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This article explores the role of tesang, a local practice, as an approach to economic empowerment amongst the Buginese and Makassarese of South Sulawesi. Tesang not only promotes the division of profits between investors and laborers but also continued efforts to improve the local economy. This article’s analysis relies on data collected through observations and interviews as well as a review of the literature. This study emphasizes that tesang is not only an economic practice but also a co mmitment to maintaining Buginese and Makassarese society in a manner that reflects the teachings of Islam. This local wisdom-based approach to empowerment may be used to realize collective empowerment and success. As such, even though it does not follow any formal structure, tesang has a real and tangible effect on society. This study recommends that future research take an in-depth approach that recognizes tesang not only as a means of empowerment but also as a foundation for strong linkages through which society’s increasingly complex demands can be fulfilled.

Londo iha is a form of bride kidnapping practiced by the Muslims of Monta, a district of Bima, Indonesia, that violates sharia (i.e. Islamic law). In this practice, a man steals away with a young woman, often for the purpose of marriage. Although marriage is strongly recommended by Islamic law, such an approach to marriage is considered to be against Islamic norms. This article seeks to explain why londo iha continues to be practiced by the Muslims of Monta, even though it violates Islamic law. Observation, in-depth interviews, and document analysis are used to collect data. The observation is for Muslim wedding activity in Monta. The interview is designed to gather useful information by interviewing eight people who are involved with londo iha. Furthermore, document analysis is managed by obtaining some documents from Bima’s Ministry of Religion Office that show londo iha’s involvement in several districts. Based on the collected data, this article finds that londo iha continues to be perceived as facilitating marriage and its continued practice is driven by various customary and religious norms. However, this practice has been controversial, as its validity is only recognized under customary norms. As it lacks religious validity, this practice has thus been detrimental to the social structures of Muslim-majority Monta. This article applies a simple socio-religious perspective, and covers a relatively brief period of time; as such, it is necessary to conduct further research using a multi-disciplinary perspective and covering a broader range of cases.

This paper discusses the interaction behavior of parents and children, facing problems in carrying out the duties and roles of the child's parents as the person in charge and the first teacher of understanding and practicing children's religiosity. This paper aims to find and describe the interaction patterns of children's parents, constraints and challenges in carrying out their duties as the first teacher in the family and effective efforts to foster children in the family. This paper is qualitative descriptive, with deductive-inductive methods. Data relying on primary sources through observation and interviews, and is complemented by secondary data obtained from literature. This paper shows the relationship between interaction behavior, the position of father and mother and child with family resilience through internalization of religious norms and values, understanding and practicing the teachings of the faith, praying five times a day, and noble morals. Parent and child interactions are temporal in nature, depending on the conditions of parents and children in the process of interaction in the family. The routine and personality activities of parents who are competent in understanding Islam are relatively constraints and challenges in the interaction between parents and children in carrying out their functions, the role of being the first teacher in the family. This paper is an indicator and motivator that encourage family life to foster children in understanding and practicing the principles of Islam. Keywords: Family resilience, behavior, interaction, parents of children, Islam. تناقش هذه الورقة السلوك التفاعلي بين الوالدين والأطفال، حيث يواجهون مشاكل في أداء واجبات وأدوار والدي الطفل بصفته الشخص المسؤول والمعلم الأول لفهم تدين الأطفال وممارسته. تهدف هذه الورقة إلى إيجاد ووصف أنماط التفاعل بين أولياء أمور الأطفال، والقيود والتحديات في أداء واجباتهم كأول معلم في الأسرة والجهود الفعالة لرعاية الأطفال في الأسرة. هذه الورقة وصفية نوعية، مع الأساليب الاستنتاجية الاستقرائية ، والبيانات التي تعتمد على المصادر الأولية من خلال الملاحظة والمقابلات وتكملها البيانات الثانوية التي تم الحصول عليها من الأدب. توضح هذه الورقة العلاقة بين السلوك التفاعلي، وموقع الأب والأم والطفل في المرونة الأسرية من خلال استيعاب الأعراف والقيم الدينية، وفهم وممارسة تعاليم الدين، والصلاة خمس مرات في اليوم، والأخلاق النبيلة. تفاعلات الوالدين والطفل مؤقتة بطبيعتها ، حسب ظروف الوالدين والأطفال في عملية التفاعل في الأسرة. تعتبر الأنشطة الروتينية والشخصية للآباء المؤهلين في فهم الإسلام قيودًا وتحديات نسبية في التفاعل بين الآباء والأطفال في أداء وظائفهم، ودور كونهم المعلم الأول في الأسرة. تعتبر هذه الورقة مؤشرا ومحفزا يشجع الحياة الأسرية لتنشئة الأبناء على فهم مبادئ الإسلام وممارستها. Tulisan ini membahas tentang perilaku interaksi orang tua dan anak, menghadapi problema dalam menjalankan tugas dan peran orang tua anak sebagai penanggung jawab dan guru pertama terhadap pemahaman dan pengamalan relegiutas anak. Tulisan ini bertujuan untuk menemukan dan mendeskripsikan pola interaksi orang tua anak, kendala dan tantangan dalam mengemban tugasnya sebagai guru pertama dalam keluarga serta upaya yang efektif pembinaan anak-anak dalam keluarga. Tulisan ini bersifat deskriftif kualitatif, dengan metode deduktif-induktif, data disandarkan kepada sumber primer melalui observasi, wawancara dan dilengkapi oleh data sekunder yang diperoleh dari leteratur. Tulisan ini menunjukkan kaitan perilaku interaksi, posisi ayah dan ibu serta anak dengan ketahanan keluarga melalui internalisasi norma dan nilai agama, pemahaman dan pengamalan ajaran akidah, salat lima waktu, serta akhlak mulia. Interaksi orang tua dan anak bersifat temporal, tergantung pada kondisi orang tua dan anak dalam proses interaksi dalam keluarga. Kesibukan rutinitas dan kepribadian` orang tua yang bersifat kompetensi pemahaman terhadap Islam relative menjadi faktor kendala dan tantangan dalam interaksi orang tua dan anak dalam menjalankan fungsi, peran sebagai guru pertama dalam keluarga. Tulisan ini menjadi indikator dan motivator yang mendorong kehidupan keluarga untuk pembinaan anak-anak dalam pemahaman dan pengamalan ajaran-ajaran prinsip dalam Islam.

This writing discusses controversial hadits and the way of understanding the hadis, using various methods and interpretation technique. Although a hadis is recognized controversial, it doesn’t mean that it cannot be solved. Some ulamas of hadis have discussed and put forward some alternative arguments to come to final conclusion. Some methods such as; al-Jam'u, al-Tarjih, al-Nasikh, wa al-Mansukh dan al-Tauqif, as well as textual, contextual interpretation, linguistic or historical approach can be regarded as ways to understand the essentian meaning of the controversial hadis.

Something important to know is understanding Asmaul Husna in al-Quran. This writing discusses some points of al-Asma a-Husna that contains close meaning with the values of human life. Mankind will be more progress, civilized, prosperious and can stand on its own feet, if they always implement the values of Asmaul Husna, both indivually or socially, this is because Asmaul Husna is the essence or heart of religion. Thus, Allah has ever reminded those who do shalat (pray) to implement its values in daily life. The values of shalat are reflected in Asmaul Husna.

This prospective study determined the prevalence of night-time discharges from intensive care unit (ICU), compared the patient outcomes between night-time and daytime ICU discharges and identified factors affecting the patient outcomes. We included alive discharged ICU patients between 1st December 2020 to 31st October 2021 and excluded those who were issued do-not-resuscitate order or readmitted after 72 hours of ICU discharge. We grouped the patients into nighttime discharges, which occurred between 1700 and 0759 the next day, or daytime discharges, which occurred between 0800 and 1659 of the same day. We analysed data of 205 patients which showed 116 patients (56.6%) we discharged at nighttime. Patient outcomes were similar when we compared them with the timing of ICU discharges. Among the night-time discharges, the readmission rates were affected by the availability of post ICU follow up (p=0.002); the rates of hospital stays longer than 10 days after ICU discharge were affected by the need for bed mobilisation to accommodate acute ICU admission (p=0.021); the in-hospital mortality rates were affected by poorly controlled infection source (p=0.004), need for bed mobilisation (p=0.001) and availability of post ICU follow-up (p=0.01). In conclusion, the timing of ICU discharges did not affect the patient outcomes. [ABSTRACT FROM AUTHOR]

This article aims to determine the correlation between the use of colloquial in Indonesian and the morals of Arabic language education students IAIN Madura. This study used a quantitative research approach with a correlational method. Data was collected through questionnaires with a sample of 25% of the total population, namely 33 people. The results showed that PBA IAIN Madura students often use colloquial in Indonesian, especially to their friends, and the morals of PBA IAIN Madura students are excellent, which is shown by a score of 88.26%. The results of the analysis obtained also stated that rXY = -0.464 with N of 33 and a significance level of 5%, then r-table = 0.344. From this data, it can be concluded that recalculate < r-table. So, there is no significant correlation between the use of colloquials in Indonesian and the morals of PBA IAIN Madura students.

Research works are actively ongoing to seek a solution for reducing the usage of sulfur hexafluoride (SF6) as a gas insulator in high-voltage equipment since it was listed as one of the greenhouse gases under the Kyoto Protocol. However, manufacturers still in favor of using SF6 due to its excellent insulation and arc-quenching properties. One way to reduce SF6 usage is to mix it with other gases or replace it with alternative gas mixtures. The research status of SF6 gas mixtures and other potential substitutes is summarized in this paper. Electrical insulation properties, physical and chemical mechanisms, and environmental considerations, along with the scope and limitations of such mixtures were analyzed. The development prospects of SF6 gas mixtures were forecasted based on their best mixture ratio. Hybrid insulation gases consisting of three compounds (two electronegative gases with one buffer gas) have shown to be an ideal compromise in terms of cost, distinguished low environmental impact, and high dielectric strength. Trifluoroiodomethane (CF3I) offers great advantages among other dielectric gases, since it exerts minimal greenhouse effects, and has a considerable liquefaction temperature and higher dielectric strength. Therefore, the application of CF3I for reducing the usage of SF6 in gas mixtures was highlighted. The fundamental knowledge on the breakdown strength of the gas mixtures and their behavior under different electric fields need to be analyzed before any recommendations can be made. [ABSTRACT FROM AUTHOR]

Purpose — The purpose of this study is to determine the convergence of economic growth in the regencies and cities of South Sulawesi. Method — The type of data utilized in this study is quantitative, sourced from secondary data obtained from the Indonesian central statistics agency/ Badan Pusat Statistik of the districts and cities within South Sulawesi Province. The convergence analysis in this study is divided into two categories, namely sigma convergence and beta convergence. The application of sigma convergence aims to assess the level of disparity based on economic growth. Result — The results of the sigma convergence analysis indicate that there has been sigma convergence in South Sulawesi Province from 2015 to 2022, as evident from the decreasing Unweighted Coefficient of Variation value. Furthermore, the analysis of beta convergence was conducted using both absolute convergence and conditional convergence models, focusing on the economic growth of all districts/cities in South Sulawesi. The findings also reveal that the average length of schooling does not have a significant effect on economic growth. However, investment demonstrates a significant impact on the economic growth of districts/cities within the province of South Sulawesi. Contribution — The academic contribution of this study lies in its novel focus on convergence analysis of economic growth in regions/cities within South Sulawesi Province, specifically investigating the potential catching-up process and convergence in rising per capita income, which has been relatively overlooked in prior research predominantly centered on overall economic development at regional or national levels.

This paper applies to the electrical engineering world by making earthing system portable in providing low and acceptable resistance path. The system is develop in a small scale portable earthing system against the massiveness of Earth and becomes leverage if soil at the place is not suitable for plant grounding system. Hence, this paper presents findings on the research of new grounding medium material that will be housed in a small scale enclosure which behaves like native earth related earthing system by using kaolin and bauxite. The data obtained from lightning flashover testing, morphological and chemical composition of material analysis indicated that bauxite is more useful for portable grounding system application much better than kaolin in term of zero reference point function. The portable earthing system can be apply to air aviation systems, railway systems and military sectors particularly for electronic equipment zero referencing. [ABSTRACT FROM AUTHOR]

Background: A timely diagnosis of Alzheimer's disease (AD) is crucial to obtain more practical treatments. In this article, a novel approach using Auto-Encoder Neural Networks (AENN) for early detection of AD was proposed. Method: The proposed method mainly deals with the classification of multimodal data and the imputation of missing data. The data under study involve the MiniMental State Examination, magnetic resonance imaging, positron emission tomography, cerebrospinal fluid data, and personal information. Natural logarithm was used for normalizing the data. The Auto-Encoder Neural Networks was used for imputing missing data. Principal component analysis algorithm was used for reducing dimensionality of data. Support Vector Machine (SVM) was used as classifier. The proposed method was evaluated using Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Then, 10fold crossvalidation was used to audit the detection accuracy of the method. Results: The effectiveness of the proposed approach was studied under several scenarios considering 705 cases of ADNI database. In three binary classification problems, that is AD vs. normal controls (NCs), mild cognitive impairment (MCI) vs. NC, and MCI vs. AD, we obtained the accuracies of 95.57%, 83.01%, and 78.67%, respectively. Conclusion: Experimental results revealed that the proposed method significantly outperformed most of the stateoftheart methods.

This paper examines whether regional economic growth across Indonesian provinces can be affected by the role of banking and labor force. In general, our empirical findings show that banking development is indeed positively linked to regional economic growth, although this relationship is more pronounced for poor provinces. Moreover, this paper finds that the link between banking development and regional economic growth is conditional on the degree of labor force. Specifically, the positive impact of banking on regional economic growth only occurs when labor force is sufficiently low regardless of whether we observe poor provinces or rich provinces. Eventually, this paper highlights that increasing access to bank credit is essential to boost regional economic growth, especially for poor provinces or provinces with lower labor force.

The main problem discussed in this study is the use of language in advertising media as a form of using Indonesian in public spaces. Through promotion through advertising, a product can be known by the public and this is the purpose of an advertised product. The approach used in this study is a qualitative approach, namely research that produces descriptive data in the form of spoken or written words from people or observed behavior. The described aspect is the result of an analysis of the use of vulgar language and the meaning contained in each advertisement. Based on an analysis of several advertised products, both on electronic media (television) and on social media, it is evident that erotic word choices are used in advertising media. Abstrak Masalah utama yang dibahas dalam penelitian ini adalah pemakaian bahasa di media iklan sebagai salah satu bentuk pemakaian bahasa Indonesia di ruang publik. Melalui promosi lewat iklan, sebuah produk dapat dikenal oleh masyarakat dan inilah yang menjadi tujuan sebuah produk diiklankan. Pendekatan yang digunakan dalam penelitian ini adalah pendekatan kualitatif yakni penelitian yang menghasilkan data deskriptif berupa kata-kata lisan atau tertulis dari orang atau prilaku yang diamati. Aspek yang dideskripsikan adalah hasil analisis pemakaian bahasa vulgar dan makna yang terkandung dalam setiap iklan. Berdasarkan hasil analisis terhadap beberapa produk yang diiklankan, baik di media elektronek (televisi) maupun di media sosial terbukti bahwa pilihan kata yang bersifat erotis digunakan dalam media iklan.

Different types of noise from the surrounding always interfere with speech and produce annoying signals for the human auditory system. To exchange speech information in a noisy environment, speech quality and intelligibility must be maintained, which is a challenging task. In most speech enhancement algorithms, the speech signal is characterized by Gaussian or super-Gaussian models, and noise is characterized by a Gaussian prior. However, these assumptions do not always hold in real-life situations, thereby negatively affecting the estimation, and eventually, the performance of the enhancement algorithm. Accordingly, this paper focuses on deriving an optimum low-distortion estimator with models that fit well with speech and noise data signals. This estimator provides minimum levels of speech distortion and residual noise with additional improvements in speech perceptual aspects via four key steps. First, a recent transform based on an orthogonal polynomial is used to transform the observation signal into a transform domain. Second, the noise classification based on feature extraction is adopted to find accurate and mutable models for noise signals. Third, two stages of nonlinear and linear estimators based on the minimum mean square error (MMSE) and new models for speech and noise are derived to estimate a clean speech signal. Finally, the estimated speech signal in the time domain is determined by considering the inverse of the orthogonal transform. The results show that the average classification accuracy of the proposed approach is 99.43%. In addition, the proposed algorithm significantly outperforms existing speech estimators in terms of quality and intelligibility measures.

A robust and transparent watermarking scheme based on contourlet transform and quantization index modulation is proposed in this paper. In proposal algorithm, after taking contourlet, the coefficients are divided into three quadrants by using the symmetric property of the contourlet coefficients, then the angle coefficients are modulated for each of three points. The experimental results revealed that if the information of the image is utilized to determine the watermark and by using quantization index modulation properties, a higher robustness and more effective imperceptibility in proposed algorithm are achieved.

The most well-known conventional speech enhancement algorithms introduce unwanted artifact noise and speech distortion to the enhanced signal. Reducing the effects of such issues require more robust linear and non-linear estimators. This paper proposes new optimum linear and non-linear Laplacian distribution-based estimators. The proposed estimators are derived based on a minimum mean squared error (MMSE) sense to minimize the distortion in different conditions of the underlying speech. Thus, artifact noise is reduced without compromising the noise reduction process. The analytical solutions of the Laplacian distribution-based estimators, linear bilateral Laplacian gain estimator (LBLG), and non-linear bilateral Laplacian gain estimator (NBLG), are presented. The proposed estimators are implemented in three steps. First, the observation signal is decorrelated through a real transform domain to obtain its transform coefficients. Second, the proposed estimators are applied to estimate the clean speech signal from the noisy signal in the decorrelated domain. Finally, the inverse of the real transform is applied to obtain the original speech signal in the time domain. Two conditions in these estimators account for interference events between the speech signal and noise coefficients in the decorrelated domain. Moreover, a mathematical aspect of mean square error of LBLG is evaluated, which presents a significant improvement over other methods. Furthermore, a comprehensive description of the whole variations of the LBLG and NBLG gains characteristics is presented. A comparative evaluation is performed with effective quality metrics, segmental signal-to-noise ratio and perceptual evaluation of speech quality, to demonstrate the advantage and effectiveness of the proposed estimators. The performance of the proposed estimators outperformed other methods, which are the traditional MMSE approach, perceptually motivated Bayesian estimator, dual gain Wiener estimator, and dual MMSE estimator in terms of different objective measurements.

Tchebichef polynomials (TPs) and their moments are widely used in signal processing due to their remarkable performance in signal analysis, feature extraction, and compression capability. The common problem of the TP is that the coefficients computation is prone to numerical instabilities when the polynomial order becomes large. In this paper, a new algorithm is proposed to compute the TP coefficients (TPCs) for higher polynomial order by combining two existing recurrence algorithms: the three-term recurrence relations in the n-direction and x-direction. First, the TPCs are computed for x, n = 0, 1, ... , (N/2) - 1 using the recurrence in the x-direction. Second, the TPCs for x = 0, 1, ... , (N/2) - 1 and n = (N/2), (N/2) + 1, ... , N - 1 based on n and x directions are calculated. Finally, the symmetry condition is applied to calculate the rest of the coefficients for x = (N/2), (N/2) + 1, ... , N - 1. In addition to the ability of the proposed algorithm to reduce the numerical propagation errors, it also accelerates the computational speed of the TPCs. The performance of the proposed algorithm was compared to that of existing algorithms for the reconstruction of speech and image signals taken from different databases. The performance of the TPCs computed by the proposed algorithm was also compared with the performance of the discrete cosine transform coefficients for speech compression systems. Different types of speech quality measures were used for evaluation. According to the results of the comparative analysis, the proposed algorithm makes the computation of the TP superior to that of conventional recurrence algorithms when the polynomial order is large.

In the past decade, many studies have been conducted to advance computer-aided systems for Alzheimer’s disease (AD) diagnosis. Most of them have recently developed systems concentrated on extracting and combining features from MRI, PET, and CSF. For the most part, they have obtained very high performance. However, improving the performance of a classification problem is complicated, specifically when the model’s accuracy or other performance measurements are higher than 90%. In this study, a novel methodology is proposed to address this problem, specifically in Alzheimer’s disease diagnosis classification. This methodology is the first of its kind in the literature, based on the notion of replication on the feature space instead of the traditional sample space. Briefly, the main steps of the proposed method include extracting, embedding, and exploring the best subset of features. For feature extraction, we adopt VBM-SPM; for embedding features, a concatenation strategy is used on the features to ultimately create one feature vector for each subject. Principal component analysis is applied to extract new features, forming a low-dimensional compact space. A novel process is applied by replicating selected components, assessing the classification model, and repeating the replication until performance divergence or convergence. The proposed method aims to explore most significant features and highest-preforming model at the same time, to classify normal subjects from AD and mild cognitive impairment (MCI) patients. In each epoch, a small subset of candidate features is assessed by support vector machine (SVM) classifier. This repeating procedure is continued until the highest performance is achieved. Experimental results reveal the highest performance reported in the literature for this specific classification problem. We obtained a model with accuracies of 98.81%, 81.61%, and 81.40% for AD vs. normal control (NC), MCI vs. NC, and AD vs. MCI classification, respectively.

The structure and appearance of the blood vessel network in retinal fundus images is an essential part of diagnosing various problems associated with the eyes, such as diabetes and hypertension. In this paper, an automatic retinal vessel segmentation method utilizing matched filter techniques coupled with an AdaBoost classifier is proposed. The fundus image is enhanced using morphological operations, the contrast is increased using contrast limited adaptive histogram equalization (CLAHE) method and the inhomogeneity is corrected using Retinex approach. Then, the blood vessels are enhanced using a combination of B-COSFIRE and Frangi matched filters. From this preprocessed image, different statistical features are computed on a pixel-wise basis and used in an AdaBoost classifier to extract the blood vessel network inside the image. Finally, the segmented images are postprocessed to remove the misclassified pixels and regions. The proposed method was validated using publicly accessible Digital Retinal Images for Vessel Extraction (DRIVE), Structured Analysis of the Retina (STARE) and Child Heart and Health Study in England (CHASE_DB1) datasets commonly used for determining the accuracy of retinal vessel segmentation methods. The accuracy of the proposed segmentation method was comparable to other state of the art methods while being very close to the manual segmentation provided by the second human observer with an average accuracy of 0.972, 0.951 and 0.948 in DRIVE, STARE and CHASE_DB1 datasets, respectively.

Road surface is designed to be the durable surface material to sustain the traffic loading. However, due to physical and mechanical stress, pavement deterioration is accelerated. Thus, modifying conventional bitumen by improving its properties is seen as the best method to prolong pavement in-service life. The purpose of this paper is to study the effect of waste natural rubber (NR) latex on rheological properties of bitumen. Conventional bitumen PEN 80/100 was modified with different content of waste NR latex using a high shear mixer at temperature of 150°C. The modified binder properties were characterized by conducting physical test (i.e. softening point, penetration and penetration index) and rheological test (i.e. dynamic shear rheometer, DSR). Results showed that, the addition of waste NR latex improved the rheology properties, which indicates by improving of rutting factor (G*/sin δ). This properties improvement has also shows a potential to resist deformation on road surface despite of high traffic loading.

Deploying large numbers of mobile robots which can interact with each other produces swarm intelligent behavior. However, mobile robots are normally running with finite energy resource, supplied from finite battery. The limitation of energy resource required human intervention for recharging the batteries. The sharing information among the mobile robots would be one of the potentials to overcome the limitation on previously recharging system. A new approach is proposed based on integrated intelligent system inspired by foraging of honeybees applied to multimobile robot scenario. This integrated approach caters for both working and foraging stages for known/unknown power station locations. Swarm mobile robot inspired by honeybee is simulated to explore and identify the power station for battery recharging. The mobile robots will share the location information of the power station with each other. The result showed that mobile robots consume less energy and less time when they are cooperating with each other for foraging process. The optimizing of foraging behavior would result in the mobile robots spending more time to do real work.

An approach to high field control, particularly in the areas near the high voltage (HV) and ground terminals of an outdoor insulator, is proposed using a nonlinear grading material; Zinc Oxide (ZnO) microvaristors compounded with other polymeric materials to obtain the required properties and allow easy application. The electrical properties of the microvaristor compounds are characterised by a nonlinear fielddependent conductivity. This paper describes the principles of the proposed fieldcontrol solution and demonstrates the effectiveness of the proposed approach in controlling the electric field along insulator profiles. A case study is carried out for a typical 11 kV polymeric insulator design to highlight the merits of the grading approach. Analysis of electric potential and field distributions on the insulator surface is described under dry clean and uniformly contaminated surface conditions for both standard and microvaristor-graded insulators. The grading and optimisation principles to allow better performance are investigated to improve the performance of the insulator both under steady state operation and under surge conditions. Furthermore, the dissipated power and associated heat are derived to examine surface heating and losses in the grading regions and for the complete insulator. Preliminary tests on inhouse prototype insulators have confirmed better flashover performance of the proposed graded insulator with a 21 % increase in flashover voltage. [ABSTRACT FROM AUTHOR]

Background: Umbilical artery thrombosis (UAT) masquerading as a single umbilical artery (SUA) is a rare but critical diagnostic challenge in prenatal care. Case Presentation: We described a case of a 22-year-old primigravida with an uneventful obstetric history who presented with reduced fetal movements at 22 weeks of gestation. Ultrasound showed no gross fetal structural anomalies while umbilical artery Doppler flow imaging revealed an isolated SUA. The patient again presented with diminished fetal movement at 24 weeks gestation, and a diagnosis of intrauterine demise was confirmed ultrasonographically. She was then induced and delivered a macerated stillborn female fetus. Placental examination revealed three umbilical vessels with an occlusive thrombus seen within the umbilical artery consistent with UAT, a finding previously mistaken for SUA. Conclusions: This case underscores the diagnostic difficulties of UAT radiologically, especially when there was no prior documented evidence of two umbilical arteries. Identification of at-risk fetuses would allow for close monitoring or effective interventions to be implemented as early as possible to avert preventable fetal loss.

Purpose: There is no standardized best method on monitoring of patients with gestational diabetes on diet modification in the country. This study aims to investigate the optimum method of self-monitoring blood glucose., Methods: This is a randomized clinical trial in a single tertiary centre involving patients with gestational diabetes mellitus (GDM) diagnosed based on NICE guideline on diet modification. The patients are randomized in 1:1 ratio to 4 or 7 points self-monitoring blood glucose. The monitoring was required to be done monthly with ultrasound for fetal growth. Blood was taken at recruitment for measurement of serum HbA 1c and fructosamine., Results: A total of 200 patients were recruited. There were significantly more Malay patients in the 7 points group (88.9% vs 78.2%, p = 0.033). Multiparous patients were significantly more in the 4 points group (82.2% vs 68.7%, p = 0.033). Both groups were similar in clinical characteristics. There was no statistical difference in the neonatal outcome particularly fetal macrosomia and admission to neonatal intensive care unit., Conclusions: In patients with GDM on diet modification, self-blood glucose monitoring using either 4 or 7 points resulted in similar maternal and perinatal outcomes. The research was registered under ClinicalTrials.gov (NCT04101396) on 17/9/2019 ( https://register., Clinicaltrials: gov/prs/app/action/SelectProtocol?sid=S00098EN&selectaction=Edit&uid=U0004RD4&ts=2&cx=-qlk1w2 )., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The cervical cancer (CC) incidence rate is increasing among young women aged <50 years despite early screening is proven effective. Electronic health (e-health) has great potential for disseminating health education., Methods: This study validated a newly developed e-health tool "SeDAR®" and assessed its usability via evaluations by health experts (HE), media experts (ME), and women. The SeDAR® content was developed based on protection motivation theory (PMT) using the nominal group technique and in-depth interviews that involved HE and women, respectively. Content validation was performed among the HE (n = 12) and ME (n = 5) using the content validation index (CVI) to identify their agreement. Subsequently, the Video Engagement Scale (VES®) was used to validate SeDAR® among women of different ethnicities (n = 11) to achieve ecological validity. The experts and women also commented on the presentation of the video., Results: The validation yielded a good CVI among the HE (scale-level CVI-average [SCVI/Ave] = 0.986; scale-level CVI-universal agreement [SCVI/UA] = 0.900) and ME (SCVI/Ave = 0.979, SCVI/UA = 0.897). The highest VES® score [mean (±SD) = 92.90(±3.46)] proved the ecological validity of SeDAR®. The experts' feedback established that SeDAR® conveyed a clear message about awareness of performing CC screening and was suitable for public viewing. The women considered SeDAR® easy to understand, and it advised early exposure for early CC screening., Conclusions: SeDAR® was valid and could constitute an important e-health tool to improve motivation and uptake of CC screening., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Romli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This review discusses the pathophysiology of diabetes in pregnancy in relation to the placental function. We review the potential use of hydroxychloroquine in improving pregnancy outcomes affected by diabetes. The review focuses on the mechanism of action of hydroxychloroquine and its potential effects on diabetes. There are several pathways in which hydroxychloroquine mediates its effects: through the inflammasome complex, inflammatory cytokines, oxidative stress, modulatory effects, and antihyperglycemic effects. As a safe drug to be used in pregnancy, it is worth exploring the possible use hydroxychloroquine as an adjunct treatment to the current therapy of diabetes in pregnancy.

Derris elliptica (Wall.) Benth, a native medicinal plant, has been used to treat diabetes for centuries; however, comprehensive documentation of its bioactive constituents and therapeutic effectiveness is lacking. In this study, we investigated the phytochemical profile and antidiabetic potential of D. elliptica methanolic leaf extract (DEME) in diabetic Sprague Dawley rats induced with streptozotocin (STZ). In normal rats, acute oral toxicity evaluations were conducted, and in STZ-induced rats, antidiabetic properties were investigated. 14 days of oral administration of standard glibenclamide and the extract at 200 and 400 mg/kg body weight to diabetic rodents. Assessed parameters included blood glucose levels, alterations in body weight, biochemical markers, and histological analysis of the pancreas, liver, and kidney. Numerous phytoconstituents were uncovered through qualitative phytochemical assays, 1 H NMR, and 1 H- 13 C HSQC screening. Quercetin was identified by 1 H NMR characterization, and a ceramide analogue compound was isolated and partially characterized by 1 H NMR. There were no indications of toxicity or mortality. The treatment with DEME significantly ( p <  0.001) decreased body weight and had a remarkable hypoglycemic effect. Both 200 mg/kg and 400 mg/kg extract concentrations decreased total cholesterol levels significantly (p < 0.01 and p < 0.05, respectively). In addition, glibenclamide and the 400 mg/kg dose of extract increased serum insulin levels substantially (p < 0.05) and decreased total bilirubin, lactic acid dehydrogenase, aspartate aminotransferase, and alanine aminotransferase levels. In addition to glibenclamide, treatment with DEME has exhibited cytoprotective effects and increased insulin secretion, thereby exerting a potent antihyperglycemic effect. These results suggest that D. elliptica may have therapeutic potential for the treatment of diabetes mellitus., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. CRediT authorship contribution statement, (© 2024 The Authors.)

Introduction: Gestational diabetes mellitus (GDM) exerts a great impact on the placenta and reflects changes on placentas both morphological and functionally. The aims of this study are to evaluate the prevalence of placental histopathological lesions in pregnancies complicated by GDM compared to gestational age-matched controls, and their association with maternal and fetal complications., Methods: Fifty-four singleton GDM-complicated pregnancies were recruited and compared to 33 consecutive normal pregnancies. Two pathologists, blinded to all clinical data, reviewed and evaluated all histological samples of the placentas in accordance with Amsterdam criteria. Relevant demographic, clinical data and primary birth outcomes were recorded., Results: A myriad of histomorphological abnormalities, including chronic inflammation (n = 9/54, p = 0.031), histological chorioamnionitis (n = 23/54, p < 0.001), umbilical/chorionic vasculitis (n = 9/54, p = 0.031), changes related to maternal vascular malperfusion (n = 22/54, p = 0.003), chorangiosis (n = 10/54, p = 0.046) and villous dysmaturity (n = 9/54, p = 0.012) were observed more frequently in the GDM placentas compared to the controls. Additionally, GDM significantly increased the risk of fetal complications, including macrosomia/fetal growth restriction (n = 13/54, p = 0.004)., Discussion: Histoarchitectural abnormalities were observed more frequently in placentas of GDM pregnancies compared to the controls. Our findings support the hypothesis that diabetic-induced damage in the placental function may be associated with the increased in fetal growth disorders in GDM-complicated pregnancies., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Cervical cancer (CC) screening remains challenging, where the motivational focus towards utilizing CC screening services is rarely highlighted. This study aimed to understand the motivation to undergo CC screening from women and healthcare practitioners' perspectives based on Protection Motivation Theory (PMT)., Method: This qualitative study used the nominal group technique (NGT) and in-depth interview (IDI), where the NGT participants were healthcare practitioners from various disciplines (n = 12). Nominal group discussions were conducted via Zoom and involved one moderator, facilitator and observer. The IDI was conducted via Google Meet among seven women who had been included based on purposive sampling. All nominal group discussions and interviews were transcribed, verbatim and underwent deductive thematic analysis., Results: Healthcare practitioners emphasized input on CC knowledge of epidemiology, risk, etiology, nature, and outcome to encourage motivation. Women underlined their important role in the family, and reducing the negative perception as a motivational focus. Having living example of witnessing the CC patient dying and fear of stigma of cancer could be the driven force to undergo screening. Emphasis on the important of sufficient knowledge and correct the misconceptions towards screening could impart the motivation among women., Conclusions: The motivational focus was enriched by the differing perspectives of the healthcare practitioners and women. The findings can guide intervention program development towards enhancing CC screening in the future., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Introduction: Diabetes mellitus in pregnancies is associated with adverse outcomes both for the mothers and babies. Postponing pregnancy in unoptimized conditions and stabilisation of glucose should be prioritized. This scoping review is aimed to determine the scope and at the same time map the types of evidence available that is related to family planning behaviours among women with diabetes mellitus, with a particular focus on their factors which influence family planning usage and subsequently enable the identification of knowledge gaps in preventing unintended pregnancies among this high-risk population., Methods: This scoping review is guided by the methodological framework by Arksey and O'Malley's and Prisma-ScR checklist. PubMed, EBSCO and OVID were searched for empirical studies between 2000 and February 2022 using the search terms "family planning", "contraceptive" and "diabetes mellitus". Data were summarized according to the study characteristics and levels of factors influencing family planning behaviours., Results: Thirty-five articles that met the eligibility criteria included 33 quantitative studies, one qualitative study and one mixed-methods study. The prevalence of family planning methods used by women with diabetes mellitus varied ranging from 4.8 to 89.8% among the studied population. Women with diabetes mellitus were reported to be less likely to utilise any family planning methods compared to women without diabetes mellitus., Conclusions: Most of the evidence to date on family planning behaviours among women with diabetes mellitus focuses on the role of individual level sociodemographic factors. Few studies focused on exploring determinants at multiple levels. In this review we found that there is limited evidence on disease control and pregnancy intention in relation to their family planning practices. Future studies with more clinical and contextual factors are needed to guide the strengthening of family planning services for high-risk group women specifically for women with diabetes mellitus., (© 2024. The Author(s).)

Introduction: Cervical cancer remains a reproductive health burden. Pap smear (PS) screening can detect cervical cancer early but is underused despite being subsidized. Motivational factors play a role in promoting PS screening. This study aimed to determine the women's motivation toward PS screening based on Protection Motivation Theory (PMT), which mainly focused on sexual and screening status., Materials and Methods: The study was conducted electronically throughout Malaysia from January to February 2022 by disseminating Google Form (https://forms.gle/cD7fkUKYR4Cq6kZC8) via multiple WhatsApp groups to reach 526 women aged 21-65 years. The questionnaire consists of 24 items based on seven PMT constructs [perceived vulnerability, perceived severity, self-efficacy, response efficacy, fear (threat appraisal), response costs (coping appraisal), and protection motivation]. The descriptive statistics and independent t -test was used to analyze data using IBM SPSS Statistics software, version 25., Results: Most respondents were sexually active [80.6% ( n = 424)] and have heard of PS screening [95.8% ( n = 504)]. More than half of respondents did not have PS screening in the last three years [59.3% ( n = 312)]. Sexually active women have heard and have undergone PS screening feel less threatened with low coping appraisals. Undergoing PS screening made women perceived more response efficacy ( P =. 011), more self-efficacy ( P <. 001), and higher protection motivation ( P <. 001) toward PS screening., Conclusions: Women's motivation related to PS screening needs to be highlighted. Future development of health education strategy should include motivation focused in emphasizing the threat and coping appraisal into educational plan to ensure women come forward for screening., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Education and Health Promotion.)

Background: Loss to follow-up (LTFU) is an unsuccessful treatment outcome for tuberculosis (TB) patients. In Malaysia, LTFU affects around 1 in 20 TB patients. Integration of qualitative research methods and evidence will provide a better understanding of LTFU and its underlying issues. In this study, we qualitatively explored TB patients' experiences in receiving treatment and their reasons for leaving TB care., Method: In-depth interviews of 15 patients with a history of LTFU were conducted from January to September 2020. Interview guides were developed to explore TB patients' experiences while receiving treatment, including challenges faced and reasons for treatment interruption. Data were thematically analysed using the framework method., Results: We identified 11 emerging themes that occurred at four levels of interaction with TB patients. First, at the patient personal level, TB beliefs referring to patients' perception of illness and wellness, patients' perceived role of traditional and complementary medicine, and substance abuse were important. Second, the healthcare system and treatment factors that were highlighted included the organisation of care and treatment, interaction with healthcare professionals, particularly in communication and counselling, and TB medications' side effects. Third, structural factors including financial burden, logistical and transportation issues and work-related factors were identified to be barriers to treatment continuation. Fourth, the interpersonal level interaction of patients should not be neglected; this includes family relationships and support as well as peer influence., Conclusion: Study findings put forth issues and challenges faced by TB patients while receiving treatment and underscore areas where actions can be taken. This will contribute to informing the development and implementation of future TB control strategies that are responsive to TB patients' needs and concerns, to effectively address LTFU and ensure better treatment completion rates among TB patients in Malaysia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Tok et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This is a cross-sectional study comparing pregnancy outcomes between participants with 4 and 6 cm of cervical os dilatation at the diagnosis of the active phase of labour. It was conducted in a single tertiary centre involving low-risk singleton pregnancies at or beyond 37 weeks with spontaneous onset of labour. A total of 155 participants were recruited, 101 in group 1 (4 cm) and 54 in group 2 (6 cm). Both groups were similar in mean maternal age, mean gestational age at delivery, ethnicity, median haemoglobin level at delivery, body mass index, and parity. There were significantly more participants in group 1 who needed oxytocin augmentation ( p < 0.001) for the longer mean duration ( p = 0.015), use of analgesia ( p < 0.001), and caesarean section rate ( p = 0.002). None of the women had a postpartum haemorrhage or a third- or fourth-degree perineal tear, and none of the neonates required admission to the neonatal intensive care unit. There were significantly more nulliparas who had a caesarean section as compared to multiparas. A cervical os dilatation of 6 cm reduces the risk of caesarean section by 11% (95% CI, 0.01-0.9) and increases three times more the need for analgesia (AOR = 3.44, 95% CI, 1.2-9.4). In conclusion, the demarcation of the active phase of labour at a cervical os dilatation of 6 cm is feasible without an increase in maternal or neonatal complications., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2023 Nadzirah Mohd Fathil et al.)

No abstract available.

Anemia in pregnancy is a public health concern. It has been diagnosed in 27% of pregnant women in Malaysia and up to 40% of pregnant women globally. This study aimed to develop and evaluate the effectiveness of an intervention initiative based on the health belief model. The MyPinkMom program was disseminated through a mobile messaging application to pregnant women to educate them on the prevention of anemia in pregnancy. We conducted a two-arm cluster-assignment, single-blinded, randomized control trial at two government antenatal clinics in Selangor. One clinic was randomly chosen as the intervention group, and the other was chosen as the control group. Sixty pregnant women with anemia from the intervention group received the MyPinkMom intervention program in the form of six infographic video clips, and 60 pregnant women with anemia from the control group received routine counseling on anemia in pregnancy. Pregnant women who had anemia secondary to hemoglobinopathy or other chronic diseases were excluded from this study. MANOVA showed significant increases in hemoglobin, knowledge, attitude, subjective norms, and perceived behavioral control scores for adherence to iron supplements, dietary iron, and dietary vitamin C intake (p < 0.001) in the intervention group at week 6. A significant reduction also occurred in dietary tannin intake (p < 0.001) in the intervention group at week 6. The intervention group at week 6 showed a large effect on hemoglobin level increments (partial eta squared, Ƞp2 0.268), dietary iron intake (Ƞp2 0.213), knowledge of anemia in pregnancy (Ƞp2 0.622), subjective norm scores for adherence to iron supplements (Ƞp2 0.167), and reduction in dietary tannin intake (Ƞp2 0.353). Similarly, repeated measures ANOVA showed that changes in hemoglobin levels were significantly different over time (i.e., at baseline, week 6, and week 12) between the intervention and control groups (p < 0.001). Hemoglobin increased rapidly over time among participants in the intervention group but gradually in the control group. To conclude, the newly developed MyPinkMom program that was delivered through a messaging application showed effectiveness in preventing anemia during pregnancy., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Abd Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The disruptive potentials of drones are rapidly growing including for the delivery of blood samples in healthcare. Maintenance of the quality of blood samples is important to ascertain that the drone is a safe mode of transportation, particularly during emergencies and in critical cases. The influence of the drone carriage material on blood samples transportation was investigated in this study. Two phases of drone simulation flights were conducted in Cyberjaya, Malaysia. In Phase 1, the effect of drone carriage material on the internal storage temperature during blood samples transportation was determined. Three types of carriage materials were compared: aluminium, expanded polystyrene (EPS) foam, and polypropylene (PP) plastic. In Phase 2, the quality of drone-transported blood samples was assessed, using the best material from Phase 1 as the drone carriage material. Biochemical and hematological analyses of 60 blood samples were conducted using five parameters. In Phase 1, EPS foam was found to be the best material to maintain a stable and favorable internal storage temperature at mean kinetic temperature ±SD of 4.70 ±1.14°C. Much higher and unfavorable mean kinetic temperatures were recorded for aluminium (11.46 ±0.35°C) and plastic (14.17 ±0.05°C). In Phase 2, laboratory tests show that the quality of blood samples was well maintained, and the mean biochemical and hematological parameters of drone-transported blood samples showed no significant alteration compared to ground controls. Drone carriage material is an important determinant of the quality of blood samples transported by drone, particularly in hot equatorial climates as in Malaysia. The blood storage temperature was best maintained using EPS foam, as evidenced by the favorable average temperature and preservation of hematological and biochemical parameters of the blood samples., Competing Interests: The authors have declared that no competing interests exist.

Cervical cancer (CC) screening can detect the cancer early but is underutilized, especially among the developing countries and low- to middle-income countries. Electronic health (e-health) has the potential for disseminating health education and is widely used in the developed countries. This systematic literature review investigates the effectiveness of e-health intervention for improving knowledge of CC and the intention or uptake for CC screening. We followed the PRISMA 2020 guideline and registered with PROSPERO (registration ID CRD42021276036). We searched the Web of Science, Scopus and EBSCO Medline Complete databases for eligible studies. Studies that conveyed informational material through e-health intervention were selected. The results were analyzed using narrative synthesis, and the pooled estimates were calculated using meta-analysis. A total of six studies involving 1886 women were included in this review. The use of e-health aids alone led to increased knowledge. The meta-analysis demonstrated that the mixed-education method of e-health movies and video education with didactic sessions increased CC screening uptake. A random-effects model revealed that CC screening uptake following e-health interventions were almost double of that of their comparison (odds ratio = 2.29, 95% confidence interval: 1.28-4.10, p < 0.05). Various areas of study demonstrated e-health intervention effectiveness (minority communities, urban areas, rural areas). Health education through e-health intervention has huge potential for promoting CC screening in the community. Nevertheless, the use of appropriate frameworks, user engagement and culturally tailored e-health need to be prioritized., Competing Interests: The authors have declared that no competing interests exist.

SONAR signal processing plays an indispensable role when it comes to parameter estimation of Direction of Arrival (DOA) of acoustic plane waves for closely spaced target exclusively under severe noisy environments. Resolution performance of classical MUSIC and ESPRIT algorithms and other subspace-based algorithms decreases under scenarios like low SNR, smaller number of snapshots and closely spaced targets. In this study, optimization strength of swarm intelligence of Cuckoo Search Algorithm (CSA) is accomplished for viable DOA estimation in different scenarios of underwater environment using a Uniform Linear Array (ULA). Higher resolution for closely spaced targets is achieved using smaller number of snapshots viably with CSA by investigating global minima of the highly nonlinear cost function of ULA. Performance analysis of CSA for different number of targets employing estimation accuracy, higher resolution, variance analysis, frequency distribution of RMSE over the monte Carlo runs and robustness against noise in the presence of additive-white Gaussian measurement noise is achieved. Comparative studies of CSA with Root MUSIC and ESPRIT along with Crammer Rao Bound analysis witnesses better results for estimating DOA parameters which are further endorsed from the results of Monte Carlo simulations., Competing Interests: The authors have declared that no competing interests exist.

Pap smear screening can detect cervical cancer early, but is underutilized. Motivational factors play a role in ensuring that women undergo Pap smear screening. This study was conducted to validate the adapted instrument, which was based on the protection motivation theory (PMT), into the Malay language to evaluate the motivational factors for Pap smear screening among women. The original 26-item PMT scale was developed based on seven constructs of the PMT framework. The adaptation involved translation by bilingual experts ( n = 4), followed by synthesis ( n = 6). Subsequently, we performed content validation (content validation index, CVI) among the health experts ( n = 5) and face validation (face validation index, FVI) among women ( n = 11). Reliability testing for internal consistency was determined via the confirmatory factor analysis (CFA) of women aged between 21 and 65 years ( n = 150). One item was deleted based on the expert consensus, leaving a total of 25 items after the adaptation. The validation yielded a good CVI and FVI. Prior to CFA reliability testing, one item was deleted due to very low factor loading. The CFA indicated a good fit for 24 items. The factor loading (range: 0.45-0.98), average variance extracted (range: 0.44-0.90), and composite reliability (range: 0.69-0.97) indicated that the convergent validity for each construct was acceptable, except for the perceived vulnerability. However, the perceived vulnerability construct was accepted based on expert verification. We confirmed that the translation, cross-cultural, adaptation, and validation of the Malay-version PMT scale were valid and reliable. The scale contains 24 items that represent the seven constructs of the PMT framework.

Anemia in pregnancy is defined as a hemoglobin level of <11 g/dl, and is commonly due to iron deficiency. This systematic review was conducted to determine the prevalence and risk factors of anemia and iron deficiency among pregnant women in Malaysia. A systematic literature search was conducted in Google Scholar, PubMed, and Cochrane Library databases. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. Eight studies comprising a total number of 2,638 pregnant women were included in this review. Only two studies focused on iron deficiency, whereas the other six investigated anemia in pregnancy without specifying iron deficiency or any other nutritional cause for the anemia, signifying the lack of published literature on this important public health nutritional issue in Malaysia. The overall prevalence of anemia in pregnancy ranged from 19.3 to 57.4%, while the prevalence of iron deficiency was 31.6 to 34.6%. Factors that were significantly associated with anemia in pregnancy were extremes of reproductive age, late antenatal booking, non-compliance to hematinics, Indian ethnicity, being in the second or third trimester, low maternal educational level, low family income, and unemployment. The prevalence of anemia in pregnancy was found to be higher in rural compared to urban areas. Meanwhile, in terms of iron deficiency anemia, grandmultiparity, late antenatal booking and Indian ethnicity were significant determinants. It is certainly plausible that the anemia in pregnancy reported in these studies is not entirely secondary to iron deficiency and may be attributable to other nutritional deficiencies, emphasizing the importance of researching deeper into this subject. Nevertheless, in the meantime, focusing on iron supplementation in high-risk mothers with emphasis on compliance, seems to be the best option, in view of the high prevalence of iron deficiency found in this review., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abd Rahman, Idris, Isa, Rahman and Mahdy.)

In-depth understanding of the pollution problems such as dry bands and the polymeric aging process requires better determination of electric field strength and its distribution over the polymeric surface. To determine the electric field distribution over the insulator surface, this research proposes utilizing a novel approach model based on nonlinear electrical characteristics derived from experimental results for polluted polymer insulators. A case study was carried out for a typical 11 kV polymeric insulator to underline the merits of this new modeling approach. The developments of the proposed pollution model and the subsequent computational works are described in detail. The study is divided into two main stages; laboratory measurements and computer simulations. In the first stage, layer conductance tests were carried out to develop nonlinear field-dependent conductivity for the pollution modeling. In the second part, equipotential and electric field distributions along the leakage were computed using the finite element method (FEM). Comparative field studies showed that the simulation using the proposed dynamic pollution model results in more detailed and realistic field profiles around insulators. This may be useful to predict the formation of dry bands and the initiation of electrical discharges on the polymeric surface.

Hunter Syndrome is a genetic disease characterized by deficiency of Iduronate-2-Sulfatase enzyme activity, resulting in accumulation of glycoaminoglycans in various organs including the central airways. We report a case of severe tracheomalacia and airway stenosis at Hospital Sultanah Aminah, Johor Bahru, Malaysia requiring mechanical ventilation in a middle aged gentleman who was previously undiagnosed of mucopolysaccharidosis. The patient underwent emergency tracheostomy for failed intubation, when he presented with shortness of breath and acute respiratory failure. A contrast-enhanced computed tomography of the neck and thorax revealed that the trachea distal to the tracheostomy tube had collapsed with narrowed right and left main bronchus. These findings were confirmed via direct visualization of the airway through a flexible bronchoscopy. Eventually, a tracheal stenting were performed to maintain the airway patency and assist in weaning off from mechanical ventilation. Further investigations to identify the aetiology of the central airway stenosis revealed elevated urinary glycoaminoglycans and the absence of iduronate-2-Sulfatase activity tested on dried blood spots, thus confirming the diagnosis of Hunter Syndrome. Managing mucopolysacharidosis with central airway obstruction requires multidisciplinary team effort in handling the difficult airway, anaesthesiology risk, potential comorbidities and providing genetic counselling.