Basic and comprehensive emergency obstetric care services in Pakistan remain a challenge considering continued high burden of maternal and newborn mortality. This study aimed to assess the ...availability of emergency obstetric and newborn care in Sindh Province of Pakistan.
This cross-sectional survey was conducted in twelve districts of the Sindh province in Pakistan. The districts were selected based on the maternal neonatal and child health indicators. Data were collected from 63 public-sector health facilities including district, Taluka (subdistrict) headquarters hospitals and rural health centers. Basic and comprehensive emergency obstetric newborn care services were assessed through direct observations and interviews with the heads of the health facilities by using a World Health Organization pretested and validated data collection tool. Participants interviewed in this study included the managers and auxiliary staff and in health facilities.
Availability of caesarean section (23, 95% C.I. 14.0-35.0) and blood transfusion services (57, 95% CI. 44.0-68.0), the two components of comprehensive emergency obstetric and newborn care, was poor in our study. However, assessment of the seven components of basic emergency obstetric and newborn services showed that 92% of the health facilities (95% C.I. 88.0-96.0) had parenteral antibiotics, 90%, (95% C.I. 80.0-95.0) had oxytocin, 92% (95% CI 88.0-96.0) had manual removal of the placenta service, 87% (95%, C.I. 76.0-93.0) of the facilities had staff who could remove retained products of conception, 82% (95% C.I. 71.0-89.0) had facilities for normal birth and 80% (95% C.I. 69.0-88.0) reported presence of neonatal resuscitation service.
Though the basic obstetric and newborn services were reasonably available, comprehensive obstetric and newborn services were not available as per the World Health Organization's standards in the surveyed public health facilities. Ensuring the availability of caesarean section and blood transfusion services within these facilities may improve population's access to these essential services around birth.
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Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Due to rapid growth in Virtual Reality (VR) technology, the industry of VR is expected to grow around 26.89 billion by 2022. However, with its extensive growth and immersive inclusion in human life, ...health-related issues are reported including, but not limited to nauseated feeling, vomiting, dizziness and cold sweats. These issues introduce a well-known side effect termed as motion sickness in VR users. Consequently, motion sickness limits the VR community in the full adaptation of this immersive technology. Since there is no lack of literature investigating motion sickness caused by VR, yet researches on the effect of VR on human's physiology is still in its infancy. This study presents novel findings, by comparing different factors such as gender, motion sickness experience, 3D games experience and VR experience. Furthermore, it reports the impact of concerning factors in a within-subjects design (46 participants participated in an experiment) under different virtual environment genres. The key findings of this article report that there is a significant difference in the amount of motion sickness when shifting from pleasant to the horror genre of the environment and having a strong dependence on gender. Moreover, the type of virtual environment is an essential factor that has a notable effect on the user's blood pressure, blood sugar and heart rate. However, past experiences with motion sickness and 3D games show no significant impact on the user's level of motion sickness.
This study proposed and evaluated a two-dimensional (2D) slice-based multi-view U-Net (MVU-Net) architecture for skull stripping. The proposed model fused all three TI-weighted brain magnetic ...resonance imaging (MRI) views, i.e., axial, coronal, and sagittal. This 2D method performed equally well as a three-dimensional (3D) model of skull stripping. while using fewer computational resources. The predictions of all three views were fused linearly, producing a final brain mask with better accuracy and efficiency. Meanwhile, two publicly available datasets—the Internet Brain Segmentation Repository (IBSR) and Neurofeedback Skull-stripped (NFBS) repository—were trained and tested. The MVU-Net, U-Net, and skip connection U-Net (SCU-Net) architectures were then compared. For the IBSR dataset, compared to U-Net and SC-UNet, the MVU-Net architecture attained better mean dice score coefficient (DSC), sensitivity, and specificity, at 0.9184, 0.9397, and 0.9908, respectively. Similarly, the MVU-Net architecture achieved better mean DSC, sensitivity, and specificity, at 0.9681, 0.9763, and 0.9954, respectively, than the U-Net and SC-UNet for the NFBS dataset.
Background: Human height estimation is critical in medicolegal cases. This anthropometric measurement not only reveals racial differences but also aids police investigation to narrow down. Foot size ...varies in different races and ethnic groups, because of genetic influence on development height. The present study aimed to explore the relationship between foot size and the height of a person in a particular context. The current research also compared log-based function and exponent-based function to explore which best fits the relation between age, foot size, and height. Methods: This cross-sectional study included foot measurements from 240 participants of 6 different age groups in the age range of 2-21 years. Foot length and height were recorded as per standard methods after obtaining ethical approval from the Institutional Review Board of COMSATs University Islamabad Pakistan and gaining consent from the study participants. Correlation and regression analyses were performed using SPSS V 23. In this study, two mathematical functions of log-based and exponent-based were compared to more accurately predict the behavior of two variables. The appropriateness of these candidate functions was evaluated using statistical parameters, including the Sum of Squared Errors (SSE), R2, adjusted R2, and Root Mean Square Error (RMSE). Results: The mean height of male participants of the age group of 3-5 years was higher than that of the female participants. Among 6-10-year-olds and 11-15-year-olds, female participants presented a greater height than males. In the age groups of 16-20 and ≥21 years, males were taller than females. The average foot size of males and females of all age groups was 22.09 cm and 20.44 cm, respectively. The exponent-based candidate functions best fitted the relationship between age, foot size, and height, compared to the log-based candidate function. Conclusion: Foot size indicated the highest correlation with height and minimum standard error in the estimation of stature. Therefore, foot size provided the highest reliability and accuracy in estimating height.
Advocates of software engineering and software project management stated in the literature that creeping of scope is one of the most common causes for the failure of software projects. Also, ...advocates believed that it could occur in almost every software project, which leads to compromise in quality, delayed schedules, increase cost and decreased customer satisfaction. However, the lack of empirical evidence demands a comprehensive investigation to identify the factors of scope creep and to propose a conceptual framework to empirically evaluate the impact of scope creep on software project success. To determine the scope creep factors in this study, two exploratory methods, i.e. a Systematic Literature Review (SLR) and interview from experts are performed. Following the analysis of these methods, a conceptual framework is proposed. To empirically evaluate the proposed conceptual framework, data is collected through a survey method. Next, the collected data is analyzed through Partial Least Squares' Structural Equation Modelling (PLS-SEM). From the results, it is evident that the identified factors of scope creep are negatively associated with software project success. The results of empirical evaluation also second the findings of SLR. The outcome of the study may help the practitioners to understand the dynamics of factors, which undermine scope creep in software SMEs and to assist them in the development of effective control and mitigation strategies, therefore, to increase the project success rate.
Mobile applications are getting a great deal of interest among researchers due to their proliferation and pervasiveness, especially in the context of digital libraries of educational institutes. ...However, their low acceptance and usage are observed, hence, in-depth investigations are required in order to understand the factors behind low acceptance and intention to use mobile library application (MLA). Therefore, the aim of this work is to empirically explore the acceptance of MLA with a proposed model that is evolved from the technology acceptance model (TAM). The study objects to deliver empirical provision on acceptance of MLA. A self-administrated cross-sectional survey-based study was conducted to gather data from 340 users of MLA. Structural equation model (SEM) with an analysis of moment structure (AMOS) software was conducted to examine quantitative data. Results revealed that perceived usefulness and perceived ease of use are direct significant predictors with the intention to use MLA whereas system quality and habit are the influencing factors toward the usage intention of MLA. The findings help as a guide for effective decision in the design and development of MLA. Further, the outcomes can be utilized in the resource allocation process for ensuring the success of the library's vision and mission.
•Study on initial acceptance of mobile library application for Pakistani context.•Model integrates external factors, habit and system quality in technology acceptance model.•Habit and system quality have strong indirect impact on behavioural intention toward mobile library application.•Perceived ease of use and perceived usefulness have strong mediating effect on mobile library application usage.•Over all, model shows the strong initial acceptance of mobile library application in Pakistan.
Organophosphates (OP) are a major agrochemical. The application of OP pesticides is expected to increase multifold in the coming decades. The etiology of diabetic diseases is attributed to multiple ...factors including OP pesticide exposure. The present study investigates pancreatic dysregulation with respect to exocrine enzymes and diabesity in groups of Pakistani and Cameroonian people exposed to a mixture of OP pesticides. Nine hundred and four OP exposed individuals were enrolled for this cross-sectional study after due consent and approval from an ethical review committee. Pesticides' residues were measured by GC-MS spectrometry. Cholinergic enzymes were measured by Elman's method. Serum glucose, insulin, serum amylase, lipase, and triglyceride were measured by spectrophotometry and ELISA; HOMA-IR was determined in OP exposed and non-exposed participants. Stata 15 and R 3.2.0 software were used for statistical analysis of the data. Malathion, chlorpyrifos, and parathion residues were evident in plasma samples. RBC-acetylcholinesterase was significantly depressed in OP exposed groups. In both population samples, investigated pancreatic functions were found to be statistically significantly more dysregulated than non-exposed. OP exposure indicated risk of diabetes and insulin, glycaemia, adiponectin, triglycerides, and TNF-α dysregulations. The study concludes that both OP exposed population groups exhibited a mixture of OP residues and pancreatic dysregulation, although the effect was more pronounced in the Cameroonian population. In addition, serum lipase has a positive correlation with OP exposure and diabetes and may be suggested as an alternate/additional diagnostic marker for diabesity under OP exposure. However, screening of other environmental co-factors with OP for pancreatic dysregulation is suggested.
Over the last few years, researchers have focused on computer‐aided polyp detection in gastroscopy. Deep learning (DL) has shown great promise for polyps' identification. The most exceptional ...contribution of DL methods in gastroenterology is their ability to identify polyps quickly and accurately using convolution neural network. Nonetheless, despite significant advancements, automatic detection of small polyps remains a challenging and complex task. Furthermore, due to multiple pooling operations, the features of small polyps are lost, resulting in low detection accuracy. This paper proposes an efficient object detection method for polyp detection using gastric images to address this issue. A single‐shot multi‐box detector (SSD) was combined with the feature extractor VGG‐16, and the Refined Map Block (RMB) was integrated into SSD's high‐resolution feature maps to get more semantic information. The RMB output was used as the input to the successive layers. The RMB comprises of attention cascade and feature map concatenation cascade. The attention cascade improved the localization accuracy, while the feature map concatenation cascade improved the classification accuracy. Using the former, the proposed attention‐based SSD for gastric polyps (ASSD‐GPNet) model focused on the specific information, a polyp, rather than the background. Furthermore, the feature map concatenation cascade adds semantic information while reducing computational complexity. The output of these two cascades was combined to produce a refined feature map that enhances the detection of small polyps. The model was trained and tested on 1970 gastric images and Pascal VOC07 + 12. Image augmentation was applied to increase the training data of gastric images to reduce overfitting and skip connections were used to overcome the vanishing gradient problem. Overall, the experimental results demonstrated that the proposed model outperformed than compared models in both medical and natural images. The ASSD‐GPNet obtained mean average precision (mAP) of 94.2% on gastric images and 76.9% on Pascal VOC.
Background. Valvular heart disease (VHD) is a major contributor to loss of physical function and longevity. Oxidative stress is one of the key causative factors involved in heart disease including ...VHD. Here, we aimed to illuminate the role and relation of oxidative stress to the VHD risk markers in the human population. Materials and Methods. 150 VHD patients and 103 healthy individuals as control were selected for the study and were divided into three groups: the aortic valve, mitral valve, and combined disease based on valvular calcification. Results. Our results demonstrated enhanced oxidative stress in the VHD condition, as we found elevated levels of reactive oxygen species (ROS) at the serum, supported by an increased level of thiobarbituric acid reactive substances (TBARs) in the cardiac valvular tissues of the VHD patients. In contrast, we experienced declined antioxidants including Super Oxide Dismutase (SOD), catalase (CAT), and peroxidase (POD) activities. Concurrently, increasing levels of C-reactive protein (CRP), high-sensitivity cardiac troponin I (hs-cTnI), and high-sensitivity cardiac troponin T (hs-cTnT) were detected in the aortic, mitral, and combined disease condition, suggesting a key association of oxidative stress to VHD conditions. Furthermore, regression analysis validated a key association between the impairment of the redox system (ROS and antioxidant enzyme activities) and VHD condition. Conclusion. Taken together, dysregulated oxidative stress contributes to the progression of VHD via positively correlating with CRP, hs-TnI, and hs-TnT level.
This paper develops the conceptual framework of barriers faced by the decision makers and management personnel of health sector. The main theme of this paper is to give a clear understanding about ...the adaption barriers of health technology faced by developing societies. The information about barriers would be useful for policy makers to decide about the particular technology. So that they can fulfill the defined mission of their organizations. Developing a conceptual framework is the first step in building organizational capacity. Information technology in health sector is spreading globally. Use of health information technology is offering evidence-based practice to endorse health and human prosperity. Globalization of health information system is inevitable for establishment and promotion of healthcare sector in developing societies. Present health systems in developing societies are inadequate to meet the needs of the population. Health sector of developing societies is facing a lot of barriers in establishment and promotion of health information system. These barriers include lack of infrastructure, cost, technical sophistications, lack of skilled human resources and lack of e- readiness of medical professionals. In this paper authors conducted a survey of hospitals in Pakistan to identify and categorized adaption barriers in health information technology. Existing health system should be transformed by using HIT to improve health status of population by eliminating barriers identified in this paper.
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