Serdang Hospital

BACKGROUND: Reliability studies are commonly used in questionnaire development studies and questionnaire validation studies. This study reviews the sample size guideline for Cronbach's alpha test. METHODS: Manual sample size calculation using Microsoft Excel software and sample size tables were tabulated based on a single coefficient alpha and the comparison of two coefficients alpha. RESULTS: For a single coefficient alpha test, the approach by assuming the Cronbach's alpha coefficient equals to zero in the null hypothesis will yield a smaller sample size of less than 30 to achieve a minimum desired effect size of 0.7. However, setting the coefficient of Cronbach's alpha larger than zero in the null hypothesis could be necessary and this will yield larger sample size. For comparison of two coefficients of Cronbach's alpha, a larger sample size is needed when testing for smaller effect sizes. CONCLUSIONS: In the assessment of the internal consistency of an instrument, the present study proposed the Cronbach's alpha's coefficient to be set at 0.5 in the null hypothesis and hence larger sample size is needed. For comparison of two coefficients' of Cronbach's alpha, justification is needed whether testing for extremely low and extremely large effect sizes are scientifically necessary.

Zinc oxide (ZnO) has been considered as one of the potential materials in solar cell applications, owing to its relatively high conductivity, electron mobility, stability against photo-corrosion and availability at low-cost. Different structures of ZnO materials have been engineered at the nanoscale, and then applied on the conducting substrate as a photoanode. On the other hand, the ZnO nanomaterials directly grown on the substrate have been attractive due to their unique electron pathways, which suppress the influence of surface states typically found in the former case. Herein, we review the recent progress of ZnO nanostructured materials in emerging solar cell applications, such as sensitized and heterojunction architectures, including those embedded with promising perovskite materials. The remarkable advancement in each solar cell architecture is highlighted towards achieving high power conversion efficiency and operational stability. We also discuss the foremost bottleneck for further improvements and the future outlook for large-scale practical applications.

In this review, the recent progress in the electrochemical sensing of dopamine with various graphene and their nanocomposite materials modified electrodes are presented.

The success of peritoneal dialysis (PD) as renal replacement therapy depends upon a safe, functional, and durable catheter access to the peritoneal cavity provided in a timely fashion. Catheter complications often lead to catheter loss and contribute to technique failure. With improvements in prevention and treatment of peritonitis, the impact of catheter-related infections and mechanical problems on PD technique survival has become more apparent. Guideline committees under the sponsorship of the International Society for Peritoneal Dialysis (ISPD) periodically update best practices for optimal peritoneal access (1–4). Recent advances in our understanding of the key aspects of providing successful placement and maintenance of peritoneal catheters compels the current update. Assessment of evidence for guidelines recommendations is made using a modification of the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system for classification of the level of evidence and grade of recommendations (5). Where scientific evidence is not available, recommendations are based on a consensus opinion. The bibliography supporting the recommendations is not intended to be comprehensive. When there are multiple similar reports on the same subject, the committee prefers to cite the more recent publications. Within each recommendation, strength is indicated as Level 1 (we recommend), Level 2 (we suggest), or not graded, and the quality of the supporting evidence is shown as A (high quality), B (moderate quality), C (low quality), or D (very low quality). The recommendations are not meant to be implemented indiscriminately in every instance but adapted as necessary according to local circumstances and the clinical situation. While many of the general principles presented here may be applied to pediatric patients, the focus of these guidelines is on adults. Clinicians who take care of pediatric PD patients should refer to the latest ISPD guidelines covering this patient group (6).

BACKGROUND: Polymer-free drug-coated stents provide superior clinical outcomes to bare-metal stents in patients at high bleeding risk who undergo percutaneous coronary intervention (PCI) and are treated with 1 month of dual antiplatelet therapy. Data on the use of polymer-based drug-eluting stents, as compared with polymer-free drug-coated stents, in such patients are limited. METHODS: In an international, randomized, single-blind trial, we compared polymer-based zotarolimus-eluting stents with polymer-free umirolimus-coated stents in patients at high bleeding risk. After PCI, patients were treated with 1 month of dual antiplatelet therapy, followed by single antiplatelet therapy. The primary outcome was a safety composite of death from cardiac causes, myocardial infarction, or stent thrombosis at 1 year. The principal secondary outcome was target-lesion failure, an effectiveness composite of death from cardiac causes, target-vessel myocardial infarction, or clinically indicated target-lesion revascularization. Both outcomes were powered for noninferiority. RESULTS: A total of 1996 patients at high bleeding risk were randomly assigned in a 1:1 ratio to receive zotarolimus-eluting stents (1003 patients) or polymer-free drug-coated stents (993 patients). At 1 year, the primary outcome was observed in 169 of 988 patients (17.1%) in the zotarolimus-eluting stent group and in 164 of 969 (16.9%) in the polymer-free drug-coated stent group (risk difference, 0.2 percentage points; upper boundary of the one-sided 97.5% confidence interval [CI], 3.5; noninferiority margin, 4.1; P = 0.01 for noninferiority). The principal secondary outcome was observed in 174 patients (17.6%) in the zotarolimus-eluting stent group and in 169 (17.4%) in the polymer-free drug-coated stent group (risk difference, 0.2 percentage points; upper boundary of the one-sided 97.5% CI, 3.5; noninferiority margin, 4.4; P = 0.007 for noninferiority). CONCLUSIONS: Among patients at high bleeding risk who received 1 month of dual antiplatelet therapy after PCI, use of polymer-based zotarolimus-eluting stents was noninferior to use of polymer-free drug-coated stents with regard to safety and effectiveness composite outcomes. (Funded by Medtronic; ONYX ONE ClinicalTrials.gov number, NCT03344653.).

Faculdade de Enfermagem, Nutricao e Fisioterapia,1 Pontificia Universidade Catolica do Rio Grande do Sul, Brazil; Department of Nephrology,2 Serdang Hospital, Jalan Puchong, Kajang, Selangor, Malaysia; Sheffield Kidney Institute,3 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Nephrology,4 Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; Renal Services,5 Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom; Nephrology,6 Sri Ramachandra University, Chennai, India; Dialysis Unit,7 Dianet Dialysis Centers and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Silicon (Si) is one of the most prevalent macroelements, performing an essential function in healing plants in response to environmental stresses. The purpose of using Si is to induce resistance to distinct stresses, diseases, and pathogens. Additionally, Si can improve the condition of soils, which contain toxic levels of heavy metals along with other chemical elements. Silicon minimizes toxicity of Fe, Al, and Mn, increases the availability of P, and enhances drought along with salt tolerance in plants through the formation of silicified tissues in plants. However, the concentration of Si depends on the plants genotype and organisms. Hence, the physiological mechanisms and metabolic activities of plants may be affected by Si application. Peptides as well as amino acids can effectively create polysilicic species through interactions with different species of silicate inside solution. The carboxylic acid and the alcohol groups of serine and asparagine tend not to engage in any significant role in polysilicates formation, but the hydroxyl group side chain can be involved in the formation of hydrogen bond with Si(OH)4. The mechanisms and trend of Si absorption are different between plant species. Furthermore, the transportation of Si requires an energy mechanism; thus, low temperatures and metabolic repressors inhibit Si transportation.

Lactic acid bacteria (LAB) are the major interest in food industry primarily by virtue of their biopreservative properties.

Probiotics have been reported to exert beneficial effects along the gut-brain axis. This randomised, double-blind and placebo-controlled human study aimed to evaluate such properties of Lactobacillus plantarum DR7 and its accompanying mechanisms in stressed adults. One hundred and eleven (n=111; DR7 n=56, placebo n=55) stressed adults were recruited based on moderate stress levels using the PSS-10 questionnaire. The consumption of DR7 (1×10 9 cfu/day) for 12 weeks reduced symptoms of stress ( P =0.024), anxiety ( P =0.001), and total psychological scores ( P =0.022) as early as 8 weeks among stressed adults compared to the placebo group as assessed by the DASS-42 questionnaire. Plasma cortisol level was reduced among DR7 subjects as compared to the placebo, accompanied by reduced plasma pro-inflammatory cytokines, such as interferon-γ and transforming growth factor-α and increased plasma anti-inflammatory cytokines, such as interleukin 10 ( P <0.05). DR7 better improved cognitive and memory functions in normal adults (>30 years old), such as basic attention, emotional cognition, and associate learning ( P <0.05), as compared to the placebo and young adults (<30 years old). The administration of DR7 enhanced the serotonin pathway, as observed by lowered expressions of plasma dopamine β-hydroxylase (DBH), tyrosine hydroxylase (TH), indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase accompanied by increased expressions of tryptophan hydroxylase-2 and 5-hydroxytryptamine receptor-6, while stabilising the dopamine pathway as observed via stabilised expressions of TH and DBH over 12 weeks as compared to the placebo ( P <0.05). Our results indicated that DR7 fulfil the requirement of a probiotic strain as per recommendation of FAO/WHO and could be applicable as a natural strategy to improve psychological functions, cognitive health and memory in stressed adults.

The refractive index of liquid solutions at the He-Ne laser wavelength, 0.6328 microm, is presented. The measurements were carried out using the conventional minimum deviation method of an equilateral hollow glass prism. The refractive indices of sucrose, sodium chloride, glucose, and caster sugar solutions for a range of density varying from distilled water to a saturated condition were measured. The result shows that at higher concentrations a slight curvature can be seen from the plot of refractive index vs concentration of solution. However, the refractive index of sucrose shows a linear relationship with concentration. The accuracy of the measurements is estimated to be better than 0.3%.

Rehabilitation is the process of treating post-stroke consequences. Impaired limbs are considered the common outcomes of stroke, which require a professional therapist to rehabilitate the impaired limbs and restore fully or partially its function. Due to the shortage in the number of therapists and other considerations, researchers have been working on developing robots that have the ability to perform the rehabilitation process. During the last two decades, different robots were invented to help in rehabilitation procedures. This paper explains the types of rehabilitation treatments and robot classifications. In addition, a few examples of well-known rehabilitation robots will be explained in terms of their efficiency and controlling mechanisms.

As the network dramatically extended, security considered as major issue in networks. Internet attacks are increasing, and there have been various attack methods, consequently. Intrusion detection systems have been used along with the data mining techniques to detect intrusions. In this work we aim to use data mining techniques including classification tree and support vector machines for intrusion detection. As results indicate, C4.5 algorithm is better than SVM in detecting network intrusions and false alarm rate in KDD CUP 99 dataset.

The Asian venous thromboembolism (VTE) prophylaxis guidelines were first published in 2012. Since its first edition, the Asian Venous Thrombosis Forum (AVTF) working group have updated the Asian VTE epidemiology and reviewed issues that were not addressed in the previous guidelines. The authors noted that the rising incidence of VTE across Asia may be attributable to aging population, dietary changes, and increasing incidence of obesity and diabetes. The new additions in the guideline include role of thrombophilia in VTE, bleeding risk in Asians, individual risk assessment, updates in the prevention of VTE in medically ill, bariatric surgery, cancer, orthopedic and trauma patients. The influence of primary thrombophilia in perioperative VTE is still unclear. The secondary risk factors, however, are similar between Asians and Caucasians. The group found no evidence of increased risk of bleeding while using pharmacological agents, including the use of novel anti-coagulants. At present, Caprini risk assessment model is widely used for individual risk assessment. Further validation of this model is needed in Asia. In medically ill patients, pharmacological agents are preferred if there is no bleeding risk. Intermittent pneumatic compression device (IPC) is recommended in patients with bleeding risk but we do not recommend using graduated compressive stockings. In bariatric patients, data on VTE is lacking in Asia. We recommend following current international guidelines. A high index of suspicion should be maintained during postbariatric surgery to detect and promptly treat portomesenteric venous thrombosis. Different cancer types have different thrombotic risks and the types of surgery influence to a large extent the overall VTE risk. Cancer patients should receive further risk assessment. In patients with higher thrombotic risk, either due to predisposing risk or concomitant surgery, low molecular weight heparin is indicated. Different countries appear to have different incidence of VTE following trauma and major orthopedic surgery. We recommend mechanical prophylaxis using IPC as the main method and additional pharmacological prophylaxis if the thrombotic risk is high. As for obstetric practice, we propose adherence to the UK Greentop guideline that is widely accepted and utilized across Asia. To improve VTE thromboprophylaxis implementation in the region, we propose that there should be better health education, establishment of hospital-based guidelines and multidisciplinary collaboration.

An electrochemical sensing platform based on a hydrothermally synthesized rGO–Co₃O₄@Pt nanocomposite was developed for the detection of <italic>in situ</italic> generated NO.

Synthesis of magnetically separable rGO/Fe₃O₄nanocomposite materials for environmental remediation<italic>via</italic>the photocatalytic degradation of methylene blue.

Phase transformation from initially α-MnO₂ to R-MnO₂ due to Fe-doping cause modification of interatomic distances affects to the electrical properties.

Nanocellulose-based antimicrobial material and its applications.

Abstract Meeting the multimillion hectare commitments for forest and landscape restoration (FLR) will require billions of tree seed and seedlings. However, the adequacy of seed supply in terms of quantity, genetic diversity and quality has received scant attention in FLR planning. We surveyed 139 FLR projects worldwide and identified widespread problems in the availability and diversity of tree seed, with potentially deleterious consequences for the vigor, productivity and long‐term persistence of restored tree populations. Large projects and those focused on climate change mitigation were particularly associated with multiple problems in seed sourcing. To avoid large‐scale failure in FLR, we recommend: (1) national assessments of seed supply and demand for FLR, (2) reviewing FLR targets and funding cycles, (3) fostering sharing of knowledge and experiences regarding seed supply and selection, (4) enhancing seed exchange across landscapes, and (5) introducing regulations for seed quality and strengthening capacities for compliance.

This paper deals with the experimental investigation outlet temperature and efficiency, of Solar Air heater (SAH). The experimental test set up designed and fabricated to study the effect of jet impingement on the corrugated absorber plate, through circular jets in a duct flow of solar air heater, and compared with conventional solar air heater on flat plat absorber. Under effect of mass flow rate (ṁ) of air and solar radiation on outlet air temperature, and efficiency, are analyzed. Results show the flow jet impingement on corrugated plat absorber is a strong function of heat transfer enhancement. The present investigation concludes that the mass flow rate of air substantially influences the heat transfer on solar air heaters. And the thermal efficiency of proposed design duct is observed almost 14% more as compare to the smooth duct. At solar radiation 500–1000 (W/M2), 308 K ambient temperature and 0.01–0.03 (Kg/S) mass flow rate

BACKGROUND: Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur. METHODS: A cross sectional study of primary aged school children was undertaken in 2008. A total of 402 boys and girls aged 7-12 years, attending primary schools in Kuala Lumpur participated in the study. Fasting blood samples were taken to assess vitamin D [as 25(OH)D], vitamin B12, folate, zinc, iron, and ferritin and haemoglobin concentrations. Height-for-age and body mass index for age (BMI-for-age) of the children were computed. RESULTS: Most of the children had normal height-for-age (96.5%) while slightly over half (58.0%) had normal BMI-for-age. A total of 17.9% were overweight and 16.4% obese. Prevalence of obesity was significantly higher among the boys (25%) than in the girls (9.5%) (χ2 = 22.949; P < .001). Most children had adequate concentrations of haemoglobin, serum ferritin, zinc, folate and vitamin B12. In contrast, 35.3% of the children had serum 25(OH)D concentrations indicative of vitamin D deficiency(≤ 37.5 nmol/L) and a further 37.1% had insufficiency concentrations (> 37.5-≤ 50 nmol/L). Among the boys, a significant inverse association was found between serum vitamin D status and BMI-for-age (χ2 = 5.958; P = .016). CONCLUSIONS: This study highlights the presence of a high prevalence of sub-optimal vitamin D status among urban primary school children in a tropical country. In light of the growing problem of obesity in Malaysian children, these findings emphasize the important need for appropriate interventions to address both problems of obesity and poor vitamin D status in children.