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In the clinical assessment of chronic rhinosinusitis with nasal polyps (CRSwNP), evaluation of symptoms, nasoendoscopy findings and sinus computed tomography (CT) scan staging is employed in the management plan. Although prior studies have been done to assess the correlation of the three modalities in CRSwNP, such evaluation in patients with eosinophilic and non-eosinophilic types of CRSwNP requires further investigation. The aim of this study was to correlate the sinus CT scan staging to symptom and endoscopic scores in both types of CRSwNP.Patients with CRSwNP were classified into 2 types, eosinophilic and non-eosinophilic. Both types were assessed by Sino-Nasal Outcome Test 22 (SNOT-22) symptom score, nasal endoscopy Lund Kennedy grading (LK) score and sinus CT Lund Mackay (LM) staging score. All three modalities were correlated.Forty-four patients were recruited for this study. There was significant correlation between sinus CT and symptom scores in the eosinophilic (r=.51, p=.031) and the non-eosinophilic (r=.76, p.001) types. There was no significant correlation between symptom and nasoendoscopic scores in the eosinophilic (r=.12, p=.641) and the non-eosinophilic (r=.22, p=.276) types. There was also no significant correlation between sinus CT and nasoendoscopic scores in the eosinophilic (r=.20, p=.418) and the non-eosinophilic (r=.14, p=.508) types.Sinus CT staging correlates well with the symptom score for both the eosinophilic and the non-eosinophilic types of CRSwNP. The good correlation suggests both modalities are a reliable guide for their evaluation and management planning.

Eosinophilic leukocytosis can be attributed to a number of clinical conditions such as parasitic infection, allergies, and neoplasms. Parasitic infection is the main cause of eosinophilia; however, a marked leukocytosis with hypereosinophilia secondary to Trichuris trichiura in adults has not been previously reported. We describe a case of a 39-year-old man who presented with fever and diarrhea. The investigation revealed a white blood cell (WBC) count of 20.69 × 109/L with an absolute eosinophil count of 12.44 × 109/L. Fecal microscopic examination demonstrated T. trichuria eggs. The WBC count returned to normal following treatment with albendazole. The literature pertaining to hematological findings associated with Trichuris trichiura is explored in this report. This case highlights that a significant elevation of leukocyte count with hypereosinophilia can be one of the manifestations of trichuriasis infection in adults. Empirical treatment with anti-helminthic agents may play a role in suspected cases to avoid severe complications, such as Trichuris dysentery syndrome.

Formal educational institutions have an important task to prepare quality Indonesian human resources (HR) in the future. In this school education environment, professional teachers hold the main key for improving the quality of future human resources (HR) and teachers are professionals who carry out the main tasks and functions of improving the knowledge, skills, and attitudes of students as Indonesian human assets for the future. In the process of quality education, it is an obligation and obligation that is required for every school, to have certified teachers so that education can increase and can affect student achievement. Decision-making system as a set of model-based procedures for data processing and assessment. to assist schools in determining teachers who are eligible to receive certification with criteria namely pedagogic, personality, social, professional. The purpose of this research is to help decision makers in the selection process easily and quickly. The simple additive weighing (SAW) method to provide decisions on the selection process for submitting teacher certification. The system developer method uses the waterfall method. An educator certificate is a requirement for proof that teachers meet educational professional standards.

ntroduction Fall is a health problem for older persons. This study investigates the potential factors of concern: the nutritional status of the elderly and non-communicable disease association with incidents of falls. Methods and Materials This study used data from NHMS 2018, a cross-sectional design, applied two-stage stratified cluster sampling. Descriptive statistics such as the percentage of each variable were done. Factors associated with falls were determined at both univariate and multivariable levels using simple logistic regression and multiple logistic regression. The data were presented as standard values for each analysis and adjusted odds ratios with 95% CI with p values (

Facility layout planning (FLP) has an important role in manufacturing industries. There are few approaches to solve FLP such as procedural, algorithmic, virtual reality (VR) based and augmented reality (AR) based approaches. This research is about AR assisted FLP (ARFLP) to visualize the arrangement of virtual models in real facilities environment in real-time. It can check the material travel distance and total area occupied by the facilities. In the ARFLP system, the virtual model design is flexible and can be modified easily to suit the actual environment. A single row layout production line was chosen as a case study with four common types of layout considered: straight line, W-shaped, U-shaped and V-shaped layouts. The best location for the new machine was suggested for each layout. ARFLP has proven to be able to check and visualize the position of a new machine to be added to the existing layout.

Ticagrelor is an oral antiplatelet drug that can reversibly bind to the platelet P2Y12 receptor. Ticagrelor is metabolized mainly by CYP3A4 and produces a rapid blood concentration-dependent platelet inhibitory effect. Unlike other P2Y12 receptor antagonists, many clinical features of ticagrelor are not related to P2Y12 receptor antagonism. This review aims to gather existing literature on the clinical effects of ticagrelor after inhibiting adenosine uptake. The current study reviewed literature related to the effects of ticagrelor on adenosine metabolism. The review also examined the drug's biological effects and clinical characteristics to see how it could be used in a clinical setting. Many studies have shown that ticagrelor can inhibit equilibrative nucleoside transporter 1 (ENT1). This inhibition leads to intracellular adenosine uptake, increased adenosine half-life and plasma concentration levels and an enhanced adenosine-mediated biological effect. Based on the studies reviewed, it was found that ticagrelor essentially inhibits adenosine absorption of adenosine into cells through ENT1, which increases the concentration in the blood and subsequently increases the protection of the heart muscle by adenosine. It also prevents platelet aggregation, and extends the biological effects of coronary arteries. Moreover, it leads to a lower mortality rate in acute coronary syndrome (ACS) patients.

Background Fast-food consumption is an unhealthy dietary behaviour because it increases the risk of diet-related chronic diseases. We aimed to investigate factors associated with fast-food consumption, namely sociodemographic characteristics, body mass index-for-age, meal away from home habit, and intake of various food groups among adolescents in Malaysia. Methods We analysed data from the National School-Based Nutrition Survey (NSNS). The NSNS was a nationwide, cross-sectional survey. Multiple-stage stratified cluster random sampling method was applied to obtain a representative sample of adolescents’ population. This study recruited adolescents aged 10–18 years who were attending schools. Pre-tested self-administered questionnaires in Malay language were used to obtain relevant information. Frequency of fast-food consumption per week was classified into three groups: “consumed fast-food four to seven days”, “consumed fast-food one to three days”, and “did not consume fast-food”. Intake of food groups was assessed by self-administered food frequency questionnaire. Descriptive and complex sample multinomial logistic regression analyses were performed in data analysis. Results A total of 26,383 from 40,012 selected adolescents completed all the relevant questions for this study. Of those surveyed, 13.5% of the respondents consumed fast-food 4 to 7 days, 69.3% of the respondents consumed fast food 1 to 3 days, and 17.2% of them did not consume fast-food in a typical week. Frequency of fast-food consumptions (4 to 7 days and 1 to 3 days per week) was significantly associated with age; sex; ethnicity; locality of schools; frequency of eating out; and not consuming recommended intake of cereals or grains, vegetables, and meat or poultry or eggs. Conclusion In conclusion, age; sex; ethnicity; locality of schools; frequency of eating out per week; imbalanced intake of cereals or grains, meat, or poultry or eggs; and inadequate vegetable intake were significantly associated with fast-food consumption among adolescents in Malaysia. The findings of this study will be useful for policy makers in promoting healthy food choices among adolescents in Malaysia.

Safety leadership has been advocated as the most appropriate approach towards injury prevention. Besides, supervisor safety role is also proposed to be crucial towards good safety performance in SMEs. Henceforth, this study aisled to determine the direct impact of safety leadership (safety concern, safety policy, and safety motivation) played by the owner-managers on safety performance within the SME manufacturers in Selangor, Malaysia. Furthermore, this study also evaluated the mediating effect of supervisor safety roles towards safety leadership and safety performance' relationship. The data was collected among 165 SME manufacturing workers from 37 factories and Partial Least Square – Structured Equation Model (PSL-SEM) was performed for data analyses. The results indicated that safety leadership in terms of safety concern, safety policy, and safety motivation has significant impact on safety performance. However, supervisor safety role does not mediate the relationship between safety leadership and safety performance. These results proved importance of direct safety management by the owner-managers and supervisors towards safety performance.Safety leadership approach delivered by the owner-managers could be the best way to improve safety performance despite all the limitation within SMEs.

PURPOSE To study the retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters in obstructive sleep apnoea (OSA) patients and their relationship with severity of the disease. METHODS A cross-sectional, hospital-based study. Fifty-four OSA subjects and 54 controls were recruited. Candidate that fulfil the criteria with normal ocular examinations then proceed with spectrum domain Cirrus optical coherence tomography examinations. ONH parameters and RNFL thickness were evaluated. Apnoea-hypopnoea index (AHI) of the OSA group were obtained from the medical record. RESULTS In OSA, mean of average RNFL thickness was 93.87 µm, standard deviation (SD) = 9.17, p = 0.008 (p < 0.05) while superior RNFL thickness was 113.59 µm, SD = 16.29, p ≤ 0.001 (p < 0.05). RNFL thickness fairly correlate with severity of the disease (AHI), superior RNFL with R = 0.293, R2 = 0.087, p = 0.030 (p < 0.05), and nasal RNFL R = 0.292, R2 = 0.085, p = 0.032. No significant difference and correlation observed on ONH parameters. In control group, mean of average RNFL thickness was 98.96 µm, SD = 10.50, p = 0.008 (p < 0.05) while superior RNFL thickness was 125.76 µm, SD = 14.93, p ≤ 0.001 (p < 0.05). CONCLUSIONS The mean of the average and superior RNFL thickness were significantly lower in the OSA group compare to control. Regression analysis showed RNFL thickness having significantly linear relationship with the AHI, specifically involving the superior and nasal quadrant.

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

Sleep-disordered breathing (SDB) is now a significant health problem in today's culture. It ranges from a spectrum of abnormal conditions during sleep from the primary snorer to mild, moderate, or severe obstructive sleep apnea (OSA). SDB also comprises other conditions, such as sleep-related hypoventilation, sleep-related hypoxemia, and central sleep apnea syndromes. : One of the components of the pathophysiology of OSA that remain unclear is the association of allergic rhinitis (AR) in the evolution of OSA. Several studies relate the co-existence of OSA and AR in the common clinical practice, but its correlation was not clear. This review article aimed to review the pathophysiological relationship between OSA and AR in terms of the role of chemical mediators and the effect of AR treatment in support of OSA. : The symptoms of AR further accelerate the clinical progression to OSA development. Inflammatory mediators such as histamine, cysteinyl leukotrienes, and interleukins are found at a high level in AR, which can aggravate AR symptoms such as nasal obstruction, rhinorrhea, and itchiness, which can then lead to sleep disruption in OSA patients. In addition, OSA patients also have increased chemical mediators such as tumor necrosis factor, interleukin 6, and 1, which would activate the T helper 2 phenotypes that can aggravate AR symptoms. This vicious cycle can potentiate each other and worsen the condition. Few studies have shown that treatment of AR can improve OSA, especially the use of intranasal steroid and leukotriene receptor antagonists. : A detailed evaluation of rhinitis symptoms should be made for OSA patients so that they can benefit not only from the improvement of AR but also the good sleep quality.

Background Sodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia. Methods A cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents’ 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0. Results Of 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl. Conclusion Our study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

Background High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population. Methods Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure. Results Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension. Conclusion Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.

Introduction: Prevalence of malnourished children in Putrajaya was unexpectedly high in 2016. This paper describes the study protocol for a case-control study conducted to identify the associated factors of malnutrition among children under 5 years old in Putrajaya. Methods: This study involved two phases. Phase I was ‘screening’ where all children aged 6-59 months in 118 preschools and four government health clinics were measured for their weight and height. The World Health Organization Anthro software was used to determine the nutritional status of these children. Phase II was the ‘interview’ where children from screening were sampled into four pairs of case and control. The optimum sample size for the case of stunted, wasted, underweight, and overweight were 380, 335, 318, and 308, respectively. The same number of controls were recruited. Parents/caregivers of selected children were approached to obtain data on parental factors, children factors, food intake factors, and environmental factors that contributed to malnutrition. Data analysis was performed by multiple logistic regression in SPSS version 26. Results: Screening phase successfully measured 8,261 (50.1%) children from an estimated 16,500 children under 5 years old in Putrajaya. The number of children who were stunted, wasted, underweight, and overweight were 2,105 (25.5%), 512 (6.2%), 1,516 (18.4%), and 248 (3.0%), respectively. As overweight was undersampled, the number of controls for overweight was doubled to increase the power of the study. Parents/caregivers of selected cases and controls were interviewed in their household or any other venues at their convenience. Conclusion: This protocol promises beneficial outputs to stakeholders and policy makers that can be used for combating malnutrition in children.

Introduction: Childhood obesity is a public health problem in Malaysia. Intake of sugar-sweetened beverages (SSB) is associated with obesity in children. There is a lack of studies on factors associated with SSB consumption in Malaysia. This study aimed to determine the sociodemographic factors associated with SSB consumption among Malaysian adolescents. Methods: Data of 2,021 students, aged 10-17 years on sociodemographic, SSB intake and anthropometrics were drawn from the school-based Adolescent Nutrition Survey 2017. A multistage stratified cluster sampling was used to obtain a nationally representative sample of primary and secondary school students. Body mass index (BMI)-for-age status was determined based on calculated z-score using the World Health Organization 2007 reference. SSB consumption was obtained from a food frequency questionnaire. Results: The prevalence of overweight and obesity among Malaysian adolescents were 16.6% and 14.7%, respectively. Malaysian adolescents consumed 1.4 cups of SSB per day. Rural children had a significantly higher SSB intake (1.5 cups) than urban (1.3 cups) children, while males (1.5 cups) had a significantly higher intake than females (1.3 cups). There were no significant differences in SSB consumption between thin, normal, overweight and obese adolescents. Conclusion: Almost all Malaysian adolescents consumed SSB during one month prior to the survey and the average amount consumed was 1.4 cups per day. Rural locality and male were associated with higher SSB consumption. There were differences in SSB consumption between Chinese and Malays, between Chinese and Indians, and between Chinese and Bumiputra Sarawak. There were no differences in consumption between the different BMI-for-age categories.

The International Frontal Sinus Anatomy Classification (IFAC) is introduced to simplify the classification of different frontal cell variants based on their topographical structures. The objectives of our study were to determine the prevalence of the frontal cell variants according to IFAC and their association with the development of frontal sinusitis. A retrospective chart review on computed tomography paranasal sinus (CTPNS) was conducted. A total of 200 patients who had clinical and endoscopic findings of chronic rhinosinusitis (CRS) and undergone CTPNS were reviewed. The CTPNS was evaluated for the presence of frontal cell variants according to IFAC and mucosal changes consistent with frontal sinus involvement. A total of 400 sides of the CTPNS were analyzed. The agger nasi cells (ANCs) were the most common (95.5%) followed by supra bulla cells (SBCs) (60.8%), supra bulla frontal cells (SBFCs) (53.0%), supra agger cells (SACs) (50.0%), supra agger frontal cells (SAFCs) (36.0%), frontal septal cells (FSCs) (8.3%), and supraorbital ethmoidal cells SOECs (5.5%). There was significant association between SOEC (p = 0.001) and FSC (p = 0.044) with the development of frontal sinusitis. Apart from ANCs, the posterior-based cells (SBCs and SBFCs) have higher prevalence than the anterior-based cells (SACs and SAFCs). Despite being the least, both SOECs and FSCs are significantly associated with frontal sinusitis.

N‐acetylcysteine (NAC) is an antidote to prevent acetaminophen (paracetamol‐APAP)‐induced acute liver injury (ALI). The 3‐bag licensed 20.25 h standard regimen, and a 12 h modified regimen, are used to treat APAP overdose. This study evaluated the redox thiol response and APAP metabolites, in patients with a single APAP overdose treated with either the 20.25 h standard or 12 h modified regimen. We used liquid chromatography tandem mass spectrometry to quantify clinically important oxidative stress biomarkers and APAP metabolites in plasma samples from 45 patients who participated in a randomized controlled trial (SNAP trial). We investigated the time course response of plasma metabolites at predose, 12 h, and 20.25 h post‐start of NAC infusion. The results showed that the 12 h modified regimen resulted in a significant elevation of plasma NAC and cysteine concentrations at 12 h post‐infusion. We found no significant alteration in the metabolism of APAP, mitochondrial, amino acids, and other thiol biomarkers with the two regimens. We examined APAP and purine metabolism in overdose patients who developed ALI. We showed the major APAP‐metabolites and xanthine were significantly higher in patients with ALI. These biomarkers correlated well with alanine aminotransferase activity at admission. Receiver operating characteristic analysis showed that at admission, plasma APAP‐metabolites and xanthine concentrations were predictive for ALI. In conclusion, a significantly higher redox thiol response with the modified NAC regimen at 12 h postdose suggests this regimen may produce greater antioxidant efficacy. At baseline, plasma APAP and purine metabolites may be useful biomarkers for early prediction of APAP‐induced ALI.

In the case of assembly wellhead, a spacer spools was used to provide space and connect between parts of the wellhead. In order to design spacer spool with specified material should comply the standards and procedures of the oil and gas industry. The results of the material calculation were using the ASME BPVC guidelines. These three materials strengths were calculated if used as a body spacer spool. Based on acceptance criteria on API 6A 21st Edition, these three materials were categorized as acceptable to be used as a body spacer spool for this specification. These three materials strengths were also calculated the stress of the flange and flange rigidity criteria. Based on the acceptance criteria on ASME BPVC guidelines, the results showed that these materials can be used for flange because it had stress value under yield strength of material which was flange rigidity criteria for operating condition has 0.59 and 0.66 for testing condition because had value of rigidity that met with minimum acceptance criteria.

Introduction: Anxiety and depression occur at a high rate in cancer patients. However, debate remains regarding the effect of anxiety and depression on cancer survival. Objective: This study aimed to determine the effect of anxiety and depressive symptoms on the survival of cancer patients. Methods: The subjects consisted of 112 cancer patients who attended the Oncology and Radiotherapy outpatient clinic Hospital Kuala Lumpur, Malaysia, in 1999. Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) questionnaire at inception. Information on patients’ mortality status for extended 13 years follow-up (in 2011) was obtained from the National Registration Department death records. Overall survival for each anxiety and depressive symptoms scores in HADS at 13 years was calculated using Cox proportional hazards regression analysis. Results: Cancer patients experienced more anxiety (83%) compared to depressive symptoms (40.2%). The mean (S.D.) HADS scores for depressive symptoms were 9.9 (2.5), and the anxiety symptoms score was 12.6 (2.1). At 13 years, half of the patients (50.9%) had died. No significant effect of anxiety (p=0.399, 95% C.I.= 6.2-8.4) or depressive symptoms at inception (p=0.749, 95% C.I.= 5.9-8.4) towards cancer patients’ survival was found at 13 years follow-up. Conclusion: The occurrence of anxiety symptoms among cancer patients in this study was 2-folds higher than depressive symptoms. However, no significant increased risk of death was found in cancer patients with anxiety or depressive symptoms at 13 years follow-up. It may imply that as time extended, survival in cancer patients may be related to various interacting elements, and intervening health factors are of importance.

This paper reviews empirical literature to develop a conceptual framework for the adoption of Facebook as a marketing channel by Small and Medium Enterprises (SMEs) in developing countries like Nigeria. Recent peer-review journal articles were reviewed to develop the conceptual framework for this study. Facebook provides SMEs with a cost-effective strategy for marketing their products and services to both local and international customers. However, SMEs in developing countries like Nigeria are slow in the adoption of Facebook. A literature review has revealed a lack of research on the adoption of Facebook by SMEs from the context of developing countries like Nigeria. Most of the existing studies on Facebook adoption were conducted in developed countries. Findings from such studies cannot be directly applied to SMEs in developing countries because they face different challenges. The paper proposes a conceptual framework based on the Technology-Organization-Environment (TOE) framework that can be empirically tested by a future researcher to determine factors influencing the intention of small and medium enterprises operating in the context of developing countries to adopt Facebook as a marketing channel to enhance their competitive advantage in the modern market. Findings from this study would be beneficial to decision-makers in Nigerian SMEs and Nigerian government agencies with responsibility for strengthening SMEs' activities in the country. It will also encourage and guide SMEs to adopt Facebook as their marketing channel.

Obstructive sleep apnea (OSA) is a heterogenous chronic disorder causing hypoxemia, excessive daytime sleepiness, non-refreshing sleep, nocturia, morning headache, irritability, and memory loss. Cardiovascular disease, cognitive impairment, metabolic disorders, and depression are its long-term consequences. The difficulty in treating patients is due to poor compliance, failure to obtain the desired outcome, and complication arising from the multimodality treatment. Direct targeted therapy may overcome these issues. Identification of its phenotypes improves understanding of the disease mechanism, the risk for adverse effects, and predicting response to targeted therapy. Phenotyping of OSA allows treating patients according to their inherent disease and not based on a “one size fits all” method, which may not be applicable for all patients. This approach may improve patients’ compliance with treatment, minimize the associated morbidities, and consequently improve their quality of life.

The DeLone and McLean (D&M) information systems (IS) success model seeks to provide a comprehensive understanding of IS success by identifying and explaining the relationships among their most critical dimensions of success. Many studies have offered important insights into this model. Nevertheless, regarding the e-learning body of knowledge, D&M research remains to be systematically reviewed comprehensively. E-learning refers to the use of information technology to disseminate knowledge for education and training. With today’s e-learning boom necessitated for the most part by COVID-19, its adoption has become increasingly mandatory. Thus, a systematic review should help focus and accelerate future research. This study systematically reviews, compiles, analyzes, and synthesizes the D&M model studies in the e-learning context. This review adopts automatic and manual search methods to collect related studies from 2010 to 2020. After applying inclusion and exclusion criteria, 92 primary studies are identified. The findings show that most of reviewed studies were conducted in the education field. The success category was the most highly investigated area from among the selected studies. Most studies developed a hybrid/extended model. Additionally, this study also identified gaps in the literature and recommends seven potential future areas requiring further investigation, such as conducting studies to examine the net benefits at the organizational level of analysis. To that end, the findings of this systematic review study provide an impactful contribution through offering a holistic review of the current state of D&M model studies in an e-learning context, providing an essential reference for scholars in this field.

In Malaysia, waqf properties are held and put under the Department of Waqf, Zakat and Hajj (JAWHAR) at the federal level and under the State’s Islamic Religious Council (SIRC) of respective states for the state level. However, all these properties need a lot of funds to manage them, and issues arose on sustainability and management of these waqf properties. The research found no guidelines identified explicitly in any investigation or findings on the appropriate guideline to solve this issue. Therefore, this research seeks to determine the actual problems and the legal and procedural constraints relating to the management and sustainability of waqf properties, especially in Johor, that has never been available before. Hence, using qualitative research method, which include content analysis and interviews during field studies; this research aims to produce a comprehensive solution and possible sources of funding for the effective management and sustainability of waqf properties in Johor. It is determined that the issue of the insufficient fund, lack of proper planning by waqf Mutawalli, unregistered waqf land under SIRC, and outdated data are among the problems that become impediments to waqf development. Therefore, Mutawalli carried a big responsibility to ensure that the waqf properties shall be developed according to the classes agreed and affirmed by the donor (waqif), leading to positive consequences to Malaysia's economic growth, especially in Johor.

Aim Older persons are vulnerable to food insecurity. Therefore, this study aimed to determine the prevalence of food insecurity and associated factors among older persons in Malaysia. Methods This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis. Results The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure. Conclusion Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.

Introduction: Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients. Methods: Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as p < 0.05. Results: COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67–2.07; p < 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age p < 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04–7.88; p < 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39–6.76; p < 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20–4.25; p < 0.00001), respiratory disease (RR 2.74: 95% CI 2.04–3.67; p < 0.00001), diabetes (RR 1.97: 95% CI 1.48–2.64; p < 0.00001), hypertension (RR 1.95: 95% CI 1.58–2.40; p < 0.00001), and cancer (RR 1.89; 95% CI 1.25–2.84; p = 0.002) but not liver disease (RR 1.64: 95% CI 0.82–3.28; p= 0.16). Conclusion: Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

Quick response (QR) code is a printed code of black and white squares that is able to store data without the use of any of the electronic devices. There are many existing researches on coloured QR code to increase the storage capacity but from time to time the storage capacity still need to be improved. This paper proposes the use ofcompress, multiplexing and multilayered techniques, as an integrated technique known as CoMM, to increase the storage of the existing QR code. The American Standard Code for Information Interchange (ASCII) text characters are used as an input and performance is measured by the number of characters that can be stored in a single black and white QR code version 40. The experiment metrics also include percentage of missing characters, number of produced QR code, and elapsed time to create the QR code. Simulation results indicate that the proposed algorithm stores 24 times more characters than the black and white QR code and 9 times more than other coloured QR code. Hence, this shows that the coloured QR code has the potential of becoming useful mini-data storage as it does not rely on internet connection.

The effects of the ABCB1 C3435T genetic polymorphism on clopidogrel responses are conflicting and inconclusive especially in patients undergoing percutaneous coronary intervention (PCI). This study...

Internet of Thing (IoT) is one of the elements that drive the development of the Industrial Revolution (IR 4.0). Therefore, IoT has become the most important agenda in the globalization era including the field of education. The IoT element has been widely engaged in higher education syllabus. However, in COVID 19 pandemic, the teaching and learning process for IoT becomes more challenging and difficult to deliver. As a solution, the Educational Kit for IoT Online Learning has been developed. This online learning kit will help students to practically learn the IoT without a face to face lecture. The objectives of the paper are to provide an overview of existing IoT education solutions and to develop IoT online learning kit. This learning kit consists of IoT development hardware and software which are equipped with a camera that connected to the online conference software. This paper will explain the development of the kit. Compared to other kits, this learning kit can directly be used for online learning and helps students to practice IoT at home, especially during a pandemic. On the other hand, IoT Online Kits is a pioneer in higher education for practical online learning.

In powder compaction process, one of the most essential aspect that needs to be considered is the strength of the compacted materials that is commonly measured using the fracture toughness test. In...

Purpose The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP. Patients and methods A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund-Kennedy (LK) endoscopic scoring, Lund-Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites. Results A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of "need to blow nose" was statistically significant in allergy vs nonallergy (p=0.01) and CCAD vs nonCCAD (p=0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p=0.01; CCAD vs nonCCAD, p=0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p=0.02; CCAD vs nonCCAD, p=0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p=0.03; LM score, p=0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p=0.141; right middle turbinate, p=0.074) and CCAD (left middle turbinate, p=0.017; right middle turbinate, p=0.009) than nonallergy and nonCCAD patients. Conclusion Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.

Mojorejo village is one of the productive migrant villages (DESMIGRATIF) in Indonesia. This study aims to determine the alternative way to increase TKI household productivity of through optimization of remittances and to desain a remittance optimization program in building a constructive financial management for TKI households in Mojorejo Village, Karangmalang, Sragen. This study uses a descriptive analysis with qualitative and systematic review approach. Data collection techniques were carried out by review the previous research and empowerement, observation through field survey, interview with informan and secondary data searching. The results show that the problem on increasing TKI household productivity is unoptimal remittance management and it tends to use for consumptive activities. Lack of public awareness to allocate remittances for investment and productive business causes the stagnant economic growth and does not lead to economic improvement in the surrounding environment. Therefore, remittance optimization can be done through the community empowerment that focus in four activities, namely financial planning training for TKI households, entrepreneurship training and business plan simulations, training in processing, packaging and marketing of rice rambak crackers, and managing mini tourism object of reservoir and selfies of "Kembangan Bersolek" in Mojorejo Village, Karangmalang, Sragen.

In treating allergic rhinitis, montelukast has the potential to be used as an alternative or addition to an oral antihistamine or intranasal corticosteroid. The objective of this systematic review was to assess the effectiveness of montelukast in treating allergic rhinitis. An electronic literature search was performed using the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from 1966 to 21 January 2019. The eligibility criteria were randomized controlled trials comparing montelukast with placebo or other standard treatments. The primary outcomes assessed were daytime nasal symptom score (DNS) and night-time nasal symptom score (NNS). The secondary outcomes assessed were composite nasal symptom score (CSS), daytime eyes symptom score (DES), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). The meta-analysis was conducted using Review Manager 5.3 software based on the random-effects model. Fifteen studies of 10387 participants met the inclusion criteria. Montelukast was more effective than placebo in improving DNS (mean difference [MD] − 0.12, 95% confidence interval [CI] − 0.15 to − 0.08; p

Objective Patients suffering from persistent inferior turbinates hypertrophy refractory to medical treatments require surgical intervention where the main aim is symptomatic relief without any complications. Extraturbinoplasty is one of the preferred procedures for turbinate reduction due to its efficacy in freeing up nasal space by removing the obstructing soft tissue and bone while preserving the turbinate mucosa. We sought to evaluate the effectiveness and safety of microdebrider assisted turbinoplasty (MAT) and coblation assisted turbinoplasty (CAT) performed as an extraturbinoplasty procedure. Methods A prospective randomized comparative trial was conducted among patients with bilateral nasal blockage secondary to inferior turbinates hypertrophy. Patients were randomly assigned to MAT or CAT. An extraturbinal medial flap turbinoplasty was performed for both techniques. Symptom assessment was based on the visual analogue score for nasal obstruction, sneezing, rhinorrhea, headache and hyposmia. Turbinate size, edema and secretions were assessed by nasoendoscopic examination. The assessments were done preoperatively, at 1st postoperative week, 2nd and 3rd postoperative months. Postoperative morbidity like pain, bleeding, crusting and synechiae were documented. The clinical outcomes of both techniques were analyzed using repeated measures ANOVA. Results A total of 33 participants were recruited, 17 patients randomized for MAT and 16 patients for CAT. Nasal obstruction, discharge, sneezing, headache and hyposmia significantly reduced from 1st week until 3 months for both procedures. Similar significant reductions were seen for turbinate size, edema and secretions. However, there was no significant difference in symptoms and turbinate size reduction were seen between both groups at the first postoperative week, 2nd and 3rd postoperative months. There was significant longer operating time for CAT when compared to MAT (p = 0.001). The postoperative complications of bleeding, crusting and synechiae did not occur in both groups. Conclusion Both MAT and CAT were equally effective in improving nasal symptoms and achieving turbinate size reduction in patients with inferior turbinate hypertrophy. Both MAT and CAT offer maximal relieve in patients experiencing inferior turbinates hypertrophy by removing the hypertrophied soft tissue together with the turbinate bone without any complications.

The most effective antiplatelet treatments for acute coronary syndrome (ACS) patients carrying CYP2C19 loss-of-function (LoF) alleles undergoing percutaneous coronary intervention (PCI) is still debating and conflicting. It was aimed to compare the efficacy and safety endpoints for these patients treated with alternative P2Y12 receptor blockers (e.g. prasugrel or ticagrelor) against clopidogrel. Literature was searched in PubMed, Cochrane library, Synapse and 1000 Genomes databases following PRISMA guidelines for identifying relevant studies. Aggregated risk was estimated by RevMan software using either fixed/random-effects models where P values

To understand the current state, health and efficiency of an organization, evaluation based on an organizational diagnostic model are vital. There have been a number of framework and models developed for this purpose which serves as a general rule, but they lack accuracy in certain industries due to its characteristics and scope. This paper critically analyzes previous models, highlighting its definition, advantages, disadvantages, applications and comparison between them. Recognizing factors that contribute to the performance of construction/engineering companies, the authors propose a new diagnostic model which is more suited to this industry. The new diagnostic model addresses issues of culture at work while redefining the scope of every pillar involved in previous diagnostic models. It is a revelation of an evaluation platform for all companies within the same industry, which allow further studies on sustainability framework to be developed on top of this platform.

Rohingya refugees are a group of people who does not only have well-founded fear that they cannot return home, but are afraid of challenges awaiting them in the host country. Due to their traumatic past experiences, the Rohingya refugees rely much on their own community specifically the community leaders for assistance. However, the lack of community leaders as well as deficient hierarchical engagement with the leaders have created more difficulties for the refugees to seek for help. Social navigation for survival becomes an issue not only because they have language barriers but also internal conflicts on the imagined terrains (the hopes) and the unexpected circumstances (the difficulties) they encounter in the host country. This study aims to develop a literacy training module for Rohingya youth refugees to become social navigators. These refugees are expected to provide horizontal (peer-like) engagement to their community. To meet the aim of the study, 15 Rohingya youth refugees were recruited using a snowball sampling technique. Both qualitative and quantitative data collection instruments were used: guided questionnaires, interviews and baseline tests. The themes from the data suggest that despite the challenges in language, the participants exhibited strong sense of brotherhood with other fellow refugees. Religion has developed a powerful bond that ignites their willingness to extend assistance to their community. However, the participants unfolded their uncertainties on the ways and resources available, to be of help. It is also apparent that, a conceptual framework suitable for this literacy training module for social navigation emerged from the overall data. The framework will serve as a guide to develop a Literacy Module to groom social navigators to help their people, the Rohingya refugees.

Purpose This cross-sectional study examined the cyber-psychological correlates of depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia. Design and methods Participants were randomly selected using multi-stage sampling methods from three public universities in the study location. Participants completed measures of internet and smartphone addictions, depression, anxiety, stress, and suicidality, along with sociodemographic items. Findings At bivariate level, both internet and smartphone addictions were found to have significant positive correlations with depression, anxiety, stress, and suicidality. At multivariate level, only internet addiction emerged as a consistent significant predictor for depression, anxiety, stress, and suicidality. Practice implications The present findings have implications for mental health professionals to routinely screen for psychological disturbance in young adults who have potential risks for internet addiction.