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Background: Mathematics is not just a science for its own sake; it is a science that proves to be useful for most other sciences. Mathematical connections play a crucial role in helping students develop a deeper understanding and enhance their thinking about mathematics. These connections represent relationships between different mathematical ideas, between mathematics and other subjects, and between mathematics and everyday life. Aim: This study aims to classify students' mathematical connection abilities when solving non-routine mathematical problems. Method: This research employs a qualitative approach using descriptive and exploratory methods. The study involved 23 students who exhibited mathematical connection skills in problem-solving. Data collection methods included tests, observations, and interviews. The data analysis process consisted of two main stages: data reduction and data presentation. To ensure data validation, the triangulation method was used by comparing the results from the subject tests (answer sheets), observations, and interviews. Results: The findings of this study revealed three distinct classifications of students’ mathematical connections when solving non-routine problems: 1) Patterns; 2) Variables; and 3) Arguments Conclusion: The implications of these findings suggest that teachers need to be aware of the different classifications of students' mathematical connections. This awareness will enable them to implement mathematics learning strategies that cater to the diverse mathematical connection classifications found in their classrooms. For instance, teachers can utilize different mathematics learning media tailored to students’ learning styles, such as mind, incubation, and visual learning. By doing so, students can better optimize their mathematical connections and achieve improved outcomes in their mathematics learning.

Abstract In real-life situations, we have to analyze the data that contains the atypical observations, and the presence of outliers has adverse effects on the performance of ordinary least square estimates. In this situation, redescedning M-estimators, proposed by Huber (1964), are used to tackle the effects of outliers to increase the efficiency of least square estimates. In this study, we introduce a redescending M-estimator designed to generate robust estimates by mitigating the influence of outlier observations, even when the tuning constant is set to low values. This innovative estimator exhibits enhanced linearity at its core and maintains continuity throughout its range. Our proposed estimator stands out for its novelty, simplicity, differentiability, and practical applicability across real-world scenarios. The results of the proposed redescedning M-estimators are compared with existing robust estimators using an extensive simulation study. Two examples based on real-life data are also added to validate the performance of the suggested function. The formulated redescedning M-estimator produced efficient results as compared to all the considered redescedning M-estimators.

Abstract The Max-Mixed EWMA Exponentially Weighted Moving Average (MM EWMA) control chart is a statistical process control technique used for joint monitoring of the mean and variance of a process. This control chart is designed to detect small and moderate shifts in the mean and variance of a process by comparing the maximum of two statistics, one based on the mean and the other on the variance. In this paper, we propose a new MM EWMA control chart. The proposed chart is compared with existing control charts using simulation studies, and the results show that the chart performs better in detecting small and moderate shifts in both the mean and variance. The proposed chart can be helpful in quality control applications, where joint monitoring of mean and variance is necessary to ensure a product’s or process’s quality. The real-life application of the proposed control chart on yogurt packing in a cup data set shows the outperformance of the MM EWMA control chart. Both simulations & real-life application results demonstrate the better performance of the proposed chart in detecting smaller shifts during the production process.

Aluminum Alloy 6061 is widely used in various engineering applications, including automotive vehicle wheels. The selection of aluminum alloy wheels involves aspects such as corrosion resistance. To enhance corrosion resistance, there are several methods, one of which is anodizing. Anodizing is a process that involves an electrolytic coating process that transforms the surface of aluminum into aluminum oxide (Al2O3), which the main process of aluminum anodizing requires a solution of sulfuric acid, chromic acid, or a mixture of sulfuric acid and oxalic acid. The sulfuric acid used must be concentrated acid, and acid is an oxidizing substance. The thickness of the oxide is approximately twice the thickness of the lost aluminum. The purpose of this research is to determine the characteristic such as surface roughness values, corrosion rates, and changes in morphology in Aluminum 6061 after undergoing anodizing. In this study, various current strengths were used, namely 0.75 Amperes, 1.5 Amperes, 2.25 Amperes, and 3 Amperes. The highest surface roughness value was obtained at 0.447 μm in the third specimen of the 0.75 Ampere variation, while the lowest was 0.075 μm in the first specimen of the 3 Ampere variation. The highest corrosion rate was observed in the 0.75 Ampere variation, with a rate of 17.724004 mpy, and the lowest was 0.0731653 mpy in the 3 Ampere variation. SEM results show that, in general, Aluminum 6061 tends to have a bright gray color, which is a surface that has been coated by cathode.

Students need to have the ability to think in order to solve a problem from the problem at hand. This study aims to describe the reflective thinking ability of seventh grade students of SMP Batik Surakarta when they solve problems involving statistics in terms of Self-Regulated Learning. This research used qualitative research method with descriptive research type. The subjects in this study were students of class VII C SMP Batik Surakarta. Data collection begins with filling out a self-regulated learning questionnaire by students and reflective thinking ability test questions then from the results of the categorisation based on the results of the questionnaire conducted interviews. The results of this study are students who have self-regulated learning with high category have high reflective thinking ability can fulfil the indicators of reflective thinking reacting, comparing, and contemplating. Students who have moderate self-regulated learning have moderate reflective thinking ability can fulfil two indicators of reacting, and comparing. Students who have low self-regulated learning category have less reflective thinking ability that only fulfils one reflective thinking indicator which is reacting

Abstract The increased global warming has increased the likelihood of recurrent drought hazards. Potential links between the frequency of extreme weather events and global warming have been suggested by earlier research. The spatial variability of meteorological factors over short distances can cause distortions in conclusions or limit the scope of drought analysis in a particular region when extreme values predominate. Therefore, it is challenging to make trustworthy judgments regarding the spatiotemporal characteristics of regional drought. This study aims to improve the quality and accuracy of regional drought characterization and the process of continuous monitoring. The new drought indicator presented in this study is called the Support Vector Machine based drought index (SVM-DI). It is created by adding different weights to an SVM-based X-bar chart that is displayed with regional precipitation aggregate data. The SVM-DI application site is located in Pakistan's northern area. Using the Pearson correlation coefficient for pairwise comparison, the study compares the SVM-DI and the Regional Standard Precipitation Index (RSPI). Interestingly, compared to RSPI, SVM-DI shows more pronounced regional characteristics in its correlations with other meteorological stations, with a significantly lower Coefficient of Variation. These results confirm that SVM-DI is a useful tool for regional drought analysis. The SVM-DI methodology offers a unique way to reduce the impact of extreme values and outliers when aggregating regional precipitation data.

Abstract This article introduces an adaptive approach within the Bayesian Max-EWMA control chart framework. Various Bayesian loss functions were used to jointly monitor process deviations from the mean and variance of normally distributed processes. Our study proposes the mechanism of using a function-based adaptive method that picks self-adjusting weights incorporated in Bayesian Max-EWMA for the estimation of mean and variance. This adaptive mechanism significantly enhances the effectiveness and sensitivity of the Max-EWMA chart in detecting process shifts in both the mean and dispersion. The Monte Carlo simulation technique was used to calculate the run-length profiles of different combinations. A comparative performance analysis with an existing chart demonstrates its effectiveness. A practical example from the hard-bake process in semiconductor manufacturing is presented for practical context and illustration of the chart settings and performance. The empirical results showcase the superior performance of the Adaptive Bayesian Max-EWMA control chart in identifying out-of-control signals. The chart’s ability to jointly monitor the mean and variance of a process, its adaptive nature, and its Bayesian framework make it a useful and effective control chart.

Abstract In the current study, we demonstrate the use of a quality framework to review the process for improving the quality and safety of the patient in the health care department. The researchers paid attention to assessing the performance of the health care service, where the data is usually heterogeneous to patient’s health conditions. In our study, the support vector machine (SVM) regression model is used to handle the challenge of adjusting the risk factors attached to the patients. Further, the design of exponentially weighted moving average (EWMA) control charts is proposed based on the residuals obtained through SVM regression model. Analyzing real cardiac surgery patient data, we employed the SVM method to gauge patient condition. The resulting SVM-EWMA chart, fashioned via SVM modeling, revealed superior shift detection capabilities and demonstrated enhanced efficacy compared to the risk-adjusted EWMA control chart.

Abstract The OLS model is built on the assumption of normality in the distribution of error terms. However, this assumption can be easily violated, especially when there are outliers in the data. A single outlier can disrupt the normality assumption of error terms, making the OLS model less effective. In such situations, M-estimators (MEs) come into play to obtain reliable estimates. We introduce a redescending M-estimators (RME) for robust regression to handle datasets with outliers. The proposed RME produces more robust estimates by effectively managing the influence of outliers, even at lower values of the tuning constant. We compared the performance of this estimator with existing RMEs using real-life data examples and an extensive simulation study. The results show that our suggested RME is more efficient than the compared ME in various situations.

Corrosion in maritime infrastructure, particularly in reinforced concrete, has emerged as a significant cause for concern due to the presence of chloride ions in seawater. To address this challenge, geopolymer concrete has been proposed as a viable solution for retrofitting and restoring marine structures. This review paper explores the potential application of fly ash geopolymer concrete in marine infrastructure restoration. Fly ash's properties make it ideal for marine infrastructure restoration. Its high levels of amorphous silica and alumina enable geopolymerization, forming a strong binder resistant to chloride corrosion. Its fine, spherical particles enhance concrete workability and density, improving mechanical strength and impermeability. This geopolymer binder offers excellent resistance to corrosion from chloride ions commonly found in seawater, making fly ash geopolymer concrete highly suitable for marine applications. Overall, fly ash's chemical composition and physical traits offer resilience and sustainability in restoring marine infrastructure, ensuring long-term durability against corrosion. This review paper explores the potential application of fly ash geopolymer concrete in marine infrastructure restoration. By examining the primary forms of damage and mechanisms underlying concrete degradation in marine settings, this study highlights the durability and sustainability of geopolymer concrete compared to traditional concrete. Additionally, it discusses current solutions for repairing and retrofitting concrete in marine environments, emphasizing the promising characteristics of geopolymer concrete for integration into such structures. Through this analysis, innovative and environmentally conscious approaches are introduced for addressing corrosion-related challenges in the maritime industry, offering a resilient solution for the construction of enduring marine structures. Finally, recommendations for further research on the application of fly ash geopolymer concrete in marine infrastructure restoration are presented.

Despite technological advances, clinical skills are the foundation of medical practice. Taking a comprehensive clinical history, performing physical examinations, and communicating effectively are crucial for high-quality patient care. Medical students need to focus on developing strong clinical skills to ensure they are well-prepared for their careers and adapt to the evolving field of medicine through continual practice and refinement.1 The medical community is worried about declining essential clinical skills among undergraduate medical students.2,3 This editorial aims to analyze the reasons for the decline and suggest evidence-based methods to address the situation. 05885.0258063. The declining standards of clinical skills among medical students can be attributed to the widespread adoption of technology-based learning, which has the potential to diminish the importance of traditional hands-on bedside teaching.4 Technology should enhance, not replace, practical clinical experiences. Practical training improves the clinical abilities, expertise, and self-assurance of medical students.5 Moreover, the growing magnitude and expansion of medical curricula provide difficulties in the development of educational programs without ample time for bedside practical teaching.6,7 There is frequently an excessive focus on remembering facts rather than on cultivating clinical reasoning abilities.8 The reduced patient interaction during medical school, due to increased reliance on simulations and less time in clinical rotations and bedside teaching, hampers the development of clinical skills.9 External factors such as limited time and extensive paperwork may affect the quality of patient encounters. Efficient communication is crucial for building good relationships with patients, obtaining accurate medical histories, and ensuring patient understanding and adherence to treatment.9 Insufficient training in communication skills can result in less-than-ideal interactions between patients and healthcare providers and can also contribute to errors in diagnosis and medical treatment.10 The provision of trained faculty for teaching medical students is an issue worldwide. Insufficient supervision and feedback during clinical rotations hinder the development of essential clinical skills.11 Larger student cohorts reduce the opportunities for individual students to practice and receive personalized instruction in clinical skills.12 Medical education often prioritizes theoretical testing over practical examinations and undervalues communication skills training. Variability in clinical experiences at different medical schools can lead to inconsistencies in skill acquisition. The scarcity of skilled clinicians as role models impacts students’ learning. Economic constraints and modern healthcare pressures limit opportunities for thorough patient interactions and clinical training.13 THE WAY FORWARD Educational institutions should prioritize hands-on clinical experiences throughout the curriculum to improve students’ diagnostic and communication abilities. These experiences should include simulation-based learning, standardized patients, and longitudinal clerkships. Faculty members need support and resources for effective clinical mentorship and development. Reflective practice should be integrated into the curriculum to enhance self-awareness and critical thinking. Open communication and mentorship programs between students and faculty can strengthen medical training and promote continual learning. To address declining clinical proficiency among medical students, institutions can adopt evidence-based approaches including curriculum changes, faculty training, promoting reflective thinking, collaboration among healthcare professionals, and fostering a culture of ongoing learning. Regulatory bodies should ensure adequate time for bedside teaching and appropriate assessment weightage.

Knowing the level of SARS-CoV-2 transmission is crucial for decision-making on Coronavirus disease (COVID-19) handling. Guidelines for measuring SARS-CoV-2 antibodies to estimate seroprevalence are conceptually straightforward and internationally available. However, challenges exist for developing countries with limited laboratory capacity, diverse geographical topography, fragmented health information systems and limited resources such as Indonesia. One year after the first case was confirmed in Indonesia, approximately ten infections were undiagnosed or underreported for every reported case. Under those circumstances, we described the method and lessons learned in conducting nationwide cohort COVID-19 serology surveys in a nation with limited resources, such as Indonesia. • Strong cross-sectoral collaboration between ministries and levels of governance (central and subnational) enables strategic use of civil registration database for efficient sampling. • All agglomeration districts (highly dense population and urban area) were selected as study sites, and additional non-agglomeration districts were selected using probability-proportional-to-size (PPS). • Involving the experienced phlebotomist in community health service provider and district laboratory cut down preparation time.

Palm oil shows significant potential for development as a lubricant due to its long molecular fatty acid chain, which is capable of minimizing wear and friction. However, in certain conditions, the formation of a thin layer of fluid film may no longer sustain to protect the contact surfaces. Therefore, a relevant additive is needed to address this issue. In this study, trimethylolpropane (TMP) was used as a lubricant, and Graphene Oxide (GO) was employed as the nano-based additive. A Four-ball tribotester was utilized to determine the friction coefficient, wear scar, and surface roughness of the contact surfaces under various operating conditions. The results were compared to mineral and synthetic-based oils. It was found that the combination of TMP and GO exhibited a lower friction coefficient compared to mineral and synthetic-based oils, but slightly higher compared to pure TMP. However, TMP+GO demonstrated significant improvement in terms of wear scar diameter and surface roughness. The physical appearance of the wear was also discussed in this study.

Abstract The simultaneous monitoring of both process mean and dispersion, particularly in normal processes, has garnered significant attention within the field. In this article, we present a new Bayesian Max-EWMA control chart that is intended to track a non-normal process mean and dispersion simultaneously. This is accomplished through the utilization of the inverse response function, especially in cases where the procedure follows a Weibull distribution. We used the average run length (ARL) and the standard deviation of run length (SDRL) to assess the efficacy of our suggested control chart. Next, we contrast our suggested control chart's performance with an already-existing Max-EWMA control chart. Our results show that compared to the control chart under consideration, the proposed control chart exhibits a higher degree of sensitivity. Finally, we present a useful case study centered around the hard-bake process in the semiconductor manufacturing sector to demonstrate the performance of our Bayesian Max-EWMA control chart under different Loss Functions (LFs) for a Weibull process. The case study highlights how flexible the chart is to various situations. Our results offer strong proof of the outstanding ability of the Bayesian Max-EWMA control chart to quickly identify out-of-control signals during the hard-bake procedure. This in turn significantly contributes to the enhancement of process monitoring and quality control.

The research area is an oil and gas field that is currently undergoing development, located in the South Sumatra Basin. Coal content, particularly within the Lower Talang Akar Formation (LTAF) interval, is frequently encountered in this field, with coal serving as the source of in-situ CO2 content formation. Consequently, CO2 content can be identified using the Amplitude Versus Offset (AVO) analysis method, allowing an assessment of its influence on the percentage presence of CO2. The data used in this study consist of well data, including log data (Density, Porosity, Vp & Vs Sonic/DT), Drill Stem Test (DST) data, well marker data resulting from stratigraphic sequence interpretation, and well reports. The AVO method to be employed encompasses a wide-angle range, approximately 0°-45°. The results obtained from this research using the AVO method, after AVO modelling on well data, indicate that the dominant AVO response within the LTAF interval is class 4 AVO. AVO analysis results regarding AVO presence indicate that reservoir intervals containing CO2 content will exhibit a class 4 AVO response, and an increase in fluid content percentage will result in a more positive intercept and a more negative gradient (towards class 2 AVO). In terms of facies and depth variations, the AVO attribute response consistently demonstrates an increase in intercept and a decrease in gradient with rising CO2 levels.

This study introduces a novel adaptive exponentially weighted moving average (AEWMA) control chart for monitoring process dispersion, employing adaptation to determine the smoothing constant. It is designed to effectively track shifts within expected ranges in process dispersion by computing the smoothing constant through a suggested adaptive approach. To determine its efficacy, the chart’s performance is evaluated by using smaller run-length profiles derived from Monte Carlo simulations. A key feature is the utilization of an unbiased estimator to calculate the smoothing constant via the proposed function, enhancing the chart’s ability to detect various magnitudes of decreasing and increasing process dispersion shifts. A comparison with an existing adaptive EWMA dispersion chart underscores the significant efficiency of the proposed chart across various types of process dispersion shift magnitudes. Moreover, the study encompasses a real-life dataset application, demonstrating the practical implementation and ease of use in real-world scenarios.

Coastal acid-sulfate soils are crucial for producing crops and thus, for food security. However, over time, these soil resources experience degradation, leading to higher agro-input, lower yields, and environmental hazards that finally threaten food security. The optimal use of this fragile resource is only attained by implementing vigorous integrated water–soil–crop management technologies amid the climate change impact. This study aimed to review the distribution, properties, use, and management of acid-sulfate soils in Kalimantan, Indonesia. Acid-sulfate soils cover about 3.5 Mha of the coastal area in Kalimantan and have high acidity, high-risk iron and aluminum toxicity, and low fertility, requiring precise water management, amelioration and fertilizer application, crop variety selection, and rice cultivation technologies. Lime, biochar, organic fertilizer, compost, ash, and fly ash are ameliorants that raise pH, reduce iron and aluminum toxicity, and improve crop yield. Rice cultivation has developed from traditional to modern but needs re-designing to fit local conditions. Depending on the soil nutrient status, rice cultivation requires 80–200 kg ha−1 of urea, 50–150 kg ha−1 of SP36, 50–150 kg ha−1 of KCl, and 125–400 kg ha−1 of NPK compound fertilizer, but is affected by CH4 and CO2 emissions. Good water management impacts the effective implementation of amelioration and fertilizer application technologies. The remaining challenges and future directions for water management, amelioration, fertilizer application, crop varieties, cultivation techniques, land use optimization, climate change adaptation and mitigation, technology adoption and implementation, and resource conservation are outlined. Acid-sulfate soils remain a resource capital that supports food security regionally and nationally in Indonesia.

Indonesia has entered a period of demographic bonus. Human resources must be optimized. The number of children who do not in employment, education or training (NEET) in each province needs attention. Several factors that could contribute to the decline in the NEET percentage are literacy rates and the number of adolescents with computer skills. Increasing these two factors is believed to be able to reduce the percentage of NEET in every province in Indonesia. To find out the relationship between these two factors and how much influence they have on the percentage of NEET, this research is modeled by Cauchy regression and includes spatial effects. The results of the analysis show that the best model is when the spatial effect is modeled by Fernandez Steel Skew Normal conditionally autoregressive (FSSN CAR). This result is seen from the smallest value of the Watanabe Akaike Information Criterion (WAIC) in this model, which is 190.5. The parameter estimated shows that the higher the literacy rate and the number of adolescents with computer skills, the lower the percentage of NEET in each province in Indonesia. The results of this research can be useful for the Indonesian government to increase the number of educational facilities related to these two factors. [ABSTRACT FROM AUTHOR]

Background: Intellectual disability (ID) is a neurodevelopmental condition affecting around 2% of children and young adults worldwide, characterized by deficits in intellectual functioning and adaptive behavior. Genetic factors contribute to the development of ID phenotypes, including mutations and structural changes in chromosomes. Pathogenic variants in the HCFC1 gene cause X-linked mental retardation syndrome, also known as Siderius type X-linked mental retardation. The MN1 gene is necessary for palate development, and mutations in this gene result in a genetic condition called CEBALID syndrome. Methods: Exome sequencing was used to identify the disease-causing variants in two affected families, A and B, from various regions of Pakistan. Affected individuals in these two families presented ID, developmental delay, and behavioral abnormalities. The validation and co-segregation analysis of the filtered variant was carried out using Sanger sequencing. Results: In an X-linked family A, a novel hemizygous missense variant (c.5705G > A; p.Ser1902Asn) in the HCFC1 gene (NM_005334.3) was identified, while in family B exome sequencing revealed a heterozygous nonsense variant (c.3680 G > A; p. Trp1227Ter) in exon-1 of the MN1 gene (NM_032581.4). Sanger sequencing confirmed the segregation of these variants with ID in each family. Conclusions: The investigation of two Pakistani families revealed pathogenic genetic variants in the HCFC1 and MN1 genes, which cause ID and expand the mutational spectrum of these genes. [ABSTRACT FROM AUTHOR]

Syphilis, caused by Treponema pallidum, is resurging globally. Molecular typing allows for the investigation of its epidemiology. In Pakistan and other nations, T. pallidum subsp. pallidum has developed widespread macrolide resistance in the past decade. A study at the Peshawar Regional Blood Centre from June 2020–June 2021 analyzed serum samples from 32,812 blood donors in Khyber Pakhtunkhwa, Pakistan, to assess circulating T. pallidum strains and antibiotic resistance. Blood samples were initially screened for T. pallidum antibodies using a chemiluminescent microparticle immunoassay (CMIA). CMIA-reactive samples underwent polymerase chain reaction (PCR) targeted the polA, tpp47, bmp, and tp0319 genes. PCR-positive samples were further analyzed for molecular subtyping using a CDC-developed procedure and tp0548 gene examination. All PCR-positive samples were analyzed for the presence of point mutations A2058G and A2059G in 23S rRNA, as well as the G1058C mutation in 16S rRNA. These mutations are known to impart antimicrobial resistance to macrolides and doxycycline, respectively. Out of 32,812 serum samples, 272 (0.83%) were CMIA-reactive, with 46 being PCR-positive. Nine T. pallidum subtypes were identified, predominantly 14d/f. The A2058G mutation in 23S rRNA was found in 78% of cases, while G1058C in 16S rRNA and A2059G in 23S rRNA were absent. The research found donor blood useful for assessing T. pallidum molecular subtypes and antibiotic resistance, especially when chancres are not present. The prevalent subtype was 14d/f (51.85%), and the high macrolide resistance of 36 (78%) indicates caution in using macrolides for syphilis treatment in Khyber Pakhtunkhwa, Pakistan. [ABSTRACT FROM AUTHOR]

Anemia and malnutrition are global health problem among all nutritional disorder with high morbidity and mortality in school aged children. Therefore the aims of the study assist the prevalence and risk factors of anemia, and malnutrition among school-going children of District Swabi Pakistan. A total of 600 school aged children of aged 4-15 years were included in the study in 2023. Hematocrit level was obtained using a centrifuge microhematocrit, and converted to hemoglobin using standard conversion. Nutritional status was determined by the anthropometric measurements, and demographic characteristics were obtained by questionnaire. Anemia and malnutrition were defined according to the World Health Organization standards. In current research work 600 children were selected for the assessment of nutritional status in which 105(17.5%) were found malnutrated. Moderate frequency of assessment were found among anemia 25(23.80%), stunting 22(21%) and underweight 18(17%) respectively. High frequency was found in malnutrition 40(38%) while very low frequency was seen in wasting 2(1.90%). Gender wise assessment of the students shows that the nutritional deficiencies were slightly high in male as compare to female students in comparison of Anemia, Malnutrition, Stunting, and Underweight and in wasting respectively. Aged group wised assessment of the students shows that the nutritional deficiencies were slightly high in low aged student (4-7 years) as compare to 8-11 years and 12-15 years in both gender. Among them Malnutrition were very high leading by Anemia while Underweight and wasting of very low frequency respectively. [ABSTRACT FROM AUTHOR]

Objective: To determine frequencies of causes and renal outcomes of pregnancy related acute kidney injury. Method: This descriptive case series study was conducted in Nephrology unit of a tertiary care hospital of Peshawar, from 1st August 2021 to 31st July 2022.A total of 100 patients with acute kidney injury secondary to obstetric conditions were enrolled via non-probability consecutive sampling technique. While patients with pre-existing renal disease, those with renal stones, or having bilateral small kidneys on ultrasound were excluded from the study. Patients were followed till 12 weeks postpartum period. Underlying obstetrical causes and outcome at 12 weeks postnatal period were determined. Results: The mean age of sample of 100 cases was 29.29 ± 6.45. Mean serum creatinine at presentation was 6.5± 3.13. Majority of patient, 89% were multigravidas. Seventy eight percent patients required hemodialysis. Primary postpartum hemorrhage remained the commonest underlying cause of pregnancy related acute kidney injury in this study. The frequency of persistent renal failure in Pr-AKI (pregnancy related acute kidney injury) in this study was 14%. In about 66% of cases complete recovery occurred. All the underlying obstetrical causes, when adjusted for age, gravidity, place and mode of delivery, had no association with persistent renal failure. Conclusion: Primary postpartum hemorrhage is the predominant cause of pregnancy related acute kidney injury. By the end of 12 weeks postpartum, two third patients recover completely from pregnancy related acute renal injury. [ABSTRACT FROM AUTHOR]

Background: Existing research indicated a high prevalence of mental health issues among adolescents. Gender and parenting styles are two factors that may influence adolescents' mental health. Nonetheless, most published studies focused on either secondary school or university students. In contrast, there is a dearth of similar research involving pre-university students. This study aimed to determine the prevalence of mental disorders among pre-university students and their association with parenting styles. Methods: A cross-sectional study via online questionnaire survey was conducted among students from a pre-university college on the East Coast of Malaysia. Convenience sampling was used to recruit the participants. The questionnaire consisted of three parts: i) sociodemographic data, ii) the Parental Authority Questionnaire and Depression, and iii) the Anxiety and Stress Scale (DASS-21). An online invitation to answer the questionnaire was done via the Student Representative Council (SRC). Data were analysed using descriptive statistics and Pearson's chi- square test. Results: A total of 431 participants responded to the online survey. The prevalence of depression, anxiety and stress was 49.0% (n = 210), 68.0% (n = 293) and 37.6% (n = 162), respectively. In addition, father's educational level (x² = 10.332, P = 0.001) and the authoritarian parenting style (x² = 10.099, P = 0.006) were significantly associated with mental health disorders among adolescents. Conclusion: The prevalence of mental disorders among pre-university students is relatively high. Pre-university admission mental health screening is vital for early detection and intervention of mental disorders among this vulnerable group. Further research is imperative to establish a comprehensive plan of action that targets parental involvement in managing adolescent mental health disorders. [ABSTRACT FROM AUTHOR]

Introduction: RAD51D has been reported as a breast cancer (BC) and ovarian cancer (OC) predisposition gene, particularly among Caucasian populations. We studied the prevalence of RAD51D variants in Pakistani BC/OC patients., Materials and Methods: In total, 371 young or familial BC/OC patients were thoroughly analyzed for RAD51D sequence variants using denaturing high-performance liquid chromatography pursued by DNA sequencing of differentially eluted amplicons. We also assessed the pathogenic effects of novel variants using in-silico algorithms. All detected RAD51D variants were investigated in 400 unaffected controls., Results: No pathogenic RAD51D variant was detected. However, we identified nine unique heterozygous variants. Of these, two missense variants (p.Pro10Leu and p.Ile311Asn) and one intronic variant (c.481-26_23delGTTC) were classified as in silico-predicted variants of uncertain significance, with a frequency of 0.8% (3/371). The p.Pro10Leu variant was detected in a 28-year-old female BC patient of Punjabi ethnic background, whose mother and maternal cousin had BCs at ages 53 and 40, respectively. This variant was also detected in 1/400 (0.25%) healthy controls, where the control subject's daughter had acute lymphoblastic leukemia. The p.Ile311Asn variant was identified in a female BC patient at age 29 of Punjabi ethnicity and in 1/400 (0.25%) healthy controls, where the control subject's daughter had Hodgkin's disease at age 14. A novel intronic variant, c.481-26_-23delGTTC, was found in a 30-year-old Punjabi female BC patient but not in 400 healthy controls., Conclusion: No pathogenic RAD51D variant was identified in the current study. Our study data suggested a negligible association of RAD51D variants with BC/OC risk in Pakistani women., Competing Interests: The author(s) declare(s) that there are no conflicts of interest., (Copyright: © 2024 Muhammad N, et al.)