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  1. Fulltext Snake Venomics and Antivenomics of Cape Cobra (Naja nivea) from South Africa: Insights into Venom Toxicity and Cross-Neutralization Activity
    Tan CH, Wong KY, Huang LK, Tan KY, Tan NH, Wu WG
    Toxins (Basel), 2022 Dec 07;14(12).
    PMID: 36548757 DOI: 10.3390/toxins14120860
    Naja nivea (Cape Cobra) is endemic to southern Africa. Envenoming by N. nivea is neurotoxic, resulting in fatal paralysis. Its venom composition, however, has not been studied in depth, and specific antivenoms against it remain limited in supply. Applying a protein decomplexation approach, this study unveiled the venom proteome of N. nivea from South Africa. The major components in the venom are cytotoxins/cardiotoxins (~75.6% of total venom proteins) and alpha-neurotoxins (~7.4%), which belong to the three-finger toxin family. Intriguingly, phospholipase A2 (PLA2) was undetected-this is a unique venom phenotype increasingly recognized in the African cobras of the Uraeus subgenus. The work further showed that VINS African Polyvalent Antivenom (VAPAV) exhibited cross-reactivity toward the venom and immunorecognized its toxin fractions. In mice, VAPAV was moderately efficacious in cross-neutralizing the venom lethality with a potency of 0.51 mg/mL (amount of venom completely neutralized per milliliter of antivenom). In the challenge-rescue model, VAPAV prevented death in 75% of experimentally envenomed mice, with slow recovery from neurotoxicity up to 24 h. The finding suggests the potential para-specific utility of VAPAV for N. nivea envenoming, although a higher dose or repeated administration of the antivenom may be required to fully reverse the neurotoxic effect of the venom.
  2. Fulltext Order batching in warehouses by minimizing total tardiness: a hybrid approach of weighted association rule mining and genetic algorithms
    Azadnia AH, Taheri S, Ghadimi P, Saman MZ, Wong KY
    ScientificWorldJournal, 2013;2013:246578.
    PMID: 23864823 DOI: 10.1155/2013/246578
    One of the cost-intensive issues in managing warehouses is the order picking problem which deals with the retrieval of items from their storage locations in order to meet customer requests. Many solution approaches have been proposed in order to minimize traveling distance in the process of order picking. However, in practice, customer orders have to be completed by certain due dates in order to avoid tardiness which is neglected in most of the related scientific papers. Consequently, we proposed a novel solution approach in order to minimize tardiness which consists of four phases. First of all, weighted association rule mining has been used to calculate associations between orders with respect to their due date. Next, a batching model based on binary integer programming has been formulated to maximize the associations between orders within each batch. Subsequently, the order picking phase will come up which used a Genetic Algorithm integrated with the Traveling Salesman Problem in order to identify the most suitable travel path. Finally, the Genetic Algorithm has been applied for sequencing the constructed batches in order to minimize tardiness. Illustrative examples and comparisons are presented to demonstrate the proficiency and solution quality of the proposed approach.
  3. Risk factors associated with outcomes of very low birthweight infants in four Asian countries
    Wariki WM, Mori R, Boo NY, Cheah IG, Fujimura M, Lee J, et al.
    J Paediatr Child Health, 2013 Jan;49(1):E23-7.
    PMID: 23282105 DOI: 10.1111/jpc.12054
    The study aims to determine the risk factors associated with mortality and necrotising enterocolitis (NEC) among very low birthweight infants in 95 neonatal intensive care units in the Asian Network on Maternal and Newborn Health.
  4. Insights into the evolutionary and medical significance of unique alpha-neurotoxin and phospholipase A2 compositions in Naja SPP. (cobra) venoms
    Tan CH, Tan KY, Tan NH, Wong KY
    Toxicon, 2020 Apr 20;177 Suppl 1:S28-S29.
    PMID: 32634978 DOI: 10.1016/j.toxicon.2019.12.027
  5. Insights into the evolutionary and medical significance of unique alpha-neurotoxin and phospholipase A2 compositions in Naja spp. (cobra) venoms
    Tan CH, Tan KY, Tan NH, Wong KY
    Toxicon, 2020 Apr 20;177 Suppl 1:S11-S12.
    PMID: 32634912 DOI: 10.1016/j.toxicon.2019.10.052
  6. Fulltext Dietary supplements: usage and opinions among health sciences students
    Teng CL, Tey KK, Lim PH, Cheng SF, Nordin MS, Ng CM, et al.
    International e-Journal of Science, Medicine & Education, 2008;2(2):30-32.
    MyJurnal
    This is a questionnaire survey of dietary supplement usage among students in the International Medical University. Just over two-fifths of these students reported using dietary supplements daily. This high usage of dietary supplements is in contrast their expressed ambivalence about these products.
  7. Energy-economy-environment assessments of refrigerants R152a and R134a in a vapor compression refrigeration system using a variable displacement oil-free linear compressor
    Fang X, Chiong MC, Jiang X, Yu LJ, Chen X, Muhieldeen MW, et al.
    Environ Sci Pollut Res Int, 2023 Sep;30(45):101223-101233.
    PMID: 37648923 DOI: 10.1007/s11356-023-29521-6
    In light of the adverse environmental impact of the R134a refrigerant, replacing it with a more environmentally friendly refrigerant has become imperative than ever. This study presents an experimental investigation into the utilization of R152a and R134a refrigerants in a vapor compression refrigeration system employing a variable displacement oil-free linear compressor. The potential for the replacement of R134a with R152a was examined based on energy, environmental, and economic performance analyses. The outcomes indicated that R152a exhibited a higher coefficient of performance (COP) in comparison to R134a under identical operating conditions. Specifically, when the pressure ratio was 2.0 and the piston stroke was 11 mm, R152a's COP was 13.0% higher than R134a. It was also discovered that reducing the operating stroke and increasing the pressure ratio could effectively lower CO2 emissions and total costs. Under the 2.0 pressure ratio and 9-mm piston stroke, R134a produced 1082.4 kg more CO2 emissions than R152a, representing a 209% increase. In addition, the R152a and R134a total cost was reduced by 8.3% with the 2.5 pressure ratio and 11-mm piston stroke. Notably, the results of the current study demonstrated that R152a outperformed R134a in energy consumption, environmental friendliness, and economy in oil-free linear compressor refrigeration systems. R152a used less electric power, generated fewer CO2 emissions, and naturally reduced predicted running costs in order to maintain the same COP.
  8. Fulltext Waste heat recovery research - a systematic bibliometric analysis (1991 to 2020)
    Kuah CT, Koh QY, Rajoo S, Wong KY
    Environ Sci Pollut Res Int, 2023 Jun;30(28):72074-72100.
    PMID: 35716302 DOI: 10.1007/s11356-022-21377-6
    Human usage of non-renewable energy resources has caused many environmental issues, which include air pollution, global warming, and climate irregularities. To counter these issues, researchers have been seeking after alternative renewable energy sources and ways to manage energy more efficiently. This is where energy recovery technologies such as waste heat recovery (WHR) come into play. WHR is a form of waste to energy conversion. Waste heat can be captured and converted into usable energy instead of dumping it into the environment. In the more recent years, the WHR research field has gained great attention in the scientific community as well as in some energy-intensive industries. This article presents a bibliometric overview of the academic research on WHR over the span of 30 years from 1991 to 2020. A total of 5682 documents from Web of Science (WoS) have been retrieved and analyzed using various bibliometric methods, including performance analysis and network analysis. The analyses were performed on different actors in the field, i.e., funding agencies, journals, authors, organizations, and countries. In addition, several network mappings were done based on co-citation, co-authorship, and co-occurrences of keywords analyses. The research identified the most productive and influential actors in the field, established and emergent research topics, as well as the interrelations and collaboration patterns between different actors. The findings can be a robust roadmap for further research in this field.
  9. Wildlife resource conservation and utilization for achieving sustainable development in China: main barriers and problem identification
    Du N, Fathollahi-Fard AM, Wong KY
    Environ Sci Pollut Res Int, 2023 Apr 22.
    PMID: 37086322 DOI: 10.1007/s11356-023-26982-7
    The rapid growth of the industrial economy has affected the survival of wildlife, and the decline in wildlife resources will in turn have some negative impact on the industrial economy. For the sustainable development of the industrial economy, human beings began to reflect on traditional development thinking and strive to find a development strategy that harmonizes industrial economic development and resource protection, and wildlife protection gradually attracted people's attention. "Protecting wild animals, maintaining ecological balance, and promoting economic development" has become a hot topic in the new century. Wildlife resources are valuable natural resources and play an important role in the ecosystem, which is related to the well-being and future of human beings. In recent years, China has made great progress in wildlife protection, while protecting and expanding wildlife habitats, introducing relevant laws and regulations, and other measures which have been implemented recently. However, there are still shortcomings in the protection of wildlife in China. Over-utilization, habitat loss and degradation, environmental pollution, climate change, weak legal awareness, and indiscriminate hunting all pose serious threats to wildlife in China. In this regard, this paper summarizes the main problems and barriers to wildlife resource conservation and utilization in China. Based on the analytic hierarchy process (AHP), the main technology factors influencing wildlife resource conservation and utilization in China are identified. Finally, the future research development direction of wildlife conservation is discussed based on the critical factors. This can provide some guidance for developing wildlife resource conservation and utilization for a sustainable ecosystem in China.
  10. Fulltext Assessment of Preservice Music Teachers' Multicultural Personality: Multicultural Music Education Perspective
    Chen S, Wong KY
    Front Psychol, 2022;13:726209.
    PMID: 35602716 DOI: 10.3389/fpsyg.2022.726209
    This study examines preservice music teachers' multicultural personality level and characteristics in the context of multicultural music education in China, focusing on the factors that influence the teachers' multicultural personality traits. We surveyed 433 preservice music teachers who responded via the Multicultural Personality Questionnaire-Short Form survey instrument. The results indicated that the multicultural personality level of preservice music teachers was intermediate, mainly due to a deficiency in the Flexibility and Emotional Stability dimensions, which are necessary for dealing with cultural differences in the face of unknown multicultural conditions. In addition, we also found that the size of a teacher's hometown and the years of studying and teaching are significant factors in shaping preservice music teachers' multicultural personalities. Preservice music teachers whose hometowns are big cities have a higher multicultural personality level than those in rural areas. The more time a preservice music teacher spent studying and teaching, the higher the multicultural personality level. Gender, educational level, and experience playing musical instruments have no statistically significant effect on the multicultural personality of preservice music teachers.
  11. Perspectives on human movement considerations in indoor airflow assessment: a comprehensive data-driven systematic review
    Kek HY, Tan H, Othman MHD, Nyakuma BB, Goh PS, Wong SL, et al.
    Environ Sci Pollut Res Int, 2023 Dec;30(58):121253-121268.
    PMID: 37979109 DOI: 10.1007/s11356-023-30912-y
    Understanding particle dispersion characteristics in indoor environments is crucial for revising infection prevention guidelines through optimized engineering control. The secondary wake flow induced by human movements can disrupt the local airflow field, which enhances particle dispersion within indoor spaces. Over the years, researchers have explored the impact of human movement on indoor air quality (IAQ) and identified noteworthy findings. However, there is a lack of a comprehensive review that systematically synthesizes and summarizes the research in this field. This paper aims to fill that gap by providing an overview of the topic and shedding light on emerging areas. Through a systematic review of relevant articles from the Web of Science database, the study findings reveal an emerging trend and current research gaps on the topic titled Impact of Human Movement in Indoor Airflow (HMIA). As an overview, this paper explores the effect of human movement on human microenvironments and particle resuspension in indoor environments. It delves into the currently available methods for assessing the HMIA and proposes the integration of IoT sensors for potential indoor airflow monitoring. The present study also emphasizes incorporating human movement into ventilation studies to achieve more realistic predictions and yield more practical measures. This review advances knowledge and holds significant implications for scientific and public communities. It identifies future research directions and facilitates the development of effective ventilation strategies to enhance indoor environments and safeguard public health.
  12. Critical review on airborne microplastics: An indoor air contaminant of emerging concern
    Kek HY, Tan H, Othman MHD, Nyakuma BB, Ho WS, Sheng DDCV, et al.
    Environ Res, 2024 Mar 15;245:118055.
    PMID: 38154562 DOI: 10.1016/j.envres.2023.118055
    Airborne Microplastics (MPs), an emerging environmental issue, have gained recent attention due to their newfound presence in indoor environments. Utilizing the Web of Science database for literature collection, the paper presents a comprehensive review of airborne MPs including emission sources, assessment methods, exposure risks, and mitigation strategies. This review delves into the diverse sources and mechanisms influencing indoor airborne MP pollution, underscoring the complex interplay between human activities, ventilation systems, and the characteristics of indoor environments. Major sources include the abrasion of synthetic textiles and the deterioration of flooring materials, with factors like carpeting, airflow, and ventilation significantly impacting MP levels. Human activities, such as increased movement in indoor spaces and the intensive use of plastic-based personal protective equipment (PPE) post-pandemic, notably elevate indoor MP concentrations. The potential health impacts of airborne MPs are increasingly concerning, with evidence suggesting their role in respiratory, immune, and nervous system diseases. Despite this, there is a scarcity of information on MPs in diverse indoor environments and the inhalation risks associated with the frequent use of PPE. This review also stresses the importance of developing effective strategies to reduce MP emissions, such as employing HEPA-filtered vacuums, minimizing the use of synthetic textiles, and enhancing indoor ventilation. Several future research directions were proposed, including detailed temporal analyses of indoor MP levels, interactions of MP with other atmospheric pollutants, the transport dynamics of inhalable MPs (≤10 μm), and comprehensive human exposure risk assessments.
  13. Turning plastics/microplastics into valuable resources? Current and potential research for future applications
    Tan H, Othman MHD, Chong WT, Kek HY, Wong SL, Nyakuma BB, et al.
    J Environ Manage, 2024 Apr;356:120644.
    PMID: 38522274 DOI: 10.1016/j.jenvman.2024.120644
    Plastics are a wide range of synthetic or semi-synthetic materials, mainly consisting of polymers. The use of plastics has increased to over 300 million metric tonnes in recent years, and by 2050, it is expected to grow to 800 million. Presently, a mere 10% of plastic waste is recycled, with approximately 75% ended up in landfills. Inappropriate disposal of plastic waste into the environment poses a threat to human lives and marine species. Therefore, this review article highlights potential routes for converting plastic/microplastic waste into valuable resources to promote a greener and more sustainable environment. The literature review revealed that plastics/microplastics (P/MP) could be recycled or upcycled into various products or materials via several innovative processes. For example, P/MP are recycled and utilized as anodes in lithium-ion (Li-ion) and sodium-ion (Na-ion) batteries. The anode in Na-ion batteries comprising PP carbon powder exhibits a high reversible capacity of ∼340 mAh/g at 0.01 A/g current state. In contrast, integrating Fe3O4 and PE into a Li-ion battery yielded an excellent capacity of 1123 mAh/g at 0.5 A/g current state. Additionally, recycled Nylon displayed high physical and mechanical properties necessary for excellent application as 3D printing material. Induction heating is considered a revolutionary pyrolysis technique with improved yield, efficiency, and lower energy utilization. Overall, P/MPs are highlighted as abundant resources for the sustainable production of valuable products and materials such as batteries, nanomaterials, graphene, and membranes for future applications.
  14. Transforming Pollution into Solutions: A Bibliometric Analysis and Sustainable Strategies for Reducing Indoor Microplastics while Converting to Value-Added Products
    Kek HY, Tan H, Othman MHD, Lee CT, Ahmad FBJ, Ismail ND, et al.
    Environ Res, 2024 Apr 16.
    PMID: 38636646 DOI: 10.1016/j.envres.2024.118928
    Microplastics (MPs), as emerging indoor contaminants, have garnered attention due to their ubiquity and unresolved implications for human health. These tiny particles have permeated indoor air and water, leading to inevitable human exposure. Preliminary evidence suggests MP exposure could be linked to respiratory, gastrointestinal, and potentially other health issues, yet the full scope of their effects remains unclear. To map the overall landscape of this research field, a bibliometric analysis based on research articles retrieved from the Web of Science database was conducted. The study synthesizes the current state of knowledge and spotlights the innovative mitigation strategies proposed to curb indoor MP pollution. These strategies involve minimizing the MP emission from source, advancements in filtration technology, aimed at reducing the MP exposure. Furthermore, this research sheds light on cutting-edge methods for converting MP waste into value-added products. These innovative approaches not only promise to alleviate environmental burdens but also contribute to a more sustainable and circular economy by transforming waste into resources such as biofuels, construction materials, and batteries. Despite these strides, this study acknowledges the ongoing challenges, including the need for more efficient removal technologies and a deeper understanding of MPs' health impacts. Looking forward, the study underscores the necessity for further research to fill these knowledge gaps, particularly in the areas of long-term health outcomes and the development of standardized, reliable methodologies for MP detection and quantification in indoor settings. This comprehensive approach paves the way for future exploration and the development of robust solutions to the complex issue of microplastic pollution.
  15. Fulltext Secondary school teachers psychological status and competencies in e-teaching during Covid-19
    Wong KY, Sulaiman T, Ibrahim A, Kunchi Mohd AG, Hassan Hussin O, Wan Jaafar WM
    Heliyon, 2021 Nov;7(11):e08238.
    PMID: 34722941 DOI: 10.1016/j.heliyon.2021.e08238
    PRESENTS PROBLEM/FOCUS OF STUDY: The Covid-19 outbreak has had a staggering impact on the global economy, public health and safety, trade and education. In Malaysia, the government implemented the Movement Control Order (MCO) as a preventive measure against Covid-19. In education, the learning process has been transferred to online teaching. However, pandemic pedagogy is making learning into completely online either synchronous or asynchronous. Therefore, the current research aims to determine the secondary school teachers' psychological status, competencies in e-teaching and teachers work motivation as well as determine the relationship between secondary school teachers' psychological status and competencies in e-teaching during the Covid-19 outbreak.

    DESIGN/METHODOLOGY/APPROACH: Current research is a descriptive-correlational quantitative survey to determine teachers' psychological status, e-teaching competencies and working motivation during Movement Control Order (MCO) to contain the Covid-19 pandemic. The study sample consists of 595 secondary school teachers selected via convenient sampling. Quantitative data are collected from an online survey through the questionnaires with demographic, psychological status (stress, anxiety and depression), e-teaching competencies (teaching, monitoring and evaluation) and teaching motivation developed by the researchers were distributed during the MCO period. SPSS 25 is applied, Statistical measures such as Cronbach's alpha, means, percentage and standard deviation were employed to analyze the data to obtain the value of the school teachers' psychological status, e-teaching competencies and teaching motivation. Consequently, a Pearson correlation table was created to show the analysis of the school teachers' psychological status and competencies in e-teaching.

    FINDINGS: This finding indicated that the teachers' psychological factors in stress, anxiety and depressed are moderate, the teachers' competencies in e-teaching is moderate as well as teachers' working motivations is also the moderate level. However, the highest mean value was found among the variables, this is revealed that despite the challenges during the Covid-19 outbreak, teachers showed positive and strong motivation in conducting e-teaching. Additionally, the result showed a negative relationship between psychological status and e-teaching competencies (-0.286, p < 0.01), as well as reported a negative relationship between dimension of psychological status and competencies in e-teaching.

    LIMITATION & RECOMMENDATIONS: This study has its limitations. This study is included only Selangor teachers and given that the information obtained from the study was gather from secondary schools, the generalizability might be limited. future research may consider expanding the scope from secondary schools to primary schools' teachers and then to university lecturers. Perhaps the scope is expanding, so more information could be obtaining and help researchers understand the teachers' competencies in e-teaching, psychological status and work motivation.

  16. Fulltext Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age
    Swami V, Tran US, Stieger S, Aavik T, Ranjbar HA, Adebayo SO, et al.
    Body Image, 2023 Sep;46:449-466.
    PMID: 37582318 DOI: 10.1016/j.bodyim.2023.07.010
    The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.
  17. Fulltext The association of the dietary approach to stop hypertension (DASH) diet with blood pressure, glucose and lipid profiles in Malaysian and Philippines populations
    Tiong XT, Nursara Shahirah A, Pun VC, Wong KY, Fong AYY, Sy RG, et al.
    Nutr Metab Cardiovasc Dis, 2018 08;28(8):856-863.
    PMID: 29853430 DOI: 10.1016/j.numecd.2018.04.014
    BACKGROUND AND AIM: Despite a growing body of evidence from Western populations on the health benefits of Dietary Approaches to Stop Hypertension (DASH) diets, their applicability in South East Asian settings is not clear. We examined cross-sectional associations between DASH diet and cardio-metabolic risk factors among 1837 Malaysian and 2898 Philippines participants in a multi-national cohort.

    METHODS AND RESULTS: Blood pressures, fasting lipid profile and fasting glucose were measured, and DASH score was computed based on a 22-item food frequency questionnaire. Older individuals, women, those not consuming alcohol and those undertaking regular physical activity were more likely to have higher DASH scores. In the Malaysian cohort, while total DASH score was not significantly associated with cardio-metabolic risk factors after adjusting for confounders, significant associations were observed for intake of green vegetable [0.011, standard error (SE): 0.004], and red and processed meat (-0.009, SE: 0.004) with total cholesterol. In the Philippines cohort, a 5-unit increase in total DASH score was significantly and inversely associated with systolic blood pressure (-1.41, SE: 0.40), diastolic blood pressure (-1.09, SE: 0.28), total cholesterol (-0.015, SE: 0.005), low-density lipoprotein cholesterol (-0.025, SE: 0.008), and triglyceride (-0.034, SE: 0.012) after adjusting for socio-demographic and lifestyle groups. Intake of milk and dairy products, red and processed meat, and sugared drinks were found to significantly associated with most risk factors.

    CONCLUSIONS: Differential associations of DASH diet and dietary components with cardio-metabolic risk factors by country suggest the need for country-specific tailoring of dietary interventions to improve cardio-metabolic risk profiles.

  18. The Body Acceptance by Others Scale-2 (BAOS-2): Psychometric properties of a Bahasa Malaysia (Malay) translation and an assessment of invariance across Malaysia, the United Kingdom, and the United States
    Swami V, Todd J, Barron D, Wong KY, Zahari HS, Tylka TL
    Body Image, 2021 Sep;38:346-357.
    PMID: 34091281 DOI: 10.1016/j.bodyim.2021.05.009
    The Body Acceptance by Others Scale-2 (BAOS-2) is a 13-item instrument measuring generalised perceptions of body acceptance by others. Here, we first demonstrate that a Bahasa Malaysia (Malay) translation of the BAOS-2 is psychometrically valid in a sample of 1,049 Malaysian adults (Study 1). Using exploratory and confirmatory factor analysis, we extracted a unidimensional model of BAOS-2 scores that retained all 13 items. BAOS-2 scores had adequate internal consistency and indices of validity (convergent, construct, concurrent, and incremental), and were scalar invariant across gender and ethnicity (Malaysian Malays vs. Chinese). Next, we assessed invariance of BAOS-2 scores across samples from Malaysia, the United Kingdom, and the United States (total N = 2,575; Study 2). Multi-group confirmatory factor analysis showed that partial scalar invariance was achieved. Participants in the interdependent cultural context of Malaysia had significantly higher scores - with small effect sizes - than their counterparts in the independent contexts of the United Kingdom and United States. In addition, women had significantly higher scores than men, but the effect size was negligible. The present study indicates that the Malay BAOS-2 is a psychometrically valid instrument and presents the first comparison of BAOS-2 scores across interdependent and independent contexts.
  19. Is pre-stroke frailty as determined by the Clinical Frailty Scale version 2.0 associated with stroke outcomes?
    Ng CC, Lim WC, Tan KM, Wong KY, Kanagarajah RR, Singh HSAK, et al.
    Singapore Med J, 2023 Mar 06.
    PMID: 36926745 DOI: 10.4103/singaporemedj.SMJ-2021-187
  20. The effect of 20-minute mindful breathing exercise on psychological well-being in epilepsy: A pilot randomized controlled trial
    Lim KS, Fong SL, Yu X, Lim YH, Wong KY, Lai ST, et al.
    Epilepsy Behav, 2024 Apr 17;155:109778.
    PMID: 38636139 DOI: 10.1016/j.yebeh.2024.109778
    INTRODUCTION: Depression and anxiety are prevalent in epilepsy patients, but psychiatric or psychological services may not be accessible to all patients. This study aimed to determine the effectiveness of the 20-minute mindful breathing on the psychological well-being of PWE using an instructional video.

    METHOD: This was a pilot, assessor-blinded, randomized controlled trial. The intervention group received a guided video and was briefed to perform the exercise twice a week for two weeks while the waitlist control group only received the video upon completion of the study. The subjects were assessed at three-time points (T0: Baseline, T1: 2 weeks after the intervention, T2: 4 weeks after intervention), using the Neurological Disorders Depression Index (NDDI-E), General Anxiety Disorder (GAD-7), Quality of Life in Epilepsy Inventory (QOLIE-31) and Mindfulness Attention Awareness Scale (MAAS).

    RESULTS: Twenty patients were recruited, with 10 in the intervention and waitlist-control groups. Compared with the waitlist-control group, participants in the intervention group showed significant improvement in NDDI-E at T1 (p = 0.022) but not at T2 (p = 0.056) and greater improvement in GAD-7 at T1 and T2 but not statistically significant. The QOLIE-31 overall score in the intervention group has significantly improved at T1 (p = 0.036) and T2 (p = 0.031) compared to the waitlist-control group. For MAAS, the intervention group also had an increased score at T2 (p = 0.025).

    CONCLUSION: The 20-minute mindfulness breathing exercise has an immediate effect in improving depression and quality of life among people with epilepsy.

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