Search results for: metabolic syndrome change

Authors: Yun Chen, David Penton, Fazlul Karim, Santosh Aryal, Shahriar Wahid, Peter Taylor, Susan M. Cuddy

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Droughts have severely affected Afghanistan over the last four decades, leading to critical food shortages where two-thirds of the country’s population are in a food crisis. Long years of conflict have lowered the country’s ability to deal with hazards such as drought, which can rapidly escalate into disasters. Understanding the spatial and temporal distribution of droughts is needed to be able to respond effectively to disasters and plan for future occurrences. This study used Standardized Precipitation Evapotranspiration Index (SPEI) at monthly, seasonal, and annual temporal scales to map the spatiotemporal change dynamics of drought characteristics (distribution, frequency, duration, and severity) in Afghanistan. SPEI indices were mapped for river basins, disaggregated into 189 sub-catchments, using monthly precipitation and potential evapotranspiration derived from temperature station observations from 1980 to 2017. The results show these multi-dimensional drought characteristics vary along different years, change among sub-catchments, and differ across temporal scales. During the 38 years, the driest decade and period are the 2000s and 1999–2022, respectively. The 2000–01 water year is the driest, with the whole country experiencing ‘severe’ to ‘extreme’ drought, more than 53% (87 sub-catchments) suffering the worst drought in history, and about 58% (94 sub-catchments) having ‘very frequent’ drought (7 to 8 months) or ‘extremely frequent’ drought (9 to 10 months). The estimated seasonal duration and severity present significant variations across the study area and throughout the study period. The nation also suffered from recurring droughts with varying length and intensity in 2004, 2006, 2008, and, most recently, 2011. There is a trend towards increasing drought with longer duration and higher severity extending all over sub-catchments from southeast to north and central regions. These datasets and maps help to fill the knowledge gap on detailed sub-catchment scale meteorological drought characteristics in Afghanistan. The study findings improve our understanding of the influences of climate change on drought dynamics and can guide catchment planning for reliable adaptation to and mitigation against future droughts.

Keywords: SPEI, precipitation, evapotranspiration, climate extremes

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Authors: Hossein Edrisi

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To study the impact of the amount and volume of power of isolation transformer on the lamps in airfield Ground Lighting Systems. A test was conducted in Persian Gulf International Airport, This airport is situated in the south of Iran and it is one of the most cutting-edge airports, the same one that owns modern devices. Iran uses materials and auxiliary equipment which are made by ADB Company from Belgium. Airfield ground lighting (AGL) systems are responsible for providing visual issue to aircrafts and helicopters in the runways. In an AGL system a great deal of lamps are connected in serial circuits to each other and each ring has its individual constant current regulators (CCR), which through that provide energy to the lamps. Control of lamps is crucial for maintenance and operation in the AGL systems. Thanks to the Programmable Logic Controller (PLC) that is a cutting-edge technology can help the system to connect the elements from substations and ATC (TOWER). For this purpose, a test in real conditions of the airport done for all element that used in the airport such as isolation transformer in different power capacity and different consuming power and brightness of the lamps. The data were analyzed with Lux meter and Multimeter. The results had shown that the increase in the power of transformer caused a significant increase in brightness. According to the Ohm’s law and voltage division, without changing the characteristics of the light bulb, it is not possible to change the voltage, just need to change the amount of transformer with which it connects to the lamps. When the voltage is increased, the current through the bulb has to increase as well, because of Ohm's law: I=V/R and I=V/R which means that if V increases, so do I increase. The output voltage on the constant current regulator emerges between the lamps and the transformers.

Keywords: AGL, CCR, lamps, transformer, Ohm’s law

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Authors: Eleni Karantzola, Athanasios Karasimos, Vasiliki Makri, Ioanna Skouvara

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Historical linguistics unveils the historical depth of languages and traces variation and change by analyzing linguistic variables over time. This field of linguistics usually deals with a closed data set that can only be expanded by the (re)discovery of previously unknown manuscripts or editions. In some cases, it is possible to use (almost) the entire closed corpus of a language for research, as is the case with the Thesaurus Linguae Graecae digital library for Ancient Greek, which contains most of the extant ancient Greek literature. However, concerning ‘dynamic’ periods when the production and circulation of texts in printed as well as manuscript form have not been fully mapped, representative samples and corpora of texts are needed. Such material and tools are utterly lacking for Early Modern Greek (16th-18th c.). In this study, the principles of the creation of EMoGReC, a pilot representative corpus of Early Modern Greek (16th-18th c.) are presented. Its design follows the fundamental principles of historical corpora. The selection of texts aims to create a representative and balanced corpus that gives insight into diachronic, diatopic and diaphasic variation. The pilot sample includes data derived from fully machine-readable vernacular texts, which belong to 4-5 different textual genres and come from different geographical areas. We develop a hierarchical linguistic annotation scheme, further customized to fit the characteristics of our text corpus. Regarding variables and their variants, we use as a point of departure the bundle of twenty-four features (or categories of features) for prose demotic texts of the 16th c. Tags are introduced bearing the variants [+old/archaic] or [+novel/vernacular]. On the other hand, further phenomena that are underway (cf. The Cambridge Grammar of Medieval and Early Modern Greek) are selected for tagging. The annotated texts are enriched with metalinguistic and sociolinguistic metadata to provide a testbed for the development of the first comprehensive set of tools for the Greek language of that period. Based on a relational management system with interconnection of data, annotations, and their metadata, the EMoGReC database aspires to join a state-of-the-art technological ecosystem for the research of observed language variation and change using advanced computational approaches.

Keywords: early modern Greek, variation and change, representative corpus, diachronic variables.

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Authors: Talha Khan, Surendhar Kumaran, Rajeev Nair

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The development of economical, efficient, and reliable next-generation thermal and water management systems to provide efficient cooling and water management technologies is being pursued application in compact and lightweight spacecraft. The elimination of liquid-vapor phase change-based thermal and water management systems is being done due to issues with the reliability and robustness of this technology. To achieve the motive of implementing the principle of using an innovative evaporator and condenser design utilizing bimodal wicks manufactured using a microsecond pulsed CO₂ laser has been proposed in this study. Cylin drical, multilayered capillary copper wicks with a substrate diameter of 39 mm are additively manufactured using a pulsed laser. The copper particles used for layer-by-layer addition on the substrate measure in a diameter range of 225 to 450 micrometers. The primary objective is to develop a novel, high-quality, fast turnaround, laser-based additive manufacturing process that will eliminate the current technical challenges involved with the traditional manufacturing processes for nano/micro-sized powders, like particle agglomeration. Raster-scanned, pulsed-laser sintering process has been developed to manufacture 3D wicks with controlled porosity and permeability.

Keywords: liquid-vapor phase change, bimodal wicks, multilayered, capillary, raster-scanned, porosity, permeability

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Authors: Sormeh Sharifi, Wasim Saman, Alemu Alemu, David Whaley

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Although various energy rating schemes and compulsory building codes are using around the world, there are increasing reports on overheating in energy efficient dwellings. Given that the cooling demand of buildings is rising globally because of the climate change, it is more likely that the overheating issue will be observed more. This paper studied the summer indoor temperature in eight air-conditioned multi-level houses in Adelaide which have complied with the Australian Nationwide Houses Energy Rating Scheme (NatHERS) minimum energy performance of 7.5 stars. Through monitored temperature, this study explores that overheating is experienced on 75.5% of top floors during cooling periods while the air-conditioners were running. This paper found that the energy efficiency regulations have significantly improved thermal comfort in low floors, but not on top floors, and the energy-efficient house is not necessarily adapted with the air temperature fluctuations particularly on top floors. Based on the results, this study suggests that the envelope of top floors for multi-level houses in South Australian context need new criteria to make the top floor more heat resistance in order to: preventing the overheating, reducing the summer pick electricity demand and providing thermal comfort. Some methods are used to improve the envelope of the eight case studies. The results demonstrate that improving roofs was the most effective part of the top floors envelope in terms of reducing the overheating.

Keywords: building code, climate change, energy-efficient building, energy rating, overheating, thermal comfort

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Authors: Jhoga Parth, T. Nasar, K. V. Anand

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An idealized definition of shoreline is that it is the zone of coincidence of three spheres such as atmosphere, lithosphere, and hydrosphere. Despite its apparent simplicity, this definition in practice a challenge to apply. In reality, the shoreline location deviates continually through time, because of various dynamic factors such as wave characteristics, currents, coastal orientation and the bathymetry, which makes the shoreline volatile. This necessitates us to monitor the shoreline in a temporal basis. If shoreline’s nature is understood at particular coastal stretch, it need not be the same trend at the other location, though belonging to the same sea front. Shoreline change is hence a local phenomenon and has to be studied with great intensity considering as many factors involved as possible. Erosion and accretion of sediment are such natures of a shoreline, which needs to be quantified by comparing with its predeceasing variations and understood before implementing any coastal projects. In recent years, advent of Global Positioning System (GPS) and Geographic Information System (GIS) acts as an emerging tool to quantify the intra and inter annual sediment rate getting accreted or deposited compared to other conventional methods in regards with time was taken and man power. Remote sensing data, on the other hand, paves way to acquire historical sets of data where field data is unavailable with a higher resolution. Short term and long term period shoreline change can be accurately tracked and monitored using a software residing in GIS - Digital Shoreline Analysis System (DSAS) developed by United States Geological Survey (USGS). In the present study, using DSAS, End Point Rate (EPR) is calculated analyze the intra-annual changes, and Linear Rate Regression (LRR) is adopted to study inter annual changes of shoreline. The shoreline changes are quantified for the scenario during the construction of breakwater in Ponnani river inlet along Kerala coast, India. Ponnani is a major fishing and landing center located 10°47’12.81”N and 75°54’38.62”E in Malappuram district of Kerala, India. The rate of erosion and accretion is explored using satellite and field data. The full paper contains the rate of change of shoreline, and its analysis would provide us understanding the behavior of the inlet at the study area during the construction of the training walls.

Keywords: DSAS, end point rate, field measurements, geo-informatics, shoreline variation

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Authors: Xiao L Dai, Wen X Wei, Shuo Wang, Jia B Li, Yan Wei

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Heavy oil pollution generated from both natural and anthropogenic sources could cause significant damages to the ecological environment, due to the toxicity of some of its constituents. Nowadays, microbial remediation is becoming a promising technology to treat oil pollution owing to its low cost and prevention of secondary pollution; microorganisms are key players in the process. Compared to the free microorganisms, immobilized microorganisms possess several advantages, including high metabolic activity rates, strong resistance to toxic chemicals and natural competition with the indigenous microorganisms, and effective resistance to washing away (in open water system). Many immobilized microorganisms have been successfully used for bioremediation of heavy oil pollution. Considering the broad choices, low cost, simple process, large specific surface area and less impact on microbial activity, modified zeolite were selected as a bio-carrier for bacteria immobilization. Three strains of heavy oil-degrading bacteria Bacillus sp. DL-13, Brevibacillus sp. DL-1 and Acinetobacter sp. DL-34 were immobilized on the modified zeolite under mild conditions, and the bacterial load (bacteria /modified zeolite) was 1.12 mg/g, 1.11 mg/g, and 1.13 mg/g, respectively. SEM results showed that the bacteria mainly adsorbed on the surface or punctured in the void of modified zeolite. The heavy oil degradation efficiency of immobilized bacteria was 62.96%, higher than that of the free bacteria (59.83%). The heavy oil degradation process of immobilized bacteria accords with the first-order reaction equation, and the reaction rate constant is 0.1483 d⁻¹, which was significantly higher than the free bacteria (0.1123 d⁻¹), suggesting that the immobilized bacteria can rapidly start up the heavy oil degradation and has a high activity of heavy oil degradation. The results suggested that immobilized bacteria are promising technology for bioremediation of oil pollution.

Keywords: heavy oil pollution, microbial remediation, modified zeolite, immobilized bacteria

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Authors: Cangir Uyarlar, E. Eren Gultepe, I. Sadi Cetingul, Ismail Bayram

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This study was conducted to investigate the effect of humic acid (Potassium Humate) at different levels on rations on the effects of both maternal and offspring health, metabolic parameters and immunity levels in transition dairy cows. For this purpose, 50 Holstein dairy cows divided 5 trial groups. Experimental groups were designed as follows: A) Control (0% Humas); B) 0.5 Humas (0,5% in concentrated diet); C) 1 Humas (1% in concentrated diet), D) 1,5 Humas (1,5% in concentrated diet), E) 2 Humas (2% in concentrated diet), respectively. The study lasted from the first day of the dry period to postpartum 30th day. Diets were prepared as isocaloric and isonitrogenic. In the experiment, the day on which the animals gave birth was accepted as ‘0 (zero)’ and blood was taken from tail vein (v. coccygea) at -60, -53, -46, -39, -32, -25, -18, -11, -4, 0, ; Colostrum samples were taken on days 0, 1 and 2; Blood samples were taken on days 0, 1, 2, 15 and 30 from the juguler vein (v. jugularis) of the new born calves. Total blood leukocyte, Lymphocyte, Monocyte, granulocytes, Hemoglobin, Hematocrit, MCV, MCH, MWC, RDW, PLT, MPV, PDW, PCT, NEFA, BHBA, Glucose, Total Cholesterol , Triglyceride, LDL, HDL, VLDL, ALT, AST, ALP, GGT and Total IgG levels and colostrum IgG levels were determined in this experiment. The results suggest that although the supplementation of humic acid at 2% level adversely affected to production parameters, the addition of humic acid (potassium humate) to the concentrate mix during the dry period (particularly 0.5 and 1% levels) may provide an increasing on mother and the offspring immunity, some improving on serum metabolism parameters and enhancing the milk production.

Keywords: humic acid, dairy cow, calf, immunity

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Authors: Hassan Karimi, Fred Piercy, Ruoxi Chen, Ana L. Jaramillo-Sierra, Wei-Ning Chang, Manjushree Palit, Catherine Martosudarmo, Angelito Antonio

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Background: The two psychotherapy camps, the randomized clinical trials (RCTs) and the common factors model, have competitively claimed specific explanations for therapy effectiveness. Recently, scholars called for empirical evidence to show the role of common factors in therapeutic outcome in marriage and family therapy. Purpose: This cross-national study aims to explore how clinicians, across different nations and theoretical orientations, attribute the contribution of common factors to therapy outcome. Method: A brief common factors questionnaire (CFQ-with a Cronbach’s Alpha, 0.77) was developed and administered in seven nations. A series of statistical analyses (paired-samples t-test, independent sample t-test, ANOVA) were conducted: to compare clinicians perceived contribution of total common factors versus model-specific factors, to compare each pair of common factors’ categories, and to compare clinicians from collectivistic nations versus clinicians from individualistic nation. Results: Clinicians across seven nations attributed 86% to common factors versus 14% to model-specific factors. Clinicians attributed 34% of therapeutic change to client’s factors, 26% to therapist’s factors, 26% to relationship factors, and 14% to model-specific techniques. The ANOVA test indicated each of the three categories of common factors (client 34%, therapist 26%, relationship 26%) showed higher contribution in therapeutic outcome than the category of model specific factors (techniques 14%). Clinicians with psychology degree attributed more contribution to model-specific factors than clinicians with MFT and counseling degrees who attributed more contribution to client factors. Clinicians from collectivistic nations attributed larger contributions to therapist’s factors (M=28.96, SD=12.75) than the US clinicians (M=23.22, SD=7.73). The US clinicians attributed a larger contribution to client’s factors (M=39.02, SD=1504) than clinicians from the collectivistic nations (M=28.71, SD=15.74). Conclusion: The findings indicate clinicians across the globe attributed more than two thirds of therapeutic change to CFs, which emphasize the training of the common factors model in the field. CFs, like model-specific factors, vary in their contribution to therapy outcome in relation to specific client, therapist, problem, treatment model, and sociocultural context. Sociocultural expectations and norms should be considered as a context in which both CFs and model-specific factors function toward therapeutic goals. Clinicians need to foster a cultural competency specifically regarding the divergent ways that CFs can be activated due to specific sociocultural values.

Keywords: common factors, model-specific factors, cross-national survey, therapist cultural competency, enhancing therapist efficacy

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Authors: Mebrahtu Haile

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Fuels obtained from renewable resources have garnered significant enthusiasm in recent decades due to concerns about fossil fuel depletion and climate change. This study aimed to investigate the potential of Prosopis juliflora pods mash for bio-ethanol production and its hydrolysis solid waste for solid fuel. Various parameters, such as acid concentration, hydrolysis times, fermentation times, fermentation temperature, and pH, were evaluated for their impact on bio-ethanol production using Saccharomyces cerevisiae yeast. The results showed that increasing acid concentration (up to 1 molar H₂SO₄) led to an increase in sugar content, reaching a maximum of 96.13%v/v. Optimal conditions for bio-ethanol production were found at 1 molar H₂SO₄ concentration (4.2%v/v), 48 hours fermentation time (5.1%v/v), 20 minutes hydrolysis time (5.57%v/v), 30°C fermentation temperature (5.57%v/v), and pH 5 (6.01%v/v), resulting in a maximum bio-ethanol yield of 6.01%v/v. The solid waste remaining after bio-ethanol production exhibited potential for use as a solid fuel, with a calorific value of 18.22 MJ/kg. These findings demonstrate the promising potential of Prosopis juliflora pods mash for bio-ethanol production and suggest a viable solution for addressing disposal challenges associated with solid waste, contributing to the exploration of renewable fuel sources in the face of fossil fuel depletion and climate change.

Keywords: prosopis juliflora, pods mash, invasive species, bio-ethanol, fermentation, Saccharomyces cerevisiae, solid fuel

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Authors: Saker Lilia, Youcef Mellouki, Lakhdar Sellami, Yacine Zerairia, Abdelhaid Zetili, Fatma Guahria, Fateh Kaious, Nesrine Belkhodja, Abdelhamid Mira

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Background: Sudden death is regarded as a suspicious demise necessitating autopsy, as stipulated by legal authorities. Chronic disseminated intravascular coagulation (DIC) is an acquired clinical and biological syndrome characterized by a severe and fatal prognosis, stemming from systemic, uncontrolled, diffuse coagulation activation. Irrespective of their origins, DIC is associated with a diverse spectrum of manifestations, encompassing minor biological coagulation alterations to profoundly severe conditions wherein hemorrhagic complications may take precedence. Simultaneously, microthrombi contribute to the development of multi-organ failures. Objective This study seeks to evaluate the role of autopsy in determining the causes of death. Materials and Methods: We present two instances of sudden death involving females who underwent autopsy at the Forensic Medicine Department of the University Hospital of Annaba, Algeria. These autopsies were performed at the request of the prosecutor, aiming to determine the causes of death and illuminate the exact circumstances surrounding it. Methods Utilized: Analysis of the initial information report; Findings from postmortem examinations; Histological assessments and toxicological analyses. Results: The presence of DIC was noted, affecting nearly all veins with distinct etiologies. Conclusion: For the establishment of a meaningful diagnosis: • Thorough understanding of the subject matter is imperative; • Precise alignment with medicolegal data is essential.

Keywords: chronic disseminated intravascular coagulation, sudden death, autopsy, causes of death

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Authors: Aliasghar Golmohammadian, Sona Rostampour Yasouri

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One of the most important intestinal pathogenic strains is E. coli O₁₅₇:H₇. This pathogenic bacterium is transmitted to humans through water and food. E. coli O₁₅₇:H₇ is the main cause of Hemorrhagic colitis (HC), Hemolytic Uremic Syndrome (HUS), Thrombotic Thrombocytopenic Purpura (TTP) and in some cases death. Since E. coli O₁₅₇:H₇ can be transmitted through the consumption of different foods, including vegetables, agricultural products, and fresh dairy products, this study aims to identify and isolate E. coli O₁₅₇:H₇ from wastewater by PCR technique. One hundred twenty samples of water and wastewater were collected by Falcom Sterile from Shahrood and Neka cities. The samples were checked for colony formation after appropriate centrifugation and cultivation in the specific medium of Sorbitol MacConkey Agar (SMAC) and other diagnostic media of E. coli O₁₅₇:H₇. Also, the plates were observed macroscopically and microscopically. Then, the necessary phenotypic tests were performed on the colonies, and finally, after DNA extraction, the PCR technique was performed with specific primers related to rfbE and stx2 genes. The number of 5 samples (6%) out of all the samples examined were determined positive by PCR technique with observing the bands related to the mentioned genes on the agarose gel electrophoresis. PCR is a fast and accurate method to identify the bacteria E. coli O₁₅₇:H₇. Considering that E. coli bacteria is a resistant bacteria and survives in water and food for weeks and months, the PCR technique can provide the possibility of quick detection of contaminated water. Moreover, it helps people in the community control and prevent the transfer of bacteria to healthy and underground water and agricultural and even dairy products.

Keywords: E. coli O₁₅₇:H₇, PCR, water, wastewater

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Authors: Neha Singh, Anshuman Rana

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Gender-Based Violence (GBV) is a violation of human rights and a form of discrimination which reinforces inequalities between men and women. It is defined as violence that is directed against a person on the basis of gender. There has been increased attention to human trafficking that has exposed to illegal migration. Trafficking is complex, but it generally takes place due to “push and pull factors”. India is both a source as well as a transit country for trafficking. Women are bought and sold with impunity and trafficked to other countries. They are forced to work as sex worker, forced labour and other practices of slavery. Trafficked victims often suffer from serious abuse and physical exhaustion. The effects of violence on women vary widely. GBV typically has physical, psychological and social effects. They face unwanted pregnancies, miscarriages, high rate of infertility and sexually transmitted disease. The social exclusion of women is so great that it constitutes a new form of apartheid. Women are considered as lesser value and deprived of their fundamental rights. Violation of human rights and fundamental freedom such as- trafficking of women, girls for sex trade, forced prostitution and sex tourism have become the focus of internationally organized crimes. My paper will analyse the impact of violence on society as well. Law alone cannot change the scenario and problem of gender-biasness. The whole issue of gender violence needs social awakening and change in attitude of masses, so that due respect and equal status is given to women.

Keywords: gender-based violence, trafficking, migration, violence impact, social exclusion, law enforcement

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Authors: Mohammad K. Abedin, Mohammad Shahjahan, Zeenat Sultana, Tawfique Jahan, Jesmin Akter

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To strengthen social and behavior change communication (SBCC) capacity of Ministry of Health and Family Welfare (MoHFW) of the Government of Bangladesh, BCCP/BKMI developed two eLearning courses providing opportunities for professional development of SBCC Program Managers who have no access to training or refreshers training. The two eLearning courses – Message and Material Development (MMD) and Monitoring and Evaluation (MandE) of SBCC programs – went online in September 2015, where all users could register their participation so results could be monitored. Methodology: To assess the uses of these courses a randomly selected sample was collected to run a pre and post-test analyses and a phone survey were conducted. Systematic random sampling was used to select a sample of 75 MandE and 25 MMD course participants from a sampling frame of 179 and 51 respectively. Results: As of September 2016, more than 179 learners have completed the MandE course, and 49 learners have completed the MMD course. The users of these courses are program managers, university faculty members, and students. Encouraging results were revealed from the analysis of pre and post-test scores and a phone survey three months after course completion. Test scores suggested a substantial increase in knowledge. The pre-test scores findings suggested that about 19% learners scored high on the MandE. The post-test scores finding indicated a high score (92%) of the sample across 4 modules of MandE. For MMD course in pre-test scoring, 30% of the learners scored high, and 100% scored high at the post-test. It was found that all the learners in the phone survey have discussed the courses. Most of the sharing occurred with colleagues and friends, usually through face to face (70%) interaction. The learners reported that they did recommend the two courses to concerned people. About 67% MandE and 76% MMD learners stated that the concepts that they had to learn during the course were put into practice in their work settings. The respondents for both MandE and MMD courses have provided a valuable set of suggestions that would further strengthen the courses. Conclusions: The study showed that the initiative offered ample opportunities to build capacity in various ways in which the eLearning courses were used. It also highlighted the importance of scaling up these efforts to further strengthen the outcomes.

Keywords: e-learning course, message & material development, monitoring & evaluation, social and behavior change communication

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Authors: Ippei Torii, Kaoruko Ohtani, Takahito Niwa, Naohiro Ishii

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This paper shows developing an objectivity index using the measurement of subtle eyeball movement to diagnose autism. The developmentally disabled assessment varies, and the diagnosis depends on the subjective judgment of professionals. Therefore, a supplementary inspection method that will enable anyone to obtain the same quantitative judgment is needed. The diagnosis are made based on a comparison of the time of gazing an object in the conventional autistic study, but the results do not match. First, we divided the pupil into four parts from the center using measurements of subtle eyeball movement and comparing the number of pixels in the overlapping parts based on an afterimage. Then we developed the objective evaluation indicator to judge non-autistic and autistic people more clearly than conventional methods by analyzing the differences of subtle eyeball movements between the right and left eyes. Even when a person gazes at one point and his/her eyeballs always stay fixed at that point, their eyes perform subtle fixating movements (ie. tremors, drifting, microsaccades) to keep the retinal image clear. Particularly, the microsaccades link with nerves and reflect the mechanism that process the sight in a brain. We converted the differences between these movements into numbers. The process of the conversion is as followed: 1) Select the pixel indicating the subject's pupil from images of captured frames. 2) Set up a reference image, known as an afterimage, from the pixel indicating the subject's pupil. 3) Divide the pupil of the subject into four from the center in the acquired frame image. 4) Select the pixel in each divided part and count the number of the pixels of the overlapping part with the present pixel based on the afterimage. 5) Process the images with precision in 24 - 30fps from a camera and convert the amount of change in the pixels of the subtle movements of the right and left eyeballs in to numbers. The difference in the area of the amount of change occurs by measuring the difference between the afterimage in consecutive frames and the present frame. We set the amount of change to the quantity of the subtle eyeball movements. This method made it possible to detect a change of the eyeball vibration in numerical value. By comparing the numerical value between the right and left eyes, we found that there is a difference in how much they move. We compared the difference in these movements between non-autistc and autistic people and analyzed the result. Our research subjects consists of 8 children and 10 adults with autism, and 6 children and 18 adults with no disability. We measured the values through pasuit movements and fixations. We converted the difference in subtle movements between the right and left eyes into a graph and define it in multidimensional measure. Then we set the identification border with density function of the distribution, cumulative frequency function, and ROC curve. With this, we established an objective index to determine autism, normal, false positive, and false negative.

Keywords: subtle eyeball movement, autism, microsaccade, pursuit eye movements, ROC curve

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Authors: Mohammad Jamal

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Non-alcoholic fatty liver disease (NAFLD) has become one of the most chronic liver diseases, prevalent among people with morbid obesity. NAFLD does not develop clinically significant liver disease, however cirrhosis and liver cancer develop in subset and currently there are no approved therapies for the treatment of NAFLD. The study is aimed to understand the various key genes involved in the mechanism of NAFLD which can be valuable for developing diagnostic and predictive biomarkers based on their histologic stage of liver. The study was conducted on 16 male Sprague Dawley rats. The animals were divided in two groups: control group (n=8) fed on ad libitum normal chow and regular water and the cafeteria group (CAF)) (n=8) fed on high fatty/ carbohydrate diet. The animals received their respective diet from 4 weeks onwards from D.O.B until 25 weeks. Liver was extracted and RT² Profiler PCR Array was used to assess the NAFLD related genes. Histological evaluation was performed using H&E stain in liver tissue sections. Our PCR array results showed that genes involved in anti-inflammatory activity (Ifng, IL10), fatty acid uptake/oxidation (Fabp5), apoptosis (Fas), lipogenesis (Gck and Srebf1), Insulin signalling (Igfbp1) and metabolic pathway (pdk4) were upregulated in the liver of cafeteria fed obese rats. Bloated hepatocytes, displaced nucleus and higher lipid content were seen in the liver of cafeteria fed obese rats. Although Liver biopsies remain the gold standard in evaluating NAFLD, however an approach towards non-invasive markers could be used in understanding the physiology, therapeutic potential, and the targets to combat NAFLD.

Keywords: biomarkers, cafeteria diet, obesity, NAFLD

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Authors: Nur Afiqah Mohd Kamal, Khamarrul Azahari Razak

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The earthquake aftermath has become a major concern, especially in high seismicity region. In Kundasang, Sabah, the earthquake on 5th June 2015 resulted in several catastrophes; landslides, rockfalls, mudflows and major slopes affected regardless of the series of the aftershocks. Certainly, the consequences of earthquake generate and induce the episodic disaster, not only life-threatening but it also affects infrastructure and economic development. Therefore, a need for investigating the change in land use and land cover (LULC) of post-earthquake geohazard is essential for identifying the extent of disastrous effects towards the development in Kundasang. With the advancement of remote sensing technology, post-earthquake geohazards (landslides, mudflows, rockfalls, debris flows) assessment can be evaluated by the employment of object-based image analysis in investigating the LULC change which consists of settlements, public infrastructure and vegetation cover. Therefore, this paper discusses the preliminary results on post-earthquakes geohazards distribution in Kundasang and evaluates the LULC classification effect upon the occurrences of geohazards event. The result of this preliminary analysis will provide an overview to determine the extent of geohazard impact on LULC. This research also provides beneficial input to the local authority in Kundasang about the risk of future structural development on the geohazard area.

Keywords: geohazard, land use land cover, object-based image analysis, remote sensing

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Authors: Ngonidzashe Mangoma, Caroline Marigold Sebata

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The release of cyanide-rich effluents from gold mines, and other industries, into the environment, is a global concern considering the well-known metabolic effects of cyanide in all forms of life. Such effluents need to be treated to remove cyanide, among other pollutants, before their disposal. This study aimed at investigating the possible use of bacteria in the biological removal of cyanide from cyanide-rich effluents. Firstly, cyanide-degrading bacteria were isolated from gold mine effluents and characterised. The isolates were then tested for their ability to grow in the presence of cyanide and their tolerance to increasing levels of the compound. To evaluate each isolate’s cyanide-degrading activities, isolates were grown in the simulated and actual effluent, and a titrimetric method was used to quantify residual cyanide over a number of days. Cyanide degradation efficiency (DE) was then calculated for each isolate. Identification of positive isolates involved 16S rRNA gene amplification and sequence analysis through BLAST. Six cyanide-utilising bacterial strains were isolated. Two of the isolates were identified as Klebsiella spp. while the other two were shown to be different strains of Clostridium bifermentans. All isolates showed normal growth in the presence of cyanide, with growth being inhibited at 700 mg/L cyanide and beyond. Cyanide degradation efficiency for all isolates in the simulated effluent ranged from 79% to 97%. All isolates were able to remove cyanide from actual gold mine effluent with very high DE values (90 – 94%) being recorded. Isolates obtained in this study were able to efficiently remove cyanide from both simulated and actual effluent. This observation clearly demonstrates the feasibility of the biological removal of cyanide from cyanide-rich gold mine effluents and should, therefore, motivate research towards the possible large-scale application of this technology.

Keywords: cyanide effluent, bioremediation, Clostridium bifermentans, Klebsiella spp, environment

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Authors: Farnaz Alaeimoghadam, Farzad Alaeimoghadam

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In low-lactose milk, due to lactose hydrolysis and its conversion to monosaccharides like glucose and galactose, the Maillard reaction (non-enzymatic browning) occurs more readily compared to non-hydrolyzed milk. This reaction incurs off-flavor and dark color, as well as a decrease in the nutritional value of milk. The target of this research was to evaluate the effect of natural antioxidants in diminishing the browning in low-lactose milk. In this research, three antioxidants, namely ascorbic acid, gallic acid, and pantothenic acid in the concentration range of 0-1 mM/L, either in combination with each other or separately, were added to low-lactose milk. After heat treatment (120 0C for 3 min.), milk samples incubated at 55 0C for one day and then stored at 4 0C for 9 days. Quality indices, including total phenol content, antioxidant activity, color indices, and sensory characters, were measured during intervals of 0, 2, 5, 7, and 9 days. Results of this research showed that the effect of storage time and adding antioxidants were significant on pH, antioxidant activity, total phenolic compounds either before or after heating, index L*, color change, and sensational characteristics (p < 0.05); however, acidity, a* and b* indices, chroma, and hue angle showed no significant changes (p > 0.05). The findings showed that the simultaneous application of gallic acid and ascorbic in the diminishing of non-enzymatic browning and color change, increasing pH, longevity, and antioxidant activity after heat treatment, and augmenting phenolic compounds before heat treatment was better than that of pantothenic acid.

Keywords: Maillard, low-lactose milk, non-enzymatic browning, natural antioxidant

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Authors: Arnab Hazra

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Breath analysis is a quick, noninvasive and inexpensive technique for disease diagnosis can be used on people of all ages without any risk. Only a limited number of volatile organic compounds (VOCs) can be associated with the occurrence of specific diseases. These VOCs can be considered as disease markers or breath markers. Selective detection with specific concentration of breath marker in exhaled human breath is required to detect a particular disease. For example, acetone (C₃H₆O), ethanol (C₂H₅OH), ethane (C₂H₆) etc. are the breath markers and abnormal concentrations of these VOCs in exhaled human breath indicates the diseases like diabetes mellitus, renal failure, breast cancer respectively. Nanomaterial-based vapor sensors are inexpensive, small and potential candidate for the detection of breath markers. In practical measurement, selectivity is the most crucial issue where trace detection of breath marker is needed to identify accurately in the presence of several interfering vapors and gases. Current article concerns a novel technique for selective and lower ppb level detection of breath markers at very low temperature based on TiO₂ nanotube array based vapor sensor devices. Highly ordered and oriented TiO₂ nanotube array was synthesized by electrochemical anodization of high purity tatinium (Ti) foil. 0.5 wt% NH₄F, ethylene glycol and 10 vol% H₂O was used as the electrolyte and anodization was carried out for 90 min with 40 V DC potential. Au/TiO₂ Nanotube/Ti, sandwich type sensor device was fabricated for the selective detection of VOCs in low concentration range. Initially, sensor was characterized where resistive and capacitive change of the sensor was recorded within the valid concentration range for individual breath markers (or organic vapors). Sensor resistance was decreased and sensor capacitance was increased with the increase of vapor concentration. Now, the ratio of resistive slope (mR) and capacitive slope (mC) provided a concentration independent constant term (M) for a particular vapor. For the detection of unknown vapor, ratio of resistive change and capacitive change at any concentration was same to the previously calculated constant term (M). After successful identification of the target vapor, concentration was calculated from the straight line behavior of resistance as a function of concentration. Current technique is suitable for the detection of particular vapor from a mixture of other interfering vapors.

Keywords: breath marker, vapor sensors, selective detection, TiO₂ nanotube array

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Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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Authors: Tony Chapman-Wilson

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Applied theatre is not an ultimate vehicle to create social change; but is more an opportunity of hope that the production material might affect this. Theatre-makers are able to deconstruct socially and politically challenging themes to encourage their audience to witness lived experiences as they consider themes of concern and injustice. This allows writers to (re) present the lived experiences of trans people, and for social injustice, continued transphobia, and lack of equity to be presented to an audience for debate. There needs to be a stronger position and presence of trans voices and active participation presented of these rather than just that of the cisgender-lens and standpoint. This research examines the relationship between human rights and theatre and considers global examples of this practice, as well as exploring the negatives formed from this relationship, and how this may be developed in the future. This focusses on the ability of theatre to denounce the violations of human rights and considers the power of theatre to support the importance of the awareness of violations to human rights for the raised awareness and potential for action of the audience – who may themselves be part of the oppressed, or indeed an oppressor. The fundamental assertion here is not one of evidenced social change, but of awareness raising of the audience and the potential for social activism and action. The practice of applied theatre is one that is experienced by the audience and the project participants alike, with the intention that theatre may consider how people interact with one another. This paper examines the opportunity of verbatim theatre techniques to allow for a cis-led trans-collaborative research project to (re) present intergenerational trans identities.

Keywords: applied theatre, verbatim, transgender, social justice

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Authors: Shokouh Momeni, Mohammad Reza Salamat, Ali Asghar Rastegari

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Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry(DXA) is an accurate non-invasive system measuring the bone density, with low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase and magnesium were measured by autoanalyzer and serum levels of vitamin D were measured by high-performance liquid chromatography(HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium did not show a significant difference between the two groups(P-value>0.05). In the control group, the relationship between alkaline phosphatase and BMC and BA in the spine was significant with a correlation coefficient of -0.402 and 0.258, respectively(P-value<0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus(Correlation=0.368; P-value=0.038). There was a significant relationship between the Z-score with calcium(Correlation=0.358; P-value=0.044). Conclusion: There was no significant relationship between the values ​​of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium parameters and bone density (spine and hip) in postmenopaus

Keywords: osteoporosis, menopause, bone mineral density, vitamin d, calcium, magnesium, alkaline phosphatase, phosphorus

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Authors: Manish Subedi, Bijay Bartaula, Ashok R. Pant, Purbesh Adhikari, Sanjib K. Sharma

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Background: The pattern of glomerular disease varies worldwide. In absence of kidney disease/Kidney biopsy registry in Nepal, the exact etiology of different forms of glomerular disease is primarily unknown in our country. Method: We retrospectively analyzed 175 cases of renal biopsies performed from dated September 2014 to August 2016 at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Results: The commonest indication for renal biopsy was nephrotic syndrome (34.9%), followed by Systemic lupus erythematosus with suspected renal involvement (22.3%). Majority of patients were in the 30-60 year bracket (57.2%), with the mean age of the patients being 35.37 years. The average number of glomeruli per core was 13, with inadequate sampling in 5.1%. IgA nephropathy (17%) was found to be the most common primary glomerular disease, followed by membranous nephropathy (14.6%) and FSGS (14.6%). The commonest secondary glomerular disease was lupus nephritis. Complications associated with renal biopsy were pain at biopsy site in 18% of cases, hematuria in 6% and perinephric hematoma in 4% cases. Conclusion: The commonest primary and secondary glomerular disease was IgA nephropathy and lupus nephritis respectively. The high prevalence of Systemic lupus erythematosus with lupus nephritis among Nepalese in comparison with other developing countries warrants further evaluation. As an initial attempt towards documentation of glomerular diseases in the national context, this study should serve as a stepping stone towards the eventual establishment of a full-fledged national registry of glomerular diseases in Nepal.

Keywords: glomerular, Nepal, renal biopsy, systemic lupus erythematoses

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Authors: Disha Batra

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The Industrial Revolution 4.0 is quite different, and a paradigm shift is underway in the media industry. With the advent of automated journalism and social media platforms, newspaper organizations have changed the way news was gathered and reported. The emergence of the fourth industrial revolution in the early 21st century has made the newspapers to adapt the changing technologies to remain relevant. This paper investigates the content of Indian business-papers in the era of the fourth industrial revolution and how these organizations have emerged in the time of convergence. The study is the content analyses of the top three Indian business dailies as per IRS (Indian Readership Survey) 2017 over a decade. The parametric analysis of the different parameters (source of information, use of illustrations, advertisements, layout, and framing, etc.) have been done in order to come across with the distinct adaptations and modifications by these dailies. The paper significantly dwells upon the thematic analysis of these newspapers in order to explore and find out the coverage given to various sub-themes of EBF (economic, business, and financial) journalism. Further, this study reveals the effect of high-speed algorithm-based trading, the aftermath of the fourth industrial revolution on the creative and investigative aspect of delivering financial stories by these respective newspapers. The study indicates a change heading towards an ongoing paradigm shift in the business newspaper industry with an adequate change in the source of information gathering along with the subtle increase in the coverage of financial news stories over the time.

Keywords: business-papers, business news, financial news, industrial revolution 4.0.

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Authors: Tomilola J. Ajayi

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A category of nanovalves system containing the α-cyclodextrin (α-CD) ring on a stalk tethered to the pores of mesoporous silica nanoparticles (MSN) is theoretically and computationally modelled. This functions to control opening and blocking of the MSN pores for efficient targeted drug release system. Modeling of the nanovalves is based on the interaction between α-CD and the stalk (p-anisidine) in relation to pH variation. Conformational analysis was carried out prior to the formation of the inclusion complex, to find the global minimum of both neutral and protonated stalk. B3LYP/6-311G**(d, p) basis set was employed to attain all theoretically possible conformers of the stalk. Six conformers were taken into considerations, and the dihedral angle (θ) around the reference atom (N17) of the p-anisidine stalk was scanned from 0° to 360° at 5° intervals. The most stable conformer was obtained at a dihedral angle of 85.3° and was fully optimized at B3LYP/6-311G**(d, p) level of theory. The most stable conformer obtained from conformational analysis was used as the starting structure to create the inclusion complexes. 9 complexes were formed by moving the neutral guest into the α-CD cavity along the Z-axis in 1 Å stepwise while keeping the distance between dummy atom and OMe oxygen atom on the stalk restricted. The dummy atom and the carbon atoms on α-CD structure were equally restricted for orientation A (see Scheme 1). The generated structures at each step were optimized with B3LYP/6-311G**(d, p) methods to determine their energy minima. Protonation of the nitrogen atom on the stalk occurs at acidic pH, leading to unsatisfactory host-guest interaction in the nanogate; hence there is dethreading. High required interaction energy and conformational change are theoretically established to drive the release of α-CD at a certain pH. The release was found to occur between pH 5-7 which agreed with reported experimental results. In this study, we applied the theoretical model for the prediction of the experimentally observed pH-responsive nanovalves which enables blocking, and opening of mesoporous silica nanoparticles pores for targeted drug release system. Our results show that two major factors are responsible for the cargo release at acidic pH. The higher interaction energy needed for the complex/nanovalve formation to exist after protonation as well as conformational change upon protonation are driving the release due to slight pH change from 5 to 7.

Keywords: nanovalves, nanogate, mesoporous silica nanoparticles, cargo

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: A. Myrzabekova, D. Nurmukhamed, K. Nurumov, A. Zhulbarissova

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It is widely believed that stress can affect teachers’ intention to change the workplace. While existing research primarily focuses on the intrinsic sources of stress stemming from the school climate, the current attempt analyzes educational policies as one of the determinants of teacher’s intention to leave schools. In this respect, Kazakhstan presents a unique case since the country endorsed several educational policies which directly impacted teaching and administrative practices within schools. Using Teaching and Learning International Survey 2018 (TALIS) data with the country specific questionnaire, we construct a statistical measure of stress caused by the implementation of educational policies and test its impact on teacher’s intention to leave through the logistic regression. In addition, we control for sociodemographic, professional, and students related covariates while considering the intrinsic dimension of stress stemming from the school climate. Overall, our results suggest that stress caused by the educational policies has a statistically significant positive effect on teachers’ intentions to transfer between schools. Both policy makers and educational scholars could find these results beneficial. For the former careful planning and addressing the negative effects of the educational policies is critical for the sustainability of the educational process. For the latter, accounting for exogenous sources of stress can lead to a more complete understanding of why teachers decide to change their schools.

Keywords: educational policies, Kazakhstani teachers, logistic regression factor analysis, sustainability education TALIS, teacher turnover intention, work stress

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Authors: Shu Tao

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Based on a global fuel consumption data product (PKU-FUEL-2007) compiled recently and a series of databases for emission factors of various sources, global emission inventories of a number of greenhouse gases and air pollutants, including CO2, CO, SO2, NOx, primary particulate matter (total, PM 10, and PM 2.5), black carbon, organic carbon, mercury, volatile organic carbons, and polycyclic aromatic hydrocarbons, from combustion sources have been developed. The inventories feather high spatial and sectorial resolutions. The spatial resolution of the inventories are 0.1 by 0.1 degree, based on a sub-national disaggregation approach to reduce spatial bias due to uneven distribution of per person fuel consumption within countries. The finely resolved inventories provide critical information for chemical transport modeling and exposure modeling. Emissions from more than 60 sources in energy, industry, agriculture, residential, transportation, and wildfire sectors were quantified in this study. With the detailed sectorial information, the inventories become an important tool for policy makers. For residential sector, a set of models were developed to simulate temporal variation of fuel consumption, consequently pollutant emissions. The models can be used to characterize seasonal as well as inter-annual variations in the emissions in history and to predict future changes. The models can even be used to quantify net change of fuel consumption and pollutant emissions due to climate change. The inventories has been used for model ambient air quality, population exposure, and even health effects. A few examples of the applications are discussed.

Keywords: air pollutants, combustion, emission inventory, sectorial information

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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