Proportional Method Research Articles

The Effectiveness of the Role of Agricultural Extension Workers to Increase Rice Paddy Productivity in Asahan Regency

Asahan Regency occupies the 13th position out of 33 regencies/cities as a rice producer in North Sumatra Province the rice productivity results are relatively low so that it is a problem that needs to be resolved. Agricultural extension workers act as motivators, educators, facilitators and communicators. This study aims to determine and analyze the influence of the role of agricultural extension agents on the productivity of paddy rice in Asahan Regency. The study was conducted in Asahan Regency, North Sumatra Province using primary data obtained from direct surveys and secondary data as supporting data using the Stratified Proportional Random Sampling method. The respondents were farmers from 3 sub-districts, namely Rawang Panca Arga, Sei Kepayang and Meranti districts. Data analysis using description analysis and Partial Least Square (PLS).

Impact of children's age on parental HIV disclosure: a parental HIV disclosure intervention among parents living with HIV in China

ABSTRACT Parental HIV disclosure, where parents living with HIV (PLH) communicate their diagnosis to their children, is crucial for family communication. This study assessed intervention effects of a parental HIV disclosure intervention on psychosocial factors, focusing on child's age impact. Data from a randomized controlled trial involving 791 PLH in China were analyzed at baseline (W1), 6-month (W2), and 12-month follow-ups (W3). The study measured effects on psychosocial factors (HIV disclosure knowledge, outcome expectancy, action self-efficacy, and action planning) using the proportional latent change score method. Among PLH with children aged 6–9, the intervention yielded significant intervention effects on knowledge (β = 0.190, p = .004), action self-efficacy (β = 0.342, p = .001), and action planning (β = 0.389, p < .001) from W1 to W2. For PLH with children aged 10-12, the intervention significantly enhanced action self-efficacy (β = 0.162, p = .003) and action planning (β = 0.367, p = .001) from W1 to W2, but there was a reduction in perceived benefits (β = −0.175, p = 0.024) from W2 to W3. For PLH with children aged 13–15, significant intervention effects were observed on action planning, both from W1 to W2 (β = 0.251, p = .045) and from W2 to W3 (β = 0.321, p < .001). These findings highlight the importance of tailoring interventions to consider psychosocial factors and children's developmental stages to enhance HIV disclosure practices.

Analyzing and Categorizing Knowledge Resources and Ranking of Knowledge Documentation Mechanisms in Iranian Medical Libraries

Background: Knowledge resources and documentation mechanisms are essential for managers' productivity. Thus, identifying and categorizing knowledge resources and developing documentation mechanisms are crucial organizational tasks. Objectives: This research aimed to analyze, categorize, and rank knowledge resources in Iranian medical science libraries. Methods: This exploratory and correlational study was conducted on 209 managers, heads, and deputies of central and hospital libraries in Iranian medical universities. Sampling was performed using a proportional stratified random sampling method, and a researcher-made questionnaire was used to collect the data. Partial least squares structural equation modeling was utilized for data analysis. Results: Knowledge resources in medical science libraries were categorized into implicit, explicit, and web-based knowledge. Regarding the stages of knowledge documentation, the results indicated that the distribution stage and its related mechanisms received the highest scores. In contrast, the storage stage and its mechanisms received the lowest scores. The path coefficient test showed that the highest path coefficient was related to implicit knowledge (0.68), while the lowest was related to web-based knowledge (0.13). Regression coefficients and Cronbach's alpha were higher than 0.7, and the average extracted variance (AVE) was higher than 0.5, indicating the adequacy of the measurement and structural model evaluation. Conclusions: Based on the results, Iranian medical science libraries lack specific mechanisms for documentation and identifying and categorizing knowledge resources. Therefore, this research provided a suitable foundation for these libraries to employ knowledge documentation mechanisms and discover knowledge resources. These libraries' sources of implicit and explicit knowledge and necessary mechanisms for recording, capturing, and documenting knowledge are not clearly defined. Consequently, organizational knowledge documentation is not conducted formally based on a knowledge management model. Therefore, the present research enables the identification of important knowledge acquisition resources and the methods and mechanisms for extracting and documenting knowledge.

Entrepreneurial Attributes of the College Students Towards the Entrepreneurship

This study investigates entrepreneurial attributes, focusing on key elements such as the need for achievement, need for independence, risk-taking behavior, and entrepreneurial motivation, with a specific emphasis on college students and their involvement in entrepreneurship. The primary objective is to analyze the motivational aspects that drive students to embark on entrepreneurial endeavors. To fulfill these objectives, the current research conducted a comprehensive evaluation of the entrepreneurial motivation of students concerning entrepreneurship. The study was carried out at Chaudhary Charan Singh Haryana Agriculture University in Hisar. A systematic and proportional sampling method was employed to select a sample of 200 students, including 100 graduates and 100 postgraduates, who have faced unemployment over the last 3–4 years. It was observed that among the graduate unemployed students, there was a predominant indication of high entrepreneurial motivation (49.0%). Furthermore, they reported a moderate level of need for achievement (63.0%), a moderate need for independence (70.0%), and a moderate inclination towards risk-taking behavior (54.0%). In contrast, postgraduate students displayed a high level of need for achievement (51.0%), a substantial need for independence (50.0%), a notable propensity for risk-taking behavior (68.0%), and also exhibited a medium level of entrepreneurial motivation (53.0%).

An evaluation of confidence intervals for a cumulative proportion to enable decisions at interim reviews of single-arm trials

BackgroundClinical trials often include interim analyses of the proportion of participants experiencing an event by a fixed time-point. A pre-specified proportion excluded from a corresponding confidence interval (CI) may lead an independent monitoring committee to recommend stopping the trial. Frequently this cumulative proportion is estimated by the Kaplan-Meier estimator with a Wald approximate CI, which may have coverage issues with small samples. MethodsWe reviewed four alternative CI methods for cumulative proportions (Beta Product Confidence Procedure (BPCP), BPCP Mid P, Rothman-Wilson, Thomas-Grunkemeier) and two CI methods for simple proportions (Clopper-Pearson, Wilson). We conducted a simulation study comparing CI methods across true event proportions for 12 scenarios differentiated by sample sizes and censoring patterns. We re-analyzed interim data from A5340, a HIV cure trial considering the proportion of participants experiencing virologic failure. ResultsOur simulation study highlights the lower and upper tail error probabilities for each CI method. Across scenarios, we found differences in the performance of lower versus upper bounds. No single method is always preferred. The upper bound of a Wald approximate CI performed reasonably with some error inflation, whereas the lower bound of the BPCP Mid P method performed well. For a trial design similar to A5340, we recommend BPCP Mid P. ConclusionsThe design of future single-arm interim analyses of event proportions should consider the most appropriate CI method based on the relevant bound, anticipated sample size and event proportion. Our paper summarizes available methods, demonstrates performance in a simulation study, and includes code for implementation.

Role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting quality of life in type 2 diabetes

One of the factors that can affect the quality of life is the psychological status of people. Also, the psychological status of individuals can be affected by other variables. Therefore, this study was aimed to determine the role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting the quality of life in Iranian patients with type 2 diabetes. This cross-sectional study was conducted in Iran in 2021 among 300 patients with type 2 diabetes. The method of selecting the participants in this study was the proportional stratified sampling method. Data collection instruments included six questionnaires of demographic questionnaire and diabetes status, DASS-21 questionnaire (depression, anxiety, and stress), diabetes health literacy scale, self-care behavior questionnaire, satisfaction with life scale (SWLS), and quality of life questionnaire. Statistical methods such as independent sample t test, one-way analysis of variance, linear regression test, and Pearson correlation were used to analyze the data. Based on the results of Pearson correlation test, there was a positive and significant correlation between diabetes health literacy (r = 0.438, p < 0.001), depression (r = − 0.380, p < 0.001), anxiety (r = − 0.355, p < 0.001), stress (r = − 0.423, p < 0.001), and SWLS (r = 0.265, p < 0.001) with quality of life. Based on the results of linear regression, variables of diabetes health literacy, life satisfaction, self -care behaviors, depression, stress, anxiety, age of onset of diabetes and diabetes duration were able to predict 31% of the quality of life (p < 0.001). The results of this study indicated that diabetes health literacy, life satisfaction, stress and the duration of diabetes are able to predict the quality of life of patients with diabetes. Therefore, it is necessary to pay more attention to these effective variables training programs, especially health literacy, the effect of which is very obvious in this study.

The Influence of Peers on Learning Motivation Class X Hospitality Student at SMK N 9 Padang

This study aims to determine the influence of peers on learning motivation of students in class X Hospitality SMK 9 Padang Semester Even in the 2021/2022 academic year. This type of research is descriptive quantitative correlational research with a population of 204 respondents, and the sample is taken using the proportional random sampling method so that the sample obtained is 135 respondents. The instrument used in this research is a questionnaire compiled according to the Likert Scale model. The type of data in this study is primary data obtained from SMK N 9 Padang. The analytical tools used are Microsoft Excel 2010 and SPSS version 20. Based on the research that has been carried out with the results of the calculated hypothesis, the rcount value is 0.222 while the rtable value is 0.169 because the rcount value is greater than the rtable value (0.222 &gt; 0.169) it can be concluded that "at the same time is the answer to the research objective, namely that there is a "positive and significant influence between peers on the learning motivation of class X students Hospitality SMK N 9 Padang.

The Influence of Marketers' Capabilities, Compensation, and Career Development on Persistence and Its Implications for the Performance of Marketers of Agricultural Production Facilities in East Java

Purpose: Agricultural product salespeople have a role in helping companies sell agricultural products and helping farmers become more productive. This study aims to examine the effect of marketers' capabilities and compensation on marketers' persistence and its implications for the performance of agricultural production facilities marketers in East Java. Theoretical framework: This research is based on the individual performance of marketing personnel which is driven by marketer capability, compensation, and career development mediated by marketer persistence. The proposed model is built with three exogenous variables, one intervening variable and one endogenous variable. Design/ methodology/approach: This research was conducted using a quantitative method based on a cross-sectional survey design. The unit of analysis in this study is the sales force of agricultural production facilities in East Java. The research sample is the sales force of agricultural production facilities in East Java who have worked at least two years in a shop of agricultural production facilities. Sampling was conducted using the proportional random sampling method technique and taken from 235 respondents. The data were then processed using Structural Equation Modeling (SEM). Findings: The results revealed that the performance of marketers of agricultural production facilities in East Java is dominantly built by the persistence of marketers which is dominantly formed by the capabilities of marketers, followed by compensation, and career development. Increasing marketers' capabilities will increase marketers' persistence which has an impact on improving marketers' performance. Compensation also plays a role in building marketers' persistence which has an impact on improving marketers' performance, but its role is smaller than marketers' capabilities. As for career development, it will only have an impact on improving the performance of marketers if marketers have persistence. Research, Practical &amp; Social Implications: The results of this study can be used as input for managers of agricultural production facilities in East Java in their efforts to improve company performance through improving the performance of marketers, by increasing the persistence of marketers, which can be built through efforts to develop marketers' capabilities, and supported by the preparation of an attractive compensation system, and the preparation of an effective career development program. The capabilities of marketers especially need to be built so that marketers have high persistence, especially in terms of closure-focused persistence.

Hypertensive Disorders of Pregnancy and Pre-Pregnancy Hypertension with Subsequent Incident Venous Thromboembolic Events.

Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and pre-pregnancy hypertension with subsequent venous thromboembolic (VTE) events. The retrospective cohort study included 444,859 women with ≥1 live, singleton birth in South Carolina (2004-2016). Hospital and emergency department visit and death certificate data defined incident VTE, HDP, and pre-pregnancy hypertension. Birth certificate data also defined the exposures. Adjusted Cox proportional hazards methods modeled VTE events risk. Of the cohort, 2.6% of women had pre-pregnancy hypertension, 5.8% had HDP, 2.8% had both pre-pregnancy hypertension and HDP (both conditions), and 88.8% had neither condition. The risk of incident VTE events within one year of delivery was higher in women with HDP (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15-2.29) and both conditions (HR = 2.32, 95% CI: 1.60-3.35) compared to those with neither condition as was the risk within five years for women with HDP (HR = 1.35, 95% CI: 1.13-1.60) and for women with both conditions (HR = 1.82, 95% CI: 1.50-2.20). One- and five-year risks did not differ in women with pre-pregnancy hypertension compared to women with neither condition. Compared to non-Hispanic White (NHW) women with neither condition, the incident VTE event risk was elevated within five years of delivery for NHW (HR = 1.29, 95% CI: 1.02-1.63; HR = 1.59, 95% CI: 1.16-2.17) and non-Hispanic Black (NHB; HR = 1.51, 95% CI: 1.16-2.96; HR = 2.08, 95% CI: 1.62-2.66) women with HDP and with both conditions, respectively, and for NHB women with pre-pregnancy hypertension (HR = 1.50, 95% CI: 1.09-2.07). VTE event risk was highest in women with HDP, and the event rates were higher in NHB women than in NHW women in the same exposure group.

Multidrug-resistant tuberculosis in Iran: a multicenter study.

The worldwide incidence of multi-drug-resistant tuberculosis (MDR-TB) is rapidly increasing, and it has emerged as a pressing public health issue in Iran. Nevertheless, there is a scarcity of up-to-date research on the prevalence of MDR-TB in individuals with pulmonary TB in the country. In this cross-sectional study, we gathered a total of 1216 respiratory samples, each corresponding to a unique patient, from five distinct regional TB laboratories in Iran. We identified clinical isolates as Mycobacterium tuberculosis using the IS6110-based PCR assay and Xpert MTB/RIF. Drug susceptibility testing (DST) was conducted using the conventional proportion method. Out of the collected specimens, 448 tested positive for M. tuberculosis. Among these isolates, 445 (99.4%) exhibited susceptibility to the tested drugs, while 3 (0.6%) were found to be MDR. The findings from this recent study indicate that the prevalence of MDR in Iran stands at 0.6%. The absence of recently approved treatment protocols in various regions of Iran, along with inadequately equipped laboratories lacking DST capabilities, could contribute significantly to the rise in TB/MDR-TB prevalence in Iran. Therefore, the implementation of enhanced treatment management strategies and the adoption of innovative technologies are essential steps towards improving the current situation.

Proportional intuitionistic fuzzy AHP method: Wind turbine selection application

The direct assignment of decimal numbers for membership and non-membership degrees of an element in intuitionistic fuzzy sets is not practical. The problem is that the expert cannot assign the same values to the degrees of membership, non-membership and hesitancy in decimal numbers for the same proposition in every attempt. Rather than the former, the assignment of proportional relationships between membership and non-membership degrees is more appropriate. We propose proportion-based models for intuitionistic fuzzy sets that include arithmetic and aggregation operators. Proportional intuitionistic fuzzy (PIF) sets require only the proportion relations between an intuitionistic fuzzy set’s parameters. These models will make it easier to define intuitionistic fuzzy sets with more accurate data that better represents expert judgments. We transform AHP method, one of the traditional multi-criteria decision making methods, to PIF AHP using PIF sets. We compare the proposed PIF AHP method by interval-valued intuitionistic fuzzy AHP method existing in the literature. A wind turbine selection problem is handled to show the validity of the proposed PIF AHP method.

Rapid detection of drug-resistant Mycobacterium tuberculosis by Modified MODS assay suitable for resource-poor settings.

Cross contamination and biosafety are concerns with the microscopic observation drug susceptibility assay. To address these issues, we modified the MODS technique in the current study. Two hundred and seventy-five samples were processed on LJ media and drug susceptibility was performed by the Indirect agar proportion method. A modified MODS test was done in tissue culture bottles. GenoType MTBDRplus assay was performed to detect the resistance and mutational pattern associated with the resistances. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of tuberculosis by modified MODS were 97.44%, 80.00%, 97.44%, and 80.00% respectively. The perfect agreement was seen between modified MODS and the Indirect agar proportion method for drug susceptibility testing of isoniazid (kappa = 0.923) and rifampicin (kappa = 1). The contamination rate, cost and TAT for modified MODS were less as compared to the solid media. In the case of MDR-TB isolates S531L (66.66%) was the most prevalent mutation in the rpoB gene followed by S315T2 mutation (58.33%) and T8C (41.66%) in katG and inhA gene respectively. In hetero-resistant strains, C-15T mutation (37.50%) was the most common followed by A-16G (12.50%) in the inhA gene. In INH mono-resistant strains only two mutations were observed i.e., S-315T1(50%) and C-15T (50%) in the katG and inhA genes respectively. Modified MODS proved to be cost-effective and user-friendly, with minimal risk to the handler and no cross-contamination between samples were observed. Hence, it can be used in low-income countries for early detection of tuberculosis and its resistance.

Impact resistance of horsetail bio-honeycombs

Inspired by the ingenious cross-sectional structure of horsetail stems, a group of novel horsetail bio-honeycombs (HBHs) are firstly proposed to pursuit a superior impact resistance performance. The out-of-plane impact resistance characteristics and mechanical properties of the proposed HBHs are investigated by means of test, theoretical analysis, and finite element (FE) analysis. In the process of deriving the theoretical model of HBHs, the novel 5-panel and 7-panel membrane energy dissipation corner elements are firstly proposed and reasonable theoretical solutions for them are obtained. Theoretical results suggest that the errors between numerical and theoretical results for the majority of the HBHs are within 7 %. In addition, the studies indicate that the HBHs outperform the circular honeycomb (CH) in terms of crashworthiness while ensuring that their relative densities are the same. The complex proportional assessment method is utilized to evaluate the crashworthiness of HBH_n_6_1.5 (n represents the number of ribs, 6 represents the size of the outer diameter, and 1.5 represents the ratio (ζ) of the outer diameter to the inner diameter) under the same relative density. Furthermore, results suggest that energy absorption and crushing force efficiency of HBH_16_6_1.5 are 31.31 % and 25.54 % higher than those of CH, respectively. Subsequently, the influences of geometric parameters, including the ζ and the thickness-to-cell length ratio (TL), on the impact resistance of HBH_16_6_1.5 are investigated thoroughly. The findings show that when the ζ is within 1.2–1.5, the HBHs can exert their maximum potential, in which the inner diameter of HBHs is close to its outer diameter. Also, the findings demonstrate that the HBHs will undergo three distinct deformation modes. When the TL is roughly within 0.0200–0.0267, the deformation of HBHs will be in the transition deformation mode.

The Role of Efflux Pumps transporter in Multi-drug Resistant Tuberculosis: Mycobacterial memberane protein(MmpL5).

The overexpression of efflux pumps (Eps) was reported to contribute to multidrug resistant tuberculosis (MDR-TB). Increases in Eps that expel structurally unrelated drugs contribute to reduced susceptibility by decreasing the intracellular concentration of antibiotics. In the present study, an association of mycobacterial membrane protein (MmpS5-MmpL5) Ep and its gene regulator (Rv0678) was investigated in MDR-tuberculosis isolates. MTB strains were isolated from patients at two different intervals, i.e., once when they had persistent symptoms despite 3-15 ≥ months of treatment and once when they had started new combination therapy ≥2-3 months. Sputum specimens were subjected to Xpert MTB/rifampicin test and then further susceptibility testing using proportional method and multiplex polymerase chain reaction (PCR) were performed on them. The isolates were characterized using both 16S-23S RNA and hsp65 genes spacer (PCR-restriction fragment length polymorphism). Whole-genome sequencing (WGS) was investigated on two isolates from culture-positive specimen per patient. The protein structure was simulated using the SWISS-MODEL. The input format used for this web server was FASTA (amino acid sequence). Protein structure was also analysis using Ramachandran plot. WGS documented deletion, insertion, and substitution in transmembrane transport protein MmpL5 (Rv0676) of Eps. Majority of the studied isolates (n = 12; 92.3%) showed a unique deletion mutation at three positions: (a) from amino acid number 771 (isoleucine) to 776 (valine), (b) from amino acid number 785 (valine) to 793 (histidine), and (c) from amino acid number 798 (leucine) to 806 (glycine)." One isolate (7.6%) had no deletion mutation. In all isolates (n = 13; 100%), a large insertion mutation consisting of 94 amino acid was observed "from amino acid number 846 (isoleucine) to amino acid number 939 (leucine)". Thirty-eight substitutions in Rv0676 were detected, of which 92.3% were identical in the studied isolates. WGS of mycobacterial membrane proteins (MmpS5; Rv0677) and its gene regulator (Rv0678) documented no deletion, insertion, and substitution. No differences were observed between MmpS5-MmpL5 and its gene regulator in isolates that were collected at different intervals. Significant genetic mutation like insertion, deletion, and substitution within transmembrane transport protein MmpL5 (Rv0676) can change the functional balance of Eps and cause a reduction in drug susceptibility. This is the first report documenting a unique amino acid mutation (insertion and deletion ≥4-94) in Rv0676 among drug-resistant MTB. We suggest the changes in Mmpl5 (Rv0676) might occurred due to in-vivo sub-therapeutic drug stress within the host cell. Changes in MmpL5 are stable and detected through subsequent culture-positive specimens.

Phenotypic and genotypic analysis of drug resistance in M. tuberculosis isolates in Gansu, China.

Tuberculosis has posed a serious threat to human health. It is imperative to investigate the geographic prevalence of tuberculosis and medication resistance, as this information is essential for informing strategies for its prevention and treatment. Drug resistance was identified using a proportion method. Drug-resistant genes and pathways were predicted using whole genome sequencing. The drug resistance range of bedaquiline was identified using the microporous plate two-fold dilution method, and drug resistance genes were studied using sequencing. The study revealed that 19.99% of the tuberculosis cases had multidrug resistance. The genes of M. tuberculosis are predominantly involved in the synthesis of ABC transporters, two-component systems, and bacterial secretion systems, as well as in energy production and conversion, and lipid transport and metabolism. The genes encode for 82.45% of carbohydrate-related enzymes such as glycoside hydrolases, glycosyl transferases, and carbohydrate esterases. The minimum inhibitory concentration (MIC) of bedaquiline against clinical strains was approximately 0.06 μg/mL, with identified mutations in drug-resistant genes Rv0678, atpE, and pepQ, specifically V152A, P62A, and T222N, respectively. The multidrug resistance tuberculosis development was attributed to the strong medication resistance exhibited. It was concluded that tuberculosis had presented a high level of drug resistance. Phenotypic resistance was related to genes, existing potential genetic resistance in M. tuberculosis. Bedaquiline was found to possess effective antibacterial properties against M. tuberculosis.

High-Frequency Discrete-Interval Binary Sequence in Asynchronous C-VEP-Based BCI for Visual Fatigue Reduction.

In code-modulated visual evoked potential (c-VEP) based BCI systems, flickering visual stimuli may result in visual fatigue. Thus, we introduced a discrete-interval binary sequence (DIBS) as visual stimulus modulation, with its power spectrum optimized to emphasize high-frequency components (40 Hz-60 Hz). 8 and 17 subjects participated, respectively, in offline and online experiments on a 4-target asynchronous c-VEP-based BCI system designed to realize a high positive predictive value (PPV), a low false positive rate (FPR) during idle states, and a high true positive rate (TPR) in control states, while minimizing visual fatigue level. Two visual stimuli modulations were introduced and compared: a maximum length sequence (m-sequence) and the high-frequency discrete-interval binary sequence (DIBS). The decoding algorithm was compared among the canonical correlation analysis (CCA), the task-related component analysis (TRCA), and two approaches of sub-band component weight calculation (the traditional method and the proportional method) for FBCCA and FBTRCA. In the online experiments, the average PPV, FPR and TPR achieved, respectively [Formula: see text], [Formula: see text], [Formula: see text] with m-sequence, while [Formula: see text], [Formula: see text] and [Formula: see text] with DIBS. Estimated by objective eye-related metrics and a subjective questionnaire, the visual fatigue in DIBS cases is significantly smaller than that in m-sequence cases. In this study, the feasibility of a novel modulation approach for visual fatigue reduction was proved in an asynchronous c-VEP system, while maintaining comparable performance to existing methods, which provides further insights towards enhancing this field's long-term viability and user-friendliness.

Diagnostic Performance and Comparative Analysis of Conventional Drug Susceptibility Testing, Line Probe Assay, and GeneXpert in Extrapulmonary Tuberculosis Cases: A Cross-sectional Observational Study

Introduction: Tuberculosis (TB), a known threat to mankind for ages, causes a significant burden on healthcare worldwide. The alarming rise of Extrapulmonary Tuberculosis (EPTB) has led healthcare professionals to opt for molecular diagnostics. Despite the availability of rapid diagnostics, conventional culture Drug Susceptibility Testing (DST) is still considered the gold standard in diagnosing TB. Aim: To assess the diagnostic accuracy of culture DST which is considered the gold standard. Materials and Methods: This cross-sectional observational study included 150 suspected EPTB patients and was conducted over a period of one year (September 2018 to August 2019) at Lokmanya Tilak Municipal Medical College and Sion Hospital (LTMMC), a tertiary care hospital in central Mumbai, Maharashtra, India. The hospital is located adjacent to Dharavi, the largest slum area with a high population density, which contributes to the majority of patients attending clinics. Patients attending the pulmonary medicine Outpatient Department (OPD) with extrapulmonary manifestations and suspected cases of EPTB were enrolled in the study. Samples, excluding sputum, were sent to the Department of Microbiology, LTMMC, Sion Hospital for GeneXpert analysis. The samples were further evaluated by microscopy, GeneXpert, and culture DST to detect the presence of Mycobacterium tuberculosis (M. tuberculosis) and drug susceptibility, respectively. Patients positive for Pulmonary Tuberculosis (PTB) were excluded from the study. Categorical variables were described using percentages. A Chi-square test was applied, and a p-value of &lt;0.05 was considered significant. All statistical analyses were performed using SPSS statistical software (IBM SPSS version 26.0, Armonk, N.Y.). Results: Out of the 150 extrapulmonary samples, 23 (15.33%) samples were culture positive for M. tuberculosis and were subjected to DST using the 1% proportion method and GeneXpert assay. The MDR isolates were tested using the firstline Line Probe Assay (LPA). Eleven (47.8%) showed resistance to first-line antitubercular drugs. Among the 12 new cases, only 2 (16.7%) showed resistance compared to 9 (81.8%) in previously treated cases. A discordance of 8.7% was observed between DST with GeneXpert and LPA. Additionally, a discordance of 8.7% was observed between DST and LPA for rifampicin resistance and 4.3% for isoniazid resistance. Conclusion: The paucibacillary nature of extrapulmonary samples contributes to the challenging diagnosis of EPTB cases, leading to increased drug resistance. Highlighting the importance of the conventional solid culture DST method, this study strongly recommends the use of conventional DST accompanied by LPA for extrapulmonary cases.

Metacognitive Awareness and Research Skills Among Senior High School Students

The Senior high school curriculum adepts research as a vital part of 21st-century skills, knowing that it is highly regarded as part of completing the chosen track. The metacognition of students might influence the research process and vice versa. Thus, this study aimed to identify the level of metacognitive awareness and research skills and the degree of relationship between these two variables. The study used a simple random technique with a proportional allocation method to have two hundred one (201) grade 12 STEM students from four clusters of senior high schools. The metacognitive awareness was measured using a 52-item adopted research instrument, and research skills were measured using a 38-item adopted research skills instrument. The data-gathering instruments were subjected to face and content validation by a panel of experts and reliability testing. The correlational research design was employed, and the statistical tools used in descriptive data analyses were average mean and composite mean. The Pearson r was used as an inferential statistical tool to determine the significant relationships among the levels of the variables of the study. Inferential tests were set at a 5% alpha level of significance. The study revealed a high level of metacognitive awareness and a high level of research skills among the respondents, and there is a strong positive significant relationship between the study variables.

Women&amp;apos;s knowledge, attitude, and practice toward menopause and hormone replacement therapy in Saudi Arabia

Background: Hormonal changes associated with menopause have been linked to a number of medical and psychological symptoms. This study aimed to assess women›s knowledge, attitudes, and practices toward menopause and hormone replacement therapy (HRT) in Saudi Arabia. Methods: In this cross-sectional study, participants were randomly selected using a proportional cluster sampling method in 2023. The target population in this study is women aged 18 years and older in Saudi Arabia. Data were collected via an online questionnaire. Results: This study included a total of 1,083 participants. The majority of them (75.6%) were between the ages of 18 and 34. Our study revealed that more than half of the study population had good knowledge about menopause (56.0%). However, more than half of them (56.1%) had a poor level of knowledge about the benefits and risks of HRT. The mean attitude score toward HRT was 2.24 ± 0.024. Moreover, mood swings were the most commonly recognized symptom of menopause, and social media was the most commonly reported source of information. Almost half of them identified the advantages of HRT. Furthermore, women who had divorced, widowed, or were students had significantly more knowledge about menopause. On the other hand, widowed women, those who achieved higher diplomas and elementary school, were significantly associated with a good level of knowledge toward the risks and benefits of HRT. Conclusion: Our study concluded that women in Saudi Arabia had sufficient knowledge and attitude toward menopause. However, they showed inadequate knowledge about the benefits and risks of HRT.

A comprehensive sustainable development framework; community capitals and village-cooperative initiative.

Considering the cooperative sector capabilities in organizing rural people, primarily focusing on empowering manpower and adopting a sustainable approach to basic resources (water and soil), village-cooperative initiative has emerged as a new concept by registering and forming 4565 new cooperatives in Iran's rural regions. The present research which was conducted in two qualitative and quantitative phases designed a new model by integrating the new village-cooperative approach along with the sustainable livelihood's framework theory. The study sample of the qualitative phase included 32 theorists of the village-cooperative initiative. To analyze the data, the grounded theory and three-step process of open coding, axial coding and selective coding were used using MAXqda18 software. Finally, a paradigm model was designed whose most important components included causal conditions (shocks and seasonal conditions), contextual conditions (trends and governmental support), intervening conditions (control and market development), central categories (sustainable livelihoods with a village- cooperative approach), strategies (coping and adaptation) and consequences (creating jobs, establishing cooperatives, supporting smart agriculture and strengthening social capital). The statistical quantitative phase population consisted of cooperatives members in the village-cooperative initiative (N=405), being selected through Cochran's formula with proportional sampling method summing up to198 people from 5 provinces. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed. The Bayesian structural equation modeling was used to analyze the data. The results of the research quantitative phase showed that the variables of financial capital, physical capital, social capital, coping and adaptation strategies, human capital and natural capital were the most effective variables on village-cooperative initiative members' sustainable livelihoods, respectively. Finally, a hybrid model based on the qualitative and quantitative studies was designed and suggestions were made; for instance, the creation of suitable grounds for off-farm activities such as rural industries and ecotourism.