Setting: Urban slums and poor rural areas in India, 2012–2014.Objective: To describe the characteristics of tuberculosis (TB) patients enrolled in treatment through Operation ASHA, a non-governmental organisation serving disadvantaged populations in India, and to identify risk factors for unfavourable treatment outcomes.Design: This was a retrospective cohort study. Patient characteristics were assessed for their relationship with treatment outcomes using mixed effects logistic regression, adjusting for clustering by treatment centre and Indian state. Outcomes were considered favourable (cured/treatment completed) or unfavourable (treatment failure, loss to follow-up, death, switch to multidrug-resistant TB treatment, transfer out).Results: Of 8415 patients, 7148 (84.9%) had a favourable outcome. On multivariable analysis, unfavourable outcomes were more common among men (OR 1.31, 95%CI 1.15–1.51), older patients (OR 1.12, 95%CI 1.04–1.21) and previously treated patients (OR 2.05, 95%CI 1.79–2.36). Compared to pulmonary smear-negative patients, those with extra-pulmonary disease were less likely to have unfavourable outcomes (OR 0.72, 95%CI 0.60–0.87), while smear-positive pulmonary patients were more likely to have unfavourable outcomes (OR 1.38, 95%CI 1.15–1.66 for low [scanty/1+] and OR 1.71, 95%CI 1.44–2.04 for high [2+/3+] positive smears).Conclusion: The treatment success rate within Operation ASHA is comparable to that reported nationally for India. Men, older patients, retreatment cases and smear-positive pulmonary TB patients may need additional interventions to ensure a favourable outcome.
The frequency of use and duration of wearing latex gloves among hospital employees has increased due to concerns about AIDS and hepatitis. In many countries there is increased consciousness about latex sensitization. In the UK, the Medical Device Agency has been monitoring latex allergy for a number of years but has not found any conclusive evidence of any significant problem. We report following a detailed questionnaire study in two hospitals in the north-west of England. A total of 1,827 members of staff were questioned about latex allergy at work. One hundred and twenty-four (7%) of these hospital employees had experienced symptoms strongly suggestive of latex allergy. Of this group, 56 had a-RAST test (IgE specific to latex), which was positive in seven (12.5%). There was a history of atopy in 31%, and a family history of atopy in 17% of the individuals. As a result of the study it was found that 17% (21 of the affected individuals) had already changed their working practice by using latex-free gloves. We were able to increase awareness of latex allergy within the hospitals. Both individuals and health care organizations need to be aware of the problem and hospital organizations should encourage staff to seek guidance to address the problem and, if necessary, to take appropriate measures to improve working practices. Practical guidelines are given with regard to identifying the problem and glove use for hospital staff.
Background: Gestational diabetes mellitus is defined as carbohydrate intolerance with onset/recognition during pregnancy where maternal and perinatal complications are increased. Aged care facilities in rural areas reports disparity in the management of gestational diabetes as compared with urban counter parts. As a need to address this, study conducted with objective to estimate prevalence of gestational diabetes mellitus within 16 weeks of gestation for GDM by oral glucose challenges test.Methods: Antenatal mothers attending primary health centers within 16 weeks of gestation were screened for GDM. Two hours, venous samples were calculated for estimation of blood glucose level. Plasma glucose level of >140mg/dl was considered as OGTT positive.Results: Among 301 patients examined 11 mothers had OGTT positive results. GDM was seen in 3.7% of Mothers. GDM is found significantly associated with increasing age (p=0.01, t=2.52, mean difference 2.54 CI 0.5-4.5), weight (p=0.04, t=2.24, mean difference 10.8 CI 0.11-21.5), and BMI (p<0.01, t=2.97, mean difference 3.6 CI 1.2-6). GDM was seen more in multigravida (P=0.01). Statistically significant association of GDM was found with mean systolic (p<0.01, t=2.62, mean difference 8.08 CI 2.01-14.14) and diastolic blood pressure (P<0.01, t=3.44, mean difference 7.87 CI 3.38-12.36). A multiple regression shows these variables statistically significantly predicted GDM, F (5, 295)= 7, p<0.001, R2=0.106.Conclusions: GDM is statistically associated with increasing age, increasing weight, BMI and multiple gravida in pregnancy. It is recommended to screen for GDM within the 1st trimester & follow up needed to prevent further complications.
This study investigates the role of machine learning (ML) and artificial intelligence (AI) in reverse logistics (RL) within the scope of e-commerce and e-waste. RL is a process to plan and manage the flow of products from consumer to provider with the purpose to generate value. From the bottom line of sustainability, it is important to manage and improve the product return and end-of-life product. Past research studies have presented several techniques to optimize the cost, schedule, and route. However, the integration of ML and AI tools in information technology systems is limited and insufficient. The purpose is to present the research gap for further study. The article is organized as follows: Section 1 provides an introduction to reverse logistics, ML, AI, e-commerce, and e-waste. Section 2 presents a comprehensive review of the current research, and Section 3 concludes the article.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.