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Electrification of rural islands is still a major challenge for many countries due to the inadequate and inchoate distribution of fossil fuels in conventional grid system. Even if these problems are eliminated, the high electricity cost makes rural people ineligible for electricity services. In addition to tackling environmental pollution, microgrids (MG) could be the appropriate solution to reduce these economic barriers. Aiming to mitigate the impediment of rural electrification, this study proposes a hybrid microgrid consists of renewable energy sources, natural gas generator, battery storage, and electric vehicle charging station where a case study is performed with and without wind turbine as a renewable energy source. The MG is simulated for two coastal areas of Bangladesh, and sensitivity analysis has taken place by varying the load demand. MG without wind energy is found more affordable than MG with wind energy. The winning case configuration estimated the cost of energy of 0.157$ and the carbon dioxide (CO2) emission of 6666.47 kg/y, which is a betimes step in ensuring pollution-free power supply as well as electrification in powerless areas. The results lead to the conclusion that the proposed model can provide affordable alongside eco-friendly electrification.

A history of atopy or allergy has been shown to be protective against the development of glioma, however the effect of atopy on patient outcomes, especially in conjunction with the survival benefit associated with IDH mutation, has not yet been investigated, and is the focus of the study we present here. Low grade glioma (LGG) data from the TCGA was downloaded, along with IDH, TERT, 1p/19q and ATRX mutational status and genetic alterations. History of asthma, eczema, hay fever, animal, or food allergies, as documented in TCGA, was used to determine patient atopy status. Patients with missing variables were excluded from the study. 374 LGG studies were included. Patients with a history of atopy demonstrated longer overall survival (OS) compared to those without (145.3 vs. 81.5 months, p = 00.0195). IDH mutant patients with atopy had longer OS compared those without atopy (158.8 vs. 85 months, p = 0.035). Multivariate cox regression analysis demonstrated that the effects of atopy on survival were independent of IDH and histological grade, (p = 0.002, HR 0.257, 95% 0.109–0.604), (p =

Glycogen storage disease type Ib (GSDIb) is characterized by hepatomegaly and fasting hypoglycaemia as well as neutropaenia and recurrent infections. We conducted a retrospective observational study on a cohort of patients with GSDIb across England. A total of 35 patients, with a median age of 9.1 years (range 1‐39 years), were included in the study. We examined the genotype and phenotype of all patients and reported 14 novel alleles. The phenotype of GSDIb in England involves a short fasting tolerance that extends into adulthood and a high prevalence of gastrointestinal symptoms. Growth is difficult to manage and neutropaenia and recurrent infections persist throughout life. Liver transplantation was performed in nine patients, which normalized fasting tolerance but did not correct neutropaenia. This is the first natural history study on the cohort of GSDIb patients in England.

Educating young people about how to interact with patients at the end of their lives is challenging. A qualitative study based on Husserl's phenomenological approach was performed to describe the learning experience of secondary education students after watching, analysing, and reflecting on two videoclips featuring Cameron Duncan, a young man suffering from terminal cancer (DFK6498 and Strike Zone). Students from three vocational centres providing training in ancillary nursing, pharmacy, and dependent care in the Community of Madrid visited the Palliative Care (PC) Hospital. A total of 110 students (102 female and 8 male), with a median age of nineteen years, participated in the study. The students' learning experience through the videoclips reveals the essential aspects required in palliative care, since the character suffers in every dimension of his being: physically as well as psychologically, socially, and spiritually. Therefore, this requires healthcare professionals to understand their experience, putting themselves in their place, to provide affectionate care and to display communication skills leading to a quality helping relationship. Four comprehensive educational categories were identified in the study. The students learned the importance of: 1) providing comprehensive and affectionate care to patients, 2) the need for communication skills in caring for patients, 3) being aware of the end of life and time left, 4) valuing life and fighting for what one wishes to attain. A visit to a PC hospital and the viewing of videoclips and reflection upon these, represents a useful strategy for secondary education healthcare students. The study indicates that videoclips are an innovative method for becoming aware of the various issues pertaining to palliative care.

The poultry selling and processing practices followed in the poultry wet markets of Bangladesh are always being overlooked unknowingly. The research was conducted to observe the existing scenario of poultry selling and processing practices at the selected wet markets located in the Gazipur City Corporation of Bangladesh. A total of 43 poultry selling shops were randomly selected and interviewed using a semi-structured questionnaire. It was surprising to observe the absence of female personnel and involvement of few (6.9%) people over the age of 50 years in the wet markets. All the persons engaged in poultry selling and processing had no institutional training. The shops found to be abstained from following some important practices such as feed withdrawal period, isolation of diseased birds, ante and post mortem inspection. The proper bleeding time (1-2) min was recorded in 58.2% cases. The killing cone was recognized as the best device in terms bleeding time. The 72.1% of the outlets never cleaned the carcass prior to deliver the customers. The absence of ante- and post-mortem inspections may cause a great threat of disease outbreak. Taken together, the poultry selling and processing practices followed in the wet market needs to be assessed carefully to deliver safe and quality meat to the customers. In addition, organizing basic training on pre-slaughter management and processing for both seller and processor and also ensuring the regular ante- and post- mortem inspection could improve the present situation in order to produce quality poultry meat. Progressive Agriculture 31 (3): 205-217, 2020

This research investigates the service gap between client’s expectation and perception regarding banking services in Bangladesh with a particular focus on the SERVQUAL model along with the five dimensions: Tangibility, Reliability, Responsiveness, Assurance, and Empathy. We investigate the dimensions of quality of banking service and its impact on customer satisfaction. A self-administered and structured questionnaire use to collect data from 200 respondents of banks’ clients. The SPSS software use here for analyzing data. Different statistical tools use which are compatible with our research, such as factor analysis, reliability analysis, and hypothesis testing. We survey twenty private commercial banks. Average of ten customers take as a sample from each bank. As for clients’ perception, the services gap (Expected service - Perceived service), in the dimensions of reliability, responsiveness, and empathy, is significant because expected service is below perceived service in the private banks in the northern region of Bangladesh.

It has now been nearly 15 years since the last major advance in the treatment of patients with glioma. "The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity". Autophagy is primarily a survival pathway, literally self-eating, that is utilized in response to stress (such as radiation and chemotherapy), enabling clearance of effete protein aggregates and multimolecular assemblies. Promising results have been observed in patients with glioma for over a decade now when autophagy inhibition with chloroquine derivatives coupled with conventional therapy. The application of autophagy inhibitors, the role of immune cell-induced autophagy, and the potential role of novel cellular and gene therapies, should now be considered for development as part of this well-established regimen.

Background The aim of the present study was to evaluate the mortality, morbidity, and readmissions associated with management of grade 3 cholecystitis in the elderly, vulnerable population. Methods This was a retrospective cohort study of non-elective admissions for acute cholecystitis from 2010 to 2015 using the nationwide readmissions database for adults ≥ 65 years with evidence of end-organ dysfunction (grade 3) who underwent percutaneous cholecystostomy (PC), laparoscopic (LC) or open cholecystectomy (OC). Index and readmission outcomes were analyzed using logistic regression and inverse probability treatment weight analysis. Results Of the estimated 358,624 patients, 14.9% underwent PC, 15.7% OC, and 69.4% LC. PC had significantly higher odds of mortality (AOR 5.8, 95%CI 5.1–6.6), composite morbidity (AOR 3.8, 95%CI 3.5–4.1), early (AOR 1.9, 95%CI 1.7–2.0) and intermediate (AOR 2.2, 95%CI 2.0–2.5) readmission compared to LC and OC. Conclusions Patients undergoing cholecystostomy had higher mortality, complications, and readmission rates warranting revaluation of criteria for cholecystostomy at initial presentation.

BACKGROUND: Dupilumab blocks the shared receptor component for IL-4 and IL-13, key drivers of type 2 inflammation, including IgE-mediated allergic inflammation in asthma. In the LIBERTY ASTHMA QUEST (NCT02414854) study, dupilumab reduced severe asthma exacerbations and improved forced expiratory volume in 1 second (FEV1) in patients with uncontrolled, moderate-to-severe asthma with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers (blood eosinophils and fractional exhaled nitric oxide) at baseline. OBJECTIVE: We assessed dupilumab's effect on key asthma outcomes in QUEST patients with/without evidence of allergic patients with uncontrolled, moderate-to-severe asthma with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers (blood eosinophils and fractional exhaled nitric oxide) at baseline. OBJECTIVE: We assessed dupilumab's effect on key asthma outcomes in QUEST patients with/without evidence of allergic asthma (total serum IgE >= 30 IU/mL and >= 1 perennial aeroallergen-specific IgE >= 0.35 kU/L at baseline). METHODS: Severe exacerbation rates and change from baseline in FEV1, asthma control, and markers of type 2 inflammation during the 52-week treatment period were assessed. RESULTS: In the allergic asthma subgroup (n = 1083), dupilumab 200/300 mg every 2 weeks versus placebo reduced severe asthma exacerbation rates (-36.9%/-45.5%; both P < .01), improved FEV1 at week 12 (0.13 L/0.16 L; both P < .001; improvements were evident by the first evaluation at week 2) with greater efficacy observed in patients with elevated type 2 inflammatory biomarkers at baseline, and improved asthma control. Dupilumab treatment also resulted in rapid and sustained reductions in type 2 inflammatory biomarkers. Comparable results were observed in patients without evidence of allergic asthma (n = 819). CONCLUSION: Dupilumab reduced severe exacerbation rates, improved FEV1 and asthma control, and suppressed type 2 inflammatory biomarkers in patients with uncontrolled, moderate-to-severe asthma with or without evidence of allergic asthma, highlighting the key role of IL-4 and IL-13 in airway inflammation. (C) 2019 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology

In this work, we present a model for origami-based sheet metal (OSM) folding that can predict the required bending force. OSM folding is enabled by introducing bending features along the bending line, named material discontinuity (MD). Firstly, the introduced analysis in this work developed a bending setup for OSM that does not require a die then introduced a method to analytically derive the bending force for a regular sheet without any added folding features. The analytical approach is followed using an experimental setup identical to the developed OSM bending configuration. Secondly, the OSM bending experiment is conducted to measure the required bending force and to identify which parameters influence the OSM bending force significantly. Finally, an empirical model is proposed considering the analytical force in the first step and the influencing parameters defined in the second step. Regression analysis is carried out using one portion of experimental force measurement to determine the coefficients of the proposed empirical model. The other measurement set is used to validate the prediction model. The validation results of the proposed prediction model show good agreement between the developed prediction model and the experiment results. The prediction model provided a shape factor that represents the topology of each bending feature, as well.

Background Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key drivers of type 2 inflammation. In the phase 3 LIBERTY ASTHMA QUEST trial (NCT02414854) in patients with uncontrolled, moderate-to-severe asthma, add-on dupilumab 200 mg or 300 mg every 2 weeks reduced exacerbations and improved forced expiratory volume in 1 s (FEV1) and quality of life over 52 weeks. This analysis evaluates dupilimab's effect on lung function in the overall population, and subgroups with baseline elevated type 2 inflammatory biomarkers. Methods Patients were randomised to 52 weeks of subcutaneous dupilumab 200 mg every 2 weeks, 300 mg every 2 weeks, or matched-volume placebos. Lung function outcomes were analysed in the overall population, in patients with ≥150 eosinophils·µL−1, ≥300 eosinophils·µL−1, ≥25 ppb fractional exhaled nitric oxide (FeNO), and both ≥150 eosinophils·µL−1 and ≥25 ppb FeNO, at baseline. Results Dupilumab treatment (200 mg and 300 mg every 2 weeks) resulted in significant improvements versus placebo after 52 weeks in pre-bronchodilator FEV1 (0.20 and 0.13 L, respectively, versus placebo) and post-bronchodilator FEV1 (0.19 and 0.13 L, respectively), forced vital capacity (FVC) (0.20 and 0.14 L, respectively), forced expiratory flow (0.19 and 0.13 L·s−1, respectively) and pre-bronchodilator FEV1/FVC ratio (1.75% and 1.61%, respectively) in the overall population (p, Dupilumab is a fully human monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, key drivers of type 2 inflammation, improving lung function outcomes in patients with uncontrolled, moderate-to-severe asthma http://bit.ly/2OhKMpi

The presented work describes the development of an engineering capstone course with multidisciplinary design projects and students’ teams. The course is offered for senior-level engineering students of four majors: those are bio-, environmental, materials, and mechanical engineering. In addition, engineering students can have minors in computer science. Most of the offered projects are sponsored by industrial partners and all are mentored by clients’ representatives and faculty members. The presented paper discusses the implementation of design-based learning approach to integrate the technical engineering design knowledge and the learning skills of interpersonal nature, such as communication skills, adaptability, teamwork, etc. In addition to the discussion of the design-based learning frame application, the paper deliberates over the importance of aligning the learning outcomes and the grading policy with the engineering design phases in engineering capstone design courses. The research objective of this study was to answer the following question: is there a difference in the peer evaluation of capstone design teams between multidisciplinary and single-disciplinary teams in terms of (1) contribution and skills and 2) team satisfaction. The presented work offers preliminary results of team’s satisfaction and performance based on the multi- and single-disciplinary teams. Preliminary findings for those two specific aspects indicate no significant differences in the overall design teams’ satisfaction. However, in terms of the team’s contribution and skills, the multidisciplinary teams scored higher mean values than the single-disciplinary teams.

Background: SRD5A3-CDG is a rare N-glycosylation defect caused by steroid 5 alpha reductase type 3 deficiency. Its key feature is an early severe visual impairment with variable ocular anomalies often leading to diagnosis. Additional symptoms are still poorly defined. In this case study, we discuss 11 genetically confirmed cases, and report on emerging features involving other systems in addition to the eye phenotype.Methods: In total, 11 SRD5A3-CDG patients in five sets of sibships were included in the study. Data on 9 of 11 patients are as of yet unpublished. Patients’ results on biochemical and genetic investigations and on in-depth phenotyping are presented.Results: Key diagnostic features of SRD5A3-CDG are ophthalmological abnormalities with early-onset retinal dystrophy and optic nerve hypoplasia. SRD5A3-CDG is also characterized by variable neurological symptoms including intellectual disability, ataxia, and hypotonia. Furthermore, ichthyosiform skin lesions, joint laxity, and scoliosis have been observed in our cohort. We also report additional findings including dystonia, anxiety disorder, gastrointestinal symptoms, and MRI findings of small basal ganglia and mal-rotated hippocampus, whereas previous publications described dysmorphic features as a common finding in SRD5A3, which could not be confirmed in our patient cohort.Conclusion: The detailed description of the phenotype of this large cohort of patients with SRD5A3-CDG highlights that the key clinical diagnostic features of SRD5A3-CDG are an early onset form of ophthalmological problems in patients with a multisystem disorder with variable symptoms evolving over time. This should aid earlier diagnosis and confirms the need for long-time follow-up of patients.

The implementation of sustainable adaptation strategies (SASs) is crucial to mitigate climate change impact as well as reduce the loss of natural disasters and increase agricultural crop production. However, current policies and programs based on agricultural incentives are mostly inadequate to increase SASs practices at the farm level. Hence, a deeper understanding of farmers’ ‘perceived typologies to the environmental issue and climate change’ is necessary for implementing SASs to enhance farmers’ ability to adapt at the farm level. This research intends to demarcate farmers in various categories, according to their perceptions on environmental and climate change issues in the northern part of Bangladesh. Principal component analysis (PCA) and cluster analysis (CA) were employed to analyze the survey data collected from 501 households in the study area. Farmers were clustered into three types, ‘Ecocentric’, ‘Worried’, and ‘Anthropocentric’, based on their perceived knowledge regarding environmental issues and climate change, which guides the adoption of SASs. The ‘Worried’ cluster showed a high sense of perceived risk of climate change and a significant positive association with the adoption of SASs. By contrast, ‘Ecocentric’ and ‘Anthropocentric’ groups showed a low sense of awareness of climate change and a significant negative association with the adoption of SASs. The findings can assist policymakers in promoting the adoption of SASs based on the farmers’ cluster and thus enhance their resilience.

Background Fluorescein is an agent that accumulates in areas of blood-brain barrier breakdown and is commonly used in neurosurgical oncology to assist with lesion localization and visualizing the extent of resection. It is considered to be cost-effective and has a favorable safety profile. Studies on the utilization of fluorescein demonstrate an improved extent of tumor resection and increased overall survival. Currently, fluorescein detection systems are all microscope based, leading to limitations such as decreased maneuverability, limited visualization of the entire operative field, and significant cost associated with obtaining and maintaining a neurosurgical operating microscope. Methods Three consecutive craniotomy patients for tumor resection were included, and surgery was carried out under loupe fluorescence guidance using the ReVeal 450 System, and also a surgical microscope for comparison. Results Loupe-mounted fluorescence system enabled excellent visualization of fluorescence in all three cases. Conclusions In this manuscript, we describe our experience with a loupe-mounted fluorescein detection system in 3 patients with malignant gliomas. We found that the loupe-mounted system offered excellent ability to visualize fluorescein fluorescence. Although loupe-mounted systems are not an alternative to surgical microscopes, they could be a useful surgical adjunct for superficial lesions and in low-middle income counties.

Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19. Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation. Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST &gt, 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome. Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.

Background: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the regional referral center over the 12-month period were included. Clinical severity of COVID-19 at hospital admission and 30-day outcomes (need for intensive care, mechanical ventilation, or death) were analyzed. Results: Derangement of LBT occurred in 2854/3812 (74.9%) of patients, most frequently due to elevation of AST (61.6%), GGT (46.1%) and ALT (33.4%). Elevated AST, ALT, GGT and low albumin were associated with more severe disease at admission. However, in multivariate Cox regression analysis, when adjusted for age, sex, obesity and presence of chronic liver disease, only AST remained associated with the risk of dying (HR 1.5081 and 2.1315, for elevations 1–3 × ULN and &gt, 3 × ULN, respectively) independently of comorbidity burden and COVID-19 severity at admission. Patients with more severe liver injury more frequently experienced defined adverse outcomes. Conclusions: Deranged LBTs are common among patients hospitalized with COVID-19 and might be used as predictors of adverse clinical outcomes.

Although short-term outcomes of endovascular and open infrainguinal revascularization in patients with peripheral arterial disease have been previously reported, 30-day readmission and resource utilization after these procedures remain unknown.We used the 2010-2014 Nationwide Readmissions Database and the International Classification of Diseases, Ninth Edition, to identify patients with peripheral arterial disease undergoing either in-hospital endovascular or open infrainguinal revascularization.Of an estimated 574,201 hospitalized patients treated for peripheral arterial disease, 308,056 and 266,145 underwent lower limb endovascular and open infrainguinal revascularization, respectively. Compared with patients who underwent open revascularization, endovascular patients were more commonly female (44.8% vs 36.7%, P.001) and older (69.5 vs 67.2 years, P.001). Moreover, they had higher rates of 30-day readmission (15.6% vs 13.5%, P.001), in-hospital complications (22.3% vs 20.9%, P.001), and in-hospital index mortality (2.1% vs 1.8%, P.001). In contrast, risk-adjusted multivariable analysis found open revascularization to be independently associated with increased odds of 30-day readmission (odds ratio, 1.13; 95% confidence interval 1.10-1.16), index complications (odds ratio, 1.23; 95% confidence interval 1.20-1.27), and mortality (odds ratio, 1.26; 95% confidence interval 1.16-1.36) compared with those who underwent endovascular revascularization. Trend analysis revealed an overall decrease in the utilization of both endovascular and open revascularization procedures in the inpatient setting.Despite lower rates of adverse events compared to endovascular, open infrainguinal revascularization is independently associated with increased risk of short-term readmission, complications, and mortality. These findings should be considered in the selection of appropriate surgical therapy for lower extremity arterial occlusive disease.

Background We have completed an audit to review our current routine endocrine surveillance of a cohort of metabolic patients who have had a haematopoietic stem cell transplant (HSCT) and ensure relevant investigations are obtained, and appropriate referral to endocrine teams are made. Aim Describe long term outcome of HSCT in children at risk of long term endocrine problems. To review whether post-HSCT metabolic patients are having the required endocrine complication-surveillance investigations undertaken, and if not to correct the problem Methods All patients with confirmed diagnosis of MPS 1H from a single tertiary centre were included. 3 MPS2 & 1 Alpha Mannosidosis included. A retrospective case notes review was undertaken to assess the following outcome measures: Post HSCT growth parameters Thyroid function tests Sex hormone levels Specific endocrine issues. Discussion We have noted among 31 patients, 16 patients were referred to endocrine team. 7 patients are referred at or after the 10 years of age whilst the rest of the 9 patients had endocrine assessment at the mean age of 2–9 years. The endocrine referral done before 10 yrs of age was because of specific endocrine problems, not as a surveillance. Most of the patients had the growth parameters checked however it was not particularly focussed or had set points for regular monitoring. We have learnt that only 10% of patients had sex hormone levels checked at the adolescent age when the expected endocrine issues are anticipated. Conclusion Overall, we highlight that proper endocrine referral at the age of 10 years is required for the post HSCT MPS patients.

Human activity recognition (HAR) is considered as one of the most difficult and challenging issues now a days. Many experiments are now in progress regarding this problem. Among many human activities, mostly six are considered for research in this area. This activity recognition issue can be measured with the help of smartphones and smartphone sensors, along with the connection of Internet of Things (IoT) devices. In this research, an improved deep learning scheme is proposed for the recognition of human activities. A customized Neural Network (NN) model was designed and tested for the research. The proposed model obtained 96.47% accuracy on the HAR with smartphones dataset that is better than most other analyzed models. Sensors such as accelerometer, gyroscope are focused on the data analysis portion of this research work. This article will give a clear idea of the dataset, Machine Learning algorithms, and the effect of the proposed algorithm.

Uninterrupted and adequate electricity supply to the resident of rural areas is still a big challenge due to the shortage of national electricity production and a weak distribution system in many countries. Along with these issues, the current high Cost of Electricity (COE) is another hindrance of ensuring electricity for rural people. To mitigate this economic impediment along with addressing environmental issues, a microgrid (MG) could be a suitable solution. This work proposes a PV-Wind-Battery-Gas connected MG architecture that provides a reasonable level of CO 2 emission in two differently located remote urban areas. Simulation results conclude that the proposed model can provide environment friendly as well as economical electrification.

The study of mobile robot(s) based applications recently gained much popularity in academic settings. Different types of locomotion techniques exist for mobile robots, among them, wheeled robots are popular for educational purposes. Mobile robot applications may consist of single or multiple robot units. Some of the key issues to be addressed in mobile robot navigation are related to the condition of the underlying terrains, obstacles, localizations, mapping, and communication, among others. In many robotics related academic course works, students are often required to apply mobile robot localization and mapping capabilities in order to meet robot task objectives. This paper addresses an obstacle free scenario with a planar platform and presents cost-effective techniques for mobile robot localization and mapping. The paper includes a review of general fixed wheeled robot dynamics, addresses simple navigation techniques based on a given reference location for standard wheeled robots, and discusses strategies for building mapping configurations. In addition, constraints and troubleshoot approaches across different types of sensors used for mapping are presented.

Background Palliative care is characterised as a holistic, interdisciplinary and humanised approach to care. It transcends the traditional bio-medical perspective in health through a bio-psycho-social and spiritual approach. Holistic point of view in palliative care is essential, and needs to be consistently hi-lighted to nursing students to improve end of life care. Objective To describe nursing students' experience in a palliative care unit in Santiago, Chile. Design A qualitative phenomenological study utilising purposive sampling of 10 nursing students from a Chilean university was undertaken, who completed their final year in a palliative care unit between 2017 and 2019. Methods Data were collected using in-depth interviews, which were conducted, recorded, transcribed and analysed according to Streubert-Carpenter method. This study was approved by the Ethics Committee of Universidad de los Andes, Chile. Results Three main themes were identified in the data with their consequent units of meaning; these were experiences from all participants. The first theme identified was the diverse learning experiences students had. Topics included were: spirituality, dignity, teamworking and communication with the patient and family. They also identified personal growth. The second theme was living through the experience of difficult times; this included how they dealt facing death and how they found meaning on this. Also, patient loneliness, abandonment and the impact of shortage of human and material resources. The final theme was recognising that touching patients is often the essence of nursing and is paramount in palliative care. Conclusions Completing a placement in a palliative care unit contributes to student nurses' personal and professional development. It provides multiple tools related to the care of terminally-ill patients and their families. It is recommended to undergraduate nurses have the opportunity to experience palliative care throughout curriculum and that they learn to embed theory to practice.

We undertook the first study systematically evaluating the risk of Anisakis-sensitization in Croatian fish-processing workers and potential genetic susceptibility to anisakiasis. Anti-Anisakis IgE seroprevalence and risk factors for 600 employees of Croatian fish processing facilities and 466 blood donor controls, were assessed by indirect ELISA targeted with: recombinant Ani s 1 and Ani s 7 allergens, an Anisakis crude extract, the commercial ImmunoCAP kit, and questionnaires. Genetic susceptibility to anisakiasis was evaluated by genotypisation of human leukocytes alleles (HLA). Anti-Anisakis seropositive and a fraction of negative subjects were also assessed by ELISA and Western Blot (WB) for IgG seroprevalence to Trichinella spp. Overall, the observed anti-Anisakis seroprevalence inferred by indirect ELISA was significantly higher in fish processing workers (1.8%, 95% CI 0.9–3.3%) compared to the controls (0%, 0–0.8%). Seven out of 11 Ani s 1 and Ani s 7-positives and none of selected 65 negative sera, tested positive on whole-Anisakis extract (ImmunoCAP), whereas Anisakis crude extract ELISA detected 3.9% (2.4–6.0%) seropositives in fish processing workers, three (14%) of which showed IgE reactivity to milk proteins. The highest risk associated with Anisakis-sensitization among workers was fishing in the free time, rather than any of attributes related to the occupational exposure. Although no association was observed between anti-Anisakis seropositivity and wearing gloves or protective goggles, the majority of workers (92%) wore protective gloves, minimizing the risk for Anisakis sensitization via skin contact. Six HLA alleles within DRB1 gene were significantly associated with seropositivity under dominant, allelic or recessive models. All sera confirmed negative for anti-Trichinella spp. IgG. The study exhaustively covered almost all marine fish processing workers in Croatia, reflecting real-time Anisakis sensitization status within the industry, already under the influence of wide array of allergens., Author summary Anisakiasis is a human disease caused by ingestion of live Anisakis spp. larvae by raw seafood. Fish processing and aquaculture workers (approximately 60 million people world-wide) are at occupational risk of becoming sensitized to Anisakis. This is the first study systematically evaluating the risk of Anisakis-sensitization in Croatian fish-processing workers and potential genetic susceptibility to anisakiasis in the analysed population. Observed seroprevalence was significantly higher in fish processing workers (1.8%) compared to the controls (0%). Surprisingly, the highest risk associated with Anisakis-sensitization among workers was fishing in their free time, rather than any of attributes related to the occupational exposure. While no association was observed between anti-Anisakis seropositivity and wearing gloves or protective goggles, the majority of workers (92%) wore protective gloves, minimizing the risk for Anisakis sensitization via skin contact. Additionally, seroprevalence to another important food-borne helminth, Trichinella spp. assessed in all Anisakis-positive subjects showed to be negative. Almost all marine fish processing workers in Croatia were part of this research, reflecting real-time Anisakis-sensitization status within the industry. This sets a baseline for the future tracking of sensitization in the sector already under the influence of wide array of allergens.

Correction: On 21st September 2018, the author 'Pravin Kumar Mishra' was changed to 'Pravin Mishra' - Editorial Board. The study has been directed to find out the occurrence of surgical affections in herbivorous zoo animals in National Zoological Garden, Dhaka, Bangladesh predicated on record books from 2012 to 2016. A total of 330 surgically affected animals were recorded. The overall occurrence of surgical affections was higher in Bovidae (34.85%) followed by Cervidae (25.45%), Equidae (13.94%), Cercopithecidae (10.61%), Giraffidae (4.85%), Elephantidae (4.55%) Hippopotamidae (4%), Rhinocerotidae (1.52%) and Macropodidae (0.61%). In this study, it is found a higher occurrence of surgically affected are male than female animals. The overall occurrence in male was 56.36% and those in female, it was 43.64%. In terms of different affections, the highest occurrence was wound (13.03% male, 16.67% female) and followed by lameness (14.55% in male, 11.82% in female), skin lesions (9.39% in male, 6.67% in female), myiasis (5.76% in male, 3.33% in female), Horn fracture 3.33% (Only in male), arthritis (2.42% male, 1.52% female), hoof injury (1.82% male, 1% female), abscess (1.52% male, 1.21% female), sore (0.61% male, 2.12% female), Fracture (1.21% male, 0.3% female), Paralysis (0.61% male, 0.3% female) and Corneal opacity (0.61% male, 0.3% female). This report may help to develop control strategies against major surgical affections reported in this study.Res. Agric., Livest. Fish.5(2): 209-214, August 2018

Background In this modern era, health care has been shifted from the hospital-based acute care to primary health care. The people are now more concern to get medical help as early as possible and Tele-medicine in the answer to this hunger. Objectives The aim of this study was to determine the Patient satisfaction over the Telemedicine service in The Dhaka City, Bangladesh. Methods A cross-sectional study was conducted in Synesis IT Bangladesh Ltd among 203 participants of all age group who have been contacted to telemedicine services from 1st November 2017 to 30th April 2018. Results The study found that majority participants (79.8%) were age group of 19-40, where most of them were housewife & privet job holders and most of them were married (72. 4%). It was observed that 76.7% of the patients took less than a minute to get a connection to a doctor over the phone. The study also found that 40.5% of the patients responded that the service was excellent and 22.5% of the patients said it was best in service. 97.5% patients said they will suggest others to call telemedicine service to get medical help. Conclusion Results of this study conclude that Telemedicine in Bangladesh is getting popular and well accepted now a day. It has earned the trust of the people and if continue like this, it will reduce the treatment dilemmas in Bangladesh. We recommend the telemedicine service providers to make them more visible and easily available, so more people will be engaged and benefited from their services. Keywords: Telemedicine, Patient satisfaction, Cross-sectional study, Bangladesh

Online motorcycle taxi is one of the latest public transportation trends to Indonesian people. Although it is still new, its existence is able to change the behavior of Indonesian people. Some people feel that they are being helped by its existence, yet some people do not. Various types of complaints or appreciation about the online motorcycle taxi are frequently discussed on popular social media, namely; twitter. Sentiment Analysis is a part of science in text mining that is able to predict someone’s feeling or feeling as outlined in text. This study uses the support of vector machine method with TF-IDF feature selection. The data set were 1183 that were taken from twitter with the keyword gojekindonesia and grabID through the data crawling process. The data set are divided into 3 classes: positive sentiment class, negative sentiment class and neutral sentiment class. The classification process was done by using five scenarios that were training comparison and Testing 50:50, 60:40, 70:30, 80:20 and 90:10. In addition, the classification process also used four kernels such as linear, rbf, sigmoid and polynomial. The highest accuracy results are in the comparison of 90% as training data and 10% as testing data while using a linear and sigmoid kernel are 0.8060 or about 80%.

Diseases have been recognized as the major obstacle to the shrimp (Penaeus monodon) and prawn (Macrobrachium rosenbergii) aquaculture production in Bangladesh. This study provides an assessment of shrimp and prawn diseases/syndromes, health management practices, and occupational health hazards associated with the handling of chemical and biological products to prevent and treat shrimp and prawn diseases. A survey was conducted using a semi-structured questionnaire with 380 shrimp and prawn farmers in the southwest of Bangladesh during February and June of 2016. The farms were categorized on the basis of the three cropping patterns: shrimp polyculture, prawn polyculture, and shrimp and prawn polyculture. Eight different diseases and/or symptoms were reported by the surveyed farmers. The white spot disease and the broken antenna and rostrum symptom were the most common in shrimp and prawn species, respectively. In total, 35 chemical and biological products (4 antibiotics, 15 disinfectants, 13 pesticides, 2 feed additives and probiotics) were used to treat and/or prevent diseases in the all farm categories. The major constraints for disease management were limited access to disease diagnostic service, inadequate product application information and lack of knowledge on better management practices. Handling chemicals and preparation of medicated feed with bare hands was identified as a potential occupational health hazard. This study suggests improvements in farmers’ knowledge and skill in disease diagnostics and health management practices, and appropriate handling of potentially hazardous chemicals., Highlights • A survey was conducted using a semi-structured questionnaire with 380 shrimp and prawn farmers in Bangladesh. • A wide range of chemical and biological products were used to prevent and/or treat diseases. • Lack of knowledge and limited access were main constraints for diseases diagnostic service and decisions on treatment. • Inappropriate handling of chemicals with bare hands may lead to occupational health hazard risks. • Development and adherence to a comprehensive set of “better management practices” for Bangladesh farmers is required.

Globally, breast cancer is the most common cancer and the second leading cause of cancer-related death among women. Surgery, chemotherapy, hormonal therapy, and radiotherapy are currently available treatment options for breast cancer therapy. However, chemotherapy, hormonal therapy, and radiotherapy are often associated with side effects and multidrug resistance, recurrence, and lack of treatment in metastasis are the major problems in the treatment of breast cancer. Recently, dietary phytochemicals have emerged as advantageous agents for the prevention and therapy of cancer due to their safe nature. Ellagic acid (EA), sulforaphane (SF), and ursolic acid (UA), which are found in widely consumed fruits and vegetables, have been shown to inhibit breast cancer cell proliferation and to induce apoptosis. This review encompasses the role of EA, SF, and UA in the fight against breast cancer. Both in vitro and in vivo effects of these agents are presented.

Background: Menopause is the estimated end of reproductive life. Having a positive attitude towards it has been shown to outcome in a positive experience, whereas a negative attitude is connected with negative experiences and symptoms. Conventionally, women regularly abstain from sex after menopause. Purpose: The study aimed to determine the level of awareness and perceptions about the menopause and sex in perimenopausal women attending a general outpatient clinic. Methods: Women over 40 years were enlisted from the Family Medicine Department of King Abdulaziz Hospital, excluding those who were menopausal. Data analyses were done with chi-square test (P

Investigations have also reported that the efficacy of telemedicine in the easy delivery of information and provision of regular patient-doctor interaction and therefore, enhancing the quality of care of diabetics and reducing the risk of developing severe complications. In the present study, we aimed to discuss telemedicine use in the management of diabetic complications, depending on information from studies within the literature. Overall, telemedicine assists patients to properly maintain basic and adequate levels of blood glucose levels through continuous reminders. Therefore, the application of this modality requires patients to have home-based assessment devices for the regular monitoring of the blood glucose levels. Moreover, the modality also enhances the connection between the patient and the physicians which make the patient at an ease of being able to communicate with the doctor whenever necessary and therefore, this might have a positive psychological impact on these patients. Moreover, telemedicine can provide patients with adequate treatment schedules that might help patients comply with their drugs. Additionally, it can provide the most appropriate dietary components that can also help in achieving the best intervention, with the necessary supervision. Although there is good evidence about the efficacy of telemedicine as an efficacious modality in the treatment of diabetes and management of complications, the evident application in the healthcare settings is still poor. The main reason behind such lack of proper application is the potential lack of adequate financial support, lack of experienced staff dealing with the modalities and maintaining the best quality of care for the patients.

Bee Kim Tan,1,2 Seng Beng Tan,3 Li-Chia Chen,4 Kian Meng Chang,5 Siew Siang Chua,1,6 Sharmini Balashanker,7 Habiba Nazeera Begum Kamarul Jaman,5 Syed Carlo Edmund,8 Ping Chong Bee3 1Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia; 3Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 4Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK; 5Department of Hematology, Ampang Hospital, Ampang, Selangor, Malaysia; 6School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University, Lakeside Campus, Subang, Selangor, Malaysia; 7School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih, Selangor, Malaysia; 8Clinical Research Center, Ampang Hospital, Ampang, Selangor, Malaysia Purpose: Poor adherence to tyrosine kinase inhibitors (TKIs) could compromise the control of chronic myeloid leukemia (CML) and contributes to poorer survival. Little is known about how medication-related issues affect CML patients’ adherence to TKI therapy in Malaysia. This qualitative study aimed to explore these issues.Patients and methods: Individual face-to-face, semistructured interviews were conducted at the hematology outpatient clinics of two medical centers in Malaysia from August 2015 to January 2016. CML patients aged ≥18 years who were prescribed a TKI were invited to participate in the study. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.Results: Four themes were identified from 18 interviews: 1) concerns about adverse reactions to TKIs, 2) personal beliefs regarding the use of TKIs, 3) mismanagement of TKIs in daily lives, and 4) financial burden in accessing treatment. Participants skipped their TKIs due to ineffective emesis control measures and perceived wastage of medication from vomiting. Participants also modified their TKI therapy due to fear of potential harm from long-term use, and stopped taking their TKIs based on belief in curative claims of traditional medicines and misconception about therapeutic effects of TKIs. Difficulty in integrating the dosing requirements of TKIs into daily lives led to unintentional skipping of doses, as well as the risk of toxicities from inappropriate dosing intervals or food interactions. Furthermore, financial constraints also resulted in delayed initiation of TKIs, missed clinic appointments, and treatment interruptions.Conclusion: Malaysian CML patients encountered a range of medication-related issues leading to a complex pattern of nonadherence to TKI therapy. Further studies should investigate whether regular contact with patients to improve understanding of treatment rationale, to elicit and address patients’ concerns about adverse reactions, and to empower patients with skills to self-manage their medications might promote better adherence to TKIs and improve CML patients’ outcome. Keywords: medication-related issues, adherence, tyrosine kinase inhibitors, chronic myeloid leukemia, qualitative study, thematic analysis

An attempt has been made to study and analyse the hydrodynamic effects of turbulent flow including its pattern and characteristics around three identical circular shaped piers. Experimentation was conducted under clear-water scour condition. Three pier groups were placed with inline and eccentric arrangement in tandem manner on a flume. Two piers were positioned inline along the flow direction and third pier was placed eccentrically in the middle of two inline piers having a transverse distance equal to three times of pier width. Three dimensional velocities were gauged at a horizontal plane located at 4% depth above the zero bed level. The readings were captured in the Cartesian coordinate-system to compute the time-mean longitudinal, transversal and vertical velocities. The hydrodynamic consequences of three piers arrangement near the horizontal bed were investigated. The contour profile and variations of time aggregated mean velocity components, kinetic energy and turbulence intensities are measured or determined and analysed. Velocity vectors and absolute velocity at horizontal plane obtained from velocity measuring areas are utilised to explain further hydrodynamic flow features. The measured depth for scour at equilibrium state for the eccentric middle pier is observed higher than the inline front and inline rear circular piers. The three pier group positioning and the interfering between the circular piers act an important function in flow characteristics and for creating and forming the larger scoured depth around the eccentric middle pier.

Paper deals with two 400 kV bushing failures which happened in a relatively short period of time, after about ten years of transformer service. Failure appearance was practically identical in both cases - breakdown between bushing end screen and turret wall followed by a small oil leak through mechanically damaged bushings. Failure happened during medium load, temperature and voltage ordinary conditions. Analysis of the periodic (off-line) and continuous (on-line) diagnostic results revealed that up to the moment of failure no any signs of possible problem had been recorded: no bushings capacitance change, no DGA rise and no any significant overvoltage. All measured values correspond to new equipment. It seems that observed bushing failures were totally unpredictable despite of applied on-line and off-line diagnostic methods. Several end screens were taken from service for further research in HV laboratory. End screen electrode is casted with a thick layer of resin. El. field inside and around end screen electrode was calculated and based on the results special test setup was developed which simulates dielectric stresses as in service. PD measurement revealed that some end screens suffered from harmful PD even on (simulated) service voltage. It was found that PD inside bushing end screen thick epoxy coating can be hidden despite of bushing and transformer testing according to relevant standards.

We explore the application of computer vision and machine learning (ML) techniques to predict material properties (e.g., compressive strength) based on SEM images. We show that it's possible to train ML models to predict materials performance based on SEM images alone, demonstrating this capability on the real-world problem of predicting uniaxially compressed peak stress of consolidated molecular solids samples. Our image-based ML approach reduces mean absolute percentage error (MAPE) by an average of 24% over baselines representative of the current state-of-the-practice (i.e., domain-expert's analysis and correlation). We compared two complementary approaches to this problem: (1) a traditional ML approach, random forest (RF), using state-of-the-art computer vision features and (2) an end-to-end deep learning (DL) approach, where features are learned automatically from raw images. We demonstrate the complementarity of these approaches, showing that RF performs best in the “small data” regime in which many real-world scientific applications reside (up to 24% lower RMSE than DL), whereas DL outpaces RF in the “big data” regime, where abundant training samples are available (up to 24% lower RMSE than RF). Finally, we demonstrate that models trained using machine learning techniques are capable of discovering and utilizing informative crystal attributes previously underutilized by domain experts. Keywords: Mechanical performance prediction, Image analysis, Random forest, Deep neural network, Machine learning

Introduction Dupilumab, a fully human interleukin (IL)-4 receptor-α monoclonal antibody inhibiting IL-4/IL-13 signaling pathways, key drivers of Type 2 inflammation, is approved for treating adults with inadequately controlled moderate-to-severe atopic dermatitis. In the phase 3 LIBERTY ASTHMA QUEST study (NCT02414854), dupilumab 200mg and 300mg administered every 2 weeks versus matched placebo reduced annualized severe exacerbation rates and improved pre-bronchodilator forced expiratory volume in 1 second (FEV1) and quality-of-life measures, and was generally well tolerated in patients with uncontrolled, moderate-to-severe asthma (≥12 years, without minimum baseline Type 2 inflammatory biomarkers). This post-hoc analysis assessed the efficacy of dupilumab in patients with and without allergic asthma. Methods Allergic asthma was defined as total serum IgE ≥30 kU/L and ≥1 positive perennial aeroallergen-specific IgE (≥0.35 kU/L) at baseline. Endpoints were annualized severe exacerbation rates over the 52-week treatment period and change from baseline to Week 12 in pre-bronchodilator FEV1 (L). Results 56% (n=1,066) of the intent-to-treat population met the criteria for allergic asthma. In patients with and without allergic asthma, dupilumab vs placebo significantly reduced annualized severe exacerbation rates during the treatment period (all P1 (L) at Week 12 (all PFigure). In both subgroups, improvements were greater with higher baseline blood eosinophil and FeNO levels. The most frequent adverse event in the dupilumab-treated groups versus placebo was injection-site reactions (15%/18% versus 5%/10%, respectively). Conclusions Add-on dupilumab reduced severe exacerbations and improved lung function in patients with allergic and non-allergic uncontrolled, moderate-to-severe asthma and was generally well tolerated. Figure. Change from baseline to Week 12 in pre-bronchodilator FEV1 (L) and annualized severe exacerbation rate during the 52-week treatment period in patients with and without allergic asthma and in subgroups defined by baseline blood-eosinophil counts and FeNO levels.