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Betensky, Rebecca A., and Dianne M. Finkelstein. "An extension of Kendall's coefficient of concordance to bivariate interval censored data." Statistics in Medicine 18, no. 22 (1999): 3101–9. http://dx.doi.org/10.1002/(sici)1097-0258(19991130)18:22<3101::aid-sim339>3.0.co;2-5.
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Nwafor, Stephen Chinedu, Happiness C. Okonkwo, and Blessing Ukamaka Onuigwe. "Enhancing Secondary School Students’ Achievement in Chemistry Using Collaborative Instructional Strategy." Journal of Digital Learning and Education 3, no. 3 (2023): 210–17. http://dx.doi.org/10.52562/jdle.v3i3.818.
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The study explores the impact of a collaborative instructional strategy (CIS) on students' academic achievement in the Aguata Education Zone of Anambra State, Nigeria. The study also delved into the potential effect of gender on students' achievement in chemistry. The pre-test, post-test non-equivalent control group design was utilized in this quasi-experimental study. There were 2,328 senior secondary two Chemistry students in the population. A sample size of 101 Chemistry students (43 males and 58 females) was selected using the purposive sampling technique from two intact classes at two co-educational schools. Using Kendall's Coefficient of Concordance (w), the Chemistry Achievement Test (CAT) reliability index was calculated to be 0.94. While ANCOVA was used to test the hypotheses at 0.05 level of significance, mean and standard were used to answer the research questions. The findings of the study showed that CIS enhances students’ achievement in chemistry more effectively than the conventional strategy. Also, gender has no significant influence on students’ achievement in chemistry. It was recommended among others that educational stakeholders should hold conferences and seminars to train the teachers on how to use CIS in teaching and learning chemistry. Moreover, CIS should be used to ensure and enhance gender equity in both chemistry learning and other school subjects.
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Zhou, Lin, Walter Timo de Vries, Alexandra Panman, Fei Gao, and Chenyu Fang. "Evaluating Collective Action for Effective Land Policy Reform in Developing Country Contexts: The Construction and Validation of Dimensions and Indicators." Land 12, no. 7 (2023): 1401. http://dx.doi.org/10.3390/land12071401.
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Although land reform can be motivated by different policy objectives, it always involves the participation of many actors. Insights from New Institutional Economics suggest that individual interests that are not aligned with collective interests tend to undermine the goals of reform. This study provides a viable framework and measures for social capital, trust, and cooperation performance and their interrelationships to compensate for the existing separate analysis of these three factors and their rare application in achieving goals of collective action. We also build a strong and deepening theoretical foundation for the indicator design, providing a rich representation of social capital, trust, and cooperation performance. After being presented with variables, indicators are used to further elaborate on the variables to enhance the richness and science of the indicator design. The validation results of indicators from 12 experts and 223 respondents are to yield an average reliable coefficient as a positive sign of reliability and validity of the evaluation process with Kendall’s Co-efficient of Concordance (W) through R programming. This study emphasizes the importance of collective action for sustainable land use and effective land policy reform, a topic that remains underrepresented in most land reform analyses.
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G R, Dr Lokesh, Harish K S, and Dr Geethanjali G. "A Study on Benefits, Challenges and Factors Impressing Customer Relationship Management (CRM) W.R.T. Private Commercial Banks at Bengaluru." Journal of Corporate Finance Management and Banking System, no. 33 (April 1, 2023): 1–13. http://dx.doi.org/10.55529/jcfmbs.33.1.13.
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Purpose: The main end of the present paper is to know whether the socio-economic characteristics impress on the CRM and to know the benefits of CRM, factors driving CRM, and challenges faced by the private commercial banks at the time of implementation of CRM. The presence of severe competition where the competitive struggle to claim a larger share and to attract major amount of customers, forces the banking companies to install CRM strategies and to fetch better results. It has been felt as a process aimed at collecting customer data, find profile of customers and use the knowledge of the customers in a particular marketing activities (Anu Putney et al. 2013) CRM is the strongest and most efficient approach in maintaining and treating close relationship with customers (Angumuthu, 2015). CRM is a management approach that seeks to create, develop and widen relationship with customers in order to derive maximum customer value, profits and shareholders value (Mallika Srinivastava, 2012). Approach: A designed questionnaire was steered as schedule in order to avoid any unexpected delay, incompleteness and non-response. Respondents were approached while they are in the bank premises either before or after their bank work, in a natural setting. A total of 217 questionnaires were in the hand and out of 217, only 200 were usable one and the remaining discarded forming 92% success rate. Chi-square, contingency co-efficient, Kendall’s co-efficient concordance weighted average, Garrett ranking technique was performed to analyse and present the data. Findings: The study revealed about the presence of favourable socio-economic characteristics revealing a significant and high relationship between the characteristics and CRM except bank at different branches which showed less significant and low degree and benefits include protection of data privacy, enhanced productivity and boosted sales. Further, the study also reveals about the factors like advanced technology, customer centric approach and safety factors driving CRM in private commercial banks. The challenges faced at the time of implementation of CRM includes choosing the right CRM, data security and time and cost of implementation of software.
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Panday, Seema, Harsha Kathard, Mershen Pillay, and Cyril Govender. "The Development of a Zulu Speech Reception Threshold Test for Zulu First Language Speakers in KwaZulu-Natal." South African Journal of Communication Disorders 54, no. 1 (2007): 111–23. http://dx.doi.org/10.4102/sajcd.v54i1.761.
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The measurement of speech reception threshold (SRT) is best evaluated in an individual’s first language. The present study focused on the development of a Zulu SRT word list, according to adapted criteria for SRT in Zulu. The aim of this paper is to present the process involved in the development of the Zulu word list. In acquiring the data to realize this aim, 131 common bisyllabic Zulu words were identified by two Zulu speaking language interpreters and two tertiary level educators. Eighty two percent of these words were described as bisyllabic verbs. Thereafter using a three point Likert scale, 58 bisyllabic verbs were rated by 5 linguistic experts as being familiar, phonetically dissimilar and being low tone verbs. According to the Kendall’s co-efficient of concordance at 95% level of confidence the agreement among the raters was good for each criterion. The results highlighted the importance of adapting the criteria for SRT to suit the structure of the language. An important research implication emerging from the study is the theoretical guidelines proposed for the development of SRT material in other African Languages. Furthermore, the importance of using speech material appropriate to the language has also being highlighted. The developed SRT word list in Zulu is applicable to the adult Zulu First Language Speaker in KZN.
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Syriopoulos, K., X. L. Velders, G. C. Sanderink, and P. F. van Der Stelt. "Sensitometric and clinical evaluation of a new F-speed dental X-ray film." Dentomaxillofacial Radiology 30, no. 1 (2001): 40–44. http://dx.doi.org/10.1038/sj/dmfr/4600575.
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OBJECTIVE To compare the sensitometric properties, diagnostic efficacy and image quality of the InSight (F-speed) and Ektaspeed Plus (E-speed) dental X-ray films (Kodak Eastman Co, Rochester, USA). METHODS Characteristic curves were constructed, using manual and automatic processing, in order to compare film speed and average gradient. The diagnostic yield was compared by assessment of endodontic file length. Endodontic files, sizes 10 and 15, were placed at the root apex or 1.5 mm short. The exposure time for the InSight films was 20% lower than that of Ektaspeed Plus. Seven dentists rated the position of file tip using a 5-point confidence scale. ROC data were analysed by means of analysis of variance. The null hypothesis was rejected when P&lt;0.05. In order to compare the image quality, 100 pairs of bitewing radiographs of the left (using Ektaspeed Plus) and the right sides (using InSight) of the same patient were made. Four dentists viewed the radiographs and the data were analysed using Kendall's coefficient of concordance. RESULTS InSight was faster than Ektaspeed Plus. It was an E-speed film when processed in manual conditions and an F-speed film when processed automatically. The films had comparable average gradient. No significant difference was found in the diagnostic yield using the two films (P=0.648). Two observers showed a significant preference for Ektaspeed Plus. CONCLUSIONS The first results of the new InSight film are promising: the exposure time can be reduced by 20% in comparison with Ektaspeed Plus at no detriment to diagnostic efficacy.
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Osuizugbo, Innocent Chigozie, and Raphael Abiodun Ojelabi. "Building production management practice in the construction industry in Nigeria." Engineering Management in Production and Services 12, no. 2 (2020): 56–73. http://dx.doi.org/10.2478/emj-2020-0011.
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AbstractGrowing demands for building projects result from economic development. The building industry is dynamic and multifaceted. Efficient and effective practice of building production management (BPM) is required to successfully execute projects and achieve project goals upon completion as well as functionality aims for the lifespan of a building. This research aims to determine factors that influence the BPM practice in the Nigerian construction industry, particularly; during the project execution phase. A cross-sectional survey used; a questionnaire to identify 73 factors, which were grouped into 12 categories and assessed. A purposive sampling technique was used to identify 20 construction organisations specialising in building production management in Lagos, Nigeria. 114 questionnaires were distributed to the pool of stakeholders, which included 31 clients, 34 consultants and 49 contractors of current and past building production projects carried out by the selected firms in Lagos. The research used a selection of statistical tools for SPSS v.23, including the chi-square test, the Kruskal-Wallis test and Kendall's coefficient of concordance. The obtained result revealed the factors that mostly influence the BPM practice namely, architectural drawings, the construction programme document, the work breakdown structure, the adequacy of communication and coordination between the parties, the adequacy of raw materials and equipment, the availability of the competent team, the implementation of the safety management system, regular maintenance of project equipment, clear and timely inspections, the availability of funds as planned throughout the project duration, the availability of skilled personnel, and the aesthetics of the completed work. The research resulted in the development of the BPM implementation framework and recommendations for the improvement of the BPM practice in Nigeria.
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K.A., Okorocha, Emeribe S.C., and Ubani E.C. "Analysis of Factors Influencing Time and Cost Overruns on Construction Projects in South Eastern Nigeria." International Journal of Management Sciences and Business Research 2, no. 02 (2013): 73–84. https://doi.org/10.5281/zenodo.4916314.
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<em>This study identifies and examines the factors influencing time and cost overruns on construction project in the south eastern Nigeria. The high level of dilapidation and deterioration of roads and other construction infrastructural facilities seen in this zone could be attributed to abysmal performance of construction project management. Survey technique with area and random sampling procedures were employed for the study. The primary data were obtained with the instrument of weighted scaled questionnaires the respondents to the questionnaire are clients, contractors and consultants from five states of south eastern Nigeria. A total of 110 and 42 hypothetical cost and time overruns respectively were identify for analysis. The methods of data analysis were spearman’s rank correlation coefficient and Kendall’s coefficient of concordance with the hypothesis tested at 5% level of significant so as to determine the degree of agreement amongst the parties. The results of this study have shown that the three parties to a project are in agreement that materials factor and external factor groups have indeed contributed immensely to delays on construction projects, while projects, contractor’s responsibilities, consultant’s responsibilities, client’s responsibilities, professional management, design and documentation, execution, labour and equipment, contractual relationship, government relations, time overruns; cost overrun and all together (time and cost overruns) factors have not greatly influenced delays on construction projects. Based on these results it is recommended that client’s, contractor’s and consultant’s should pay more attention to both material and external factors for there to be effective and efficient delivery on construction projects at the right time and cost. </em>
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Dinda Puspitaa, Ellida Novita Lidya, Firdasari, and M Irvanni bahri. "ANALYSIS OF SUCCESSFUL FACTORS IN THE HALAL TOURISM FACILITIES DEVELOPMENT PROJECT." IHTIYATH : Jurnal Manajemen Keuangan Syariah 6, no. 2 (2022): 204–24. http://dx.doi.org/10.32505/ihtiyath.v6i2.5187.
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ANALYSIS OF SUCCESSFUL FACTORS IN THE HALAL TOURISM FACILITIES DEVELOPMENT PROJECT Abstract Purpose: This research investigates factors contributing to the success of Halal tourism facility development projects, focusing on three key projects in Langsa City. The study aims to identify project success factors and assess the role of project management in influencing construction project success. Design/methodology/approach: Utilizing a non-probability sampling questionnaire survey with purposive sampling, data were collected from contractors, consultants, technical supervisors, officials involved in decision-making, and staff in youth, sports, and city tourism infrastructure. The analysis employed the SPSS program, employing Kendall's Concordance Analysis method. Findings: The research identified ten influential factors for the success of tourism facility development projects in Langsa City. These include the emphasis on high-quality construction, effective communication systems, cost considerations, efficient construction direction, a focus on faster implementation, rule-setting abilities, project manager experience, scheduling, on-site management, and contractor experience. Project management was found to significantly impact project success, accounting for 65.08% of all factors. Research limitations/implications: While the study provides valuable insights, potential limitations include external economic factors not considered in the analysis. Future research may explore additional variables for a more comprehensive understanding. Practical implications: The study recommends that attention be given to the identified factors, emphasizing quality construction, effective communication, cost control, and experienced project management to enhance the success of tourism facility development projects in Langsa City. Keywords: Planning Management, Tourism Facilities, Tourism, Construction Projects, Halal Tourism. ANALISIS FAKTOR-FAKTOR YANG BERHASIL DALAM PROYEK PENGEMBANGAN FASILITAS PARIWISATA HALAL Abstrak Tujuan: Penelitian ini menyelidiki faktor-faktor yang berkontribusi terhadap keberhasilan proyek pengembangan fasilitas pariwisata Halal, dengan fokus pada tiga proyek utama di Kota Langsa. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor keberhasilan proyek dan menilai peran manajemen proyek dalam mempengaruhi keberhasilan proyek konstruksi. Desain / metodologi / pendekatan: Memanfaatkan survei kuesioner pengambilan sampel non-probabilitas dengan purposive sampling, data dikumpulkan dari kontraktor, konsultan, pengawas teknis, pejabat yang terlibat dalam pengambilan keputusan, dan staf di pemuda, olahraga, dan infrastruktur pariwisata kota. Analisis ini menggunakan program SPSS, menggunakan metode Analisis Konkordansi Kendall. Temuan: Penelitian ini mengidentifikasi sepuluh faktor berpengaruh bagi keberhasilan proyek pengembangan fasilitas pariwisata di Kota Langsa. Ini termasuk penekanan pada konstruksi berkualitas tinggi, sistem komunikasi yang efektif, pertimbangan biaya, arah konstruksi yang efisien, fokus pada implementasi yang lebih cepat, kemampuan menetapkan aturan, pengalaman manajer proyek, penjadwalan, manajemen di tempat, dan pengalaman kontraktor. Manajemen proyek ditemukan secara signifikan mempengaruhi keberhasilan proyek, terhitung 65,08% dari semua faktor. Keterbatasan / implikasi penelitian: Sementara penelitian ini memberikan wawasan yang berharga, keterbatasan potensial termasuk faktor ekonomi eksternal yang tidak dipertimbangkan dalam analisis. Penelitian di masa depan dapat mengeksplorasi variabel tambahan untuk pemahaman yang lebih komprehensif. Implikasi praktis: Studi ini merekomendasikan agar perhatian diberikan pada faktor-faktor yang diidentifikasi, menekankan konstruksi berkualitas, komunikasi yang efektif, pengendalian biaya, dan manajemen proyek yang berpengalaman untuk meningkatkan keberhasilan proyek pengembangan fasilitas pariwisata di Kota Langsa. Kata kunci: Manajemen Perencanaan, Fasilitas Pariwisata, Pariwisata, Proyek Konstruksi, Pariwisata Halal.
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P. Chellasamy and S. Kannamudaiyar. "Measuring the Consistency of Liquidity and its Financial Health: A Study on Tribal Co-operative Marketing Development Federation of India." Jurnal Multidisiplin Madani 4, no. 3 (2024): 361–65. http://dx.doi.org/10.55927/mudima.v4i3.4187.
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The present study of the paper aims to show the consistency of the liquidity and its effects on the financial health of Tribal Co-operative Marketing Development Federation of India (TRIFED). The objective of the study is to examine the extent of association between the variables and to show the consistency of the liquidity position of the TRIFED. For examining the significance of the value of W, Chi-square (χ2) and Altman’s Z-score has been used to check the organization monetary position. The result of the analysis concludes that Kendall’s coefficient of concordance (W) among the given six ratios are found to be statistically significant at the 5 % level. In addition, one sample t-test portray a remarkable difference in the Altman’s Z-score of Tribal Co-operative Marketing Development Federation of India (TRIFED) during the study period. The study leads to significant conclusion based on the study’s result
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Jaganathan, B., and Kalyani Desikan. "Enhanced Web Page Ranking Method Using Laplacian Centrality." International Journal of Engineering & Technology 7, no. 4.10 (2018): 566. http://dx.doi.org/10.14419/ijet.v7i4.10.21282.
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In today's era of computer technology where users want not only the most relevant data but they also want the data as quickly as possible. Hence, ranking web pages becomes a crucial task. The purpose of this research is to find a centrality measure that can be used in place of original page rank. In this article concept of Laplacian centrality measure for directed web graph has been introduced to identify the web page ranks. Comparison between the original page rank and Laplacian centrality based Page rank has been made. Kendall's correlation co-efficient has been used as a measure to find the correlation between the original page rank and Laplacian centrality measure based page rank.
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Egharevba, Jolly Osaretin, and Festus Amasikomwan Atewe. "Insecurity and the Coping Strategies of Residents in Benin Metropolis, Nigeria." Ghana Journal of Geography 16, no. 3 (2024): 108–19. http://dx.doi.org/10.4314/gjg.v16i3.11.
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This paper examines urban insecurity and the coping strategies of residents in the Benin metropolis. The main objective of the research is to determine insecurity challenges and coping strategies of residents in the Benin metropolitan area. The research adopted the survey method. A total of 384 copies of the questionnaire were administered to the residents in the study area. However, only 367 valid copies of the questionnaire were returned. The results of the analysis revealed that armed robbery was the most common crime incident in the study area with Kendall’s Coefficient of Concordance value of 0.84 and a mean ranking of 1.16. The results further showed that Ikpoba-Okha Local Government Area (LGA) had the highest proportion of armed robbery cases (33.66%), car snatching (34.69%), and rape (38.6%) with a total crime incident of 106.95% (n=138) while Egor LGA had the highest proportion of burglary cases (37.97%). The study further revealed that the perception of respondents to crime incidents was high with a mean value of 4.04. Majority of the respondents (with Kendall’s Coefficient Concordance value of 0.66 (66%) and a mean ranking of 1.56) were of the view that the government should empower local vigilantes to combat crime in the area. The paper concluded with the recommendation that police patrol of the various neighbourhoods in the study area should be intensified and there should be an efficient channel of information gathering with utmost confidentiality between the informants and the respective agencies that are responsible for combating crime.
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Asamoah, Richard Oduro, John Solomon Ankrah, Kofi Offei-Nyako, and Ernest Osei Tutu. "Cost Analysis of Precast and Cast-in-Place Concrete Construction for Selected Public Buildings in Ghana." Journal of Construction Engineering 2016 (October 26, 2016): 1–10. http://dx.doi.org/10.1155/2016/8785129.
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The construction industry in Ghana is becoming efficient in the area of cost and achieving advance technologies. The effective management of cost enables clients, developers, and facilitators to achieve value for money. Concrete is a major component in every construction project. The use of precast concrete technology has been embraced by the construction industry in Ghana. This study seeks to analyze cost estimating of the structural frame (column and slab) by considering cast-in-place and precast concrete slabs and columns, respectively. Relative importance and Kendall’s concordance agreement were used to determine the rankings and agreement of advantages of using precast concrete. The study established that precast concrete slabs were on average 23.22% cheaper than the cast-in-place concrete elements and precast columns were averagely 21.4% less than cast-in-place concrete columns. The study established that professionals prefer the use of precast concrete products because of the life cycle cost.
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Abdullahi, Taiye Ibrahim, Jamiu Kayode Sakariyau, Kayode Rasheed Ajibade, and Sulaiman AbdulKarim AbdulHafeez. "EXAMINATION OF CO-OPERATORS' SATISFACTION WITH STRATEGIES OF HOUSING FINANCE OF COOPERATIVE SOCIETIES IN TERTIARY INSTITUTIONS IN KWARA STATE." GEO-STUDIES FORUM 9, no. 2 (2024): 69–83. https://doi.org/10.5281/zenodo.13373105.
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Housing issues have persisted particularly for the nation’s public servants. Staffs of tertiaryinstitution have embraced the evolution of informal institution cooperative as a way of fulfilling theiraspiration of being home owners. This study examined the level of co-operators satisfaction withstrategies of housing finance of cooperative societies in Al-Hikmah University and Kwara StateUniversity. The study employed a quantitative and qualitative survey. The total number of co-operatorsat Al-Hikmah Cooperative Societies and Kwara State University Cooperatives Societies was 119. 119copies of questionnaire were therefore distributed and 92 were recovered and used for data analysis.Data were acquired using a selective sample strategy known as purposive sampling. The 92 copies ofquestionnaire retrieved were analyzed using Cooperator’s Satisfaction index (Mean, StandardDeviation), Range of Dissatisfaction Index (RDI), T-test and Kendall coefficient of concordance. Thestudy revealed that the cooperators level of satisfaction in Al-Hikmah cooperative societies has a meanof 4.56, 3.44 and 3.44. While in Al-Halal cooperative societies collateral, availability and interest ratewas ranked 1st, 2nd and 3rd with a mean of 4.55 and 4.24, 3.88 respectively. There was no statisticallysignificance difference in Cooperator’s level of satisfaction on the strategies of housing finance. Thestudy concluded that cooperative societies have helped staff in various housing intervention but there isthe need to further strengthen some weak areas of intervention. The National Housing Policy of Nigeriashould be reviewed by incorporating cooperative societies into the policy for a combined effect.
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Osei-Kyei, Robert, Albert P. C. Chan, Yu Yao, and Khwaja Mateen Mazher. "Conflict prevention measures for public–private partnerships in developing countries." Journal of Financial Management of Property and Construction 24, no. 1 (2019): 39–57. http://dx.doi.org/10.1108/jfmpc-06-2018-0032.
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Purpose Conflict between project parties is among the major risk factors in public–private partnership (PPP) in developing countries that has, in extreme cases, led to the failure or distress of many PPP projects. This paper aims to explore conflict prevention measures for PPPs in developing countries using Ghana as a case study. Design/methodology/approach From a comprehensive review of literature, a list of conflict prevention measures was derived; further, a questionnaire survey was conducted with PPP experts from Ghana. Kendall’s coefficient of concordance test, range normalization method and factor analysis were used for data analysis. Findings Results show four significant conflict prevention measures for PPPs in developing countries, they include extensive stakeholder consultation in decision makings, clear goals and mutual benefit objectives, clarity of roles and responsibilities of parties and transparent appeal procedures. Using the factor analysis technique, the prevention measures are grouped into three unrelated categories, they are efficient communication structure and risk assessments, transparency and openness and proficient service delivery. Originality/value The research findings inform policymakers and local practitioners of the strategic measures and procedures needed to minimize the occurrence of conflicts in PPPs in developing countries.
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Huang, Zhiyong, Ziyan Luo, and Naihua Xiu. "High-Dimensional Least-Squares with Perfect Positive Correlation." Asia-Pacific Journal of Operational Research 36, no. 04 (2019): 1950016. http://dx.doi.org/10.1142/s0217595919500167.
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The least-squares is a common and important method in linear regression. However, it often leads to overfitting phenomenon as dealing with high-dimensional problems, and various regularization schemes regarding prior information for specific problems are studied to make up such a deficiency. In the sense of Kendall’s [Formula: see text] from the community of nonparametric analysis, we establish a new model wherein the ordinary least-squares is equipped with perfect positive correlation constraint, sought to maintain the concordance of the rankings of the observations and the systematic components. By sorting the observations into an ascending order, we reduce the perfect positive correlation constraint into a linear inequality system. The resulting linearly constrained least-squares problem together with its dual problem is shown to be solvable. In particular, we introduce a mild assumption on the observations and the measurement matrix which rules out the zero vector from the optimal solution set. This indicates that our proposed model is statistically meaningful. To handle large-scale instances, we propose an efficient alternating direction method of multipliers (ADMM) to solve the proposed model from the dual perspective. The effectiveness of our model compared to ordinary least-squares is evaluated in terms of rank correlation coefficient between outputs and the systematic components, and the efficiency of our dual algorithm is demonstrated with the comparison to three efficient solvers via CVX in terms of computation time, solution accuracy and rank correlation coefficient.
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Idigo, F. U., N. I. K. Chijioke, A. C. Anakwue, U. B. Nwogu, and B. U. Maduka. "Assessment of Scheduling Method,Appointment Delay, and No-show Rate in the Ultrasound Unit of a Nigerian Teaching Hospital." Journal of Health Management 25, no. 2 (2023): 201–7. http://dx.doi.org/10.1177/09720634231177347.
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Increasing incidence of no-shows has been identified as a major challenge to planning of appointment schedules which imparts negatively on revenue generation and system efficiency. This cross-sectional study analysed the scheduling method in use, appointment delay time, appointment compliance rate and no-show rate of patients in the ultrasound unit of a Nigerian tertiary hospital, using observation, patient records and questionnaires. Information obtained were: The time interval between clinician request and examination appointment schedule, patient load distribution, scheduling method, number of patients scheduled and number that kept to appointment scheduling, and as well staff opinion on reasons for patients’ length of stay for ultrasound investigations. The results showed that the single-block scheduling method was used and patients’ arrival was highest between 7:12 and 9:00 hours with decreasing rate as the day progresses. The time interval between request and appointment was 12–14 days. Appointment compliance rate was observed to be 5.5, while no show rate was 4.5. Poor state of ultrasound machines was observed to be the highest contributing factor to patient delays with Kendall’s coefficient of concordance 0.466. The findings of this work can be utilized in efficient planning of public hospital ultrasound units to enhance patient access.
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Benerji, Therissa, Sarath Bodepudi, Gayathri Devi Cherukuri, Madhavi Kodali, and Krishna Mohan Parvathaneni. "Diagnostic concordance in consultation liaison psychiatry – Referring physicians to psychiatrists." IP Indian Journal of Neurosciences 9, no. 4 (2023): 214–20. http://dx.doi.org/10.18231/j.ijn.2023.042.
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Psychiatric co-morbidity in patients with physical illness is known to influence the course and outcome of both conditions. Consultation liaison psychiatry [CLP] can be regarded as an essential service between psychiatry and other medical specialties. Efficient communication between different levels of care is known to have an impact on the quality of health care. To study the patterns of referrals to the department of psychiatry and diagnostic concordance between referring physicians to CL-Psychiatrist.The present study was a cross-sectional study conducted in the Department of Psychiatry of a tertiary care hospital. All the patients referred to the Psychiatry department for 4 months were taken after excluding referrals sent for disability assessment. Socio-demographic details, source of referral, reason for referral, and the psychiatric diagnosis by both the referring doctor and CL-psychiatrist were recorded. Statistical analysis was done using SPSS 25.0 software and kappa value was used to estimate the diagnostic concordance.In the sample of 100 referrals studied, the mean age of the sample was 40.96±13.42 years. The majority of the cases referred were inpatients (61%), from the department of general medicine and allied branches (85%), (General medicine -55, Neurology- 21). The most common diagnosis was alcohol dependence syndrome 24 (24%), followed by depression (18%) and phobic anxiety (18%).The concordance of the diagnosis between the referral and the psychiatry team was in perfect agreement (κ=0.81- 1.00) for paranoid schizophrenia, bipolar affective disorder, delirium, dissociative disorder, delusional disorder, and alcohol dependence syndrome. Very low concordance was observed in diagnosing obsessive-compulsive disorder (k=0) and adjustment disorder (k=0).The overall diagnostic concordance was poor for adjustment disorder, OCD, and vascular dementia, and good for paranoid schizophrenia, delirium, dissociative disorder, delusional disorder, and BPAD.
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Anusha, V. V. S. S., S. R. Patel, and Ganga Devi. "FROM CONSTRAINT TO OPPORTUNITY: STRATEGIES FOR EFFECTIVE AGRICULTURE CREDIT MANAGEMENT." Gujarat Journal of Extension Education 38, no. 1 (2024): 78–84. https://doi.org/10.56572/gjoee.2024.38.1.0014.
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Agriculture as a business activity is at a juncture where it has to pivot to either high-end technology-oriented or natural/organic farming. For this, understanding the credit scenario is imperative to boost economic activity. An Ex-post facto was formulated to elucidate farmers’ constraints in credit availing, utilization, and repayment, obtain suggestions, and formulate strategies. In Gujarat state, two districts were conveniently selected from which four blocks and four villages from each, making a sample size of 230. With pre-tested, well-structured interview schedule response was obtained for which statistical analysis as frequency, percentage, and Kendall’s coefficient of concordance (W) were put to use, and results were tabulated. Market price fluctuations (Mean score 176.67), low farm profitability (164.00), and inaccessibility of credit information (133.33) were ranked as the top three constraints. The study revealed a moderate agreement (W= 0.291) among farmers regarding these constraints, emphasizing the need for tailored solutions. Farmers’ suggestions, such as lowering interest rates (52.17%), increasing loan amounts (42.61%), and offering loans in both cash and kind (31.30%), reflect their desire for more flexible and accessible credit options. Establishing agriculture credit counselling services within banks, promoting sustainable agricultural practices, like Zero Budget Natural Farming, Leveraging fintech solutions, and revitalizing Primary Agriculture Credit Societies (PACS) would make the agricultural credit system more inclusive and efficient, transforming constraints into opportunities for India’s farmers.
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Chowdhury, AHM Yeaseen, Nazrul Islam, and Md Zahedul Alam. "Impediments of Supply Chain Management Application in Readymade Garments Industry of Bangladesh." Journal of Business and Social Sciences Research 4, no. 1 (2019): 1–12. http://dx.doi.org/10.3126/jbssr.v4i1.28989.
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There is a paramount importance of the Readymade Garments (RMG) industry of Bangladesh as it is the highest contributor in earning foreign exchange for the country. But the industry is facing stiff competition from other RMG producing countries including China, India, and Sri Lanka of the world. Hence, competitiveness especially at the manufacturing level became important for this industry. An efficient Supply Chain Management can increase the competitiveness and the satisfaction of the customers. Nowadays, SCM plays an integral part of a firm’s success as it allows firms to quickly deliver products to the end-user for a low cost. Hence, RMG companies have very limited options other than implementing SCM as a strategy in order to remain competitive. This study intends to identify the impediments in applying sound SCM in the RMG industry. A mixed research method with a questionnaire survey has been employed for determining the impediments objectively. Use of descriptive analysis and Kendall Coefficient of Concordance have been made for ranking the challenges. This study found workplace safety, unavailability of raw materials and political instability are the major impediments for SCM applications in the RMG industry of Bangladesh.
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Espeleta, Rina Marie. "Utilization of Standard Electronic Payment System among Private Higher Education Institutions in the Province of Albay." JPAIR Multidisciplinary Research 50, no. 1 (2022): 140–58. http://dx.doi.org/10.7719/jpair.v50i1.571.
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Electronic Payment Systems, the transfer of funds through electronic or digital mediums. Several electronic payment options are available, including mobile wallets, bank cards, and mobile banking. Electronic payments are quick and efficient, and the fund transfer occurs instantly. Electronic payments are quickly gaining popularity in the Philippines, giving students a secure and practical means to pay for enrolment fees and other educational costs as schools adopt alternative learning techniques. The purpose of this research is to determine the status of electronic payment in the selected Private Higher Education Institutions (PHEIs) in the second district of Albay and propose a systematic model that HEIs can adopt to lessen the costs and risks of handling cash transactions. The study used a mixed method, the qualitative and quantitative research design, to analyze and hence boost the validity of the data. According to the data presented, the GCASH application is one of the most used applications when paying online. It is more accessible and less hassle to use. Furthermore, using the Kendall Coefficient of Concordance, the perception of the selected private HEIs has shown a significant correlation to each other, resulting in a rare use based on the data analysis. The selected private institutions currently take electronic payments. Still, they have not yet thought about giving students and parents the most control over those payments online, and schools are still adapting electronic payment systems.
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Osei-Kyei, Robert, and Albert P. C. Chan. "Perceptions of stakeholders on the critical success factors for operational management of public-private partnership projects." Facilities 35, no. 1/2 (2017): 21–38. http://dx.doi.org/10.1108/f-10-2015-0072.
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Purpose This paper aims to explore the perceptual differences on the factors that contribute to the successful management of public-private partnership (PPP) projects at the operational stage among stakeholders. Design/methodology/approach An international questionnaire survey was conducted with purposively sampled PPP experts from the private, public and academic sectors. Survey responses were analyzed using Kendall’s coefficient of concordance (W), mean score ranking analysis, Kruskal–Wallis test and Mann–Whitney U test. Findings The research findings show that each stakeholder group considers an efficient and well-structured payment mechanism as the most important operational management critical success factor (CSF). Moreover, the public sector considers open and constant communication among stakeholders as the second most important CSF, whereas the private and academic sectors consider effective operational risk management and well-structured legal dispute resolution mechanism, respectively. Further analysis using non-parametric tests (i.e. Kruskal–Wallis and Mann–Whitney U statistics) reveal significant differences in the importance of three operational management CSFs – “open and constant communication among stakeholders”, “effective changes of shareholdings in private consortium” and “stable macroeconomic indicators”. Research limitations/implications The generalizability of the research findings is limited considering the low sample size and non-participation of users/general public in the study. Hence, it is recommended that future research should be conducted in a specific country using both face-to-face and email questionnaire distribution approaches. This would likely increase the response rate and facilitate the inclusion of the general public/users. Originality/value The results of this study highlight and provide significant insights into how different PPP stakeholders perceive the critical conditions that are required to ensure the operational efficiency of PPP projects. This would, therefore, enable a better cooperation and collective effort from all stakeholders towards achieving the overall project success. In addition, the study offers new and additional CSFs which would enhance the comprehensiveness of the existing list of CSFs for the general implementation of PPP projects.
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Aghabayk, Kayvan, Sina Rejali, Seyed Alireza Samerei, and Nirajan Shiwakoti. "Evaluating Safety Issues for Taxi Transport Management." Journal of Advanced Transportation 2021 (February 26, 2021): 1–14. http://dx.doi.org/10.1155/2021/6638640.
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Taxi drivers face many problems every day including safety issues. The tendency to quickly transport passengers to their destinations for more income has resulted in dangerous driving behaviors leading to traffic violations. So, taxi drivers need appropriate support and training programs to improve safety and reduce the risk of crashes. Implementing different support and safety training programs requires an effective management system. There is a dearth of research on the safety issues of taxis from the perspective of taxi organization managers. This study aims to evaluate the safety issues of taxi transport management through a case study of the Tehran Taxi Organization. A questionnaire survey was conducted with 22 regional managers and 20 transportation specialists of the Tehran Taxi Organization. Issues related to taxi drivers, roads and road users, vehicles, and management systems were evaluated in the questionnaire. Participants determined the relevance level and priority ranking of each question. The level of agreement was then tested using the Kendall concordance test. According to the results, the use of GPS was selected as the best in-vehicle monitoring system that can be used to evaluate drivers in the fleet. Participants believed that passengers’ loading and unloading had the most risk for taxi users. The start-inhibit technology to detect open doors was unanimously evaluated as an efficient technology for taxi safety. With respect to educating taxi users, starting education in schools had the most relevance and priority. Recommendations for increasing the safety of taxis include the use of GPS in taxis to monitor and evaluate drivers, receiving crash reports from police and submitting monthly safety assessment reports, flexibility in drivers’ working hours’ schedule, providing training on drivers fatigue management, and evaluating drivers’ health.
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Bojanov, Glenn, Carla Garcia-Sanz, and Jose M. Palomo. "Colloidal Protein–Silver Nanoparticle Metalloenzyme as Artificial Redox Biocatalyst." Catalysts 15, no. 1 (2025): 61. https://doi.org/10.3390/catal15010061.
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Efficient and sustainable catalytic processes are crucial for advancing green chemical manufacturing. Here, we describe the synthesis of novel silver artificial metalloenzymes in colloidal form in aqueous media and room temperature. The strategy is based on the in situ generation of silver nanoparticles by a genetically modified Geobacillus thermocatenulatus lipase (GTL) in the active site as an inducer and scaffold protein, producing an enzyme–Ag bioconjugate. Using a structural analysis of the formation of silver nanoparticles by XRD and UV spectra, we found the formation of Ag2O species with nanoparticles of around 11 nm average diameter size. Gel filtration chromatography demonstrated the presence of single protein molecules in the bioconjugates, although silver nanoparticles were initially formed by cysteine coordination in the active site but later were formed in other parts of the protein (five AgNPs per molecules, which is in concordance with the UV size). The enzyme structure was altered after nanoparticle formation and Ag-S interaction, which was observed in fluorescence analysis. This new enzyme showed reductive activity against p-nitrophenol to p-amino and a high conversion > 99% in the reduction of acetophenone to phenylethanol, although the enantioselective was quite moderate but higher in water that in the presence of co-solvents. Finally, oxidase-like activity was evaluated in the direct oxidation of phenylethanol to acetophenone in water, obtained at around a 23% yield of ketone after 60 h.
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Arup, Kr Saha, Saha Arpita, and Paul Ashis. "Study on Regional Disparities in the level of Socio-economic Development of Kochbihar District, West Bengal." RESEARCH REVIEW International Journal of Multidisciplinary 03, no. 10 (2018): 53–60. https://doi.org/10.5281/zenodo.1455721.
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Regional disparity has remained a subject of interest for many regional economist and geographers. Regional disparity and economic development of a country are inter-linked and can be classified into geographical, social and economic inequality (Yu & Wei.2003).In the present paper attempt has been made to find out the spatial variation in the level of socio-economic development of kochbihar district of North eastern West Bengal. We use thirty components to determine the spatial variation socio-economic development. This thirty component broadly categorized into three groups or indicators namely Social indicators, Economic indicators, Demographic indicators. The analysis of regional disparity shows that disparity are present in different sector like social development, Economic development, Human resource development. In case of over-all development there is also existence of disparity. Effective economic and social policies should be adapted which helps to eliminate the issue of regional disparity and develop the lagging areas.
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Bozza, Nicola, Nicola Guindani, Giuseppe Pezzotta, Ferrari Alberto, and Claudio C. Castelli. "15-year follow-up of MoM 36-mm THA: clinical, laboratory, and radiological (CT and MRI) prospective assessment." HIP International 30, no. 2_suppl (2020): 42–51. http://dx.doi.org/10.1177/1120700020971662.
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Introduction: There is limited knowledge of the long-term results of metal-on-metal total hip arthroplasty (MoM THA), particularly concerning adverse local tissue reaction (ALTR), Co/Cr ions level and revision rate. Even if MoM bearing surfaces are no longer used, long-term data could help in defining the course and best management for these patients. The purpose of this study is to investigate the clinical outcomes, describe radiological findings including CT metal artefact reduction algorithm for orthopaedic implants (O-MAR) and MRI multi acquisition variable resonance image combination (MAVRIC) in 36-mm MoM THA. Methods: In this long-term prospective study, 46 consecutive patients with primary MoM THA (mono- or bilateral) were enrolled between 2004 and 2005. Pinnacle acetabular cup, Summit cementless stem with 36-mm metal head and Ultamet CoCr alloy liner (Depuy Inc.) were implanted, in the same centre by the same senior surgeon. Patients were reviewed at 5-, 10- and 15-years, including Co/Cr levels and standard radiographs at every follow-up, whilst the 15-year follow-up included hip sonography, MRI MAVRIC and CT O-MAR. Results: At 15 years, the overall survival rate of the implants (both stems and cups) was 83% (30/36). Revisions were performed in 9% (4/46) because of ALTR, 2% (1/46) septic loosening and 2% periprosthetic fracture. Both Cr and Co concentration increased over time, even though remaining at low level risk at 15 years: Co from 0.11 (+/– 0.18) to 4.29 (+/– 3.26) and Cr from 0.38 (+/– 0.32) to 1.37 (+/– 1.15). Functional scores in non-revised patients showed good to excellent results in more than 90%. Engh-score correlated with time from surgery ( p = 0.017) and with sonographic, CT and RM findings ( p < 0.05). Concordance has been found between CT and MRI findings (sign-rank test, p = 0.241; Intraclass Correlation Coefficients 0.987); however, no specific MRI or CT lesion patterns could be recognised among symptomatic and non-symptomatic patients. Discussion: The long-term rate of ALTR after 36-mm MoM THA was comparable with previous studies; a regular follow-up for those implants is mandatory. During follow-up Co-Cr levels increased over time and radiography was a suitable screening technique; the Engh score in particular, proved to be a reliable assessment tool. CT O-MAR and MRI with MAVRIC protocols may add valuable data in clinical practice, although MRI is significantly more efficient than CT in the identification of ALTR lesions, peri-articular effusion and in the evaluation of soft tissues.
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Song, Yuanbin, Ashley Taylor, Anthony Rongvaux, et al. "Efficient Engraftment and Disease Replication of Myelodysplastic Syndromes Using a Novel Humanized Mice Model." Blood 126, no. 23 (2015): 4100. http://dx.doi.org/10.1182/blood.v126.23.4100.4100.
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Abstract Myelodysplastic Syndromes (MDS) are a heterogeneous disorder of the hematopoietic stem cell caused by a large number of genetic and epigenetic alterations. With the development of novel therapeutics a reliable model to test the drugs' efficacy in correlation with genetic and epigenetic alterations and disease phenotype is essential. Recent advances in the field of MDS xenotransplantation have been achieved by transgenic expression of human cytokines in the murine host as well as by co-transplantation of primary patient derived mesenchymal stromal cells (MSCs) concurrent with MDS stem cells. However, neither model to date affords efficient transplantation of MDS at a scale that allows in vivo mechanistic studies or provides a platform to develop and test novel therapeutics. We sought to establish a MDS xenotransplantation model in humanized immunodeficient mice amenable to mechanistic in vivo studies and therapeutic testing. Several murine cytokines essential for hematopoiesis are non-crossreactive with their human counterpart. "MISTRG" mice express several human, non-crossreactive cytokines, namely M -CSF, I L-3, GM-CSF, and T hrombopoietin from the respective murine loci, as well as human macrophage receptor signal regulatory protein-alpha (S IRPα) to prevent murine macrophage-mediated immune rejection in the Rag2-/- IL2rγ-/- background (Rongvaux et al. Nature Biotech 32(4): 364 - 372, 2014). To establish a reliable, efficient MDS xenotransplantation model we optimized the host irradiation dose, transplantation route, CD34+ cell number and cell preparation. Mice were allowed to engraft for >10 weeks. Peripheral blood (PB), bone marrow (BM), and spleen were analyzed for engraftment by flow cytometry. BM, spleen, and liver were also fixed and sectioned for histologic analysis. Human CD45+ cells were sorted from engrafted MISTRG bone marrow and genomic testing was performed by cytogenetics, FISH, and/or targeted exome sequencing. MISTRG mice consistently supported higher engraftment in peripheral blood and bone marrow than NSG mice for the majority of MDS samples assessed. Out of 25 different patient's BM samples, including 6 RCMD, 5 RAEB I, 12 RAEB II, and 2 CMML patient samples, 23 samples engrafted in MISTRG mice, while 19 of the samples were transplanted concurrently into NSG mice (6 RCMD, 3 RAEB I, and 11 RAEB II patient samples) out of which 12 samples engrafted. Mice were classified as engrafted when huCD45+ cells accounted for over 1% of all nucleated cells in BM. On average, huCD45 engraftment was 7.3-fold higher in MISTRG than in NSG mice (17.78% vs. 2.45%). 56.1% of all MISTRG mice compared with 26.7% of NSG mice transplanted with MDS were engrafted. The number of engrafted MISTRG mice per sample ranged from 2-10 mice could be further improved with optimal bone marrow sample collection. We verified engraftment of the MDS clone via cytogenetics, FISH, and/or targeted exome sequencing, also revealing preserved clonal distribution and mutant allele frequencies in engrafted mice. Flow cytometric analysis of lineage differentiation revealed robust myeloid engraftment in MISTRG mice as opposed to NSG mice. In addition terminal differentiation of myeloid cells was markedly improved in MISTRG over NSG mice, with immunophenotypic concordance between engrafted MISTRG mice and the patient's primary bone marrow. Histologic analysis showed striking similarities between engrafted MISTRG bone marrow and the concurrent patient's bone marrow, such as marked dysplasia and clustering of human CD61 positive megakarocytes with resultant myelofibrosis as evident by reticulin staining. MISTRG mice lack the DNA repair defect inherent to NSG mice and are thus tolerant of chemotherapeutic agents. Studies testing hypomethylating drugs and targeted agents are now underway to establish MISTRG as promising "co-clinical" model for MDS. In conclusion, physiologic expression of essential non-crossreactive human cytokines greatly facilitates long-term engraftment of MDS patient derived CD34+ HSPCs in the murine immunodeficient host. MISTRG mice engraft lower and higher grade MDS with replication of the disease genotypes and phenotypes, supporting higher engraftment in bone marrow and blood than NSG mice for all MDS samples assessed. MISTRG mice may provide a xenotransplantation model for MDS allowing us to study the biology of the disease and to test therapeutics in vivo. Disclosures No relevant conflicts of interest to declare.
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Martens, Anne W. J., Susanne R. Janssen, Ingrid A. M. Derks, et al. "CD3xCD19 Dart Treatment Is Efficient in Venetoclax Resistant CLL and Reverses T Cell Dysfunction." Blood 134, Supplement_1 (2019): 3043. http://dx.doi.org/10.1182/blood-2019-123350.
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Intro - Agents targeting the apoptosis pathway, like the Bcl-2 inhibitor venetoclax, are highly effective in chronic lymphocytic leukemia (CLL). However, not all patients experience deep responses and acquired resistance has already been described. T cell mediated lysis is another tool currently exploited in hematologic malignancies. In contrast to acute lymphoblastic leukemia (ALL) however, efficacy of autologous based T cell therapy, such as CAR T cells, in CLL has been low. This is linked to a CLL mediated acquired T cell dysfunction. Bispecific T cell engagers targeting CD19 are successfully applied in ALL, but whether it overcomes the acquired T cell dysfunction in CLL is unknown. We therefore tested efficacy of a CD3xCD19 Dual Affinity Re-Targeting molecule (DART) in CLL. Since it has been observed that bispecific antibodies can overcome deficient synapse formation in CLL (Robinson et al, 2018) and based on our assumption that T cell mediated lysis differs from venetoclax-mediated killing, we hypothesized that usage of a CD3xCD19 DART in CLL overcomes T cell dysfunction and will be effective against venetoclax resistant CLL. Methods - Co-culture of CLL derived or aged-matched healthy donor (HD) CD4+ and/or CD8+ T cells with (CD40 activated) primary CLL or CD19+ cell lines JeKo-1 or Ramos in presence of CD3xCD19 (JNJ-64052781), CD3xFITC, anti-CD3/28 antibodies was performed. R esults - JeKo-1 cells were highly sensitive to CD3xCD19 mediated HD T cell killing with close to 70% of lysis in a concentration of 10ng/mL using an E:T ratio of 4:1. In the same conditions, primary CLL cells proved sensitive for CD3xCD19 mediated HD T cell killing with 50% of lysis. Killing was observed irrespective of IGHV mutation or chemorefractory status. We next compared HD with CLL-derived T cells by measuring activation levels between direct TCR (anti-CD3/CD28) and CD3xCD19 stimulation. As described, TCR stimulation resulted in impaired CLL CD4+ and CD8+ T cell activation and proliferation when compared to HD. In contrast, treatment of CLL derived PBMCs with CD3xCD19 did not resulted in dysfunctional CLL-derived T cell responses (Fig 1A-C). Consistently, co-culture of CLL derived CD4+, CD8+ or a combination with either JeKo-1 or allogeneic CLL cells in the presence of CD3xCD19 resulted in significant cytotoxicity (Fig. 1D). In the allogeneic setting, cytotoxic capacity of CD4+ T cells was similar to their CD8+ counterparts. When targeting autologous CLL, a benefit was observed when both CD4+ and CD8+ T cells were present (Fig. 1D). We then studied whether venetoclax resistant CLL cells could be targeted by CD3xCD19 mediated T cell killing. Bcl-2 overexpressing Ramos were equally lysed in presence of the CD3xCD19 DART as their wildtype counterpart, indicating that Bcl-2 expression does not inhibit CD3xCD19 mediated cell death. Following CLL cell stimulation by CD40 ligation, anti-apoptotic Bcl-XL, Bfl-1 and Mcl-1 are highly induced (Thijssen et al., 2015) resulting in venetoclax resistance (Fig 1E). Nevertheless, CD40L stimulated CLL cells were as efficiently lysed upon CD3xCD19 treatment as unstimulated CLL. (Fig 1F). This indicates that an augmented apoptotic threshold does not impact efficacy of CD3xCD19. Further examination of the mechanism of CD3xCD19 mediated killing showed that lysis depended on granzymes, as blocking granule exocytosis prevented cell death. Independence of the mitochondrial apoptotic pathway was shown by equal sensitivity to CD3xCD19 mediated T cell lysis comparing BAX/BAK knockout Jeko-1 cells to the parental cell line. Also, caspase blockage did not inhibit cell death, pointing to apoptosis independent killing. In concordance, PARP cleavage could only be detected when caspase activity was not blocked. Conclusion - This is the first report describing reversal of CLL mediated T cell dysfunction by applying a CD3xCD19 DART. Furthermore, it shows that venetoclax resistant CLL can still be efficiently targeted by T cells, in a non-apoptotic fashion. These results imply that T cell mediated therapy could be used alongside venetoclax. Figure 1 Disclosures Eldering: Celgene: Research Funding; Roche: Research Funding; Janssen Pharmaceutical Companies: Research Funding. van der Windt:Genmab: Employment. Kater:Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Acerta: Membership on an entity's Board of Directors or advisory committees, Research Funding; Roche/Genentech: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Research Funding.
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Pfisterer, Wolfgang K., Stephen Papadopoulos, Denise A. Drumm, Kris Smith, and Mark C. Preul. "Fiducial Versus Nonfiducial Neuronavigation Registration Assessment and Considerations of Accuracy." Operative Neurosurgery 62, suppl_1 (2008): ONS201—ONS208. http://dx.doi.org/10.1227/01.neu.0000317394.14303.99.
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Abstract Objective: For frameless stereotaxy, users can choose between anatomic landmarks (ALs) or surface fiducial markers (FMs) for their match points during registration to define an alignment of the head in the physical and radiographic image space. In this study, we sought to determine the concordance among a point-merged FM registration, a point-merged AL registration, and a combined point-merged anatomic/surface-merged (SM) registration, i.e., to determine the accuracy of registration techniques with and without FMs by examining the extent of agreement between the system-generated predicted value and physical measured values. Methods: We examined 30 volunteers treated with gamma knife surgery. The frameless stereotactic image-guidance system called the StealthStation (Medtronic Surgical Navigation Technologies, Louisville, CO) was used. Nine FMs were placed on the patient's head and four were placed on a Leksell frame rod-box, which acted as a rigid set to determine the difference in error. For each registration form, we recorded the generated measurement (GM) and the physical measurement (PM) to each of the four checkpoint FMs. Bland and Altman plot difference analyses were used to compare measurement techniques. Correlations and descriptive analyses were completed. Results: The mean of values for GMs were 1.14 mm for FM, 2.3 mm for AL, and 0.96 mm for SM registrations. The mean errors of the checkpoints were 3.49 mm for FM, 3.96 mm for AL, and 3.33 mm for SM registrations. The correlation between GMs and PMs indicated a linear relationship for all three methods. AL registration demonstrated the greatest mean difference, followed by FM registration; SM registration had the smallest difference between GMs and PMs. Differences in the anatomic registration methods, including SM registration, compared with FM registration were within a mean ± 1.96 (standard deviation) according to the Bland and Altman analysis. Conclusion: For our sample of 30 patients, all three registration methods provided comparable distances to the target tissue for surgical procedures. Users may safely choose anatomic registration as a less costly and more time-efficient registration method for frameless stereotaxy.
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Marin, Nicoleta Mirela, Anton Ficai, Lucian Alexandru Constantin, Ludmila Motelica, and Roxana Trusca. "New Chelate Resins Prepared with Direct Red 23 for Cd2+, Ni2+, Cu2+ and Pb2+ Removal." Polymers 14, no. 24 (2022): 5523. http://dx.doi.org/10.3390/polym14245523.
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In this paper, two chelate resins prepared by a simple procedure were used for the removal of Cd2+, Ni2+, Cu2+, and Pb2+ (M2+) from aqueous solutions. Amberlite IRA 402 strongly basic anion exchange resin in Cl− form (IRA 402 (Cl−) together with Amberlite XAD7HP acrylic ester co-polymer (XAD7HP) were functionalized with chelating agent Direct red 23 (DR 23). The chelate resins (IRA 402-DR 23 and XAD7HP-DR 23) were obtained in batch mode. The influence of interaction time, pH and the initial concentration of DR 23 solution was investigated using UV-Vis spectrometry. The time necessary to reach equilibrium was 90 min for both resins. A negligible effect of adsorption capacity (Qe) was obtained when the DR 23 solution was adjusted at a pH of 2 and 7.9. The Qe of the XAD7HP resin (27 mg DR 23/g) is greater than for IRA 402 (Cl−) (21 mg DR 23/g). The efficiency of chelating resins was checked via M2+ removal determined by the atomic adsorption spectrometry method (AAS). The M2+ removal by the IRA 402-DR 23 and XAD7HP-DR 23 showed that the latter is more efficient for this propose. As a consequence, for divalent ions, the chelated resins followed the selectivity sequence: Cd2+ > Cu2+ > Ni2+ > Pb2+. Additionally, Cd2+, Cu2+ and Ni2+ removal was fitted very well with the Freundlich model in terms of height correlation coefficient (R2), while Pb2+ was best fitted with Langmuir model for IRA 402-DR 23, the Cu2+ removal is described by the Langmuir model, and Cd2+, Ni2+ and Pb2+ removal was found to be in concordance with the Freundlich model for XAD7HP-DR 23. The M2+ elution from the chelate resins was carried out using 2 M HCl. The greater M2+ recovery from chelating resins mass confirmed their sustainability. The chelate resins used before and after M2+ removal by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) analysis were evaluated.
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Rawstron, Andy, Claudia Fazi, Neus Villamor, et al. "A Complementary Role of High Throughput Sequencing and Multiparameter Cytometry for Minimal Residual Disease (MRD) Detection in Chronic Lymphocytic Leukemia (CLL):an European Research Initiative (ERIC) Study." Blood 124, no. 21 (2014): 1976. http://dx.doi.org/10.1182/blood.v124.21.1976.1976.
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Abstract BACKGROUND. The detection of minimal residual disease (MRD) at the level of 0.01%/10-4 or above is a strong independent predictor of reduced progression-free (PFS) and overall survival (OS) in patients with CLL treated with chemoimmunotherapy. Although newer agents such as B-cell receptor pathway inhibitors can result in prolonged survival without achieving complete response, there remains a important role for MRD analysis in assessing therapeutic strategies aimed at disease eradication and cure. This is particularly important in front-line trials for fit patients which now require at least five years of follow-up if PFS is used as an endpoint. The feasibility of using MRD as a surrogate or intermediate endpoint for accelerated approval of new treatments is under review by regulatory agencies but further prospective validation is required. At the same time technology is rapidly evolving and high-throughput sequencing (HTS) technologies now detect MRD at the 0.0001%/10-6 level. It is therefore important to determine the most effective approaches for quantifying MRD that are compatible with previous studies but sufficiently sensitive for current treatments. AIMS. This collaborative project had two objectives. First, to identify the simplest and most flexible flow cytometry panel capable of detecting MRD at the 0.01%/10-4 or lower, that is compatible with published data and independent of instrument/reagent manufacturer. Second, to compare the flow cytometry approach with HTS analysis using the ClonoSEQ assay (Adaptive Biotechnologies, Seattle, WA). METHODS AND RESULTS. A core panel of antibodies for MRD detection was identified by testing an 8-marker combination in 52 samples (27 post-treatment and 25 dilution study) and re-analysing data with serial exclusion of single markers to determine redundancy. A 1-tube core panel of CD19, CD20, CD5, CD43, CD79b, and CD81 was identified and validated against the previously published 2-tube 6-marker and 4-tube 4-marker ERIC panels in 76 samples (19 post-treatment and 57 dilution study). The results showed good concordance (for log-transformed data above the LoQ, linearity=0.977, Pearson correlation co-efficient=0.983, average difference=0.026 log, 95% limit of agreement 0.20log) and a limit of detection of 0.001%/10-5 for the 1-tube core panel. Inter-operator variation was similar to CML MRD monitoring with both experienced operators, or inexperienced cytometrists after ~1 hour of specific education, achieving a 95% limit of agreement less than 0.3log in samples with MRD levels ranging from 0.0001 – 100%. The flow cytometry approach was compared with the ClonoSEQ HTS assay in 109 samples (21 dilution study and 88 post-treatment samples, complete data currently available on 13/88). The assay was applicable to the vast majority CLL patients, often with two clonal markers. There was 94% concordance at the 0.01% (10-4) threshold (15 samples with ≥0.01% CLL by both methods, 14 samples with <0.01% by both methods, 1 sample with 0.03% CLL by HTS and <0.003% CLL by flow cytometry, and 1 sample with 0.005% CLL by HTS and 0.012% by flow cytometry. HTS detected CLL IGH sequences in 22% (7/31) samples with no detectable CLL cells by flow cytometry (i.e. CLL level 0.0001-0.001%, 3/13 patient samples and 4/18 dilution samples). HTS demonstrated a relatively high variability in quantification, as seen in previous studies, but with a clear superiority in the limit of detection and good linearity (linearity=0.905, Pearson correlation co-efficient=0.870, average difference=0.078 log, 95% limit of agreement 1.5 log). CONCLUSIONS. The 1-tube 6-marker flow cytometry core panel is compatible with published studies, manufacturer-independent and flexible, providing directly quantitative results to 0.001%/10-5 without requiring a pre-treatment sample. HTS requires further work to standardise the quantitative analysis and prospective validation but the ClonoSEQ assay is applicable to >95% of CLL patients, does not require viable cells and is extremely sensitive, detecting residual disease in a significant proportion of cases with <0.01% CLL. The results indicate that flow cytometry and HTS are complementary technologies with a combined approach offering the most reliable way of quantifying CLL at the 0.01%/10-4 threshold while allowing higher sensitivity in clinical trials aimed at disease eradication. Disclosures Rawstron: Roche: Honoraria; Biogen Idec: Consultancy; Gilead: Consultancy, Honoraria; Abbvie: Honoraria; BD Biosciences: Intrasure reagent Patents & Royalties; Celgene: Honoraria; GSK: Honoraria. Williamson:Adaptive Biotechnologies: Employment, Equity Ownership. Sanders:Adaptive Biotechnologies: Employment, Equity Ownership. Robins:Adaptive Biotechnologies: Consultancy, Equity Ownership, Patents & Royalties. Hallek:Celgene: Honoraria, Research Funding; Mundipharma: Honoraria, Research Funding; Roche: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; GSK: Honoraria; Gilead: Honoraria. Hillmen:Roche: Honoraria, Research Funding; GSK: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Pharmacyclics: Honoraria, Research Funding; Gilead: Honoraria, Research Funding.
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van der Zouwen, Boris, Alwine B. Kruisselbrink, Peter A. Von Dem Borne, Roelof Willemze, J. H. Frederik Falkenburg, and Inge Jedema. "Potent Alloreactive Effector T Cells Cause Limited Damage to Non-Hematopoietic Tissues Under Non-Inflammatory Conditions, Despite Proper Expression of the Relevant Target Antigens." Blood 114, no. 22 (2009): 2454. http://dx.doi.org/10.1182/blood.v114.22.2454.2454.
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Abstract Abstract 2454 Poster Board II-431 Donor T cells specific for minor histocompatibility antigens (mHags) contribute to graft-versus-leukemia (GvL) reactivity and graft versus host disease (GvHD) following HLA-matched stem cell transplantation. Hematopoiesis-restricted mHags may give rise to a more specific GvL effect without GvHD, whereas ubiquitously expressed mHags can be targets for both GvHD and GvL. Interestingly, high frequencies of circulating T cells specific for ubiquitously expressed mHags (e.g. male-specific epitopes, LB-ADIR-1F) have been detected in patients showing strong GvL with no or limited GvHD. Although both hematopoietic and non-hematopoietic cells express the proteins encoding these mHags, the immune effector response in these patients appears to be skewed towards hematopoietic cells. Therefore, we hypothesized that non-hematopoietic tissues are relatively unsusceptible to the cytotoxic effect of these mHag-specific T cells. To test this hypothesis, we developed an in vitro system in which HLA-A2+, ADIR+ primary human fibroblasts were exposed to mHag LB-ADIR-1F or allo-A2 specific CD8+ T cells. ADIR+ EBV-LCL were used as a control for hematopoietic cells. CTL-mediated cytotoxicity was measured using 4, 8 and 20 hours chromium release assays. Whereas all EBV-LCL were killed within 4 hours, 10% lysis of fibroblasts was found after 4 hours, only gradually increasing to 70% lysis after 20 hours in the continuous presence of the CTLs at 10/1 effector/target (E/T) ratios. To analyze whether this inefficient killing was due to low antigen expression by the human primary fibroblasts, we examined cytotoxicity against targets loaded with increasing concentrations of ADIR-peptide. Exogenous loading of fibroblasts with saturating concentrations (10-6M) of ADIR-peptide did not increase the sensitivity to T cell mediated cell death. To exclude that the observed inferior cell killing was due to the number of T cells available for engaging the fibroblasts, E/T ratios were increased to >100/1, but this did not change the poor susceptibility of the fibroblasts to CTL-mediated killing. Since apparently inefficient elimination of non-hematopoietic targets was found despite proper expression of the relevant antigen and the presence of functional T cells, we investigated whether insufficient engagement of T cells during contact with the fibroblasts was the cause of the impaired killing. To analyze this, kinetics of T cell degranulation upon target encounter was measured by CD107a, perforin and granzyme B expression. Although the onset of T cell activation was already seen after 2 hours, stimulation with fibroblasts resulted in degranulation in only a proportion of the T cells (50-60%) after 4hrs, resulting in full activation only after prolonged co-culture. In contrast, stimulation with EBV-LCL resulted in rapid, complete, and profound degranulation (100% of T cells within 2hrs). In concordance with this, T cell activation, as measured by the production of interferon gamma (IFNg) after stimulation with the fibroblasts, was suboptimal as compared to stimulation with EBV-LCL. These data suggest formation of an initial low avidity interaction with fibroblasts under steady state conditions, possibly only leading to efficient T cell engagement and fibroblast killing after a prolonged period of co-culture, resulting in the formation of a local pro-inflammatory environment. To confirm whether susceptibility to mHag-specific T cells was increased under pro-inflammatory conditions, we pre-treated fibroblasts with IFNg. Analysis of the expression of a panel of known adhesion and co-stimulatory molecules revealed that IFNg treatment resulted in a 2-5 fold upregulation of expression of HLA class I, HLA class II and ICAM-1, leading to a more uniform and profound T cell activation. This increased T cell activation resulted in more efficient direct fibroblast killing. In conclusion, despite proper expression of the relevant target antigens, low-avidity interaction between effector T cells and non-hematopoietic tissues results in minimal damage under non-inflammatory conditions. Disclosures: No relevant conflicts of interest to declare.
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Young, Betty Hai Ka, Isaac Chak Yan Kwok, Chih-Wei Tsai, et al. "0449 Pilot Study: AI-Enhanced COMISA Diagnosis in Hong Kong Public Hospitals Using Objective Sleep and HRV Metrics." SLEEP 47, Supplement_1 (2024): A193. http://dx.doi.org/10.1093/sleep/zsae067.0449.
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Abstract Introduction The underdiagnosed and high overlapping prevalence of comorbid insomnia and obstructive sleep apnea (COMISA) often suffer worst cardiovascular outcomes than patients with either OSA or Insomnia. The scarcity of multi-disciplinary clinics addressing both conditions may impede timely COMISA diagnosis and treatment efficacy. This study explored the feasibility of leveraging objective sleep and HRV metrics through Belun Ring (BR), the AI-powered wearable, to facilitate COMISA diagnosis and personalized treatment. Methods Consecutive suspected OSA or Insomnia cases were co-screened by clinical psychologist and pulmonologist. Participants were categorized into the OSA group if PSG-AHI ≥ 15 events/h, insomnia if Insomnia Severity Index (ISI) ≥ 15 or diagnosed based on the International Classification of Sleep Disorders, third edition (ICSD-3), or COMISA if meeting both conditions. All subjects completed a 3-night (≥ 100 mins/night) sleep assessment using the BR. Kruskal-Wallis tests and PCA analyses were conducted for comparative analyses among the three groups. Results Among 54 subjects, 31 had insomnia, 13 had OSA, and 10 had COMISA. Marked discrepancies between subjective and AI-generated sleep statistics (concordance rate= 0.07) COMISA exhibited the highest wake after sleep onset (median, mins) compared to insomnia and OSA (76.5 vs. 48.1 vs. 21.2, P&lt; 0.001). COMISA and insomnia had upregulated wakefulness (median, count) compared to OSA (14.9 vs. 15.2 vs. 8.3, P&lt; 0.05). Moreover, COMISA exhibited the lowest SDNN (median, ms) and RMSSD (median, ms) compared to insomnia and OSA (SDNN: 49.0 vs. 63.8 vs. 92.9, P&lt; 0.01; RMSSD: 44.9 vs. 53.8 vs. 79.8, P&lt; 0.01). COMISA had dropped PRR50 (median, %) compared to OSA (6.6 vs. 24.8, P&lt; 0.05). Normalized LF and LF/HF did not differ across the three groups. The novel workflow reduced waiting time for consultation from 104 to 45 weeks. Conclusion This is the first study to demonstrate the use of AI-assisted sleep and HRV parameters to single-out COMISA for better personalized treatment and efficient workflow. The worst cardiovascular outcomes in COMISA patients were objectively reflected by the lowest SDNN and RMSSD findings. This novel study elucidated the potential how AI can assist to identify COMISA patients even in monodisciplinary settings for better patient care. Support (if any)
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Silvanus, V., PP Kafle, A. Pokhrel, B. K. Baral, and BR Pokhrel. "Evaluation of Fasting Capillary Glucose and Fasting Plasma Glucose as Screening Tests for Diabetes and Prediabetes among Adults in a Semi-Urban Area in the Kathmandu District, Nepal." Nepal Medical College Journal 21, no. 4 (2019): 265–75. http://dx.doi.org/10.3126/nmcj.v21i4.27615.
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The natural history of type 2 diabetes includes a preceding period of impaired fasting glucose or impaired glucose tolerance which is referred to as prediabetes. During the asymptomatic phase of prediabetes, an estimated 20-30% of persons may develop complications like retinopathy, cardiovascular disease, neuropathy and nephropathy. Screening and lifestyle management may help to delay or arrest progression to diabetes. In primary care settings, point of care devices that measure glucose in capillary blood can be used for diagnosis of diabetes. This study was carried out to evaluate the performance of fasting capillary glucose (FCG) and fasting plasma glucose (FPG) measurement in screening for diabetes and prediabetes among adults in a semi-urban community in the Kathmandu district of Nepal. An observational, cross-sectional study design was used and FCG, FPG performance was evaluated by the 2-hour plasma glucose levels (2-hr PG) following Oral glucose tolerance test (75g glucose) using WHO 1998 criteria. Linear regression was performed to assess correlation co-efficient (r) between FPG, FCG and 2 hr PG. Bland Altman plot and Receiver operator characteristic (ROC) curves were constructed to assess concordance, measure ROC AUC and determine sensitivity and specificity of the measurements at recommended cut-off values for identifying diabetes and prediabetes. Among the study participants (n=162), 104 were female and 58 were male. Prevalence of undiagnosed diabetes and prediabetes was 4.32% (95% CI 1.75% to 8.70%) and 7.14% (95% CI 3.89% to 12.58%). Strong positive correlation was seen between FPG and FCG (Spearman’s r 0.67). FPG & FCG had a moderate positive correlation (r = 0.49 & 0.45) with 2 hr PG levels (p<0.0001). FCG and FPG ROC AUC was 0.91 (95% CI 0.85 to 0.97) and 0.87 (95% CI 0.78 to 0.97) in comparison to 0.98 (95% CI 0.97 to 1.0) for the gold standard 2 hr PG. At 110 mg/dl and above, FCG had an optimal sensitivity and specificity of 84.21% and 81.12% in comparison to 47.37% and 100% for FPG. At 100 mg/dl, the sensitivity and specificity of FCG was 100% and 51.75% in comparison to 57.89% and 97.20% for FPG. In conclusion, at each recommended cut-off value, FCG was more sensitive than FPG with no significant difference between ROC AUCs of the two tests. Hence, FCG may be a suitable, sensitive, and convenient screening tool for diabetes and prediabetes in community-based settings. Larger prospective studies may validate the cost-effectiveness and efficiency of similar screening strategies in the Nepalese community.
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Islam, Md Ashraful, Sabrina Lomax, Amanda K. Doughty, Mohammed R. Islam, and Cameron E. F. Clark. "Automated Monitoring of Panting for Feedlot Cattle: Sensor System Accuracy and Individual Variability." Animals 10, no. 9 (2020): 1518. http://dx.doi.org/10.3390/ani10091518.
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Heat stress causes significant economic losses by reducing the productivity and welfare of cattle whilst requiring a significant investment in resource for amelioration. Panting score (PS) is considered a robust indicator of cattle heat stress; however, individualised visual monitoring is impractical. Thermal index-based monitoring and mitigation decisions are applied at the herd level, but they have limited application for the individual animal. As such, an automated system to monitor the real-time animal response to heat stress is required for strategic mitigation. Our objectives were to validate an accelerometer-based ear tag sensor to monitor cattle panting and to determine individual variability in heat stress responses with reference to thermal indices. Two experiments were conducted: Experiment 1 validated the sensors, and Experiment 2 determined individual variability comparing sensor data against thermal indices. Ear tag sensors were fitted at feedlot entry to continuously monitor the behaviour of 100 steers of mixed breed in Experiment 1 and 200 steers and heifers of mixed breed in Experiment 2. Sensor-derived ‘heavy breathing’ was validated against visually observed PS. Sensor-derived behaviour bouts were analysed as ‘raw’, and single behaviour states were also converted to the preceding bout of ≥2 min, which was referred to as ‘fill’ data for the validation study. Our results demonstrate the sensors’ ability to accurately monitor panting in feedlot cattle. Sensor-recorded ‘heavy breathing’ duration per animal was highly correlated to observed panting duration for both raw (r = 0.89) and fill (r = 0.90) data; however, the concordance correlation co-efficient was lower for raw (0.45) as compared with fill (0.76). Predicted agreement for raw data were 75%, 45%, and 68% and predicted agreement for fill data were 65%, 54%, and 83% for PS0, PS1, and PS2, respectively. Sensitivity for raw data were 39%, 37%, and 45% and for fill data, they were 59%, 54% and 82% for all PS data, PS1 and PS2, respectively. Specificity and positive predictive values for both raw (77% and 79%, respectively) and fill (65% and 77%, respectively) data show the probability of reporting false positives by sensors to be low. Experiment 2 revealed that the duration of panting increased from 0800 to 1700 h alongside changes in thermal indices with significant differences between and within breed and coat colour categories of cattle, suggesting that grouping and allocating heat amelioration measures by breed and coat colour can be effective in commercial feedlots. However, there was high variability (CV > 80%) in the duration of panting between individuals within the same breed and same coat colour, revealing the potential for strategic management at an individual level, and with the same data, genetic selection for heat resilience.
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Grigoris, Giannarakis, Litinas Nikolaos, and Theotokas Ioannis. "Perceptions of Corporate Social Responsibility Concept in Greece." June 20, 2009. https://doi.org/10.5281/zenodo.1081605.
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This study attempts to clarify major perspectives of Corporate Social Responsibility (CSR) in the Greek market related to companies that have sufficient CSR. An empirical analysis was undertaken, based on literature review and previous observations and surveys, in order to provide a general analysis of the CSR concept in Greece. The results of Accountability Rating institution were used in order to identify companies that adopt an integrated social responsibility approach. Companies that responded to the survey are both regional and international and belong to different industrial fields. Some of the main survey results reveal: multiple aspects for the CSR concept, weak consensus as regards the importance of stakeholders and benefits from the CSR implementation, the important role of CSR in the decision procedure and CSR practices concerning social issues that affect mostly company-s competitiveness. Sharing companies- experience could address common social issues through CSR best practices and develop new knowledge.
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Prathap, T. A., and K. Apsar Basha. "PRE AND POST LEVEL OF FINANCIAL LITERACY OF SHG MEMBERS, IMPACT OF FINANCIAL LITERACY ON ECONOMIC EMPOWERMENT AND FACTORS DRIVING ECONOMIC EMPOWERMENT – A STUDY WITH REFERENCE TO CHIKKABALLAPURA DISTRICT, KARNATAKA." ShodhKosh: Journal of Visual and Performing Arts 5, no. 6 (2024). https://doi.org/10.29121/shodhkosh.v5.i6.2024.3455.
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Purpose: The main intention of the present study is to know whether the demographic profiles impact on the study of financial literacy and women economic empowerment. Further, the study is also conducted to know the level of financial literacy of women SHG members before and after joining self help groups (SHGs), and to study the impact of financial literacy on economic women empowerment. Also further, the study conducted to know the factors impacting economic women empowerment, women studies reveal that unless and until women are developed their empowerment programs have no real meaning. Women empowerment has been noticed as a pre-requisite condition to reduce the level of poverty in developing nations (Aysha et al., 2018). Methodology / Design: A well defined previously known questionnaire which was managed as schedule after knowing the constraints in collecting back questionnaires with their incompleteness and avoid. A total of 108 questionnaire where in the hard and out of this only 100 were usable one balance of questionnaires were rejected. Chi-square, contingency co-efficient, Kendall's co-efficient of concordance, weighted average and Impact of Financial Literacy Index (IFLI) quantitative techniques were performed. The participants of the study include SHG members of 6 blocks selected villages. Findings: The present research work reveals that all the demographics are supporting the study and there exist significant variation in the data. The financial literacy has improved after joining SHGs. Factors of financial literacy impacting on ecommerce women empowerment includes in the order, women gains financial knowledge, road to economic empowerment and reduction in financial anxiety and stress. Further, the study also found about the factors driving women economic empowerment which includes in the order economic independence, savings formation and reduction in dependency on money lenders.
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Joseph, Edward A., and Casey J. Allen. "Long‐Term Quality of Life and Survivorship Priorities in Esophageal Cancer Patients: A Survey‐Based Assessment." Journal of Surgical Oncology, December 19, 2024. https://doi.org/10.1002/jso.28045.
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ABSTRACTBackground and ObjectivesThis study examines the long‐term quality of life (QOL) and priorities of survivors who underwent management for esophageal cancer (EC).MethodsWe cross‐sectionally surveyed EC patients through online support groups to assess the relative importance of their overall survival, experience, costs of care, and QOL. Kendall's co‐efficient of Concordance (W) was utilized to assess agreement among respondents.ResultsAmong 100 respondents (age 57.2 ± 10.4 years, 54% male, 90% Caucasian), median overall survival was 18.0 (7.8–49.8) months, with a maximum survivorship of 48.3 years. Respondents ranked overall survival most important, followed by functional independence, emotional well‐being, treatment experience, and costs of care (W = 0.342, p < 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority. The cohort's physical QOL (P‐QOL; 39.79 ± 10.16) and mental QOL (M‐QOL; 42.29 ± 15.43) were below that of the general population (50.00 ± 10.00); both p < 0.050. There was no difference in P‐QOL and M‐QOL based on the presence of metastatic disease (both p > 0.050). Patients who underwent curative surgery had superior M‐QOL (45.00 ± 15.22 vs. 36.70 ± 14.53, p = 0.010). Although P‐QOL was similar based on duration of survival (40.30 ± 9.75 [< 1 year], 39.33 ± 10.52 [1–5 years], 39.81 ± 10.68 [> 5 years], p = 0.873), M‐QOL was higher in patients with extended survivorship (36.87 ± 14.24 [< 1 year], 45.05 ± 14.94 [1–5 years], 47.30 ± 16.36 [> 5 years], p = 0.008).ConclusionsDespite enduring physical health impairments, a majority of EC survivors prioritized their survival. However, a few survivors prioritized costs and treatment experience, underscoring the importance of tailoring treatments to ensure alignment with individual patient‐driven priorities.
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Abildso, Christiaan G., Vaike Haas, Shay M. Daily, and Thomas K. Bias. "Field Test of a Passive Infrared Camera for Measuring Trail-Based Physical Activity." Frontiers in Public Health 9 (March 17, 2021). http://dx.doi.org/10.3389/fpubh.2021.584740.
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Introduction: Trails are ubiquitous and far-reaching, but research on the impact trails have on physical activity is limited by the lack of resource-efficient, accurate, and practical systematic observation tools. Commonly used infrared trail sensors count trail use and may broadly differentiate activity (i.e., bicyclist vs. pedestrian), but cannot detect nuances needed for outcomes research such as frequency, intensity, time, and type of activity. Motion-activated passive infrared cameras (PICs), used in ecological research and visitor management in wildlife areas, have potential applicability as a systematic observation data collection tool.Materials and Methods: We conducted a 7-month field test of a PIC as a systematic observation data collection tool on a hiking trail, using photos to identify each trail user's physical activity type, age, sex, and other characteristics. We also tallied hourly trail use counts from the photos, using Bland–Altman plots, paired t-tests, Concordance Correlation Coefficient, Kendall's Tau-b, and a novel inter-counter reliability measure to test concordance against concurrent hourly counts from an infrared sensor.Results: The field test proved informative, providing photos of 2,447 human users of the trail over 4,974 h of data collection. Nearly all of the users were walkers (94.0%) and most were male (69.2%). More of the males used the trail alone (44.8%) than did females (29.8%). Concordance was strong between instruments (p &lt; 0.01), though biased (p &lt; 0.01). Inter-counter reliability was 91.1% during the field study, but only 36.2% when excluding the hours with no detectable trail use on either device. Bland–Altman plots highlighted the tendency for the infrared sensor to provide higher counts, especially for the subsample of hours that had counts &gt;0 on either device (14.0%; 694 h).Discussion: The study's findings highlight the benefits of using PICs to track trail user characteristics despite the needs to further refine best practices for image coding, camera location, and settings. More widespread field use is limited by the extensive amount of time required to code photos and the need to validate the PICs as a trail use counter. The future potential of PICs as a trail-specific PA research and management tool is discussed.
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Bisht, Akanksha, Satyam Arora, Gopal Patidar, and Neelam Marwaha. "Knowledge assessment of a donor adverse reaction severity grading tool by the National Blood Donor Vigilance Programme of India." Vox Sanguinis, August 2, 2023. http://dx.doi.org/10.1111/vox.13502.
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AbstractBackground and ObjectivesThe severity grading tool (SGT) was recently designed by the Association for Advancement of Blood and Biotherapies (AABB) to have more objectivity in severity assignment for an adverse donor reaction after blood donation. A study was performed in India to assess the knowledge (post‐training) and determine the degree of agreement of the SGT between participating centres and the subject expert group.Materials and MethodsThis prospective cross‐sectional survey‐based study was conducted by the National Coordinating Centre (NCC) of the National Blood Donor Vigilance Programme (NBDVP) of India. Thirty‐five real‐world case scenarios, validated by seven national and two international experts, were sent to the participating centres, and their responses received (diagnosis and severity grade) were compared and analysed.ResultsA total of 50 blood centres participated in the study. The overall agreement between the participating centres and the expert group was 66.4%, with a fair Kendall's coefficient of concordance (W) of 0.271 (p‐value < 0.05). The degree of agreement was observed to be more than 80% for 12 centres, 60%–80% for 27 centres and <60% for 11 centres. The overall degree/percentage of agreement for cases with single and multiple types of donor adverse reaction was 71.3% and 42.6%, respectively.ConclusionThe SGT will be an efficient mode to have uniform objective reporting of the adverse donor reactions and may be implemented in the NBDVP of India. This study also highlights the need for training of the blood centres on the basic definitions and categorization of the donor's adverse reaction.
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Arora, Manali, Lovepreet Singh Randhawa, Devkant Lakhera, et al. "Interobserver reproducibility of RENAL nephrometry score in comparison to Simplified PADUA Renal nephrometry score." Urology Annals, August 3, 2023. http://dx.doi.org/10.4103/ua.ua_37_23.
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Abstract Introduction: Nephron-sparing surgery (NSS) is the standard of care for renal tumors, especially in the early stages. RENAL Nephrometry scores provide a comprehensive presurgical predictive module for the choice of NSS or Radical Nephrectomy. The validity and reliability of Nephrometry scores is being tested continuously with advancement in the surgical techniques. The Simplified PADUA Nephrometry score (SPARE NS) is a newer proposed score which aims to better the reproducibility of the previously established nephrometry scores. Materials and Methods: The retrospective observational study studied the comparative inter-observer reliability of RENAL (RENAL NS) and SPARE nephrometry scoring systems amongst two radiologists while assessing solid renal tumors in contrast-enhanced computed tomography scans of 42 patients. Interobserver reliability for all components of both scores, final scores and risk grading was done by Kendall’s Concordance Coefficient (Tau). Results: Both RENAL NS and SPARE NS showed strong to excellent agreement (RENAL NS = 78.57% and SPARE NS = 88.09%) among observers with comparable correlation co-efficient (RENAL NS = 0.944 and SPARE NS = 0.935). Lesion radius and exophytic/endophytic properties were the most reproducible components of RENAL NS with 97.61% and 92.85% agreement, respectively. Location across polar lines was the least reproducible component with 85.71% agreement among observers. Exophytic rate (97.61%) and Rim location were the most reproducible components of SPARE NS. The final lesion risk stratification by both observers for both was concordant in 92.85% of cases. Conclusion: The SPARE system of scoring matches up to the RENAL NS in total score and risk stratification reproducibility. However, the individual components of the SPARE score are more reproducible than those of RENAL NS, bringing about better compliance among radiology consultants. Comparable reproducibility with the RENAL NS, lesser number of variables, and ease of doing make SPARE NS a plausible option for the customary preoperative assessment of renal tumors.
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Weiss Freccia, Guilherme, Wladymir Kulkamp, Jairo Júnior, Joana Muller, Kleber Santos, and Lorival Carminatti. "A comparison of absolute, ratio standard and allometric approaches for bench press performance assessment in men over 60." Journal of Physical Education 34, no. 1 (2023). http://dx.doi.org/10.4025/jphyseduc.v34i1.3424.
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Body mass is known to affect muscle strength and the outcome of some functional tests, so that heavier and taller people will be stronger than lighter and smaller ones. Ratio standard (RS) has been widely used to remove the body mass effect, despite long date criticism due to its inadequacy. Allometry (ALLO), in turn, has been applied as an efficient method for normalizing muscular strength. As the bench press (BP) is a well-recognized strength and conditioning exercise for older adults, the aim of the present study was to verify the influence of body mass on the performance assessment of a group of older men in the BP, by comparing the absolute, RS and ALLO approaches. Sixteen healthy old men (65.5±5.13 years old; 75.42±9.78Kg; 1.73±5.98m; 25.11±2.71 kg/m2; 24.76±4.10 %fat) volunteered to participate in the study. Maximum dynamic load was verified by individual one-repetition maximum (1-RM) tests. Comparisons of means revealed that significant 1-RM difference between lighter (54.9±8.85Kg) and heavier (66.2±8.86Kg) participants was identified only in absolute approach (p<0.05; ES=0.57). RS failed in completely remove the body mass effect, allowing correlation between normalized muscular strength and BM (r=0.23), in contraire of ALLO (r=0.03 and 0.06). Kendall's concordance coefficient revealed an absolute lack of agreement between approaches when compared their respective ordinal classifications (kw=0.003; p>0.05). In line with previous research, ALLO has shown to be the only suitable method to remove adequately the body mass effect and to provide appropriated performance scores for the older men evaluated in this study.
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Dr, Ajatashatru Samal, Manasa N. Dr, and KP Rajimol. "Application of Extended Reality (XR) technologies, benefits and challenges faced - A study w.r.t. Yelahanka sub-districts of Bengaluru Urban district." December 1, 2022. https://doi.org/10.5281/zenodo.8022774.
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<strong>Purpose</strong> The major intention of the present study is to know how far the socio economic factor impress the study on XR technologies. Further, the study is also aimed at knowing the benefits of XR technologies, XR application, application of XR technology in education field, major challenges faced by XR technologies, of late XR technologies use has been on the rise to tackle various the areas like training, education safety etc. (Sanika Doolani et al. 2020). The latest developments in augmented reality (AR), virtual reality (VR) and mixed reality (MR) has been on the rise in the use of XR technologies to train the work force. Immersive technologies (XR) in education offer a number of opportunities but the convergence with AI can have a profound impact on considerations for applications at all levels. Universities must be a catalyst for necessary changes in society so that their graduates can be part of the transformation of the whole society. XR technologies are making a rehabilitative the way people experience the physical and virtual environments from observation to immersion. <strong>Approach</strong> A specific known in advance, questionnaire was administered as schedule in order to avoid delay, incompleteness rejection and respecting the Covid-19 pandemic norms. Innumerable students belonging to different streams were interviewed and the necessary data collected. X2, contingency co-efficient, ANOVA, Kendall’s co-efficient of concordance, weighted arithmetic mean and XRI tools’ were performed in order to gather the needful data on XR technologies. <strong>Findings</strong> The study found the existence of socio-economic characteristics showing a significant variation and high degree of variation except gender revealing a significant variation with a low degree of relationship. The XR application is found in the areas of remote work, marketing education and retail. The benefits are ranked and include, engages all students, breaks physical barriers and time machine allows students to travel in time. The application of XR technology to the education sector includes providing ways for training centric to educate their students in an immersive learning environment, Virtual reality (VR) provides the user with the perception of being physically present in a non physical world and XR provides a new space to access the educational space. The challenges include heterogeneous users, privacy and security and effects on health. <strong>Purpose</strong> The major intention of the present study is to know how far the socio economic factor impress the study on XR technologies. Further, the study is also aimed at knowing the benefits of XR technologies, XR application, application of XR technology in education field, major challenges faced by XR technologies, of late XR technologies use has been on the rise to tackle various the areas like training, education safety etc. (Sanika Doolani et al. 2020). The latest developments in augmented reality (AR), virtual reality (VR) and mixed reality (MR) has been on the rise in the use of XR technologies to train the work force. Immersive technologies (XR) in education offer a number of opportunities but the convergence with AI can have a profound impact on considerations for applications at all levels. Universities must be a catalyst for necessary changes in society so that their graduates can be part of the transformation of the whole society. XR technologies are making a rehabilitative the way people experience the physical and virtual environments from observation to immersion. <strong>Approach</strong> A specific known in advance, questionnaire was administered as schedule in order to avoid delay, incompleteness rejection and respecting the Covid-19 pandemic norms. Innumerable students belonging to different streams were interviewed and the necessary data collected. X2, contingency co-efficient, ANOVA, Kendall’s co-efficient of concordance, weighted arithmetic mean and XRI tools’ were performed in order to gather the needful data on XR technologies. <strong>Findings</strong> The study found the existence of socio-economic characteristics showing a significant variation and high degree of variation except gender revealing a significant variation with a low degree of relationship. The XR application is found in the areas of remote work, marketing education and retail. The benefits are ranked and include, engages all students, breaks physical barriers and time machine allows students to travel in time. The application of XR technology to the education sector includes providing ways for training centric to educate their students in an immersive learning environment, Virtual reality (VR) provides the user with the perception of being physically present in a non physical world and XR provides a new space to access the educational space. The challenges include heterogeneous users, privacy and security and effects on health.
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Lakshmi, Priya M. C., and Ramanaiah G. Dr. "GROWTH IN EXCHANGE TRADED FUNDS (ETFS), AWARENESS, ADVANTAGES AND INVESTMENT PATTERN – A STUDY W.R.T. URBAN BENGALURU." November 11, 2022. https://doi.org/10.5281/zenodo.7435643.
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Purpose: Exchange Traded Funds (ETFs) are one of the major source of finance to the industrialists and rising willing to participate in the investment avenue. Even small investor can invest on ETFs (Velu Murugan et al. 2015). When compare to other countries the Indian status of STFs is not up to the expectation and has a long way to go in the ETFs market, but the numbers spell promising situation. As per SEBI report the ETFs has almost doubled from Rs. 1.54 lakh crores at the beginning of February 21 to Rs. 2.9 lakh crores by the end of February 21. ETFs are similar to mutual funds but unlike mutual funds, they are listed on an exchange and traded throughout the day (Abbas Vallok, 2022) ETFs are generally have lower expense rates and contain tax and vantage compared to traditional mutual funds and they allow investors to buy and sell shares at intraday market prices. ETFs have grown up tremendously as one of the successful and innovative product. The rational behind ETFs is that it requires small investment and gold required huge amount and it is impossible to small investors to invest in gold and hence they invest in the ETFs. Further, innovations in the area of financial service as responsible for the emergence of new product every now and then. Approach: A precise capricious questionnaire was managed as schedule in order to avoid nonresponse, delay incompleteness and respecting covid norms. Respondents were approached in all four zonal areas. A total of 624 questionnaire were in the hand and out of 624 questionnaires only 600 were usable one forming success rate of 96.15%. Chi-square, contingency co-efficient, summation score, Kendall’s co-efficient of concordance and factor analysis were performed to analyze and factor analysis were performed to analyze and present the data. Findings: The study probed about the presence of significant variation in socio economic characteristics and found the existence of significant variation in the characteristics and also significant relationship between the two variables. The factor analysis highlights about existing types of investment. The factor, being most important like paper gold and NSS and this segment named as paper gold and NSS. The second factor explained about the respondents more awareness of safety, higher return and higher status. The third factor considered most important two factors, NBFC Deposit and commodities and these two are named as investors preference of NBFC and commodities. The major advantages being convenience and safety, affordability and opportunity to invest even by the small investors. All the drivers of investment pattern of investors reveals significance except appreciation and price stability, avoid committing mistakes, study systematic risk and study the available documents to verify the legitimacy of investment. All the factors 1500 are more significant.
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C P, Poornima, and Husain A S. "Information needs of farmers on cultivation of salad cucumber Cucumis sativus under polyhouse." Journal of Horticultural Sciences 18, no. 2 (2023). http://dx.doi.org/10.24154/jhs.v18i2.1228.
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The conventional practice of crop production is now giving its way to hi-tech farming practices. Salad cucumber (Cucumis sativus), is a relatively new crop in Kerala and has proven yield benefit under polyhouse conditions. The study intended to assess the information needs of farmers regarding various technical and cultivation aspects of salad cucumber production under polyhouse. Kendall’s coefficient of concordance (W) and mean values were used to identify the information needs. Most of the cultivation aspects fell under either the ‘highly essential’ or ‘moderately needed’ information category. The technical aspects of construction, maintenance and repair of polyhouse were the most critical information need of farmers along with the specifics of fertilizers for polyhouse and fertigation system. Pests, diseases and nutrient deficiency problems were also the main concerns of farmers. Weed management and pollination, with low mean scores were among the least felt information need. Hence, these aspects are also found to be among essential needs. The study elucidated that an efficient information delivery system through appropriate channels is required to boost polyhouse cultivation of vegetables in Kerala.
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Gallopin, Mélina, Gilles Celeux, Florence Jaffrézic, and Andrea Rau. "A model selection criterion for model-based clustering of annotated gene expression data." Statistical Applications in Genetics and Molecular Biology 14, no. 5 (2015). http://dx.doi.org/10.1515/sagmb-2014-0095.
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AbstractIn co-expression analyses of gene expression data, it is often of interest to interpret clusters of co-expressed genes with respect to a set of external information, such as a potentially incomplete list of functional properties for which a subset of genes may be annotated. Based on the framework of finite mixture models, we propose a model selection criterion that takes into account such external gene annotations, providing an efficient tool for selecting a relevant number of clusters and clustering model. This criterion, called the integrated completed annotated likelihood (ICAL), is defined by adding an entropy term to a penalized likelihood to measure the concordance between a clustering partition and the external annotation information. The ICAL leads to the choice of a model that is more easily interpretable with respect to the known functional gene annotations. We illustrate the interest of this model selection criterion in conjunction with Gaussian mixture models on simulated gene expression data and on real RNA-seq data.
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Bhoola, Vanita, and Antonio Giangreco. "HR activities and practices for project success: A multi-method approach from Indian IT firms." Australasian Journal of Information Systems 22 (June 19, 2018). http://dx.doi.org/10.3127/ajis.v22i0.1679.
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The purpose of this study is to examine the impact of Human Resource activities and practices (HRAPs) on value-driven project management in the Indian IT industry. It is a sector that offers various jobs for young IT skilled labour force, but faces major challenges in recruiting and retaining talent. A multi-method research has been carried out, using Delphi technique and a simultaneous equations model. Using the Delphi method, we developed an initial set of 136 globally accepted HRAPs. This was reduced to 20 most significant attributes applicable to Indian IT projects with the help of Kendall’s coefficient of concordance (W) used over three rounds of iterations. Later, from 431 observations, we selected the top 10 HRAPs based on mean ranks in round 3 to study the impact on value-driven project success, in terms of meeting project, customer and organizational goals. The study also uses triangulation through a multi-method research approach to achieve convergence. The significant HRAPs impacting value-driven project management include efficient project leadership, effective communication, training of project leaders, ensuring job-matching and listening to team members’ issues. Frequent team conflicts and personnel turnover, however, adversely impact IT project success. Our results confirm that the impact of HRAPs on project goals is more prominent and immediate as compared to meeting customer or organizational goals, which is often delayed. The results emphasize the necessity of integrating all stakeholders of IT projects in order to accomplish value-driven success.
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Xiao, Shuang-Yan, Feng-Dong Zhu, Dan-Jing Wang, et al. "Efficient blocking ELISA for bovine alphaherpesvirus 1 using a gB epitope–specific monoclonal antibody." Journal of Veterinary Diagnostic Investigation, June 18, 2025. https://doi.org/10.1177/10406387251346909.
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Infectious bovine rhinotracheitis (IBR) is an infectious respiratory disease in cattle that is caused by bovine alphaherpesvirus 1 (BoAHV1). We immunized BALB/c mice with inactivated and purified BoAHV1 to prepare hybridoma cells. After the successful establishment of a positive hybridoma cell line, co-immunoprecipitation coupled with mass spectrometry unveiled the predominant targeting of glycoprotein B (gB) by the hybridoma cells. Through bioinformatics analysis and Western blot techniques, we identified the epitope of the monoclonal antibody (mAb) against gB to amino acids 1–170. Subsequently, the 1H3 mAb was leveraged for the development of a gB blocking ELISA (gB-bELISA), utilizing inactivated BoAHV1 virions as the coating antigen. The optimized protocol involved diluting samples 2-fold with 1% fish gelatin, followed by incubation periods of 120 min for samples, 30 min for HRP-conjugated 1H3 mAb, and 15 min for the TMB substrate. We validated our assay using 268 bovine serum samples with clear backgrounds and established the cutoff value of 43.8% through ROC analysis. Additionally, we tested 256 clinical bovine serum samples using both our gB-bELISA and a virus neutralization test, achieving a concordance rate of 95.3%. Based on testing 495 randomly selected sera from 18 counties for BoAHV1 antibodies with our gB-bELISA, the seroprevalence of IBR in the Central China region was 22.0% (95% CI: 18.4, 25.7). Our gB-bELISA could be a valuable tool for the clinical detection of IBR, supporting disease control and eradication efforts.
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Wang, Xuan, Xiaotong Zhang, and Yuchen Zhang. "Predictive analysis of brain imaging data based on deep learning algorithms." Applied Mathematics and Nonlinear Sciences 9, no. 1 (2024). http://dx.doi.org/10.2478/amns-2024-0702.
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Abstract This paper analyzes the effectiveness of predictive analysis of brain imaging data based on deep learning algorithms, and improves the prediction accuracy and efficiency of brain imaging data through improved methods. The first step is to measure the local consistency of the brain imaging data using Kendall’s concordance coefficient (KCC), and to analyze the differences between the datasets using the two-sample t-test. Secondly, a batch normalized convolutional neural network (BN-CNN)-based prediction method for brain imaging data has been developed. This method extracts spatial and temporal features in two convolutional layers, followed by a fully connected layer for classification. Experimental results show that this method is helpful in predicting missing structural data in brain imaging. Secondly, a batch normalized convolutional neural network (BN-CNN) based brain imaging data prediction method is developed, which extracts spatial and temporal features in two convolutional layers. Then it connects to a fully connected layer for classification. The experimental results show that this method’s structural similarity index (SSIM) and feature similarity index (FSIM) in brain imaging data prediction of missing data reaches 0.9446 and 0.9465, respectively, which is significantly better than that of other GAN benchmarks. In applying the method to epilepsy and Parkinson’s cases, this algorithm is used to epilepsy and Parkinson’s cases, and a two-sample t-test analyzes the differences in the data sets. In the application of epilepsy and Parkinson’s cases, the algorithm in this paper has an average prediction accuracy of 93.37%, effectively reducing the rate of incorrect predictions. Deep learning algorithms are highly efficient and accurate in predicting brain imaging data, which is crucial for future clinical diagnosis and treatment.
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Agambire, Ramatu, and Charles Adusei. "Knowledge of Hospital Staff on the Procedures and Obstacles to Public Procurement in Ghana." Asian Journal of Medicine and Health, August 24, 2019, 1–11. http://dx.doi.org/10.9734/ajmah/2019/v16i130133.
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Healthcare is an essential part of human life and cannot be disregarded whether for an individual, a family or a state. A conscious and planned effort must be taken by the state to make sure that goods and services are made available and accessed through effective and efficient procurement systems. The purpose of the study was to examine hospital staff knowledge on application, procedures and obstacles to public procurement at Oda Government Hospital in Ghana. A mixed method approach using survey and interview guide was used to solicit information from the hospital staff and the Procurement Manager. Data was analysed using descriptive statistics and Kendall Coefficient of Concordance. The study revealed that the staff had knowledge on procurement procedures and tried to follow the recommended guidelines. The highest mean was scored for application and familiarity with the Public Procurement Act (PPA) whereas verification of documentation, opening tenders for bidding and publishing contract awards were the key procurement procedures.Major obstacles identified included bureaucracy, lack of skilled personnel and adhoc membership of the tender team. The Medical Superintendent and the hospital Administrator were the officers responsible for policy approval and supervision of the Public Procurement Act. There is a need to enforce adherence to the Public Procurement Act and ensure regular training of staff and stronger stakeholder participation in the procurement processes to equip the staff with knowledge and skills on the application of the Public Procurement Act.