A pilot randomized controlled trial comparing the outcome of sustained low efficiency daily dialysis (sledd) with sustained low efficiency daily diafiltration (sledd-f) in critical care patients with acute kidney injury

Background: Acute Kidney Injury (AKI) is common in Critical Care patient and cause significant increase mortality and morbidity. Early management of Renal Replacement Therapy with correct dose and suitable modality is an essential intervention in severe AKI. Hybrid therapy like Sustained Low Efficiency Daily Dialysis (SLEDD) has emerged as an alternative to CRRT in Intensive Care Unit (ICU) patients. Sustained Low Efficiency Daily Diafiltration (SLEDD-f), which contains both diffusion and convection principles, also suggested to provides stable renal replacement therapy. Thus, we formulated this study to compare the outcome between the administration of SLEDD and SLEDD-f in Critical Care patient with Acute Kidney Injury. Objectives: The objective of this randomized control trial is to compare the Intensive Care Unit (ICU) Survival between SLEDD and SLEDD-f in Critical Care patient with Acute Kidney Injury. The specific objective is to compare Length of Stay in ICU and Hospital, Days of Ventilatory support, as well as control of acid base balance, small solute (urea and creatinine) and electrolytes (sodium and potassium) between SLEDD and SLEDD-f. Methods: Fourteen patient, with Acute Kidney Injury in Critical Care were selected with selection criteria were randomized into two group to received either Sustained Low Efficiency Daily Dialysis (SLEDD) or Sustained Low Efficiency Daily Diafiltration (SLEDD-f) for Renal Replacement Therapy. Selected parameters and blood investigation were recorded and compared including ICU predicted score, acid base status, renal function test, urine output and electrolytes are all taken during admission to hospital and critical care, before initiating the dialysis, day one after starting the dialysis until discharged from critical care and hospital, as well as during follow up until 42 days after dialysis. 3 month mortality also been recorded. Results: In both SLEDD and SLEDD-f group, the distributions of social-demographic, medical background status, as well as ICU predicted mortality like SOFA, SAPS II and APACHE II were similar. 85.7% of the AKI was due to sepsis while 14.3% due to multifactorial cause. Overall, there is no significant differences of outcome distribution (ICU and hospital survival, length of ICU and hospital stay; and duration of ventilatory support) and parameter distribution (urea, creatinine, sodium, pottasium and acid base balance) between patients receiving SLEDD and SLEDD-f technique (p>0.05). Mortality rate at day 60 reveals no significant difference in between both modalities with SLEDD having 42.9% mortality and SLEDD-f 14.3 % (p=0.554). In general, patients in SLEDD-f group have a shorter duration of ICU stay (median, 11 days [IQR 5 to 37 days]), duration of ventilation (median, 5 days [IQR 4 to 33 days]) and have a higher ICU survival (85.7%) compare to SLEDD group, but this was not statistically significant. Meanwhile, SLEDD have a shorter duration of hospital stay (median, 25 days [IQR 16 to 29 days]) and this may result from higher mortality compare to SLEDD-f as the survivor may have prolonged length of stay at hospital. Conclusion: The administrations of SLEDD and SLEDD-f in ICU patients with AKI are feasible and comparable in terms of ICU survival, Length of ICU stay, Days of Ventilatory support as well as control of small solutes, electrolytes and acid base balance. Therefore, SLEDD-f can be used as an alternative therapy other than the conventional SLEDD with shorter duration of 4 hours as compared to SLEDD of 6 hours

Kekangan pembelajaran ICT di sekolah luar bandar: Satu kajian

Kajian ini bertujuan mengenal pasti permasalahan yang dihadapi oleh pelajar-pelajar khususnya di luar bandar dalam pembelajaran matapelajaran ICT di sekolah, khususnya di Langkawi. Fokus diberi kepada para pelajar tentang permasalahan yang dihadapi semasa proses pembelajaran samada di sekolah mahupun di luar waktu persekolahan. Untuk mencapai objektif tersebut, satu kajian tindakan telah dijalankan selama satu bulan di Sekolah Menengah Kebangsaan Tunku Putra, Langkawi yang melibatkan pelajar tingkatan 1 di sekolah tersebut. Dapatan kajian menunjukan terdapat 60% pelajar menghadapi masalah dalam pembelajaran matapelajaran ICT Literacy dan memerlukan satu tindakan yang sewajarnya dalam membantu pelajar-pelajar tersebut. Beberapa cadangan telah dikemukakan untuk mengatasi masalah tersebut

Studies on antidiabetic and antioxidant effects of local tualang Oney in streptozotocin-induced diabetic rats

This study shows that tualang honey does not produce antioxidant effect in non-diabetic rats. neither does tt increase or decrease blood glucose in normal/healthy rats. Our results also show that tualang honey. in a dose dependent response, ameliorates oxidative stress in kidney of diabetic rats and also has hypoglycemic effect. Tualang honey produces weight gain more than glibenclamide and/or metformin in experimental diabetes

Ergonomics Concept in Inclusive Public Playground Targeting on Children with Disabilities

Nowadays, playgrounds are underused to improve the physical and social development of young children with special needs. Therefore, this study aims to identify the key criteria of ergonomic inclusive public children playground aim for children with disabilities (CWDs). The study explored the process of universal design and the ergonomics function of play equipment that focuses on CWDs through physical site observation and interview protocol done among caregivers, parents of children with disabilities, and all stakeholders involved in the development of the public playground in Malaysia. The result presents three major themes as a guideline to create an ergonomic inclusive playground. Keywords: Ergonomics; Universal Design; Public Playground; Children with disabilities. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: 10.21834/ebpj.v5i15.249

Detection of Freezing of Gait using Unsupervised Convolutional Denoising Autoencoder

At the advanced stage of Parkinson’s disease, patients may suffer from ‘freezing of gait’ episodes: a debilitating condition wherein a patient’s “feet feel as though they are glued to the floor”. The objective, continuous monitoring of the gait of Parkinson’s disease patients with wearable devices has led to the development of many freezing of gait detection models involving the automatic cueing of a rhythmic auditory stimulus to shorten or prevent episodes. The use of thresholding and manually extracted features or feature engineering returned promising results. However, these approaches are subjective, time-consuming, and prone to error. Furthermore, their performance varied when faced with the different walking styles of Parkinson’s disease patients. Inspired by state-of-art deep learning techniques, this research aims to improve the detection model by proposing a feature learning deep denoising autoencoder to learn the salient characteristics of Parkinsonian gait data that is applicable to different walking styles for the elimination of manually handcrafted features. Even with the elimination of manually handcrafted features, a reduction in half of the data window sizes to 2s, and a significant dimensionality reduction of learned features, the detection model still managed to achieve 90.94% sensitivity and 67.04% specificity, which is comparable to the original Daphnet dataset research

Evidence in Support of Potential Applications of Lipid Peroxidation Products in Cancer Treatment

Cancer cells generate reactive oxygen species (ROS) resulting frommitochondrial dysfunction, stimulation of oncogenes, abnormal metabolism, and aggravated inflammatory activities. Available evidence also suggests that cancer cells depend on intrinsic ROS level for proliferation and survival. Both physiological and pathophysiological roles have been ascribed to ROS which cause lipid peroxidation. In spite of their injurious effects, the ROS and the resulting lipid peroxidation products could be beneficial in cancer treatment. This reviewpresents research findings suggesting that ROS and the resulting lipid peroxidation products could be utilized to inhibit cancer growth or induce cancer cell death. It also underscores the potential of lipid peroxidation products to potentiate the antitumor effect of other anticancer agents.The review also highlights evidence demonstrating other potential applications of lipid peroxidation products in cancer treatment. These include the prospect of lipid peroxidation products as a diagnostic tool to predict the chances of cancer recurrence, to monitor treatment progress or how well cancer patients respond to therapy. Further and detailed research is required on how best to successfully, effectively, and selectively target cancer cells in humans using lipid peroxidation products.This may prove to be an important strategy to complement current treatment regimens for cancer patients

The effects of extrusion conditions on the properties of Amplang, a traditional fish snack in Borneo

The effects of extrusion process parameters on Amplang fish snack production are investigated in this study using a single-screw extrusion machine. The extrusion parameters are based on two factors, namely the barrel temperature (100 - 140oC) and screw speed (146 - 208 rpm). The central composite design (CCD) is used to produce thirteen experimental combinations and the effects of the extrusion parameters on the physical and functional characteristics (hardness, bulk density, expansion ratio, and water absorption and solubility indexes) of the Amplang fish extrudate were assessed as responses. The fish extrudates investigated in this study varied between 45.57 - 246.33 N (hardness), 0.09 - 0.21 g/cm3 (bulk density), 1.00 - 2.67 (expansion ratio), 2.58 - 4.01 g/g (water absorption index), and 19.25 - 29.8% (water solubility index). The bulk density, expansion ratio, water absorption index, and water solubility index were shown to be significantly (P < 0.05) affected by the barrel temperature and screw speed. In conclusion, barrel temperature and screw speed can influence the physical and functional properties of extruded fish snacks and the extrusion technique demonstrated in this study can be utilised to produce Amplang fish snacks in Sabah

The challenges in raising autistic children: The voices of mothers

Autism spectrum disorder (ASD) is defined as a lifetime developmental disorder usually identified by social interaction impairment, communication deficits, and repetitive behavior. The cases of children detected with ASD are rising globally, including Malaysia. Parents, as the prime caregiver to these children, face numerous challenges due to what is entailed in taking care of their children. This paper describes a case study where we examined the views and experience of three mothers, each of whom has an ASD child. Data were gathered through face-to-face semi-structured interviews, after which they were transcribed and analyzed using the thematic analysis method. The mothers narrated that the challenges they encountered include the difficulty they had in initially accepting their child’s diagnosis; labelling and discrimination; phase-based temporal challenges; endless physical, emotional, and mental sacrifices; finding the strength and patience to deal with the situation; academic vs. non-academic struggles, as well as their own coping mechanisms. This paper concludes with the need to provide support for parents-especially mothers-to enable them to overcome their challenges and focus on the development of their autistic children

Study of relationship between water quality parameters, selective heavy metals and radioactive elements content in rivers at Gebeng, Kuantan, Pahang, Malaysia

This study was focused on the correlation between water quality parameters with the level of radioactive elements and heavy metals at six different sampling points of rivers. For achieving these objectives, collected data was done for Balok river and Tunggak river in dry seasons. Both of the rivers selected were located in Gebeng industrial area, Pahang, Malaysia. The physical parameters such as temperature, specific conductivity, pH, turbidity and dissolved oxygen were measured by using hydrolab. The water samples were then collected for tracing the radioactive elements and heavy metals by using inductively coupled plasma-mass spectrometry (ICP-MS). The readings obtained from both in situ and ex situ analysis was analyzed by using SPSS to know the correlation between water quality parameter, radioactive elements and heavy metals. There were significant relationships found between all water quality parameters and most heavy metals selected (lead and cadmium), except for arsenic. While, for radioactive elements, in the year 2015, there were significant relationships found between most water quality parameters and thorium, exception for uranium. However, for year 2014, there is no significant relationship observed. The findings of the study showed some of the presence of pollutants such as heavy metals and radioactive elements concentrations were reflected some of the water quality parameters at all the sampling locations. © 2019 Chemical Publishing Co. All rights reserved

Bonding properties and performance of multi-layered kenaf board

Kenaf (Hibiscus cannabinus) has recently been introduced to the Malaysian bio-composite industry. Based on their basic properties, both the bast fibres and core material of kenaf are distinctly different. While bast fibres are stiffer and low in wettability, the core material of kenaf is weaker and has excellent absorbing properties. This study evaluated the properties of kenaf board made from a combination of bast fibres and core material. The bast fibres were separated first from the core, followed by pre-treatment with NaOH, then combing until the fibres became loose. The properties of kenaf board were tested using MS standards 1787: 2005. An analysis of variance was carried out to study the effects of resin types and bast to core proportion on the boards. The buffering capacity study revealed that kenaf bast, kenaf core and rubberwood behaved similarly in alkali but differently in an acidic condition. Both the kenaf bast and core were relatively less stable in acid compared with rubberwood. Due to its morphological characteristics, the kenaf core inner surface exhibited higher wettability than the outer surface. There was significant interaction between resin type and the proportion of bast:core at p < 0.01. Generally, boards made from 100% kenaf core and bonded with urea formaldehyde (UF) resin had superior performance. The mechanical properties [modulus of elasticity (MOE), modulus of rupture (MOR), internal bond (IB)] of the boards were significantly influenced by the amount of bast fibre in the board––the higher the amount, the poorer the strengths. This effect, however, was reversed for thickness swelling (TS). Only UF-bonded kenaf-based boards had comparable water absorption (WA) property to that of the control (100% rubberwood). The incorporation of low molecular weight phenol formaldehyde (LPF) resin in the fibres had mixed effects on board properties. The effects varied based on the resin used; it improved the MOE and MOR of the board but not the IB, TS and WA when used with UF resin. It improved the IB only when used with melamine urea formaldehyde (MUF) resin. The best performance was given by boards made from 100% kenaf core irrespective of the type of resin used. All kenaf boards in this study had higher MOR than that of 100% rubberwood. Insufficient curing of LPF resin was identified as the main factor for the poor performance of LPF-bonded boards