Fabrication of nanocomposite membrane via combined electrospinning and casting technique for direct methanol fuel cell

Emergence of nanotechnology has resulted in the introduction of the electrospinning process in fabricating and characterising the polymer electrolyte membrane from the sulfonated poly (ether ether ketone) (SPEEK) nanocomposite membrane comprised of electrospun Cloisite15A® (e-spun CL) for direct methanol fuel cell (DMFC). Poly (ether ether ketone) polymer is sulfonated up to 63% by sulfuric acid. SPEEK63/e-spun CL nanofibers were fabricated via electrospinning in which SPEEK63 was used as carrier polymer while the SPEEK63/e-spun CL nanocomposite membrane was obtained by the casting method. Characterizations on physical, morphological and thermal properties of SPEEK63/e-spun CL were conducted and compared to the SPEEK membrane fabricated by casting simple mixing 2.5wt.% Cloisite15A® and 5.0wt.% triaminopyrimidine solution (SPEEK63/2.5CL/5.0TAP). Scanning electron microscopy (SEM) showed well electrospun Cloisite15A® with an average diameter nanofiber around 187.4 nm. Moreover, field emission scanning electron microscopy (FESEM) revealed that Cloisite15A® particles at a nanometer range were uniformly distributed and 66% smaller than those in SPEEK63/2.5CL/5.0TAP. Furthermore, x-ray diffraction proved that the dispersion state of Cloisite15A® fell into an intercalated phase. A very small amount of Cloisite15A® (0.05wt.%) in SPEEK63/e-spun CL successfully enhanced the proton conductivity up to 50%, whereas, unfortunately the methanol permeability value was 27 times higher than SPEEK63/2.5CL/5.0TAP. Proton conductivity and methanol permeability of SPEEK63/e-spun CL were 24.49 x 10-3 Scm-1 and 3.74 x 10-7 cms-1, respectively. Even though this study contributed to 95% selectivity lower than SPEEK63/2.5CL/5.0TAP, electrospinning showed a promising technique to further reduce original sized Cloisite15A® particles from mixed size (μm and nm) to nanometer sized. In addition, by fine tuning, the dispersion of Cloisite15A® enhances the SPEEK63/e-spun CL performance in DMFC

Snapticon: Developing effective listening skills for group oral discussion

In many higher education institutions (HEIs) around the world, one of the popular English oral assessments for ESL learners is group discussion. In group discussions, it is vital that they have the ability to manage topics in a discussion by knowing how to initiate a topic, expand on the topic, seamlessly shift from one topic to another as well as close the topic appropriately. Students are therefore required to utilise their verbal and non-verbal skills to actively interact with all group members. Listening and speaking skills are equally important for effective communication including participating in group oral discussion. In order to help ESL learners to be active participants in group discussions, a card game called Snapticon was created. Open-ended questionnaires were distributed to 25 respondents in the study and observations were made while the game was being played. It was found from the findings that the respondents were positive as they regarded the game as interesting and fun. Therefore, it can be concluded that Snapticon has the potential to be used as a learning material to help develop ESL learners’ effective listening skills in group oral discussions. Moreover, the use of Snapticon enables learners to be interactionally competent when participating in group oral discussions

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Topic Management in Collaborative Oral Group Discussion of English as a Second Language Learners

This study investigates the management of topic in peer collaborative interaction in assessment context. The ability to manage discussion topic in a specific communicative event is fundamental to interactional competence. Topic initiation, topic expansion, moving from one topic to another as well as introducing new topics to peers during collaborative talk requires not only participants’ linguistic abilities but also active participation of all members. This study analysed oral group interactions of English as a Second Language Learners in an institution of higher learning in Malaysia. Group oral interactions of five groups from thirty students were transcribed and analysed using qualitative analysis software, Atlas.Ti. for thematic analysis. The topics used for the oral group discussion were part of compulsory assessments that the students had to undergo in order to complete the course. The findings show that the students were able to initiate the discussion, expand the topic at hand, provided agreement and disagreement where necessary in their effort to ensure the successful completion of the assigned task. The findings of the study have direct implications for language teaching and learning development especially where oral group interactional competence is concerned

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to &lt; 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of &amp; GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P &lt; 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo