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This research explores the implementation of Disaster Preparedness Areas in Indonesia, with a focus on formulating the role of critical communication elements in strengthening disaster response. The Disaster Preparedness Area involves community participation in disaster management efforts, and this research identified twelve critical communication elements. The qualitative approach was expressed with qualitative software by describing secondary data located in the Pangandaran Regency. This study bridged data limitations, important analyses, and the context of regional differences in Indonesia. The results emphasize the need for development, implementation, and education in a comprehensive communication strategy and active participation of the community. The findings are presented in the form of a radar curve with critical communication element scores on five scales. Some limitations emerged in this study, but it was able to provide valuable insights into the implementation of Disaster Preparedness Areas by prioritizing the importance of critical communication in disaster management. Recommendations can help stakeholders develop more effective communication strategies in dealing with disasters in Indonesia.This research investigates the implementation of Disaster Preparedness Areas in Indonesia, focusing on the role of critical communication elements in enhancing disaster response. Community participation is integral to the Disaster Preparedness Area, and this study identifies twelve crucial communication elements. Employing a qualitative approach, qualitative software is utilized to analyze secondary data from Pangandaran Regency, addressing data limitations and considering regional differences in Indonesia. The results underscore the necessity for the development, implementation, and education of a comprehensive communication strategy, along with the active involvement of the community. Findings are visually represented through a radar curve, presenting scores for critical communication elements across five scales. While certain limitations are acknowledged, the study provides valuable insights into Disaster Preparedness Area implementation, emphasizing the significance of critical communication in effective disaster management. Recommendations are outlined to assist stakeholders in devising more impactful communication strategies for disaster management in Indonesia.

Researchers and industry are looking for green and sustainable materials as reinforcement for lightweight composite structures. This research aim was designed to study the characteristics of the fibre extracted from a waste product of the spathe of date palm (SDP). In this work, density, crystallinity index, crystal size, tensile strength, surface roughness, extreme degradation temperature and thermal stability of SDP fibres were investigated. Density is estimated to be 0.59 g/cm3. X-ray diffraction analysis indicated the crystallinity index about (57.82%) and the crystal size is (19 nm). The results of the thermal analysis gave the degradation temperature as 270 °C and Ea as 69.14 kJ/mol. Scanning electron microscopy (SEM) investigation confirmed the presence of surface contaminants including wax and other foreign materials. Also, the mechanical properties identified are tensile strength (100 ± 21.5 MPa), and Young's modulus (4 ± 0.9% GPa). Based on the study's findings, SDP fibres should be considered for usage as a reinforcing material in the development of novel polymer composites with a wide range of lightweight industrial applications.

Date palm midribs, major agricultural residues in Egypt, were utilized in the development of a novel prefabricated thermal cladding panel as a local cost-efficient option by which users can retrofit their houses to enhance thermal comfort and reduce energy consumption, while complimenting the existing interior context. The developed panel consisted of midribs-strip-boards cladding surface encasing midribs-fibers non-woven insulating core. Firstly, cladding specimen and insulating core specimens of different densities were tested to determine their thermal conductivity. Secondly, results were used to design various configurations according to the requirements of The Egyptian Code of Energy Efficiency in Residential Buildings. Thirdly, Design Builder “Whole Building” simulations were used to compare between the annual cooling and heating energy consumption savings achieved after using standard insulation methods and savings achieved using the developed thermal-cladding panels. Results showed that midribs thermo-cladding panels effectively enhanced energy efficiency as a successful equivalent to standard insulation wall retrofitting techniques.

Sampah plastik telah menjadi permasalahan lingkungan yang mendesak. Menurut data dari Kementerian Lingkungan Hidup dan Kehutanan pada tahun 2021, total sampah yang dihasilkan mencapai sekitar 68,5 juta ton, dengan sekitar 11,6 juta ton atau sekitar 17% dari total tersebut adalah sampah plastik. Metode konvensional dalam pengolahan sampah plastik, seperti landfill dan open dumping, berdampak negatif terhadap lingkungan. Pembakaran plastik juga berkontribusi pada polusi udara. Daur ulang plastik hanya mengubahnya menjadi bentuk yang berbeda tanpa mengurangi jumlah sampah plastik secara keseluruhan. Oleh karena itu, diperlukan metode alternatif, dan salah satu metodenya adalah pirolisis. Pirolisis adalah proses yang mendegradasi material pada suhu antara 300°C dan 1000°C, menghasilkan gas yang dikondensasi dan dipecah menjadi minyak, meninggalkan arang. Berbagai faktor seperti komposisi material, suhu, waktu tinggal, dan ukuran bahan baku memengaruhi proses pirolisis. Penelitian ini bertujuan untuk mengembangkan teknologi pirolisis yang ramah lingkungan untuk mengubah sampah plastik menjadi bahan bakar alternatif berbasis minyak, mengevaluasi kualitas produk minyak, dan mengidentifikasi jenis sampah plastik yang cocok untuk pirolisis. Hasil penelitian menunjukkan bahwa pirolisis sampah plastik LDPE pada suhu 800°C menghasilkan minyak dengan sifat yang mendekati standar bensin dan solar Pertamina.

This paper presents an experimental study of acoustic absorption of novel fabric acoustic panels utilizing non-woven fabric cores and fabric facings made of date palm midribs-fibers; to be used as absorbent panels for spaces with privacy needs. Normal acoustic absorption coefficients of various configurations; different densities, thicknesses and facings; were measured using impedance tube. Findings showed that the highest absorption was exhibited by 50 mm- thick midribs-fibers cores. Additionally, 150 kg/m3 cores balanced between high tortuosity and porosity. Results of full assembly tests showed that 30 mm-150 kg/m3 and 40 mm-100 kg/m3 cores with woven midribs-fibers facings enjoyed significantly high absorption at low frequencies and high frequencies. Additionally, 40 mm-100 kg/m3 and 50 mm-200 kg/m3 cores with cotton facings provided competitive overall performances to commercial acoustic panels while providing flexible interior design options. Thus, interior designers can incorporate midribs-based fabric acoustic panels into their designs as local sustainable absorbent panels to enhance acoustical quality and complement space aesthetics.

Significant interest for utilizing and processing natural fibers (NF) to develop sustainable and fully biodegradable composites evolved as the global environmental concerns upsurge. Date palm tree (DPT) accounts for more than 2.8 million tons of waste annually, making it the most abundant agricultural biomass waste in the MENA region. This study investigates the effect of date palm fiber (DPF) density, diameter size and content on both the mechanical and physical properties of polylactic acid (PLA) reinforced DPF bio-composite. The bio-composites are developed using melt-mixing technique which is followed by compression molding. The influence of the mechanical properties is investigated by evaluating the tensile, flexural and impact strengths. Meanwhile bio-composite thickness swelling (TS), moisture content (MC) and water absorption (WA) characteristics are evaluated. Bio-composite microstructures are examined using SEM to investigate the interfacial bonding between PLA matrix and DPF. Results showed that at 40 wt.% DPF, the TS, MC, and WA were the highest demonstrating an increase of 4.10%, 4.95%, and 8.22%, respectively. Although the results demonstrated a decrease in mechanical properties as DPF content increased (depending on DPF geometry), the results indicate that the developed technologies could be commercialized under the waste management scheme for non-structural applications.

Highlights Patients will experience severe psychological stress in the face of a positive diagnosis of HIV. Patients who are diagnosed with HIV are prone to make a blunder and dreadful decisions. AIDS patients need emotional and informational support when they receive a positive diagnosis. As a piece of bad news, presenting the positive diagnosis of HIV required the psychic preparation of the patient

ObjectiveThe majority of pediatric severe acute respiratory syndrome coronavirus 2 (COVID-19) cases demonstrate asymptomatic, mild or moderate disease. The main symptoms in children with COVID-19 are respiratory symptoms but some patients develop gastrointestinal symptoms and liver injury. We aim to review gastrointestinal symptoms and liver injury in children with confirmed COVID-19 infection.MethodThis is a retrospective case note review of children with positive COVID-19 nasal Polymerase Chain Reaction aged 0–18 years admitted to a tertiary pediatric hospital from March 1st till June 1st 2020.Results180 children were identified. Mean age was 5 years (Range: 0.01–17), the majority of patients were school aged (30%). Patients were mainly from East Asia 81 (45%) and Arabs 67 (37%). Gastrointestinal symptoms were encountered in 48 (27%) patients and 8 (4%) patients had only Gastrointestinal symptoms with no associated fever or respiratory symptoms. Liver injury was seen in 57 (32%) patients. Patients with fever and cough were more likely to have gastrointestinal symptoms (P =

ObjectivesAdvancements in pediatric percutaneous endoscopic gastrostomy placement (PEG), laparoscopic-assisted gastrostomy (LAG) technique, and laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) procedure have opened up new options for gastrostomy tube placement. LAPEG utilizes endoscopy and laparoscopy for gastrostomy insertion. This review compares the outcomes and complications of LAG and LAPEG techniques in children.MethodsAll LAG and LAPEG gastrostomy tube placements in children from September 2010 to September 2019 were reviewed retrospectively. Patient demographic, along with procedural and 1-year complication data, were collected.ResultsIn total, 92/181 of gastrostomies were LAG and 89/181 were LAPEG. The mean age, weight and patient characteristics were comparable. Conversion rate was 1% in both groups (p = 0.74), there was no peritoneal leak in either group, a minor serosal injury to the stomach was seen in 1 patient in LAG with no bowel injury in LAPEG cohort (p = 0.51), need for re-operation was 1 and 2% in LAG and LAPEG, respectively (p = 0.49), early tube dislodgement was in 8 (9%) patients in LAG and 7 (6%) in LAPEG (p = 0.53) and wound infection was 13/92 in LAG and 11/89 in LAPEG (p = 0.8). The median operative time for LAPEG was less than LAG (p < 0.001) by 11 min but the median length of hospital stay was not significantly different (p < 0.096).ConclusionBoth LAG and LAPEG techniques in children are safe with comparable complication rates and length of hospital stay, the addition of endoscopy to LAG allowed for shorter operative time in the LAPEG technique.

We aimed to describe a case of neovascular glaucoma (NVG) as a first presenting sign of catastrophic antiphospholipid syndrome (CAPS) with heart valve aseptic vegetations known as Libman-Sacks endocarditis. A 39-year-old man was referred for left eye decreased visual acuity and pain, upon examination left eye high intraocular pressure; rubeosis iridis of both eyes (BE); and prominent retinal ischemia. Clinical and fluorescein angiography findings established the diagnosis of left eye NVG with vaso-occlusive disease in BE. Magnetic resonance imaging of the head showed widespread ischemic lesions and hemorrhagic foci. The transesophageal echocardiogram showed 2 big mitral valve lesions consistent with the diagnosis of Libman-Sacks endocarditis. Laboratory and clinical diagnosis of CAPS and suspected SLE was confirmed, and treatment with anticoagulants and IV steroids was initiated. This case demonstrates that severe vaso-occlusive retinopathy with severe brain ischemia should raise the suspicion of systemic autoimmune pro-coagulative diseases with heart valve aseptic vegetations.

Background: Obesity is the single most burdensome lifestyle disease, which has reached epidemic proportions. This study aimed to examine the eating behavior patterns and beliefs in a group of adolescents living in the United Arab Emirates (UAE). Procedure: A questionnaire was administered to adolescents (aged 11 and 18 years) attending outpatients' clinics at governmental health facilities. Informed consent was obtained, and the questionnaire was available in English or Arabic languages. Results: In all, 36 adolescent subjects participated in our study with 12 males and 24 females. UAE nationals constituted 72% of our participants and 28% were of other ethnic backgrounds; 75% were overweight to obese with 17% normal and 8% underweight. The majority of patients were healthy with only 6 patients suffering chronic medical diseases. We uncovered that in less than half of our cohort, the decision to eat came directly from the individuals themselves, but it was more influenced by their families. Food consumption was largely in response to physical hunger with the sensation perceived in the upper abdomen by one-third and the remainder localizing it to various other areas. Excessive caloric intake with frequent meals and snacks was also reported. Our study subjects decided what to consume mainly based on what appeared appetizing, followed by availability and cravings and to a lesser extent based on health recommendations. Excessive speed of food ingestion was self-reported in the majority of participants. Moreover, almost half of the adolescents were unable to turn down food offerings from their close family members and over one-fourth were unable to refuse food from other persons. Common symptoms reported included dysphoric mood, disordered sleep, decreased energy and concentration difficulties as well as low self-esteem. Conclusion: Our study uncovered certain eating behaviors in the cohort of adolescents, which may be important in promoting weight gain. These included misconceived hunger signals, excessive frequency, amount and speed of food consumption as well as more focus on food taste, inattentiveness to cravings and a strong social influence on food intake decisions. The findings of our study aim to shed some light on the eating patterns among adolescents and encourage research to investigate eating behaviors on an expanded scale evaluating ethnic, gender and age-related differences.

استناد به مصلحت در سیاستگذاری جنایی همواره از موضوعات چالشی میان فقها و حقوقدانان تلقی شده است. علیرغم تمام ایراداتی که توسط مخالفان حجیت و کاربرد مصلحت در امور فقهی و حقوقی اقامه گردیده ولیکن ضرورت استناد به آن البته در پرتو ضوابط شرعی و عقلی در لزوم رعایت مصالح و مقتضیات زمان و مکان و در صدور احکام و تدوین قوانین ضمن از بین بردن محجوریت اسلام و کاهش شبهه تحجّر و تصلّب دینی در عدم تامین نیازهای ضروری انسان، باعث فتح بابی ضابطه‌مند در تجدیدنظر در موضوعات مستحدثه خواهد شد. بنابراین ضرورت دارد تا با توجه به حساسیت‌های موجود درباره کاربرد مصلحت در امور کیفری که مستقیما با حقوق بنیادین افراد رابطه دارد، ضوابط استناد به آن در مصلحت‌انگاری در ابعاد مختلف سیاست جنایی تبیین گردد. یافته‌های این مقاله که با روش توصیفی و تحلیلی تهیه شده بیان می‌دارد که قلمرو کاربرد مصلحت را نبایستی صرفا منحصر به نوع خاصی از احکام مانند تعزیرات دانست بلکه به دلیل تبعیت تمام احکام از مصالح و مفاسد نفس‌الامری، در تمام احکام جاری و ساری خواهد بود ولیکن این جریان منطبق با قواعد و ضوابط کلی عقلی و شرعی و تحت ضوابطی خواهد بود که در این مقاله احصا گردیده است.

BACKGROUND: The prevalence of sellar masses (SMs) is reported in Europe and North America but only limited data are available from the Middle East and North Africa (MENA) region. OBJECTIVES: Assess the prevalence and characteristics of SMs in Al Ain city, United Arab Emirates. DESIGN: Retrospective, descriptive multicenter study. SETTING: Three endocrine centers in Al Ain. PATIENTS AND METHODS: All patients diagnosed with SMs in the city of Al Ain, Emirate of Abu Dhabi, between 2011 and 2016 were evaluated. Cases were identified using ICD 9 and 10 codes and demographic and clinical data were collected. The prevalence rate was calculated for patients alive and residing in Al Ain city until 31 December 2016. MAIN OUTCOME MEASURES: Clinical presentations and prevalence rate. SAMPLE SIZE: 272. RESULTS: The mean (SD) age on presentation was 40.8 (14.3) years (range: 6-114 years, median: 40.0). The 170 (61.8%) females and 128 (46.5%) were native citizens of the United Arab Emirates. Two hundred and forty five (90%) patients had pituitary adenomas (PAs) while 27 (10%) had non-pituitary sellar lesions. The four most common SMs were prolactinoma (n=139, 51.1%), nonfunctioning adenoma (NFA) (n= 69, 25.4%), somatotroph adenoma (n=32, 11.8%) and craniopharyngioma (n=15, 5.5%). Patients with prolactinoma, corticotroph adenoma, and Rathke’s cleft cyst had small sellar masses (

Tururi (Manicaria saccifera Gaertn.) is a natural fibrous mesh which protects the fruits of the Amazon Ubuçu palm tree. This research targets developing natural fiber composites from Tururi fibers and characterizing their impact properties. A set of composites from Tururi fiber with different construction parameters (number of layers, fiber orientation, and fiber volume fraction) were manufactured. The results indicated that increasing the number of layers significantly increased the impact resistance up to a limit after which the resin penetration is impaired; moreover, stretching the preform significantly reduced the fiber volume fraction, and hence the impact properties. Finally, the fiber orientation had a negligible effect on the impact energy; yet, it had a significant effect on the failure mechanism.

We conducted a retrospective cohort review of 180 patients aged 0–18 years with positive COVID-19 nasal PCR swab admitted to the only designated paediatric COVID-19 hospital in Abu Dhabi from 1 March to 1 June 2020. 60 (33%) patients were asymptomatic, 117 (65%) patients had mild or moderate symptoms and 3 patients required intensive care with no mortality reported. Symptoms at presentation were fever in 84 patients, cough in 62 patients and gastrointestinal symptoms in 48 patients.

Termite is an economically important pest species in the pest control industry and considered as one of the urban pests. Although it had caused a great loss, only a few studies on termite control demand were found. This study attempted to identify determinants and build the econometric model of termite control demand in Jakarta. The findings are expected to give the pest control industry a better understanding of the pest control market. Two ad-hoc models, linear and double log models, were investigated using the Least Square Dummy Variable (LSDV) technique. The results showed that the double log model was found better than the linear model based on sign expectation and significance. The price of termite control service, building permits, price of structural metals and dummy variables for the large company were statistically significant determinants, whereas dummy variables for risk class were not. Termite control demand for medium and small companies was not significantly different, but both of them were significantly lower than demand for the large company. This study also found that the demand for termite control was elastic. Keywords: demand analysis, econometric modeling, pest control, termite control, urban pest

Meandering river bend migration is a common phenomenon which destroys agricultural lands and civil infrastructures around the river. The main cause of such migration is due to developing a secondary flow within the bend in which a helicoidally circulation is developed and as a results the scour hole at the outer bank toe is created which causes collapse of the outer bank and its migration. Over the last decade many countermeasures against such scour have been developed. These measures modify the flow within the bend redistribute the local bed shear stress for the purpose of reducing the toe bank scour. Triangular vanes are one of such structures that help stabilize the outer bank by modifying the flow pattern in the river bend to prevent the scouring of the outer bank. Triangular vanes have been studied successfully by Bhuiyan et al. (2010) in a sinuosity river path and in a 90 degree flume bend by Bahrami-Yarahmadi and Shafai Bejestan (2016). Based on these studies this measure, if designed properly, not only can shift the scour from the outer bank toe to the middle of the river, it transport sediment to the downstream of the vane and deposited in between the vanes which create a new bank. The structure has been defined environment friendly since it create an environment suitable for aquatic animals. The aim of the present study is to investigate the application of triangular vanes in a 180 degrees of Jangiyeh bend in Karoon River south of Ahvaz and to determine the bets distance for installing the vanes.

Perkembangan industri di Indonesia meningkat pesat. Namun, beberapa jenis sampah industri masih menjadi persoalan yang perlu dipecahkan, di antaranya adalah serbuk kayu sengon, kulit singkong dan kertas HVS bekas. Ketiga jenis limbah tersebut memiliki kandungan selulosa yang dapat dimanfaatkan untuk pembuatan kertas karton daur ulang. Kandungan selulosa yang di-miliki, secara berturut-turut adalah sebesar 67,94 %, 15,20 %, dan 58,30 %. Tujuan penelitian ini adalah untuk mengetahui pengaruh variasi perbandingan kertas HVS bekas, serbuk kayu se-ngon (Paraserianthes falcataria) dan kulit singkong (Manihot utilissima) terhadap kekuatan daya tarik kertas daur ulang yang dihasilkan. Jenis penelitian yang digunakan adalah eskperimen de-ngan post-test only with control group design. Uji kekuatan daya tarik kertas dilakukan sebanyak sembilan kali ulangan dan diperoleh rata-rata dari variasi perbandingan 1:0:0 sebesar 0,3785 N/mm; perbandingan 1:1:2, 0,7598 N/mm; perbandingan 1:2:1, 0,7614 N/mm, dan perbandingan 2:1:1, 1,0016 N/mm. Hasil uji statistik dengan one way anova memperoleh nilai p lebih kecil dari 0,001 yang berarti bahwa perbedaan di antara kuat tarik-kuat tarik kertas tersebut bermakna secara statistik. Dapat disimpulkan bahwa variasi perbandingan kertas HVS : serbuk kayu se-ngon : kulit singkong yang menghasilkan kuat tarik kertas yang tertinggi adalah 2:1:1.

Abstract Background Regional evidence-based guidelines for the prophylaxis and management of infantile colic are not available for the Middle East and North Africa (MENA) region. The Allied Against Infantile Functional GI Disorders (ACT) Working Group was created in January, 2015 to determine the knowledge gaps and the current management practices of infantile colic by physicians in the MENA region. The ACT group determined the need for a survey to address these questions. The objectives of the survey were to highlight current clinical practices on the management of infantile colic and to raise awareness on colic severity in the MENA region. Methods The ACT working group developed the survey which included respondent characteristics and closed questions on practice in colic prevention. The survey was subject to validation and ethics committee approval in all countries. Results A total of 1628 physicians (mostly pediatricians (75.4%), neonatologists (2.4%) and general practitioners (19.8%)) responded to the survey. The 5 most represented countries were KSA (27.9%), Kuwait (22.1%), Morocco (13.8%), Lebanon (10.6%), and Iraq (7.4%). Most of the respondents (77.8%) practiced in governmental settings. A majority of respondents (91.7%) reported that colic is diagnosed predominantly by clinical examination. Above 63%, of pediatricians surveyed, believed that the colic prevalence rate was >40%, which is greater than the 20% rate reported in worldwide surveys. Yet, most of the responding physicians (73%) prefer to simply reassure parents rather than prescribe a therapeutic agent. Most physicians were either neutral (58%) or did not endorse (18.4%) colic prophylaxis. Of those who prescribed formulae for non-breastfed children, a majority (64.3%) chose “Comfort” formulae over hydrolyzed or lactose-free formulae or formulae with probiotics. Conclusions The results of this survey suggest that a substantial proportion of responding physicians from the selected MENA countries do not advocate for prophylaxis of colic. The findings of this survey suggest that more educational efforts are required to increase awareness of the strong body of evidence supporting the efficacy of probiotics in the prevention and management of infantile colic.

Similar with other construction materials, wood strength is decreasing when applied by long term loading. Wooden cooling tower structure at Star Energy Geothermal (Wayang Windu) Ltd was built in 1998 and it should be evaluated to avoid sudden structural failure. Evaluation conducted through several steps: wood species identification, the physical and mechanical properties testing, and estimation for remaining service-lifetime by generating mathematical models derived from creep test and reduction of cross sectional area of the wood. Identification result that the wood are redwood (Sequoia sempervirens) and Douglas fir (Pseudotsuga menziesii). The wood density value has degraded from the surface until 0.25 cm depth. Strength characteristics of the wood have considerably decreased, but the allowable stress for bending, tension parallel to grain, and shear were still higher than NDS2005 requirements. The allowable stress for compression parallel to grain was slightly lower than NDS, while compression perpendicular to grain was much lower. Average modulus of elasticity reduces become lower than the value stated by the code, but the minimum value of modulus of elasticity (Emin) of redwood was still higher than the code value, while Emin of Douglas fir is slightly lower. Then, in accordance with those findings, the construction would not failure yet but the deformation and vibration will occur in higher rate than design planning. This research develops mathematical models for estimating the remaining service-lifetime of the wooden cooling tower structure in geothermal power plant based on the wood performance in resisting long term loading and its deterioration rate. The deterioration rate of wood member of cooling tower structure at Star Energy Geothermal (Wayang Windu) Ltd is 0.0147 cm depth per year, so equation for the residual service life estimation is σlaterσtoday=bh2(b−0.0147T)(h−0.0147T)2, and σlater must be lower than allowable stress.

Abstract Background A number of scientific organisations have developed guidelines for the primary prevention of allergic disease through nutritional interventions. However, even if the best evidence-based guidelines are available, these guidelines do not necessarily lead to adherence and improved health outcomes. Method To determine how closely the practice of physicians in select Middle Eastern and North African countries compares with the current recommendations on the primary prevention of allergy a survey study was performed using a structured questionnaire and convenience sampling. Results A total of 1481 physicians responded, of which 66.1% were pediatricians. A total of 76.6% of responding physicians routinely identify infants who are at risk for developing allergy. In infants at risk for developing allergy, 89.1% recommend exclusive breastfeeding for at least 4 months. In contrast to current recommendations, 51.6% routinely recommend avoidance of any allergenic food in the lactating mother. In infants at risk of developing allergy who are completely formula fed, standard infant formula was recommended by 22.5% of responders. Of the responding physicians, 50.6% would recommend delaying the introduction of complementary food in infants at risk of allergy compared to those not at risk, whereas 62.5% would recommend postponing the introduction of potentially allergenic foods. Only 6.6% stated they follow all current recommendations on food allergy prevention. Conclusion The results of this survey suggest that a substantial part of responding physicians from select Middle Eastern and North African (MENA) countries do not follow current recommendations on primary prevention of allergic disease through nutritional interventions.

Pengelolaan sampah di sekolah menjadi salah satu upaya untuk menjadikan sekolah menjadi tempat yang nyaman dan bersih. Tempat sampah bervideo adalah tempat sampah yang dibuat untuk merangsang siswa agar dapat membuang sampah dengan tepat sesuai jenisnya dengan bantuan rangsangan audiovisual. Tujuan penelitian ini untuk mengetahui pemanfaatan model tempat sampah bervideo terhadap ketepatan siswa dalam memilah sampah yang sesuai dengan petunjuknya. Penelitian ini berbentuk eksperimen dengan desain penelitian post test only control group dan berlokasi di dua sekolah, yaitu SDN Kanoman sebagai kelompok kontrol dan SDN Patran sebagai kelompok perlakuan, dengan responden adalah seluruh siswa kelas empat. Kedua sekolah tersebut terletak di Desa Banyuraden, Gamping, Sleman. Hasil penelitian menunjukkan bahwa persentase ketepatan memilah sampah pada kelompok perlakuan adalah 79,41 % untuk sampah kertas, 87,50 % untuk sampah plastik, dan 86,66 % untuk sampah sisa makanan; sementara pada kelompok kontrol adalah 68,96 % untuk sampah kertas, 70,37 % untuk sampah plastik dan 68,18 % untuk sampah sisa makanan. Analisis data dengan uji-t bebas pada 􀄮 = 0,05 menghasilkan nilai p sebesar 0,022 yang berarti dapat disimpulkan bahwa model tempat sampah bervideo mempengaruhi ketepatan murid sekolah dasar dalam memilah jenis sampah sesuai dengan petunjuk yang diberikan.

Abstract Background Childhood obesity is one of the most serious public health issues of the twenty-first century affecting even low- and middle-income countries. Overweight and obese children are more likely to stay obese into adulthood. Due to the paucity of data on local practices, our study aimed to assess the knowledge and practices of physicians from the Middle East and North Africa region with respect to early-onset obesity. Methods A specific questionnaire investigating the perception and knowledge on early-onset obesity was circulated to healthcare providers (general physicians, pediatricians, pediatric gastroenterologist, neonatologists) practicing in 17 Middle East and North African countries. Results A total of 999/1051 completed forms (95% response) were evaluated. Of all respondents, 28.9% did not consistently use growth charts to monitor growth during every visit and only 25.2% and 46.6% of respondents were aware of the correct cut-off criterion for overweight and obesity, respectively. Of those surveyed, 22.3, 14.0, 36.1, 48.2, and 49.1% of respondents did not consider hypertension, type 2 diabetes, coronary heart disease, fatty liver disease, and decreased life span, respectively, to be a long-term complication of early childhood obesity. Furthermore, only 0.7% of respondents correctly answered all survey questions pertaining to knowledge of early childhood overweight and obesity. Conclusion The survey highlights the low use of growth charts in the evaluation of early childhood growth in Middle East and North Africa region, and demonstrated poor knowledge of healthcare providers on the short- and long-term complications of early-onset obesity. This suggests a need for both continued professional education and development, and implementation of guidelines for the prevention and management of early childhood overweight and obesity.

Bidan praktik swasta (BPS) dalam melaksanakan pelayanan kesehatan kepada masyarakat berpotensi menimbulkan pencemaran lingkungan dan penularan penyakit. Untuk mencegah risiko tersebut maka BPS melaksanakan kegiatan penyehatan lingkungan. Tujuan penelitian ini untuk mengetahui kegiatan tersebut serta mengetahui biaya yang dikeluarkan oleh BPS melalui observasi lapangan serta wawancara tentang biaya yang dikeluarkan. Kegiatan observasi me-liputi penyediaan air bersih, pengelolaan limbah medis padat, pengendalian serangga, tikus dan binatang pengganggu lainnya serta sterilisasi. Dari hasil penelitian diketahui bahwa penye-hatan lingkungan yang berhubungan dengan penyediaan air bersih kegiatannya adalah meng-gunakan air dari PDAM dan memeriksakan kualitas air; pengelolaan limbah medis padat: me-nyediakan tempat penampungan sementara berupa safety box, dan menggunakan chlorine se-bagai bahan habis pakai dalam pengelolaannnya, serta untuk memusnahkan bekerja sama de-ngan rumah sakit, puskesmas dan perusahaan swasta. Dalam kegiatan pengendalian serang-ga, tikus dan binatang pengganggu, tindakan pertama dalam mencegah masuk adalah dengan menggunakan pintu tertutup, serta cara pencegahan yang lain berupa penggunakan kasa stri-min dan perangkap, dan pembasmi serangga bila sudah masuk ke dalam rumah serta menjaga kebersihan. Dalam kegiatan sterilisasi yang dilakukan adalah sterilisasi ruangan dan alat de-ngan menggunakan alkhohol, chlorine dengan teknik sterilisasi merebus/mengukus. Rata rata biaya per bulan yang dikeluarkan oleh BPS untuk kegiatan penyediaan air bersih adalah Rp. 62.272, biaya pengelolaan limbah medis padat: Rp.57.778, pengendalian serangga, tikus dan binatang pengganggu: Rp.41.041, dan biaya sterilisasi: Rp.38.833. Untuk empat kegiatan pe-nyehatan lingkungan tersebut diperlukan rata rata biaya: Rp. 199.925/bulan. Untuk menjaga a-gar kegiatan penyehatan lingkungan tetap berjalan, maka perlu pengawasan, monitoring dan dukungan dari puskesmas dan pengurus IBI setempat serta perlu disusun SOP untuk masing masing kegiatan penyehatan lingkungan yang telah dan yang belum dilakukan.

Karl Marx’s objection to religion, as other scholars’, should not be faced defensively and apologetically. A wise attitude is needed because a criticism can be used as a self-criticism towards our formal model of religiosity. By understanding Karl Marx’s social context, his criticism toward religion can be interpreted as his dissonance on a model of religion at his time, which is dominantly used as a means of power. The existence of religion didn’t improve the quality of humanity, but it was manipulated give an ethical legitimation to explore and exploit poor and marginal society. Religion alienated human beings from themselves and their social reality, which resulted in systemic social sins. Karl Marx’s criticism can be considered as a step to reconstruct a humanistic theology, which is able to freed and emancipate human being from any shackle. Gugatan Karl Marx terhadap agama, seperti halnya kritik tokoh-tokoh pemikir lain, tidak perlu dihadapi secara defensif apologetik. Sikap yang bijaksana perlu dikedepankan, karena kritik bisa dijadikan otokritik atas kekurangan model keberagamaan kita yang bersifat formal. Dengan memahami konteks sosial Karl Marx, kritiknya terhadap agama dapat dipahami sebagai kegelisahannya atas model keberagamaan yang dominan saat itu yang justru menjadi alat kekuasaan. Eksistensi agama bukannya meningkatkan kualitas kemanusiaan, tapi justru dimanipulasi untuk memberikan legitimasi etis untuk mengeksploitasi dan menindas masyarakat miskin dan marginal. Agama mengalienasikan manusia dari diri dan realitas sosial, sehingga dosa sosial dapat terjadi secara sistemik. Kritik Marx di atas bisa dijadikan pijakan untuk merekonstruksi teologi yang humanis yang mampu membebaskan dan mengemansipasi manusia dari segala belenggu.

Sampah dari berbagai sumber berpotensi mencemari lingkungan, baik tanah, udara maupun air. Pasar buah dan sayur Giwangan menghasilkan sampah sebanyak 1-3 truk setiap hari. Kandu-ngan Nitrogen, Phosphor dan Kalium (NPK) limbah sayur dan buah dari pasar tersebut, masing-masing secara berturut-turut adalah 331 ppm, 838,1 ppm, dan 268,1 ppm. Air cucian beras merupakan sumber primer bahan organik bagi jaringan tanaman. Pupuk kotoran ayam memiliki sumber K terbesar dibandingkan dengan pupuk kandang yang lain, yaitu sebesar 1,50 %. Tuju-an penelitian adalah mengetahui perbedaan kualitas pupuk organik cair dari campuran sampah buah, air cucian beras dan kotoran ayam dengan menggunakan lima variasi komposisi, dengan melakukan eksperimen berdesain post-test with control group. Analisis data menggunakan uji statistik anova satu jalan dan uji LSD pada derajat kepercayaan 95 %. Pengamatan kondisi fisik pupuk organik cair meliputi parameter bau dan warna. Secara deskriptif, hasil penelitian menun-jukkan bahwa kandungan N tertinggi ditemui pada Kontrol, kandungan P tertinggi pada pupuk organik cair B dan kandungan K tertinggi juga pada Kontrol. Hasil uji statistik menyimpulkan kan-dungan N dan P pupuk organik cair yang dihasilkan dari tiap komposisi bahan berbeda secara bermakna (nilai p masing-masing: 0,007 dan

Background: Lipid metabolism is one of the hepatitis C virus (HCV) life cycle steps. Statins can reduce cholesterol level and finally can decrease HCV replication. Thus, we assessed the effect of Statins in combination with standard antiviral treatment on hyperlipidemic genotype I HCV infected patients. Materials and Methods: This study was a prospective clinical trial. 40 patients were selected from those referred to educational and Therapeutic Centers of Isfahan University of Medical Sciences from 2009 to 2010 with confirmed HCV viremia. All patients received Peg-interferon-a2a and ribavirin. 20 hyperlipidemic Patients received 20 mg atorvastatin nightly for 3 months and placebo was prescribed for 20 normolipidemic HCV infected patients as a control group. Liver enzymes and complete blood count were checked monthly and thyroid stimulating hormone was checked every 3 months. We also performed quantitative HCV-ribonucleic acid (RNA) test in 12 th week of therapy, at the end of treatment and 6 months after therapy for all samples. Results: We didn′t find any significant differences in the mean of HCV-RNA numbers between statin and placebo groups in 12 th week of treatment, in the end of treatment and 6 months after treatment (P > 0.05). Conclusion: Atorvastatin has no effect on the mean of HCV viral load when we added it to standard treatment for hepatitis C infection. Further studies are necessary to examine the possible antiviral properties of statins and their potential role as adjuncts to standard HCV therapy.

Assigning facilities to locations is one of the important problems, which significantly is influence in transportation cost reduction. In this study, we solve quadratic assignment problem (QAP), using a meta-heuristic algorithm with deterministic tasks and equality in facilities and location number. It should be noted that any facility must be assign to only one location. In this paper, first of all, we have been described exact methods and heuristics, which are able to solve QAP; then we have been applied a meta-heuristic algorithm for it. QAP is a difficult problem and is in NP-hard class, so we have been used honey bee mating optimization (HBMO) algorithm to solve it.This method is new and have been applied and improved NP-hard problems. It’s a hybrid algorithm from Honey-Bee Mating system, simulated annealing and genetic algorithm.

The most fundamental model which is considerably used in designing of treatment plant is Monod model. Although there are some problems regarding using this model, it is frequently used by the engineers. In the present study the accuracy and precision of this model was evaluated in different range of S0/X0 ratio. The results of simulation showed that the Monod model for low ranges of S0/X0 does not have a great precision, but for high ranges of S0/X0, it shows acceptable concordance.

Background: Low energy availability (LEA) occurs when athletes' energy intake fails to match the energy expended during exercise, resulting in insufficient energy to support essential functions for optimal health, a condition known as relative energy deficiency in sports (REDs)., Objective: This study aims to explore the prevalence of LEA among Malaysian national athletes and its associations with health-related outcomes., Methods: A total of 43 athletes (51.2% males, aged 18-40) identified previously as having moderate or high risk of REDs through a questionnaire underwent comprehensive clinical assessments. Resting metabolic rate (RMR) was measured using indirect calorimetry, with an RMR ratio of <0.90 indicating LEA. Weight and height were measured, and fasting blood samples were analysed for ferritin, free triiodothyronine (fT3), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol (female athletes) and testosterone (male athletes). Bone mineral density (BMD) of the lumbar spine and total left hip, as well as body composition, were measured using dual-energy X-ray absorptiometry (DXA)., Results: Out of the 43 athletes, 12 showed evidence of LEA, exhibiting at least one of the following characteristics: low estradiol levels (87.5%), low testosterone (75.0%), low fT3 (66.7%), low LH (58.3%), low FSH (58.3%), low ferritin (25.0%) and low BMD (8.3%). Notably, fT3, estradiol and testosterone were significant predictors for LEA., Conclusions: A low but noteworthy incidence of LEA among Malaysian national athletes was associated with hormone imbalances. Awareness about LEA among athletes and sports personnel is essential for early detection and appropriate intervention., Competing Interests: None declared., (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Relative energy deficiency in sport (RED-S), which underpins the concept of low energy availability (LEA), can negatively affect athletes' health and performance. This study aims to investigate the prevalence of RED-S among national athletes in Malaysia. A total of 192 national athletes (97 males, 18-39 years old) responded to an online survey regarding the RED-S risk. Most athletes (67.2%) were classified as having a medium/high RED-S risk. Female (41.2%), weight-class (23.9%), and intermittent sports (20.3%) had the highest prevalence of medium/high RED-S risk. Overall, most athletes spent 2-5 h daily (55.2%) and 6-7 days weekly (53.6%) practicing or playing their sport, and 47.9% reported feeling tired recently. The athletes were also terrified of being overweight (61.5%), worried about what they eat (64.7%), concerned about having fat on their bodies (62.6%), and thinking about burning calories while exercising (69.3%). Only 16.7% of the athletes had a prior history of stress fractures, and 40.6% continued to participate in activities 6-7 days per week while injured. The majority of female athletes (88.3%) had regular menstrual cycles. These findings support the notion that RED-S screening should be addressed in the athletic community. Future research is needed to clinically assess these athletes and investigate the impacts of RED-S on their health and sports performance.

Significant efforts are increasingly directed towards identifying novel therapeutic targets for autism spectrum disorder (ASD) with a rising role of aberrant glutamatergic transmission in the pathogenesis of ASD-associated cellular and behavioral deficits. This study aimed at investigating the role of chronic memantine (20 mg/kg/day) and aripiprazole (3 mg/kg/day) combination therapy in the management of prenatal sodium valproate (VPA)-induced autistic-like/cognitive deficits in male Wistar rats. Pregnant female rats received a single intraperitoneal injection of VPA (600 mg/kg) to induce autistic-like behaviors in their offspring. Prenatal VPA induced autistic-like symptoms (decreased social interaction and the appearance of stereotyped behavior) with deficits in spatial learning (in Morris water maze) and cognitive flexibility (in the attentional set-shifting task) in addition to decreased hippocampal protein levels of phosphorylated cAMP response element-binding protein (p-CREB), brain-derived neurotrophic factor (BDNF), and gene expression of glutamate transporter-1 (Glt-1) with a decline in GABA/glutamate ratio (both measured by HPLC). These were accompanied by the appearance of numerous neurofibrillary tangles (NFTs) with enhanced apoptosis in hippocampal sections. Memantine/aripiprazole combination increased the protein levels of p-CREB, BDNF, and Glt-1 gene expression with restoration of GABA/glutamate balance, attenuation of VPA-induced neurodegenerative changes and autistic-like symptoms, and improvement of cognitive performance. This study draws attention to the favorable cognitive effects of memantine/aripiprazole combination in autistic subjects which could be mediated via enhancing CREB/BDNF signaling with increased expression of astrocytic Glt-1 and restoration of GABA/glutamate balance, leading to inhibition of hippocampal NFTs formation and neuronal apoptosis., (© 2023. The Author(s).)

The knowledge of RNA editing modifications and its subsequent proteomic diversity in is still limited and represents only the tip of the iceberg. Adenosine to inosine (A-to-I) RNA editing is the most prevalent in RNA editome with a rising role for ADARgene family as a major regulator of the dynamic landscape of RNA editing. This study aimed at evaluating the potential chemopreventive effects of the epigenetic regulator "pterostilbene" in diethylnitrosamine (DEN)-exposedrat model. Consequently, the hepatic Adars expression was investigated as a possible mechanism for mediation of the putative pterostilbene-induced chemopreventive effect. The effects of administration of pterostilbene were investigated on the structural changes, immunohistochemical staining, liver function test, serum alpha feto-protein (AFP), IL-6, and hepatic Adar1 and Adar2 relative gene expression at the beginning and at the 6th week of the study. Pterostilbene attenuated DEN-induced liver injury, improves hepatocyte parrafin-1 (Hep Par-1), decreases heat shock protein 70 (HSP70), improved AFP, serum albumin, transaminases, IL-6 with alleviation of disturbed hepatic Adar1 and Adar2 expression. This study spotlights the role of pterostilbene in attenuation of DEN-induced liver injury which could be mediated, at least partially, through the alleviation of the aberrant expression of Adar enzymes. Yet, more in-depth studies are needed to further elucidate the molecular mechanisms underlying the effects of pterostilbene on RNA editing enzymes., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Mobile health (mHealth) apps play an important role in delivering education, providing advice on treatment, and monitoring patients' health. Good usability of mHealth apps is essential to achieve the objectives of mHealth apps efficiently. To date, there are questionnaires available to assess the general system usability but not explicitly tailored to precisely assess the usability of mHealth apps. Hence, the mHealth App Usability Questionnaire (MAUQ) was developed with 4 versions according to the type of app (interactive or standalone) and according to the target user (patient or provider). Standalone MAUQ for patients comprises 3 subscales, which are ease of use, interface and satisfaction, and usefulness., Objective: This study aimed to translate and validate the English version of MAUQ (standalone for patients) into a Malay version of MAUQ (M-MAUQ) for mHealth app research and usage in future in Malaysia., Methods: Forward and backward translation and harmonization of M-MAUQ were conducted by Malay native speakers who also spoke English as their second language. The process began with a forward translation by 2 independent translators followed by harmonization to produce an initial translated version of M-MAUQ. Next, the forward translation was continued by another 2 translators who had never seen the original MAUQ. Lastly, harmonization was conducted among the committee members to resolve any ambiguity and inconsistency in the words and sentences of the items derived with the prefinal adapted questionnaire. Subsequently, content and face validations were performed with 10 experts and 10 target users, respectively. Modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the M-MAUQ was assessed by 51 healthy young adult mobile phone users. Participants needed to install the MyFitnessPal app and use it for 2 days for familiarization before completing the designated task and answer the M-MAUQ. The MyFitnessPal app was selected because it is one among the most popular installed mHealth apps globally available for iPhone and Android users and represents a standalone mHealth app., Results: The content validity index for the relevancy and clarity of M-MAUQ were determined to be 0.983 and 0.944, respectively, which indicated good relevancy and clarity. The face validity index for understandability was 0.961, which indicated that users understood the M-MAUQ. The kappa statistic for every item in M-MAUQ indicated excellent agreement between the raters (κ ranging from 0.76 to 1.09). The Cronbach α for 18 items was .946, which also indicated good reliability in assessing the usability of the mHealth app., Conclusions: The M-MAUQ fulfilled the validation criteria as it revealed good reliability and validity similar to the original version. M-MAUQ can be used to assess the usability of mHealth apps in Malay in the future., (©Norashikin Mustafa, Nik Shanita Safii, Aida Jaffar, Nor Samsiah Sani, Mohd Izham Mohamad, Abdul Hadi Abd Rahman, Sherina Mohd Sidik. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 04.02.2021.)

General Objective: To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan., Methods: A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach's alpha was found to be 0.62., Results: Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001)., Conclusion: The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan.

Background: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive loss of cognitive abilities. Epigenetic modification, oxidative stress, and inflammation play an important role in the pathogenesis of the disease. We aimed to detect noninvasive peripheral biomarkers with a high degree of sensitivity and specificity in diagnosis and progression of AD., Methods: A total of 25 elderly patients with AD and 25 healthy control participants were selected and subjected to cognitive assessment and laboratory measures including histone deacetylases (HDACs), copper, and interleukin 8 (IL-8) levels., Results: The levels of HDACs, copper, and IL-8 were significantly higher in patients with AD (P < .001) and had a significant negative effect on all cognitive assessment tests. Receiver-operating curve (ROC) analysis revealed that HDACs and copper levels had higher sensitivity and specificity., Conclusions: Plasma levels of HDACs and copper may be used as peripheral biomarkers in diagnosis of AD, while IL-8 level could be a useful biomarker in following AD progression.