Demistifikasi Tokoh Don Juan dalam La Nuit De Valognes Karya Eric-Emmanuel Schmitt

Don Juan is a myth about a seducer, a man with many love adventures, a women's heat conqueror, and many other predicates. Don Juan as a myth is well-known world wide over, appearing in about 50 writings such as novels, plays, operas. But a French writer Eric-Emannuel Schmitt proposes a new figure of Don Juan in his play La Nuit de Valognes (Night in Valognes): the seducer is judged by five victims and convicted to marry one of his victims in order to stop his adventures. Surprisingly, Don Juan accepts this verdict without conditions. This sudden change becomes the theme of the play: the demythification of Don Juan. A flash back scene shows the beginning of this change and the interpretations that might arise from here. One possible interpretation is proposed and discussed in this paper: Don Juan found the way to a purer love, which is the union with God, and decides to begin his journey. This play can thus be categorised as a sufi text

Inflammatory Bowel Disease: Epidemiology

Inflammatory bowel disease (IBD) is characterized by two partially distinct alimentary disease processes, namely Crohn’s disease (CD) and ulcerative colitis (UC), affecting genetically predisposed individuals. CD and UC were first described in 1932 and 1859, respectively. It is estimated that 1.5 million in North America and 2.5 million persons in Europe have IBD. The peak incidence of CD and UC is between 20–30 years and 30–40 years of age, respectively. Both incidence and prevalence of CD and UC are similar across males and females. However, several studies suggest a female predominance in CD and a male predominance in UC. The pathogenesis of IBD is attributed to an uncontrolled immune-mediated inflammatory response to an unrecognized environmental trigger that interacts with the intestinal flora. Various determinants of IBD include the following: peculiar environmental triggers, intestinal immune mechanisms, heritable factors, gut flora, diet, mesenteric fat, medications, nicotine, infectious agents, immunization, hygiene, pregnancy, breastfeeding, stress and lifestyle. Predominant complications in IBD are surgery, malnutrition, disease exacerbations and cancer. Patients with CD have a higher mortality compared to general population. Epidemiological studies continue to expand our understanding of the distribution, determinants and mechanisms of IBD. This has enabled us to recognize safer and effective approaches to management

Assessment of drinking and irrigation groundwater quality in Bundung-West Coast, Gambia

Laboratory investigation performed to examine the suitability of groundwater quality from an open well, cover well and tap water for drinking and irrigation purposes around Bundung West Coast of the Gambia. The overall mean values obtained are; pH (7.89), Temperature (26.5 oC), Electrical Conductivity (1070.8 mS/cm), Total Dissolved Solids (696.00 mg/l), Salinity (0.44 %) and Faecal Coliforms (55.2/100ml). The Coefficient of Variability (CV) among samples for each analytical parameter was > 1, reflecting inconsistency among analysed samples. Nitrate (9.2 mg/l), Phosphate (0.81 mg/l), Sulphate (6.2 mg/l), Ammonia (1.61 mg/l), Nitrite (0.010 mg/l), Total Hardness (273.9 mg/l) and Alkalinity113.5 mg/l) had shown high variance among samples in the site (CV >1). Results of Total Hardness (273.9), is indicative of contaminated groundwater. The microbiological properties exposed colonies of microorganisms (coliforms) resulting from contamination by faecal matter or seeping of sewage effluent into the groundwater and hence unfit for consumption. The groundwater samples in the study site were under high salinity class (>2250 μS/cm), unsuitable for irrigation agriculture. The coefficient of variability is > 1, high variance among samples in the entire site. Total Dissolved Solids (CV>1) contents of the groundwater can be fit only for tolerant crops. The findings suggest that groundwater is unsafe for drinking purposes without decontamination, and measures should be in place for quality water for irrigation agriculture.Keywords: Groundwater, quality indicators, domestic use, Irrigatio

On the convexity of static output feedback control synthesis for systems with lossless nonlinearities

Computing a stabilizing static output-feedback (SOF) controller is an NP-hard problem, in general. Yet, these controllers have amassed popularity in recent years because of their practical use in feedback control applications, such as fluid flow control and sensor/actuator selection. The inherent difficulty of synthesizing SOF controllers is rooted in solving a series of non-convex problems that make the solution computationally intractable. In this note, we show that SOF synthesis is a convex problem for the specific case of systems with a lossless (i.e., energy-conserving) nonlinearity. Our proposed method ensures asymptotic stability of an SOF controller by enforcing the lossless behavior of the nonlinearity using a quadratic constraint approach. In particular, we formulate a bilinear matrix inequality~(BMI) using the approach, then show that the resulting BMI can be recast as a linear matrix inequality (LMI). The resulting LMI is a convex problem whose feasible solution, if one exists, yields an asymptotically stabilizing SOF controller.Comment: Submitted to Automatica as a Technical Communiqu

Individual and community level response for pulmonary tuberculosis patients in India

Background: Host-related and environment-related factors have been shown to play a role in the development of tuberculosis (TB), but few studies were carried out to identify their respective roles in Central India.Methods: This was a descriptive case control study, which was conducted at tertiary care government hospital. The duration of the study was from January 2011 to September 2013. A total of 822 sputum smear-positive TB patients were included in the study. Cases were newly detected smear positive TB patients. Two controls were recruited for each case, one within the household of the case, and one in the community.Results: Regarding host-related factors, univariate analysis by conditional logistic regression of 687 matched pairs of cases and household controls showed that TB was associated with male sex, family history of TB, smoking, alcohol, anaemia, HIV infection, and history and treatment of worm infection. In a multivariable model based on 601 matched pairs, male sex, family history of TB, smoking, and HIV infection were independent risk factors of TB. The investigation of environmental factors based on the comparison of 816 cases/community control pairs showed that the risk of TB was associated with single marital status, family history of TB and adult crowding.Conclusions: TB is a multifactorial disorder, in which environment interacts with host-related factors. This study provided useful information for the assessment of host and environmental factors of TB for the improvement of TB control activities in developing countries

Acute-on-chronic Liver Failure: MELD Score 30-day Mortality Predictability and Etiology in a Pakistani Population

Background: Cirrhosis is a pathological condition that ultimately leads to liver failure. Acute on chronic liver failure (ACLF) has a high short term mortality rate. Viral hepatitis is the most common cause of liver failure in our local population. We carried out this study to identity the 30-day mortality and etiology of patients presenting with ACLF using Model for End-Stage Liver Disease (MELD) score predictability. Methodology: This was a descriptive case series, conducted at Sheikh Zayed Hospital, Lahore, Pakistan from January 31, 2018 to July 30, 2018. One hundred and eighty five patients who met the inclusion criteria were enrolled using 95% confidence level and 4% margin of error. Data was entered and analyzed with SPSS version 23.0. Numerical variables including age was presented by Mean ± S.D. Categorical variables i.e. gender, etiology of acute-on-chronic liver failure and 30-day mortality were presented by frequency and percentage. Data was stratified for age, gender, duration of chronic liver disease and MELD grade to address the effect modifiers. Post-stratification chi-square test was calculated using 95% significance (p≤0.05). Results: Majority of the enrolled patients were male (74.6%) while only 25.4% of the patients were female. One hundred and thirty patients (70.3%) had underlying viral hepatitis while twelve patients (6.5%) and forty three patients (23.2%) presented with alcoholic liver disease and drug-induced ACLF, respectively. Eighty patients (43.2%) died within 30 days of admission.The 30-day mortality with respect to MELD grade was statistically significant (p<0.001) with the highest mortality noted in grade-IV and thirty five patients (43.8%) dying within 30 days of admission (p<0.001). Grade-II and III MELD scores also contributed to the 30-day mortality with twenty three patients (28.8%) and nineteen patients (23.8%) dying within 30 days of admission (p<0.001). Conclusion: MELD scores are able to accurately predict the short-term mortality in patients with ACLF and viral hepatitis was the most common etiology in our population. Early detection and use of appropriate prognostic models may alleviate mortality and morbidity in paitents with ACLF

Structured Singular Value of a Repeated Complex Full-Block Uncertainty

The structured singular value (SSV), or mu, is used to assess the robust stability and performance of an uncertain linear time-invariant system. Existing algorithms compute upper and lower bounds on the SSV for structured uncertainties that contain repeated (real or complex) scalars and/or non-repeated complex full blocks. This paper presents algorithms to compute bounds on the SSV for the case of repeated complex full blocks. This specific class of uncertainty is relevant for the input output analysis of many convective systems, such as fluid flows. Specifically, we present a power iteration to compute a lower bound on SSV for the case of repeated complex full blocks. This generalizes existing power iterations for repeated complex scalar and non-repeated complex full blocks. The upper bound can be formulated as a semi-definite program (SDP), which we solve using a standard interior-point method to compute optimal scaling matrices associated with the repeated full blocks. Our implementation of the method only requires gradient information, which improves the computational efficiency of the method. Finally, we test our proposed algorithms on an example model of incompressible fluid flow. The proposed methods provide less conservative bounds as compared to prior results, which ignore the repeated full block structure.Comment: Submitted to the International Journal of Robust and Nonlinear Contro

Priority Based Energy Aware (PEA) routing protocol for WBANs

Wireless Body Area Networks (WBANs) is a new technology for remote monitoring of patients. Sensor nodes are placed on different parts of the body such as implants and on body to collect data and transfer to the Sink node. Change in body posture, placement of sensors, priority of sensor data and energy consumption makes routing very difficult. Therefore, a Priority based Energy Aware (PEA) routing protocol is proposed in this paper. Child nodes choose a parent node connected to Sink based on a cost function that depends upon priority, residual energy and distance of node. Residual energy facilitates load balancing i.e. selection of different nodes for transmission. Distance helps in successful packet delivery to the parent node and caters for body postures. Priority helps to select a best possible path to forward the critical data keeping in view the energy constraint in WBANs. Comparison of different cost functions with proposed PEA protocol for performance metrics such as network lifetime, throughput and residual energy reveals that the proposed protocol results in increased network lifetime, throughput improvement of around 50% and higher residual energy

Glucocentric drugs in cardiovascular disease protection and heart failure

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant reductions in adverse cardiovascular outcomes independent of their glycemic effect. Remarkably, it was the evidence from SGLT2 inhibitors cardiovascular outcome trials that prompted further evaluation of the drug class in patients with heart failure irrespective of their diabetes status, demonstrating a broader cardiometabolic effect of these drugs. In this review, we assess the evidence for cardiovascular outcomes with common older- and newer-generation glucose-lowering drugs in the management of type 2 diabetes. We also discuss emerging glucose-lowering drugs with novel metabolic targets that influence the risk of adverse cardiovascular events and expand on the role of these drugs beyond the management of type 2 diabetes