appropriate regulations. However, students may have poor SRL processes and performance due to their poor monitoring. Researchers have suggested providing external feedback to facilitate better student SRL. However, SRL involves many meta-cognitive internal processes that are hidden and difficult to observe and measure. This study proposed a SRL model to illustrate the relationship among external SRL tools, internal SRL processes, internal feedback, and external feedback. Based on the model, this study designed a system with SRL tools and open leaner models (OLMs) to assist students in conducting SRL, including self-assessing their initial learning performance (i.e. perceived initial performance and monitoring of learning performance) after listening to a teacher’s lecture, being assessed by and receiving external feedback from the OLM (i.e. actual performance) in the system, setting target goals (i.e. desired performance) of follow-up learning, conducting follow-up learning (i.e. strategy implementation), and evaluating their follow-up learning performance (i.e. perceived outcome performance and strategy outcome monitoring). These SRL tools also externalize students’ internal SRL processes and feedback, including perceived initial, desired, and perceived outcome performances, for investigation. In addition, this study explores the impact of external feedback from the OLM on students’ internal SRL processes and feedback. An evaluation was conducted to record and analyze students’ SRL processes and performance, and a questionnaire was administered to ask students about their SRL processes. There are three main findings. First, the results showed that students often have poor internal SRL processes and poor internal feedback, including poor self-assessment, inappropriate target goals, a failure to conduct follow-up learning, and a failure to achieve their goals. Second, the results revealed that the SRL tools and external feedback from the OLM assisted most students in SRL, including monitoring their learning performance, goal-setting, strategy implementation and monitoring, and strategy outcome monitoring. Third, some students still required further support for SRL.

A multi-sectoral investigation of a neonatal unit outbreak of Klebsiella pneumoniae bacteraemia at a regional hospital in South Africa, 2018

Background: Rates of healthcare-associated infections (HAIs) among babies born in developing countries are higher than those born in resource-rich countries, driven by sub-optimal infection prevention and control (IPC) practices. Following two reported deaths in neonates with carbapenem-resistant Klebsiella pneumoniae bloodstream infections (BSI), we conducted an outbreak investigation in a neonatal unit of a regional hospital in Gauteng Province. Objectives: To confirm an outbreak of K. pneumoniae BSI and assess the IPC programme within the neonatal unit. Methods and materials: We calculated total and organism-specific BSI incidence risks for culture-confirmed cases in the neonatal unit for baseline and outbreak periods. We conducted a clinical record review for a subset of cases with K. pneumoniae BSI. An IPC audit was performed in different areas of the neonatal unit. We confirmed species identification, antimicrobial susceptibility, presence of carbapenemase genes by PCR and pulsed-field gel electrophoresis (PFGE) typing of submitted clinical isolates. Results: From January 2017 to August 2018, 5262 blood cultures were submitted, of which 11% (560/5262) were positive. Of 560 positive blood cultures, 52% (n = 292) were culture-positive for organisms that are associated with HAI BSIs. Klebsiella pneumoniae comprised the largest proportion (32%; 93/292). The total incidence risk of HAI BSIs for the baseline period (January 2017–March 2018) was 6.8 cases/100 admissions, and that for the outbreak period (April-September 2018) was 10.1 cases/100 admissions. The incidence risk of K. pneumoniae BSIs for the baseline period was 1.6 cases/100 admissions, compared to 5.0 cases/100 admissions during the outbreak period. Among a subset of 12 neonates with K. pneumoniae bacteraemia, all were premature with low birth weight. The median gestational age at birth was 27 w (IQR, 26–29 w) and median birth weight was 1100 g (IQR, 880–1425 g). Twelve bloodstream and 31 colonising isolates were OXA-48 positive. PFGE analysis demonstrated that all isolates were genetically related (89% similarity). Poor IPC practices were noted, including overcrowding, sub-optimal aseptic technique and hand washing, and poor monitoring and reporting of antimicrobial use. Conclusion: Overcrowding, poor IPC practices and inadequate antimicrobial stewardship contributed to a large outbreak of BSIs caused by genetically-related carbapenemase-producing K. pneumoniae isolates in the neonatal unit.

Study of surface-based temperature inversions in the city of Nadym (Western Siberia) with direct measurements and numerical simulation

Frequent surface-based inversions are persistent features of climate in the Arctic and, in particular, in its Russian part. Most favourable conditions for temperature inversion formation during the winter period in this region are observed. Surface-based inversions formed in cities are most interesting for research, because of their impact on people’s health. Besides, “urban” surface-based inversions differ from “rural” ones, because of interactions with the urban heat island (UHI). Actually, urban surface-based inversions in the Arctic are weakly understood due to poor meteo monitoring equipment of most Arctic regions and because the reanalysis resolution is too low for the cities. To estimate the frequency of surface-based inversions and spatial distributions in the city of Nadym (Western Siberia), measurements with gradient complexes during the period from 18.12.2018 to 15.10.2019 have been conducted, and a numerical experiment with a model Advanced Research WRF (ARW) has been performed for the coldest days of the period. In the research, first statistic microclimatic data of vertical temperature distributions in the city of Nadym have been obtained. Such model experiments are realized for that region, and the results obtained for the rural area are compared with microwave temperature profiler MTP-5 measurements.

Electronic DNA Analysis of CSF Cell-free Tumor DNA to Quantify Multi-gene Molecular Response in Pediatric High-grade Glioma.

Pediatric high-grade glioma (pHGG) diagnosis portends poor prognosis and therapeutic monitoring remains difficult. Tumors release cell-free tumor DNA (cf-tDNA) into cerebrospinal fluid (CSF), allowing for potential detection of tumor-associated mutations by CSF sampling. We hypothesized that direct, electronic analysis of cf-tDNA with a handheld platform (Oxford Nanopore MinION) could quantify patient-specific CSF cf-tDNA variant allele fraction (VAF) with improved speed and limit of detection compared with established methods. We performed ultra-short fragment (100-200 bp) PCR amplification of cf-tDNA for clinically actionable alterations in CSF and tumor samples from patients with pHGG (n = 12) alongside nontumor CSF (n = 6). PCR products underwent rapid amplicon-based sequencing by Oxford Nanopore Technology (Nanopore) with quantification of VAF. Additional comparison to next-generation sequencing (NGS) and droplet digital PCR (ddPCR) was performed. Nanopore demonstrated 85% sensitivity and 100% specificity in CSF samples (n = 127 replicates) with 0.1 femtomole DNA limit of detection and 12-hour results, all of which compared favorably with NGS. Multiplexed analysis provided concurrent analysis of H3.3A (H3F3A) and H3C2 (HIST1H3B) mutations in a nonbiopsied patient and results were confirmed by ddPCR. Serial CSF cf-tDNA sequencing by Nanopore demonstrated correlation of radiological response on a clinical trial, with one patient showing dramatic multi-gene molecular response that predicted long-term clinical response. Nanopore sequencing of ultra-short pHGG CSF cf-tDNA fragments is feasible, efficient, and sensitive with low-input samples thus overcoming many of the barriers restricting wider use of CSF cf-tDNA diagnosis and monitoring in this patient population.

Psychosocial and socio-environmental factors associated with adolescents' tobacco and other substance use in Bangladesh.

Tobacco, alcohol, and marijuana are the top three substances used by adolescents. The adverse health effects of these three substances are well documented in epidemiological literature, yet little is known about the substance use and associated factors among adolescents in Bangladesh. This study examines the risk factors for tobacco and other substances use among school-going adolescents in Bangladesh. We analyzed data from the 2014 Bangladesh Global School-based Student Health Survey (GSHS) of adolescents aged 13-17 years. We used two outcome measures: tobacco use (TU) and other substance use (SU; alcohol and/or marijuana). We examined a set of reported psychosocial and socio-environmental adverse events as risk factors. Logistic regression analyses were used to identify associations. The prevalence of TU and other SU among school-going adolescents was 9.6% and 2.3%, respectively. The likelihood of TU and other SU was higher among adolescents who reported being bullied (TU: adjusted odd ratio [AOR]: 1.93; 95% confidence interval [CI]: 1.24-3.00; and other SU: AOR: 3.43; 95% CI: 1.46-7.99) and having sexual history (TU: AOR: 19.38; 95% CI: 12.43-30.21; and other SU: AOR: 5.34; 95% CI: 2.17-13.29). Moreover, anxiety-related sleep loss was associated with adolescents' TU (AOR: 2.41; 95% CI: 1.02-5.82) whereas the likelihood of other SU (AOR: 3.27; 95% CI: 1.14-9.44) was higher among lonely adolescents. Experience of adverse socio-environmental factors, such as parental substance use (TU: AOR: 7.81; 95% CI: 5.08-12.01), poor monitoring (TU: AOR: 1.96; 95% CI: 1.16-3.31) and poor understanding (TU: AOR: 2.22; 95% CI: 1.36-3.65), and lack of peer support (TU: AOR: 3.13; 95% CI: 1.84-5.31; and other SU: AOR: 2.45; 95% CI: 1.02-5.91), and truancy (other SU: AOR: 4.29; 95% CI: 1.81-10.12) were also positively associated with TU and/or other SU. Additionally, higher odds of tobacco use were observed among adolescents who reported 1 (AOR: 4.36 times; 95% CI: 1.34-14.24), 2 (AOR: 8.69 95% CI: 1.67-28.23), and ≥3 (AOR: 17.46; 95% CI: 6.20-49.23) adverse psychosocial experiences than who did not report any psychosocial events. Tobacco and other substance use among school-going adolescents are prevalent in Bangladesh. Several psychosocial and socio-environmental events are associated with TU and other SU, which should be incorporated into adolescent substance use and health promotion programs.