BIDIRECTIONAL GLENN SHUNT AND REPAIR OF TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION IN A 3 YEARS OLD CHILD WITH HETEROTAXY SYNDROME: A CASE REPORT

Right Atrial Isomerism (RAI) and total anomalous pulmonary venous connection (TAPVC) is a rare condition with very high mortality in neonatal period, but outcomes may be better in older children. A cyanotic 3 years old boy with dyspnea and growth retardation diagnosed with RAI and supracardiac type of TAPVC undergone a successful repair of TAPVC and simultaneous Glenn shunt. Older patients with RAI may be a distinct, more suitable group for surgical repair.

Detection of anti-M. leprae antibodies in children in leprosy-endemic areas: A systematic review

Background Leprosy elimination primarily targets transmission of Mycobacterium leprae which is not restricted to patients’ households. As interruption of transmission is imminent in many countries, a test to detect infected asymptomatic individuals who can perpetuate transmission is required. Antibodies directed against M. leprae antigens are indicative of M. leprae infection but cannot discriminate between active and past infection. Seroprevalence in young children, however, reflects recent M. leprae infection and may thus be used to monitor transmission in an area. Therefore, this literature review aimed to evaluate what has been reported on serological tests measuring anti-M. leprae antibodies in children without leprosy below the age of 15 in leprosy-endemic areas. Methods and findings A literature search was performed in the databases Pubmed, Infolep, Web of Science and The Virtual Health Library. From the 724 articles identified through the search criteria, 28 full-text articles fulfilled all inclusion criteria. Two additional papers were identified through snowballing, resulting in a total of 30 articles reporting data from ten countries. All serological tests measured antibodies against phenolic glycolipid-I or synthetic derivatives thereof, either quantitatively (ELISA or UCP-LFA) or qualitatively (ML-flow or NDO-LID rapid test). The median seroprevalence in children in endemic areas was 14.9% and was stable over time if disease incidence remained unchanged. Importantly, seroprevalence decreased with age, indicating that children are a suitable group for sensitive assessment of recent M. leprae infection. However, direct comparison between areas, solely based on the data reported in these studies, was impeded by the use of different tests and variable cut-off levels. Conclusions Quantitative anti-PGL-I serology in young children holds promise as a screening test to assess M. leprae infection and may be applied as a proxy for transmission and thereby as a means to monitor the effect of (prophylactic) interventions on the route to leprosy elimination.

Capillary Characteristics and Applicability of Coal Bottom Ash as an Anti-Capillary Material for Coastal Constructions

Utilization of Coal bottom ash (CBA) as well as finding the solutions to prevent saline intrusion, meeting the needs of coastal infrastructure development have been considered by the authors of the article for a long time. In this study, the authors focused on analyzing capillary characteristics in order to find a suitable group of CBA particles, which can be applied in the design of foundations with the high ability in restricting or preventing the effects of salt in saline groundwater. The obtained results show that (1) The capillary height is inversely proportional to the particle size: the larger the particle, the smaller the capillary height and vice versa. The CBA group with a diameter of 2.0 - 5.0 mm has an average capillary height around 3.33 cm; a group of particles size of 1.0 - 2.0 mm is 7.16 cm; a group of particles size of 0.5 – 1.0 mm is 23.36 cm. Meanwhile, the group of particles size of 0.1 - 0.5 mm is 31.26 cm. (2) The capillary height is inversely proportional to the salt concentration in the capillary solution: the maximum capillary height exhibits with the lowest capillary solution salinity ~ 0.0 g/L, whereas it reaches minimum value when salinity approximate 33.0 g/L. Thus, CBA with the same particle size of gravel (diameter from 2.0 to 5.0 mm) is able to block capillary flow. This study forms the basis for the design solutions of anti-saline foundation, especially in the context of climate change and sea-level rise.

Marine Crustaceans as Bioindicators: Amphipods as Case Study

A bioindicator species can be defined as “an organism that provides information on the environmental conditions of its habitat by its presence or absence, and its behavior.” In this sense, crustaceans present many biological and ecological characteristics that make them particularly useful as bioindicators (e.g., widespread distribution in different habitats and geographical areas, key role in community functioning, great diversity of life history strategies). Within Crustacea, the order Amphipoda has been considered an especially relevant and suitable group due to its direct development and its special sensibility to disturbances, among other reasons. Crustaceans can be used in biomonitoring studies in a wide variety of habitats (e.g., both soft- and hard-bottom substrata from intertidal to deep environments) and for different types of environmental stressors. An extensive amount of literature has reported the sensitivity of crustacean species to heavy metal contamination, sewage and desalination discharges, or engineering and aquaculture activities, among others. Special emphasis has been placed on the role of crustaceans in the most used indexes (e.g., AMBI, BENTIX, BOPA) developed to establish the environmental quality of European coastal and marine areas. Crustaceans are one of the groups with a higher contribution to those indexes, although their presence is not necessarily indicative of low environmental disturbances. Within amphipods, the importance of the family Caprellidae as a monitoring tool in environmental programs (e.g., trace metal or tributyltin pollution) is highlighted. Alien crustaceans can also play a pivotal role as bioindicators of anthropogenic pressures, and their likely influence on the accuracy of ecological assessment programs should be taken into account. Finally, there is an increasing need to improve our scarce taxonomic knowledge in many crustacean groups since that information is vital for the correct development of monitoring tools. Studies dealing with the species’ ecological and biological traits are also encouraged in order to understand the potential application of these species as bioindicators.

Attitude of infectious diseases physicians in Turkey about HIV pre-exposure prophylaxis: results of an online survey

Pre-exposure prophylaxis (PrEP) is the provision of antiretroviral drugs before HIV exposure to prevent infection for those in whom it is indicated. We conducted an online survey about PrEP in a national sample of infectious diseases physicians in Turkey. They were surveyed from March to April 2019 and they were asked about their attitudes, knowledge and clinical practise about PrEP. Overall, 209 of 2100 (10%) completed the survey, of whom 66.3% were female, 69.5% were specialist and 41.1% were working at education and research hospitals. Most of the participants reported their PrEP knowledge as ‘low’. Men who have sex with men was the most suitable group for PrEP according to participants. 27.9% of them were requested to prescribe PrEP which was to be paid by individuals themselves and 24.2% of the participants had recommended PrEP in their clinical practice. The primary concerns among those who would not recommend PrEP were the possible increase in sexually transmitted infections, the potential low cost-effectiveness of PrEP, the ineffectiveness of PrEP in HIV transmission and the time lost to following-up the individuals taking PrEP. Developing a national guideline would support clinicians in order to change their attitudes and to find answers to their concerns.

Thailand Medical Mobile Application for Patients Triage Base on Criteria Based Dispatch Protocol

Background : Before patients are admitted into the emergency department, it is important to undertake a pre-hospital process, both in terms of treatment performance and a request for resources from an emergency unit. The existing system to triage patients in Thailand is not functioning to its full capacity in either the primary medical system or pre-hospital treatment with shortcomings in the areas of speed, features, and appropriate systems. There is a high possibility of issuing a false Initial Dispatch Code (IDC), which will cause the over- or under-utilisation of emergency resources, such as rescue teams, community hospitals and emergency medical volunteers. Methods : A usability system design, together with a reliability test, was applied to develop an application to optimise the pre-hospital process, specifically to sort patients, using an IDC to improve the request for emergency resources. The triage mobile application was developed on both iOS and Android operating systems to support patient triage based on Criteria Based Dispatch (CBD). The 25 main symptom categories covered by CBD were used to design and develop the application, and 12 emergency medical staff, including doctors and nurses, were asked to test the system in the aspects of triage protocol correction, triage reliability, usability and user satisfaction. Results : The results of testing the proposed triage application were compared with the time used to triage by experienced staff and it was found that, in non-trauma cases, it was faster and more effective to use the application for emergency operations and to correct the IDC code representation. Conclusions : The triage application will be utilised to support the pre-hospital process and to classify patients’ conditions before they are admitted to the Emergency Department (ED). The application is suitable for users who are not medical emergency staff. Patients with non-trauma symptoms may be a suitable group to use the application in terms of time used to identify IDC for their own symptoms. The use of the application can be beneficial for those who wish to self-identify their symptoms before requesting medical services.

Thailand Medical Mobile Application for Patients Triage Base on Criteria Based Dispatch Protocol

Background : Before patients are admitted into the emergency department, it is important to undertake a pre-hospital process, both in terms of treatment performance and a request for resources from an emergency unit. The existing system to triage patients in Thailand is not functioning to its full capacity in either the primary medical system or pre-hospital treatment with shortcomings in the areas of speed, features, and appropriate systems. There is a high possibility of issuing a false Initial Dispatch Code (IDC), which will cause the over- or under-utilisation of emergency resources, such as rescue teams, community hospitals and emergency medical volunteers. Methods : A usability system design, together with a reliability test, was applied to develop an application to optimise the pre-hospital process, specifically to sort patients, using an IDC to improve the request for emergency resources. The triage mobile application was developed on both iOS and Android operating systems to support patient triage based on Criteria Based Dispatch (CBD). The 25 main symptom categories covered by CBD were used to design and develop the application, and 12 emergency medical staff, including doctors and nurses, were asked to test the system in the aspects of triage protocol correction, triage reliability, usability and user satisfaction. Results : The results of testing the proposed triage application were compared with the time used to triage by experienced staff and it was found that, in non-trauma cases, it was faster and more effective to use the application for emergency operations and to correct the IDC code representation. Conclusions : The triage application will be utilised to support the pre-hospital process and to classify patients’ conditions before they are admitted to the Emergency Department (ED). The application is suitable for users who are not medical emergency staff. Patients with non-trauma symptoms may be a suitable group to use the application in terms of time used to identify IDC for their own symptoms. The use of the application can be beneficial for those who wish to self-identify their symptoms before requesting medical services.

Pengembangan Sistem Pengelompokan Belajar Mahasiswa pada Matakuliah Struktur Data dengan Metode K-Means

The development of science and technology requires tertiary institutions as formal education institutions, to be able to produce qualified and competent graduates. Learning about higher education needs to be more innovative and creative in producing learning and responsive to labor needs. "Successful constraints of lecturers in teaching Data Structure subjects do not have learning models that approach students with abstract theories that are difficult for students to understand, to overcome these conflicts. learn with the Application of Cooperative Oriented Problems. However, in terms of grouping learning with the application of this method, it still takes a relatively long time to do individual testing several times to find a suitable group, so that the learning grouping is less than optimal. The method used in this study is K-Means Clustering, from the software that was built to help instructors in the subject of data structure in the process of grouping tutoring students. Grouping methods can be implemented to build valid student guidance grouping software. Keywords: Learning Grouping System, Clustering, K-Means

Intracytoplasmic morphologically selected sperm injection, but for whom?

SummaryIntracytoplasmic sperm injection (ICSI) is performed in cases of infertility by injecting a motile and morphologically normal sperm cell under a routine ×400 magnification at which is hard to distinguish morphologically healthy sperm. Recently, the use of high-powered differential interference contrast optics gave the opportunity to select a sperm under ultra-high magnification of ×10,160. The aim of the present study was to evaluate the efficacy of the intracytoplasmic morphologically selected sperm injection (IMSI) technique in different infertility populations undergoing ICSI. Main outcome measures of routine ICSI were compared with IMSI in three different groups of patients (1, non-selected; 2, male infertility; and 3, repeated implantation failure group). Results were analysed to evaluate the effects of the IMSI procedure and to find the most suitable group of patients who may benefit from the procedure. IMSI caused a significant increase in the fertilization and top quality embryo rates in the male infertility group and a significant increase in fertilization and pregnancy rates in the repeated implantation failure group, whereas no effect was observed in the non-selected group with patients of various indications. A positive effect of IMSI on the outcome of male factor infertility and repeated implantation failure patients was observed. Data observed confirmed that the application of IMSI was beneficial for a selected group of patients with male factor infertility and repeated implantation failure.

Morphological evolution of the skull roof in temnospondyl amphibians mirrors conservative ontogenetic patterns

Addressing the patterns of ontogenetic allometry is relevant to understand morphological diversification because allometry might constrain evolution to specific directions of change in shape but also facilitate phenotypic differentiation along lines of least evolutionary resistance. Temnospondyl amphibians are a suitable group to address these issues from a deep-time perspective because different growth stages are known for numerous Palaeozoic and Mesozoic species. Herein we examine the patterns of ontogenetic allometry in the skull roof of 15 temponspondyl species and their relationship with adult morphological evolution. Using geometric morphometrics, we assessed ontogenetic and evolutionary allometries of this cranial part and the distribution of adult shapes in the morphospace to investigate whether these patterns relate to each other and/or to lifestyle and phylogeny. We found conspicuous stereotyped ontogenetic changes of the skull roof which are mirrored at the evolutionary level and consistency of the adult shape with phylogeny rather than lifestyle. These results suggest that the evolution of adult cranial shape was significantly biased by development towards pathways patterned by ontogenetic change in shape. The retrieved conserved patterns agree with a widespread evolutionary craniofacial trend found in amniotes, suggesting that they might have originated early in tetrapod evolutionary history or even earlier.