Displaying publications 1 - 20 of 110 in total

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  1. Atif M, Sulaiman SA, Shafie AA, Ali I, Asif M
    Springerplus, 2012;1:40.
    PMID: 23961366 DOI: 10.1186/2193-1801-1-40
    Tuberculin skin testing (TST) and chest X-ray are the conventional methods used for tracing suspected tuberculosis (TB) patients. The purpose of the study was to calculate the cost incurred by Penang General Hospital on performing one contact tracing procedure using an activity based costing approach. Contact tracing records (including the demographic profile of contacts and outcome of the contact tracing procedure) from March 2010 until February 2011 were retrospectively obtained from the TB contact tracing record book. The human resource cost was calculated by multiplying the mean time spent (in minutes) by employees doing a specific activity by their per-minute salaries. The costs of consumables, Purified Protein Derivative vials and clinical equipment were obtained from the procurement section of the Pharmacy and Radiology Departments. The cost of the building was calculated by multiplying the area of space used by the facility with the unit cost of the public building department. Straight-line deprecation with a discount rate of 3% was assumed for the calculation of equivalent annual costs for the building and machines. Out of 1024 contact tracing procedures, TST was positive (≥10 mm) in 38 suspects. However, chemoprophylaxis was started in none. Yield of contact tracing (active tuberculosis) was as low as 0.5%. The total unit cost of chest X-ray and TST was MYR 9.23 (2.90 USD) & MYR 11.80 (USD 3.70), respectively. The total cost incurred on a single contact tracing procedure was MYR 21.03 (USD 6.60). Our findings suggest that the yield of contact tracing was very low which may be attributed to an inappropriate prioritization process. TST may be replaced with more accurate and specific methods (interferon gamma release assay) in highly prioritized contacts; or TST-positive contacts should be administered 6H therapy (provided that the chest radiography excludes TB) in accordance with standard protocols. The unit cost of contact tracing can be significantly reduced if radiological examination is done only in TST or IRGA positive contacts.
  2. Hilmi AB, Halim AS, Hassan A, Lim CK, Noorsal K, Zainol I
    Springerplus, 2013 Dec;2(1):79.
    PMID: 23503998 DOI: 10.1186/2193-1801-2-79
    Chitosan is a marine-derived product that has been widely used in clinical applications, especially in skin reconstruction. The mammalian scaffolds derived from bovine and porcine material have many limitations, for example, prion transmission and religious concerns. Therefore, we created a chitosan skin regenerating template (SRT) and investigated the behavior of fibroblast cell-scaffold constructs. Primary human dermal fibroblasts (HDF) were isolated and then characterized using vimentin and versican. HDF were seeded into chitosan SRT at a density of 3×10(6) cells/cm(2) for fourteen days. Histological analysis and live cells imaging revealed that the cell-chitosan constructs within interconnected porous chitosan showed significant interaction between the cells as well as between the cells and the chitosan. Scanning electron microscopy (SEM) analysis revealed cells spreading and covering the pores. As the pore sizes of the chitosan SRT range between 40-140 μm, an average porosity is about 93 ± 12.57% and water uptake ratio of chitosan SRT is 536.02 ± 14.29%, it is a supportive template for fibroblast attachment and has potential in applications as a dermal substitute.
  3. Kuldas S, Ismail HN, Hashim S, Bakar ZA
    Springerplus, 2013 Dec;2(1):105.
    PMID: 23556145 DOI: 10.1186/2193-1801-2-105
    This review aims to provide an insight into human learning processes by examining the role of cognitive and emotional unconscious processing in mentally integrating visual and verbal instructional materials. Reviewed literature shows that conscious mental integration does not happen all the time, nor does it necessarily result in optimal learning. Students of all ages and levels of experience cannot always have conscious awareness, control, and the intention to learn or promptly and continually organize perceptual, cognitive, and emotional processes of learning. This review suggests considering the role of unconscious learning processes to enhance the understanding of how students form or activate mental associations between verbal and pictorial information. The understanding would assist in presenting students with spatially-integrated verbal and pictorial instructional materials as a way of facilitating mental integration and improving teaching and learning performance.
  4. Norhisham AR, Abood F, Rita M, Hakeem KR
    Springerplus, 2013 Dec;2(1):9.
    PMID: 23419805 DOI: 10.1186/2193-1801-2-9
    Wood products are highly exposed to infestation by powder post beetles. Dinoderus minutus (bamboo borer) is a wood boring beetle that seriously damage dried bamboo and finished bamboo products. Management of D. minutus using pesticides showed negative effects on environment despite being very costly. By understanding influence of natural climatic conditions on their reproductive behaviour, could help us to develop a cost effective and environmental friendly strategy to cope up with this problem. In the present study, reproductive parameters and egg development of the bamboo borer were determined at 20%, 40%, 56%, 75% and 85% r.h. levels at constant temperature of 30° ± 2°C with 8 L-16D photoregime. From the results, eclosion to first instar larva was recorded at all relative humidities tested. The lowest shortest percentage of hatchability was recorded at 20% and 85% relative humidity with a mean incubation period of 4.63 ± 0.25 and 10.43 ± 0.32 days, respectively. It was noted that pre-ovipositional period decreased from 14.20 ± 0.49 to 7.20 ± 0.31 days as relative humidity increased from 20% to 75% and slightly increased to 8.00 ± 0.37 days at 85% relative humidity. We conclude that female beetles may have a particular hygropreference in oviposition as total egg production increased with increasing relative humidity.
  5. Firdaus-Nawi M, Zamri-Saad M, Nik-Haiha NY, Zuki MA, Effendy AW
    Springerplus, 2013;2:611.
    PMID: 24340241 DOI: 10.1186/2193-1801-2-611
    Histological assessments on the intestinal morphology and immunity of tiger grouper juveniles, Epinephelus fuscoguttatus help in determining the earliest age to start an oral vaccination. This study describes the morphological development of the intestinal immunity of tiger grouper of various ages. Clinically healthy tiger groupers were selected and divided into 4 groups of 20 fish per group. Groups 1, 2, 3 and 4 consisted of juveniles of 30, 60, 90 and 120 days old, respectively. The whole intestine was collected and divided into three regions, the anterior, mid and posterior intestine and fixed in 10% buffered formalin before slides were prepared for microscopic examinations. It was found that the histological structures of the anterior intestine were for absorption of nutrient from digested food particles. The significantly (p 
  6. Hushiarian R, Yusof NA, Dutse SW
    Springerplus, 2013;2:555.
    PMID: 24255849 DOI: 10.1186/2193-1801-2-555
    The oil palm, an economically important tree, has been one of the world's major sources of edible oil and a significant precursor of biodiesel fuel. Unfortunately, it now faces the threat of a devastating disease. Many researchers have identified Ganoderma boninense as the major pathogen that affects the oil palm tree and eventually kills it. But identification of the pathogen is just the first step. No single method has yet been able to halt the continuing spread of the disease. This paper discusses the modes of infection and transmission of Ganoderma boninense and suggests techniques for its early detection. Additionally, the paper proposes some possible ways of controlling the disease. Such measures, if implemented, could contribute significantly to the sustainability of the palm oil industry in South East Asia.
  7. Ali F, Ranneh Y, Ismail A, Vaes B
    Springerplus, 2013;2:590.
    PMID: 24294542 DOI: 10.1186/2193-1801-2-590
    A decrease in the lineage commitment of multipotent Mesenchymal stem cells (MSC) to the bone forming osteoblast lineage and an increase in the commitment to the fat forming adipocyte lineage is more common in bone marrow of elderly persons. A link between methylation status and MSC differentiation remains unclear. Therefore, we hypothesize that hypomethylation may decide the fate decisions of MSC. In the current study, murine bone marrow derived-C3H10T1/2 stem cell was used to examine the role of methylation mechanism on the differentiation potential of stem cells into osteoblasts or adipocytes. C3H10T1/2 cells were treated with Periodate oxidized adenosine (Adox), an inhibitor of S-adenosylhomocysteine-dependent hydrolase (SAHH), which in turn block the non-DNA methylation pathway. The effect of hypomethylation on C3H10T1/2 stem cell differentiation was determined by measuring the alkaline phosphates activity and the degree of mineralization as well as Oil-red O staining and lipid content. The ratio of S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) was determined as a metabolic indicator of cellular methylation potential. It was clearly observed that hypomethylation significantly (P 
  8. Abdullah S, Omar N, Yusoff SM, Obukwho EB, Nwunuji TP, Hanan L, et al.
    Springerplus, 2013;2:286.
    PMID: 23961386 DOI: 10.1186/2193-1801-2-286
    This study investigates the clinicopathological features of acute experimental streptococcosis in red tilapia using various routes of infection; intraperitoneal (IP), immersion (IM) and immersion cut (IC). Twenty four red tilapia in duplicates were inoculated intraperitoneally with 10(9) CFU/ml of S. agalactiae while another sets: intact, one with sharp cut at the tail end were exposed to bacterial inoculums 10(9) CFU/ml diluted in water while two groups of control fish were similarly manipulated. Clinical signs were recorded; samples from the gills, brain, eyes and kidneys were also taken for bacterial isolation and histopathology. Immunohistochemistry (IHC) and polymerase chain reaction (PCR) were employed to detect the antigen. The diseased fish showed skin, fin haemorrhages and exophthalmia with obvious signs in IP at 2 hpc followed by IC and IM at 4 hpc. The lesions were noticed earlier in the kidney and most severe in IP. IHC detected antigen as early as PCR and isolation with intense staining in blood vessel lumen and wall, macrophages in choroid, focal haemorrhage in the renal interstitium and meninges especially in IP followed by IC and IM. The immunolocalisation of the antigen described for the first time further explain the pathogenesis of streptococcosis in red tilapia.
  9. Akbar MA, Ali NH, Mohyud-Din ST
    Springerplus, 2013;2:326.
    PMID: 23961400 DOI: 10.1186/2193-1801-2-326
    The (G'/G)-expansion method is one of the most direct and effective method for obtaining exact solutions of nonlinear partial differential equations (PDEs). In the present article, we construct the exact traveling wave solutions of nonlinear evolution equations in mathematical physics via the (2 + 1)-dimensional breaking soliton equation by using two methods: namely, a further improved (G'/G)-expansion method, where G(ξ) satisfies the auxiliary ordinary differential equation (ODE) [G'(ξ)](2) = p G (2)(ξ) + q G (4)(ξ) + r G (6)(ξ); p, q and r are constants and the well known extended tanh-function method. We demonstrate, nevertheless some of the exact solutions bring out by these two methods are analogous, but they are not one and the same. It is worth mentioning that the first method has not been exercised anybody previously which gives further exact solutions than the second one. PACS numbers 02.30.Jr, 05.45.Yv, 02.30.Ik.
  10. Akbar MA, Mohd Ali NH, Mohyud-Din ST
    Springerplus, 2013;2:327.
    PMID: 24010025 DOI: 10.1186/2193-1801-2-327
    Over the years, (G'/G)-expansion method is employed to generate traveling wave solutions to various wave equations in mathematical physics. In the present paper, the alternative (G'/G)-expansion method has been further modified by introducing the generalized Riccati equation to construct new exact solutions. In order to illustrate the novelty and advantages of this approach, the (1+1)-dimensional Drinfel'd-Sokolov-Wilson (DSW) equation is considered and abundant new exact traveling wave solutions are obtained in a uniform way. These solutions may be imperative and significant for the explanation of some practical physical phenomena. It is shown that the modified alternative (G'/G)-expansion method an efficient and advance mathematical tool for solving nonlinear partial differential equations in mathematical physics.
  11. Khan YH, Mallhi TH, Sarriff A, Khan AH
    Springerplus, 2013;2:463.
    PMID: 24083110 DOI: 10.1186/2193-1801-2-463
    OBJECTIVES: The objective of the current study is to analyze different approaches of pharmacists and general practitioners towards availability and use of osteoporosis prescreening tools and to find out reasons that explain non utilization of such tools in clinical practice.
    SETTINGS: Among General practitioners and Community pharmacists in Pulau Penang, Malaysia.
    METHODOLOGY: An explorative cross sectional study was carried out using convenience sampling approach. A pre-validated self- administered questionnaire was used to carry out the study. A total of 170 healthcare professionals participated in study.
    MAIN OUTCOME: Evaluation of awareness, use and opinions of healthcare professionals regarding osteoporosis prescreening tools.
    RESULTS: Response rate of study was 56%. The mean age of the participants was 39.00 + 7.89 years. Less than one third of participants were familiar with term prescreening tools or Clinical decision rules. The only osteoporosis prescreening tool that was recognized and used by majority of participants was FRAX. Participants agreed that low level of awareness regarding availability of prescreening tools poses hindrance in utilization of such tools in clinical practice. Majority of participants showed willingness to gain information and use such tools in future.
    CONCLUSIONS: The results of our study demonstrate an urgent need of implementation of osteoporosis prescreening tools educational and awareness programs among healthcare professionals.
  12. Salimon J, Abdullah BM, Yusop RM, Salih N, Yousif E
    Springerplus, 2013;2:429.
    PMID: 24083099 DOI: 10.1186/2193-1801-2-429
    Biolubricant base oils, 9,12-hydroxy-10,13-oleioxy-12-octadecanoic acid (HYOOA) was synthesized based on the esterification reaction of Monoepoxide linoleic acid 9(12)-10(13)-monoepoxy 12(9)-octadecanoic acid (MEOA) with oleic acid (OA) and catalyzed by p-Toluenesulfonic acid. The optimum conditions for the experiment using D-optimal design to obtain high yield% of 84.61, conversion% of 83.54 and lowest OOC% of 0.05 were predicted at OA/MEOA ratio of 0.2:1 (mol/mol), PTSA/MEOA ratio of 0.4:1 (mol/mol), reaction temperature at 110°C, and reaction time at 4.5 h. The FTIR peaks of HYOOA indicate the disappearance of the absorption band at 820 cm(-1), which belongs to the oxirane ring. (13)C and (1)H NMR spectra analyses confirmed the result of HYOOA with appearance carbon-ester (C = O) chemical shift at 174.1 ppm and at 4.06 ppm for (13)C and (1)H NMR respectively.
  13. Islam MN, Dungani R, Abdul Khalil H, Alwani MS, Nadirah WW, Fizree HM
    Springerplus, 2013;2:592.
    PMID: 25674417 DOI: 10.1186/2193-1801-2-592
    In this study, a green composite was produced from Oil Palm Trunk Lumber (OPTL) by impregnating oil palm shell (OPS) nanoparticles with formaldehyde resin. The changes of physical, mechanical and morphological properties of the OPS nanoparticles impregnated OPTL as a result of natural weathering was investigated. The OPS fibres were ground with a ball-mill for producing nanoparticles before being mixed with the phenol formaldehyde (PF) resin at a concentration of 1, 3, 5 and 10% w/w basis and impregnated into the OPTL by vacuum-pressure method. The treated OPTL samples were exposed to natural weathering for the period of 6 and 12 months in West Java, Indonesia according to ASTM D1435-99 standard. Physical and mechanical tests were done for analyzing the changes in phenol formaldehyde-nanoparticles impregnated (PF-NPI) OPTL. FT-IR and SEM studies were done to analyze the morphological changes. The results showed that both exposure time of weathering and concentration of PF-NPI had significant impact on physical and mechanical properties of OPTL. The longer exposure of samples to weathering condition reduced the wave numbers during FT-IR test. However, all these physical, mechanical and morphological changes were significant when compared with the untreated samples or only PF impregnated samples. Thus, it can be concluded that PF-NP impregnation into OPTL improved the resistance against natural weathering and would pave the ground for improved products from OPTL for outdoor conditions.
  14. Azeez D, Ali MA, Gan KB, Saiboon I
    Springerplus, 2013;2:416.
    PMID: 24052927 DOI: 10.1186/2193-1801-2-416
    Unexpected disease outbreaks and disasters are becoming primary issues facing our world. The first points of contact either at the disaster scenes or emergency department exposed the frontline workers and medical physicians to the risk of infections. Therefore, there is a persuasive demand for the integration and exploitation of heterogeneous biomedical information to improve clinical practice, medical research and point of care. In this paper, a primary triage model was designed using two different methods: an adaptive neuro-fuzzy inference system (ANFIS) and artificial neural network (ANN).When the patient is presented at the triage counter, the system will capture their vital signs and chief complains beside physiology stat and general appearance of the patient. This data will be managed and analyzed in the data server and the patient's emergency status will be reported immediately. The proposed method will help to reduce the queue time at the triage counter and the emergency physician's burden especially duringdisease outbreak and serious disaster. The models have been built with 2223 data set extracted from the Emergency Department of the Universiti Kebangsaan Malaysia Medical Centre to predict the primary triage category. Multilayer feed forward with one hidden layer having 12 neurons has been used for the ANN architecture. Fuzzy subtractive clustering has been used to find the fuzzy rules for the ANFIS model. The results showed that the RMSE, %RME and the accuracy which evaluated by measuring specificity and sensitivity for binary classificationof the training data were 0.14, 5.7 and 99 respectively for the ANN model and 0.85, 32.00 and 96.00 respectively for the ANFIS model. As for unseen data the root mean square error, percentage the root mean square error and the accuracy for ANN is 0.18, 7.16 and 96.7 respectively, 1.30, 49.84 and 94 respectively for ANFIS model. The ANN model was performed better for both training and unseen data than ANFIS model in term of generalization. It was therefore chosen as the technique to develop the primary triage prediction model. This primary triage model will be combined with the secondary triage prediction model to produce the final triage category as a tool to assist the medical officer in the emergency department.
  15. Ahmad A, Dada AC, Usup G, Heng LY
    Springerplus, 2013;2:425.
    PMID: 24052928 DOI: 10.1186/2193-1801-2-425
    There is currently no established bacteriological beach quality monitoring (BQM) program in place in Malaysia. To initiate cost-effective, sustainable bacteriological BQM schemes for the ultimate goal of protecting public health, policy decision makers need to be provided robust, indigenous empirical findings that validate appropriate water quality parameters for inclusion in such monitoring programs. This is the first study that assesses the validity of enterococci as an ideal indicator for bacteriological BQM in Malaysia using a multivariate approach. Beach water and sand samples from 7 beach locations were analyzed for a total of twenty-one microbial and non-microbial water quality parameters. A multivariate approach incorporating cluster analyses (CA), principal component analyses (PCA), and factor analysis (FA) was also adopted. Apart from the weak correlations of Staphylococcus aureus with concentrations of Vibro species (r = 0.302, p = 0.037) and total coliforms (r = 0.392, p = 0.006) in seawater, no correlation existed between S. aureus concentration and other parameters. Faecal coliforms failed to correlate with any of the tested parameters. Enterococci also correlated with more quality parameters than faecal coliforms or any other indicator. Multiple linear regressions highlighted a significant, best fit model that could predict enterococci concentrations in relation to other parameters with a maximum predictive success of 69.64%. PCA/FA clearly delineated enterococci and faecal coliforms as parameters that weighed strongly for BQM while Staphylococcus aureus, faecal coliforms and enterococci weighed strongly for beach sand quality monitoring. On the whole, higher correlations of enterococci levels with other parameters than was observed for faecal coliforms suggest that the former be considered a preferred parameter of choice for BQM in Malaysia. Our findings provide meaningful evidence particularly as it relates to the correlation of Enterococci with pathogens and other non-microbial parameters. It also provides empirical data to validate the applicability of the enterococci indicator paradigm for bacteriological beach quality monitoring in Malaysia. The current study thus provides policy decision makers evidenced based approach to parameter streamlining for optimized beach sampling and sustainable bacteriological quality monitoring.
  16. Abdul Ghani AS, Mat Isa NA
    Springerplus, 2014;3:757.
    PMID: 25674483 DOI: 10.1186/2193-1801-3-757
    The quality of underwater image is poor due to the properties of water and its impurities. The properties of water cause attenuation of light travels through the water medium, resulting in low contrast, blur, inhomogeneous lighting, and color diminishing of the underwater images. This paper proposes a method of enhancing the quality of underwater image. The proposed method consists of two stages. At the first stage, the contrast correction technique is applied to the image, where the image is applied with the modified Von Kries hypothesis and stretching the image into two different intensity images at the average value with respects to Rayleigh distribution. At the second stage, the color correction technique is applied to the image where the image is first converted into hue-saturation-value (HSV) color model. The modification of the color component increases the image color performance. Qualitative and quantitative analyses indicate that the proposed method outperforms other state-of-the-art methods in terms of contrast, details, and noise reduction.
  17. Khan A, Ahmad R, Hamdan AR, Mustaffa MS, Tahir LM
    Springerplus, 2014;3:756.
    PMID: 25674482 DOI: 10.1186/2193-1801-3-756
    The present study examined the predictors of psychological strengths and subjective well-being for dealing with academic stress perceived by university engineering students. Sample of 400 Malaysian (N = 180 boys and N = 220 girls) age varies 18 to 25 years and 400 Indian students (N = 240 boys and N = 160 girls) age varies 18 to 25 years from public universities were participated. Quantitative method was used for data analysis. Findings shows that gender, religiosity and socioeconomic status are significantly influencing psychological strengths and subjective well-being of both Indian and Malaysian students. Findings also revealed that parental involvement and problem solving coping styles were significantly predicting psychological strengths and subjective well-being among both countries participants. Findings of the current study provide the insight for the educators, and parents dealing with adolescents.
  18. Beiranvand Pour A, Hashim M
    Springerplus, 2014;3:130.
    PMID: 25674434 DOI: 10.1186/2193-1801-3-130
    This paper provides a review of the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), Advanced Land Imager (ALI), and Hyperion data and applications of the data as a tool for ore minerals exploration, lithological and structural mapping. Spectral information extraction from ASTER, ALI, and Hyperion data has great ability to assist geologists in all disciplines to map the distribution and detect the rock units exposed at the earth's surface. The near coincidence of Earth Observing System (EOS)/Terra and Earth Observing One (EO-1) platforms allows acquiring ASTER, ALI, and Hyperion imagery of the same ground areas, resulting accurate information for geological mapping applications especially in the reconnaissance stages of hydrothermal copper and gold exploration, chromite, magnetite, massive sulfide and uranium ore deposits, mineral components of soils and structural interpretation at both regional and district scales. Shortwave length infrared and thermal infrared bands of ASTER have sufficient spectral resolution to map fundamental absorptions of hydroxyl mineral groups and silica and carbonate minerals for regional mapping purposes. Ferric-iron bearing minerals can be discriminated using six unique wavelength bands of ALI spanning the visible and near infrared. Hyperion visible and near infrared bands (0.4 to 1.0 μm) and shortwave infrared bands (0.9 to 2.5 μm) allowed to produce image maps of iron oxide minerals, hydroxyl-bearing minerals, sulfates and carbonates in association with hydrothermal alteration assemblages, respectively. The techniques and achievements reviewed in the present paper can further introduce the efficacy of ASTER, ALI, and Hyperion data for future mineral and lithological mapping and exploration of the porphyry copper, epithermal gold, chromite, magnetite, massive sulfide and uranium ore deposits especially in arid and semi-arid territory.
  19. Sabti AA, Chaichan RS
    Springerplus, 2014;3:460.
    PMID: 25187883 DOI: 10.1186/2193-1801-3-460
    This study examines the attitudes of Saudi Arabian high school students toward the use of computer technologies in learning English. The study also discusses the possible barriers that affect and limit the actual usage of computers. Quantitative approach is applied in this research, which involved 30 Saudi Arabia students of a high school in Kuala Lumpur, Malaysia. The respondents comprised 15 males and 15 females with ages between 16 years and 18 years. Two instruments, namely, Scale of Attitude toward Computer Technologies (SACT) and Barriers affecting Students' Attitudes and Use (BSAU) were used to collect data. The Technology Acceptance Model (TAM) of Davis (1989) was utilized. The analysis of the study revealed gender differences in attitudes toward the use of computer technologies in learning English. Female students showed high and positive attitudes towards the use of computer technologies in learning English than males. Both male and female participants demonstrated high and positive perception of Usefulness and perceived Ease of Use of computer technologies in learning English. Three barriers that affected and limited the use of computer technologies in learning English were identified by the participants. These barriers are skill, equipment, and motivation. Among these barriers, skill had the highest effect, whereas motivation showed the least effect.
  20. Lo MC, Thurasamy R, Liew WT
    Springerplus, 2014;3:432.
    PMID: 25157334 DOI: 10.1186/2193-1801-3-432
    Building upon the social exchange theory, this paper hypothesized the direct effect of bases of power on job stress with mentoring as moderator. Power bases and job stresses were conceptualized as 7- and 3- dimensional constructs, respectively. One hundred and ninety-five Malaysian managers and executives working in large-scale multinational companies participated in this study. The results have indicated that bases of power as possessed by supervisors have strong effect on employees' job stress and mentoring was found to have moderated the relationship between power bases and job stress. Implications of the findings, potential limitations of the study, and directions for future research were discussed further.
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