Uncovering psychological gratifications affecting social media utilization : a multiblock hierarchical analysis

The purpose of this study is to examine internet users’ experience and gratifications of social media, which affect the utilization of the medium. The research model was developed in hierarchical multiblock, which consists of three key psychological components–personal, tension release, and social–that are derived from the Uses and Gratifications theoretical perspective. Data were collected through stratified probability sampling of 428 social media users using a web-based questionnaire. They were selected because they spend a significant amount of time on social media sites, at least on Facebook, Twitter, YouTube, LinkedIn, and Instagram. Based on hierarchical multiblock PLS analysis, the results confirmed that social media utilization is affected by three key component psychological factors. All of these factors play a significant part in influencing user attitude toward utilizing social media. The findings are believed to increase understanding, especially for user-experience designers (UXD) concerning venues that can be used for direct targeting in designing social media marketing. The implications and recommendations for future research are discussed

Numerical Study of N-Heptane Fuelled Hcci Under Different Air Fuel Ratio and Inlet Air Temperature

This paper examines on numerical modeling of Homogenous Charge Compression Ignition (HCCI) engine model using n-heptane as base fuel. The parameters used in this study is different air to fuel ratio (AFR) (25, 30, 35, 40, 45, 50) and different air inlet temperature (25°C, 50°C, 75°C, 100°C). Performance and emission characteristics of n-heptane were investigated at constant engine speed of 1000 rpm in a HCCI engine model. The effects of inlet air temperature were also examined. The test results showed that brake power, brake mean effective pressure and brake specific fuel consumption decreased when increased AFR and inlet air temperature. Meanwhile, brake thermal efficiency shows an increase when increase when AFR and temperature of the inlet increased. The test results also showed that NOx, CO and HC emissions decreased with the increase of inlet air temperature for all AFR value. Overall, this numerical model can be used to predict the performance and emission of the HCCI engine

Multiple urological problems in young age: a case report

Renal stone disease has been regarded as an uncommon problem in children as compared to adult population. The incidence varies in different parts of continent. Posterior urethral valve is also regarded as uncommon urological problem in pediatric population. The incidence is about 1 per 8,000 to 25,000 life births. A combination of renal calculi, posterior uerthral valve and vesicoureteric reflux in any given case is extremely rare especially in pediatri

Is there a risk of suburban transmission of malaria in Selangor, Malaysia?

Background The suburban transmission of malaria in Selangor, Malaysia’s most developed and populous state still remains a concern for public health in this region. Despite much successful control efforts directed at its reduction, sporadic cases, mostly brought in by foreigners have continued to occur. In addition, cases of simian malaria caused by Plasmodium knowlesi, some with fatal outcome have caused grave concern to health workers. The aim of this study was to investigate the possibility of local malaria transmission in suburban regions of Selangor, which are adjacent to secondary rainforests. Findings A malaria survey spanning 7 years (2006 - 2012) was conducted in Selangor. A total of 1623 laboratory confirmed malaria cases were reported from Selangor’s nine districts. While 72.6% of these cases (1178/1623) were attributed to imported malaria (cases originating from other countries), 25.5% (414/1623) were local cases and 1.9% (31/1623) were considered as relapse and unclassified cases combined. In this study, the most prevalent infection was P. vivax (1239 cases, prevalence 76.3%) followed by P. falciparum (211, 13.0%), P. knowlesi (75, 4.6%), P. malariae (71, 4.4%) and P. ovale (1, 0.06%). Mixed infections comprising of P. vivax and P. falciparum were confirmed (26, 1.6%). Entomological surveys targeting the residences of malaria patients’ showed that the most commonly trapped Anopheles species was An. maculatus. No oocysts or sporozoites were found in the An. maculatus collected. Nevertheless, the possibility of An. maculatus being the malaria vector in the investigated locations was high due to its persistent occurrence in these areas. Conclusions Malaria cases reported in this study were mostly imported cases. However the co-existence of local cases and potential Plasmodium spp. vectors should be cause for concern. The results of this survey reflect the need of maintaining closely monitored malaria control programs and continuous extensive malaria surveillance in Peninsula Malaysia

PCNL in horseshoe kidney- the first experience at HUSM

Horseshoe kidney is one of the commonest congenital renal fusion anomalies with an incidence of 0.25% in general population. Disturbances in urine flow, drainage and concomitant infections promote stone formation is common. Percutaneous nephrolithotripsy (PCNL) in horseshoe kidney is a challenge due to its anatomical difference and thus a modified technique is needed. Hereby, we report our first experience with PCNL in this anomaly, a 55 year old with left staghorn renal calculi in a horseshoe kidne

High-flow priapism in a 12-year-old boy: Role of super-selective embolization

Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types, low flow priapism due to venous occlusion and high flow priapism due to uncontrolled arterial flow to the veins. High flow priapism most frequently occurs as a result of penile trauma where the intercavernosal artery discruption causes an arteriocavernosal fistula. It is rarely encountered in the pediatric and pre-pubertal population. Clinically it manifests as a painless, prolonged erection after perineal trauma. Treatment has ranged from expectant management to open surgical exploration with vessel ligation. We report the successful treatment of high flow priapism in a 12 year old pre-pubertal boy with superselective embolisatio

Young upper tract urothelial carcinoma: a case report

Upper urinary tract transitional cell carcinomas are rare tumors. They account for 5 to 7% of the urothelial tumors with renal pelvic lesions representing the majority. The disease is rarely seen under the age of 50. Smoking, occupational carcinogens, analgesic abuse, Balkan nephropathy are the risk factors. Approximately 20 to 50% of patients with upper urinary tract transitional cell carcinomas have bladder cancer at some point on their course. We report a rare case of 20 year old man with transitional cell carcinoma of renal pelvis

Failure to prescribe pneumocystis prophylaxis is associated with increased mortality, even in the cART era: results from the Treat Asia HIV observational database

<p>Abstract</p> <p>Background</p> <p>Pneumocystis jiroveci pneumonia (PCP) prophylaxis is recommended for patients with CD4 counts of less than 200 cells/mm³. This study examines the proportion of patients in the TREAT Asia HIV Observational Database (TAHOD) receiving PCP prophylaxis, and its effect on PCP and mortality.</p> <p>Methods</p> <p>TAHOD patients with prospective follow up had data extracted for prophylaxis using co-trimoxazole, dapsone or pentamidine. The proportion of patients on prophylaxis was calculated for each calendar year since 2003 among patients with CD4 counts of less than 200 cells/mm³. The effect of prophylaxis on PCP and survival were assessed using random-effect Poisson regression models.</p> <p>Results</p> <p>There were a total of 4050 patients on prospective follow up, and 90% of them were receiving combination antiretroviral therapy. Of those with CD4 counts of less than 200 cells/mm³, 58% to 72% in any given year received PCP prophylaxis, predominantly co-trimoxazole. During follow up, 62 patients developed PCP (0.5 per 100 person-years) and 169 died from all causes (1.36/100 person-years). After stratifying by site and adjusting for age, CD4 count, CDC stage and antiretroviral treatment, those without prophylaxis had no higher risk of PCP, but had a significantly higher risk of death (incident rate ratio 10.8, p < 0.001). PCP prophylaxis had greatest absolute benefit in patients with CD4 counts of less than 50 cells/mm³, lowering mortality rates from 33.5 to 6.3 per 100 person-years.</p> <p>Conclusions</p> <p>Approximately two-thirds of TAHOD patients with CD4 counts of less than 200 cells/mm³received PCP prophylaxis. Patients without prophylaxis had significantly higher mortality, even in the era of combination ART. Although PCP may be under-diagnosed, these data suggest that prophylaxis is associated with important survival benefits.</p

Tuberculosis screening among ambulatory people living with HIV: a systematic review and individual participant data meta-analysis

BACKGROUND: The WHO-recommended tuberculosis screening and diagnostic algorithm in ambulatory people living with HIV is a four-symptom screen (known as the WHO-recommended four symptom screen [W4SS]) followed by a WHO-recommended molecular rapid diagnostic test (eg Xpert MTB/RIF [hereafter referred to as Xpert]) if W4SS is positive. To inform updated WHO guidelines, we aimed to assess the diagnostic accuracy of alternative screening tests and strategies for tuberculosis in this population. METHODS: In this systematic review and individual participant data meta-analysis, we updated a search of PubMed (MEDLINE), Embase, the Cochrane Library, and conference abstracts for publications from Jan 1, 2011, to March 12, 2018, done in a previous systematic review to include the period up to Aug 2, 2019. We screened the reference lists of identified pieces and contacted experts in the field. We included prospective cross-sectional, observational studies and randomised trials among adult and adolescent (age ≥10 years) ambulatory people living with HIV, irrespective of signs and symptoms of tuberculosis. We extracted study-level data using a standardised data extraction form, and we requested individual participant data from study authors. We aimed to compare the W4SS with alternative screening tests and strategies and the WHO-recommended algorithm (ie, W4SS followed by Xpert) with Xpert for all in terms of diagnostic accuracy (sensitivity and specificity), overall and in key subgroups (eg, by antiretroviral therapy [ART] status). The reference standard was culture. This study is registered with PROSPERO, CRD42020155895. FINDINGS: We identified 25 studies, and obtained data from 22 studies (including 15 666 participants; 4347 [27·7%] of 15 663 participants with data were on ART). W4SS sensitivity was 82% (95% CI 72-89) and specificity was 42% (29-57). C-reactive protein (≥10 mg/L) had similar sensitivity to (77% [61-88]), but higher specificity (74% [61-83]; n=3571) than, W4SS. Cough (lasting ≥2 weeks), haemoglobin (<10 g/dL), body-mass index (<18·5 kg/m2), and lymphadenopathy had high specificities (80-90%) but low sensitivities (29-43%). The WHO-recommended algorithm had a sensitivity of 58% (50-66) and a specificity of 99% (98-100); Xpert for all had a sensitivity of 68% (57-76) and a specificity of 99% (98-99). In the one study that assessed both, the sensitivity of sputum Xpert Ultra was higher than sputum Xpert (73% [62-81] vs 57% [47-67]) and specificities were similar (98% [96-98] vs 99% [98-100]). Among outpatients on ART (4309 [99·1%] of 4347 people on ART), W4SS sensitivity was 53% (35-71) and specificity was 71% (51-85). In this population, a parallel strategy (two tests done at the same time) of W4SS with any chest x-ray abnormality had higher sensitivity (89% [70-97]) and lower specificity (33% [17-54]; n=2670) than W4SS alone; at a tuberculosis prevalence of 5%, this strategy would require 379 more rapid diagnostic tests per 1000 people living with HIV than W4SS but detect 18 more tuberculosis cases. Among outpatients not on ART (11 160 [71·8%] of 15 541 outpatients), W4SS sensitivity was 85% (76-91) and specificity was 37% (25-51). C-reactive protein (≥10 mg/L) alone had a similar sensitivity to (83% [79-86]), but higher specificity (67% [60-73]; n=3187) than, W4SS and a sequential strategy (both test positive) of W4SS then C-reactive protein (≥5 mg/L) had a similar sensitivity to (84% [75-90]), but higher specificity than (64% [57-71]; n=3187), W4SS alone; at 10% tuberculosis prevalence, these strategies would require 272 and 244 fewer rapid diagnostic tests per 1000 people living with HIV than W4SS but miss two and one more tuberculosis cases, respectively. INTERPRETATION: C-reactive protein reduces the need for further rapid diagnostic tests without compromising sensitivity and has been included in the updated WHO tuberculosis screening guidelines. However, C-reactive protein data were scarce for outpatients on ART, necessitating future research regarding the utility of C-reactive protein in this group. Chest x-ray can be useful in outpatients on ART when combined with W4SS. The WHO-recommended algorithm has suboptimal sensitivity; Xpert for all offers slight sensitivity gains and would have major resource implications. FUNDING: World Health Organization