Minor head injury in a developing country like Malaysia is managed by primary care physicians and/or medical assistants in district hospitals. These patients are seen initially in their local hospitals, which have at least an X-ray machine for the purpose of screening. This study aimed to guide these physicians to manage these patients at a primary care level. A cross-sectional study was conducted and the study revealed significant predictors of significant computed tomographic (CT) findings. The presence of a Glasgow coma scale (GCS) score of 14 or 13 was associated with the risk of developing significant CT findings compared to patients with a GCS of 15 (p<0.001). Thirty-seven out of 50 patients with GCS of 14 or 13 developed clinically significant brain injury on CT scan. Similarly, the presence of skull fracture was associated with the risk of developing CT abnormalities (p<0.001). Forty-two out of 51 patients with skull fracture developed clinically significant CT findings. Vomiting was associated with developing CT abnormalities (p=0.017). Twenty-seven out of 40 patients with vomiting showed significant CT findings. Soft tissue injury was also found to be associated with developing CT abnormalities (p=0.007). Therefore, we propose reclassifying minor head injury based on the GCS score. Patients with a GCS score of 15 were classified as having mild head injury, while patients with a GCS score of 13 or 14 were at higher risk of developing brain injury and therefore categorized as high risk mild head injury. This group requires emergency CT scan examination, especially when associated with non-motor vehicle accidents, abnormal central nervous system (CNS) examination, craniofacial injuries or skull fractures. They should be referred to a general surgical unit which can treat head injuries or a neurosurgical tertiary centre.
There is an increasing interest in bioinspired dynamic materials. Abundant illustrations of protein domains exist in nature, with remarkable ligand binding characteristics and structures that undergo conformational changes. For example, calmodulin (CaM) can have three conformational states, which are the unstructured Apo-state, Ca2+-bound ligand-exposed binding state, and compact ligand-bound state. CaM's mechanical response to biological cues is highly suitable for engineering dynamic materials. The distance between CaM globular terminals in the Ca2+-bound state is 5 nm and in the ligand-bound state is 1.5 nm. CaM's nanoscale conformational changes have been used to develop dynamic hydrogel microspheres that undergo reversible volume changes. The current work presents the fabrication and preliminary results of layer-by-layer (LbL) self-assembled Dynamic MicroCapsules (DynaMicCaps) whose multilayered shell walls are composed of polyelectrolytes and CaM. Quasi-dynamic perfusion results show that the DynaMicCaps undergo drastic volume changes, with up to ∼1500% increase, when exposed to a biochemical ligand trifluoperazine (TFP) at pH 6.3. Under similar test conditions, microcapsules without CaM also underwent volume changes, with only up to ∼290% increase, indicating that CaM's bio-responsiveness was retained within the shell walls of the DynaMicCaps. Furthermore, DynaMicCaps exposed to 0.1 M NaOH underwent volume changes, with only up to ∼580% volume increase. Therefore, DynaMicCaps represent a new class of polyelectrolyte multilayer (PEM) capsules that can potentially be used to release their payload at near physiological pH. With over 200 proteins that undergo marked, well-characterized conformational changes in response to specific biochemical triggers, several other versions of DynaMicCaps can potentially be developed.
A chronology of mathematical models for heat and mass transfer equation is proposed for the prediction of moisture and temperature behavior during drying using DIC (Détente Instantanée Contrôlée) or instant controlled pressure drop technique. DIC technique has the potential as most commonly used dehydration method for high impact food value including the nutrition maintenance and the best possible quality for food storage. The model is governed by the regression model, followed by 2D Fick's and Fourier's parabolic equation and 2D elliptic-parabolic equation in a rectangular slice. The models neglect the effect of shrinkage and radiation effects. The simulations of heat and mass transfer equations with parabolic and elliptic-parabolic types through some numerical methods based on finite difference method (FDM) have been illustrated. Intel®Core™2Duo processors with Linux operating system and C programming language have been considered as a computational platform for the simulation. Qualitative and quantitative differences between DIC technique and the conventional drying methods have been shown as a comparative.
Psychrophilic basidiomycete yeast, Glaciozyma antarctica strain PI12, was shown to be a protease-producer. Isolation of the PI12 protease gene from genomic and mRNA sequences allowed determination of 19 exons and 18 introns. Full-length cDNA of PI12 protease gene was amplified by rapid amplification of cDNA ends (RACE) strategy with an open reading frame (ORF) of 2892 bp, coded for 963 amino acids. PI12 protease showed low homology with the subtilisin-like protease from fungus Rhodosporidium toruloides (42% identity) and no homology to other psychrophilic proteases. The gene encoding mature PI12 protease was cloned into Pichia pastoris expression vector, pPIC9, and positioned under the induction of methanol-alcohol oxidase (AOX) promoter. The recombinant PI12 protease was efficiently secreted into the culture medium driven by the Saccharomyces cerevisiae α-factor signal sequence. The highest protease production (28.3 U/ml) was obtained from P. pastoris GS115 host (GpPro2) at 20°C after 72 hours of postinduction time with 0.5% (v/v) of methanol inducer. The expressed protein was detected by SDS-PAGE and activity staining with a molecular weight of 99 kDa.
The validity of using rainfall characteristics as lumped parameters for investigating the pollutant wash-off process such as first flush occurrence is questionable. This research study introduces an innovative concept of using sector parameters to investigate the relationship between the pollutant wash-off process and different sectors of the runoff hydrograph and rainfall hyetograph. The research outcomes indicated that rainfall depth and rainfall intensity are two key rainfall characteristics which influence the wash-off process compared to the antecedent dry period. Additionally, the rainfall pattern also plays a critical role in the wash-off process and is independent of the catchment characteristics. The knowledge created through this research study provides the ability to select appropriate rainfall events for stormwater quality treatment design based on the required treatment outcomes such as the need to target different sectors of the runoff hydrograph or pollutant species. The study outcomes can also contribute to enhancing stormwater quality modelling and prediction in view of the fact that conventional approaches to stormwater quality estimation is primarily based on rainfall intensity rather than considering other rainfall parameters or solely based on stochastic approaches irrespective of the characteristics of the rainfall event.
A deficiency in the photoelectrical dynamics at the interface due to the surface traps of the TiO2 electron transport layer (ETL) has been the critical factor for the inferiority of the power conversion efficiency (PCE) in the perovskite solar cells. Despite its excellent energy level alignment with most perovskite materials, its large density of surface defect as a result of sub lattice vacancies has been the critical hurdle for an efficient photovoltaic process in the device. Here, we report that atoms thick 2D TiS2 layer grown on the surface of a (001) faceted and single-crystalline TiO2 nanograss (NG) ETL have effectively passivated the defects, boosting the charge extractability, carrier mobility, external quantum efficiency, and the device stability. These properties allow the perovskite solar cells (PSCs) to produce a PCE as high as 18.73% with short-circuit current density (Jsc), open-circuit voltage (Voc), and fill-factor (FF) values as high as 22.04 mA/cm2, 1.13 V, and 0.752, respectively, a 3.3% improvement from the pristine TiO2-NG-based PSCs. The present approach should find an extensive application for controlling the photoelectrical dynamic deficiency in perovskite solar cells.
An anodic film with a nanoporous structure was formed by anodizing niobium at 60 V in fluorinated ethylene glycol (fluoride-EG). After 30 min of anodization, the anodic film exhibited a "pore-in-pore" structure; that is, there were smaller pores growing inside larger pores. The as-anodized film was weakly crystalline and became orthorhombic Nb2O5 after heat treatment. The energy band gap of the annealed nanoporous Nb2O5 film was 2.9 eV. A photocatalytic reduction experiment was performed on Cr(VI) under ultraviolet (UV) radiation by immersing the nanoporous Nb2O5 photocatalyst in a Cr(VI) solution at pH 2. The reduction process was observed to be very slow; hence, ethylenediaminetetraacetic acid (EDTA) was added as an organic hole scavenger, which resulted in 100% reduction after 45 min of irradiation. The photocatalytic reduction experiment was also performed under visible light, and findings showed that complete reduction achieved after 120 min of visible light exposure.
In this study, nanoporous anodic film was produced by anodization of niobium, Nb in a fluoride ethylene glycol electrolyte. The effect of anodization voltage and electrolyte temperature was studied to find an optimum condition for circular, ordered, and uniform pore formation. The diameter of the pores was found to be larger when the applied voltage was increased from 20 to 80 V. The as-anodized porous film was also observed to comprise of nanocrystallites which formed due to high field-induced crystallization. The nanocrystallites grew into orthorhombic Nb2O5 after post-annealing treatment. The Cr(VI) photoreduction property of both the as-anodized and annealed Nb2O5 samples obtained using an optimized condition (anodization voltage: 60 V, electrolyte temperature: 70 °C) was compared. Interestingly, the as-anodized Nb2O5 film was found to display better photoreduction of Cr(VI) than annealed Nb2O5. However, in terms of stability, the annealed Nb2O5 presented high photocatalytic efficiency for each cycle whereas the as-anodized Nb2O5 showed degradation in photocatalytic performance when used continually.
Perovskite solar cells have emerged as a potential energy alternative due to their low cost of fabrication and high power conversion efficiency. Unfortunately, their poor ambient stability has critically limited their industrialization and application in real environmental conditions. Here, we show that by introducing hexamine molecules into the perovskite lattice, we can enhance the photoactive phase stability, enabling high-performance and air-processable perovskite solar cells. The unencapsulated and freshly prepared perovskite solar cells produce a power conversion efficiency of 16.83% under a 100 mW cm-2 1.5G solar light simulator and demonstrate high stability properties when being stored for more than 1500 h in humid air with relative humidity ranging from 65 to 90%. We envisage that our findings may revolutionize perovskite solar cell research, pushing the performance and stability to the limit and bringing the perovskite solar cells toward industrialization.
Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents' health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.
Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.
Hepcidin is a principal regulator of iron homeostasis and its dysregulation has been recognised as a causative factor in cancers and iron disorders. The strategy of manipulating the presence of hepcidin peptide has been used for cancer treatment. However, this has demonstrated poor efficiency and has been short-lived in patients. Many studies reported using minihepcidin therapy as an alternative way to treat hepcidin dysregulation, but this was only applied to non-cancer patients. Highly conserved fish hepcidin protein, HepTH1-5, was investigated to determine its potential use in developing a hepcidin replacement for human hepcidin (Hepc25) and as a therapeutic agent by targeting the tumour suppressor protein, p53, through structure-function analysis. The authors found that HepTH1-5 is stably bound to ferroportin, compared to Hepc25, by triggering the ferroportin internalisation via Lys42 and Lys270 ubiquitination, in a similar manner to the Hepc25 activity. Moreover, the residues Ile24 and Gly24, along with copper and zinc ligands, interacted with similar residues, Lys24 and Asp1 of Hepc25, respectively, showing that those molecules are crucial to the hepcidin replacement strategy. HepTH1-5 interacts with p53 and activates its function through phosphorylation. This finding shows that HepTH1-5 might be involved in the apoptosis signalling pathway upon a DNA damage response. This study will be very helpful for understanding the mechanism of the hepcidin replacement and providing insights into the HepTH1-5 peptide as a new target for hepcidin and cancer therapeutics.Communicated by Ramaswamy H. Sarma.
Many studies reported that the activation of tumour suppressor protein, p53 induced the human hepcidin expression. However, its expression decreased when p53 was silenced in human hepatoma cells. Contrary to Tilapia hepcidin TH1-5, HepTH1-5 was previously reported to trigger the p53 activation through the molecular docking approach. The INhibitor of Growth (ING) family members are also shown to directly interact with p53 and promote cell cycle arrest, senescence, apoptosis and participate in DNA replication and DNA damage responses to suppress the tumour initiation and progression. However, the interrelation between INGs and HepTH1-5 remains unknown. Therefore, this study aims to identify the mechanism and their protein interactions using in silico approaches. The finding revealed that HepTH1-5 and its ligands had interacted mostly on hotspot residues of ING proteins which involved in histone modifications via acetylation, phosphorylation, and methylation. This proves that HepTH1-5 might implicate in an apoptosis signalling pathway and preserve the protein structure and function of INGs by reducing the perturbation of histone binding upon oxidative stress response. This study would provide theoretical guidance for the design and experimental studies to decipher the role of HepTH1-5 as a potential therapeutic agent for cancer therapy. Communicated by Ramaswamy H. Sarma.
Games have been used as a learning tool for centuries. Gamification and game-based learning are becoming more prominent in educational settings for several reasons. When it comes to learning, being focused and immersed can massively improve a student's experience. The purpose of this study is to map the emerging trends of gamification and game-based learning (GBL) in the Vocational and Education Training (VET) sector. For this purpose, a Systematic Literature Review was conducted through the three most relevant scientific databases - Web of Science, Scopus, ScienceDirect, and PubMed with Google Scholar as a supporting database. The obtained sample was further selected following the PRISMA guidelines with screening and eligibility processes conducted based on inclusion criteria that were defined with consideration to the research's aim. This review comprised seventeen studies. The findings revealed a growing interest in the Asian continents in research from 2020 onwards. Furthermore, most of the study is centred on vocational schools and colleges in the engineering and healthcare fields. According to the overview, the digital learning platform and simulation technology are the most promising tools used in the research. The findings support the conclusion that gamification and game-based learning can improve academic performance, engagement, and motivation in vocational education learners. As a result, this study suggests that more research is needed to determine the gamification strategies that are most suited for vocational education and learning.
The COVID-19 pandemic affected everyone's lives and general well-being worldwide, including young adults. Young adulthood is marked by a shift in various social areas including acquiring financial independence. As the pandemic was an exceptional scenario in all nations, there is a research gap in analysing how it would affect financial experiences of young adults, particularly the Muslim young adults. These individuals may face financial stress as a result of the COVID-19 pandemic due to their high level of financial strain. Furthermore, little is still known about the role that religiosity may play in the relationship between the financial strain and financial stress, notably during the pandemic. The objectives of this study were to examine the level of financial strain and financial stress of Muslim young adults, assess the effect of financial strain on financial stress of Muslim young adults and investigate the moderating effect of religiosity on the relationship between Muslim young adults' financial strain and financial stress during the COVID-19 pandemic. A survey of 230 Muslim young adults was conducted in Malaysia. Results showed that thirty percent of Muslim young adults fell under high level of financial strain while majority of them fell under high level of financial stress. Additionally, financial strain had a significant positive effect on the financial stress of Muslim young adults. This means that the more financially strained, the more Muslim young adults experienced financial stress during the COVID-19 pandemic. Religiosity, however, did not moderate the relationship between financial strain and financial stress. These results highlighted the significance of comprehending the level of financial strain and financial stress experienced by Muslim young adults during the COVID-19 pandemic. The results provided relevant parties insights in developing strategies for Muslim young adults to manage financial strain and financial stress to reduce the negative effect of the COVID-19 pandemic.
Academy in Factory (AiF) was recently introduced in Malaysia to cater to the talent development and education attainment for a future-ready workforce. Though ideally expected to be an effective initiative, a lack of a strong curriculum framework hinders its implementation. To date the literature on AiF is very limited. It was found that its vague definition and characteristics, non-harmonised interaction between industry and academia, and non-existing curriculum framework are among contributing factors to its ineffective implementation. Thus, this study is aimed at reshaping a curriculum framework that is responsive to its aims and objectives. Building upon an extensive review of literature on AiF, industry-based curriculum, employability and human capital development, and best practices in the international context, the proposed framework is hoped to serve as a reference to improve its current practice.
In this article, we developed a new higher-order implicit finite difference iterative scheme (FDIS) for the solution of the two dimension (2-D) time fractional Cable equation (FCE). In the new proposed FDIS, the time fractional and space derivatives are discretized using the Caputo fractional derivative and fourth-order implicit scheme, respectively. Moreover, the proposed scheme theoretical analysis (convergence and stability) is also discussed using the Fourier analysis method. Finally, some numerical test problems are presented to show the effectiveness of the proposed method.
We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and underwent ultrasonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic (CT) scanning of the liver and biliary tree. All the investigations confirmed a type IVa choledochal cyst. At operation, the grossly dilated biliary system was packed with a thick mucoid material and the mucosa of the bile ducts was visibly abnormal with scattered nodules. This mucoid material had caused occlusion of the entire biliary tree resulting in obstructive jaundice. To the best of our knowledge, this is probably the first report of obstructive jaundice caused by thick mucus. The peculiar management problems of this case and the risk of malignant change in choledochal cysts are discussed.
This study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18-96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0-5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index