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IntroductionThe objective of this study is to evaluate the performance of an automatic workflow for head-and-neck (H&N) radiotherapy using a multi-atlas based auto-contouring software and an a-priori multicriteria plan optimization algorithm and implement an adaptive online approach with CBCT images. Two different modalities are investigated, the fluence-to-position (FTP) and the adapt-to-shape (ATS) approach.Materials and methodsNine patients are used for the multi-atlas database. The organs at risk (OARs) of the H&N district and five additional structures (air, fat, tissue, bone and patient’s exterior) subsequently used for the creation of the synthetic CT are auto-contoured with the Elekta ADMIRE® software. The mCycle algorithm is used for the a-priori multicriteria plan calculation. A total of twenty H&N patients are selected for this step. The automatic plans are compared to manual VMAT plans by assessing differences in planning time, dose delivered to targets and OARs, and calculating the plan quality indexes (PQIs). Two patients are chosen for the retrospective CBCT adaptive online feasibility analysis. To assess the differences for the two adaptive modalities, the clinical goals for targets and OARs and the number of passed constraints are explored. An analysis of the timing for the different steps is carried out to assess its clinical applicability.ResultThe dice of the five HU layer structures range between 0.66 and 0.99. The mCycle auto-planning significantly reduces planning time, from 2 hours to 10 minutes. The radiotherapist deems all plans clinically acceptable, and in the majority of cases the automatic plan is the preference choice. The automatic plans enhance OARs sparing and preserve a good target coverage, this is also confirmed by the PQIs result. Comparing FTP and ATS modes in adaptive radiotherapy, ATS exhibits superior outcomes, mostly in the target coverage. In the FTP techniques target coverage is inadequate and statistically different from the accepted values. In the ATS the results align with the initial approved values. Using the ATS mode the planning time takes around 14 minutes and approximately 20 minutes for the entire treatment.ConclusionThis study contributes to the advancement of automatic and adaptive radiotherapy, demonstrating the potential of an automated workflow in H&N treatments.

The country has been facing the Covid-19 crisis that has affected the rest of the world in this decade. Numerous approaches and alternatives are implemented by the government to overcome this pandemic either controlled or stopped utterly. In order for the government to succeed, the emphasis on breaking the chain of infection of Covid-19 and the direction of the Movement Control Order (MCO) must be strengthened. Thus, the main goal of this study is to identify the level of patient’s knowledge regarding Covid-19 and Movement Control Order as well as to analyze the relationship between the level of knowledge about Covid-19 and Movement Control Order () among patients who come for treatment at the Kinarut Health clinic. Methodology: This study applies the quantitative research methodology, specifically surveys through questionnaires, whereas the sampling method used is systematic sampling with 200 patients in the Kinarut area. Analysis of instrument evaluation and sampling technique is also discussed in this study. Analysis: The finding showed that the patients' knowledge level about Covid-19 was at a moderate level with a mean value = 3.610, SD = 0.345. The level of knowledge relating to Movement Control Order (MCO) is also at a moderate level with a mean value = 3.610, SP = 0.345. Result: The correlation analysis showed that there is a strong relationship between the level of knowledge about Covid-19 and the level of knowledge of the Movement Control Order, with a correlation value of r = 0.71, p> 0.05. Thus, the results of this analysis show that there is a strong relationship between the variables of the knowledge level of Covid-19 and Movement Control Order in breaking the chain of infection Covid-19, particularly among patients who are living around Kinarut.

Precise outpatient volume prediction holds significant importance in hospital management. While the Gated Recurrent Unit (GRU) is a frequently utilized deep learning technique for forecasting hospital outpatient volumes, creating a proficient GRU model necessitates the fine-tuning of pertinent GRU parameters. The adjustment of suchparameters relies heavily on an individual’s practical experience and prior knowledge. The recently proposed Cheetah optimizer is a novel intelligent algorithm with unique optimization capabilities. The Cheetah optimizer holds significant research potential; however, additional investigations are warranted, as it may be vulnerable to issues related to local optimization. In the present study, the selection of hyperparameters for the GRU model was optimized through the utilization of the Modified Cheetah Optimization (MCO) algorithm, and a combined MCO-GRU model was established. Using the Successive Variational Mode Decomposition (SVMD) method to decompose outpatient volume sample data, the parameters of the GRU model were optimized with the MCO method to construct a hybrid forecasting model. This yielded the smallest Root Mean Square Error (RMSE) for the proposed model, with a value of 0.0843. Additionally, the results indicate that in comparison to SVMD, Long Short-Term Memory (LSTM), GRU, Particle Swarm Optimization-GRU (PSO-GRU), and Cheetah Optimization-GRU (CO-GRU), the proposed model significantly enhanced the accuracy of outpatient volume forecasting.

The COVID-19 cases have taken its strike since December 2019 in Wuhan, China and then has spread to other countries. Malaysia was not excluded from this pandemic, in which the first case of COVID-19 was discovered on 25th January 2020. The disease has caused a pandemic outbreak ever since, driving many countries to close international gateways and implement lockdowns and many studies have been trying to model and forecast the rising number of Covid-19 cases worldwide. This study aimed to prove the effectiveness of Movement Control Order (MCO) phases implemented in Malaysia. From 8 MCO phases implemented in Malaysia, 5 of the MCO phases were taken into consideration for this study. Line plots were used to observed the pattern, increasing (+) or decreasing (-) number of cases for each MCO implementation. The before and after trends for each phase were recorded and tabulated. Using the Wilcoxon Signed-rank test with Binomial probability calculation showed the p-value=0.001< α=0.05 obtained. Hence, supported the hypothesis that MCO implementation reduces the number of positive cases in Malaysia. In conclusion, the implementation of lockdown would ‘flatten the curve’ of the daily COVID-19 cases, resulting in better control over the spread of the COVID-19 virus in Malaysia.

Los estudios de participación cultural tienden a concentrar su enfoque en el análisis de las variables socioeconómicas o la disponibilidad de infraestructuras, dejando en un segundo plano variables de carácter idiosincrático como el interés manifestado o la predisposición a participar. Empleando los datos de la Encuesta de Hábitos y Prácticas Culturales de España 2018-2019, y mediante la modelización con mínimos cuadrados ordinarios (MCO), se busca estudiar los pesos de las variables socioeconómicas clásicas, así como las diferentes variables que componen el capital cultural dado su carácter aditivo en el desarrollo del interés. Los principales resultados obtenidos presentan al capital cultural como el componente más determinante en la formación del interés, siendo la lectura en la infancia la que presenta el mayor impacto. Destaca también la posible existencia de transferencia intergeneracional del interés, al presentar un mayor peso entre las variables la participación de los padres que la del propio sujeto durante la infancia.

Cet article examine les déterminants du chômage en RDC. Le caractère réduit de l’échantillon, à savoir un pays, et cela s’explique par la disponibilité des données portant sur la période 2001-2020. Le modèle inspiré de la littérature empirique est estimé par la méthode des moindres carrés ordinaires (OLS). Nos résultats économétriques révèlent que les variables éducation, l’inflation, l’investissement direct à l’étranger, la population explique significativement le niveau de chômage des jeunes au seuil d’un 1% et de 5 %. L’éducation et les investissements directs à l’étranger tendent à augmenter le taux de chômage tandis que la croissance de la population et l’inflation tendent à réduire le taux de chômage.

Due to the COVID-19 pandemic, many countries have implemented movement control orders (MCO). Globally, including in Malaysia, such bans have reduced pollution. Thus, this study used remote sensing to examine the particle dispersion and intensity of PM10. Unlike previous research, this technique used Landsat 8 Operational Land Imager (OLI) satellite images to estimate anthropogenic level changes within the study area. Eight models are used to estimate PM10 levels. The models work well because they were developed and tested in India, which has a similar climate to Malaysia. Two models returned results that matched the study area's CAQMs station. Between 10th March 2020 and 26th March 2020 the CAQMS showed an average PM10 concentration of 17-32 g/m3 . The pixel based PM10 estimation is 30-35% off in g/m3 . However, the percent reduction of PM10 before and during MCO was within 2% of Model 5 and 7. Incorporating geospatial technology into baseline studies to assess current air quality is clearly beneficial. Since the first MCO in March 2020, toxic pollution emissions have decreased significantly.

The study aims to analyse factors such as perceived ease of use, technology and communication and institution involvement in influencing the effectiveness of online systems and applications for final online examinations held at International Islamic University College Selangor (KUIS) during the period of movement control order (MCO) 2020. Basic model of Technology Acceptance Model (TAM) is applied in this research to study the effectiveness of online systems and applications used by students of KUIS who undergo final online examinations during MCO 2020. This is a quantitative research and questionnaires have been used as the research instrument. The questionnaires were distributed to KUIS students� who took part in the final online examinations during MCO 2020 and a total of 351 data have been collected. Through multiple regression analysis, it is discovered that perceived ease of use and technology are the main factors that influence the most towards the effectiveness of online systems and applications for final online examinations purposes at KUIS while institution involvement factor influences the least. As a conclusion, by studying through these factors, the findings of this research study can serve and be beneficial towards KUIS and the teaching staff in the direction of improving the effectiveness of using online platforms for online examination purposes.

Anna Lindgren,1,2 Erik Fjellstedt,2,3 Anders Christensson2,3 1Department of Nephrology, Skåne University Hospital, Lund, Sweden; 2Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; 3Department of Nephrology, Skåne University Hospital, Malmö, SwedenCorrespondence: Anna LindgrenDepartment of Clinical Sciences Malmö, Lund University, SUS Malmö, Jan Waldenströms Gata 15, Malmö SE-205 02, SwedenTel +46-46-171698Fax +46-40-337052Email Anna.Lindgren@med.lu.sePurpose: Conventional hemodialysis (HD) treatment has an acceptable removal of small uremic molecules, but so-called “middle molecules” in the range of 0.5– 60 kDa are poorly cleared with HD compared to a native kidney, which may contribute to morbidity in the dialysis population. Hemodiafiltration (HDF) has a better removal of middle molecules compared to HD but is technically demanding and requires well-functioning dialysis access. The newly introduced medium cutoff (MCO) filters have been developed to enhance middle molecule clearance in HD-mode. The aim of this study was to compare reduction ratios (RRs) of molecules with different molecular weights (0.06– 150 kDa) during dialysis with MCO dialyzer (used in HD-mode) compared to online-hemodiafiltration (ol-HDF) treatment with a conventional high-flux dialyzer.Patients and Methods: This is a prospective controlled single-center cross-over study, including 16 patients in Malmö, Sweden. All patients had ongoing post-dilution ol-HDF treatment before the study. The study compared reduction ratios of small-, middle-, and large-sized molecules during a single 4h dialysis treatment with post-dilution ol-HDF (Polyflux 210H) to a 4h dialysis treatment with MCO dialyzer (Theranova 500) in HD-mode. Between treatments, the patients had a washout period of at least two weeks of their ordinary HDF treatment to reach their ordinary steady state.Results: ol-HDF had significantly higher RR for cystatin C (13 kDa), compared to MCO (RR 68.1 vs 65.8, p=0.003), during a 4h dialysis treatment (mean convection volume of 24.5 L for HDF, and mean Qb of 324 mL/min for HDF and 323 mL/min for MCO). There was no significant difference in the RR for other middle molecules, or for smaller or larger molecules.Conclusion: Overall, the RRs were comparable for ol-HDF and MCO-HD. There was a slightly higher RR of cystatin C (a small middle molecule) for HDF compared to MCO but no difference in other measured molecules.Keywords: chronic hemodialysis, dialysis, hemodiafiltration, hemodialysis, MCO, uremic toxins

This study has highlighted the trend of recently-reported dengue cases after the implementation of the Movement Control Orders (MCOs) caused due to COVID-19 pandemic in Malaysia. The researchers used the dengue surveillance data published by the Malaysian Ministry of Health during the 3 phases of MCO (which ranged between 17th March 2020 and 28th April 2020) was used for determining the cumulative number of dengue patients. Thereafter, the dengue cases were mapped using the Geographical Information System (GIS). The results indicated that during the 42 days of MCO in Peninsular Malaysia, 11,242 total cases of dengue were reported. The daily trend of the dengue cases showed a decrease from 7268 cases that occurred before the MCOs to 4662 dengue cases that occurred during the initial 14 days of the COVID-19 pandemic (i.e., MCO I), to 3075 cases occurring during the MCO II and 3505 dengue cases noted during MCO III. The central peninsular region showed a maximal decrease in new dengue cases (52.62%), followed by the northern peninsular region (1.89%); eastern coastal region (1.25%) and the southern peninsular region (1.14%) during the initial MCO implementation. However, an increase in the new dengue cases was noted during the MCO III period, wherein all states showed an increase in the new dengue cases as compared during MCO II. The decrease in the pattern was not solely based on the MCO, hence, further investigation is necessary after considering different influencing factors. These results have important implication for future large-scale risk assessment, planning and hazard mitigation on dengue management.

The year 2020 was being ushered in by a global pandemic. Within months, COronaVIrus Disease (COVID-19) has spread to almost every country. With its long incubation period and highly contagious characteristics, most countries have initiated lockdown and social distancing is the new norm in most societies. Malaysia implemented the Movement Control Order (MCO) on 18 March 2020 when the cumulative COVID-19 cases were still below 800. Since then, MCO was extended several times and the latest phase of Recovery MCO (RMCO) will last until 31 August 2020. As seafood represents an important protein source, the aquaculture sector supports the livelihood of coastal communities in Malaysia, particularly those involved in micro- and small-scale fish farming activities. The emergence and spread of this pandemic severely disrupt market demand and supply chains of seafood industries. Therefore, this case report looks into the potential impacts of COVID-19 on the aquaculture sector of Malaysia. Then, the coping strategies implemented by Malaysia are highlighted and their potential effectiveness is discussed. Also, some useful recommendations are suggested to ensure the continuity and growth of the aquaculture sector. We believe that insights in this report are applicable to other sectors and countries with similar economic characteristics.

Metallic interconnects represent the main component of a solid oxide fuel cell (SOFC) stack in terms of weight and volume. They are typically made of ferritic stainless steel (FSS) coated on the air side. At the stack operating conditions, the interconnect is exposed to a dual atmosphere: air at the cathode side; fuel (a hydrogen-rich mixture) at the anode side. The stacks considered in this study were field operated in reformed natural gas for 5000, 9000 and 20,000 h respectively. The analyzed interconnects are made from CROFER22APU and coated on the air side with Co-Mn base spinel. One interconnect has been studied for each stack by sampling and preparing cross section the inlet and outlet positions. The samples were characterized by SEM-EDXS in order to investigate the evolution of the interconnect at the air side. The interaction between the metal substrate and the coating is investigated highlighting the formation of chromia based thermal grown oxide (at the FSS/coating interface) and the solid-state diffusion of Cr and Fe from the metal into the coating. The microstructural features evolving as a function of time are also quantified.

Pseudomonas putida (P. putida) MnB1 is a widely used model strain in environment science and technology for determining microbial manganese oxidation. Numerous studies have demonstrated that the growth and metabolism of P. putida MnB1 are influenced by various environmental factors. In this study, we investigated the effects of hydrogen peroxide (H2O2) and manganese (Mn2+) on proliferation, Mn2+ acquisition, anti-oxidative system, and biofilm formation of P. putida MnB1. The related orthologs of 4 genes, mco, mntABC, sod, and bifA, were amplified from P. putida GB1 and their involvement were assayed, respectively. We found that P. putida MnB1 degraded H2O2, and quickly recovered for proliferation, but its intracellular oxidative stress state was maintained, with rapid biofilm formation after H2O2 depletion. The data from mco, mntABC, sod and bifA expression levels by qRT-PCR, elucidated a sensitivity toward bifA-mediated biofilm formation, in contrary to intracellular anti-oxidative system under H2O2 exposure. Meanwhile, Mn2+ ion supply inhibited biofilm formation of P. putida MnB1. The expression pattern of these genes showed that Mn2+ ion supply likely functioned to modulate biofilm formation rather than only acting as nutrient substrate for P. putida MnB1. Furthermore, blockade of BifA activity by GTP increased the formation and development of biofilms during H2O2 exposure, while converse response to Mn2+ ion supply was evident. These distinct cellular responses to H2O2 and Mn2+ provide insights on the common mechanism by which environmental microorganisms may be protected from exogenous factors. We postulate that BifA-mediated biofilm formation but not intracellular anti-oxidative system may be a primary protective strategy adopted by P. putida MnB1. These findings will highlight the understanding of microbial adaptation mechanisms to distinct environmental stresses.

The purpose of this paper is to give a short overview of the model developed regarding common spaces record for the condominiums in urban area of Prishtina. The proposed model developed from the author of this article aimed to adopt 3D cadastre requirements and techniques for common spaces registration. The techniques adopted within project represent one of the first steps towards 3D cadastre in Republic of Kosovo.