Digital Commons Network^™

Acute Otitis Media: Low Dose Versus High Dose Amoxicillin, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

A Saturated Map Of Common Genetic Variants Associated With Human Height, Loïc Yengo, E Warwick Daw, Lihua Wang, Mary F. Feitosa, Michael A. Province, Dabeeru C. Rao, Adam E. Locke, Et Al.

2020-Current year OA Pubs

No abstract provided.

Correlation Of Gut Alteration With The Progression Of Experimental Autoimmune Encephalomyelitis (Eae) In C57bl/6 Mice, Al Anood Ahmed Al Naqbi

Theses

Background: Experimental autoimmune encephalomyelitis (EAE) is the mouse disease model of multiple sclerosis (MS), a chronic autoimmune disease targeting the central nervous system (CNS) resulting in neuroinflammation, neuroaxonal degeneration, and demyelination. Autoreactive CD4⁺ T cells are known for their role in the pathogenesis of MS. CD8⁺ T cells and NK cells were also found to be associated with the disease.

Aim: There is a limited number of studies investigating the link between gut alterations and immune cells in the gut influencing the outcome of the disease since the vast majority of MS patients experience gastrointestinal (GI) problems. Here, …

The Effectiveness Of Movement Control Order (Mco) Phases Implementation In Malaysia, Hezlin Aryani Abd Rahman, Muhammad Akram Rahman, ‘Ain Najihah Rozaimi, Irfan Bihar Zulnahar

Malaysian Journal of Computing (MJoC)

The COVID-19 cases have taken its strike since December 2019 in Wuhan, China and then has spread to other countries. Malaysia was not excluded from this pandemic, in which the first case of COVID-19 was discovered on 25th January 2020. The disease has caused a pandemic outbreak ever since, driving many countries to close international gateways and implement lockdowns and many studies have been trying to model and forecast the rising number of Covid-19 cases worldwide. This study aimed to prove the effectiveness of Movement Control Order (MCO) phases implemented in Malaysia. From 8 MCO phases implemented in Malaysia, 5 …

A Dynamic Sir Model For The Spread Of Novel Coronavirus Disease 2019 (Covid-19) In Malaysia, Nur Aziean Mohd Idris, Siti Khadijah Mohtar, Zaileha Md Ali, Khadijah Abdul Hamid

Malaysian Journal of Computing (MJoC)

The emergence of the first coronavirus disease 2019 (COVID-19) case in Malaysia has increased the number of infected cases. Hence, this study proposes a Susceptible-Infected-Recovery (SIR) epidemiological model of the COVID-19 epidemic to portray the outbreak's situation. The SIR model is numerically solved using the Fourth-order Runge-Kutta (RK4) method in Matlab®. The Euler method verifies that the graphical results of the SIR model are reliable and valid. In addition, this study analyses the stability of disease-free and endemic equilibriums of the SIR model by the Jacobian matrix. The results show the outbreak for phase 1 occurs in the first 100 …

Prediction Of Life Expectancy For Asian Population Using Machine Learning Algorithms, Nurul Shahira Pisal, Shuzlina Abdul-Rahman, Mastura Hanafiah, Saidatul Izyanie Kamarudin

Malaysian Journal of Computing (MJoC)

Predicting life expectancy has become more important nowadays as life has become more vulnerable due to many factors, including social, economic, environmental, education, lifestyle, and health condition. A lot of studies on life expectancy have been carried out. However, studies focusing on the Asian population are limited. This study presents machine learning algorithms for life expectancy based on the Asian population dataset. Comparisons are made between tree classifier models, namely, J48, Random Tree, and Random Forest. Cross validations with 10 and 20 folds are used. Results show that the highest accuracy is obtained with Random Forest with 84% accuracy with …

Water Microbial Pollution Risk Simulation And Prediction Using Ml, Dania Al Safadi

Theses

Water quality has been a global concern due to its scarcity as well as it is direct effects on wellbeing and food production. Therefore, many studies have been addressing this matter in order to address the consequences left behind. Consider the harmful effects of polluted water moving uninterrupted over vast distances and through countless homes. The water we drink, cook with, and bathe in would not be safe requiring an immediate response in order to reduce the damage as a direct result of the pollution. The aim of this study was to develop models that could evaluate the microbial water …

Fraudulent Insurance Claims Detection Using Machine Learning, Arif Ismail Alrais

Theses

As the different countries around the world evolve into a more economical-based and stimulating their economy is the goal. The main purpose of most of these countries is to fight off money launderers and fraudsters for better economic growth. A popular fraud topic in this regard is insurance fraud since it costs the companies and the public billions. Applying data analysis and machine learning are great ways used to address many problems regarding any automated system. To address this problem, first extensive research should be made to check out what has been applied and what the most promising solution using …

Exponential Growth Bias And The Law: Why Do We Save Too Little, Borrow Too Much, And Fail To React On Time To Deadly Pandemics And Climate Change?, Doron Teichman,, Eyal Zamir, Professor Of Commercial Law

Vanderbilt Law Review

Many human decisions, ranging from the taking of loans with compound interest to fighting deadly pandemics, involve phenomena that entail exponential growth. Yet a wide and robust body of empirical studies demonstrates that people systematically underestimate exponential growth.

This phenomenon, dubbed the exponential growth bias (“EGB”), has been documented in numerous contexts and across different populations, using both experimental and observational methods.

Despite its centrality to human decisionmaking, legal scholarship has thus far failed to account for the EGB. This Article presents the first comprehensive study of the EGB and the law. Incorporating the EGB into legal analysis sheds a …

Emergence Of A Multidrug-Resistant And Virulent Streptococcus Pneumoniae Lineage Mediates Serotype Replacement After Pcv13: An International Whole-Genome Sequencing Study, Stephanie W. Lo, Kate Mellor, Robert Cohen, Alba Redin Alonso, Sophie Belman, Narender Kumar, Paulina A. Hawkins, Rebecca A. Gladstone, Sadia Shakoor, Muhammad Imran Nisar

Department of Pathology and Laboratory Medicine

Background: Serotype 24F is one of the emerging pneumococcal serotypes after the introduction of pneumococcal conjugate vaccine (PCV). We aimed to identify lineages driving the increase of serotype 24F in France and place these findings into a global context.
Methods: Whole-genome sequencing was performed on a collection of serotype 24F pneumococci from asymptomatic colonisation (n=229) and invasive disease (n=190) isolates among individuals younger than 18 years in France, from 2003 to 2018. To provide a global context, we included an additional collection of 24F isolates in the Global Pneumococcal Sequencing (GPS) project database for analysis. A Global Pneumococcal Sequence Cluster …

Adherence To Screening And Management Guidelines Of Maternal Group B Streptococcus Colonization In Pregnancy, Sabine Pangerl, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

Aims: To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led). Design: This retrospective quantitative study has employed a descriptive design using administrative health data. Methods: Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis. Results: The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to …

The Association Of Baseline Plasma Sars-Cov-2 Nucleocapsid Antigen Level And Outcomes In Patients Hospitalized With Covid-19, Activ-3/Tico Study Group, Angela J Rogers, Deborah Wentworth, Andrew Phillips, Katy Shaw-Saliba, Robin L Dewar, Neil R Aggarwal, Abdel G Babiker, Weizhong Chang, Nila J Dharan, Victoria J Davey, Elizabeth S Higgs, Norman Gerry, Adit A Ginde, J W Awori Hayanga, Helene Highbarger, Jeroen L Highbarger, Mamta K Jain, Virginia Kan, Kami Kim, Perrine Lallemand, Bradley G Leshnower, Joseph K Lutaakome, Gail Matthews, Ahmad Mourad, Eleftherios Mylonakis, Ven Natarajan, Maria L Padilla, Lavannya M Pandit, Roger Paredes, Sarah Pett, Srikanth Ramachandruni, M Tauseef Rehman, Brad T Sherman, D Clark Files, Samuel M Brown, Michael A Matthay, B Taylor Thompson, James D Neaton, H Clifford Lane, Jens D Lundgren

Faculty, Staff and Students Publications

BACKGROUND: Levels of plasma SARS-CoV-2 nucleocapsid (N) antigen may be an important biomarker in patients with COVID-19 and enhance our understanding of the pathogenesis of COVID-19.

OBJECTIVE: To evaluate whether levels of plasma antigen can predict short-term clinical outcomes and identify clinical and viral factors associated with plasma antigen levels in hospitalized patients with SARS-CoV-2.

DESIGN: Cross-sectional study of baseline plasma antigen level from 2540 participants enrolled in the TICO (Therapeutics for Inpatients With COVID-19) platform trial from August 2020 to November 2021, with additional data on day 5 outcome and time to discharge.

SETTING: 114 centers in 10 countries. …

Crucial Nuances In Understanding (Mis)Associations Between The Neonatal Microbiome And Cesarean Delivery, Alexa M Sassin, Grace J Johnson, Alison N Goulding, Kjersti M Aagaard

Faculty, Staff and Students Publications

As rates of Cesarean delivery and common non-communicable disorders (NCDs), such as obesity, metabolic disease, and atopy/asthma, have concomitantly increased in recent decades, investigators have attempted to discern a causal link. One line of research has led to a hypothesis that Cesarean birth disrupts the presumed normal process of colonization of the neonatal microbiome with vaginal microbes, yielding NCDs later in life. However, a direct link between a disrupted microbiota transfer at time of delivery and acute and/or chronic illness in infants born via Cesarean has not been causally established. Microbiota seeding from maternal vaginal or stool sources has been …

The Association Of Baseline Plasma Sars-Cov-2 Nucleocapsid Antigen Level And Outcomes In Patients Hospitalized With Covid-19, Angela J Rogers, Deborah Wentworth, Andrew Phillips, Katy Shaw-Saliba, Robin L Dewar, Neil R Aggarwal, Abdel G Babiker, Weizhong Chang, Nila J Dharan, Victoria J Davey, Elizabeth S Higgs, Norman Gerry, Adit A Ginde, J W Awori Hayanga, Helene Highbarger, Jeroen L Highbarger, Mamta K Jain, Virginia Kan, Kami Kim, Perrine Lallemand, Bradley G Leshnower, Joseph K Lutaakome, Gail Matthews, Ahmad Mourad, Eleftherios Mylonakis, Ven Natarajan, Maria L Padilla, Lavannya M Pandit, Roger Paredes, Sarah Pett, Srikanth Ramachandruni, M Tauseef Rehman, Brad T Sherman, D Clark Files, Samuel M Brown, Michael A Matthay, B Taylor Thompson, James D Neaton, H Clifford Lane, Jens D Lundgren

Faculty, Staff and Students Publications

BACKGROUND: Levels of plasma SARS-CoV-2 nucleocapsid (N) antigen may be an important biomarker in patients with COVID-19 and enhance our understanding of the pathogenesis of COVID-19.

OBJECTIVE: To evaluate whether levels of plasma antigen can predict short-term clinical outcomes and identify clinical and viral factors associated with plasma antigen levels in hospitalized patients with SARS-CoV-2.

DESIGN: Cross-sectional study of baseline plasma antigen level from 2540 participants enrolled in the TICO (Therapeutics for Inpatients With COVID-19) platform trial from August 2020 to November 2021, with additional data on day 5 outcome and time to discharge.

SETTING: 114 centers in 10 countries. …

Genome Interpretation Using In Silico Predictors Of Variant Impact, Panagiotis Katsonis, Kevin Wilhelm, Amanda Williams, Olivier Lichtarge

Faculty, Staff and Students Publications

Estimating the effects of variants found in disease driver genes opens the door to personalized therapeutic opportunities. Clinical associations and laboratory experiments can only characterize a tiny fraction of all the available variants, leaving the majority as variants of unknown significance (VUS). In silico methods bridge this gap by providing instant estimates on a large scale, most often based on the numerous genetic differences between species. Despite concerns that these methods may lack reliability in individual subjects, their numerous practical applications over cohorts suggest they are already helpful and have a role to play in genome interpretation when used at …

Azithromycin Use Increases The Risk Of Sudden Cardiac Death In Patients With Hemodialysis-Dependent Kidney Failure, Magdalene M Assimon, Patrick H Pun, Lily Wang, Sana M Al-Khatib, M Alan Brookhart, David J Weber, Wolfgang C Winkelmayer, Jennifer E Flythe

Faculty, Staff and Students Publications

Azithromycin is an antibiotic with QT-prolonging potential commonly prescribed to individuals receiving hemodialysis. Hemodialysis patients have a high prevalence of clinical conditions, such as structural heart disease, that can enhance the pro-arrhythmic effects azithromycin, but were excluded from prior investigations evaluating the cardiac safety of azithromycin. Using data from the United States Renal Data System (2007–2017), we conducted two cohort studies to examine the cardiac safety of azithromycin relative to amoxicillin-based antibiotics (amoxicillin, amoxicillin/clavulanic acid) and levofloxacin (a fluoroquinolone antibiotic known to prolong the QT-interval) in the hemodialysis population. The primary outcome was five-day sudden cardiac death. Using inverse probability …

Giving Heroes Their Shields: Providing More Immunity To The Healthcare Industry During The Covid-19 Pandemic, Gabriella Levine

Journal of Civil Rights and Economic Development

(Excerpt)

The year is 2022. We are experiencing a global pandemic and economic uncertainty. And while traffic might have improved, as many work remotely and socially distance, everything else is unknown as people are face-to-face with death. The future has never looked bleaker.

As of September 12, 2022, there were 1,044,461 Coronavirus (“COVID-19”) related deaths and 94,973,074 reported COVID-19 cases in the United States (“U.S.”). The effects of COVID-19 impacted people who contracted the disease, family members who lost someone, and people at risk who have been in isolation for over one year.

Another group that has been heavily affected …

Small Business Relief In The Time Of Covid-19: Deservingness Judgments Lead The Ppp To Failure, Blair Hendricks

Journal of Civil Rights and Economic Development

(Excerpt)

In 2020, going to the grocery store or getting a bite to eat looked a little different than usual: normal outings in 2020 required masks and temperature checks, among other safety precautions. As if patronizing businesses was not difficult enough, operating a business in 2020 could have been downright tragic. In December 2020, Steven Klein, the owner of Vision Lanes Bowling Alley, posted a tribute on his Facebook page to his beloved business. The following is an excerpt from that post:

This is NOT a political post. My sources are telling me an extension is going to be announced. …

2022-September-30-Meharry Medical College President, Ceo To Speak At Etsu On Oct. 13, University Marketing And Communication, East Tennessee State University

ETSU News

JOHNSON CITY (Sept. 30, 2022) – Noted scientist, physician and administrator Dr. James E.K. Hildreth will give a free public lecture at East Tennessee State University on Thursday, Oct. 13.

Hildreth, president and CEO of Meharry Medical College, will speak at 6:30 p.m. in the Grand Soldiers Ballroom of the Carnegie Hotel, following a 5:30 p.m. reception.

His talk, titled “An Immunological Paradox Explained: HIV as Trojan Exosome,” is sponsored by the university’s Black American Studies Program. It is also part of the ETSU College of Public Health’s Leading Voices in Public Health Lecture Series serving as the second …

Public Health Information Seeking, Trust, And Covid-19 Prevention Behaviors: Cross-Sectional Study, Emmanuel Kwabena Tetteh, Todd Combs, Elvin Hsing Geng, Virginia Ruth Mckay

2020-Current year OA Pubs

BACKGROUND: Preventative health measures such as shelter in place and mask wearing have been widely encouraged to curb the spread of the COVID-19 disease. People's attitudes toward preventative behaviors may be dependent on their sources of information and trust in the information.

OBJECTIVE: The aim of this study was to understand the relationship between trusting in COVID-19 information and preventative behaviors in a racially and politically diverse metropolitan area in the United States.

METHODS: We conducted a web-based cross-sectional survey of residents in St. Louis City and County in Missouri. Individuals aged ≥18 years were eligible to participate. Participants were …

A Novel Piggyback Strategy For Mrna Delivery Exploiting Adenovirus Entry Biology, Myungeun Lee, Paul J Rice-Boucher, Logan Thrasher Collins, Ernst Wagner, Lorenzo Aulisa, Jeffrey Hughes, David T Curiel

2020-Current year OA Pubs

Molecular therapies exploiting mRNA vectors embody enormous potential, as evidenced by the utility of this technology for the context of the COVID-19 pandemic. Nonetheless, broad implementation of these promising strategies has been restricted by the limited repertoires of delivery vehicles capable of mRNA transport. On this basis, we explored a strategy based on exploiting the well characterized entry biology of adenovirus. To this end, we studied an adenovirus-polylysine (AdpL) that embodied "piggyback" transport of the mRNA on the capsid exterior of adenovirus. We hypothesized that the efficient steps of Ad binding, receptor-mediated entry, and capsid-mediated endosome escape could provide an …

Help Is Available: Supporting Mental Wellness Through Peer Health Navigation With Young Black Men Who Have Sex With Men With Hiv, Donald R Gerke, Jeff Glotfelty, Maria Freshman, Julia Schlueter, Alex Ochs, Katie Plax

2020-Current year OA Pubs

Young black men who have sex with men (YBMSM) with HIV experience disproportionate rates of trauma, incarceration, poverty, racial discrimination, and homophobia. The synergistic effects of these adverse experiences, along with increased rates of mental health disorders, increase their risk for poor health. To address this need, the study authors adapted a current HIV service model to include a peer-health navigation intervention (WITH U) to attend to behavioral health, health literacy, linkage to services, and psychosocial support for YBMSM with HIV. This longitudinal, mixed-methods, nonexperimental study reports on the mental health burden among participants and the association between participation in …

Seasonal Habitat Selection By American White Pelicans, Frederick L. Cunningham, Guiming Wang, D. Tommy King

United States Department of Agriculture Wildlife Services: Staff Publications

Resource utilization strategies of avian migrants are a major concern for conservation and management. Understanding seasonal habitat selection by migratory birds helps us explain the ongoing continental declines of migratory bird populations. Our objective was to compare the secondorder and third-order habitat selection by the American White Pelican (Pelecanus erythrorhynchos; hereafter pelican) between the breeding and non-breeding grounds. We tested the Lack hypothesis that habitat selection by migratory birds is stronger on the breeding grounds than on the nonbreeding grounds. We used random-effect Dirichlet-multinomial models to estimate the second-order habitat selection between the seasons with the GPS locations …

Biodiversity Of Culicidae (Insecta: Diptera) In The Region Of Khenchela (Northeast Algeria), Imane Halimi, Fatima Zohra Zohra Kara-Toumi, Salim Lebbal, Ruben Bueno Mari, Asma Ghorab, Fairouz Saidi

Journal of Bioresource Management

Mosquitoes are considered as vectors of serious human diseases. The prevention of parasitic and arboviral vector-borne diseases is based mostly on vector control strategies. This control cannot be effective unless a strong knowledge of mosquito biology and distribution in the working area. In this context, and in order to improve the knowledge on the specific diversity of the culicids fauna in the region of Khenchela (northeast of Algeria), an inventory of mosquitoes was carried out for the first time in this region. Larval collection was conducted in various types of habitats through continuous monitoring of seven sites from May 2020 …

Characteristics Of Community-Acquired Carbapenem-Resistant Enterobacterales, Rima Shrestha, Courtney L Luterbach, Weixiao Dai, Lauren Komarow, Michelle Earley, Gregory Weston, Erica Herc, Jesse T Jacob, Robert Salata, Darren Wong, Deverick Anderson, Kirsten B Rydell, Cesar A Arias, Liang Chen, David Van Duin, Mdro Investigators

Faculty, Staff and Student Publications

BACKGROUND: Community-acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat.

METHODS: In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured >48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling.

RESULTS: CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was …

Mutation Of Aspergillus Sp. Using Ultraviolet Light And Nitrous Acid For Amylase Production From Banana Peels, Cyprian Erumiseli Oshoma, Johnson Oche Akor, Beckley Ikhajiagbe, Marcel James Ikenebomeh

Makara Journal of Science

Strain improvement through mutagenesis is important in the commercial development of microbial fermentation. This study aimed to produce amylase from banana (Musa sapientum) peels by using mutant Aspergillus sp. strains obtained via ultraviolet (UV) radiation and nitrous acid-based mutagenesis. Results revealed that banana peels pretreated with 0.8 N HCl had a biomass yield of 3.02 g/L and amylase activity of 2.81 U/L. Of the UV mutants, strain AUV1 had the highest biomass and amylase activity of 4.50 ± 0.21 g/L and 3.46 ± 0.14 U/L, respectively. Subsequently, HNO₂ mutants showed that strain ANA6 had 30.64% and …

Thirty-Six Months Recurrence After Acute Ischemic Stroke Among Patients With Comorbid Type 2 Diabetes: A Nested Case-Control Study, Lu Wang, Hongyun Li, Jiheng Hao, Chao Liu, Jiyue Wang, Jingjun Feng, Zheng Guo, Yulu Zheng, Yanbo Zhang, Hongxiang Li, Liyong Zhang, Haifeng Hou

Research outputs 2022 to 2026

Background:

Stroke patients have to face a high risk of recurrence, especially for those with comorbid T2DM, which usually lead to much more serious neurologic damage and an increased likelihood of death. This study aimed to explore determinants of stroke relapse among patients with comorbid T2DM.

Materials and methods:

We conducted this case-control study nested a prospective cohort of ischemic stroke (IS) with comorbid T2DM. During 36-month follow-up, the second stroke occurred in 84 diabetic IS patients who were allocated into the case group, while 613 patients without recurrence were the controls. We collected the demographic data, behaviors and habits, …

Pulse-Field Analysis Diversity Of Extended Spectrum Beta Lactamases Producing Gram Negative Bacteria Isolated From Periplaneta Americana (Cockroaches), Omolara D. Popoola, Moses O. Efuntoye, Georgia C. Agu, Benjamin T. Thomas

Tanzania Journal of Science

Extended spectrum beta lactamase (ESBL) producing bacteria are organisms of public health significance that have been implicated in prolonged hospital stay, treatment failures and higher fatalities. These organisms were originally thought to be widely distributed in hospital, but have since grown in terms of their epidemiological coverage. This study was therefore aimed at using pulse-field gel electrophoresis (PFGE) to understand the diversity of ESBL producing organisms originating from cockroaches in Ago-Iwoye, Nigeria. The diversity was determined by using a set of twenty six (26) ESBL producing bacterial strains isolated from cockroaches sampled in Ago-Iwoye community, Ogun State, Nigeria. PFGE analysis …

Keping Puzzle Yang Hilang: Menelaah Hak Yang Sirna Terhadap Narapidana, Muhammad Abdul Azis, Riski Ananda Kusuma Putri, Nur Rahman

Jurnal Hukum & Pembangunan

Prisons have a reputation for being cages of deprivation of freedom and atonement for wrongdoing. Prisoners lose their independence because prisons restrict their movement, including their sexual needs, which is like the "missing piece of the puzzle." The discussion in this article tries to explore the missing piece of prisoners' rights, examine, and analyze the impact of the Conjugal Visit program for prisoners in Indonesia, to bring new light to the realization of human rights in the prison system aimed at legal protection and fulfillment of human rights. This article uses normative legal methods. Systematic legal comparison is used to …

Determinants Of Hypertension Incidence In The Work Areas Of The Bone And Barru District Health Centers In 2022, Ida Leida Maria, Andi Selvi Yusnitasari, Clement Lifoia, A. Tiara Aurelia Annisa, Sri Mulyani

Media Kesehatan Masyarakat Indonesia

Hypertension is often called the silent killer because it does not show any symptoms. Hence, not all people with hypertension are aware that they suffer from a chronic condition that can cause degenerative diseases, to death. Hypertension is a problem that is often found in society, both in developed and developing countries, especially in Indonesia. The purpose of this study was to determine the factors associated with the incidence of hypertension in the work area of Dua Boccoe Health Center and Blue Health Center of Bone Regency and Padongko Health Center and Palakka Health Center of Barru Regency, with a …