Culturally tailored DSMES: A new key for South Asian patients with Type 2 Diabetes Mellitus

South Asians have an exceptionally high risk for developing Type 2 diabetes mellitus. It is very challenging for healthcare providers to successfully manage diabetes and control glucose levels at target due to the unique lifestyle of the South Asian population. Culturally tailored diabetes self-management education and support (DSMES) can be more effective in guiding South Asian patients with Type 2 diabetes. Unique considerations to address lifestyle modification for South Asians include a diet that typically consists of a high carbohydrate to lipids/proteins ratio, preference for high glucose index fruits, regular intake of traditional sweets or desserts, late afternoon tea break followed by late dinner, lack of vigorous exercise (yoga or walking being the preferred activity), lack of DSMES knowledge and skills, and poor access to culturally appropriate resources for diabetes care. We present a 38-year-old male diagnosed with diabetes four years ago who showed poor glucose control before our intervention. Our interventions included education on the importance of blood glucose monitoring, exercise, and diet. Based on our experience with this case, we propose the following recommendations for a tailored approach to DSMES for South Asian patients with Type 2 diabetes: make appropriate dietary changes (decrease total daily caloric intake, decrease the percentage of carbohydrates, addlow glucose index fruits and vegetables, avoid late afternoon tea breaks, eat dinner before 8 PM); incorporate appropriate daily physical activity; and monitor blood glucose daily for prompt feedback.

ANALISIS TEMPERATUR LINGKUNGAN TERHADAP KINERJA COOLING TOWER DI PT. INDOCEMENT TUNGGAL PRAKARSA TBK. P-12 TARJUN KALIMANTAN - SELATAN

Sistem kerja pendingin di PT. Indocement Tunggal Prakarsa Tbk Tarjun Plant-12 menggunakan cooling tower marley fan 3 tipe mechanical draft, counterflow flow 10.221 m3/h yang berfungsi untuk mendinginkan air keluaran dari kondensor melalui nozzle untuk menyemprotkannya dengan menyemprotkan sebagian air ke udara dan mengeluarkannya ke atmosfer, sehingga air jatuh ke bak air melalui eliminator melayang. Suhu lingkungan mempengaruhi kinerja menara pendingin. Semakin dingin lingkungan semakin baik kinerja menara pendingin. Pengaruh suhu lingkungan dan kinerja pada menara pendingin menjadi pembahasan dalam penelitian ini. Hasil perhitungan dalam penelitian menunjukkan bahwa suhu lingkungan mempengaruhi kinerja menara pendingin dimana pada pagi sampai sore hari pada suhu atau cuaca tertentu kinerja menara pendingin mengalami peningkatan dan penurunan yang signifikan. Sedangkan efisiensi rata-rata range dan approach dari tahun 2016 hingga 2019 mengalami penurunan efisiensi sebesar 8,44%, penurunan range sebesar 1,24°C dan penurunan approach sebesar 0,82°C. Cooling work system at PT. Indocement Tunggal Prakarsa Tbk Tarjun Plant-12 uses a cooling tower marley fan 3 type mechanical draft, counterflow flow 10.221 m3 / h which functions to cool the output water from the condenser through a nozzle to spray it by spraying some water into the air and discharging it into the atmosphere, so water falls into the water basin through a drift eliminator. Environmental temperature affects the cooling tower performance. The cooler the environment the better the cooling tower performance. The effect of environmental temperature and performance on cooling tower is the discussion in this study. The results of calculations in the study show that the environmental temperature affects the cooling tower performance where in the morning until late afternoon at certain temperatures or weather the cooling tower performance experiences a significant increase and decrease. While the average efficiency, the range and approach from 2016 to 2019 has decreased efficiency by 8.44%, decreasing the range by 1.24 ° C and decreasing the approach by 0.82 ° C.

PENERAPAN BEADING EMBROIDERY DENGAN KOMBINASI CABOCHON TECHNIQUE SEBAGAI HIASAN PADA EVENING GOWN

Evening gown is one type of party dress that is divided according to the time of use, namely late afternoon or late evening. Evening gowns usually have more prominent characteristics than other types of party dress. Both of the model and decoration/garniture. The application of beads as an evening gown decoration is one way to impress a luxurious impression of evening party dress. Beads or in English called "beads" comes from the Middle English bede which means "prayer" (object of Worship). Because at first the beads were associated with occult things in previous religious ceremonies. Beads are usually made of stone, bone, wood, shell, glass, metal, and so on. The technique of stringing beads is known as beading embroidery. Beading embroidery is usually done by stringing beads on fabric using the help of a needle and thread. One of the techniques in making beading embroidery is the Cabochon technique. The term of Cabochon comes from French which means head, this term is often used for gemstones that have been polished so that it has a smooth round shape. In its development, the cabochon is decorated with small beads strung around a large gemstone which is likened to the head or center of this ornament..The study aims to 1) To apply the knowledge obtained from the course milineris accessories and Houte Couture as the basis in making milineris accessoires and garniture on the evening gown. 2) To introduce beading embroidery especially the cabochon technique as one of the alternative for garniture or ornament on the evening gown,and 3) To improve the student’s creativities in making garniture on the evening gown through making beading embroidery with cabochon technique. This kind of study is experimental study. The method used is the PBL (Project Base Learning) method. Namely learning methods that use projects / activities as a medium by conducting exploration, assessment, interpretation, synthesis, and information to produce various forms of learning outcomes.

Impact of high energy oral nutritional supplements consumed in the late afternoon on appetite, energy intake and cardio-metabolic risk factors in females with lower BMI

Background/Objective Morning consumption of a single dose of high-energy oral nutritional supplement (ONS) in females with a lower BMI displaces some of the food eaten at breakfast but increases overall daily energy intake. This study investigated the effectiveness of ONS intake in the late afternoon and for longer duration. Subjects/Methods Twenty-one healthy females (mean ± SD, age 25 ± 5 years; BMI 18.7 ± 1.2 kg/m2) participated in a randomised, crossover study with two experimental trials. In the afternoon of days 1–5, participants consumed either ONS (2.510 MJ) or low-energy PLACEBO drink (0.377 MJ) and recorded food eaten at home. On day six, energy intake was measured during buffet meals, and energy expenditure, appetite measurements and blood samples were collected throughout the day. Result Over the 5-day period, in the ONS trial energy intake from evening meals was lower (ONS, 2.7 ± 0.25 MJ; Placebo, 3.6 ± 0.25 MJ, P = 0.01) but averaged total daily energy intake was higher (ONS, 9.2 ± 0.3 MJ; PLACEBO, 8.2 ± 0.4 MJ, P = 0.03). On day six, energy intake, appetite scores, plasma GLP-1 and PYY, and energy expenditure were not significantly different between the two trials but fasting insulin concentration and HOMAIR, were higher (P < 0.05) and insulin sensitivity score based on fasting insulin and TAG lower (P < 0.05) in ONS trial. Conclusion Late afternoon consumption of ONS for five consecutive days by females with a lower BMI has only a partial and short-lived energy intake suppression and thus increases daily energy intake but reduces insulin sensitivity.

Diurnal Response of Photosystem I to Fluctuating Light Is Affected by Stomatal Conductance

Upon a sudden transition from low to high light, electrons transported from photosystem II (PSII) to PSI should be rapidly consumed by downstream sinks to avoid the over-reduction of PSI. However, the over-reduction of PSI under fluctuating light might be accelerated if primary metabolism is restricted by low stomatal conductance. To test this hypothesis, we measured the effect of diurnal changes in stomatal conductance on photosynthetic regulation under fluctuating light in tomato (Solanum lycopersicum) and common mulberry (Morus alba). Under conditions of high stomatal conductance, we observed PSI over-reduction within the first 10 s after transition from low to high light. Lower stomatal conductance limited the activity of the Calvin–Benson–Bassham cycle and aggravated PSI over-reduction within 10 s after the light transition. We also observed PSI over-reduction after transition from low to high light for 30 s at the low stomatal conductance typical of the late afternoon, indicating that low stomatal conductance extends the period of PSI over-reduction under fluctuating light. Therefore, diurnal changes in stomatal conductance significantly affect the PSI redox state under fluctuating light. Moreover, our analysis revealed an unexpected inhibition of cyclic electron flow by the severe over-reduction of PSI seen at low stomatal conductance. In conclusion, stomatal conductance can have a large effect on thylakoid reactions under fluctuating light.

Efficiency of Different Traps and Baits for Catching Freshwater Prawn Macrobrachium Spp. for Broodstock Development

Catching of wild freshwater prawns in Palawan is done by using different fishing gears, including baited traps. However, there are only limited studies related to the efficiency of these traps on catching freshwater prawns. In this study, the efficiency of four different traps (traditional plastic traps, bamboo traps, modified traps, and rattan traps) and three baits (low-valued fish, grilled coconut, and octopus) was tested in catching live Macrobrachium spp. from the rivers of two localities in the Barangay Bagongbayan, Roxas and Sitio Catama, Dumaran, Palawan at two sampling events with 12-hr intervals along the river bank. Each trap was deployed randomly 5-8 meters apart in the collection site late afternoon and retrieved the following day. The highest catch was obtained using plastic traps with low-value fish as bait. All samples from the different traps were collected alive. Modifications are underway to improve the design of these traps to improve catch efficiency. Regulating the collection of Macrobrachium from the wild by developing it into broodstocks will support the sustainable aquaculture industry using hatchery-produced seedstocks instead of sourcing it from the wild.

Clinically Meaningful Improvements in Early Morning and Late Afternoon/Evening Functional Impairment in Children with ADHD Treated with Delayed-Release and Extended-Release Methylphenidate

Objective: The Before School Functioning Questionnaire and Parent Rating of Evening and Morning Behavior–Revised assess early morning (BSFQ, PREMB-R AM subscale) and late afternoon/evening (PREMB-R PM subscale) functional impairment in children with ADHD. Clinically meaningful improvements were identified and applied to a trial of delayed-release and extended-release methylphenidate (DR/ER-MPH) in children with ADHD (NCT02520388) to determine if the statistically-determined improvements in functional impairment were also clinically meaningful. Method: Clinically meaningful improvements in BSFQ/PREMB-R were established post hoc by receiver operating characteristics curves, using anchors of Clinical Global Impression–Improvement (CGI-I) = 1 and CGI-I ≤ 2. Percentages of participants achieving these thresholds were calculated. Results: Thresholds for CGI-I = 1/CGI-I ≤ 2, respectively, were 27/20 (BSFQ), 5/3 (PREMB-R AM), and 9/5 (PREMB-R PM)-point decreases. More children achieved clinically meaningful improvements with DR/ER-MPH versus placebo (all p < .05). Conclusion: DR/ER-MPH increased proportions of children achieving clinically meaningful improvements in BSFQ and PREMB-R.

Statistical Analysis of Mesovortices During The First Rainy Season In South China

Based on the Doppler radar observation and reanalysis data, the statistical characteristics of mesovortices (MVs) during the first rainy season (April–June) in South China from 2017 to 2019 are studied, including their spatio-temporal distributions, structural features and favorable environmental conditions. The results show that the MVs usually exhibit short lifetime, among which about 70% last for less than 30 minutes. The intensity and horizontal scale of the MVs are proportional to their lifetime. Long-lived MVs have larger horizontal scales and stronger intensities than short-lived ones. The MVs are mainly observed over the Pearl River Delta region, followed by the western Guangdong province, but relatively fewer in both eastern and northern Guangdong province. The uneven spatial distribution of the MVs is closely related to the differences of environment conditions over South China. The monsoonal south-westerlies, water vapor flux, atmospheric instability and vertical wind shear over southwest Guangdong are significantly larger than those in other regions, which are favorable for the formation of MVs. The occurrence frequencies of MVs in central and southern parts of Guangdong display similar diurnal variations, reaching the peak during the late afternoon and early evening, while dropping to the minimum overnight. However, the situation is opposite in northern Guangdong, with the peak overnight and the minimum during the late afternoon and early evening.

Contrasting Cloud Regimes and Associated Rainfall over the South Asian and East Asian Monsoon Regions

The Asian monsoon has large spatial and temporal variabilities in winds and precipitation. This study reveals that the Asian monsoon also exhibits pronounced regional differences in cloud regimes and cloud–rainfall relationship at a wide range of time scales from diurnal to seasonal to interannual. Over South (East) Asia, the convectively active regime of deep convection (CD) occurs frequently in June–September (March–September) with a late-afternoon peak (morning feature). The intermediate mixture (IM) regime over South Asia mainly occurs in summer and maximizes near noon. It develops as CD at late afternoon and dissipates as convective cirrus (CC) after midnight, showing a life cycle of thermal convection in response to solar radiation. Over East Asia, IM is dominant in cold seasons with a small diurnal cycle, indicating a prevalence of midlevel stratiform clouds. Further analyses show that CD and CC contribute 80%–90% of the rainfall amount and most of the intense rainfall in the two key regions. The CD-related rainfall also accounts for the pronounced diurnal cycles of summer rainfall with a late-afternoon peak (morning feature) over northern India (Southeast China). The afternoon CD-related rainfall mainly results from thermal convection under the moderate humidity but warm conditions particularly over northern India, while the morning CD-related rainfall over Southeast China is more related to the processes with high humidity. The CD/CC-related rainfall also exhibits large interannual variations that explain ~90% of the interannual variance of summer rainfall. The interannual variations of CD/CC occurrence are positively correlated with the moist southerlies and induced convergence, especially over Southeast China, suggesting a close relationship between cloud regimes and monsoon activities.