A study on plea bargaining against theories of punishment and criminal justice / Abdul Hakeem Putra Abdul Rahman Putra, Ahmad Solehin Abd. Ghani, and Amee Asraaf Khairee Amin.

On December 13, 2010, it was reported that a change in the Malaysian Criminal Procedure Code to include the concept of formal plea bargaining in criminal cases would soon be implemented by the court. According to the former Chief Justice Yang Amat Arif Tun Tan Sri Dato' Sri Zaki Azmi, the plea bargaining have already put into practice now but this will become a more formal and standard procedure under the amendment. Plea bargaining will only be offered within 30 days after a person has been charged, and the case would go to a full trial after 90 days if no agreement has been reached. Plea bargains will be an option in cases involving first-time offenders including for offenses for which the maximum penalty is death. However, if there is a minimum sentence for the offense, a lesser term will not be available. The Deputy Public Prosecutor will be able to determine whether or not to offer plea bargains in each case. Plea bargaining may also involve a reduction of the charges. It will be the duty of the court to ensure that the plea bargain was entered into voluntarily by the parties. Judges will be able to call the accused in camera to ensure that this has occurred. Once a sentence has been determined neither the prosecution nor the defence will be able to appeal the decision, except on technical grounds. The Chief Justice said that the concept of formal plea bargaining would expedite the disposal of criminal cases and reduce the backlog in the courts. However, we also need to consider certain hidden danger on the application of the plea bargaining in Malaysia. This research will examine the issues pertaining whether the implementation of plea bargaining will fulfilled the theories of punishment and uphold criminal justice or it will be vice versa

Nonlinear studies on the effect of non-uniform heat generation/absorption on hydromagnetic flow of nanofluid over a vertical plate

The analytical and numerical studies are performed to investigate the non-uniform heat generation/absorption effect on the boundary layer flow of an incompressible, electrically conducting nanofluid over a vertical plate in the presence of thermal radiation. The highly nonlinear governing equations along with the boundary conditions are converted into ordinary differential equations by appropriate similarity transformations. The transformed highly nonlinear ordinary differential equations are solved both analytically and numerically using homotopy analysis method and fourth order Runge–Kutta method with shooting technique respectively, for the various values of physical parameters. The results show that the presence of both space and temperature dependent heat generation enhances the velocity and temperature profiles and reduces the solid volume fraction of nanofluid profile. Comparison between present analytical and numerical results is found to be good

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Production and Characterisation of Acellular Human Liver Matrix: Potential Auxiliary Liver Graft

Shortage of donor organs combined with ever increasing liver disease has directed attention towards growing implantable liver tissue in the laboratory setting. Recent developments in decellularisation and recellularisation techniques have opened exciting facets for liver whole organ reengineering. The aim of this study was to develop a decellularisation protocol for human liver, assess the structural and biochemical integrity and assess the biocompatibility of the acellular matrix. Discarded human livers were split and the left lateral and right posterior lobes with a mean weight of 399 ± 162 g were used (n=8 lobes). Perfusion decellularisation was carried out through the hepatic artery and portal vein. Hypotonic buffer, 0.1 % (w/v) sodium dodecyl sulphate, hypertonic buffer and nuclease solutions were used to remove cells plus nuclear material. Following several iterations of a previously patented Leeds University decellularisation protocol, greater than 91.0 % (w/w) DNA was removed from all areas of liver tissue. Fluoroscopy confirmed integrity of vascular tree. Histological analysis demonstrated lack of cells and maintenance of the portal triad histioarchitecture. Immunohistochemistry demonstrated positive staining for key extracellular proteins such as collagen type I and III, fibronectin and laminin. Scanning electron microscopy showed an intact extracellular matrix. Biochemical assessment confirmed significant reduction in glycosaminoglycan content, but there was increase in collagen content, the latter likely due to extraction by dry weight of other soluble components in the matrix. The acellular tissues and extracts were not cytotoxic to either murine 3T3 or baby hamster kidney cells. Preliminary recellularisation (n=3 lobes) showed the matrix to be biocompatible to primary cryopreserved human hepatocytes seeded at 30,000 cells. The study has developed a suitable protocol for decellularisation of human liver lobes, without adversely affecting the extracellular matrix. The biocompatible acellular scaffold has the potential to be recellularised with hepatocytes, with a view to engineering a transplantable auxiliary liver graft

Enhancing student’s creativity in architectural design by learning from the design cognitive process of a prominent architect

Architecture is a professional discipline that integrates art and science to build attractive, practical and safe structures for human activities. In architecture, design is a core subject where students are taught the main skills to produce drawings and models of building design. Furthermore, architectural design involves a cognitive process that generates higher level of creativity in producing noble design solution. Such process is also fundamental to students who are learning architecture in the higher education. It helps student to develop their level of creativity and competency in design. This intellectual capability is an important aspect for architectural students to practice as professional architect when they graduated. Malaysia has many talented and internationally well-known professional architects. Their works represent high level of creativity that can be beneficial sources of practical knowledge to the students. Unfortunately, these respectable architects’ creative cognitive processes are not properly documented for references to others within the architectural community. Therefore, this paper aims at exploring and identifying the cognitive process characteristics of a local prominent, visionary architect, Dato’ Dr Ken Yeang who is well known for his creative, masterpiece architectural works. A semi-structured interview was conducted to gather insights on his cognitive process while designing to produce creative solution for complex architectural problems. The study found that this professional architect has a distinct formulation of knowledge, skills, attributes and principles that he utilises while designing and looking for creative solutions. This dynamic, integrated process involves imagination (intrinsic) and modelling(extrinsic) capabilities that produce renowned local architectural buildings. Such significant cognitive attributes will be useful guides to improve creativity in design among the young architectural students

Efficient lead sorption from wastewater by carbon nanofibers

Wastewater from many industries contains toxic metal ions, which should be removed before water is released into the environment. Many adsorbents have been developed to remove metals, but their efficiency should be improved by, e.g., increasing surface area. Here, we tested the use of carbon nanofibers synthesized on the surface of activated carbon, to remove lead ions (Pb2?). We studied the effect of carbon nanofiber dose, pH, contact time and agitation speed on the sorption capacity. The best conditions were with nanofiber dose of 0.25 g/L, pH of 5.5, contact time of 60 min and agitation speed of 200 rpm. The nanocomposite product was also used for the removal of lead from industrial wastewater. We also found a successful removal of 67 % of lead ions from semiconductor wastewater sample