Higher education in East Asia and Singapore: rise of the Confucian Model

The paper reviews Asia–Pacific higher education and university research, focusing principally on the “Confucian” education nations Japan, Korea, China, Hong Kong China, Taiwan, Singapore and Vietnam. Except for Vietnam, these systems exhibit a special developmental dynamism—still playing out everywhere except Japan—and have created a distinctive model of higher education more effective in some respects than systems in North America, the English-speaking world and Europe where the modern university was incubated. The Confucian Model rests on four interdependent elements: (1) strong nation-state shaping of structures, funding and priorities; (2) a tendency to universal tertiary participation, partly financed by growing levels of household funding of tuition, sustained by a private duty, grounded in Confucian values, to invest in education; (3) “one chance” national examinations that mediate social competition and university hierarchy and focus family commitments to education; (4) accelerated public investment in research and “world-class’ universities. The Model has downsides for social equity in participation, and in the potential for state interference in executive autonomy and academic creativity. But together with economic growth amid low tax regimes, the Confucian Model enables these systems to move forward rapidly and simultaneously in relation to each and all of mass tertiary participation, university quality, and research quantity and quality.     

Educational gaps in medical care and health behavior: Evidence from US Natality data

The US Natality files provide information on medical procedures and health related behavior during pregnancy and childbirth. The data set represents nearly the universe of mothers who give birth in the US, providing the most complete coverage possible of medical care and health behavior among a specific patient population. We document gaps in outcomes by education of the mother and the changes in these educational gaps during 1989-2002.     

Finite-time stability and stabilization results for switched impulsive dynamical systems on time scales

In this article, we study the finite-time stability (FTS) and finite time stabilization problems for a class of switched impulsive systems evolving on an arbitrary time domain. This problem is formulated using time scale theory where the time domain can be continuous, discrete, union of disjoint intervals with variable gaps and variable lengths or any combination of these. Using common Lyapunov-quadratic and Lyapunov-like functions, we establish sufficient conditions to ensure the FTS results. Further, to solve the stabilization problem, we design state feedback controllers. We have illustrated the effectiveness of the obtained analytical results though numerical examples.     

Effect of Vitamin E on sP-Selectin Levels in Pre-Eclampsia

P-selectin, a cell adhesion molecule is elevated in many inflammatory conditions including preeclampsia which is characterized by generalized endothelial dysfunction and vasoconstriction presumably due to free radicals or mediators released by defective placentation. Vitamin E has been documented to protect cell membranes from oxidative damage and also decrease platelet aggregation. The role of vitamin E in pre-eclampsia is contradictory and hence the study was undertaken. Soluble P-selectin was measured by ELISA and Vitamin-E levels in plasma was estimated spectrofluorometrically. In our study the effect of supplementation of 400 IU/day of Vitamin E (a-tocopheryl acetate) to patients of pre-eclampsia showed significant decreased levels of soluble P-selectin by 2nd week as compared to patients given placebo (P = 0.005). In this short period of study no direct correlations were observed between Vitamin E or P-selectin levels with blood pressure as well as with proteinuria. Future studies may focus on the effect of a-tocopheryl acetate or the phosphate form of Vitamin-E, recently proposed to be the more active form on other inflammatory markers like IL-6, an important stimuli of P-selectin release in pre-eclampsia.     

Diagnostic Dilemma of HbA1c Detection in Presence of a Hemoglobinopathy: A Case Report

We report a case of a diabetic, heterozygote with near normal hematology, marginally low level of hemoglobin A₂(HbA₂) having an increased level of hemoglobin F(HbF) that was pancellularly distributed among the red cells. BioRad DiaSTAT measurements gave a high glycated hemoglobin A1c(HbA1c) of 31.5% and the BioRad Variant analyzer recorded an HbA1c value which was very low, in discordance with the detected blood glucose levels. Flow cytometry and polymerization chain reaction (PCR) based studies were carried out which revealed the case to be that of the common hereditary persistence of fetal hemoglobin (HPFH)-3, an Asian Indian mutation. Fructosamine estimation and HbA1c by Boronate affinity chromatography were able to resolve the discordant value detected and was able to confirm the diabetes status. The case would have been a diagnostic dilemma, if reported without correlation.     

Are we using Thyroid Function Tests Appropriately?

Thyroid function tests are very important for the diagnosis and monitoring of patients with thyroid dysfunction. The guidelines recommend serum thyroid stimulating hormone (TSH) as the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism. The aim of this study was to analyze the ordering pattern for thyroid function tests by physicians and the analysis of results based on the clinical history. The mean age of the patients was 32.5 ± 6.5 years. Majority of samples (87.7% of total) were received from the departments of Medicine and Gynae. Thyroid profiles (47.5%) were ordered more frequently as compared to TSH only (46%). There was no significant difference in the percentage of normal reports for both types of tests. 77.8% of TFT and 76.6% of TSH samples had results within the reference range. The percentage of abnormal results was 13.7% in the patients who were screened for thyroid disorders. There is a need to redefine the case definition for thyroid dysfunction and order the appropriate test in a rational and cost effective manner.     

Application of Sigma Metrics for the Assessment of Quality Assurance in Clinical Biochemistry Laboratory in India: A Pilot Study

Ensuring quality of laboratory services is the need of the hour in the field of health care. Keeping in mind the revolution ushered by six sigma concept in corporate world, health care sector may reap the benefits of the same. Six sigma provides a general methodology to describe performance on sigma scale. We aimed to gauge our laboratory performance by sigma metrics. Internal quality control (QC) data was analyzed retrospectively over a period of 6 months from July 2009 to December 2009. Laboratory mean, standard deviation and coefficient of variation were calculated for all the parameters. Sigma was calculated for both the levels of internal QC. Satisfactory sigma values (>6) were elicited for creatinine, triglycerides, SGOT, CPK-Total and Amylase. Blood urea performed poorly on the sigma scale with sigma <3. The findings of our exercise emphasize the need for detailed evaluation and adoption of ameliorative measures in order to effectuate six sigma standards for all the analytical processes.     

Distribution of Methionine Synthase Reductase (MTRR) Gene A66G Polymorphism in Indian Population

Methionine synthase reductase (MTRR) is an important enzyme of the folate/homocysteine pathway. It is responsible for regulation of methionine enzyme by reductive methylation. A common variant A66G is reported in the FMN-binding domain of the MTRR gene, which leads to substitution of isoleucine by methionine (I22M) in MTRR enzyme with reduced activity. Reduced catalytic activity of enzyme leads to high homocysteine concentration in blood and increases risk for numerous diseases. The frequency of A66G polymorphism varies in different ethnic groups. The present study has been designed to evaluate the frequency of MTRR A66G gene polymorphism in the Eastern UP population by PCR–RFLP method. Along with this we also performed a meta-analysis to evaluate the global prevalence of this polymorphism. Databases were screened to identified the eligible studies. The prevalence of the G allele and GG genotype was determined by the use of prevalence proportion with 95% CI. Open meta-analyst software was used for the meta-analysis. Total 1000 blood samples were analyzed, the frequencies of A and G alleles were 0.35 and 0.65 respectively. Meta-analysis results revealed that the prevalence of G allele and GG genotype were 49.4% (95% CI 40.6–58.1, p ≤ 0.001) and 24.3% (95% CI 17.8–30.9, p ≤ 0.001) respectively. In sub-group meta-analysis, the lowest frequency of G allele was found in South America (32.7%; 95% CI 14.1–51.3, p ≤ 0.001), and highest in Asia (56.4%; 95% CI 39.5–73.3, p ≤ 0.001). The results of the meta-analysis showed that the Asian population has the highest frequency of G allele and highest frequency of the GG genotype was found in the European population.