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The previous regressor-based control method to control two cooperative manipulators in handling a deformable object leads to complex calculations and complicated programming in experimental hardware tests. There is an existing lack of studies about the development of the controller based on a partial differential equation (PDE)-based model and considering the model’s uncertainties. Previous studies have shown fewer experimental validations regarding two cooperative manipulators that handle deformable objects under uncertain model parameters. This study proposes a composite controller comprising a function approximation technique (FAT)-based adaptive control (FATAC) for a slow subsystem and a velocity feedback control (VFC) for a fast subsystem. The proposed FATAC is used for trajectory tracking, and VFC is used to suppress the vibration of the deformable object. Lyapunov stability analysis has been carried out to design controllers that stabilize a non-linear system of two cooperative manipulators handling the flexible object. Simulation and hardware experimental tests have been carried out to validate the performance of proposed controllers. The results verified that the proposed composite controller comprising the FATAC has successfully driven the cooperative manipulators to handle the deformable object so that it follows the desired trajectories. The VFC has successfully suppressed the transverse vibration of the deformable object.

Jamun plant displays enormous diversity throughout Pakistan, which necessitates its screening, evaluation, and validation to document elite genotypes having better traits for the benefit of the fruit industry and farmers. Surveys were made in natural Jamun habitats across Punjab, Pakistan, and genotypes were marked based on visual diversity of trees and fruits. In total, 60 Jamun genotypes were selected for characterization based on phenotypic and genetic markers. Phenotypic characters related to trees, leaf, and flower along with fruit qualitative traits were assessed in situ. Results revealed significant diversity with high (>25%) coefficient of variance values and the first two components of correspondence analysis exhibited 41.71% variation among genotypes. A strong association was observed among traits like upright tree and round fruit shape (0.74), bluish-colored fruit and pinkish pulp (0.85), and elliptic-shaped fruit with low fruit waxiness (−0.72). Leaves of phenotypically characterized plants were brought to Wheat Biotechnology Lab., University of Agriculture, Faisalabad, Pakistan, where Jamun genotypes were investigated genetically using Random Amplified Polymorphic DNA (RAPD) and Inter Simple Sequence Repeat (ISSR) markers. A total of 132 bands were scored, of which 108 were polymorphic, corresponding to almost 81% polymorphism among collected genotypes. High polymorphism information content values were observed against RAPD (0.389) and ISSR (0.457) markers. Genotypes were compared in relation to genetic markers, which exhibited that almost 86% of genetic variability was attributed to differences among accessions, while 14% of variation was due to differences between collections of different areas. Findings of this study confirmed wide phenotypic and genetic distinctness of Jamun in Pakistan that can aid breeders for marker-assisted selection and germplasm enhancement for future crop improvement programs.

An investigation was conducted to explore the optimum composition to fabricate a zinc silicate glass substrate for optoelectronic device applications. The composition was determined based on the empirical formula (ZnO)x-(SiO2)1-x, where x = 0.40, 0.50, 0.60 and 0.70 wt%, which was prepared by the conventional melt quenching technique. The focus is on characterizing the physical and structural aspects as well as the optical properties of the glass substrate. The physical properties of zinc silicate samples were assessed using the densitometer and their physical appearance. In addition, the materials' amorphous and glassy characteristics were verified using X-ray diffraction (XRD) and Fourier transform infrared (FTIR) techniques. Finally, ultraviolet–visible (UV–Vis) spectroscopy and photoluminescence spectrometer were used to study the optical properties of samples. The density of the samples was observed to increase from 2805 to 3878 kg/m3 as the percentage of ZnO in the glass composition increased. X-ray diffraction analysis indicated the absence of sharp peaks in the samples containing up to 0.60 wt% of ZnO, suggesting the presence of an amorphous phase. Furthermore, the results of this study indicate that ZnO-SiO2 glass substrate samples favor direct forbidden transitions, with an increase in ZnO leading to higher absorption and consequently a lower band gap. The photoluminescence spectrum showed blue light emissions at 422 nm, associating with the variation of band gaps in the ZnO phase. Overall, from the interesting results achieved, this zinc silicate-based composite material at 0.60 wt% ZnO can be a potent candidate in optoelectronic applications, among other concentrations used in this study.

Aim: This study aimed to compare the efficacy of ozonated water mouth rinse over chlorhexidine mouth rinse against the accumulation of plaque in chronic gingivitis patients. Materials and methods: A total of 30 patients with chronic generalized gingivitis were choosen for the study. The duration of this study was 15 days and was divided into three groups. Group 1 patients were advised to rinse with ozonated water¸ group 2 with a chlorhexidine mouth rinse and group 3 with water for 15 days. The clinical parameters like plaque index, gingival index, and bleeding index were recorded at baseline, 7th, and 15th day respectively. Saliva samples were collected for microbial culture at baseline that is before mouth rinse and on the 15th day that is after using mouth rinse from each patient. Results: The statistical analysis was performed by using ANOVA and Bonferroni’s Post Hoc test on 30 patients at the end of the 15thday. There was a significant decrease in mean plaque, gingival, and bleeding scores in group 2 patients that are chlorhexidine mouth rinse. There was also a decrease in the microbial culture at the end of the 15th day in patients with chlorhexidine mouth rinse compared to ozonated water. Conclusion: The results of this study demonstrate that ozonated water was less effective compared to chlorhexidine mouth rinse in reducing plaque in gingivitis patients. But ozonated water can be used as an alternative to CHX.

BackgroundAcute stroke care is complex and requires multidisciplinary networking. There are insufficient data on stroke care in the Middle East and adjacent regions in Asia and Africa.ObjectiveEvaluate the state of readiness of stroke programs in the Middle East North Africa and surrounding regions (MENA+) to treat acute stroke.MethodOnline questionnaire survey on the evaluation of stroke care across hospitals of MENA+ region between April 2021 and January 2022.ResultsThe survey was completed by 34/50 (68%) hospitals. The median population serviced by participating hospitals was 2 million. The median admission of patients with stroke/year was 600 (250–1,100). The median length of stay at the stroke units was 5 days. 34/34 (100%) of these hospitals have 24/7 CT head available. 17/34 (50%) have emergency guidelines for prehospital acute stroke care. Mechanical thrombectomy with/without IVT was available in 24/34 (70.6%). 51% was the median (IQR; 15–75%) of patients treated with IVT within 60 min from arrival. Thirty-five minutes were the median time to reverse warfarin-associated ICH.ConclusionThis is the first large study on the availability of resources for the management of acute stroke in the MENA+ region. We noted the disparity in stroke care between high-income and low-income countries. Concerted efforts are required to improve stroke care in low-income countries. Accreditation of stroke programs in the region will be helpful.

Abstract Nowadays the fenomenon of emigrate (Hijrah) becoming a trend in Indonesia. Hijrah means to change ourselves for the better, in accordance with the religion guidance. Deciding to change and get out of the comfort zone it is not an easy task. Individual who try to emigrate often feel doubts, feel lonely due to being left behind by friends, facing cornering questions and comments. This research was conducted to find out the well-being emigrate women caused by gratitude and social support, using 200 young mothers who decided to Hijrah. The questionnaires for measuring subjective well-being using Flourishing Scale by Diener, Oishi, et al., (2009) and SPANE (Scale of Positive and Negative Experience) by Diener, Wirtz, et al., (2009), gratitude using GRAT (The Gratitude Resentment and Appreciation Test) by Watkins et al., (2003), and social support using MSPSS (Multidimensional Scale of Perceived Social Support) by Dahlem et al., (1991). Confirmatory Factor Analysis (CFA) was used to test the validity of each item in the questionnaire. Data analysis technique used in this study is multiple regression analysis (multiple regression analysis) of SPSS for windows. In this study we hypothesized that there would be significant influence of gratitude and social support on emigrate woman. Our result shows that, only sense of abundance has a significant effect to well-being of woman who emigrate but there is no social support that has a significant effect to well being on them. Abstrak Saat ini fenomena hijrah menjadi tren di Indonesia. Hijrah mengandung pengertian merubah diri menjadi lebih baik sesuai dengan tuntunan agama. Memutuskan untuk berubah dan keluar dari zona nyaman adalah hal yang tidak mudah. Individu yang mencoba hijrah sering merasa ragu, merasa kesepian karena ditinggal oleh teman, menghadapi pertanyaan dan komentar. Penelitian ini dilakukan untuk mengetahui kesejahteraan wanita yang berhijrah disebabkan oleh rasa terima kasih dan sosial, menggunakan 200 ibu muda yang memutuskan untuk Hijrah. Kuesioner yang digunakan untuk mengukur subjective well-being menggunakan Flourishing Scale oleh Diener, Oishi, et al., (2009) dan SPANE (Scale of Positive and Negative Experience) oleh Diener, Wirtz, et al., (2009), gratitude diukur menggunakan GRAT (The Gratitude Resentment and Appreciation Test) oleh Watkins et al., (2003), dan social support diukur menggunakan MSPSS (Multidimensional Scale of Perceived Social Support) oleh Dahlem et al., (1991). Uji validitas alat ukur menggunakan teknik Confirmatory Factor Analysis (CFA) untuk menguji validitas tiap-tiap item kuesioner. Analisis data dalam penelitian ini menggunakan teknik analisis regresi berganda (multiple regression analysis) dengan software SPSS. Dalam penelitian ini kami berhipotesis bahwa akan ada pengaruh yang signifikan terhadap gratitude dan social support pada wanita yang berhijrah. Hasil penelitian ini menunjukkan bahwa, hanya sense of abundance yang benar-benar memberikan efek signifikan bagi kesejahteraan wanita yang berhijrah, tetapi tidak ada dukungan sosial yang memberikan efek signifikan pada perempuan yang berhijrah.

Abstract This study aims to examine the effect of individual needs on subjective well-being employees in the PPKGBK office (Center for Management of the Bung Karno Complex). This research uses a quantitative approach involving 161 PPKGB employees. Sampling was carried out using probability sampling with accidental sampling technique. The author uses a measuring instrument namely The Modified BBC Subjective Well-Being Scale (BBC-SWB) developed by Kinderman, Schwannauer, Pontin & Tai (2011). The data analysis technique used to answer the research question is multiple regression analysis. Based on the results of the major hypothesis test, the first conclusion obtained from this study is that there is a significant influence between individual needs on subjective well-being of employees at the headquarters of the Bung Karno complex management. Then, based on the results of the minor hypothesis test there are two variables whose regression coefficient values are significant namely: abasement dan achievement, while 14 other variables were not significant. Abstrak Penelitian ini bertujuan untuk menguji pengaruh individual need terhadap subjective well-being pegawai di kantor PPKGBK (Pusat Pengelolaan Kompleks Gelora Bung Karno). Penelitian ini menggunakan pendekatan kuantitatif dengan melibatkan 161 pegawai PPKGB. Pengambilan sampel yang dilakukan menggunakan menggunakan probability sampling dengan teknik accidental sampling. Penulis menggunakan alat ukur yaitu The Modified BBC Subjective Well-Being Scale (BBC-SWB) yang dikembangkan oleh Kinderman, Schwannauer, Pontin & Tai (2011). Teknik analisis data yang digunakan untuk menjawab pertanyaan penelitian adalah analisis regresi berganda. Berdasarkan hasil uji hipotesis mayor, kesimpulan pertama yang diperoleh dari penelitian ini adalah terdapat pengaruh yang signifikan antara individual needs terhadap subjective well-being pada pegawai di kantor pusat pengelolaan komplek Gelora Bung Karno. Kemudian, berdasarkan hasil uji hipotesis minor terdapat dua variabel yang nilai koefisien regresinya signifikan yaitu: abasement dan achievement, sementara 14 variabel lain tidak signifikan.

The study aimed to identify the factors affecting the practice of e-commerce from the perspective of Saudi consumer, and the impact (technical infrastructure, and environmental legislation, culture, and skills of human resources) on the use of e-commerce.The study adopted the descriptive survey methodology in order to describe these factors. The target population of t this research is Al-Baha Region at kingdom of Saudi Arabia. The researcher designed and distributed 320 questionnaire forms and excluded 70 forms due to the lack of information which means overall sample is 250. The data for the study was collected at 2017-2018. The data collected were edited, coded and processed with the Statistical Package for Science Solutions (SPSS), and discussed in narrative style for clarity and better understanding. The arithmetic mean general of the level of availability of the factors affecting combined was average, amounting to (3.25), and the results showed the presence of significant effect of the variables of independent factors (environmental (legislation), environmental (culture), and factors related to the skills of human resources) in the use of e-commerce with Saudi companies from the viewpoint of Saudi consumer. Based on the results of the study recommended the study: the development and drafting of legislation and appropriate laws, develop the technical infrastructure, developing the skills of human resources, increasing the information awareness of Saudi society. Finally, E-commerce practices at kingdom of Saudi Arabia is good, however the continuous improvement for all factors affecting on e-commerce practices is required to activate its practices in an effective way.

We propose and demonstrate a new multiwavelength Brillouin-Raman fiber laser with switchable 10 and 20 GHz spacing. This is achieved by proper adjustments of optical coupling ratios that are incorporated in the design that consists of an enhanced nonlinear amplifying fiber loop. By utilizing a 50/50 coupler, 443 flat amplitude channels with 10 GHz spacing is realized. On the other hand, a 99/1 coupler is feasible for 20 GHz spacing that yields 215 lasing lines. In both cases, the average optical signal-to-noise ratios (OSNR) are 16.5 dB (50/50 coupler) and 24 dB (99/1 coupler). Wide multiwavelength bandwidth, flexible wavelength spacing, and high number of channels with excellent OSNRs are achieved using only a single Raman pump unit through a simple construction.

Seaweed cultivation is an export-oriented aquaculture subsector that is rapidly spreading specifically in South East Asia. Recently, almost all segments of seaweed industry are still facing many obstacles, especially at the level of small-scale farmers’ management in the production and processing industry. The most obvious issue is linked to the development of seaweed operators. The main objective of this study is to assess the seaweed operators’ attitude towards the entrepreneurial inclination. The survey was conducted among the seaweed operators in Semporna based on entrepreneurial attitude orientation (EAO) questionnaire. The result shows that the adjusted R square (Adj. R2 ) value is equivalent to 0.301. This indicates that 30.1 per cent of the entrepreneurial intention were explained by the four entrepreneurial attitude subscales; achievement, innovation, personal control and self-esteem. The result exhibits that the achievement, innovation and personal control were statistically significant at 95 per cent confidence interval. Self-esteem shows no significant relationship and thus signifies subscale as did not contribute much to the regression. The EAO factors contributes little to the regression of the entrepreneurial inclination, which indicates that the other factor such as socioeconomic inputs such as skills, knowledge, extension agent, gender and financial roles might include in the future study.

Background Fragility fractures are linked to significant costs for society as well as significant pain and suffering, disability, and even death. It is well-recognized that osteoporosis-related fragility fractures raise the risk of subsequent fragility fractures. One of the most frequent osteoporotic fractures brought on by low bone mineral density and other risk factors is vertebral fractures. Considering that most vertebral fractures are asymptomatic and not clinically identified, proactive screening could stop additional impairment. Objective The current study aims to determine the prevalence and risk factors of hidden vertebral fractures in Egyptian males who have fragility hip fractures. Patients and methods A cross-sectional case-control study examining the correlation of risk factors between cases (fragility hip fracture and vertebral fractures) and a control group (fragility hip fracture without vertebral fracture) was carried out from September 2020 to September 2021 on patients visiting the orthopedic emergency department of a university hospital in Cairo, Egypt. Males who presented to the emergency room (ER) with fragility hip fractures and were 40 years of age or older met our inclusion criteria. For every patient who presented with a fragility hip fracture, standard lateral and anteroposterior radiographs of the dorso-lumbar spine were taken. Results A total of 43,935 patients visited the orthopedic emergency room (ER) throughout the study period; 13,034 of those patients were men, accounting for 29.7% of all orthopedic ER visits. Our inclusion criteria for fragility hip fractures were met by 132 male participants. The screening lumbosacral plain X-rays identified 27 (20.5%) of the 132 patients as having concomitant vertebral fractures in addition to the fragility hip fractures. Concomitant hidden vertebral fractures among Egyptian males with other fragility fractures, particularly fragility hip fractures, are predicted by the number of co-morbid diseases, hypertension, and continuous use of steroids and anti-epileptics. Conclusion Most fragility fractures are avoidable. Because one fragility fracture increases the likelihood of others, early detection is crucial. To prevent complications and mortality, it is important to identify and manage individuals who have a fragility hip fracture as they frequently have concurrent hidden vertebral fractures. Predictive risk factors for fragility vertebral fractures include hypertension, the number of concomitant illnesses, and chronic drugs (anti-epileptics and steroids)., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Abbas et al.)

Breast cancer is the most common malignancy in women and represents a leading cause of cancer-related mortalities. Females' awareness toward breast cancer is essential for the early diagnosis and detection especially in low and middle-income countries. This study aims to assess the awareness of breast cancer risk factors among females in the Syrian Coast., Methodology: An online cross-sectional survey was conducted among Syrian females during the COVID-19 pandemic. The questionnaire used in the study was derived from the Cancer Research UK questionnaire and modified to fit the perspective of the study. Statistical Package for Social Sciences (SPSS) was used for data analysis. The independent samples t -test and the one-way analysis of variance (ANOVA) were applied to determine whether there is statistical evidence or any statistically significant differences between the variables., Results: A total of 1305 females participated in the study. The majority aged between 18 and 25, (28.8%) of the participants obtained their information related to breast cancer from internet, (36.7%) of were smokers and (82.8%) had a family member with breast cancer. These results suggested a significant correlation between smoking, family history of cancer, marital status, and breast cancer awareness., Conclusion: This study showed which factors are significantly related to women's awareness of breast cancer risk factors. These results can contribute in the implementation of awareness programs and campaigns, thus raising the level of awareness among women., Competing Interests: NA., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Endobronchial Metastasis from extrathoracic tumors is a rare neoplasm that accounts for approximately 1.1% of total endobronchial malignancies. The most common primary tumors associated with EBM are from the colorectal, breast, and kidney regions. Although it represents a late manifestation in the context of tumor progression, it can rarely antedate the diagnosis of the primary tumor., Case Presentation: A 67-years-old male was referred from another city hospital to our thoracic surgery department due to a 4-months history of hemoptysis and productive cough. A chest X-ray and computed tomography scan showed a soft-tissue mass within the left main bronchus and atelectasis of the anterior segment of the left upper lobe. Furthermore, a flexible bronchoscopy revealed a hypervascular lesion occluding completely the left upper lobe bronchus. The patient underwent lobectomy and pathological examination suggested endobronchial metastasis from clear cell renal cell carcinoma. A second computed tomography scan of the abdomen and pelvis showed a well-defined mass arising from the lateral aspect of the right kidney; therefore, the patient underwent right radical nephrectomy three weeks later and pathology confirmed the diagnosis of clear renal cell carcinoma with endobronchial metastasis., Conclusion: Despite its rarity, physicians should consider the possibility of endobronchial metastases in the setting of endobronchial lesions. Proper diagnostic approaches should also be considered to rule out the potential of asymptomatic extrathoracic neoplasms. In this manuscript, we aimed to report a rare case -the first from Syria to our knowledge- of an endobronchial metastasis that preceded the diagnosis of renal cell carcinoma. Importantly, we reviewed the existing literature and discussed the diagnostic and treatment approaches., (© 2023. The Author(s).)

Studies on end-of-life care reveal different practices regarding withholding and/or withdrawing life-sustaining treatments between countries and regions. Available data about physicians' practices regarding end-of-life care in ICUs in Egypt is scarce. This study aimed to investigate physicians' attitudes toward end-of-life care and the reported practice in adult ICUs in Ain Shams University Hospitals, Cairo, Egypt. 100 physicians currently working in several ICU settings in Ain Shams University Hospitals were included. A self-administered questionnaire was used for collection of data. Most of the participants agreed to implementation of "do not resuscitate" (DNR) orders and applying pre-written DNR orders (61% and 65% consecutively), while only 13% almost always/often order DNR for terminally-ill patients. 52% of the participants agreed to usefulness of limiting life-sustaining therapy in some cases, but they expressed fear of legal consequences. 47% found withholding life-sustaining treatment is more ethical than its withdrawal. 16% almost always/often withheld further active treatment but continued current ones while only 6% almost always/often withdrew active therapy for terminally-ill patients. The absence of legislation and guidelines for end-of-life care in ICUs at Ain Shams University Hospitals was the main influential factor for the dissociation between participants' attitudes and their practices. Therefore, development of a consensus for end-of-life care in ICUs in Egypt is mandatory. Also, training of physicians in ICUs on effective communication with patients' families and surrogates is important for planning of limitation of life-sustaining treatments., (© 2020. Springer Nature B.V.)

Background: The ongoing scientific debate regarding the association between physical function and cognitive impairment has focused mainly on global cognitive performance rather than specific cognitive functions tests and the importance of recognition of its associations and any factors that could play a role later in the prevention of such decline., Objective: This study examined the association between physical function, using handgrip strength (HGS) and Timed Up-and-Go test (TUGT), and executive function (EF), using Clock Drawing Test (CDT), among community-dwelling Egyptian elderly., Methods: A cross-sectional study was conducted in 5 social clubs in Cairo, Egypt and included a sample of 136 elderly males and females aged≥55 years old. All participants had their physical function assessed using TUGT, and measurement of HGS using a pneumatic hand-held dynamometer. Assessment of EF using CDT was also done., Results: Higher CDT scores were significantly associated with both better HGS, and lower TUGT (OR = 3.77, and 0.65 respectively). This persisted even after adjustment for age and gender (OR = 2.56, and 0.71 respectively) and after further adjustment for weight, systolic blood pressure, education, smoking, hyperlipidemia, hypothyroidism, and physical activity (O.R. = 4.79, and 0.76 respectively). Adjustment for both male and female genders showed an association between physical (HGS and TUGT) and EF was stronger among men., Conclusion: A strong association between CDT score and both of HGS and TUGT was found among the studied sample. Higher HGS and lower TUGT was significantly associated with better performance in the CDT. This association is stronger in males than in females for both HGS and TUGT.

Background: Obesity and osteoporosis are two conditions that are associated with morbidity and mortality; there is contradictory evidence regarding this association., Purpose: The aim of the current study was to explore further the association between obesity and calcaneus stiffness index (CSI), as a measure of bone density, in a community-based cross-sectional study in an Egyptian population., Methods: A cross-sectional study was conducted among active subjects, aged ≥20 years old, over one year. CSI was measured by Quantitative ultrasound (QUS), in addition; QUS T-score and Z-score of the non-dominant heel scan were recorded., Results: Two hundred and eighty participants were recruited; 7 subjects were excluded because of Z score more than -2, mean age was 61 (± 11.9) years, and mean BMI was 29.7 (±5.6). Female participants were 77.7%, with mean of age 60.3 (± 11.6); and age range 20-82 years. Male participants were 22.3%, with mean of age 63.6 (± 12.7); and age range 30-80 years. Older subjects (>55 years) had significantly lower CSI and worse T-score than the younger subjects (P < 0.001 for both). In the younger age group, BMI was not significantly associated with CSI, even after adjustment for gender (P= 0.52). However, in the older age group, BMI was significantly associated with stiffness index (P= 0.049, O.R.= 1.73), even after adjustment for gender (P= 0.041, O.R.= 1.7)., Conclusion: Compared to young subjects, older subjects (≥55 years) had significantly lower bone strength as measured by CSI, and their BMI was significantly positively associated with bone density. In younger people (<55 years), BMI was not associated with bone strength., Competing Interests: The authors declare that they have no conflict of interest in this work., (© 2019 Ali et al.)

This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers. Overall experts strongly agreed that hospice and palliative care should be available in long-term care facilities and that both are defined by holistic, interdisciplinary approaches using measures of comfort across domains. However, it appears the experts felt that in most countries the reality fell short of what they believed would be ideal care. As a result, experts call for increased training, communication, and access to specialized EOL services within the nursing home., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ's reliability and validity., Methods: Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach's alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). Test retest Intraclass Correlation Coeeficient (ICC) was used to determine the reliability of the scale., Results: The result showed that the sensitivity and specificity for EDQ was 71.2% and 59.5%. The overall Cronbach's alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach's alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). The Intraclass Correlation Coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong overall agreement, ICC = 0.764, N = 160, P <0.001., Conclusions: The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Introduction: We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia., Methods: This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009., Results: Predictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66-2.33) and 70-79 years (OR 1.43, 95% CI 1.20-1.71); Malay (OR 1.53, 95% CI 1.41-1.66) and Indian (OR 1.32, 95% CI 1.19-1.46) ethnicities; T2DM durations of 5-10 years (OR 1.46, 95% CI 1.35-1.58) and > 10 years (OR 1.75, 95% CI 1.59-1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32-10.34), insulin only (OR 17.93, 95% CI 9.91-32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47-52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01-1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38-1.59) and triglycerides (OR 1.61, 95% CI 1.51-1.73). Hypertension (OR 0.71, 95% CI 0.64-0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61-0.75), pre-obesity (OR 0.89, 95% CI 0.82-0.98) and obesity (OR 0.76, 95% CI 0.70-0.84) were less likely to be associated with poor glycaemic control., Conclusion: Young-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control.

Objective: To assess the awareness level of undergraduate dentistry students as well as fresh graduates about the significance of professional ethics., Methods: The cross sectional study was conducted among the 3rd, 4th and final year male and female BDS students as well as fresh graduate Interns from the College of Dentistry, King Saud University from January to June 2011. The students were asked to give their opinion about need for applications of professional ethics in dental practice on a five point Likert Scale varying from 'strongly agree' to 'strongly disagree'. Minitab statistical software was used for data analysis., Results: Students at all levels considered professional ethics a very important prerequisite for dental practice with overall mean value of 4.42 +/- 0.36. However, the responses from the senior academic levels were significantly on the higher side compared to those from the junior grades. Generally the religious teachings and spirituality was considered as one of the top most motives for practicing professional ethics in dentistry followed by reputation, financial benefits, fear of punishment and self projection, with overall mean values of 3.93 +/- 0.58, 3.81 +/- 0.49, 3.25 +/- 0.94, 3.21 +/- 1.07 and 3.16 +/- 1.04, respectively., Conclusion: The present findings revealed that Professional Ethics is appreciated by the students as a highly significant factor for their success in dental practice as well as acquiring a good name and position in the society.

Aim: The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia., Methods: A cross-sectional study was carried out using cases notified to the Adult Diabetes Control and Management database between 1 January and 31 December 2009. A total of 10 363 people aged over 60 years with type 2 diabetes mellitus were included in the analyses. A standard online case report form was used to record demographic data, clinical factors (diabetes duration, comorbid condition and treatment modalities), cardiovascular disease risk factors, diabetes complications and laboratory assessments. The cardiovascular disease risk factors controls assessed included glycosylated hemoglobin (HbA(1c)) <7.0%, blood pressure, body mass index, waist circumference and lipid profiles., Results: The proportion of older adults who achieved target HbA(1c) (<7.0%) was 41.7%. A greater proportion of older adults aged ≥80 years significantly achieved the targets of HbA(1c) <7% (P < 0.001), waist circumference (P < 0.001), low-density lipoprotein cholesterol <2.6 mmol/L (P = 0.007) and triglycerides <1.7 mmol/L (P = 0.001) when compared with the younger elderly groups. They were also associated with achieving target HbA(1c) <7.0% (OR = 1.90, 95% CI 1.68-2.26) and triglycerides <1.7 mmol/L (OR = 1.20, 95%CI 1.04-1.46) than those aged 60-69 years., Conclusion: The control of cardiovascular disease risk factors was suboptimal in older adults with type 2 diabetes. The oldest elderly were more likely to achieve target HbA(1c) (<7.0%) and triglycerides (<1.7 mmol/L) than older adults aged 60-69 years., (© 2013 Japan Geriatrics Society.)

Background: Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women., Methods: This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009. All Malaysian women aged 18 years old and above and diagnosed with T2D for at least 1 year were included in the analysis. The target for glycemic control (HbA1c < 6.5%) is in accordance to the recommended national guidelines. Both univariate and multivariate approaches of logistic regression were applied to determine whether reproductive age women have an association with poor glycemic control., Results: Data from a total of 30,427 women were analyzed and 21.8% (6,622) were of reproductive age. There were 12.5% of reproductive age women and 18.0% of non-reproductive age women that achieved glycemic control. Reproductive age group women were associated with poorer glycemic control (OR = 1.5, 95% CI = 1.2-1.8). The risk factors associated with poor glycemic control in the reproductive age women were being of Malay and Indian race, longer duration of diabetes, patients on anti-diabetic agents, and those who had not achieved the target total cholesterol and triglycerides., Conclusion: Women with T2D have poor glycemic control, but being of reproductive age was associated with even poorer control. Health care providers need to pay more attention to this group of patients especially for those with risk factors. More aggressive therapeutic strategies to improve their cardiometabolic control and pregnancy outcome are warranted.

This study aimed to examine the control of cardiovascular risk factors among the ethnic groups with type 2 diabetes in Malaysia. The authors analyzed the data of 70 092 adults from the Malaysian diabetes registry database. Malays had the worst achievement of target for most of the risk factors. Indians had poor achievement of control for waist circumference (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.6-0.7) and high-density lipoprotein cholesterol (OR = 0.5, 95% CI = 0.4-0.5). As compared with the Malays, the Chinese had a better achievement of target control for the risk factors, including the following: body mass index (OR = 1.3, 95% CI = 1.2-1.4), blood pressure (OR = 1.3, 95% CI = 1.3-1.4), total cholesterol (OR = 1.7, 95% CI = 1.6-1.8), low-density lipoprotein cholesterol (OR = 1.7, 95% CI = 1.6-1.8), glycated hemoglobin A1c (OR = 1.4, 95% CI = 1.3-1.4) and fasting blood glucose (OR = 1.4, 95% CI = 1.3-1.5). Ethnicity, sociocultural factors, and psychobehavioral factors should be addressed in designing and management strategies for the control of cardiovascular risk factors among type 2 diabetes patients.