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The World Health Organization (WHO) is committed to empowering countries by implementing a gender, equity, and human rights approach in the health sector. The objective of this gender and inclusion analysis is to assess potential gender disparities of health sector management in the Kyrgyz Republic. The employed mixed-method approach takes advantage of data triangulation. Besides information from the literature and policy documents available at the international and national levels, the analysis includes interviews and data from the self-assessment of health services managers in the Kyrgyz Republic. A convenience sample of 75 health managers was taken and after up to three reminders a commendable response rate of 80% was achieved which resulted the final sample size of N = 60. A factor analysis using quartimax orthogonal rotation was applied to investigate the correlation between Teaching Qualification, Digitalization, Training Usefulness, Computer Workplace, and Gender Equality. In 2021, the Kyrgyz Republic adopted a new Constitution, which provides a sound legal framework to support gender equality and promote women's empowerment. However, according to a survey, only 42.9% of the respondents felt that equal rights and opportunities were integrated into their job descriptions. Similarly, only 40.7% believed that their institutions' written documents reflected a commitment to equal rights and opportunities for both genders. Two factors were identified as influencing gender equality: (1) personal and (2) technical aspects. Regarding personal aspects, gender equality, teaching qualification, and training usefulness were found to be significant. Regarding technical aspects, the computer workplace was related. In recent years, the Kyrgyz Republic has been developing a culture of gender equality. Political will is essential to promote and make organizational change possible. It is important to create a written mid-term policy that affirms a commitment to gender equality in organizational behavior, structures, staff, and management board compositions. Healthcare institutions need to prepare strategic and operational plans that incorporate gender equality principles.

Background: This study examines whether employee perceptions of supervisor behavioral integrity for safety moderates the relationship between top-management safety climate and safety performance (i.e., safety compliance and safety participation) and the mediated relationships through safety motivation. Methods: Data collected from 389 blue-collar employees were analyzed using latent moderated structural equation modeling. Results: The results indicate that the relationship between top-management safety climate and safety behavior, and the mediating role of safety motivation were replicated. Moreover, the results show that the mediated relationships between top-management safety climate and safety behaviors through safety motivation were stronger for employees who report high supervisor behavioral integrity for safety. Conclusion: The study findings suggest the role of supervisor behavioral integrity for safety in clarifying how the employee perceptions of top-management safety climate transfer to the employee safety behaviors through the motivational pathway.

Calcium is always present in alumina systems as an unintentional (or intentional) dopant, and yet the fundamental effect of its incorporation into the aluminas is not well understood, and is further complicated by the presence of Si. The synthesis of powders of two calcium aluminate phases (CaAl4O7, which is also known as CaO · 2Al2O3 or CA2, and CaAl12O19, which is also known as CaO · 6Al2O3 or CA6) has been investigated using low-temperature chemical-processing techniques. The crystallization of these powders from the amorphous precursor has been examined using various characterization techniques. The precursors for the powders were prepared by mixing stoichiometric proportions of the nitrate salts into a 5 wt% aqueous solution of poly(vinyl alcohol). Conversion of the amorphous precursors to crystalline powders and the subsequent phase transitions were monitored using differential thermal analysis (DTA), thermogravimetric analysis (TGA) and powder X-ray diffractometry (XRD). While powders with CA2 stoichiometry crystallized directly at 883°C, amorphous powders with CA6 stoichiometry first crystallized into an intermediate structure without partitioning and then transformed into CA6 at 1175°C. Fully and partially crystallized powders were analyzed using transmission electron microscopy and electron energy-loss spectroscopy (EELS). Measured near-edge structures (Al-L2,3, Ca-L2,3 and O-K) are presented for the CA2, γ-Al2O3 and CA6 phases. The intermediate phase, identified as γ-Al2O3, was found to accommodate a significant concentration of Ca. [ABSTRACT FROM AUTHOR]

Objective: Childhood obesity is a worldwide health concern. Studies have shown autonomic dysfunction in obese children. The exact mechanism of this dysfunction is still unknown. The aim of this study was to assess the relationship between erythrocyte membrane fatty acid (EMFA) levels and cardiac autonomic function in obese children using heart rate variability (HRV). Methods: A total of 48 obese and 32 healthy children were included in this case-control study. Anthropometric and biochemical data, HRV indices, and EMFA levels in both groups were compared statistically. Results: HRV parameters including standard deviation of normal-to-normal R-R intervals (NN), root mean square of successive differences, the number of pairs of successive NNs that differ by >50 ms (NN50), the proportion of NN50 divided by the total number of NNs, high-frequency power, and low-frequency power were lower in obese children compared to controls, implying parasympathetic impairment. Eicosapentaenoic acid and docosahexaenoic acid levels were lower in the obese group (p

The research question addressed in this study was how the performance of construction crews working in a certain project or locality could be evaluated, ranked and improved. To develop and demonstrate the relevant framework, data envelopment analysis (DEA) was applied to establish the relative efficiency of plastering crews working in building projects located in different cities around Turkey. Data were collected from 40 crews of varying characteristics, and their technical efficiency scores were computed using the Banker, Charnes and Cooper (BCC) model, which is based on variable returns-to-scale (VRS). The model yields efficiency scores that range between 0 and 1, and a company or crew is considered efficient if its score is 1.0 (100%). Efficient and inefficient crews were identified and ranked on this basis in the study. Cross tabulation analyses were subsequently conducted to gain further insights into the relationships between the efficiency scores and input factors of numbers of skilled and unskilled laborers, daily labor unit costs, work hours, average age of crew members, total crew experience, plastering location, plastering technique, and plaster type. No discernible relationship could be identified between the efficiency scores and productivity outputs of the crews. It was found that plastering technique, plastering location, and total crew experience had a significant association with crew efficiency. Efficiency improvement strategies identified included training, hiring experienced plasterers, adopting more advanced plastering technology, implementing better jobsite management practices, and enhancing workers’ knowledge, skills and attitude towards productivity and quality. First published online: 25 Sep 2014

Artificial neural networks have been effectively used in various civil engineering fields, including construction management and labour productivity. In this study, the performance of the feed forward neural network (FFNN) was compared with radial basis neural network (RBNN) in modelling the productivity of masonry crews. A variety of input factors were incorporated and analysed. Mean absolute percentage error (MAPE) and correlation coefficient (R) were used to evaluate model performance. Research results indicated that the neural computing techniques could be successfully employed in modelling crew productivity. It was also found that successful models could be developed with different combinations of input factors, and several of the models which excluded one or more input factors turned out to be better than the baseline models. Based on the MAPE values obtained for the models, the RBNN technique was found to be better than the FFNN technique, although both slightly overestimated the masons’ productivity. First published online: 22 Oct 2014

Aim: The aim of this study is to analyze possible autonomic nerve system alterations and assess the efficacy of heart rate variability (HRV) analysis in anticipation of cardiovascular risks in pediatric patients with familial Mediterranean fever (FMF)., Method: In this study, cardiac autonomic functions were investigated in children with FMF by analyzing HRV and its other probable cardiac effects by echocardiography. We studied 70 pediatric patients with FMF and 50 healthy controls., Results: The time-domain parameters of HRV were compared between the FMF and control groups. SDNN (standard deviation of all NN intervals) was significantly decreased in patients with FMF as compared to control subjects. The other time-domain parameters of HRV and the frequency-domain parameters of HRV were similar in both groups. Frequency-dependent HRV parameters were similar in both groups, as were conventional echocardiographic parameters., Conclusion: HRV is a convenient and reliable technique for evaluation of autonomic functions. There are only a few studies on the assessment of autonomic functions by means of HRV in adult FMF patients but not in pediatric patients. Further studies are required to assess whether there is autonomic dysfunction in children with FMF., (© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)

Extracorporeal membrane oxygenation (ECMO) is a well-established tool of cardiopulmonary circulatory support for cardiopulmonary failure in children and adults. It has been used as a supportive strategy during interventional procedures in neonates with congenital heart disease. Herein, we describe a neonate with hypoplastic left heart syndrome who underwent stenting of the Sano shunt and left pulmonary artery after Norwood Sano operation using intra-procedural ECMO support. The use of ECMO as a bridge to recovery might be a feasible and reasonably safe adjunctive approach in the treatment of complications in selective case of neonates having undergone the Norwood Sano procedure.

Purpose: Doxorubicin (DXR) is an effective chemotherapeutic agent but causes severe cardiac failure over known doses. Thus, early detection and prevention of cardiac damage is important. Various markers have been tested for early detection of cardiac damage. Myostatin is a protein produced in skeletal muscle cells inhibits muscle differentiation and growth during myogenesis., Methods: We evaluated the role of myostatin as a marker for showing DXR induced cardiac damage and compared with well known cardiac markers like NT-proBNP, hs-TnT and CK in a rat model of chronic DXR cardiotoxicity., Results: Myostatin, NT-proBNP, and hs-TnT but not CK rose significantly during DXR treatment., Conclusion: Myostatin can be used as an early marker of DXR induced cardiotoxicity., (© 2016 by the Association of Clinical Scientists, Inc.)

Background: Despite concerns about complications with the implantable cardioverter defibrillator (ICD), it is effective for the prevention of sudden cardiac death (SCD). We aimed to analyze our midterm experience with ICD in children and young adults., Methods: This retrospective study included patients who were implanted with an ICD between 2001 and 2014. Demographic characteristics, clinical information, shock features, and complications for all patients with ICD were analyzed. The study population was divided into two groups: early-era patients implanted before 2008, and late-era patients implanted after 2008., Results: Sixty-nine patients (median age: 12 years, median follow-up: 52 months) were implanted with an ICD. Diagnostic categories were channelopathy (56.6%), cardiomyopathy (36.2%), congenital heart disease (5.8%), and other (1.4%). We performed implantation for primary prevention in 66.6% (39.3% in early-era patients and 85.4% in late-era patients). Thirty-one (44.9%) received 139 appropriate shocks (66% of total shocks) while 14 (20.2%) received 71 inappropriate shocks. However, there was no statistically significant difference in the use of appropriate shocks in the primary (66.7%) versus the secondary (72.2%) prevention groups. The incidence of appropriate and inappropriate shock was 66.7% and 33.3% in the primary prevention group, and 72.2% and 27.8% in the secondary prevention group, respectively. Two patients died, although only one death was the result of a lead problem., Conclusions: Although lead integrity problems, inappropriate shocks, and infections are significant issues, ICD therapy appears to be a safe, effective, and necessary option for the prevention of SCD in both children and young adults., (© 2016 Wiley Periodicals, Inc.)

Doxorubicin (DXR) extravasation result with serious morbidity like skin ulceration and necrosis. The purpose of this study is to determine the protective effects of ozone, olive oil, dimethyl sulfoxide (DMSO), and coenzyme Q10 in the treatment of DXR-induced skin ulcers on rats. After an intradermal injection of DXR on a basis of an animal extravasation model, the materials were topically applied. The ulcer sizes were measured, and a punch biopsy was taken from the extravasation site in which the skin ulcers formed at the end of the experiment. The samples were analyzed for tumor necrosis factor alpha (TNF-α), interleukin 1-beta (IL1β), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) enzymes, and examined histopathologically. The ulcer sizes clearly decreased in the study groups, including DMSO, olive oil, ozone plus coenzyme Q10, and ozone plus olive oil groups in comparison with the control group with the exception of the coenzyme Q10 group. The malondialdehyde levels were lower in the DMSO, olive oil, ozone plus olive oil, and ozone plus coenzyme Q10 groups than they were in the control group, but they were not significantly different. The TNF-α level was lower in the DMSO, ozone plus olive oil, coenzyme Q10, and ozone plus coenzyme Q10 groups in comparison with the control group. There was no significant change in the SOD, GSH-Px, and IL1β levels in the study groups in comparison with the control and the sham groups. The ozone plus olive oil group could be considered to be an alternate therapy for skin ulcers due to DXR extravasation., (© The Author(s) 2015.)

Coronary artery fistula (CAF) is a rare clinical abnormality characterized by a connection between one or more coronary arteries and an adjacent cardiac chamber or vascular structure. Although CAF complications are more common in older children over time, there is still no consensus in terms of treatment indications in children with asymptomatic fistula. We describe an asymptomatic infant diagnosed with a severely dilated right coronary artery and a coronary-cameral fistula treated successfully by transcatheter device closure. The Amplatzer Vascular Plug II appears to be safe, effective and relatively easy to use for CAF closure in infants., (Copyright © 2015. Published by Elsevier España.)

Purpose: Necrotizing enterocolitis (NEC) is a severe disease of mostly premature infants with high morbidity and mortality rates. There is no reliable biomarker for detecting newborns at risk for NEC development. We aimed to investigate small intestinal lactoferrin (LF) and calprotectin (CAL) levels as predictors and indicators of disease severity in an experimental newborn rat model., Materials and Methods: Newborn pups were randomly divided into two groups, NEC and control. The NEC group pups were decapitated on the second, third and fourth days of the experiment for an assessment of the different stages of NEC. In the study group, hypoxia-reoxygenation model used to induce NEC. As biochemical parameters, small intestinal LF and CAL levels were measured with an enzyme-linked immunosorbent assay technique and intestinal injury scoring was evaluated as a pathologic parameter., Results: Small intestinal levels of both LF and CAL increased in the second and the third day groups, but began to decrease by the fourth day. The first, second and third day levels of LF and CAL were higher than controls. The intestinal injury scores of all NEC groups were significantly higher than the control group., Conclusion: Small intestinal lactoferrin and calprotectin were good markers for demonstrating NEC. However, instead of spot testing, monitoring the levels of these markers may be more informative., (Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)