Search results for: Noor Aina Mohamad Zuki
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 445

Search results for: Noor Aina Mohamad Zuki

85 Evaluation and Risk Assessment of Heavy Metals Pollution Using Edible Crabs, Based on Food Intended for Human Consumption

Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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84 Design and Development of an Innovative MR Damper Based on Intelligent Active Suspension Control of a Malaysia's Model Vehicle

Authors: L. Wei Sheng, M. T. Noor Syazwanee, C. J. Carolyna, M. Amiruddin, M. Pauziah

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This paper exhibits the alternatives towards active suspension systems revised based on the classical passive suspension system to improve comfort and handling performance. An active Magneto rheological (MR) suspension system is proposed as to explore the active based suspension system to enhance performance given its freedom to independently specify the characteristics of load carrying, handling, and ride quality. Malaysian quarter car with two degrees of freedom (2DOF) system is designed and constructed to simulate the actions of an active vehicle suspension system. The structure of a conventional twin-tube shock absorber is modified both internally and externally to comprehend with the active suspension system. The shock absorber peripheral structure is altered to enable the assembling and disassembling of the damper through a non-permanent joint whereby the stress analysis of the designed joint is simulated using Finite Element Analysis. Simulation on the internal part where an electrified copper coil of 24AWG is winded is done using Finite Element Method Magnetics to measure the magnetic flux density inside the MR damper. The primary purpose of this approach is to reduce the vibration transmitted from the effects of road surface irregularities while maintaining solid manoeuvrability. The aim of this research is to develop an intelligent control system of a consecutive damping automotive suspension system. The ride quality is improved by means of the reduction of the vertical body acceleration caused by the car body when it experiences disturbances from speed bump and random road roughness. Findings from this research are expected to enhance the quality of ride which in return can prevent the deteriorating effect of vibration on the vehicle condition as well as the passengers’ well-being.

Keywords: active suspension, FEA, magneto rheological damper, Malaysian quarter car model, vibration control

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83 Seroprevalence of Toxoplasmosis among Hemato-Oncology Patients in Tertiary Hospital of East Cost Malaysia

Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman

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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.

Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis

Procedia PDF Downloads 152
82 Studying the Influence of Systematic Pre-Occupancy Data Collection through Post-Occupancy Evaluation: A Shift in the Architectural Design Process

Authors: Noor Abdelhamid, Donovan Nelson, Cara Prosser

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The architectural design process could be mapped out as a dialogue between designer and user that is constructed across multiple phases with the overarching goal of aligning design outcomes with user needs. Traditionally, this dialogue is bounded within a preliminary phase of determining factors that will direct the design intent, and a completion phase, of handing off the project to the client. Pre- and post-occupancy evaluations (P/POE’s) could provide an alternative process by extending this dialogue on both ends of the design process. The purpose of this research is to study the influence of systematic pre-occupancy data collection in achieving design goals by conducting post-occupancy evaluations of two case studies. In the context of this study, systematic pre-occupancy data collection is defined as the preliminary documentation of the existing conditions that helps portray stakeholders’ needs. When implemented, pre-occupancy occurs during the early phases of the architectural design process, utilizing the information to shape the design intent. Investigative POE’s are performed on two case studies with distinct early design approaches to understand how the current space is impacting user needs, establish design outcomes, and inform future strategies. The first case study underwent systematic pre-occupancy data collection and synthesis, while the other represents the traditional, uncoordinated practice of informally collecting data during an early design phase. POE’s target the dynamics between the building and its occupants by studying how spaces are serving the needs of the users. Data collection for this study consists of user surveys, audiovisual materials, and observations during regular site visits. Mixed methods of qualitative and quantitative analyses are synthesized to identify patterns in the data. The paper concludes by positioning value on both sides of the architectural design process: the integration of systematic pre-occupancy methods in the early phases and the reinforcement of a continued dialogue between building and design team after building completion.

Keywords: architecture, design process, pre-occupancy data, post-occupancy evaluation

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81 ELISA Based hTSH Assessment Using Two Sensitive and Specific Anti-hTSH Polyclonal Antibodies

Authors: Maysam Mard-Soltani, Mohamad Javad Rasaee, Saeed Khalili, Abdol Karim Sheikhi, Mehdi Hedayati

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Production of specific antibody responses against hTSH is a cumbersome process due to the high identity between the hTSH and the other members of the glycoprotein hormone family (FSH, LH and HCG) and the high identity between the human hTSH and host animals for antibody production. Therefore, two polyclonal antibodies were purified against two recombinant proteins. Four possible ELISA tests were designed based on these antibodies. These ELISA tests were checked against hTSH and other glycoprotein hormones, and their sensitivity and specificity were assessed. Bioinformatics tools were used to analyze the immunological properties. After the immunogen region selection from hTSH protein, c terminal of B hTSH was selected and applied. Two recombinant genes, with these cut pieces (first: two repeats of C terminal of B hTSH, second: tetanous toxin+B hTSH C terminal), were designed and sub-cloned into the pET32a expression vector. Standard methods were used for protein expression, purification, and verification. Thereafter, immunizations of the white New Zealand rabbits were performed and the serums of them were used for antibody titration, purification and characterization. Then, four ELISA tests based on two antibodies were employed to assess the hTSH and other glycoprotein hormones. The results of these assessments were compared with standard amounts. The obtained results indicated that the desired antigens were successfully designed, sub-cloned, expressed, confirmed and used for in vivo immunization. The raised antibodies were capable of specific and sensitive hTSH detection, while the cross reactivity with the other members of the glycoprotein hormone family was minimum. Among the four designed tests, the test in which the antibody against first protein was used as capture antibody, and the antibody against second protein was used as detector antibody did not show any hook effect up to 50 miu/l. Both proteins have the ability to induce highly sensitive and specific antibody responses against the hTSH. One of the antibody combinations of these antibodies has the highest sensitivity and specificity in hTSH detection.

Keywords: hTSH, bioinformatics, protein expression, cross reactivity

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80 Using of the Fractal Dimensions for the Analysis of Hyperkinetic Movements in the Parkinson's Disease

Authors: Sadegh Marzban, Mohamad Sobhan Sheikh Andalibi, Farnaz Ghassemi, Farzad Towhidkhah

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Parkinson's disease (PD), which is characterized by the tremor at rest, rigidity, akinesia or bradykinesia and postural instability, affects the quality of life of involved individuals. The concept of a fractal is most often associated with irregular geometric objects that display self-similarity. Fractal dimension (FD) can be used to quantify the complexity and the self-similarity of an object such as tremor. In this work, we are aimed to propose a new method for evaluating hyperkinetic movements such as tremor, by using the FD and other correlated parameters in patients who are suffered from PD. In this study, we used 'the tremor data of Physionet'. The database consists of fourteen participants, diagnosed with PD including six patients with high amplitude tremor and eight patients with low amplitude. We tried to extract features from data, which can distinguish between patients before and after medication. We have selected fractal dimensions, including correlation dimension, box dimension, and information dimension. Lilliefors test has been used for normality test. Paired t-test or Wilcoxon signed rank test were also done to find differences between patients before and after medication, depending on whether the normality is detected or not. In addition, two-way ANOVA was used to investigate the possible association between the therapeutic effects and features extracted from the tremor. Just one of the extracted features showed significant differences between patients before and after medication. According to the results, correlation dimension was significantly different before and after the patient's medication (p=0.009). Also, two-way ANOVA demonstrates significant differences just in medication effect (p=0.033), and no significant differences were found between subject's differences (p=0.34) and interaction (p=0.97). The most striking result emerged from the data is that correlation dimension could quantify medication treatment based on tremor. This study has provided a technique to evaluate a non-linear measure for quantifying medication, nominally the correlation dimension. Furthermore, this study supports the idea that fractal dimension analysis yields additional information compared with conventional spectral measures in the detection of poor prognosis patients.

Keywords: correlation dimension, non-linear measure, Parkinson’s disease, tremor

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79 Unveiling the Nexus: A Holistic Investigation on the Role of Cultural Beliefs and Family Dynamics in Shaping Maternal Health in Primigravida Women

Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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78 The Effect of MOOC-Based Distance Education in Academic Engagement and Its Components on Kerman University Students

Authors: Fariba Dortaj, Reza Asadinejad, Akram Dortaj, Atena Baziyar

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The aim of this study was to determine the effect of distance education (based on MOOC) on the components of academic engagement of Kerman PNU. The research was quasi-experimental method that cluster sampling with an appropriate volume was used in this study (one class in experimental group and one class in controlling group). Sampling method is single-stage cluster sampling. The statistical society is students of Kerman Payam Noor University, which) were selected 40 of them as sample (20 students in the control group and 20 students in experimental group). To test the hypothesis, it was used the analysis of univariate and Co-covariance to offset the initial difference (difference of control) in the experimental group and the control group. The instrument used in this study is academic engagement questionnaire of Zerang (2012) that contains component of cognitive, behavioral and motivational engagement. The results showed that there is no significant difference between mean scores of academic components of academic engagement in experimental group and the control group on the post-test, after elimination of the pre-test. The adjusted mean scores of components of academic engagement in the experimental group were higher than the adjusted average of scores after the test in the control group. The use of technology-based education in distance education has been effective in increasing cognitive engagement, motivational engagement and behavioral engagement among students. Experimental variable with the effect size 0.26, predicted 26% of cognitive engagement component variance. Experimental variable with the effect size 0.47, predicted 47% of the motivational engagement component variance. Experimental variable with the effect size 0.40, predicted 40% of behavioral engagement component variance. So teaching with technology (MOOC) has a positive impact on increasing academic engagement and academic performance of students in educational technology. The results suggest that technology (MOOC) is used to enrich the teaching of other lessons of PNU.

Keywords: educational technology, distance education, components of academic engagement, mooc technology

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77 Neighbor Caring Environment System (NCE) Using Parallel Replication Mechanism

Authors: Ahmad Shukri Mohd Noor, Emma Ahmad Sirajudin, Rabiei Mamat

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Pertaining to a particular Marine interest, the process of data sampling could take years before a study can be concluded. Therefore, the need for a robust backup system for the data is invariably implicit. In recent advancement of Marine applications, more functionalities and tools are integrated to assist the work of the researchers. It is anticipated that this modality will continue as research scope widens and intensifies and at the same to follow suit with current technologies and lifestyles. The convenience to collect and share information these days also applies to the work in Marine research. Therefore, Marine system designers should be aware that high availability is a necessary attribute in Marine repository applications as well as a robust backup system for the data. In this paper, the approach to high availability is related both to hardware and software but the focus is more on software. We consider a NABTIC repository system that is primitively built on a single server and does not have replicated components. First, the system is decomposed into separate modules. The modules are placed on multiple servers to create a distributed system. Redundancy is added by placing the copies of the modules on different servers using Neighbor Caring Environment System(NCES) technique. NCER is utilizing parallel replication components mechanism. A background monitoring is established to check servers’ heartbeats to confirm their aliveness. At the same time, a critical adaptive threshold is maintained to make sure a failure is timely detected using Adaptive Fault Detection (AFD). A confirmed failure will set the recovery mode where a selection process will be done before a fail-over server is instructed. In effect, the Marine repository service is continued as the fail-over masks a recent failure. The performance of the new prototype is tested and is confirmed to be more highly available. Furthermore, the downtime is not noticeable as service is immediately restored automatically. The Marine repository system is said to have achieved fault tolerance.

Keywords: availability, fault detection, replication, fault tolerance, marine application

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76 Hyaluronic Acid - Alginate Hydrogel for the Transdifferentiation of Testis Cells into Erythrocyte and Hepatocyte-like Cells; A Practice Within an Effective Agent Choice

Authors: Leila Rashki Ghaleno, Mohamad Amin Hajari, Leila Montazeri, Abdolhossein Shahverdi, Mojtaba Rezazadeh Valojerdi

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Background: Spermatogonia stem cells (SSCs) exhibit pluripotency, enabling them to undergo differentiation into many cell lineages, including neurons, glia, endothelial cells, and hepatocytes when cultured in vitro. Although the specific mechanisms are not yet fully understood, it has been observed that biopolymer agents, such as hyaluronic acid (HA) and alginate (Alg), have the potential to induce transdifferentiation of SSCs. The current work aimed to examine the process of in vitro spermatogenesis and the conversion of mouse testicular cells into hepatocytes and erythrocyte-like cells utilizing the HA-Alg hydrogel. Method: After being extracted from the testes of a 5-day postpartum mouse (5 DPP), the testicular cells were separated into two enzymatic stages and then put into a composite hydrogel containing 0.5% HA and 1% alginate. On days 14 and 28 of culture, the colonies' growth, the cells' viability, and their histology were assessed. Result: Despite observing significant cell proliferation on day 14 and the development of circular-shaped organoids on day 28, it was noted that the organoids generated in the HA-Alg medium tended to maintain their circular morphology on day 28. Notably, the testicular cells underwent transdifferentiation into cell types resembling erythrocytes and hepatocytes. The hepatocyte-like cells exhibited the presence of glycogen and lipid deposits, indicating their hepatocyte-like characteristics. Interestingly, immunostaining analysis revealed the secretion of albumin and the presence of VEGFR on day 14. However, on day 28, albumin expression was not detected, while the expression of Sox9 (a marker for hepatocytes), Vegf, CD34, and C-kit (markers for erythrocytes) showed increased levels in the gene expression evaluation. Conclusion: The present findings indicated that HA-Alg could be a potent and effective agent for the transdifferentiation of testis cells into erythrocyte and hepatocyte-like cells, as recent studies have confirmed the transformation of SSCs into hepatocyte cells during in vitro culture.

Keywords: 3D culture, mouse testicular cell, hyaluronic acid, liver organoids

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75 A Comparative Study of Specific Assessment Criteria Related to Commercial Vehicle Drivers

Authors: Nur Syahidatul Idany Abdul Ghani, Rahizar Ramli, Jamilah Mohamad, Ahmad Saifizul, Mohamed Rehan Karim

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Increasing fatalities in road accidents in Malaysia over the last 10 years are quite alarming. Based on Malaysian Institute of Road Safety Research (Miros) latest research ‘Predicting Malaysian Road Fatalities for year 2020; it is predicted that road fatalities in Malaysia for 2015 is 8,780 and 10,716 for the year 2020 which 30 percent of fatalities were caused by accidents involving commercial vehicles. Government, related agencies and NGOs have continuously and persistently work to reduce the statistics through enforcement, educating the public, training to drivers, road safety campaigns, advertisements etc. However, the trend of casualties does not show encouraging pattern but instead, steadily growing. Thus, this comparative study reviews the literature pertaining on method of measurement used to evaluate commercial drivers competency. In several studies driving competency has been assessed with different assessment based on the license procedures and requirements according to the country regulation. The assessment criteria that has been establish for commercial drivers generally focus on driving tasks and assessment e.g. theory test, medical test and road assessment rather than driving competency test or physical test. Realizing the importance of specific assessment test for drivers competency this comparative study reviews the most discussed literature related to competency assessment method to identify competency of the drivers include (1. judgement and reaction, 2. skill of drivers, 3. experiences and fatigue). The concluding analysis of this paper is a comparative table for assessment methodology to access driver’s competency. A comparative study is a further discussion reviewing past literature to provide an overview on existing assessment test and potential subject matters that can be identified for further studies to increase awareness of the drivers, passengers as well as the authorities about the importance of competent drivers in order to improve safety in commercial vehicles.

Keywords: commercial vehicles, driver’s competency, specific assessment

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74 Efficacy of Gamma Radiation on the Productivity of Bactrocera oleae Gmelin (Diptera: Tephritidae)

Authors: Mehrdad Ahmadi, Mohamad Babaie, Shiva Osouli, Bahareh Salehi, Nadia Kalantaraian

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The olive fruit fly, Bactrocera oleae Gmelin (Diptera: Tephritidae), is one of the most serious pests in olive orchards in growing province in Iran. The female lay eggs in green olive fruit and larvae hatch inside the fruit, where they feed upon the fruit matters. One of the main ecologically friendly and species-specific systems of pest control is the sterile insect technique (SIT) which is based on the release of large numbers of sterilized insects. The objective of our work was to develop a SIT against B. oleae by using of gamma radiation for the laboratory and field trial in Iran. Oviposition of female mated by irradiated males is one of the main parameters to determine achievement of SIT. To conclude the sterile dose, pupae were placed under 0 to 160 Gy of gamma radiation. The main factor in SIT is the productivity of females which are mated by irradiated males. The emerged adults from irradiated pupae were mated with untreated adults of the same age by confining them inside the transparent cages. The fecundity of the irradiated males mated with non-irradiated females was decreased with the increasing radiation dose level. It was observed that the number of eggs and also the percentage of the egg hatching was significantly (P < 0.05) affected in either IM x NF crosses compared with NM x NF crosses in F1 generation at all doses. Also, the statistical analysis showed a significant difference (P < 0.05) in the mean number of eggs laid between irradiated and non-irradiated females crossed with irradiated males, which suggests that the males were susceptible to gamma radiation. The egg hatching percentage declined markedly with the increase of the radiation dose of the treated males in mating trials which demonstrated that egg hatch rate was dose dependent. Our results specified that gamma radiation affects the longevity of irradiated B. oleae larvae (established from irradiated pupae) and significantly increased their larval duration. Results show the gamma radiation, and SIT can be used successfully against olive fruit flies.

Keywords: fertility, olive fruit fly, radiation, sterile insect technique

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73 Feasibility of Voluntary Deep Inspiration Breath-Hold Radiotherapy Technique Implementation without Deep Inspiration Breath-Hold-Assisting Device

Authors: Auwal Abubakar, Shazril Imran Shaukat, Noor Khairiah A. Karim, Mohammed Zakir Kassim, Gokula Kumar Appalanaido, Hafiz Mohd Zin

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Background: Voluntary deep inspiration breath-hold radiotherapy (vDIBH-RT) is an effective cardiac dose reduction technique during left breast radiotherapy. This study aimed to assess the accuracy of the implementation of the vDIBH technique among left breast cancer patients without the use of a special device such as a surface-guided imaging system. Methods: The vDIBH-RT technique was implemented among thirteen (13) left breast cancer patients at the Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia. Breath-hold monitoring was performed based on breath-hold skin marks and laser light congruence observed on zoomed CCTV images from the control console during each delivery. The initial setup was verified using cone beam computed tomography (CBCT) during breath-hold. Each field was delivered using multiple beam segments to allow a delivery time of 20 seconds, which can be tolerated by patients in breath-hold. The data were analysed using an in-house developed MATLAB algorithm. PTV margin was computed based on van Herk's margin recipe. Results: The setup error analysed from CBCT shows that the population systematic error in lateral (x), longitudinal (y), and vertical (z) axes was 2.28 mm, 3.35 mm, and 3.10 mm, respectively. Based on the CBCT image guidance, the Planning target volume (PTV) margin that would be required for vDIBH-RT using CCTV/Laser monitoring technique is 7.77 mm, 10.85 mm, and 10.93 mm in x, y, and z axes, respectively. Conclusion: It is feasible to safely implement vDIBH-RT among left breast cancer patients without special equipment. The breath-hold monitoring technique is cost-effective, radiation-free, easy to implement, and allows real-time breath-hold monitoring.

Keywords: vDIBH, cone beam computed tomography, radiotherapy, left breast cancer

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72 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis

Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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71 Effect of Molecular Weight Distribution on Toughening Performance of Polybutadiene in Polystyrene

Authors: Mohamad Mohsen Yavarizadeh

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Polystyrene (PS) and related homopolymers are brittle materials that typically fail in tensile tests at very low strains. These polymers can be toughened by the addition of rubbery particles which initiate a large number of crazes that produce substantial plastic strain at relatively low stresses. Considerable energy is dissipated in the formation of these crazes, producing a relatively tough material that shows an impact toughness of more than 5 times of pure PS. While cross linking of rubbery phase is necessary in aforementioned mechanism of toughening, another mechanism of toughening was also introduced in which low molecular weight liquid rubbers can also toughen PS when dispersed in the form of small pools in the glassy matrix without any cross linking. However, this new mechanism which is based on local plasticization, fails to act properly at high strain rate deformations, i.e. impact tests. In this work, the idea of combination of these two mechanisms was tried. To do so, Polybutadiene rubbers (PB) with bimodal distribution of molecular weight were prepared in which, comparable fractions of very high and very low molecular weight rubbers were mixed. Incorporation of these materials in PS matrix in a reactive process resulted in more significant increases in toughness of PS. In other words, although low molecular weight PB is ineffective in high strain rate impact test by itself, it showed a significant synergistic effect when combined with high molecular weight PB. Surprisingly, incorporation of just 10% of low molecular weight PB doubled the impact toughness of regular high impact PS (HIPS). It was observed that most of rubbery particles could initiate crazes. The effectiveness of low molecular weight PB in impact test was attributed to low strain rate deformation of each individual craze as a result of producing a large number of crazes in this material. In other words, high molecular weight PB chains make it possible to have an appropriate dispersion of rubbery phase in order to create a large number of crazes in the PS matrix and consequently decrease the velocity of each craze. Low molecular weight PB, in turn, would have enough time to locally plasticize craze fibrils and enhance the energy dissipation.

Keywords: molecular weight distribution, polystyrene, toughness, homopolymer

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70 High Heating Value Bio-Chars from a Bio-Oil Upgrading Process

Authors: Julius K. Gane, Mohamad N. Nahil, Paul T. Williams

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In today’s world of rapid population growth and a changing climate, one way to mitigate various negative effects is via renewable energy solutions. Energy and power as basic requirements in almost all human endeavours are also the banes of the changing climate and the impacts thereof. Thus it is crucial to develop innovative and environmentally friendly energy options to ameliorate various negative repercussions. Upgrading of fast pyrolysis bio-oil via hydro-treatment offers such opportunities, as quality renewable liquid transportation fuels can be produced. The process, however, is typically accompanied by bio-char formation as a by-product. The goal of this work was to study the yield and some properties of bio-chars formed from a hydrotreatment process, with an overall aim to promote the valuable utilization of wastes or by-products from renewable energy technologies. It is assumed that bio-chars that have comparable energy contents with coals will be more desirable as solid energy materials due to renewability and environmental friendliness. Therefore, the analytical work in this study focused mainly on determining the higher heating value (HHV) of the chars. The method involved the reaction of bio-oil in an autoclave supplied by the Parr Instrument Company, IL, USA. Two main parameters (different temperatures and resident times) were investigated. The chars were characterized using a Thermo EA2000 CHNS analyser, then oxygen contents and HHVs computed based on the literature. From the results, these bio-chars can readily serve as feedstocks for the production of renewable solid fuels. Their HHVs ranged between 29.26-39.18 MJ/kg, affected by different temperatures and retention times. There was an inverse relationship between the oxygen content and the HHVs of the chars. It can, therefore, be concluded that it is possible to optimize the process efficiency of the hydrotreatment process used through the production of renewable energy materials from the 'waste’ char by-products. Future work should consider developing a suitable balance between the primary objective of bio-oil upgrading processes (which is to improve the quality of the liquid fuels) and the conversion of its solid wastes into value-added products such as smokeless briquettes.

Keywords: bio-char, renewable solid biofuels, valorisation, waste-to-energy

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69 A Study on ZnO Nanoparticles Properties: An Integration of Rietveld Method and First-Principles Calculation

Authors: Kausar Harun, Ahmad Azmin Mohamad

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Zinc oxide (ZnO) has been extensively used in optoelectronic devices, with recent interest as photoanode material in dye-sensitize solar cell. Numerous methods employed to experimentally synthesized ZnO, while some are theoretically-modeled. Both approaches provide information on ZnO properties, but theoretical calculation proved to be more accurate and timely effective. Thus, integration between these two methods is essential to intimately resemble the properties of synthesized ZnO. In this study, experimentally-grown ZnO nanoparticles were prepared by sol-gel storage method with zinc acetate dihydrate and methanol as precursor and solvent. A 1 M sodium hydroxide (NaOH) solution was used as stabilizer. The optimum time to produce ZnO nanoparticles were recorded as 12 hours. Phase and structural analysis showed that single phase ZnO produced with wurtzite hexagonal structure. Further work on quantitative analysis was done via Rietveld-refinement method to obtain structural and crystallite parameter such as lattice dimensions, space group, and atomic coordination. The lattice dimensions were a=b=3.2498Å and c=5.2068Å which were later used as main input in first-principles calculations. By applying density-functional theory (DFT) embedded in CASTEP computer code, the structure of synthesized ZnO was built and optimized using several exchange-correlation functionals. The generalized-gradient approximation functional with Perdew-Burke-Ernzerhof and Hubbard U corrections (GGA-PBE+U) showed the structure with lowest energy and lattice deviations. In this study, emphasize also given to the modification of valence electron energy level to overcome the underestimation in DFT calculation. Both Zn and O valance energy were fixed at Ud=8.3 eV and Up=7.3 eV, respectively. Hence, the following electronic and optical properties of synthesized ZnO were calculated based on GGA-PBE+U functional within ultrasoft-pseudopotential method. In conclusion, the incorporation of Rietveld analysis into first-principles calculation was valid as the resulting properties were comparable with those reported in literature. The time taken to evaluate certain properties via physical testing was then eliminated as the simulation could be done through computational method.

Keywords: density functional theory, first-principles, Rietveld-refinement, ZnO nanoparticles

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68 Studies on Population and Management of Melon Fruit Fly Bactrocera cucurbitae (Coquillett) in Vegetables Agro-Ecosystem in District Hyderabada

Authors: Abro Zain-Ul-Aabdin, Naheed Baloch, Khuhro Niaz Hussain, Waseem Akbar, Noor Abid Saeed

Abstract:

The Melon Fruit Fly Bactrocera cucurbitae (Coq.) belongs to family: Tephritidae order: Diptera and is distributed throughout the vegetable growing areas of Pakistan. The B. cucurbitae is injurious pest of more than 125 species of the vegetables throughout the world. In the present studies we investigated the population of this important pest in cucurbit crops and influence of abiotic parameters such as: temperature, relative humidity and rainfall. The study was carried out at two different locations of District, Hyderabad. The locations were Jeay Shah and Dehli farm where three cucurbit vegetable crops, such as bottle gourd (Lagenaria siceraria), bitter gourd (Momordica charantia) and ridge gourd (Luffa acutangula) were grown. The traps were baited with Cue-lure and deployed at three meter height in the all locations from 01.01.2015 and up to 30.06.2015. Results revealed that overall significantly higher (P < 0.05) population was recorded on L.acutangula, M.charantia and L.siceraria (130.64, 127.21, and 122.91), respectively. However, significantly higher (P < 0.05) population was observed on L. acutangula (339.4±22.59) during the 4th week of May 2015 followed by M. charantia (334.6±22.76) L. siceraria (333.2±20.13). Whereas; lowest population was recorded on L. siceraria (5.8±1.39) followed by L. acutangula and M. charantia (6.8±0.80g, 8.0±1.30) respectively during the 4th week of January. The population of B. cucurbitae was significantly correlated with the temperature while negatively correlated with relative humidity. Meanwhile in the parasitism preference experiment pupal parasitoid Dirhinus giffardii showed significantly higher (P<0.05) parasitization when the pupae of B.cucurbitae were reared on Cucumber (Cucumis sativus) (24.8±0.48) and also female were yielded from pupae reared on C.sativus under no choice experiment. Similarly higher parasitization and female were recovered when pupae were supplied C. sativus under free choice experiment. Results of the present investigation would be useful in developing a sustainable pest management strategy in the vegetable agro-ecosystem.

Keywords: Dirhinus giffardii, Bactrocera cucurbitae Cucumis sativus, diptera, free choice, parasitization

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67 Prevalence and Clinical Significance of Antiphospholipid Antibodies in COVID-19 Patients Admitted to Intensive Care Units

Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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66 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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65 Thermoelectric Cooler As A Heat Transfer Device For Thermal Conductivity Test

Authors: Abdul Murad Zainal Abidin, Azahar Mohd, Nor Idayu Arifin, Siti Nor Azila Khalid, Mohd Julzaha Zahari Mohamad Yusof

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A thermoelectric cooler (TEC) is an electronic component that uses ‘peltier’ effect to create a temperature difference by transferring heat between two electrical junctions of two different types of materials. TEC can also be used for heating by reversing the electric current flow and even power generation. A heat flow meter (HFM) is an equipment for measuring thermal conductivity of building materials. During the test, water is used as heat transfer medium to cool the HFM. The existing re-circulating cooler in the market is very costly, and the alternative is to use piped tap water to extract heat from HFM. However, the tap water temperature is insufficiently low to enable heat transfer to take place. The operating temperature for isothermal plates in the HFM is 40°C with the range of ±0.02°C. When the temperature exceeds the operating range, the HFM stops working, and the test cannot be conducted. The aim of the research is to develop a low-cost but energy-efficient TEC prototype that enables heat transfer without compromising the function of the HFM. The objectives of the research are a) to identify potential of TEC as a cooling device by evaluating its cooling rate and b) to determine the amount of water savings using TEC compared to normal tap water. Four (4) peltier sets were used, with two (2) sets used as pre-cooler. The cooling water is re-circulated from the reservoir into HFM using a water pump. The thermal conductivity readings, the water flow rate, and the power consumption were measured while the HFM was operating. The measured data has shown decrease in average cooling temperature difference (ΔTave) of 2.42°C and average cooling rate of 0.031°C/min. The water savings accrued from using the TEC is projected to be 8,332.8 litres/year with the application of water re-circulation. The results suggest the prototype has achieved required objectives. Further research will include comparing the cooling rate of TEC prototype against conventional tap water and to optimize its design and performance in terms of size and portability. The possible application of the prototype could also be expanded to portable storage for medicine and beverages.

Keywords: energy efficiency, thermoelectric cooling, pre-cooling device, heat flow meter, sustainable technology, thermal conductivity

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64 A Systematic Review of the Psychometric Properties of Augmentative and Alternative Communication Assessment Tools in Adolescents with Complex Communication Needs

Authors: Nadwah Onwi, Puspa Maniam, Azmawanie A. Aziz, Fairus Mukhtar, Nor Azrita Mohamed Zin, Nurul Haslina Mohd Zin, Nurul Fatehah Ismail, Mohamad Safwan Yusoff, Susilidianamanalu Abd Rahman, Siti Munirah Harris, Maryam Aizuddin

Abstract:

Objective: Malaysia has a growing number of individuals with complex communication needs (CCN). The initiation of augmentative and alternative communication (AAC) intervention may facilitate individuals with CCN to understand and express themselves optimally and actively participate in activities in their daily life. AAC is defined as multimodal use of communication ability to allow individuals to use every mode possible to communicate with others using a set of symbols or systems that may include the symbols, aids, techniques, and strategies. It is consequently critical to evaluate the deficits to inform treatment for AAC intervention. However, no known measurement tools are available to evaluate the user with CCN available locally. Design: A systematic review (SR) is designed to analyze the psychometric properties of AAC assessment for adolescents with CCN published in peer-reviewed journals. Tools are rated by the methodological quality of studies and the psychometric measurement qualities of each tool. Method: A literature search identifying AAC assessment tools with psychometrically robust properties and conceptual framework was considered. Two independent reviewers screened the abstracts and full-text articles and review bibliographies for further references. Data were extracted using standardized forms and study risk of bias was assessed. Result: The review highlights the psychometric properties of AAC assessment tools that can be used by speech-language therapists applicable to be used in the Malaysian context. The work outlines how systematic review methods may be applied to the consideration of published material that provides valuable data to initiate the development of Malay Language AAC assessment tools. Conclusion: The synthesis of evidence has provided a framework for Malaysia Speech-Language therapists in making an informed decision for AAC intervention in our standard operating procedure in the Ministry of Health, Malaysia.

Keywords: augmentative and alternative communication, assessment, adolescents, complex communication needs

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63 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study

Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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62 Identifying the Determinants of the Shariah Non-Compliance Risk via Principal Axis Factoring

Authors: Muhammad Arzim Naim, Saiful Azhar Rosly, Mohamad Sahari Nordin

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The objective of this study is to investigate the factors affecting the rise of Shariah non-compliance risk that can bring Islamic banks to succumb to monetary loss. Prior literatures have never analyzed such risk in details despite lots of it arguing on the validity of some Shariah compliance products. The Shariah non-compliance risk in this context is looking to the potentially failure of the facility to stand from the court test say that if the banks bring it to the court for compensation from the defaulted clients. The risk may also arise if the customers refuse to make the financing payments on the grounds of the validity of the contracts, for example, when relinquishing critical requirement of Islamic contract such as ownership, the risk that may lead the banks to suffer loss when the customer invalidate the contract through the court. The impact of Shariah non-compliance risk to Islamic banks is similar to that of legal risks faced by the conventional banks. Both resulted into monetary losses to the banks respectively. In conventional banking environment, losses can be in the forms of summons paid to the customers if they won the case. In banking environment, this normally can be in very huge amount. However, it is right to mention that for Islamic banks, the subsequent impact to them can be rigorously big because it will affect their reputation. If the customers do not perceive them to be Shariah compliant, they will take their money and bank it in other places. This paper provides new insights of risks faced by credit intensive Islamic banks by providing a new extension of knowledge with regards to the Shariah non-compliance risk by identifying its individual components that directly affecting the risk together with empirical evidences. Not limited to the Islamic banking fraternities, the regulators and policy makers should be able to use findings in this paper to evaluate the components of the Shariah non-compliance risk and make the necessary actions. The paper is written based on Malaysia’s Islamic banking practices which may not directly related to other jurisdictions. Even though the focuses of this study is directly towards to the Bay Bithaman Ajil or popularly known as BBA (i.e. sale with deferred payments) financing modality, the result from this study may be applicable to other Islamic financing vehicles.

Keywords: Islamic banking, Islamic finance, Shariah Non-compliance risk, Bay Bithaman Ajil (BBA), principal axis factoring

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61 Primary Health Care Vital Signs Profile in Malaysia: Challenges and Opportunities

Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

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Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

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60 Distribution of Malaria-Infected Anopheles Mosquitoes in Kudat, Ranau and Tenom of Sabah, Malaysia

Authors: Ahmad Fakhriy Hassan, Rohani Ahmad, Zurainee Mohamed Nor, Wan Najdah Wan Mohamad Ali

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In Malaysia, it was realized that while the incidence of human malaria is decreasing, the incidence of Plasmodium knowlesi malaria appears to be on the rise, especially in rural areas of Sabah, East Malaysia. The primary vector for P. knowlesi malaria in Sabah is An. balabacensis a species found abundant in rural areas, shown to rest and feed outdoor throughout the night, which makes its control very challenging. This study aims to examine the distribution of malaria-infected Anopheles mosquitoes in three areas in Sabah, namely Kudat, Ranau, and Tenom, known as areas in Sabah that presented high number of malaria cases. Briefly, mosquitoes were caught every 6 weeks for the period of 18 months using Human Landing Catching (HLC) technique from May 2016 to November 2017. Identification of species was done using microscopy and molecular methods. Molecular method is also used to detect malaria parasite in all mosquito collected. An. balabacensis was present in all the study areas. In Kudat, six other Anopheles species were also detected, namely, An. barumbrosus, An. latens, An. letifer, An. maculatus, An. sundaicus and An. tesselatus. In Ranau five other Anopheles species were detected, namely, An. barumbrosus, An. donaldi., An. hodgkini, An. maculatus, and An. tesselatus while in Tenom seven more species An. donaldi, An. umbrosus, An. barumbrosus, An.latens, An. hodgkini, An. maculatus, and An. tesselatus were detected. This study showed 24% out of 259, 39% out of 127, and 26% out of 265 Anopheles mosquito collected in Kudat, Ranau, and Tenom were detected positive for malaria parasite respectively. In Kudat An. balabacensis, An. barumbrosus, An. latens, An. maculatus, An. sundaicus and An. tesselatus were the six out of eight Anopheles species that were found infected with malaria parasite. All Anopheles species collected in Ranau were positive for malaria while In Tenom, only five out of eight species; An. balabacensus, An. donaldi, An. hodgkini, An. maculatus, and An. latens were detected positive for malaria parasite. Interestingly, for all study areas An. balabacensis was shown to be the only species infected with four malaria species; P. falciparum, P. knowlesi, P. vivax, and Plasmodium sp. This finding clearly indicates that An. balabacensis is the dominant malaria vector in Kudat, Ranau, and Tenom.

Keywords: Anopheles balabacensis, human landing catching technique, nested PCR, Plasmodium knowlesi, Simian malaria

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59 The Effect of Different Parameters on a Single Invariant Lateral Displacement Distribution to Consider the Higher Modes Effect in a Displacement-Based Pushover Procedure

Authors: Mohamad Amin Amini, Mehdi Poursha

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Nonlinear response history analysis (NL-RHA) is a robust analytical tool for estimating the seismic demands of structures responding in the inelastic range. However, because of its conceptual and numerical complications, the nonlinear static procedure (NSP) is being increasingly used as a suitable tool for seismic performance evaluation of structures. The conventional pushover analysis methods presented in various codes (FEMA 356; Eurocode-8; ATC-40), are limited to the first-mode-dominated structures, and cannot take higher modes effect into consideration. Therefore, since more than a decade ago, researchers developed enhanced pushover analysis procedures to take higher modes effect into account. The main objective of this study is to propose an enhanced invariant lateral displacement distribution to take higher modes effect into consideration in performing a displacement-based pushover analysis, whereby a set of laterally applied displacements, rather than forces, is monotonically applied to the structure. For this purpose, the effect of different parameters such as the spectral displacement of ground motion, the modal participation factor, and the effective modal participating mass ratio on the lateral displacement distribution is investigated to find the best distribution. The major simplification of this procedure is that the effect of higher modes is concentrated into a single invariant lateral load distribution. Therefore, only one pushover analysis is sufficient without any need to utilize a modal combination rule for combining the responses. The invariant lateral displacement distribution for pushover analysis is then calculated by combining the modal story displacements using the modal combination rules. The seismic demands resulting from the different procedures are compared to those from the more accurate nonlinear response history analysis (NL-RHA) as a benchmark solution. Two structures of different heights including 10 and 20-story special steel moment resisting frames (MRFs) were selected and evaluated. Twenty ground motion records were used to conduct the NL-RHA. The results show that more accurate responses can be obtained in comparison with the conventional lateral loads when the enhanced modal lateral displacement distributions are used.

Keywords: displacement-based pushover, enhanced lateral load distribution, higher modes effect, nonlinear response history analysis (NL-RHA)

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58 Burnout and Salivary Cortisol Among Laboratory Personnel in Klang Valley, Malaysia During COVID-19 Pandemic

Authors: Maznieda Mahjom, Rohaida Ismail, Masita Arip, Mohd Shaiful Azlan, Nor’Ashikin Othman, Hafizah Abdullah, nor Zahrin Hasran, Joshita Jothimanickam, Syaqilah Shawaluddin, Nadia Mohamad, Raheel Nazakat, Tuan Mohd Amin, Mizanurfakhri Ghazali, Rosmanajihah Mat Lazim

Abstract:

COVID-19 outbreak is particularly detrimental to the mental health of everyone as well as leaving a long devastating crisis in the healthcare sector. Daily increment of COVID-19 cases and close contact, necessitating the testing of a large number of samples, thus increasing the workload and burden to laboratory personnel. This study aims to determine the prevalence of personal-, work- and client-related burnout as well as to measure the concentration of salivary cortisol among laboratory personnel in the main laboratories in Klang Valley, Malaysia. This cross-sectional study was conducted in late 2021 and recruited a total of 404 respondents from three laboratories in Klang Valley, Malaysia. The level of burnout was assessed using Copenhagen Burnout Inventory (CBI) comprising three sub-dimensions of personal-, work- and client-related burnout. The cut-off score of 50% and above indicated possible burnout. Meanwhile, salivary cortisol was measured using a competitive enzyme immunoassay kit (Salimetrics, State College, PA, USA). Normal levels of salivary cortisol concentration in adults are within 0.094 to 1.551 μg/dl (morning) and can be none detected to 0.359 μg/dl (evening). The prevalence of personal-, work- and client-related burnout among laboratory personnel were 36.1%, 17.8% and 7.2% respectively. Meanwhile, the abnormal morning and evening cortisol concentration recorded were 29.5% and 21.8% excluding 6.9%-7.4% missing data. While the IgA level is normal for most of the respondents, which recorded at 95.53%. Laboratory personnel were at risk of suffering burnout during the COVID-19 pandemic. Thus, mental health programs need to be addressed at the department and hospital level by regularly screening healthcare workers and designing an intervention program. It is also vital to improve the coping skills of laboratory personnel by increasing the awareness of good coping skill techniques. The training must be in an innovative way to ensure that the lab personnel can internalise the technique and practise it in real life.

Keywords: burnout, COVID-19, laborotary personnel, salivary cortisol

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57 Positivity Rate of Person under Surveillance among Institut Jantung Negara’s Patients with Various Vaccination Statuses in the First Quarter of 2022, Malaysia

Authors: Mohd Izzat Md. Nor, Norfazlina Jaffar, Noor Zaitulakma Md. Zain, Nur Izyanti Mohd Suppian, Subhashini Balakrishnan, Geetha Kandavello

Abstract:

During the Coronavirus (COVID-19) pandemic, Malaysia has been focusing on building herd immunity by introducing vaccination programs into the community. Hospital Standard Operating Procedures (SOP) were developed to prevent inpatient transmission. Objective: In this study, we focus on the positivity rate of inpatient Person Under Surveillance (PUS) becoming COVID-19 positive and compare this to the National rate in order to see the outcomes of the patient who becomes COVID-19 positive in relation to their vaccination status. Methodology: This is a retrospective observational study carried out from 1 January until 30 March 2022 in Institut Jantung Negara (IJN). There were 5,255 patients admitted during the time of this study. Pre-admission Polymerase Chain Reaction (PCR) swab was done for all patients. Patients with positive PCR on pre-admission screening were excluded. The patient who had exposure to COVID-19-positive staff or patients during hospitalization was defined as PUS and were quarantined and monitored for potential COVID-19 infection. Their frequency and risk of exposure (WHO definition) were recorded. A repeat PCR swab was done for PUS patients that have clinical deterioration with or without COVID symptoms and on their last day of quarantine. The severity of COVID-19 infection was defined as category 1-5A. All patients' vaccination status was recorded, and they were divided into three groups: fully immunised, partially immunised, and unvaccinated. We analyzed the positivity rate of PUS patients becoming COVID-positive, outcomes, and correlation with the vaccination status. Result: Total inpatient PUS to patients and staff was 492; only 13 became positive, giving a positivity rate of 2.6%. Eight (62%) had multiple exposures. The majority, 8/13(72.7%), had a high-risk exposure, and the remaining 5 had medium-risk exposure. Four (30.8%) were boostered, 7(53.8%) were fully vaccinated, and 2(15.4%) were partial/unvaccinated. Eight patients were in categories 1-2, whilst 38% were in categories 3-5. Vaccination status did not correlate with COVID-19 Category (P=0.641). One (7.7%) patient died due to COVID-19 complications and sepsis. Conclusion: Within the first quarter of 2022, our institution's positivity rate (2.6%) is significantly lower than the country's (14.4%). High-risk exposure and multiple exposures to positive COVID-19 cases increased the risk of PUS becoming COVID-19 positive despite their underlying vaccination status.

Keywords: COVID-19, boostered, high risk, Malaysia, quarantine, vaccination status

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56 Investigation of Leishmaniasis, Babesiosis, Ehrlichiosis, Dirofilariasis, and Hepatozoonosis in Referred Dogs to Veterinary Hospitals in Tehran, 2022

Authors: Mohamad Bolandmartabe, Nafiseh Hassani, Saeed Abdi Darake, Maryam Asghari

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Dogs are highly susceptible to diseases, nutritional problems, toxins, and parasites, with parasitic infections being common and causing hardship in their lives. Some important internal parasites include worms (such as roundworms and tapeworms) and protozoa, which can lead to anemia in dogs. Important bloodborne parasites in dogs include microfilariae and adult forms of Dirofilaria immitis, Dipetalonema reconditum, Babesia, Trypanosoma, Hepatozoon, Leishmania, Ehrlichia, and Hemobartonella. Babesia and Hemobartonella are parasites that reside inside red blood cells and cause regenerative anemia by directly destroying the red blood cells. Hepatozoon, Leishmania, and Ehrlichia are also parasites that reside within white blood cells and can infiltrate other tissues, such as the liver and lymph nodes. Since intermediate hosts are more commonly found in the open environment, the prevalence of parasites in stray and free-roaming dogs is higher compared to pet dogs. Furthermore, pet dogs are less exposed to internal and external parasites due to better care, hygiene, and being predominantly indoors. Therefore, they are less likely to be affected by them. Among the parasites, Leishmania carries significant importance as it is shared between dogs and humans, causing a dangerous disease known as visceral Leishmaniasis or kala-azar and cutaneous Leishmaniasis. Furthermore, dogs can act as reservoirs and spread the disease agent within human communities. Therefore, timely and accurate diagnosis of these diseases in dogs can be highly beneficial in preventing their occurrence in humans. In this article, we employed the Giemsa staining technique under a light microscope for the identification of bloodborne parasites in dogs. However, considering the negative impact of these parasites on the natural life of dogs, the development of chronic diseases, and the gradual loss of the animal's well-being, rapid and timely diagnosis is essential. Serological methods and PCR are available for the diagnosis of certain parasites, which have high sensitivity and desirable characteristics. Therefore, this research aims to investigate the molecular aspects of bloodborne parasites in dogs referred to veterinary hospitals in Tehran city.

Keywords: leishmaniasis, babesiosis, ehrlichiosis, dirofilariasis, hepatozoonosis

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