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The identification of etiology is very important when managing patients with community-acquired pneumonia (CAP). In Pakistan, studies regarding the viral etiology in CAP are scarce. The main objective of this study was to evaluate the frequency of viral etiology in CAP patients and analyze the clinical features and their impact on prognosis. Medical records of CAP patients admitted to Aga Khan University Hospital (Karachi, Pakistan) from March 2022 to February 2023 were retrospectively reviewed, patients who had microbiological tests performed within 48 hours of the hospital admission were included, and the frequency of viral and bacterial etiology was calculated. Patients who were immunocompromised were excluded. Epidemiological and clinical characteristics were examined, and the impact on prognosis was explored. A total of 166 patients were included; 115 (69.3%) patients were identified as having pneumonia with known causative microorganisms. A total of 83 (72.1%) patients had a viral etiology alone, 18 (15.6%) had only bacterial infection, and 14 (12.2%) had a viral and bacterial co-infection. Influenza A was most frequently detected (n=46/97; 47.4%), followed by Rhinovirus/Enterovirus (n=19/97; 19.6%). Staphylococcus aureus accounted for the majority (n=18; 56.3%) of cases among bacteria. Bacterial and viral-bacterial co-infection was significantly higher among non-survivors (38.1% vs. 16.6%, p=0.034). Confusion-Urea-Respiratory Rate-Blood Pressure-Age of 65 scores of 3-5 [odds ratio (OR) 4.234; 95% confidence interval 1.156-15.501], leukocytosis (OR 0.137; 0.030-0.636), high C-reactive protein (>10mg/L) (OR 1.008; 1.001-1.014), high serum procalcitonin level (≥0.5 ng/mL) (OR 10.731; 3.018-38.153), and mechanical ventilation required (OR 47.104; 13.644-162.625) were associated with mortality. Mechanical ventilation requirement was independently associated with increased odds of mortality (OR 43.407; 8.083-233.085). Of 166 patients, 21 (12.7%) had died, with the highest percentage (28.6%) seen in the viral-bacterial coinfection group (p=0.046). To conclude, respiratory viruses are increasingly being recognized as an important etiology in CAP, with higher mortality seen in bacterial infection, whether alone or with viral co-infection.

Time to update abstract submission categories to promote dissemination of global oncology research.

Abstract Background The number of academic clinicians in the UK is declining and there are demographic inequalities in the clinical-academic workforce. Increased research productivity by medical students is believed to reduce future attrition in the clinical-academic workforce. Thus, this study investigated the association between student demographics and research productivity amongst UK medical students. Methods This is a national multicentre cross-sectional study of UK medical students in the 2020/21 academic year. We appointed one student representative per medical school, and they disseminated a 42-item online questionnaire over nine weeks, through departmental emails and social media advertisements. The outcome measures were: (i) publications (yes/no) (ii) number of publications (iii) number of first-authored publications (iv) abstract presentation (yes/no). We utilised multiple logistic and zero-inflated Poisson regression analyses to test for associations between the outcome measures and predictor variables at a 5% significance level. Results There are 41 medical schools in the UK. We received 1573 responses from 36 UK medical schools. We failed to recruit student representatives from three newly formed medical schools, whilst two medical schools prohibited us from sending the survey to their students. Women had lower odds of having a publication (OR: 0.53, 95% CI: 0.33–0.85) and on average had fewer first-author publications than men (IRR: 0.57, 95% CI: 0.37–0.89). Compared to white students, mixed-ethnicity students had greater odds of having a publication (OR: 3.06, 95% CI: 1.67–5.59), an abstract presentation (OR: 2.12, 95% CI: 1.37–3.26), and on average had a greater number of publications (IRR: 1.87, 95% CI: 1.02–3.43). On average, students who attended independent UK secondary schools had a higher rate of first-author publications compared to those that attended state secondary schools (IRR: 1.97, 95% CI: 1.23–3.15). Conclusion Our data suggest that there are gender, ethnic and socioeconomic inequalities in research productivity among UK medical students. To tackle this, and potentially improve diversity in clinical academia, we recommend that medical schools should facilitate targeted high quality research mentorship, funding and training, especially for under-represented-in-medicine students.

Abstract Background African countries have not had the high case and death rates from COVID-19 as was predicted early in the pandemic. It is not well understood what factors modulated the rate of COVID-19 cases and death on the continent. Methods We collated data from the World Bank data site, Our World in Data and Freedom House for African for 54 African countries who are members of the African Union. We used them as explanatory variables in two general linear model regression analyses. COVID cases and deaths per 100,000 obtained from WHO COVID-19 dashboard on August 12, 2021, as outcome variables in two prediction models. Results GDP, percentage of population under 14 years of age, Maternal Mortality Ratio, number of international tourists visiting per year and public transportation closures were not significant in predicting COVID-19 cases. Higher percentage of unemployed adults in the population, lower percentage of the population over 25 years of age with secondary education, internal travel restrictions increased spread of COVID-19 while international travel restrictions were associated with lower COVID-19 cases per 100,000 population. Higher levels of democratization results in higher cases of COVID-19. Unemployment, education and democratization were still significant for COVID-19 death in the same direction as they were for COVID-19 cases. Number of tourism visitors per year was also associated with higher COVID-19 death rates but not with case rates. Conclusion In African countries, internal movement restrictions enacted to inhibit COVID-19, had the opposite effect and enabled COVID-19 spread. Low Education levels and high unemployment were associated with having higher death rates from COVID-19. More studies are needed to understand the impact of tourism on COVID-19 and other infectious diseases arising from other regions on African countries, in order to put in place adequate control protocols.

Academic Frequently Asked Questions (FAQ) service is a service designed to answer academic questions that are often asked by students. A survey conducted on April 12, 2022, to 33 students of the Ahmad Dahlan University Informatics study program showed that 39.4% of students rarely open the FAQ menu on the portal application. Students more often ask questions to administrators and lecturers, but 30.3% of students receive answers that last more than 10 minutes. Chatbot is an artificial intelligence system used to interact with users in real-time to provide information. The use of dialog flow in the system helps manage information and can provide an answer quickly and precisely to users. This research uses the waterfall method, which is a simple classic model with a linear flow system. The User Experience Questionnaire (UEQ) survey results get a score of 1,536 for attractiveness, 1,714 for clarity, 1,375 for efficiency, 1,357 for fixity, 1,536 for stimulation, and 0.964 for novelty. Based on these results, it shows that the application level is above average on the UEQ scale.

Teachers are one of the main factors for success in education. The teacher is an agent of change to students. The purpose of this study is to use a literature review approach to gain insight into the systematic mapping review for the article under consideration. A literature review, one of the main reasons for the importance of a professional teacher who becomes an agent of change for his students. Methods in this study using the literature review method by searching various sources from Google Scholar, Scopus, WOS and also Erics. The results of this study are that being a professional teacher is required. The teacher's professional attitude is manifested in the form of being able to control oneself, which is expressed through a spiritual mental attitude, so that he always acts based on moral values, principles of life, and behaves religiously in accordance with his religion and belief in carrying out his duties.

Summary: Background: Avoidant restrictive food intake disorder (ARFID) is a new eating disorder with a heterogeneous clinical presentation. It is unclear which patient characteristics contribute to its heterogeneity. Methods: To identify these patient characteristics, we performed symptom-level correlation and driver-level regression analyses in our cross-sectional study in up to 261 ARFID patients (51% female; median age = 12.7 years) who were assessed at the Maudsley Centre for Child and Adolescent Eating Disorders, London between November 2019 and July 2022. Findings: Symptoms across the three drivers 1) avoidance based on sensory characteristics of food; 2) apparent lack of interest in eating; and 3) concern about aversive consequences positively correlated with each other. Patients' anxiety traits showed the greatest positive correlations with symptoms of concern about aversive consequences of eating. Patient sex was not significantly associated with any of the three ARFID drivers. Patients with comorbid autism spectrum disorder (ASD; 28%) showed more food-related sensory sensitivities (RR = 1.26) and greater lack of interest in eating (RR = 1.18) than those of patients without ASD (49%). Interpretation: In our clinical sample, the ARFID drivers occurred together and did not show clinically meaningful differences between the sexes. ASD may accentuate food-related sensory sensitivities and lack of interest, but may not drive a completely different symptom presentation. ARFID is multi-faceted and heterogenous, requiring a comprehensive multidisciplinary assessment to sufficiently understand the drivers of the restrictive eating behaviour. Results need replication in larger samples with more statistical power. Funding: None.

FAQ is an important part of a system because it is used to make it easier for users to solve problems faced by users. Some FAQ systems have even started using Chatbot technology to make it easier for users. Chatbots have been widely used as a medium for services in almost all fields. Starting from marketing, service systems, education, health, culture and entertainment. Various types of chatbots have sprung up, ranging from text-based like short messaging applications to voice-based ones. However, not all forms of chatbot designs have been successfully implemented in the FAQ system. Adjustments need to be made, especially considering the persona of the user. This research provides a solution by implementing a hybrid conversational design. Hybrid conversation design is accomplished by incorporating text, voice, and buttons into the chatbot interface. Conversation activities with this hybrid interface provide keywords that users may search for in the form of buttons. The hybrid design of the FAQ Chatbot is proven to be able to improve user usability compared to full text chatbots and full text FAQs. The increase in user usability is measured using UEQ, the results of which show an increase in usability from all existing aspects. However, the implementation of this hybrid design also has the consequence that the conversation management system must have structured initial information.

This study describes the use of mobile learning technology for students at the elementary school level. There are many educational applications, so researchers want to know whether these applications are needed for education. In this study, in order to understand how students, understand the use of educational applications that can be used on mobile devices, a qualitative method is used. Researchers in this case also use data collection techniques by conducting semi-structured interviews with students and elementary school students who use cellular technology in learning activities. The children said that using instructional apps had helped them improve their skills. When they work in groups, they develop relational and communication skills. On the other hand, there are some students who do not see the value or convenience of using educational apps on their mobile devices. The result of this research is the application of arithmetic and storytelling helps children improve their cognitive abilities. At the same time, when they interact with others, this activity stimulates them and offers emotional benefits. Use Study participants demonstrated a wide range of learning skills and capacities, as demonstrated by this study. Finally, this work offers new possibilities for future research in this exciting field.

We investigate the combined effects of surface diffraction and total internal reflection (TIR) in the design of 3-dimensional materials exhibiting distinct structural colour on various facets. We employ mechanical wrinkling to introduce surface diffraction gratings (from the nano to the micron scales) on one face of an elastomeric rectangular parallelepiped-shaped slab and explore the roles, in the perceived colours, of wrinkling pattern, wavelength, the directionality of incident light and observation angles. We propose a simple model that satisfactorily accounts for all experimental observations. Employing polydimethylsiloxane (PDMS), which readily swells in the presence of various liquids and gases, we demonstrate that such multifaceted colours can respond to their environment. By coupling a right angle triangular prism with a surface grating, we demonstrate the straightforward fabrication of a so-called GRISM (GRating + prISM). Finally, using a range of examples, we outline possibilities for a predictive material design using multi-axial wrinkling patterns and more complex polyhedra.

Prolonged therapy with isoniazid is used for the treatment of pulmonary tuberculosis. Drug-induced lupus erythematosus is a rare, adverse event associated with isoniazid use and can complicate treatment, especially if it is associated with pneumonitis. The diagnosis is made by clinical suspicion, elevated serum titers of anti-nuclear antibody and anti-histone antibody, and new ground-glass opacities on chest tomography. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsy of affected areas of the lung is useful to increase diagnostic accuracy and differentiate between drug-induced pneumonitis, concomitant infection, or other inflammatory processes. Treatment includes systemic corticosteroids and cessation of isoniazid therapy.

The energy demand in the world has increased rapidly in the last few decades. This demand is arising the need for alternative energy resources. Solar energy is the most eminent energy resource which is completely free from pollution and fuel. However, the problem occurs when it comes to efficiency under different atmospheric conditions such as varying temperature and solar irradiance. To achieve its maximum efficiency, an algorithm of maximum power point tracking (MPPT) is needed to fetch maximum power from the photovoltaic (PV) system. In this article, a nonlinear backstepping terminal sliding mode control (BTSMC) is proposed for maximum power extraction. The system is finite-time stable and its stability is validated through the Lyapunov function. A DC-DC buck-boost converter is used to deliver PV power to the load. For the proposed controller, reference voltages are generated by a radial basis function neural network (RBF NN). The proposed controller performance is tested using the MATLAB/Simulink tool. Furthermore, the controller performance is compared with the perturb and observe (P&O) MPPT algorithm, Proportional Integral Derivative (PID) controller and backstepping MPPT nonlinear controller. The results validate that the proposed controller offers better tracking and fast convergence in finite time under rapidly varying conditions of the environment.

Abstract Objectives: To assess the burden of sleep disorders in the elderly, and the effects of various co-morbidities linked with sleep disorders. Method: The longitudinal cross-sectional study was conducted in different outpatient departments at a tertiary care centre in Islamabad, Pakistan, from June 2014 to June 2015, and comprised patients of either gender aged 60 years or above. Pittsburgh sleep quality index and Epworth sleepiness scale were used to measure the quality and patterns of sleep and daytime sleepiness in the elderly. Data was analysed using SPSS 21. Results: Of the 1000 subjects, 638(63.8%) were males, and 362(36.2%) were females. The overall mean age was 66.96±7.05 years. Epworth sleepiness scale >10 was found in 265(26.5%) subjects, while Pittsburgh sleep quality index score in 516(51.6%) was >5. Sleep quality score in 578(57.8%) women was statistically significant compared to 478(47.8%) males (p

The state-of-charge (SoC) of an energy storage system (ESS) should be kept in a certain safe range for ensuring its state-of-health (SoH) as well as higher efficiency. This procedure maximizes the power capacity of the ESSs all the times. Furthermore, economic load dispatch (ELD) is implemented to allocate power among various ESSs, with the aim of fully meeting the load demand and reducing the total operating cost. In this research article, a distributed multi-agent consensus based control algorithm is proposed for multiple battery energy storage systems (BESSs), operating in a microgrid (MG), for fulfilling several objectives, including: SoC trajectories tracking control, economic load dispatch, active and reactive power sharing control, and voltage and frequency regulation (using the leader-follower consensus approach). The proposed algorithm considers the hierarchical control structure of the BESSs and the frequency/voltage droop controllers with limited information exchange among the BESSs. It embodies both self and communication time-delays, and achieves its objectives along with offering plug-and-play capability and robustness against communication link failure. Matlab/Simulink platform is used to test and validate the performance of the proposed algorithm under load disturbances through extensive simulations carried out on a modified IEEE 57-bus system. A detailed comparative analysis of the proposed distributed control strategy is carried out with the distributed PI-based conventional control strategy for demonstrating its superior performance.

Science, Technology, Engineering and Mathematics (STEM) Project-Based Learning (PjBL) is increase effectiveness, create meaningful learning and influence student attitudes in future career pursuit. There are several studies in the literature reporting different aspects of STEM into a PjBL pedagogy. However, the effect of implementing STEM PjBL in terms of improving students' skills in self-efficacy levels in physics mechanics at high school level has not been demonstrated as expected in the previous literature. This study followed a quasi-experimental research method. Bandura's social cognitive theory is used to assess and compare the effect of STEM PjBL with conventional teaching method on students' self-efficacy level in learning physics among over 100 high school students. The result illustrated that STEM PjBL improve students' self-efficacy to solve physics problem. Also, the study proposes a guideline for future research.

The Malaysian government aims to help the bottom billion countries, which are its neighbouring countries in the South East Asian region, for their human capital development through providing university postgraduate scholarship projects. Those countries include Cambodia, Laos PDR, Burma or Myanmar, and Vietnam (CLMV), which are favourite countries for its technical assistance. Due to the countries' various educational systems, postgraduate students have experienced some academic difficulties during their studies and research in Malaysian universities. A qualitative research method is employed to investigate students' living strategies, perception of academic success, and academic adjustment problems in a Malaysian university. Research samples were conducted conveniently selected from a total of 17 students made up of 6 Cambodian, 4 Laotian, 2 Myanmar, and 5 Vietnamese postgraduate students (47, 05% females and 52, 94% males) who have studied in the Universiti Sains Malaysia (USM) so called the Research University in the academic year 2012/2013, where they have attended the schools of educational studies, social science, and materials and mineral resource engineering. The result showed that the most difficult problem in term of academic adjustment which is English language difficulty in their new learning environment. In order to remedy such matters, they must strive to study hard, to improve English proficiency, and to make good relations with their academic staff, thesis supervisors, and other postgraduate students. In other words, social adjustment is considered as one of the important strategies that enable them to cope with the context of Malaysian culture. Based on the findings, the researchers provide recommendations to facilitate CLMV students to make better adjustments in a Malaysian research university and to achieve their academic endeavour.

In the context of global and national economic development, higher education in Cambodia plays a significant role to develop human capital with technical knowledge, skills, values, and attitudes for sustainable economic growth, social development, and alleviation of poverty. When the civil war in 1998 was over, the Royal Government of Cambodia considered higher education as a top priority on the list of priorities in order to be integrated into the Association of South East Asian Nations Community by 2015 through implementing numerous mechanisms and policies to promote quality education for the students. This paper will discuss the status of national and institutional policies to promote educational quality to ensure academic success for students in a Cambodian public university. The documents and data of existing government ministries, development partners and higher education institutions will be used in the analysis of policies.

The purpose of this conceptual research framework is to develop and integrate a safety training model using a behaviour-based safety training programme into laboratories for young adults, during their tertiary education, particularly in technical and vocational education. Hence, this research will be investigating the outcome of basic safety knowledge among young adults and precautions needed to avoid occupational accidents and work-related diseases before they are exposed to real-life working situations. Numerous findings have found young adults are more prone to accidents compared to older adults and it happens due to lack of effective safety training and ineffective dispersion of safety knowledge to the young adults. An explanatory mixed method design is suggested for use as the main method; quantitative in the form of questionnaire based and supported by short interview in qualitative methods. A pre-test post-test non-equivalent control group design (with delayed post-test) is identified and it will use questionnaires (based on Theory of Planned Behaviour with an extension of a cognitive mediator) to predict and identify the changes in the safety practices behaviour of engineering students. Behaviour Based Safety (BBS) programme and Standard Safety programme will be used as individual interventions and integrated in the engineering laboratories; whilst the traditional programme will be monitored as the control group method. Three groups of purposive sampling engineering students will be selected and two of the groups will undergo different interventions concurrently leaving one group intact for control measurement. The expected results of analysis of variance (ANOVA) for pre-test, post-test and delayed post-test data between Behaviour Based Safety (BBS) programme, Standard Safety programme and traditional programme will determine the most effective among intervention safety programmes conducted for the engineering students. These future findings should also be able to provide proof that the combination of safety education and safety behaviour based training is the best method to be integrated as effective intervention into the engineering students' safety practices behaviour at the laboratories. The expected findings will help to develop an effective ways of educating and training young adults about work safety, which can be used in engineering laboratories and workshops.

The purpose of this study was to investigate the effect of Herrmann Whole Brain Teaching Method over conventional teaching method on eight graders in their understanding of simple electric circuits in Jordan. Participants (N = 273 students; M = 139, F = 134) were randomly selected from Bani Kenanah region-North of Jordan and randomly assigned to both teaching methods (Hermann Whole Brain Teaching Method = 135, Conventional Teaching Method = 138). A multiple choice concept test was developed measuring misconceptions commonly held by eight grade students on simple electric circuits. The results showed that Hermann Whole Brain Teaching Method was more successful than the conventional teaching method in fostering students' understanding of simple electric circuits. However, there was no significant differences attributed to gender or interaction between methods and gender on student' understanding of simple electric circuits. The results suggest that curriculum developers and textbook authors are advised to take into account students' learning styles and characteristics of brain parts as illustrated by Hermann Whole Brain Model in the curricula and textbooks they develop. Teachers are also recommended to focus on individual differences among students and respond to their learning styles during science lessons.

The objective of the study was to examine students' attitudes toward learning science in three "low performing" secondary schools in Penang, Malaysia. 214 students from these schools were involved in completing a questionnaire containing items consisting of six constructs. Data collected were analyzed using Rasch modeling. Students in low performing schools tended to have less positive self-concept of science and were unlikely to experience that learning science were related to their future careers. However, students believed that science is useful for society, and experienced that learning science was interesting. Implications for science educators based on these results are discussed.

The purpose of the present study is to investigate the effectiveness of Conflict Maps and the V-Shape method as teaching methods in bringing about conceptual change in science among primary eighth-grade students in Jordan. A randomly selected sample (N = 63) from the Bani Kenana region North of Jordan was randomly assigned to the two teaching methods (Conflict Maps, N = 31; V-Shape, N = 32). A conceptual multiple-choice test was developed to measure misconceptions regarding electric energy commonly held by eighth-grade students. The data gathered were statistically processed using SPSS software. The results indicated that both methods, Conflict Maps and the V-Shape method, were successful in bringing about conceptual changes in the students. At the same time, the results did not prove either method to be superior in facilitating conceptual shifts regarding electric energy in eighth-grade students. In light of earlier results, this study recommends that curriculum developers take into account teaching methods designed according to conceptual change models and organize training workshops for teachers to learn how to integrate Conflict Maps and the V-Shape method into their teaching. Furthermore, this study recommends that similar studies be conducted with various subjects.

The research examined the effect of a teaching strategy emphasizing on instructional congruence on students' interests towards learning science. This study was conducted in three "low performing" secondary schools in Penang, Malaysia. There were 214 students involved in this study. A questionnaire was utilized to collect data on students' interest towards science. Data were analyzed using t-test. In general, findings showed that the implementation of this teaching strategy revealed a significant increase in students' interest towards learning science.

The aim of this study is to compare and contrast the science process skills (SPS) included in the 10th-12th grade physics textbooks content utilized in Yemeni schools. The study revealed weaknesses and strengths in the textbooks' content. For instance, a number of science process skills (SPS), such as measuring, predicting and hypothesizing, have been neglected in the 11th grade textbook. For all three textbooks content, the maximum percentage of basic science process skills (BSPS) was devoted to observation. However, the maximum percentage of integrated science process skills (ISPS) was different for each grade: experimenting had the highest percentage for 10th grade, interpreting data for 11th grade, and operational definitions for 12th grade. In conclusion, there are similarities in the percentage of SPS between the physics textbooks' content for the 10th and 11th grades, and both differ from the 12th grade.