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  1. A Hamid MS, Sazlina SG
    PLoS One, 2019;14(1):e0209746.
    PMID: 30625165 DOI: 10.1371/journal.pone.0209746
    BACKGROUND: Childhood overweight and obesity has emerged as a major public health threat worldwide with challenges in its management. This review assessed the effectiveness of interventions for childhood overweight and obesity.

    METHODS: A systematic literature search was conducted using CINAHL, EMBASE, Ovid MEDLINE, PsycINFO and SPORTDiscus databases to retrieve articles published from 1st January 2000 to 31st December 2017. Randomised controlled trials (RCTs) and quasi-experimental studies comparing different strategies in managing overweight and obesity among schoolchildren (6 to 12 years of age) were included. The main outcomes of interest were reductions in weight related variables included anthropometry and body composition measurements. All variables were analysed using random effects meta-analyses.

    RESULTS: Fourteen studies were reviewed, 13 were RCTs and one was a quasi-experimental study. The risk of bias for randomisation was low risk for all of RCTs except for one, which was unclear. The risk of bias for randomisation was high for the quasi-experimental study. Most interventions incorporated lifestyle changes and behavioural strategies such as coping and problem solving skills with family involvement. The meta-analyses did not show significant effects of the intervention in reducing weight related outcomes when compared with controls.

    CONCLUSION: Meta-analyses of the selected studies did not show significant effects of the interventions on weight related outcomes among overweight and obese schoolchildren when compared with controls. The role of interdisciplinary team approaches with family involvement using behaviour and lifestyle strategies to curb obesity among schoolchildren is important.

  2. A Hamid MS, Sazlina SG
    PLoS One, 2021;16(5):e0251111.
    PMID: 33970936 DOI: 10.1371/journal.pone.0251111
    Shoulder rotator cuff tendinopathy is a common debilitating condition that affects a person daily function and the quality of life. Despite its frequent occurrence, the best treatment is still inconclusive. This review assessed the clinical effect of platelet-rich plasma injection for rotator cuff tendinopathy. A systematic literature search was conducted using CINAHL, Medline, SCOPUS, SPORTSDiscus and Web of Science databases to retrieve articles published in peer-reviewed journals until December 2020. Randomised controlled trials (RCTs), which compared clinical effects of PRP injection to the usual care among adults diagnosed with rotator cuff conditions were reviewed. The main outcomes of interest were changes in shoulder pain symptoms and shoulder functions. All variables were analysed using random effects meta-analyses. Eight RCTs were reviewed in this study. The risk of bias for randomization was low for 6 RCTs, one study had unclear risk and the other was a high risk. Studies vary on the PRP techniques including preparation and injections. Moreover, the control intervention also differs. Four studies compared PRP with normal saline injection while in the remaining 4 RCTs the control intervention were rehabilitation program and dry needling. Meta-analysis of selected studies showed that PRP injection was safe and effective intervention for long-term pain control and shoulder function in patients with RC disorders.
  3. A MH, C A R N, S M C, S R, P M, R H WS, et al.
    PLoS One, 2023;18(7):e0288325.
    PMID: 37459344 DOI: 10.1371/journal.pone.0288325
    INTRODUCTION: The current and simpler healthy eating concept 'Malaysian Healthy Plate', was introduced in 2016. This study aims to determine the prevalence of ever-never heard, understanding, and practice of this concept and also the associated factors to never-heard of Malaysian Health Plate after three years of the implementation.

    METHODOLOGY: This study utilized the data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional survey that applied two-stage stratified cluster sampling. Questionnaires pertained to ever heard, knowledge, and practised of Malaysian Healthy Plate were asked along with another questionnaire. Complex sample analysis was applied to fit with the study design.

    RESULTS: Estimated 16.9 million (79.6%) adults in Malaysia were never heard of the Malaysian Healthy Plate Concept in 2019. Never heard of this concept was significantly associated with sex (men, aOR 0.265), ethnicity (other ethnicities, aOR 1.79), an education level (no education, aOR 9.59; primary, aOR 3.50; secondary, aOR 1.70), occupation (private, aOR 2.16; self-employed, aOR 2.31; retirees, aOR 1.69; student, aOR 2.31; unpaid workers, aOA 2.35; not working, aOR 2.86), non-diabetes aOR 1.43, and low fruit and vegetable intake person aOR 1.86. Meanwhile, another 20.4% or an estimated 4.3 million adults who were ever heard of Malaysian Healthy Plate. Among those who are ever heard, 80.8% (3.5 million) correctly interpreted or understood the concept and among those who ever heard and understood the concept, only 70.5% (2.5 million) have been practising it daily or occasionally.

    CONCLUSIONS: Four-fifth of adults never heard of the 'Malaysian Healthy Plate' and among those who ever heard, the understanding and practising of the concept were probably unsatisfactory. Multisectoral collaboration is an urge to fasten the promotion to spark awareness and educate the public to practice the concept to promote healthy eating and a healthier nation.

  4. Aalsalem MY, Khan WZ, Saad NM, Hossain MS, Atiquzzaman M, Khan MK
    PLoS One, 2016;11(7):e0158072.
    PMID: 27409082 DOI: 10.1371/journal.pone.0158072
    Wireless Sensor Networks (WSNs) are vulnerable to Node Replication attacks or Clone attacks. Among all the existing clone detection protocols in WSNs, RAWL shows the most promising results by employing Simple Random Walk (SRW). More recently, RAND outperforms RAWL by incorporating Network Division with SRW. Both RAND and RAWL have used SRW for random selection of witness nodes which is problematic because of frequently revisiting the previously passed nodes that leads to longer delays, high expenditures of energy with lower probability that witness nodes intersect. To circumvent this problem, we propose to employ a new kind of constrained random walk, namely Single Stage Memory Random Walk and present a distributed technique called SSRWND (Single Stage Memory Random Walk with Network Division). In SSRWND, single stage memory random walk is combined with network division aiming to decrease the communication and memory costs while keeping the detection probability higher. Through intensive simulations it is verified that SSRWND guarantees higher witness node security with moderate communication and memory overheads. SSRWND is expedient for security oriented application fields of WSNs like military and medical.
  5. Ab Mumin N, Ramli Hamid MT, Abdul Hamid S, Chiew SF, Ahmad Saman MS, Rahmat K
    PLoS One, 2023;18(8):e0290772.
    PMID: 37624821 DOI: 10.1371/journal.pone.0290772
    OBJECTIVE: To assess the association between breast cancer tumour stroma and magnetic resonance imaging (MRI) features.

    MATERIALS AND METHODS: A total of 84 patients with treatment-naïve invasive breast cancer were enrolled into this retrospective study. The tumour stroma ratio (TSR) was estimated from the amount of tumour stroma in the pathology specimen of the breast tumour. The MRI images of the patients were analysed based on Breast Imaging Reporting and Data Systems (ACR-BIRADS) for qualitative features which include T2- weighted, diffusion-weighted images (DWI) and dynamic contrast-enhanced (DCE) for kinetic features. The mean signal intensity (SI) of Short Tau Inversion Recovery (STIR), with the ratio of STIR of the lesion and pectoralis muscle (L/M ratio) and apparent diffusion coefficient (ADC) value, were measured for the quantitative features. Correlation tests were performed to assess the relationship between TSR and MRI features.

    RESULTS: There was a significant correlation between the margin of mass, enhancement pattern, and STIR signal intensity of breast cancer and TSR. There were 54.76% (n = 46) in the low stromal group and 45.24% (n = 38) in the high stromal group. A significant association were seen between the margin of the mass and TSR (p = 0.034) between the L/M ratio (p <0.001), and between STIR SI of the lesion and TSR (p<0.001). The median L/M ratio was significantly higher in the high TSR group as compared to the lower TSR group (p < 0.001).

    CONCLUSION: Breast cancer with high stroma had spiculated margins, lower STIR signal intensity, and a heterogeneous pattern of enhancement. Hence, in this preliminary study, certain MRI features showed a potential to predict TSR.

  6. Ab Rasid AM, Muazu Musa R, Abdul Majeed APP, Musawi Maliki ABH, Abdullah MR, Mohd Razmaan MA, et al.
    PLoS One, 2024;19(2):e0296467.
    PMID: 38329954 DOI: 10.1371/journal.pone.0296467
    The identification and prediction of athletic talent are pivotal in the development of successful sporting careers. Traditional subjective assessment methods have proven unreliable due to their inherent subjectivity, prompting the rise of data-driven techniques favoured for their objectivity. This evolution in statistical analysis facilitates the extraction of pertinent athlete information, enabling the recognition of their potential for excellence in their respective sporting careers. In the current study, we applied a logistic regression-based machine learning pipeline (LR) to identify potential skateboarding athletes from a combination of fitness and motor skills performance variables. Forty-five skateboarders recruited from a variety of skateboarding parks were evaluated on various skateboarding tricks while their fitness and motor skills abilities that consist of stork stance test, dynamic balance, sit ups, plank test, standing broad jump, as well as vertical jump, were evaluated. The performances of the skateboarders were clustered and the LR model was developed to classify the classes of the skateboarders. The cluster analysis identified two groups of skateboarders: high and low potential skateboarders. The LR model achieved 90% of mean accuracy specifying excellent prediction of the skateboarder classes. Further sensitivity analysis revealed that static and dynamic balance, lower body strength, and endurance were the most important factors that contributed to the model's performance. These factors are therefore essential for successful performance in skateboarding. The application of machine learning in talent prediction can greatly assist coaches and other relevant stakeholders in making informed decisions regarding athlete performance.
  7. Ababneh BF, Ong SC, Hussain R
    PLoS One, 2023;18(3):e0282991.
    PMID: 36897873 DOI: 10.1371/journal.pone.0282991
    INTRODUCTION: There is a lack of attention to drive-thru services in the community pharmacy setting, particularly during the COVID-19 period in Malaysia. The main objective of this study was to assess the public awareness, attitudes, and perceptions towards drive-thru community pharmacy services among during COVID-19 in Malaysia.

    METHODS: A cross-sectional study was conducted using a self-administrated, web-based survey (Google form) among the public in Malaysia between May and June 2022. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the use of drive-thru community pharmacy services were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with perceptions towards drive-thru community pharmacy services.

    RESULTS: A total of 565 (70.6%) of the general public completed the survey instrument. The median age of study participants was 40.0 (IQR = 36.0) and about half of them were males (50.6%, n = 286). Although 18.6% (n = 105) of the participants reported the presence of DTCPS in their cities, only 9.0% (n = 51) reported having used this service. Most of the participants were supportive to establish drive-thru services at community pharmacies in the country. Most of the believed advantages among participants were that DTCPS are helpful during COVID-19 and quarantine time 48.0% (n = 271) by enhancing social distancing and reducing the spread of the COVID-19 virus 48.5% (n = 274). Among sociodemographic factors, non-Malaysian nationality (p<0.001), and age above 55 years (p = 0.01) were found to negatively affect participants' perceptions towards drive-thru community pharmacy services.

    CONCLUSION: This study showed positive awareness, attitudes, and perceptions toward drive-thru community pharmacy services during COVID-19 in Malaysia among the public. The participants believed that those services were helpful during COVID-19 to enhance social distancing and to reduce the spread of the COVID-19 virus.

  8. Abas A, Gan ZL, Ishak MH, Abdullah MZ, Khor SF
    PLoS One, 2016;11(7):e0159357.
    PMID: 27454872 DOI: 10.1371/journal.pone.0159357
    This paper studies the three dimensional (3D) simulation of fluid flows through the ball grid array (BGA) to replicate the real underfill encapsulation process. The effect of different solder bump arrangements of BGA on the flow front, pressure and velocity of the fluid is investigated. The flow front, pressure and velocity for different time intervals are determined and analyzed for potential problems relating to solder bump damage. The simulation results from Lattice Boltzmann Method (LBM) code will be validated with experimental findings as well as the conventional Finite Volume Method (FVM) code to ensure highly accurate simulation setup. Based on the findings, good agreement can be seen between LBM and FVM simulations as well as the experimental observations. It was shown that only LBM is capable of capturing the micro-voids formation. This study also shows an increasing trend in fluid filling time for BGA with perimeter, middle empty and full orientations. The perimeter orientation has a higher pressure fluid at the middle region of BGA surface compared to middle empty and full orientation. This research would shed new light for a highly accurate simulation of encapsulation process using LBM and help to further increase the reliability of the package produced.
  9. Abbas M, Majid AA, Md Ismail AI, Rashid A
    PLoS One, 2014;9(1):e83265.
    PMID: 24427270 DOI: 10.1371/journal.pone.0083265
    In this paper, a numerical method for the solution of a strongly coupled reaction-diffusion system, with suitable initial and Neumann boundary conditions, by using cubic B-spline collocation scheme on a uniform grid is presented. The scheme is based on the usual finite difference scheme to discretize the time derivative while cubic B-spline is used as an interpolation function in the space dimension. The scheme is shown to be unconditionally stable using the von Neumann method. The accuracy of the proposed scheme is demonstrated by applying it on a test problem. The performance of this scheme is shown by computing L∞ and L2 error norms for different time levels. The numerical results are found to be in good agreement with known exact solutions.
  10. Abbasi A, Woo CS, Ibrahim RW, Islam S
    PLoS One, 2015;10(4):e0123427.
    PMID: 25884854 DOI: 10.1371/journal.pone.0123427
    Digital image watermarking is an important technique for the authentication of multimedia content and copyright protection. Conventional digital image watermarking techniques are often vulnerable to geometric distortions such as Rotation, Scaling, and Translation (RST). These distortions desynchronize the watermark information embedded in an image and thus disable watermark detection. To solve this problem, we propose an RST invariant domain watermarking technique based on fractional calculus. We have constructed a domain using Heaviside function of order alpha (HFOA). The HFOA models the signal as a polynomial for watermark embedding. The watermark is embedded in all the coefficients of the image. We have also constructed a fractional variance formula using fractional Gaussian field. A cross correlation method based on the fractional Gaussian field is used for watermark detection. Furthermore the proposed method enables blind watermark detection where the original image is not required during the watermark detection thereby making it more practical than non-blind watermarking techniques. Experimental results confirmed that the proposed technique has a high level of robustness.
  11. Abbasi GA, Tiew LY, Tang J, Goh YN, Thurasamy R
    PLoS One, 2021;16(3):e0247582.
    PMID: 33684120 DOI: 10.1371/journal.pone.0247582
    In recent years, the growth of cryptocurrency has undergone an enormous increase in cryptocurrency markets all around the world. Sadly, only insignificant heed has been paid to the unveiling of determinants of cryptocurrency adoption globally, particularly in emerging markets like Malaysia. The purpose of the study is to examine whether the application of deep learning-based dual-stage Partial Least Square-Structural Equation Modelling (PLS-SEM) & Artificial Neural Network (ANN) analysis enable better in-depth research results as compared to single-step PLS-SEM approach and to excavate factors which can predict behavioural intention to adopt cryptocurrency. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model were extended with the inclusion of trust and personnel innovativeness. The model was further validated by introducing a new path model compared to the original UTAUT2 model and the moderating role of personal innovativeness between performance expectancy and price value, with a sample of 314 respondents. Contrary to previous technology adoption studies that used PLS-SEM & ANN as single-stage analysis, this study further enhanced the analysis by applying a deep learning-based dual-stage PLS-SEM and ANN method. The application of deep learning-based dual-stage PLS-SEM & ANN analysis is a novel methodological approach, detecting both linear and non-linear associations among constructs. At the same time, it is regarded as a superior statistical approach as compared to traditional hybrid shallow SEM & ANN single-stage analysis. Also, sensitivity analysis provides normalised importance using multi-layer perceptron with the feed-forward-back-propagation algorithm. Furthermore, the deep learning-based dual-stage PLS-SEM & ANN revealed that trust proved to be the strongest predictor in driving user intention. The introduction of this new methodology and the theoretical contribution opens the vistas of the extant body of knowledge in technology-adoption related literature. This study also provides theoretical, practical and methodological contributions.
  12. Abbasi IA, Jan SU, Alqahtani AS, Khan AS, Algarni F
    PLoS One, 2024;19(1):e0294429.
    PMID: 38289970 DOI: 10.1371/journal.pone.0294429
    Cloud computing is vital in various applications, such as healthcare, transportation, governance, and mobile computing. When using a public cloud server, it is mandatory to be secured from all known threats because a minor attacker's disturbance severely threatens the whole system. A public cloud server is posed with numerous threats; an adversary can easily enter the server to access sensitive information, especially for the healthcare industry, which offers services to patients, researchers, labs, and hospitals in a flexible way with minimal operational costs. It is challenging to make it a reliable system and ensure the privacy and security of a cloud-enabled healthcare system. In this regard, numerous security mechanisms have been proposed in past decades. These protocols either suffer from replay attacks, are completed in three to four round trips or have maximum computation, which means the security doesn't balance with performance. Thus, this work uses a fuzzy extractor method to propose a robust security method for a cloud-enabled healthcare system based on Elliptic Curve Cryptography (ECC). The proposed scheme's security analysis has been examined formally with BAN logic, ROM and ProVerif and informally using pragmatic illustration and different attacks' discussions. The proposed security mechanism is analyzed in terms of communication and computation costs. Upon comparing the proposed protocol with prior work, it has been demonstrated that our scheme is 33.91% better in communication costs and 35.39% superior to its competitors in computation costs.
  13. Abbasi SH, Aftab RA, Chua SS
    PLoS One, 2020;15(6):e0234376.
    PMID: 32569265 DOI: 10.1371/journal.pone.0234376
    BACKGROUND: Profound healthcare challenges confront societies with an increase in prevalence of end-stage renal disease (ESRD), which is one of the leading causes of morbidity and mortality worldwide. Due to several facility and patient related factors, ESRD is significantly associated with increased morbidity and mortality attributed to infections.

    AIMS AND OBJECTIVE: The aim of this study was to assess systematically the characteristics of patients and risk factors associated with nosocomial infections among ESRD patients undergoing hemodialysis.

    METHODS: A systematic literature search was performed to identify eligible studies published during the period from inception to December 2018 pertaining to risk factors associated with nosocomial infections among hemodialysis patients. The relevant studies were generated through a computerized search on five databases (PubMed, EBSCOhost, Google Scholar, ScienceDirect and Scopus) using the Mesh Words: nosocomial infections, hospital acquired infections, healthcare associated infections, end stage renal disease, end stage renal failure, hemodialysis, and risk factors. The complete protocol has been registered under PROSPERO (CRD42019124099).

    RESULTS: Initially, 1411 articles were retrieved. Out of these, 24 were duplicates and hence were removed. Out of 1387 remaining articles, 1337 were removed based on irrelevant titles and/or abstracts. Subsequently, the full texts of 50 articles were reviewed and 41 studies were excluded at this stage due to lack of relevant information. Finally, nine articles were selected for this review. Longer hospital stay, longer duration on hemodialysis, multiple catheter sites, longer catheterization, age group, lower white blood cell count, history of blood transfusion, and diabetes were identified as the major risk factors for nosocomial infections among hemodialysis patients.

    CONCLUSION: The results of this review indicate an information gap and potential benefits of additional preventive measures to further reduce the risk of infections in hemodialysis population. Moreover, several patient-related and facility-related risk factors were consistently observed in the studies included in this review, which require optimal control measures.

  14. Abd Khalim MA, Sukeri S
    PLoS One, 2023;18(1):e0278404.
    PMID: 36649258 DOI: 10.1371/journal.pone.0278404
    Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.
  15. Abd Majid M, Zainol Ariffin KA
    PLoS One, 2021;16(11):e0260157.
    PMID: 34797896 DOI: 10.1371/journal.pone.0260157
    Cyberattacks have changed dramatically and have become highly advanced. This latest phenomenon has a massive negative impact on organizations, such as financial losses and shutting-down of operations. Therefore, developing and implementing the Cyber Security Operations Centre (SOC) is imperative and timely. Based on previous research, there are no international guidelines and standards used by organizations that can contribute to the successful implementation and development of SOC. In this regard, this study focuses on highlighting the significant factors that will impact and contribute to the success of SOC. Simultaneously, it will further design a model for the successful development and implementation of SOC for the organization. The study was conducted quantitatively and involved 63 respondents from 25 ministries and agencies in Malaysia. The results of this study will enable the retrieval of ten success factors for SOC, and it specifically focuses on humans, processes, and technology. The descriptive analysis shows that the top management support factor is the most influential factor in the success of the development and implementation of SOC. The study also contributes to the empirical finding that technology and process factors are more significant in the success of SOCs. Based on the regression test, the technology factor has major impact on determining the success of SOC, followed by the process and human factors. Relevant organizations or agencies can use the proposed model to develop and implement SOCs, formulate policies and guidelines, strengthen human models, and enhance cyber security.
  16. Abd Rahim IN, Mohd Kasim NA, Omar E, Abdul Muid S, Nawawi H
    PLoS One, 2024;19(1):e0295212.
    PMID: 38207245 DOI: 10.1371/journal.pone.0295212
    Previous research has shown that natural medications pose health risks, especially in subjects with comorbidities. This study aimed to evaluate the safety of saffron ethanolic extract (SEE) administration in early and established atherosclerotic rabbits. Rabbits were given a high-cholesterol diet (HCD) for 4 and 8 weeks to induce early and established atherosclerosis respectively, and then they were treated with 50 and 100 mg/kg/day SEE. The body weight of the animals was recorded. Blood samples were collected at baseline, pre-treatment, and post-treatment for hematological studies, lipid profiles, and biochemical profiles. Tissue specimens of the vital organs were subjected to histological examination. The above parameters were significantly altered post-intervention with 4 and 8 weeks of HCD. No significant differences in body weight were observed in all the groups post-treatment with 50 and 100mg/kg of SEE compared to pre-treatment. However, low-density lipoprotein cholesterol, total cholesterol, serum urea, and glucose significantly decreased post-treatment with 50 and 100mg/kg/day SEE compared to pre-treatment in early and established atherosclerosis groups. Hematological parameters that were affected post-intervention with HCD returned to their baseline values post-treatment with 50 and 100mg/kg/day SEE. There was a significant improvement in the vital organs post-treatment with 50 and 100mg/kg SEE. SEE can safely be administered without causing harmful effects on the hematological, biochemical profiles, and vital organs. Notably, SEE exerts hypolipidemic and hypoglycemic effects on atherosclerotic conditions. Further clinical trials are warranted to ensure the safety of saffron administration in patients with atherosclerosis-related diseases.
  17. Abd Rahman M, Ahmad Zaki R, Sarimin R, Ariff MI, Suli Z, Mahmud M, et al.
    PLoS One, 2017;12(11):e0184559.
    PMID: 29095822 DOI: 10.1371/journal.pone.0184559
    The Malaysian Dengue Clinical Practice Guidelines (CPG) have been developed to provide evidence-based guidance in the management of dengue infections. The use of these guidelines is essential to ensure its recommendations are being practiced. However, the adherence to the guidelines for management of dengue (revised 2nd edition) by healthcare providers still remains unknown. Therefore, the aim of this study was to evaluate the proportion among healthcare providers that adhere to this Dengue CPG. A retrospective cohort study of dengue cases registered from 1 January 2014 to 1 June 2015 was conducted in public hospitals and health clinics in Selangor, Putrajaya and Kuala Lumpur. Adherence to the CPG recommendations were recorded by reviewing patients' case notes. Overall proportion of adherence in clinical components of the recommendation were (7.1 to 100.0% versus 7.7 to 73.8%) in history taking, (6.7 to 100.0% versus 12.3 to 60.0%) in physical examinations, (18.4 to 100.0% versus 23.1 to 83.2%) in assessment of warning signs, (0.6 to 100.0% versus 12.3 to 87.7%) in assessment of haemodynamic status, (60.0 to 100.0% versus 27.7 to 40.0%) in diagnosis, (46.6 to 80.0% versus 52.3%) in case notifications, (73.2 to 100.0% versus 89.2 to 96.9%) in performing specific laboratory investigations and (7.9 to 100.0% versus 21.5%) in monitoring, for outpatient versus inpatient, respectively. Adherence trends were demonstrated to be higher in hospital settings compared to outpatient settings. Adherence to this Dengue CPG varies widely with overall good clinical outcomes observed.

    Study site: public hospitals and health clinics in Selangor, Putrajaya and Kuala Lumpur
  18. Abd Rahman R, Idris IB, Md Isa Z, Abd Rahman R
    PLoS One, 2022;17(12):e0278192.
    PMID: 36473006 DOI: 10.1371/journal.pone.0278192
    Anemia in pregnancy is a public health concern. It has been diagnosed in 27% of pregnant women in Malaysia and up to 40% of pregnant women globally. This study aimed to develop and evaluate the effectiveness of an intervention initiative based on the health belief model. The MyPinkMom program was disseminated through a mobile messaging application to pregnant women to educate them on the prevention of anemia in pregnancy. We conducted a two-arm cluster-assignment, single-blinded, randomized control trial at two government antenatal clinics in Selangor. One clinic was randomly chosen as the intervention group, and the other was chosen as the control group. Sixty pregnant women with anemia from the intervention group received the MyPinkMom intervention program in the form of six infographic video clips, and 60 pregnant women with anemia from the control group received routine counseling on anemia in pregnancy. Pregnant women who had anemia secondary to hemoglobinopathy or other chronic diseases were excluded from this study. MANOVA showed significant increases in hemoglobin, knowledge, attitude, subjective norms, and perceived behavioral control scores for adherence to iron supplements, dietary iron, and dietary vitamin C intake (p < 0.001) in the intervention group at week 6. A significant reduction also occurred in dietary tannin intake (p < 0.001) in the intervention group at week 6. The intervention group at week 6 showed a large effect on hemoglobin level increments (partial eta squared, Ƞp2 0.268), dietary iron intake (Ƞp2 0.213), knowledge of anemia in pregnancy (Ƞp2 0.622), subjective norm scores for adherence to iron supplements (Ƞp2 0.167), and reduction in dietary tannin intake (Ƞp2 0.353). Similarly, repeated measures ANOVA showed that changes in hemoglobin levels were significantly different over time (i.e., at baseline, week 6, and week 12) between the intervention and control groups (p < 0.001). Hemoglobin increased rapidly over time among participants in the intervention group but gradually in the control group. To conclude, the newly developed MyPinkMom program that was delivered through a messaging application showed effectiveness in preventing anemia during pregnancy.
  19. Abdelaziz A, Fong AT, Gani A, Garba U, Khan S, Akhunzada A, et al.
    PLoS One, 2017;12(4):e0174715.
    PMID: 28384312 DOI: 10.1371/journal.pone.0174715
    Software Defined Networking (SDN) is an emerging promising paradigm for network management because of its centralized network intelligence. However, the centralized control architecture of the software-defined networks (SDNs) brings novel challenges of reliability, scalability, fault tolerance and interoperability. In this paper, we proposed a novel clustered distributed controller architecture in the real setting of SDNs. The distributed cluster implementation comprises of multiple popular SDN controllers. The proposed mechanism is evaluated using a real world network topology running on top of an emulated SDN environment. The result shows that the proposed distributed controller clustering mechanism is able to significantly reduce the average latency from 8.1% to 1.6%, the packet loss from 5.22% to 4.15%, compared to distributed controller without clustering running on HP Virtual Application Network (VAN) SDN and Open Network Operating System (ONOS) controllers respectively. Moreover, proposed method also shows reasonable CPU utilization results. Furthermore, the proposed mechanism makes possible to handle unexpected load fluctuations while maintaining a continuous network operation, even when there is a controller failure. The paper is a potential contribution stepping towards addressing the issues of reliability, scalability, fault tolerance, and inter-operability.
  20. Abdelhaq M, Alsaqour R, Abdelhaq S
    PLoS One, 2015;10(5):e0120715.
    PMID: 25946001 DOI: 10.1371/journal.pone.0120715
    A mobile ad hoc network (MANET) is a set of mobile, decentralized, and self-organizing nodes that are used in special cases, such as in the military. MANET properties render the environment of this network vulnerable to different types of attacks, including black hole, wormhole and flooding-based attacks. Flooding-based attacks are one of the most dangerous attacks that aim to consume all network resources and thus paralyze the functionality of the whole network. Therefore, the objective of this paper is to investigate the capability of a danger theory-based artificial immune algorithm called the mobile dendritic cell algorithm (MDCA) to detect flooding-based attacks in MANETs. The MDCA applies the dendritic cell algorithm (DCA) to secure the MANET with additional improvements. The MDCA is tested and validated using Qualnet v7.1 simulation tool. This work also introduces a new simulation module for a flooding attack called the resource consumption attack (RCA) using Qualnet v7.1. The results highlight the high efficiency of the MDCA in detecting RCAs in MANETs.
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