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Abstract Background Research on antenatal depressive, anxiety and stress symptoms among women with gestational diabetes mellitus (GDM) is lacking in Malaysia. This study aimed to determine the prevalence and factors associated with antenatal depressive, anxiety and stress symptoms among Malaysian women with GDM. Methods This was a descriptive, cross-sectional study of 526 women with GDM. Depressive, anxiety and stress symptoms are defined as the final score in mild to extremely severe risk in the severity rating scale. Data analysis was performed using SPSS v.21, while multiple logistic regression was used to identify predictors of depressive, anxiety and stress symptoms. Results Prevalence of anxiety symptoms was highest (39.9%), followed by depressive symptoms (12.5%) and stress symptoms (10.6%) among women with GDM. According to multiple logistic regression analyses, younger age (OR = 0.955, 95% CI = 0.919–0.993), comorbidity with asthma (OR = 2.436, 95% CI = 1.219–4.870) and a family history of depression and anxiety (OR = 4.782, 95% CI = 1.281–17.853) had significant associations with antenatal anxiety symptoms. Being non-Muslim (OR = 2.937, 95% CI = 1.434–6.018) and having a family history of depression and anxiety (OR = 4.706, 95% CI = 1.362–16.254) had significant associations with antenatal depressive symptoms. Furthermore, being non-Muslim (OR = 2.451, 95% CI = 1.273–4.718) had a significant association with antenatal stress symptoms. Conclusions Within a population of women with GDM in Malaysia, those at higher risk of having depressive, anxiety and stress symptoms can be identified from several baseline clinical characteristics. Clinicians should be more alert so that the high-risk patients can be referred earlier for further intervention.

Abstract Background The association of HTRA1 rs11200638 and ARMS2 rs10490924 gene polymorphisms with response to intravitreal ranibizumab therapy among neovascular AMD (nAMD) subjects in Malaysia was determined in this study, followed by the expression of HTRA1 and ARMS2 genes. Results Both single nucleotide polymorphisms (SNPs) recorded a significant association between nAMD and controls with HTRA1 rs11200638 at P = 0.018 (OR = 1.52, 95% CI = 1.07–215) and ARMS2 rs10490924 at P

The article discusses that the Industrial Revolution during the Anthropogenic has resulted in total change in the pattern of living in the world. Topics discussed include the plant kingdom which supplies food also maintains the temperature, and brings rain; and today plant biodiversity is getting disturbed; and the living conditions of sea animals and marine plants are disturbed due to pollution of the sea.

Abstract Background Gestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis. Methods We systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). Results Eighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9–12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35–13.23); macrosomia (OR 4.41, 95% CI 3.09–6.31); and congenital anomalies (OR 4.25, 95% CI 1.52–11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81–3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19–4.68); family history of diabetes (OR 2.77, 2.22–3.47); history of stillbirth (OR 2.39, 95% CI 1.68–3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72–3.17); history of abortion (OR 2.25, 95% CI 1.54–3.29); age ≥ 25 (OR 2.17, 95% CI 1.96–2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24–1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21–3.07). Conclusion We found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy. Trial registration PROSPERO (2017: CRD42017070104).

BackgroundMigraine may lead to a negative impact on the patients' quality of life with a subsequent substantial burden to society. Therapy options for treatment and prevention of migraine have progressed over the years and repetitive transcranial magnetic stimulation (rTMS) is one of the promising non-pharmacological options. It induces and alters electric current in the brain via repetitive non-invasive brain stimulation in high frequency. In migraine patients, two common stimulation sites are the M1 cortex and dorsolateral prefrontal cortex (DLPFC). The mechanism on how rTMS exerts therapeutic effects on migraine is not fully established, but the main postulation is that the neuromodulation via high-frequency rTMS (hf-rTMS) might inhibit pain perception. However, evidence from studies has been conflicting, thus the usefulness of hf-rTMS as migraine preventive treatment is still uncertain at this moment.MethodsThis is a systematic review protocol describing essential reporting items based on the PRISMA for systematic review protocols (PRISMA-P) (Registration number: CRD42020220636). We aim to review the effectiveness, tolerability, and safety of hf-rTMS at DLPFC in randomised controlled trials (RCTs) as migraine prophylactic treatment. We will search Scopus, Cumulative Index to Nursing and Allied Health Literature Plus, PubMed, Cochrane Central Register of Controlled Trials and Biomed Central for relevant articles from randomised controlled clinical trials that used hf-rTMS applied at DLPFC for the treatment of migraine. The risk of bias will be assessed using the version 2 "Risk of bias" tool from Cochrane Handbook for Systematic Reviews of Interventions Version 6.1. We will investigate the evidence on efficacy, tolerability and safety and we will compare the outcomes between the hf-rTMS intervention and sham groups.DiscussionThis systematic review will further determine the efficacy, safety, and tolerability of hf-rTMS applied at DLPFC for migraine prophylaxis. It will provide additional data for health practitioners and policymakers about the usefulness of hf-rTMS for migraine preventive treatment.

Thin film manganese oxides (manganites) display remarkable properties, such as colossal magnetoresistance and charge ordered phases, and became a focal point of research in the past two decades owing to potential applications ranging from oxide spintronics to resistive switching-based memories. LaxCa1-xMnO3 (LCMO), a widely studied manganite, is known to substantially improve its transport properties when doped with Ag. However, despite the abundance of studies on LCMO, the effect of silver on the surface structure is unknown. Here, through in-situ methods, scanning tunneling microscopy (STM) is performed on La5/8Ca3/8MnO3 films grown by pulsed laser deposition. Films doped by silver, as confirmed by in-situ X-ray photoelectron spectroscopy, display large-scale reconstructions, interpreted as being of type (√10 x √10)R18.4°, while films lacking silver display a (√2 x √2)R45° reconstruction that may be associated with a surface charge-ordered state. It is posited that the possible cause of the varied reconstructions is due to a vacancy ordering on top of the existing (√2 x √2)R45° reconstruction. These studies highlight the influence of Ag on the surface structure, and therefore a route towards modifying the surface properties of manganites [ABSTRACT FROM AUTHOR]

BaTiO nanoparticles were prepared by high energy ball milling and subjected to conventional and microwave post sintering at 1,000 °C. From the powder X-ray diffraction results, the synthesized material exhibits strong tetragonality with large c/a ratio. Scanning electron microscope results show the formation of tetragonal shaped BaTiO crystals in the nanometer scale and a significant reduction in the particle size for the microwave sintered sample. The reduced d-spacing of 1.741 Å with high crystallinity for the microwave sintered material is revealed by high resolution transmission electron microscopy analysis. Ultraviolet-visible spectroscopy studies confirm the higher optical band gap (E) of 4.157 eV for the microwave sintered sample. Microwave sintered sample shows a very high dielectric constant of ε = 4,445 with a low dielectric loss as tan δ = 0.0961. Microwave sintered sample exhibit a high polarization maximum of 73 μC/mm with reduced coercivity to be 0.293 kV/mm. [ABSTRACT FROM AUTHOR]

Background: Several studies in various populations have been conducted to determine candidate genes that could contribute to age-related macular degeneration (AMD) pathogenesis. Objective: The present study was undertaken to determine the association of high temperature requirement A-1 (HTRA1), vascular endothelial growth factor (VEGF) and very-low-density receptor (VLDR) genes with wet AMD subjects in Malaysia. Methods: A total of 125 subjects with wet AMD and 120 subjects without AMD from the Malaysian population were selected for this study. Genomic DNA was extracted and copy number variations (CNVs) were determined using quantitative real-time Polymerase Chain Reaction (qPCR) and comparison between the two groups was done. The demographic characteristics were also recorded. Statistical analysis was carried out using software where a level of P 0.05). Conclusion: Observations of an association between CNVs of VEGF gene and wet AMD have revealed that the CNVs of VEGF gene appears to be a possible contributor to wet AMD subjects in Malaysia. Keywords: Age-related macular degeneration, Copy number variations, VEGF, HTRA1, VLDR genes and Malaysia

Background: Genetic and environmental factors are known to be risk factors in development of neovascular age-related macular degeneration (nAMD). Genetic factors such as polymorphisms in the complement component pathway genes might play a role in pathogenesis of nAMD and has been studied in various populations excluding Malaysia. Aim of the study: To determine the association of the R102G polymorphism of the complement component (C3) gene in nAMD subjects. Patients and methods: A total of 301 Malaysian subjects (149 case and 152 controls) were recruited and genotyped for the R102G (rs2230199) variant of the C3 gene. Genotyping was conducted using the PCR-RFLP method and association analysis was conducted using appropriate statistical tests. Results: From our findings, no significant association was observed in the allele distribution of C3 R102G between nAMD and controls (OR = 1.42, 95% CI = 0.77–2.62, P = 0.268). A further analysis that compared three genetic models (dominant, recessive and co-dominant) also recorded no significant difference (P > 0.05). These findings could be due to the low frequency of the GG variant in the case (4.7%) and control (1.3%) groups, compared to the normal variant CC, which is present in 91.3% of case and 92.8% of control alleles. Conclusion: The present study showed no evidence of association between C3 R102G polymorphism and nAMD in Malaysian subjects. Keywords: Age-related macular degeneration, Complement component 3, C3 gene, R102G gene polymorphism

Aim: This pilot study was done to evaluate the immediate effect of Sukha Pranayama, a slow and deep breathing technique on maternal and fetal cardiovascular parameters. Subjects and Methods: Single session pre-post comparison was done for 10 min of Sukha Pranayama in 12 pregnant women in their 3rd trimester. The study participants were guided to breathe in and out in a slow and regular manner for a count of 4 s each. Maternal cardiovascular parameters, namely mean heart rate (MHR), systolic pressure (SP), and diastolic pressure (DP), were measured before and after the session and rate-pressure product (RPP) derived with the formulae. Fetal heart rate (FHR) was derived from the nonstress test tracing. Results: SP, MHR, FHR, and RPP reduced significantly after single session of Sukha Pranayama. The mothers reported that they felt more relaxed and also sensed active fetal movement while performing the pranayama. Discussion: Reduction in maternal cardiovascular parameters may be attributed to reduced sympathetic activity coupled with enhanced vagal parasympathetic tone. Reduction in RPP signifies reduced myocardial oxygen consumption and load on the heart as evidenced by previous studies. These changes in cardiac autonomic status may enhance placental circulation, leading to healthier fetal development. Conclusion: The present study reiterates the importance of yoga for the psychosomatic health of maternal-fetal unit as an add-on relaxation technique. We plan to develop this pilot study into a full-fledged evaluation of maternal and fetal wellbeing through yoga.

AIM: To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy (PDT) among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014. METHODS: Study subjects were recruited retrospectively using the Electronic Medical Record (EMR) database software in Hospital Selayang. Demographic data, medical history, diagnostic procedure, treatments and diagnosis of patients were recorded. RESULTS: The five-year analysis included 821 patients with a mean age of 65.9±11.73y. Overall, there were a higher number of males (63.1%) and a higher number of Chinese (47.4%) patients. Among the 821 patients, 62.9% received ranibizumab injection followed by 19.2% PDT therapy and 17.9% had ranibizumab combined with PDT therapy. Age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) were the most common retinal eye diseases reported, recording prevalence of 25.0% and 45.6%, respectively. The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014. In terms of treatment, following multiple logistic regression, AMD was associated with the subjects being more likely to have received ranibizumab monotherapy (P

Age-related macular degeneration (AMD) is the most widely recognised cause of irreversible vision loss and previous studies have suggested that the advancement of wet AMD is influenced by both modifiable and non-modifiable elements. Single nucleotide polymorphism (SNPs) and copy number of variations (CNVs) have been associated with AMD in various populations, however the results are conflicting. Our aim is to determine the CNVs of Complement Factor H-Related genes among Malaysian subjects with wet AMD. 130 patients with wet AMD and 120 healthy controls were included in this research. DNA was extracted from all subjects and CNVs of CFH, CFHR1 and CFHR3 genes; determined using quantitative real-time PCR and were compared between the two groups. A consistent association was observed between CFH gene and wet AMD susceptibility (P

The ever-increasing demand for materials to have superior properties and satisfy functions in the field of soft robotics and beyond has resulted in the advent of the new field of four-dimensional (4D) printing. The ability of these materials to respond to various stimuli inspires novel applications and opens several research possibilities. In this work, we report on the 4D printing of one such Shape Memory Polymer (SMP) tBA-co-DEGDA (tert-Butyl Acrylate with diethylene glycol diacrylate). The novelty lies in establishing the relationship between the various characteristic properties (tensile stress, surface roughness, recovery time, strain fixity, and glass transition temperature) concerning the fact that the print parameters of the laser pulse frequency and print speed are governed in the micro-stereolithography (Micro SLA) method. It is found that the sample printed with a speed of 90 mm/s and 110 pulses/s possessed the best batch of properties, with shape fixity percentages of about 86.3% and recovery times as low as 6.95 s. The samples built using the optimal parameters are further subjected to the addition of graphene nanoparticles, which further enhances all the mechanical and surface properties. It has been observed that the addition of 0.3 wt.% of graphene nanoparticles provides the best results.

Abstract: A numerical investigation is performed to study the behaviour of a composite plate under low velocity impact. The finite element simulation is performed to investigate the stress distribution during the impact on the laminated composite plate. The effectiveness of the developed numerical model is investigated by comparing the results in terms the transverse-deflection and stress, longitudinal stress and impact duration with those of available literature. Various parametric studies are performed to study the effect of boundary conditions, thickness of the laminate, impactor mass and velocity and composite lay-up sequence on stress variation of the composite laminate. It is concluded that the stresses are distributed symmetrically along the bottom and top layers irrespective of the boundary conditions. Furthermore, it is shown that the maximum tensile stress is yielded at the bottom layer while the maximum compressive stress is yielded at the top layer of the laminated composite plate. Symmetric variation in in-plane shear stress distribution is also observed. It is also shown that the thickness of the composite plate plays an important role on the deflection of the plate. It is further shown that depending on the boundary conditions considered, the significant variation of shear stress is observed along the shear plane with respect to the mass and velocity of the impactor and the lay –up configuration. [Copyright &y& Elsevier]

Abstract: Zirconia toughened alumina (ZTA) nanocomposites with different zirconia contents (5–20mol%) were prepared by the sol–gel method. The prepared composites were sintered at 1300°C by both conventional and microwave techniques. The crystallinity, average grain size, microstructure and densification of the samples prepared by conventional and microwave sintering methods were compared. X-ray diffraction analysis shows that the microwave sintered samples possess higher tetragonality and also exhibit reduced particle size compared to conventional sintering. HR-SEM surface micrograph reveals that the microwave sintered samples have homogeneous particle size distribution with less degree of porosity. TEM analysis confirms uniform distribution of particles with an average particle size of 20nm for the microwave sintered sample. SAED pattern reveals that the microwave sintered samples possess improved crystallinity compared to conventional sintered samples. The apparent porosity and density of ZTA nanocomposites measured for different zirconia contents show that the densification of 97% could be achieved for the microwave sintered samples with higher content of zirconium. [Copyright &y& Elsevier]