METHODS: For this integrative analysis, we identified regions in the world where there was evidence of a connection between EIDs and anthropogenic land-use changes between Nov 9, 1999, and Oct 25, 2021, through a targeted literature review of academic literature and grey literature to identify evidence of drivers of anthropogenic land-use change and their association with commodity production in these regions. We only included publications in English that showed a connection between deforestation and the production of one or more commodities. Publications merely describing spatial or temporal land-use change dynamics (eg, a reduction of forest or an increase of palm-oil plantations) were excluded. As we were assessing financial influence on corporate activities through ownership specifically, we focused our analysis on publicly listed companies. Equity data and data about ownership structure were extracted from Orbis, a company information database. We assessed financial influence by identifying financial entities with the largest equity ownership, descriptively mapping transboundary connections between investors and publicly listed companies.
FINDINGS: 227 public and private companies operating in five economic sectors (ie, production of palm oil, pulp and wood products, cocoa, soybeans, and beef) between Dec 15, 2020, and March 8, 2021, were identified. Of these 227, 99 (44%) were publicly listed companies, with 2310 unique shareholders. These publicly listed companies operated in six geographical regions, resulting in nine case-study regions. 54 (55%) companies with complete geographical information were included in the countries network. Four financial entities (ie, Dimensional, Vanguard, BlackRock, and Norway's sovereign wealth fund) each had ownership in 39 companies or more in three of the case-study regions (ie, north America, east Asia, and Europe). Four large US-based asset managers (ie, Vanguard, BlackRock, T Rowe Price, and State Street) were the largest owners of publicly listed companies in terms of total equity size, with ownership amounts for these four entities ranging from US$8 billion to $21 billion. The specific patterns of cross-national ownership depended on the region of interest; for example, financial influence on EIDs risks that was associated with commodity production in southeast and east Asia came from not only global asset managers but also Malaysian, Chinese, Japanese, and Korean financial entities. India, Brazil, the USA, Mexico, and Argentina were the countries towards which investments were most directed.
INTERPRETATION: Although commodity supply chains and financial markets are highly globalised, a small number of investors and countries could be viewed as disproportionally influential in sectors that increase EIDs risks. Such financial influence could be used to develop and implement effective policies to reduce ecological degradation and mitigate EIDs risks and their effects on population health.
FUNDING: Formas and Networks of Financial Rupture-how cascading changes in the climate and ecosystems could impact on the financial sector.
METHODS: A two-phase mixed-methods approach was used. Phase 1 involved qualitative interviews with hypertensive patients from two health clinics in Kuala Lumpur, Malaysia. The themes extracted from these interviews were used to generate items for the MAANS. In Phase 2, data from 213 participants were analysed using exploratory factor analysis (EFA) to establish the scale's factor structure, thereby created the modified version of the MAANS. Confirmatory factor analysis (CFA) was then conducted on a separate dataset of 205 participants to confirm the factor structure, resulted in the final version of the MAANS. The reliability of the final MAANS version was assessed using Cronbach's alpha coefficient. The MAANS scores were used to predict subscales of the Malay version of the WHO Quality-of-Life (QOL) BREF, demonstrating the scale's predictive validity.
RESULTS: Ten qualitative interviews yielded 73 items. The EFA produced a modified MAANS with 21 items grouped into five factors. However, the CFA retained three factors in the final scale: Perceived Non-Susceptibility, Poor Doctor-Patient Relationship, and Unhealthy Lifestyle. The final 14-item, 3-factor MAANS demonstrated moderate reliability (Cronbach's alpha coefficient = 0.64) and exhibited partial predictive validity, with the Poor Doctor-Patient Relationship and Unhealthy Lifestyle subscales significantly predicting Social QOL and Environmental QOL.
CONCLUSION: The MAANS is a reliable, valid, and multidimensional scale specifically developed to evaluate non-adherence to anti-hypertensive medications in local clinical settings with the potential to further the advancement of research and practice in sociomedical and preventive medicine.
METHODS: Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.
RESULTS: The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.
CONCLUSION: This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.
METHODS: A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables.
RESULTS: A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351).
CONCLUSION: The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.
MATERIAL AND METHODS: A total of 380 babies from Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur and Sarawak General Hospital (SGH) were recruited in this retrospective study. All babies with birthweight less than 1500grams nursed in the Neonatal Intensive Care Unit (NICU) between January 2014 till December 2019 was included in the study. Data was analysed on demography, interval taken for hearing intervention and defaulter rate. The data of patient parameters between both hospitals were analysed and association between various factors were evaluated.
RESULTS: A total 187 Very Low Birth Weight (VLBW) Kuala Lumpur babies and 193 VLBW Sarawak babies met the inclusion and exclusion criteria, among which 10.1% and 10.9% had SNHL in Kuala Lumpur and Sarawak respectively. CHL was reported among 8.6% Kuala Lumpur and 14% of Sarawak babies. When studied on the different types and degrees of hearing loss, 2.6% of Kuala Lumpur babies born less than 28 Weeks Gestation Age (WGA) had moderate SNHL and 2.0% of Sarawak babies had profound SNHL. In this study only gestational age (week) (p=0.003) and dysmorphism (p<0.001) were statistically significant to be associated with hearing loss.
CONCLUSION: The prevalence of hearing loss among VLBW babies in Kuala Lumpur was 20.3% and 24.8% in Sarawak. Gestational age (p=0.044) and presence of dysmorphism (p<0.001) were found to have statistically significant association with prevalence of hearing loss. The defaulter rate at Kuala Lumpur was 52.6% and 42.3% in Sarawak.
MATERIALS AND METHODS: A total of 159 patients from the Hospital Canselor Tuanku Muhriz (HCTM) Cochlear Implant Programme were recruited in this retrospective cross-sectional study. All paediatric Cochlear Implant (CI) recipients with pre-lingual deafness were included in this retrospective study. The study was conducted from January 2019 until December 2020. The pre-lingual cochlear implant recipients' data were analysed based on demographics and interval from diagnosis to hearing aid fitting and implantation. The association between the dependent variables with early and late cochlear implantation was compared.
RESULTS: A total of 83 (52%) patients were female. Chinese race constituted most of the patients, which was 90/159 (57%). The majority were from middle-income families (M40); 89 (56%). The most common aetiology of Hearing Loss (HL) was idiopathic; 139 (87%), followed by intrauterine infections, which comprised of congenital CMV; 8 (5%) and congenital Rubella; 1 (1%) and nonspecific intrauterine infection 2 (1%). The relationship between the universal neonatal hearing screening and the interval between diagnosis to implantation was significant (p=0.033). Other variables were not significant.
CONCLUSION: UNHS was a significant factor contributing to early and late implantation. The median age of diagnosis of hearing loss was 18 months (interquartile range; 15); the age of CI was 34 months (interquartile range; 24); the interval from diagnosis to hearing aid was 2 months (interquartile range; 5), and the interval from diagnosis to CI was 16 months (interquartile range; 14).
METHODS: The prospective clinical study was conducted at Selayang Hospital (SH) and Hospital Canselor Tuanku Muhriz (HCTM) within one year. A total of 38 children ranging from 3 to 18 years old underwent hearing evaluation using ABR tests and MSSR under sedation. The duration of both tests were then compared.
RESULTS: The estimated hearing threshold of frequency specific chirp MSSR showed good correlation with ABR especially in higher frequencies such as 2000 Hz and 4000Hz with the value of cronbach alpha of 0.890, 0.933, 0.970 and 0.969 on 500Hz, 1000Hz, 2000Hz and 4000Hz. The sensitivity of MSSR is 0.786, 0.75, 0.957 and 0.889 and specificity is 0.85, 0.882, 0.979 and 0.966 over 500Hz, 1000Hz, 2000Hz and 4000Hz. The duration of MSSR tests were shorter than ABR tests in normal hearing children with an average of 35.3 minutes for MSSR tests and 46.4 minutes for ABR tests. This can also be seen in children with hearing loss where the average duration for MSSR tests is 40.0 minutes and 52.0 minutes for ABR tests.
CONCLUSION: MSSR showed good correlation and reliability in comparison with ABR especially on higher frequencies. Hence, MSSR is a good clinical test to diagnose children with hearing loss.
METHODS AND ANALYSIS: Initially, during Phase I of the study, the serum level of IL-1β, IL-6 and TNF-α; ERP changes in the EEG and fecal microbiota content will be compared between 120 AUD patients and 120 healthy controls. Subsequently in Phase II of the study, 120 AUD patients will be randomized by stratified permuted block randomization into the probiotic, ACT and placebo groups in a 1:1:1 ratio. Participants in the probiotic and placebo groups will be administered one sachet per day of Lactobacillus spp. probiotic and placebo, respectively for 12 weeks. While those in the ACT group will receive one session per week of ACT for 8 weeks. Outcome measures will be administered at four timepoints, such as t0 = baseline assessment prior to intervention, t1 = 8 weeks after intervention began, t2 = 12 weeks after intervention and t3 = 24 weeks after intervention. Primary outcomes are the degrees of alcohol craving, alcohol withdrawal during abstinence and AUD. Secondary outcomes to be assessed are the severity of co-morbid depression and anxiety symptoms; the serum levels of IL-1β, IL-6 and TNF-α; changes in ERP and fecal microbiota content.
TRIAL REGISTRATION NUMBER: NCT05830708 (ClinicalTrials.gov). Registered on April 25, 2023.
METHODS: The data was collected in training and matches of a professional adult male soccer team during three complete seasons (2020/21-2022/2023). The sample included 6 different HCs (48.8 ± 7.4 years of age; 11.2 ± 3.9 years as a HC). The 4 weeks and 4 games before and after the replacement of HCs were analysed. External load variables were collected with Global Positioning System (GPS) devices. A logistic regression (LR) model was developed to classify the HCs' retention or dismissal. A sensitivity analysis was also conducted to determine the specific locomotive variables that could predict the likelihood of HC retention or dismissal.
RESULTS: In competition, locomotor performance was better under the dismissed HCs, whereas the new HC had better values during training. The LR model demonstrated a good prediction accuracy of 80% with a recall and precision of 85% and 78%, respectively, amongst other model performance indicators. Meters per minute in games was the only significant variable that could serve as a potential physical marker to signal performance decline and predict the potential dismissal of an HC with an odd ratio of 32.4%.
DISCUSSION: An in-depth analysis and further studies are needed to understand other factors' effects on HC replacement or retention.