Search

Abstract Background Effective and feasible large-scale interventions are urgently needed to reverse the current rise in childhood obesity. The objective of this study was to evaluate the efficacy of a multicomponent intervention program, MyBFF@school, on anthropometric indices and body composition metrics among overweight and obese adolescent schoolchildren in Malaysia. Methods This is a cluster randomized controlled trial which involved schoolchildren aged 13, 14 and 16 years old from 15 out of 415 government secondary schools in central Peninsular Malaysia which were randomly assigned into six intervention (N = 579 schoolchildren) and nine control (N = 462 schoolchildren).The intervention group followed MyBFF@school program carried out by trained personnel for 6 month while the control group only followed the existing school curriculum by the Ministry of Education. The primary outcomes presented in this study were body mass index adjusted for age (BMI z-score), waist circumference (WC), percentage body fat (PBF) and skeletal muscle mass (SMM), measured at baseline, three and six months. Analyses of all outcomes except for the baseline characteristics were conducted according to the intention-to-treat principle. Mixed linear models adjusted for baseline outcome value and gender were used to evaluate the effectiveness after three and six months of intervention. Results Overall, there was no significant difference in the mean difference (MD) of BMI z-score (MD = 0.05, Confident Interval (95%CI: -0.077 to 0.194), WC (MD = 0.437, (95%CI:-3.64 to 0.892), PBF (MD = 0.977,95%CI:-1.04 to 3.0) and SMM (MD = 0.615,95%CI:-2.14,0.91) between the intervention and control group after 6 months of intervention after controlling for outcomes measured at baseline and gender. Conclusions Although the MyBFF@school programme appeared promising in engaging children and promoting awareness of healthy behaviors, it did not lead to significant improvements in the anthropometric outcomes. Possible reasons for the lack of effectiveness could include the need for more intensive or targeted interventions, parental involvement, or challenges in sustaining behavior changes outside of school settings. Trial registration Clinical trial number: NCT04155255, November 7, 2019 (Retrospective registered). National Medical Research Register: NMRR-13-439-16,563. Registered July 23, 2013. The intervention program was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia and Educational Planning and Research Division (EPRD), Ministry of Education Malaysia. It was funded by the Ministry of Health Malaysia.

Seaweed liquid waste from filter-squeezed drying process of Gracilaria sp. causes an unpleasant odour to the environment. Although this waste can partially be used as biofertilizer and heavy metals adsorbent, a bigger portion of the waste remains unutilized thus causing a problem to the environment. The present study aimed to utilize seaweed liquid waste as a supplement in fermentation media. To achieve this aim, Saccharomyces cerevisiae as a famous bioethanol producer was used to examine the ability of seaweed liquid to supply macronutrients and micronutrients in the media to produce ethanol. Interestingly, when used as a supplement in the fermentation media to produce ethanol, the liquid boosted ethanol production three folds from 200 mg/L of 2 % glucose alone to 600 mg/L of 2 % glucose in liquid. Additionally, the liquid was able to substitute yeast extract and peptone within YPD media to produce 647.48 mg/L ethanol as compared to only 542.39 mg/L with normal YPD which contains yeast extract and peptone. For that reason, the utilization of seaweed liquid as the supplement in the medium should be considered as an alternative cost-effective media for enhancing ethanol production without the addition of other nutrients. [ABSTRACT FROM AUTHOR]

The influence of Environmental, Social, and Governance (ESG) risks on bank stability has become a critical area of study in the banking sector. This study examines the influence of ESG risks on bank stability using unbalanced panel data from 134 commercial banks in Indonesia from 2003 to 2022. Employing a fixed effects model, the findings reveal a significant negative effect of ESG risks on bank stability, where higher ESG risks significantly reduce bank stability. Specifically, government-owned banks face a greater stability decline than private banks due to their often higher exposure to regulatory and reputational pressures. Smaller banks are more adversely affected than larger ones because they lack the resources and diversification to effectively mitigate ESG risks. Additionally, non-listed banks experience a larger decrease in stability than listed banks, as the latter tend to have stricter governance structures and more robust risk management practices. These findings underscore the need for tailored risk management strategies to address ESG risks, particularly for government-owned, smaller, and non-listed banks.

BACKGROUND: Transfusion support is vital for the management of patients with hepatobiliary disease. Repeated blood transfusions increase the risk of alloimmunization, i.e., the development of alloantibodies, which might lead to difficulties in blood crossmatching. AIMS: This study aims to: (1) determine the incidence of red blood cell (RBC) alloimmunization and (2) evaluate the associations between antibody development and demographic factors among hepatobiliary patients. METHOD: ABO blood grouping, antibody screening, antibody identification and crossmatch were done on all patients samples included in the study. SETTINGS AND DESIGN: A cross-sectional study was conducted from February 2021 to September 2021, with a total of 132 samples from hepatobiliary patients. The relationships between RBC alloimmunization in transfused hepatobiliary patients and demographic factors (gender, age, and history of transfusion) were assessed by binary logistic regression. RESULTS: Overall, 67.4% of the patients developed alloimmunization. The majority had a single alloantibody (75.2%) and the most frequently identified antibody specificities were anti-E (37.6%), anti-c (12.8%), anti-Mia (14.4%), and anti-Kidd (11.2%). The predominant antibodies were those against the Rh system (58.4%). Female patients recorded the highest incidence of alloimmunization (69.8%). Female patients also demonstrated a higher tendency to produce both anti-E + anti-c than male patients. CONCLUSION: The prevalence of RBC alloimmunization is high among hepatobiliary patients and it may cause complications requiring multiple transfusions. The number of transfused packed cells has been clearly shown to be proportionally significant with the risk for alloimmunization in hepatobiliary patients. Hence, this study highlights the importance of immunohematology tests before blood transfusion.

Merapoh, Pahang, is an area rich with limestone karst located within the Lipis National Geopark and home to the Sungai Relau gate of Taman Negara Pahang, a totally protected rainforest in Malaysia. Much of the research conducted here is mainly inside the National Park, with few published faunal records for the Merapoh caves. This study compiled the data on the bat species diversity of eight Merapoh caves (March 2020 to March 2022) using mist nets and harp traps. Our results indicate that Chiroptera diversity at Merapoh caves is rich, with a total of 32 species recorded from 865 individuals and four new locality records for the State of Pahang, namely Rousettus leschenaultii, Lyroderma lyra, Rhinolophus coelophyllus and Hipposideros pomona. Gua Gunting has the highest diversity of bats recorded in this study (19 species). Significant Merapoh caves with bat colony roosts in Merapoh include Gua Jinjang Pelamin (Eonycteris spelaea & Rousettus leschenaultii), Gua Tahi Bintang (Hipposideros larvatus) and Gua Pasir Besar (Miniopterus medius). Rhinolophus convexus, previously recorded only in upper montane rainforests, was also recorded in Merapoh caves indicating that this species can also be found in lower elevations than previously thought. Based on the findings of the current study and additional records from two previous studies, the Merapoh bat species diversity checklist totalled up to 38 species. On the whole, the rich bat diversity in Merapoh is reflective of its immense limestone karst landscape, which highlights the reason Lipis National Geopark has been recently gazetted. Future bat research should continue here and in other karsts within Lipis Geopark to sustainably conserve biological diversity, manage geological structures and raise awareness amongst the locals to appreciate their national heritage.

Abstract Background In recent years, there has been a surge of interest in the metabolic phenotype among children with obesity characterized by the absence of associated cardiometabolic risk factors (CRFs), known as metabolically healthy obesity (MHO), as opposed to those with metabolically unhealthy obesity (MUO). This study investigated the effect of lifestyle intervention on CRFs among children with MHO and MUO. Methods A total of 102 school-aged children with obesity (54 girls and 48 boys) aged 8–16 years completed a 16-week school-based lifestyle modification intervention program, MyBFF@school Phase I. The intervention consisted of physical activity, healthy eating promotion, and psychological empowerment. MHO and MUO statuses were defined based on the 2018 consensus-based criteria. Fasting venous blood collection, body composition measurement, clinical assessment and physical fitness testing were conducted at baseline and at the end of week 16. Results After the intervention, the CRFs of the children with MUO improved with significant decreases in systolic (p

This study aims to analyze the influence of Service-Dominant Logic (SDL) on Brand Attitude, Emotional Brand Attachment, and Brand Engagement and the impact of these three variables on Brand Awareness and Brand Loyalty among hotel users in Bandung City. A quantitative approach was used in this study with data collection techniques through questionnaires distributed to 230 respondents, namely hotel users in Bandung. The Structural Equation Modeling method based on Partial Least Squares (SEM-PLS) was used to test the relationship between variables in the research model. The results of the study indicate that SDL has a significant positive effect on Brand Attitude, Emotional Brand Attachment, and Brand Engagement. In addition, Brand Attitude, Emotional Brand Attachment, and Brand Engagement also have a positive effect on Brand Awareness and Brand Loyalty. These findings indicate that the SDL approach implemented by hotels can strengthen emotional relationships and consumer engagement with the brand, which ultimately increases customer awareness and loyalty to the hotel brand.

The floating markets of South Kalimantan, a vital piece of cultural heritage and economic icon, are at risk of extinction due to modernization and the declining interest of the Gen Z children of acil jukung (floating market traders) in continuing the tradition. This research addresses the critical issue of regeneration barriers through the lens of uncertainty-identity theory, exploring why younger generations are reluctant to sustain this livelihood. Using a qualitative case study approach, data were collected through observations, semi-structured interviews, and focus group discussions with nine Gen Z participants (six female and three male) from the Lok Baintan and Muara Kuin floating markets. The findings identify three primary obstacles: income uncertainty, environmental unpredictability, and a perceived mismatch between the profession and Gen Z's aspirations, often accompanied by feelings of shame. Despite these challenges, participants expressed pride in their parents' roles and proposed innovations, such as diversifying merchandise, enhancing boat aesthetics, utilizing social media for promotion, and forming a community of traders. This study highlights the psychological and social dynamics behind regeneration challenges while offering actionable strategies to preserve the cultural and economic sustainability of floating markets.

Abstract Background Although significant and disabling consequences are presented due to geriatric population-related depression, an insufficient comprehension of various biological, psychological, and social factors affecting this issue has been observed. Notably, these factors can contribute to geriatric population-related depression with low social support. This study aimed to identify factors associated with depression among the community-dwelling geriatric population with low social support in Malaysia. Methods This study used secondary data from a population-based health survey in Malaysia, namely the National Health Morbidity Survey (NHMS) 2018: Elderly Health. The analysis included 926 community-dwelling geriatric population aged 60 and above with low social support. The primary data collection was from August to October 2018, using face-to-face interviews. This paper reported the analysis of depression as the dependent variable, while various biological, psychological and social factors, guided by established biopsychosocial models, were the independent variables. Multiple logistic regression was applied to identify the factors. Analysis was performed using the complex sampling module in the IBM SPSS version 29. Results The weighted prevalence of depression among the community-dwelling geriatric population aged 60 and above with low social support was 22.5% (95% CI: 17.3–28.7). This was significantly higher than depression among the general geriatric Malaysian population. The factors associated with depression were being single, as compared to those married (aOR 2.010, 95% CI: 1.063–3.803, p: 0.031), having dementia, as opposed to the absence of the disease (aOR 3.717, 95% CI: 1.544–8.888, p: 0.003), and having a visual disability, as compared to regular visions (aOR 3.462, 95% CI: 1.504–7.972, p: 0.004). The analysis also revealed that a one-unit increase in control in life and self-realisation scores were associated with a 32.6% (aOR: 0.674, 95% CI: 0.599–0.759, p

Companies’ decision to go public is risky because of the high uncertainty level from the companies’ unknown history prior to their listing. Recent studies in the Malaysian market reported the declining trend of companies’ initial performance, relating it to investors’ current demand for higher information transparency that can reflect companies’ sustainable evolution as a means to attract their demand in subscribing newly issued shares. Thus, this study aims to investigate the impact of disclosing ESG practices on companies’ initial performance. Using a linear regression with maximum likelihood (ML) estimation, this study examines 171 initial public offerings (IPOs) issued in the Malaysian market from 2015 to 2023. By using two ways of measuring companies’ initial performance (offer-to-open and offer-to-close), the findings show that higher information disclosure on ESG practices will only be reflective and positively affect companies’ performance by the end of the day. Further examination of individual ESG pillars indicates that environmental disclosures negatively influence companies’ initial performance, while social and governance disclosures positively influence companies’ initial performance. A large investment in maintaining a high level of environmental practice can be costly, negatively influencing companies’ performances. Higher social and governance disclosure attracts socially conscious investors and reflects good internal governance, increasing demand for the companies’ shares during the IPO and positively influencing companies’ performances. This study contributes to the growing literature concerning ESG and post-IPO performances specific to the Malaysian market and proposes recommendations on the importance of disclosing ESG practices prior to their IPO. AcknowledgmentsThe authors would like to acknowledge that this article is part of a research project funded by Universiti Teknologi MARA (UiTM) for the MyRA Grant Scheme, file no: 600-RMC 5/3/GPM (118/2022).

Abstract Background As the ageing population grows, the demand for long-term care (LTC) services will rise, concurrently amplifying healthcare utilisation. This review aims to examine and consolidate information on LTC interventions that influence healthcare utilisation among older persons. Methods A scoping review was performed through a systematic search in PubMed, EBSCO CINAHL, EBM Reviews - Cochrane Database of Systematic Reviews, Embase, APA PsycInfo, EBM Reviews - Health Technology Assessment, and EBM Reviews - NHS Economic Evaluation Database. Systematic reviews with meta-analyses published between 1 January 2010 and 2 June 2022 among older persons aged 60 and above were included. The characteristics of LTC interventions were mapped to the World Health Organization (WHO) Healthy Ageing Framework. The effect sizes of healthcare utilisations for LTC interventions were recalculated using a random-effects model. The methodological quality was assessed with the AMSTAR-2 checklist, while the quality of evidence for each association was evaluated using GRADE. Results Thirty-seven meta-analyses were included. The most prominent domain of the healthy ageing framework was managing chronic conditions. One hundred twelve associations between various LTC interventions and healthcare utilisations were identified, with 22 associations impacting healthcare utilisation. Four interventions were supported by suggestive or convincing evidence. Preventive home visits were found to reduce hospital admission (OR: 0.73, 95% CI: 0.59, 0.91, p = 0.005), caregiver integration during discharge planning (OR: 0.68, 95% CI: 0.57, 0.81, p

Abstract Intrastromal cell therapy utilizing quiescent corneal stromal keratocytes (qCSKs) from human donor corneas emerges as a promising treatment for corneal opacities, aiming to overcome limitations of traditional surgeries by reducing procedural complexity and donor dependency. This investigation demonstrates the therapeutic efficacy of qCSKs in a male rat model of corneal stromal opacity, underscoring the significance of cell-delivery quality and keratocyte differentiation in mediating corneal opacity resolution and visual function recovery. Quiescent CSKs-treated rats display improvements in escape latency and efficiency compared to wounded, non-treated rats in a Morris water maze, demonstrating improved visual acuity, while stromal fibroblasts-treated rats do not. Advanced imaging, including multiphoton microscopy, small-angle X-ray scattering, and transmission electron microscopy, revealed that qCSK therapy replicates the native cornea’s collagen fibril morphometry, matrix order, and ultrastructural architecture. These findings, supported by the expression of keratan sulfate proteoglycans, validate qCSKs as a potential therapeutic solution for corneal opacities.

Pemberdayaan perempuan merupakan salah satu upaya untuk memberikan akses kepada perempuan dalam sektor ekonomi, sosial, budaya, dan politik. Melalui usaha Boneka Handmade Suka-suka mampu memberikan dorongan kepada perempuan agar mampu memberdayakan dirinya dalam berbagai sektor terutama di dunia kerja. Penelitian ini dilakukan untuk mengetahui proses pemberdayaan perempuan yang dilakukan oleh usaha Boneka Handmade Suka-suka dengan menggunakan budaya RESPECT. Penelitian ini menggunakan metode kualitatif dengan teknik pengumpulan wawancara dan observasi. Analisis data penelitian ini menggunakan Miles dan Huberman. Hasil penelitian ini menunjukan bahwa: 1) pemberdayaan perempuan yang dilakukan oleh usaha Boneka Handmade Suka-suka mampu meminimalisir angka kemiskinan. 2) budaya RESPECT yang dikembangkan oleh usaha Boneka Handmade Suka-suka mampu memberikan budaya kerja yang nyaman bagi tenaga kerja perempuannya.

Religious moderation has become an important issue recently in line with the increasing conflict originating from ideological and identity political competition, which tends to be extreme, both right and left. In an effort to minimize the occurrence of conflict due to these problems, the Ministry of Religion Affair has launched religious moderation as the main program in developing Indonesia. The strategy of internalizing the values ​​of religious moderation can be carried out by all levels of society, one of which is early childhood education institutions. The strategy is to use the ABCD approach where the focus of this service is more directed at implementing the Kurikulum Merdeka, namely the activities of the Proyek Penguatan Profil Pelajar Pancasila with the theme We are All Brothers. The results of this service are that partners can develop P5 teaching modules according to the guidelines, receive material regarding strategies for internalizing the values ​​of religious moderation in PAUD, visit Pancasila villages, and receive a literacy corner and religious moderation APE. The level of partner satisfaction is also quite good so there is a commitment to continue carrying out activities to internalize these values ​​in the following years

IntroductionIn the current digital age, people’s use of electronic devices has significantly increased screen time, which may have an impact on different aspects of their lives. Adolescents today are exposed to excessive screen time, which may affect their sleep and contribute to anxiety and depression. The purpose of this study is to examine the relationship between screen time with sleep quality, anxiety and depression, among adolescents in Klang Valley, Malaysia.MethodsThis study is a cross-sectional study information was gathered from among 353 secondary school students in the Klang Valley using a questionnaire. The instrument that was used in this study was Pittsburgh Sleep Quality Index (PSQI) Malay version, screen-based media usage (SCREENS-Q) and Hopkins Symptom Check List-25 (HSCL-25) Malay version. The sampling method was stratified and convenience sampling method. The analysis study used the Smart Partial least squares (PLS) method to analyze the data.ResultsUsing the Smart PLS technique, we examined the relationship between these variables and identified revealed that screen time has a direct, positive, and significant impact on anxiety level (Mean = 0.134, β = 0.123, p 0.05) and depression (Mean = 0.044, β = 0.043, p

The Malaysian healthcare system for individuals with Parkinson’s disease is still underdeveloped. Self-stigma has a significant influence on how successfully individuals with Parkinson’s disease handle their condition. Therefore, this study aimed to explore the association between self-stigma, basic and instrumental activities of daily living, and communication participation among individuals with Parkinson’s disease. In Study 1, 25 individuals with Parkinson’s disease from the Malaysian Parkinson’s Disease Association completed the Stigma Scale for Chronic Illness-8 Items, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, and Communicative Participation Item Bank. Survey responses were analyzed using descriptive statistics and correlation/regression. In Study 2, semi-structured interviews were conducted with nine individuals with Parkinson’s disease. Interview data were transcribed verbatim and analyzed using thematic analysis. Survey results indicated that a higher level of self-stigma was associated with lower levels of basic ( r = −.47) and instrumental ( r = −.21) activities of daily living and communication participation ( r = −.41) among individuals with Parkinson’s disease. Furthermore, five main themes emerged from the in-person interviews: “challenges in performing activities of daily living due to Parkinson’s disease,” “speech and communication adaptations due to Parkinson’s disease,” “psychological responses toward one’s own Parkinson’s disease symptoms,” “self-stigmatization with impacts on self-concept,” and “perception formation of Parkinson’s disease resulting from self-stigmatization.” In conclusion, the self-stigma of individuals with Parkinson’s disease was considerably related to their activities of daily living and communication participation. Therefore, healthcare providers should address these factors collectively in their care of individuals with Parkinson’s disease. Moreover, health-related organizations and Parkinson’s disease associations must play a crucial role in educating and raising awareness of Parkinson’s disease in our society, considering that self-stigma is related to both how an individual perceives their condition and the public’s attitudes and perceptions toward it.

Abstract Background Tumor-associated macrophages (TAMs) are a prominent immune subpopulation in the tumor microenvironment that could potentially serve as therapeutic targets for breast cancer. Thus, it is important to characterize this cell population across different tumor subtypes including patterns of association with demographic and prognostic factors, and breast cancer outcomes. Methods We investigated CD163+ macrophages in relation to clinicopathologic variables and breast cancer outcomes in the Women’s Circle of Health Study and Women’s Circle of Health Follow-up Study populations of predominantly Black women with breast cancer. We evaluated 611 invasive breast tumor samples (507 from Black women, 104 from White women) with immunohistochemical staining of tissue microarray slides followed by digital image analysis. Multivariable Cox proportional hazards models were used to estimate hazard ratios for overall survival (OS) and breast cancer-specific survival (BCSS) for 546 cases with available survival data (median follow-up time 9.68 years (IQR: 7.43–12.33). Results Women with triple-negative breast cancer showed significantly improved OS in relation to increased levels of tumor-infiltrating CD163+ macrophages in age-adjusted (Q3 vs. Q1: HR = 0.36; 95% CI 0.16–0.83) and fully adjusted models (Q3 vs. Q1: HR = 0.30; 95% CI 0.12–0.73). A similar, but non-statistically significant, association was observed for BCSS. Macrophage infiltration in luminal and HER2+ tumors was not associated with OS or BCSS. In a multivariate regression model that adjusted for age, subtype, grade, and tumor size, there was no significant difference in CD163+ macrophage density between Black and White women (RR = 0.88; 95% CI 0.71–1.10). Conclusions In contrast to previous studies, we observed that higher densities of CD163+ macrophages are independently associated with improved OS and BCSS in women with invasive triple-negative breast cancer. Trial registration Not applicable.

Homeownership, viewed as a form of economic behavior, warrants a comprehensive examination considering individual perspectives. This study seeks to redefine cultural perception as an additional variable that extends the influential Theory of Planned Behavior, which serves as the foundational framework for studies in economic behavior. It presents a conceptual framework introducing the pivotal concept of cultural perception in the analysis of homeownership, drawn from an extensive literature review in economics and housing. The study delves into the notions of cultural dimensions, norms rooted in culture, homeownership, Theory of Reasoned Action (TRA), and Theory of Planned Behavior (TPB), addressing the existing gap regarding the “cultural influence” within the TPB framework. Furthermore, this study introduces a novel perspective by expanding TPB by incorporating perception variables linked to cultural values, forming a synthesis of economics, cultural, and psychological disciplines. A metric for assessing perception concerning cultural values is also proposed to effectively encapsulate the essence of the homeownership concept. This study is anticipated to augment the precision and comprehensiveness of investigations into the dynamics of homeownership behavior, and thus enrich the behavioral literature by integrating ideas from diverse disciplines.

The Psychological Strain Scale (PSS) has been widely used in various populations to assess the risks of suicidality and mental disorders. The current study aims to shorten the original 40-item scale and test its psychometric properties. Data were derived from three samples in China: (1) undergraduate students (n = 10,742), (2) non-medical office employees (n = 1044), and (3) hospital workers (n = 949). A questionnaire was administered to the samples at about the same time of the year 2017. Data were randomly divided into Sub-study 1 (70% of the sample) and Sub-study 2 (30% of the sample). In Sub-study 1, principal component analyses were run and five items with the highest factor loadings within each subscale were retained, resulting in a 20-item PSS scale. Cronbach’s α estimates were above 0.70. In Sub-study 2, confirmatory factor analyses for the three samples revealed RMSEA values below 0.10, PNFI values below 0.50 for all samples, and CFI, TLI and NFI values above 0.90 for the student and non-medical office employee samples, but the hospital worker sample had a TLI of 0.88. The PSS-20 and its subscales were significantly associated with past-year suicidal ideation. The PSS-20 has acceptable psychometric properties but requires further testing in university students and hospital workers.

The key derivation function is a specific cryptographic algorithm that transforms private string and public strings into one or more cryptographic keys. The cryptographic keys are essential for protecting electronic data during transmission on the internet. This function is designed based on a computational extractor and pseudorandom expander and is typically constructed using various cryptography ciphers such as stream ciphers, keyed-hash message authentication codes, and block ciphers. Having secure and efficient key derivation function designs is essential in the development of numerous security systems. A vulnerable key derivation function could potentially give attackers the ability to compromise an otherwise secure cryptosystem. This research proposes a different approach by combining two different cryptography ciphers to develop key derivation functions. The findings demonstrate that a computational extractor utilizing keyed-hash message authentication codes and a pseudorandom expander using stream ciphers maintain the highest level of security while also providing efficiency benefits in terms of execution time compared to existing key derivation function schemes.

Background and Objective Digital computerized assessment can provide objective values for the measurement of gingival pigmentation. This study aims to compare the Commission Internationale de l’Eclairage Lab color space (CIELAB) values and the computerized intensity values (CIVs) from digital imaging with clinical evaluations using the Dummett–Gupta Oral Pigmentation Index (DOPI) for assessing gingival pigmentation in a multi-ethnic population. Methodology Digital photographs of 188 participants were taken using standardized parameters. The buccal gingival pigmentation was evaluated using three methods (a) a clinical evaluation by two independent assessors using the DOPI, (b) the CIELAB values using the Adobe Photoshop® software (Version 23.1.1) and (c) the CIV calculated using the ImageJ software (Version 1.53k). A hierarchical clustering analysis was used to identify colour groups that clustered together. Agreement between the clinical and digital categorization of the pigmentation was carried out using weighted kappa analysis. Agreements between CIELAB and CIV were compared using intra-class correlation coefficient. Results There was a statistically significant difference in the DOPI, the L*, a*, and b* coordinates, and the CIV between the different ethnic groups of the participants. Cluster analysis for the CIELAB and CIV both identified four clusters. The gingival pigmentation categorization using the L*, a*, and b* values moderately agreed with the clinical evaluation using the DOPI index while the categorization with the CIV was in slight agreement with the clinical evaluations. Conclusion This study identified four clusters of gingival pigmentation in 188 multi-ethnic participants. The clusters, determined by CIELAB values, align with the clinical assessment of gingival pigmentation. Digital measurements derived from clinical photographs can serve as an effective means of pigmentation measurement in dental clinics.

This qualitative research elaborates that Nahdlatul Ulama (NU) is Indonesia's most prominent Islamic organization, contributing to the green pesantren. This article also explores NU's change, challenge, and contribution through Pesantren in environmental and ecological issues. The primary data in this research methodology are interviews and documents. The secondary data includes other resources that are relevant to this research, such as articles, books, and news. This research shows that NU, through the Green Pesantren program, is trying to contribute to being part of the problem solver on environmental, ecological, and climate change issues. This article also explains green pesantren as an answer to the debate about the relationship between Islam, ecology, and the environment. The concern of green pesantrenis is not only in the teaching and learning aspects of Islamic doctrine and individual piety but also in today's environmental, ecological, and human problems. In this context, the roles and functions of kiai, pesantren students, and alums in addressing environmental and ecological issues are multifaceted. They combine education, community engagement, religious perspectives, advocacy, practical solutions, and role modeling to effect meaningful change and contribute to a more sustainable future.

In the expanding realm of online learning, student mind wandering has become an increasingly prominent challenge, negatively impacting learning efficiency and engagement. This review systematically investigates the effectiveness of visual design as a strategic intervention to reduce mind wandering in digital educational settings. Through a comprehensive selection process, this study critically analyzes key indicators of mind wandering and evaluates existing theoretical models addressing this issue. Special attention is dedicated to interventions utilizing visual design elements, gaze tracking technologies, and Region of Interest (ROI) methods for detection and management. Additionally, the review explores advanced technological tools that apply visual design principles to enhance student focus and engagement. Findings underscore the significant potential of visual design interventions to improve the online learning experience and provide actionable insights for future research aimed at practical implementation and evaluation. This review equips educational technologists and course designers with strategies to develop more engaging and immersive online learning environments, effectively addressing the challenge of mind wandering.

Background/Objectives: Thymoquinone (TQ) exhibits diverse biological activities, but its poor solubility and bioavailability limit its cancer efficacy, requiring innovative solutions. This study explores the development of an oral delivery system targeting colon cancer based on TQ pectin beads (TQ-PBs) produced through an adjustable electrospray technique. This study hypothesised that adjusting bead diameter through the electrospray technique enables precise control over water absorption and erosion rates, thereby achieving a controlled release profile for encapsulated TQ, which enhances targeted delivery to the colon. Methods: TQ-PBs were synthesised and optimised using an electrospray technique based on the ionic gelation method. The prepared beads were characterised based on particle size, sphericity, encapsulation efficiency (EE), water uptake, erosion, surface morphology, molecular interactions, and texture. The cumulative TQ release studies, an accelerated stability test, and cytotoxicity evaluation against the colon cancer HT-29 cell line were also assessed. Results: The optimised TQ-PB formulation demonstrated an average bead size of 2.05 ± 0.14 mm, a sphericity of 0.96 ± 0.05, and an EE of 90.32 ± 1.04%. The water uptake was 287.55 ± 10.14% in simulated gastric fluid (SGF), 462.15 ± 12.73% in simulated intestinal fluid (SIF), and 772.41 ± 13.03% in simulated colonic fluid (SCF), with an erosion rate of 45.23 ± 5.22%. TQ release was minimal in SGF (8.13 ± 1.94% after 2 h), controlled in SIF (29.35 ± 3.65% after 4 h), and accelerated in SCF (94.43 ± 2.4% after 3 h). Stability studies over one month showed a size reduction of 17.50% and a 6.59% decrease in TQ content. Cytotoxicity assessments revealed significant anticancer activity of TQ-PB, with an IC50 of 80.59 ± 2.2 μg/mL. Conclusions: These findings underscore the potential of TQ-PB as an effective oral drug delivery system for targeted colorectal cancer therapy.

Abstract This study explores utilizing pineapple peel (PP) hydrolysate as a promising carbon source for xylitol production, covering scopes from the pre-treatment to the fermentation process. The highest xylose concentration achieved was around 20 g/L via mild acid hydrolysis (5% nitric acid, 105 °C, 20-min residence time) with a solid loading of 10%. Two sets fermentability experiments were carried out of varying pH levels in synthetic media that includes acetic acid as the main inhibitors and hydrolysate supplemented with diverse nitrogen source. The results revealed that pH 7 exhibited the highest xylitol production, yielding 0.35 g/g. Furthermore, urea was found to be a highly promising and cost-effective substitute for yeast extract, as it yielded a comparable xylitol production of 0.31 g/g with marginal difference of only 0.01 g/g compared to yeast extract further highlights the viability of urea as the preferred option for reducing xylitol production cost. The absence of a significant difference between the synthetic media and hydrolysate, with only a marginal variance of 0.35 to 0.32 g/g, implies that acetic acid is indeed the primary constraint in xylitol production using PP hydrolysate. The study sheds light on PP biomass's potential for xylitol production, aligning economic benefits with environmental sustainability and waste management.

Abstract Introduction High-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance. Objective To determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection. Methods The study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14. Results The programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30–39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30–49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV. Conclusion Targeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan. Trial registration Trial registration number: NMRR ID-22-00187-DJU.

BACKGROUND: Emergence of drug resistance due to epidermal growth factor receptor (EGFR) Exon 20 T790M poses a challenge in the effective management of non-small cell lung carcinoma (NSCLC). Significant breakthrough in the management of NSCLC with a specific genetic alteration causes substantial condition improvement in patients whose cancer progressed after first-generation tyrosine kinase inhibitor treatment and who developed tumors with EGFR Exon 20 T790M mutation. The present study analyzed a cohort of NSCLC patients and investigated the incidence of the EGFR Exon 20 T790M status with Osimertinib therapy, along with its impact on survival rates. METHODS: This was a retrospective cohort study on 22 NSCLC subjects who were genetically examined for EGFR status from plasmic cell free total nucleic acid. Subjects with EGFR Exon 20 T790M mutation were treated with/without Osimertinib. Demographic and clinical data were descriptively summarized, and the differences of each variable and correlation between survival rate and EGFR Exon 20 T790M were analyzed. RESULTS: Subjects with (n=13) and without (n=9) EGFR Exon 20 T790M had survival rates of 10.77±2.45 and 4.78±1.48, respectively (p=0.000). Based on 1-year survival status of subjects with EGFR Exon 20 T790M, there were 3 Osimertinib-treated survivors and 2 Osimertinib-treated non-survivors. Eight subjects with EGFR Exon 20 T790M and without Osimertinib treatment did not survive (p=0.001). CONCLUSION: Since the treatment of Osimertinib demonstrated a noteworthy survival rate among NSCLC subjects with EGFR Exon 20 T790M, thus Osimertinib could be suggested as a potential targeted therapy for NSCLC subjects with EGFR Exon 20 T790M. KEYWORDS: non-small cell lung carcinoma, EGFR, Exon 20, T790M, osimertinib

Education plays a crucial role in creating individuals who contribute positively to the development of a country. The private education sector in Malaysia, has proven to be a major source of revenue for the Malaysian government, and it is the government’s aspiration to capture a large percentage of the higher education global market. The purpose of this paper is to analyse the challenges faced by academic leaders in managing private universities in Malaysia and to provide feasible recommendations to overcome them. The findings are expected to provide valuable information to the management of Malaysian private universities, policymakers, and regulatory agencies. The information gathered could provide enlightenment regarding the difficulties faced in order to design and implement further policies to elevate their operational method and ensure long-term survival. Valuable recommendations have been provided to ensure the institutions remain profitable and sustainable as the development of Malaysia’s social and economic sector is dependent on its education sector.

Objective This study aimed to examine the mediation role of perceived social support in the relationship between functional limitations, depressive symptoms and quality of life among older people in Malaysia.Setting The Malaysian National Health Morbidity Survey 2018: Elderly Health was a cross-sectional health community survey among adults aged 50 and above.Participants 3977 community-dwelling older Malaysians aged 60 and above.Outcome measures Functional limitations were defined as personal activities of daily living (PADL) and instrumental activities of daily living (IADL), tested in separate paths in all analyses. PADL was measured using the Barthel Index, while IADL was measured using the Lawton and Brody scale. Perceived social support, depressive symptoms and quality of life were measured using the Duke Social Support Index, Geriatric Depression Scale-14 and Control, Autonomy, Self-Realisation and Pleasure-19 tools. We used mediation analysis through structural equation modelling to explore the role of perceived social support.Results Perceived social support mediated the relationship between PADL and IADL with depressive symptoms, with the indirect effects at −0.079 and −0.103, respectively (p

The primary purpose of this research is to find out how memorable tourism experiences influence revisit intention and recommendation intention of tourists who have visited to enjoy historical tourism and taste Rajamangsa local cuisine in Kebondalem Kidul Cultural Tourism Village, with destination image and satisfaction as mediating factors. This research uses a quantitative and descriptive-analytical approach, using a 5-point Likert scale for measurement. Non-probability sampling, specifically judgment sampling, was used to collect primary data. The sample consisted of 245 tourist respondents who had visited to enjoy historical tourism and taste Rajamangsa local cuisine in Kebondalem Kidul Cultural Tourism Village. Structural Equation Modeling (SEM) with SmartPLS 3.2.9 was used as the analysis tool. The findings of this study indicate that memorable tourism experiences directly influence destination image, travel satisfaction, local food tasting, and revisit intention when visiting Kebondalem Kidul Cultural Tourism Village. In addition, destination image travel satisfaction and local food tasting partially mediate between memorable tourism experiences and revisit intention and fully mediate between memorable tourism experiences and recommendation intention of tourists in cultural tourism destinations. This research highlights the positive impact of memorable tourism experiences on revisit intentions, destination perceptions, and traveller satisfaction. The practical implications are significant for tourism management in increasing satisfaction and building a positive destination image. However, this study has limitations regarding location coverage and online data collection methods. Future research must consider geographic variation, data collection methods, and other factors influencing tourism experiences.

i-Swift was designed to assist the public navigate and manage logistics industries. People often struggle with estimating travel distances based on the time taken, especially during exercise routines, outdoor activities, or daily commutes. The lack of a fast and accurate method to calculate distance from elapsed time hampers individuals' ability to monitor progress, plan activities, and make informed decisions about their physical movement. Nevertheless, calculating the optimum distance may be tedious and error-prone due to doing it manually. As a solution, with this graphical user interface (GUI), referred to as i-Swift, it can help to improve travel and commuting experience by estimating the distance using The Newton Forward Divided Difference Interpolation Formula. i-Swift also assists to determine the mathematical equations for providing instant, accurate distance estimates. This app takes the complexity out of distance calculations, utilizing the Newton Forward Divided Difference Interpolation Formula to swiftly determine distances based on time. i-Swift presents an innovative solution catering to both the public and the logistics sectors. By simplifying travel for the public, it eliminates hurdles, ensuring stress-free journeys. i-Swift enables logistics firms to improve their operations, promoting punctuality in deliveries and cutting operational expenses. Furthermore, educators and researchers in logistics, mathematics, and technology can benefit from i-Swift, offering applications for academic exploration.

Authentication is one of the security services that assures the system’s adequate security through identification and verification. Additionally, it guarantees that the communication party is who they claim to be. In politics, the economy, banking, daily life, and other areas, quantum identity authentication is essential to guarantee the security of information in communication. The multiphoton strategy is an improved version of the single-photon approach, with higher transmission rates and longer photon travel distances via the Quantum Communication network. Despite the advantages of multiphoton, enforcing authentication on behalf of numerous participants in the quantum channel remains a problem, since existing multiphoton only considers two parties involved in secret message sharing. The issue of scalability arises here when the number of parties involved in the quantum network increases. Furthermore, an eavesdropper might hide her position among other parties and take advantage of the situation to obtain a certain information. Therefore, we require a protocol, that creates a more secure environment in term of authentication in which multiple parties may freely and openly communicate. This paper further identifies research gaps covering critical aspect on how Quantum Identity Authentication (QIA) can be realized and effectively utilized for multiphoton without entanglement based. These include suggestion of future direction to implement multiphoton in multiparty from current protocol.

Composting is a natural process that occurs as a result of microbial succession and marks the degradation and stabilization of organic matter in waste. The use of microbial additives during composting is believed to be highly efficient, as it increases the production of various enzymes, resulting in a faster rate of waste degradation. The process converts waste into a humus-like substance that can enhance the physical, chemical, and biological properties of soil. In this study, to assess the contribution of microorganisms to the composting process, we selected the thermophilic bacteria degrading Bacillus subtilis-ReK1Hs-Cr1 as the inoculant. The analysis of temperature, pH, moisture, microbial population, compost maturity, seed germination test, and C:N ratio were all monitored during the composting process. Physical changes in the compost, such as color, texture, and smell, were also observed. The findings showed that the inoculation of this thermophile with the addition of chicken manure was able to raise the temperature up to 67.3oC, which may have resulted in the elimination of pathogens, which is above the recommended temperature level of 55oC for 3 consecutive days. There was an increase in the microbial population (4.6 x105 -2.9 x107) at the start of the experimental works and the temperature decreased as the composting process proceeded because of the maturity phase. The pH; 7–9 and moisture content; 51–63 % of compost materials were in the range of optimum composting conditions. The weight of the compost materials in all three treatments, except for the control, decreased by 47% to 55%. The color of the compost turned to dark brown, the obnoxious odor was eliminated, and the texture changed to lose and easy pulverize at the final stage of composting. High germination index (GI) was obtained from the test, indicating that the final product is free from phytotoxic substances and thus suitable as a soil conditioner/fertilizer. Therefore, B. subtilis ReK1Hs-Cr1 is the best candidate as an inoculant added with chicken manure to degrade OPEFB on a large scale using windrow technology.

Abstract Background Demand for rapid evidence-based syntheses to inform health policy and systems decision-making has increased worldwide, including in low- and middle-income countries (LMICs). To promote use of rapid syntheses in LMICs, the WHO’s Alliance for Health Policy and Systems Research (AHPSR) created the Embedding Rapid Reviews in Health Systems Decision-Making (ERA) Initiative. Following a call for proposals, four LMICs were selected (Georgia, India, Malaysia and Zimbabwe) and supported for 1 year to embed rapid response platforms within a public institution with a health policy or systems decision-making mandate. Methods While the selected platforms had experience in health policy and systems research and evidence syntheses, platforms were less confident conducting rapid evidence syntheses. A technical assistance centre (TAC) was created from the outset to develop and lead a capacity-strengthening program for rapid syntheses, tailored to the platforms based on their original proposals and needs as assessed in a baseline questionnaire. The program included training in rapid synthesis methods, as well as generating synthesis demand, engaging knowledge users and ensuring knowledge uptake. Modalities included live training webinars, in-country workshops and support through phone, email and an online platform. LMICs provided regular updates on policy-makers’ requests and the rapid products provided, as well as barriers, facilitators and impacts. Post-initiative, platforms were surveyed. Results Platforms provided rapid syntheses across a range of AHPSR themes, and successfully engaged national- and state-level policy-makers. Examples of substantial policy impact were observed, including for COVID-19. Although the post-initiative survey response rate was low, three quarters of those responding felt confident in their ability to conduct a rapid evidence synthesis. Lessons learned coalesced around three themes – the importance of context-specific expertise in conducting reviews, facilitating cross-platform learning, and planning for platform sustainability. Conclusions The ERA initiative successfully established rapid response platforms in four LMICs. The short timeframe limited the number of rapid products produced, but there were examples of substantial impact and growing demand. We emphasize that LMICs can and should be involved not only in identifying and articulating needs but as co-designers in their own capacity-strengthening programs. More time is required to assess whether these platforms will be sustained for the long-term.

Hypopigmented mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma, a type of extranodal non-Hodgkin lymphoma. This report presents the case of a 9-year-old boy with a 2-year history of asymptomatic, hypopigmented skin lesions that were resistant to topical treatment. He was initially treated for a fungal skin infection and had received multiple courses of topical antifungals and steroids but showed no improvement, which led to further evaluation and a referral to a dermatologist. A skin biopsy was performed, and the diagnosis of hypopigmented MF was confirmed through skin histopathology and immunohistochemistry study. His lesions responded well to cycles of narrowband ultraviolet B phototherapy, showing almost complete clearance after 4 months without any side effects.

Summary: Partial replacement of resident Aedes aegypti mosquitoes with introduced mosquitoes carrying certain strains of inherited Wolbachia symbionts can result in transmission blocking of dengue and other viruses of public health importance. Wolbachia strain wAlbB is an effective transmission blocker and stable at high temperatures, making it particularly suitable for hot tropical climates. Following trial field releases in Malaysia, releases using wAlbB Ae. aegypti have become operationalized by the Malaysian health authorities. We report here on an average reduction in dengue fever of 62.4% (confidence intervals 50–71%) in 20 releases sites when compared to 76 control sites in high-rise residential areas. Importantly the level of dengue reduction increased with Wolbachia frequency, with 75.8% reduction (61–87%) estimated at 100% Wolbachia frequency. These findings indicate large impacts of wAlbB Wolbachia invasions on dengue fever incidence in an operational setting, with incidence expected to further decrease as wider areas are invaded.