Browse publications by year: 2023

  1. Comparisons of automated machine learning (AutoML) in predicting whistleblowing of academic dishonesty with demographic and theory of planned behavior
    Rahman RA, Masrom S, Mohamad M, Sari EN, Saragih F, Rahman ASA
    MethodsX, 2023 Dec;11:102364.
    PMID: 37744883 DOI: 10.1016/j.mex.2023.102364
    Machine learning has been very promising in solving real problems, but the implementation involved difficulties mainly for the inexpert data scientists. Therefore, this paper presents an automated machine learning (AutoML) to simplify and accelerate the modeling tasks. Focused on Python and RapidMiner rapid modeling tools, Tree-based Pipeline Optimization Tool (TPOT) and AutoModel were used. This paper presents a comprehensive comparison between these tools with regard to the prediction accuracy and Area Under Curve (AUC) in classifying real cases of whistleblowing academic dishonesty among undergraduate students of two universities in Indonesia. Additionally, the correlations weight from demographic and Theory of Planned Behavior (TOB) attributes in the different machine learning models are also discussed. All the machine learning algorithms from TPOT and AutoModel are considerable powerful to generate good accuracy level (between 70-93% of AUC) in classifying both cases of whistleblowing and non-whistleblowing on the hold-out samples from the testing process. Generally, based on the validation results of the prediction models, demographic attributes presented more importance than the TBP attributes. The findings of this study will be a great interest of many research scholars to conduct a more in-depth analysis on AutoML for many domains mainly in education and academic misconduct fields.•AutoML is the first of its kind to be empirically compared between TPOT and AutoModel in an application to predict academic dishonesty whistleblowing.•Besides accuracy performances of the AutoML, the proportion of the variance of each attribute from demographic and Theory of Planned Behavior (TPB) is also presented in the prediction models of academic dishonesty whistleblowing.•AutoML is a convenient and reproducible rapid modeling method of machine learning to be used in many kinds of prediction problem.
  2. Teleosts as behaviour test models for social stress
    Lai NHY, Mohd Zahir IA, Liew AKY, Ogawa S, Parhar I, Soga T
    Front Behav Neurosci, 2023;17:1205175.
    PMID: 37744951 DOI: 10.3389/fnbeh.2023.1205175
    Stress is an important aspect of our everyday life and exposure to it is an unavoidable occurrence. In humans, this can come in the form of social stress or physical stress from an injury. Studies in animal models have helped researchers to understand the body's adaptive response to stress in human. Notably, the use of behavioural tests in animal models plays a pivotal role in understanding the neural, endocrine and behavioural changes induced by social stress. Under socially stressed conditions, behavioural parameters are often measured physiological and molecular parameters as changes in behaviour are direct responses to stress and are easily assessed by behavioural tests. Throughout the past few decades, the rodent model has been used as a well-established animal model for stress and behavioural changes. Recently, more attention has been drawn towards using fish as an animal model. Common fish models such as zebrafish, medaka, and African cichlids have the advantage of a higher rate of reproduction, easier handling techniques, sociability and most importantly, share evolutionary conserved genetic make-up, neural circuitry, neuropeptide molecular structure and function with mammalian species. In fact, some fish species exhibit a clear diurnal or seasonal rhythmicity in their stress response, similar to humans, as opposed to rodents. Various social stress models have been established in fish including but not limited to chronic social defeat stress, social stress avoidance, and social stress-related decision-making. The huge variety of behavioural patterns in teleost also aids in the study of more behavioural phenotypes than the mammalian species. In this review, we focus on the use of fish models as alternative models to study the effects of stress on different types of behaviours. Finally, fish behavioural tests against the typical mammalian model-based behavioural test are compared and discussed for their viability.
  3. Pandemic effects on the care of patients with inborn errors of immunity
    Abdul Latiff AH
    Asia Pac Allergy, 2023 Sep;13(3):95-96.
    PMID: 37744956 DOI: 10.5415/apallergy.0000000000000117
  4. Drug allergy knowledge, attitude, and practice: A survey among doctors and pharmacists in public health facilities of Sabah, Malaysia
    Kwan MSK, Tan SL, Keowmani T, Goh SL, Voo JYH, Tan HS, et al.
    Asia Pac Allergy, 2023 Sep;13(3):121-126.
    PMID: 37744958 DOI: 10.5415/apallergy.0000000000000115
    BACKGROUND: Given the deficits in allergists and testing capacity, the diagnosis of drug allergy is largely dependent on the clinician's and pharmacist's judgment. The ability to recognize drug allergies and respond appropriately is crucial to patient safety. Currently, there is a void in the evidence that limits the ability to recommend comprehensive and swift improvements on this front.

    OBJECTIVE: This study thus aimed to evaluate the knowledge, attitude, and practice toward drug allergy among doctors and pharmacists working in public healthcare facilities in Sabah, Malaysia.

    METHODS: This cross-sectional study was conducted in 24 hospitals and 11 clinics in Sabah. A validated Drug Allergy Knowledge, Attitude, and Practice Questionnaire was adapted from a published study and developed on an online survey platform. The questionnaire was distributed to all listed eligible respondents via email and personal messenger service.

    RESULTS: A total of 549 doctors and pharmacists responded, with an overall response rate of 18.2%. The total mean knowledge, attitude, and practice scores were 8.3 (SD, 1.98), 18.9 (SD, 2.55), and 17.3 (SD, 4.4), respectively. It was found that pharmacists performed significantly poorer than both medical officers (mean score difference = -0.5; P = 0.006) and specialists (mean score difference = -0.9; P = 0.020) in the knowledge domain. As the time in service doubles, the knowledge score increases significantly by 0.3 (P = 0.015).

    CONCLUSION: Knowledge, attitude, and practice on drug allergy among doctors and pharmacists in Sabah were poor. It is thus timely for advanced educational programs on drug allergy to be formalized and implemented.

  5. Evaluating immune responses to pneumococcal vaccines
    Thong BY, Pawankar R, Park HS, Abdul Latiff AH
    Asia Pac Allergy, 2023 Sep;13(3):127-131.
    PMID: 37744960 DOI: 10.5415/apallergy.0000000000000114
    Streptococcus pneumoniae (pneumococcus) is a significant cause of bacterial infections ranging from mild infections affecting the respiratory tract such as otitis media and sinusitis to severe diseases including bacteremia, pneumonia, and invasive pneumococcal disease (IPD) (eg, meningitis, septic arthritis, and endocarditis). Pneumococcal vaccines were first developed in the 1970s as capsular pneumococcal polysaccharide vaccines, which were T-cell independent and hence lacked immunologic memory. Subsequently in the year 2000, pneumococcal conjugate vaccines (PCV) conjugated to a protein to increase immunogenicity were developed and made commercially available. The increasing number of pneumococcal serotypes identified and the expanding pipeline of PCV vaccines with improved immunogenicity have significantly reduced the morbidity and mortality associated with IPD in high-risk patients. Pneumococcal vaccines also play an important role in the diagnosis and immunophenotyping of children and adults with inborn errors of immunity (IEI) given the increasing diversity/heterogeneity of IEI presenting with primary and/or specific antibody deficiency. Other than the quantitation of serotype levels in routine clinical care, other measurements of immune response including the functional activity of antibodies, antibody avidity, cell-mediated immunity, and immunological memory remain limited to clinical trials during vaccine development.
  6. On the Stability and Null-Controllability of an Infinite System of Linear Differential Equations
    Azamov A, Ibragimov G, Mamayusupov K, Ruziboev M
    J Dyn Control Syst, 2023;29(3):595-605.
    PMID: 37745007 DOI: 10.1007/s10883-021-09587-6
    In this work, the null controllability problem for a linear system in ℓ2 is considered, where the matrix of a linear operator describing the system is an infinite matrix with λ∈ℝ on the main diagonal and 1s above it. We show that the system is asymptotically stable if and only if λ ≤- 1, which shows the fine difference between the finite and the infinite-dimensional systems. When λ ≤- 1 we also show that the system is null controllable in large. Further we show a dependence of the stability on the norm, i.e. the same system considered ℓ∞ is not asymptotically stable if λ = - 1.
  7. Prevalence of Antimicrobial-resistant Bacteria in HACCP Facilities
    Subramaniam R, Jambari NN, Hao KC, Abidin UFUZ, Mahmud NK, Rashid A
    Food Saf (Tokyo), 2023 Sep;11(3):54-61.
    PMID: 37745160 DOI: 10.14252/foodsafetyfscj.D-23-00004
    Foodborne pathogens, such as Staphylococcus aureus and Salmonella spp., develop antimicrobial resistance (AMR) over time, resulting in compromised food safety. Therefore, this study aimed to determine the prevalence, compliance against Malaysia's veterinary standing procedure directive (APTVM 16 (c): 1/2011): Appendix 713), and antimicrobial resistance (AMR) profiles of S. aureus and Salmonella spp., in raw poultry meat, poultry meat products, and poultry-based ready-to-eat (RTE) foods. Here, 699 raw poultry meat and meat products samples were obtained from selected hazard analysis critical control points (HACCP)-certified poultry meat-processing plants. Additionally, 377 samples of poultry-based RTE meals were collected from dine-in establishments and hospital catering facilities in Klang Valley, Malaysia. Salmonella spp. and S. aureus were present in 2.1% and 2.8% of the analyzed samples, respectively. Salmonella spp isolated from raw poultry meat and its products displayed resistance to ampicillin (100%), chloramphenicol (87.0%), cefuroxime (60.9%), cefazolin (56.5%), and kanamycin (52.2%). Similarly, S. aureus isolated from raw poultry meat, its products, and poultry-based RTE foods exhibited resistance against tetracycline, chloramphenicol, penicillin, ciprofloxacin, trimethoprim, kanamycin, and cefoxitin. The multi-antibiotic resistance (MAR) demonstrated by these foodborne pathogens makes their prevalence disconcerting. This highlights the need for more stringent monitoring and enduring sanitary and hygiene practices in HACCP establishments to prevent foodborne infections and potential transmission of AMR bacteria.
  8. Two new karst-adapted species in the Cyrtodactyluspulchellus group (Reptilia, Gekkonidae) from southern Thailand
    Termprayoon K, Rujirawan A, Grismer LL, Wood PL, Aowphol A
    Zookeys, 2023;1179:313-352.
    PMID: 37745621 DOI: 10.3897/zookeys.1179.109712
    The exploration of unsurveyed areas in southern Thailand discovered two new karst-adapted species, Cyrtodactylussungaiupesp. nov. and Cyrtodactyluswangkhramensissp. nov., from Thung Wa and La-ngu Districts, Satun Province, respectively. These new species are members of the C.pulchellus group that occur along the Thai-Malay Peninsula. The new species can be distinguished from all other congeners by their key morphological characters and genetic divergence. Morphologically, Cyrtodactylussungaiupesp. nov. and Cyrtodactyluswangkhramensissp. nov. can be diagnosed from other members by having a combination of differences in body size; degree of dorsal tuberculation; absence of tubercles on ventral surfaces; number of ventral scales, paravertebral tubercles and femoroprecloacal pores in males only; deep precloacal groove only in males; absence of a scattered pattern of white dorsal tubercles; number of dark body bands; and the extent of caudal tubercles on an original tail. Although the two species are sister taxa and have nearly identical morphologies, they are considered to be different species, based on a relatively high uncorrected pairwise genetic divergence of the mitochondrial ND2 gene (6.59-6.89%), statistically significant univariate and multivariate morphological differences (PERMANOVA and ANOVA) and diagnostic characteristics of caudal tuberculation on the original tail. Moreover, Cyrtodactylussungaiupesp. nov. and Cyrtodactyluswangkhramensissp. nov. are currently restricted to their karstic type localities which may serve as a geographic barrier to dispersal and gene flow.
  9. Editorial: Global excellence in plant science: Southeast Asia
    Doni F, Mispan MS
    Front Plant Sci, 2023;14:1285250.
    PMID: 37746022 DOI: 10.3389/fpls.2023.1285250
  10. Ardisiarecurvipetala (Primulaceae-Myrsinoideae), a new species from northern Peninsular Malaysia
    Julius A, Siti-Munirah MY, Utteridge TMA
    PhytoKeys, 2023;232:89-98.
    PMID: 37746325 DOI: 10.3897/phytokeys.232.103649
    Recent fieldwork in Terengganu, Peninsular Malaysia, resulted in the collection of an endemic new species of Ardisia, described here as Ardisiarecurvipetala Julius, Siti-Munirah & Utteridge. The species is a member of subgenus (§) Crispardisia on account of its vascularised glands (bacterial nodules) on the leaf margin and the terminal inflorescence on a specialised lateral branch subtended by a normal leaf (rather than a reduced bract-like leaf). Ardisiarecurvipetala is unique amongst all members of §Crispardisia by having leaf margins with both vascularised glands and pustule-like structures and can be further distinguished from other Peninsular Malaysian members of this subgenus by the lamina raised between the leaf venation giving a somewhat bullate appearance, unbranched inflorescences, brownish-red pedicels and recurved corolla lobes, each with a creamy-white apex and a small pink patch at the base. Ardisiarecurvipetala is known only from a single location in Terengganu and its conservation status is assessed as Data Deficient (DD).
  11. Interpositional Arthroplasty With Quadriceps Tendon in Patellofemoral Joint Osteoarthritis: An Alternative Way
    Shamsuddin MAF, Ahmad Hanif KA, Mohd Nasir MN
    Cureus, 2023 Aug;15(8):e43920.
    PMID: 37746381 DOI: 10.7759/cureus.43920
    We present a case report of a 45-year-old Malay female prison officer with a diagnosis of lateral patellofemoral joint (PFJ) osteoarthritis (OA) in her right knee for whom conservative treatment failed. She was periodically followed up for the unresolving anterior right knee pain, and the patient was offered interpositional PFJ arthroplasty with the quadriceps tendon. A novel technique of interpositional PFJ arthroplasty using lateral inner section ipsilateral quadriceps tendon was applied. The approach and surgical technique were described in this case report. The aim of this study is to describe why this technique was chosen, step by step with images on how interpositional PFJ arthroplasty is done and its satisfactory outcome following a three-month follow up.
  12. Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion
    Adzahar S, Hassan MN, Zulkafli Z, Mohd Noor NH, Ramli M, Mohamed Yusoff S, et al.
    Cureus, 2023 Aug;15(8):e44012.
    PMID: 37746385 DOI: 10.7759/cureus.44012
    Introduction Platelet additive solutions (PASs) are nutrient media commonly used to replace and reduce the need for storage plasma. They are an alternative medium to maintain high-quality platelets lasting longer on the shelf for about seven days. Platelets with high titer of ABO antibody can pose a hemolytic transfusion reaction (HTR) risk if units are given across the ABO barrier. The risk of complication is greater when group O platelet is released to non-group O patients. The PAS has been known as a safe medium, where the titer of ABO antibodies is expected to be diluted. In this study, we compared the anti-A and anti-B antibody titers of apheresis platelets in PAS and non-PAS (plasma) as the suspending media. Methods A total of 20 apheresis platelet donors were selected, with seven from blood group A, eight from blood group B, and five from blood group O. The platelets were collected using an Amicus cell separator. They were suspended in PAS and plasma before being stored at a temperature range of 22-24º C. Anti-A (blood group B and O) and Anti-B (blood group A and O) antibody titers were measured and compared between the two suspending media. Wilcoxon signed-rank test is used for statistical analysis, and a p-value <0.05 is considered significant. Results The median titer of the anti-A antibody of apheresis platelets showed a significant difference between suspended in PAS (2.50) and plasma (4.00), p=0.002. Similar findings were also seen with the median titer of the anti-B antibody of apheresis platelet, in which it showed a significant difference between suspended in PAS (2.00) and plasma (4.00), p=0.004. It was observed that there was a significant reduction in both anti-A and anti-B antibody titers in the PAS as compared to the plasma group. Conclusion The decrease in ABO antibody titer in apheresis platelets stored with PAS can be beneficial for patients. This reduces the risk of HTRs if ABO-incompatible platelet units need to be issued. Thus, using PAS as a storage medium significantly improves platelet inventory management without compromising patient safety.
  13. Evaluation of Retinal Nerve Fiber Layer and Macular Thickness Pre- and Post-Chemotherapy With Carboplatin and Paclitaxel in Patients With Endometrial and Ovarian Cancer
    Chin JJ, Wan Hitam WH, Chong MF, Lee SJ, Yew JM, Ngoo QZ
    Cureus, 2023 Aug;15(8):e43943.
    PMID: 37746413 DOI: 10.7759/cureus.43943
    Background Carboplatin and paclitaxel are two standard chemotherapeutic agents known to cause neurotoxicity. In this study, we aim to evaluate the toxicity of these agents by measuring the peripapillary retinal nerve fiber layer (RNFL) and macular thickness in patients with endometrial and ovarian cancers who are receiving them. Methods A one-year prospective cohort study involving 28 patients who were treated intravenously with carboplatin (200-400 mg/m2) and paclitaxel (175 mg/m2) three-weekly for six cycles was conducted. RNFL and macula thickness were measured using optical coherence tomography (OCT) before the commencement of chemotherapy, after the third cycle, and one month after the sixth cycle. The main outcome measurements were the average RNFL thickness and central subfield thickness of the macula. Results The mean age of the 28 participants was 54.68 years old (standard deviation [SD] 9.03). Eleven had endometrial cancer, while 17 had ovarian cancer. The mean of the average RNFL thickness during baseline pre-chemotherapy was 96.43 µm (SD 11.39). One month after cessation of treatment, the mean RNFL thickness increased to 101.57 µm (SD 13.54). Statistical analysis showed a significant increment in the mean RNFL thickness (p ≤ 0.001), from baseline to after three cycles, and baseline to one month after six cycles of chemotherapy, except the nasal quadrant. The increment of all macular quadrants was statistically significant (p < 0.05) except for central subfield thickness. Conclusion Systemic administration of carboplatin and paclitaxel affected both the peripapillary RNFL and macula thickness. This represents early evidence of subacute subclinical retinal toxicity. OCT can be used as a screening tool to assess peri-chemotherapeutic retinal alterations.
  14. Operative challenges in a gigantic ganglioneuroma of the posterior mediastinum with mediastinal compression
    Amir MA, Isahak MI, Adnan I, Dimon MZ
    J Surg Case Rep, 2023 Sep;2023(9):rjad524.
    PMID: 37746526 DOI: 10.1093/jscr/rjad524
    Symptomatic giant ganglioneuromas with mediastinal compression are rare, complicating its management with significant morbidity and mortality risks. A meticulous multidisciplinary preoperative planning is pivotal in ensuring success. We describe a case of a 30-year-old man with a giant posterior mediastinal mass with compression and displacement of the mediastinal structures. Biopsy confirmed a ganglioneuroma and patient underwent excision. Surgery was challenging in view of the size and adherence to the local structures. Haemodynamic instabilities were encountered necessitating a pre-emptive femoral-femoral cannulation for CPB. A piece-meal debulking of the tumour was performed, complicated with massive haemorrhage requiring autologous blood transfusion using an intraoperative blood salvage device. The patient recovered and was discharged home well at Day 8. A thorough pre-operative planning involving a multidisciplinary approach, an understanding of the surgical anatomy as well as anticipating impending complications is of paramount importance  in the management of this particular case.
  15. Human Expansion-Induced Biodiversity Crisis over Asia from 2000 to 2020
    Yang C, Li Q, Wang X, Cui A, Chen J, Liu H, et al.
    Research (Wash D C), 2023;6:0226.
    PMID: 37746659 DOI: 10.34133/research.0226
    Asia stands out as a priority for urgent biodiversity conservation due to its large protected areas (PAs) and threatened species. Since the 21st century, both the highlands and lowlands of Asia have been experiencing the dramatic human expansion. However, the threat degree of human expansion to biodiversity is poorly understood. Here, the threat degree of human expansion to biodiversity over 2000 to 2020 in Asia at the continental (Asia), national (48 Asian countries), and hotspot (6,502 Asian terrestrial PAs established before 2000) scales is investigated by integrating multiple large-scale data. The results show that human expansion poses widespread threat to biodiversity in Asia, especially in Southeast Asia, with Malaysia, Cambodia, and Vietnam having the largest threat degrees (∼1.5 to 1.7 times of the Asian average level). Human expansion in highlands induces higher threats to biodiversity than that in lowlands in one-third Asian countries (most Southeast Asian countries). The regions with threats to biodiversity are present in ∼75% terrestrial PAs (including 4,866 PAs in 26 countries), and human expansion in PAs triggers higher threat degrees to biodiversity than that in non-PAs. Our findings provide novel insight for the Sustainable Development Goal 15 (SDG-15 Life on Land) and suggest that human expansion in Southeast Asian countries and PAs might hinder the realization of SDG-15. To reduce the threat degree, Asian developing countries should accelerate economic transformation, and the developed countries in the world should reduce the demands for commodity trade in Southeast Asian countries (i.e., trade leading to the loss of wildlife habitats) to alleviate human expansion, especially in PAs and highlands.
  16. Effects of COVID-19 on Patient Safety Culture among Staff at a Teaching Hospital in Malaysia
    Krishnasamy K, Zakaria MI, Tan MP, Chinna K, Narayanan V, Hasnan N
    Disaster Med Public Health Prep, 2023 Sep 25;17:e494.
    PMID: 37746761 DOI: 10.1017/dmp.2023.141
    MeSH terms: Hospitals, Teaching; Humans; Malaysia/epidemiology
  17. Fulltext A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative
    Zuberbier T, Abdul Latiff A, Aggelidis X, Augustin M, Balan RG, Bangert C, et al.
    Clin Transl Allergy, 2023 Sep;13(9):e12299.
    PMID: 37746794 DOI: 10.1002/clt2.12299
    INTRODUCTION: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.

    METHODS: The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres.

    RESULTS: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD.

    CONCLUSION: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

  18. Fulltext Natural language processing in narrative breast radiology reporting in University Malaya Medical Centre
    Tan WM, Ng WL, Ganggayah MD, Hoe VCW, Rahmat K, Zaini HS, et al.
    Health Informatics J, 2023;29(3):14604582231203763.
    PMID: 37740904 DOI: 10.1177/14604582231203763
    Radiology reporting is narrative, and its content depends on the clinician's ability to interpret the images accurately. A tertiary hospital, such as anonymous institute, focuses on writing reports narratively as part of training for medical personnel. Nevertheless, free-text reports make it inconvenient to extract information for clinical audits and data mining. Therefore, we aim to convert unstructured breast radiology reports into structured formats using natural language processing (NLP) algorithm. This study used 327 de-identified breast radiology reports from the anonymous institute. The radiologist identified the significant data elements to be extracted. Our NLP algorithm achieved 97% and 94.9% accuracy in training and testing data, respectively. Henceforth, the structured information was used to build the predictive model for predicting the value of the BIRADS category. The model based on random forest generated the highest accuracy of 92%. Our study not only fulfilled the demands of clinicians by enhancing communication between medical personnel, but it also demonstrated the usefulness of mineable structured data in yielding significant insights.
    MeSH terms: Humans; Malaysia; Natural Language Processing*; Radiology*; Universities; Data Mining
  19. Fulltext Tourist behaviour: The role of digital marketing and social media
    Armutcu B, Tan A, Amponsah M, Parida S, Ramkissoon H
    Acta Psychol (Amst), 2023 Oct;240:104025.
    PMID: 37741033 DOI: 10.1016/j.actpsy.2023.104025
    Social media and its applications are a part of daily life in Turkey and the rest of the world. In 2022, about 80.7 % of Turkey's population (69.9 million people) spent an average of 8 h daily using the Internet, providing a significant opportunity to encourage and influence tourists' purchase intentions through social media. This study aims to determine the effects of digital marketing and social media on tourist behaviours in Turkey. This study proposes a comprehensive model for the antecedents of tourists' behavioural intentions in their destination selection that can be found in the tourist destination online content (TDOC). The quality and user-friendly accessibility of the online information provides essential clues that influence tourists' behavioural intentions (intention to visit the destination and eWOM). Tourists' level of satisfaction with their first destination visits and the digital marketing interaction channels through which they share their experiences may positively affect their repeat visits/other tourists' behavioural intentions. Therefore, this study investigates the mediator effect of satisfaction and digital marketing interactions on the behavioural intentions of tourists of Eastern origin during their destination selection. Data was collected from 264 structured questionnaires and analyzed using partial least squares structural equation (PLS-SEM) modelling. Findings show that tourists' TDOC perceptions directly affect their behavioural intentions and that tourist satisfaction has a mediator role in the relationship between tourists' TDOC perceptions and behavioural intentions. Also, the results show that satisfaction and digital marketing interactions are important determinants of the intention to visit a tourist destination and eWOM intentions. Understanding tourists' perspectives on destination choice is crucial for policy makers, businesses and marketers as it will help formulate appropriate strategies to increase destination visits. In this respect, it is recommended to develop strategies to encourage tourists to share their experiences and satisfaction levels through digital marketing channels by improving the quality of products and services. Finally, the population of this study is limited to Turkey, and future research can extend this study to countries with different cultures and make new contributions to the related literature.
    MeSH terms: Behavior Therapy; Humans; Surveys and Questionnaires; Intention; Marketing; Social Media*
  20. Percutaneous over traditional: Efficacy of minimally invasive trigger finger release amidst COVID-19 constraints in Malaysia
    Tay JQ, Tan LH, Tay JS, Lim ZL
    J Plast Reconstr Aesthet Surg, 2023 Nov;86:192-194.
    PMID: 37741035 DOI: 10.1016/j.bjps.2023.09.014
    MeSH terms: Humans; Malaysia; Minimally Invasive Surgical Procedures; Orthopedic Procedures*
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