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The present study seeks whether there is a significant effect of using Picture Word Inductive model on students’ ability of SMAN 4 Pekanbaru in writing descriptive texts or not. This research uses quantitative method, namely by applied Pre-Experimental Design. The research sampling technique is Purposive Sampling. Class X.11 was selected as the sample with the total of 36 students. The instrument used is writing test. The hypothesis was tested using Wilcoxon Test. The research results show that there is a significant effect of using Picture Word Inductive model on students’ ability of SMAN 4 Pekanbaru in writing descriptive texts. This is proven from the students' average pre-test score, namely 60.08 (Poor), which experienced a significant increase after using PWIM in students' post-test average score into 82.25 (Very Good). Furthermore, the hypothesis test results show Sig. value 0.000 < 0.05 leads to the acceptance of the alternative hypothesis (Ha). Thus, it can be concluded that there is a significant effect of using Picture Word Inductive model on students’ ability of SMAN 4 Pekanbaru in writing descriptive texts. In addition, students' overall post-test scores have reached the standard of learning achievement criteria in Merdeka Curriculum after applying Picture Word Inductive model.

The objective of the study was to determine the extent to which market orientation (MO) is related to university performance. The study was based on 212 respondents from private and public universities across Tanzania. Market orientation was measured by MKTOR. Structural Equation Model (AMOS 22) and SPSS were deployed for data analysis. Tests for reliability and validity showed that the measures have sound psychometric properties. Two hypotheses were tested and both were supported. This is the first study in Tanzania which is pan territorial drawing its sample from both public as well as private universities, notwithstanding the relatively low representation by private universities. This study is cross sectional. A longitudinal study would have provided a more appropriate explanation on underlying relationships over a period of time. Furthermore, in view of complexity of high education industry, mediating variables would have shaded more light on the relationship between the two constructs under different set of circumstances. Obvious practical implication is that universities should design programs that address wider customer needs which will make them a “go to” universities and in the process increase their reputation. High reputation will attract funding from different sources thereby giving the universities ability to offer scholarships to students. This will lead to increased access to university education and hence help the Government to solve some of social problems. Abstrak dalam Bahasa Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui sejauh mana orientasi pasar (MO) terkait dengan kinerja universitas. Studi ini didasarkan pada 212 responden dari universitas swasta dan negeri di seluruh Tanzania. Orientasi pasar diukur dengan MKTOR. Model Persamaan Struktural (AMOS 22) dan SPSS digunakan untuk analisis data. Uji reliabilitas dan validitas menunjukkan bahwa langkah-langkah tersebut memiliki sifat psikometrik yang baik. Dua hipotesis diuji dan keduanya didukung. Ini adalah studi pertama di Tanzania yang merupakan pan teritorial yang mengambil sampelnya dari universitas negeri maupun swasta, meskipun perwakilan universitas swasta relatif rendah. Penelitian ini bersifat cross sectional. Studi longitudinal akan memberikan penjelasan yang lebih tepat tentang hubungan yang mendasari selama periode waktu tertentu. Selain itu, mengingat kompleksitas industri pendidikan tinggi, variabel mediasi akan lebih memperjelas hubungan antara dua konstruksi dalam keadaan yang berbeda. Implikasi praktis yang jelas adalah bahwa universitas harus merancang program yang menjawab kebutuhan pelanggan yang lebih luas yang akan membuat mereka menjadi universitas “go to” dan dalam proses meningkatkan reputasi mereka. Reputasi tinggi akan menarik pendanaan dari berbagai sumber sehingga memberikan kemampuan universitas untuk menawarkan beasiswa kepada mahasiswa. Hal ini akan mengarah pada peningkatan akses ke pendidikan universitas dan karenanya membantu Pemerintah untuk memecahkan beberapa masalah sosial.

Introduction Social accountability is important for improving the delivery of health services and empowering citizens. The government of Tanzania has transferred authority to plan, budget and manage financial resources to the lower health facilities since 2017. Health facility governing committees (HFGCs) therefore play a pivotal role in ensuring social accountability. While HFGCs serve as bridges between health facilities and their communities, efforts need to be made to reinforce their capacity. This project therefore aims to understand whether, how and under what conditions informed and competent HFGCs improve social accountability.Methods and analysis This study adopts a participatory approach to realist evaluation, engaging members of the HFGCs, health managers and providers and community leaders to: (1) map the challenges and opportunities of the current reform, (2) develop an initial programme theory that proposes a plan to strengthen the role of the HFGCs, (3) test the programme theory by developing a plan of action, (4) refine the programme theory through multiple cycles of participatory learning and (5) propose a set of recommendations to guide processes to strengthen social accountability in the Tanzanian health system. This project is part of an ongoing strong collaboration between the University of Dar es Saalam (Tanzania), and Umeå University (Sweden), providing opportunities for action learning and close interactions between researchers, decision-makers and practitioners.Ethics and dissemination Ethical approval to conduct the study was obtained from the National Ethical Review Committee in Tanzania— National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/3928). Permissions to conduct the study in the health facilities were given by the President’s Office Regional Administration and Local Government and relevant regional and district authorities. The results will be published in open-access, peer-reviewed journals and presented at scientific conferences.

A modern power grid is a cyber-physical system, which are vulnerable to cyber attacks. A recently found attack, the time-delay switch attack (TDSA), is made by inserting time delays into communication channels. A TDSA can be highly destructive to a power system as it can lead to instability. This paper presents a novel model predictive control (MPC) for fast frequency controller in a power system which can effectively mitigate the unknown TDSA. The MPC recently has received great attentions to be applied as FFC in a power system. Most of the MPC design are based on discrete-time model, whose future plant behaviour is calculated through iteration, rather than convolution. Nevertheless, one crucial step in the derivation of discrete-time MPC (DTMPC) is to capture the control trajectory over a finite prediction horizon. This imposes a challenge in designing a DTMPC to counteract the time-delay with unknown time length. Thus, a continuous-time MPC (CTMPC) is proposed to deal with TDSA. To overcome the unknown time delay, we synthesize an accurate time-delay estimator and sequential state predictor (SSP), are designed to accurately estimate and effectively counteract the unknown and random TDSA. All presented case studies are based on a real Taipower system and justification of the effectiveness of the proposed method was verified.

A partial shading condition (PSC) is one of the most common problems in the photovoltaic (PV) system. It causes the output power of a PV system drastically decrease. Meta-heuristic algorithms (MHA) can track the maximum power point in a power-voltage (P-V) curve with multiple peaks. Grey wolf optimization (GWO) algorithm is a new optimization algorithm based on MHA. It has been used to solve optimization problems in many applications including MPPT for a PV system. However, the accuracy and tracking time in the original GWO (OGWO) can still be further improved for various PSCs. Therefore, there have been some modified grey wolf optimization (MGWO) algorithms proposed to improve the GWO. Nevertheless, only incremental improvement has been made. Therefore, a modified GWO, named enhanced grey wolf optimization (EGWO) is proposed in this paper. The proposed method adds the weighting average, the pouncing behavior and nonlinear convergence factor in the OGWO. In particular, since real wolves may engage in pouncing action when they are hunting, inclusion of pouncing completes the GWO algorithm and yields great improvements. As will be shown via simulation and experiment, the EGWO can drastically reduce the tracking time (up to 45.5% of the OGWO) and the dynamic tracking efficiency can be improved by more than 2%, compared to the OGWO. Moreover, the EGWO achieves the highest maximum power point compared to some of the existing GWO and other swarm based algorithms.

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

This study is aimed to develop an educational game media called ludo-science that is compiled with Somatic Auditory Visualization Intellectually (SAVI) approach which can be used to train the activeness and students' conceptual understanding. The development procedure is reference to the ADDIE development model. The research data were obtained in the form of validation data, readability data, response data, activeness data, and pretest posttest scores. The results showed that after going through the product validation process by material experts obtained an average percentage of 92,70% and included in the category of very feasible. Product validation by media experts obtained an average percentage of 82,39% and included in the very feasible category. The average readability gained 95,75% and included in the excellent category. The results of activeness obtained an average activity of students by 82,94% and included in the category of very active. The pretest and posttest showed an increase in students' conceptual understanding. The classical calculation state that at the pretest the concept understands is 37,27% while at the posttest is 63,59%. The average questionnaire responses for the use of Ludo-science media with SAVI received an average of 86,79% and included in the excellent category.

Solar modules under partial shading (PS) conditions will result in power and voltage characteristic curves (P-VCC) having multiple peaks. If the maximum power point cannot be obtained, the output power of the solar modules will be greatly reduced. Hence, there have been various maximum power point tracking (MPPT) control methods developed to address this problem. One alternative is to employ the meta-heuristic approach (MHA) to track the global maximum power point (GMPP). Recently, a new MHA called Bat Algorithm (BA) has performed well in the MPPT. Nevertheless, BA may fail to track the GMPP when there are some local maximum power points (LMPPs) close to the GMPP. Also, the tracking time needs to be further reduced to accommodate rapidly changing irradiance. Therefore, a combination of BA with the abandonment mechanism of Cuckoo Search (CS) is proposed to improve the tracking performance of the BA. Both simulation and experimental results show that the proposed method, as compared to BA, yields better accuracy and an improvement of convergence speed of about 35% for various P-VCCs can be achieved. Moreover, the MBA has also been tested against some of the state-of-the-art MPPT algorithms such as Particle Swarm Optimization and Grey Wolf Optimization (GWO), and the results showed the superiority of the proposed method.

Background Decentralisation in the health sector has been promoted in low- and middle-income countries (LMICs) for many years. Inherently, decentralisation grants decision-making space to local level authorities over different functions such as: finance, human resources, service organization, and governance. However, there is paucity of studies which have assessed the actual use of decision-making space by local government officials within the decentralised health system. The objective of this study was to analyse the exercise of decision space across four districts in Tanzania and explore why variations exist amongst them. Methods The study was guided by the decision space framework and relied on interviews and documentary reviews. Interviews were conducted with the national, regional and district level officials; and data were analysed using thematic approach. Results Decentralisation has provided moderate decision space on the Community Health Fund (CHF), accounting for supplies of medicine, motivation of health workers, additional management techniques and rewarding the formally established health committees as a more effective means of community participation and management. While some districts innovated within a moderate range of choice, others were unaware of the range of choices they could utilise. Leadership skills of key district health managers and local government officials as well as horizontal relationships at the district and local levels were the key factors that accounted for the variations in the use of the decision space across districts. Conclusion This study concludes that more horizontal sharing of innovations among districts may contribute to more effective service delivery in the districts that did not have active leadership. Additionally, the innovations applied by the best performing districts should be incorporated in the national guidelines. Furthermore, targeted capacity building activities for the district health managers may improve decision-making abilities and in turn improve health system performance.

This paper presents a novel method for current control for a modular multilevel converter (MMC). The proposed current control methodology is based on a modified sliding mode control (SMC) with proportional and integral (PI) sliding surface which allows fast transient responses and improves the robustness of the MMC control performance. As the proposed method is derived via Lyapunov direct method, the closed-loop stability is ensured and results in globally asymptotically stable. Furthermore, the reaching time is also guaranteed by the proposed method, leading to fast transient responses. The proposed method is validated by comparing with some existing methods, which are proportional integral controller and conventional SMC, via offline and hardware-in-loop (HIL) simulations where a 10 MW, medium-voltage MMC system is tested. According to these results, the proposed method is able to provide fast transient responses, zero overshoot, and robustness to the weak grid and short-circuit conditions.

This research is aimed to study growth adaptation of Wojalaka black rice variety which is cultivated with The Banjarese system cultivation and its problem during planting period. A descriptive exploratory research was conducted in rainfed rice field in Binuang Village, Binuang District, Tapin Regency, South Kalimantan Province on November 2016 to May 2017. Land preparation was done with Tepulikampar technology and the seedbed was done in two stages, i.e. dry seedbed and continued with wet nursery. Observations were made on plant height, plant age, number of productive tillers, panicle length, number of seeds per panicle, weight per panicle, weight of 1000 seeds, total weight and problems during plant growth including pests, diseases and environmental conditions. The results showed that Wojalaka black rice variety were 125 cm high and the plant age was 176 days or longer than the normal age of 127 days. Number of productive tillers is relatively small as many as 12 tillers. The yield potential is almost equal to the potential yield in the area of origin. The Banjarese planting system is less suitable to be applied to the Wojalaka black rice variety because it causes the longer period of harvest and the decrease of the harvest. The attacks of rice ear bugs and birds and diseases caused by fungus Ustilaginoidea virens also cause the decline of crop yields. Keywords: Black rice, Growth, Wojalaka, Banjarese system cultivation

The partial shading of photovoltaic (PV) modules due to clouds or blocking objects, such as buildings or tree leaves, is a common problem for photovoltaic systems. To address this, maximum power point tracking (MPPT) is implemented to find the global maximum power point (GMPP). In this paper, a new hybrid MPPT is proposed that combines a modified grasshopper optimization algorithm (GOA) with incremental conductance (IC). In the first stage, the proposed modified GOA is implemented to find a suitable tracking area where the GMPP is located. Then the system moves to the second stage by implementing IC to get the correct GMPP. IC is a fast-performing and reliable algorithm. By combining GOA and IC, the proposed method can find the GMPP accurately with a short tracking time. Various experimental results show that the proposed method yields the highest tracking efficiency and lowest tracking time compared to some of the state-of-the-art MPPT algorithms, such as particle swarm and modified firefly optimizations.

Background: PfSPZ Vaccine, a promising pre-erythrocytic stage malaria vaccine candidate based on whole, radiation-attenuated Plasmodium falciparum (Pf) sporozoites (SPZ), has proven safe and effective in mediating sterile protection from malaria in malaria-naïve and exposed healthy adults. Vaccine-induced protection presumably depends on cellular responses to early parasite liver stages, but humoral immunity contributes., Methods: On custom-made Pf protein microarrays, we profiled IgG and IgM responses to PfSPZ Vaccine and subsequent homologous controlled human malaria infection (CHMI) in 21 Tanzanian adults with (n = 12) or without (n = 9) HIV infection. Expression of the main identified immunogens in the pre-erythrocytic parasite stage was verified by immunofluorescence detection using freshly purified PfSPZ and an in vitro model of primary human hepatocytes., Findings: Independent of HIV infection status, immunisation induced focused IgG and IgM responses to circumsporozoite surface protein (PfCSP) and merozoite surface protein 5 (PfMSP5). We show that PfMSP5 is detectable on the surface and in the apical complex of PfSPZ., Interpretation: Our data demonstrate that HIV infection does not affect the quantity of the total IgG and IgM antibody responses to PfCSP and PfMSP5 after immunization with PfSPZ Vaccine. PfMSP5 represents a highly immunogenic, so far underexplored, target for vaccine-induced antibodies in malaria pre-exposed volunteers., Funding: This work was supported by the Equatorial Guinea Malaria Vaccine Initiative (EGMVI), the Clinical Trial Platform of the German Center for Infection Research (TTU 03.702), the Swiss Government Excellence Scholarships for Foreign Scholars and Artists (grant 2016.0056) and the Interdisciplinary Center for Clinical Research doctoral program of the Tübingen University Hospital. The funders had no role in design, analysis, or reporting of this study., Competing Interests: Declaration of interests Sanaria Inc. manufactured PfSPZ Vaccine and PfSPZ Challenge and was the sponsor of the clinical trial. YA, BKLS, TLR, TM, and SLH are salaried, full-time employees of Sanaria, and LWPC and PFB were full-time, salaried employees of Sanaria at the time the trial was conducted. All authors associated with Sanaria have potential conflicts of interest. All other authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background and Objectives: Despite decades of increasingly sophisticated neurocritical care, patient outcomes after spontaneous intracerebral hemorrhage (ICH) remain dismal. Whether this reflects therapeutic nihilism or the effects of the primary injury has been questioned. In this contemporary cohort, we determined the 30- and 90-day mortality, cause-specific mortality, functional outcome, and the effect of surgical intervention in a culture of aggressive medical and surgical support., Methods: This was a retrospective cohort study of consecutive adult patients with spontaneous ICH admitted to a tertiary neurocritical care unit. Patients with secondary ICH and those subject to limitation of care before 72 hours were excluded. For each ICH score, mortality at 30- and 90-days, and the modified Rankin Scale (mRS) within 1-year were examined. The effect of craniotomy/craniectomy ± hematoma evacuation on the outcome of supratentorial ICH was determined using propensity score matching. Median patient follow-up after discharge was 2.2 (interquartile range [IQR] 0.4-4.4) years., Results: Among 319 patients with spontaneous ICH (median age was 69 [IQR 60-77] years, 60% male), 30- and 90-day mortality were 16% and 22%, respectively, and unfavorable functional outcome (mRS score 4-6) was 50% at a median 3.1 months after ICH. Admission predictors of mortality mirrored those of the original ICH score. Unfavorable outcomes for ICH scores 3 and 4 were 73% and 86%, respectively. The most common adjudicated primary causes of mortality were direct effect or progression of ICH (54%), refractory cerebral edema (21%), and medical complications (11%). In matched analyses, lifesaving surgery for supratentorial ICH did not significantly alter mortality or unfavorable functional outcome in patients overall. In subgroup analyses restricted to (1) surgery with hematoma evacuation and (2) ICH score 3 and 4 patients, the odds of 30-day mortality were reduced by 71% (odds ratio [OR] 0.29, 95% CI 0.09-0.9, p = 0.032) and 80% (OR 0.2, 95% CI 0.04-0.91, p = 0.038), respectively, but no difference was observed for 90-day mortality or unfavorable functional outcome., Discussion: This study demonstrates that poor outcomes after ICH prevail despite aggressive treatment. Unfavorable outcomes appear related to direct effects of the primary injury and not to premature care limitations. Lifesaving surgery for supratentorial lesions delayed mortality but did not alter functional outcomes., (© 2023 American Academy of Neurology.)

Our understanding of the human immune response to malaria remains incomplete. Clinical trials using whole-sporozoite-based vaccination approaches such as the Sanaria PfSPZ Vaccine, followed by controlled human malaria infection (CHMI) to assess vaccine efficacy offer a unique opportunity to study the immune response during Plasmodium falciparum infection. Diverse populations of T cells that are not restricted to classical HLA (unconventional T cells) participate in the host response during Plasmodium infection. Although several populations of unconventional T cells exist, the majority of studies focused on TCR Vγ9Vδ2 cells, the most abundant TCR γδ cell population in peripheral blood. In this study, we dissected the response of three TCR γδ cell subsets and mucosal-associated invariant T cells in healthy volunteers immunized with PfSPZ Vaccine and challenged by CHMI using Sanaria PfSPZ Challenge. Using a flow cytometry-based unbiased analysis followed by T cell cloning, several findings were made. Whereas major ex vivo alterations were not detectable after immunization with PfSPZ Vaccine, TCR Vδ2, and mucosal-associated invariant T cells expanded after asexual blood-stage parasitemia induced by CHMI. CHMI, but not vaccination, also induced the activation of TCR Vδ1 and Vδ1 - Vδ2 - γδ T cells. The activated TCR Vδ1 cells were oligoclonal, suggesting clonal expansion, and upon repeated CHMI, showed diminished response, indicating long-term alterations induced by blood-stage parasitemia. Some TCR Vδ1 clones recognized target cells in the absence of parasite-derived Ags, thus suggesting recognition of self-molecules. These findings reveal the articulate participation of different populations of unconventional T cells to P. falciparum infection., (Copyright © 2019 by The American Association of Immunologists, Inc.)

Background: Malaria is endemic in Tanzania with majority of clinical cases caused by Plasmodium falciparum. Additionally, Plasmodium malariae and Plasmodium ovale spp. are also present and clinical manifestations caused by these infections are not well described. Clinical episodes caused by P. malariae infections are often characterized by a relatively mild illness with a low number of parasites, which can persist for long periods. In this report, two cases of P. malariae infections that were identified during a clinical trial evaluating the P. falciparum malaria vaccine candidate, PfSPZ Vaccine are described. The two participants were followed up and monitored for clinical and laboratory parameters to assess vaccine safety providing the opportunity to study clinical manifestations of P. malariae over 4 months., Case Presentation: Two young, healthy Tanzanian men infected with low density asexual blood stage P. malariae diagnosed by quantitative polymerase chain reaction (qPCR) are described. Retrospective analysis of collected and stored blood samples revealed that the two volunteers had constant asexual blood stage parasitaemia for more than 4 months. During the 132 days of infection, the volunteers' vital signs, body temperature and serum biochemistry all remained within normal ranges. Haematological abnormalities, which were transiently outside normal ranges, were regarded as not clinically significant. During this time period, four consecutive evaluations of blood samples by thick blood smear microscopy conducted by an experienced microscopist were all negative, indicating the presence of low-density sub-microscopic infections., Conclusions: The two cases of P. malariae infections presented here confirm the ability of this Plasmodium species to persist at low density in the human host for extended time periods without causing clinical symptoms. The presented data also demonstrate that clinical study sites in malaria endemic regions need to have a strong malaria diagnostic infrastructure, including the ability of capturing sub-microscopic parasitaemia and differentiation of Plasmodium species. Trial registration ClinicalTrials.gov: NCT02613520, https://clinicaltrials.gov/ct2/show/NCT02613520 , Registered: November 24th 2015, Enrolment of the first participant to the trial: December 15th 2015, Trial was registered before the first participant was enrolled.

Background: The assessment of antibody responses after immunization with radiation-attenuated, aseptic, purified, cryopreserved Plasmodium falciparum sporozoites (Sanaria PfSPZ Vaccine) has focused on IgG isotype antibodies. Here, we aimed to investigate if P. falciparum sporozoite binding and invasion-inhibitory IgM antibodies are induced following immunization of malaria-preexposed volunteers with PfSPZ Vaccine., Methods: Using serum from volunteers immunized with PfSPZ, we measured vaccine-induced IgG and IgM antibodies to P. falciparum circumsporozoite protein (PfCSP) via ELISA. Function of this serum as well as IgM antibody fractions was measured via in vitro in an inhibition of sporozoite invasion assay. These IgM antibody fractions were also measured for binding to sporozoites by immunofluorescence assay and complement fixation on whole sporozoites., Results: We found that in addition to anti-PfCSP IgG, malaria-preexposed volunteers developed anti-PfCSP IgM antibodies after immunization with PfSPZ Vaccine and that these IgM antibodies inhibited P. falciparum sporozoite invasion of hepatocytes in vitro. These IgM plasma fractions also fixed complement to whole P. falciparum sporozoites., Conclusions: This is the first finding that PfCSP and P. falciparum sporozoite-binding IgM antibodies are induced following immunization of PfSPZ Vaccine in malaria-preexposed individuals and that IgM antibodies can inhibit P. falciparum sporozoite invasion into hepatocytes in vitro and fix complement on sporozoites. These findings indicate that the immunological assessment of PfSPZ Vaccine-induced antibody responses could be more sensitive if they include parasite-specific IgM in addition to IgG antibodies., Clinical Trials Registration: NCT02132299.