METHOD: We collected data on demographics, retention and completion and abstinence between January 2021-August 2023 in MSM using Beyond-66. Using 10-point Likert scales, we compared motivation to remain abstinent and mental wellbeing at the beginning and end of Beyond-66.
RESULTS: 25 MSM have either completed or dropped out/referred out of Beyond-66, 12/25(48%) were living with HIV and the median duration of chemsex use was 5 years (IQR = 4-6). 19 (76%) completed programme; 3 were referred out for a psychiatry assessment and 3 dropped out of the programme. 14 (74%) remain abstinent and 5 relapsed. The median motivation for abstinence scores for the 19 completers increased significantly between the pre-programme and post-programme period (7/10 (IQR = 4-8) to 9/10 (IQR = 5-10), p = .04) and the median mental health score (Likert score out of 10 where 10 is poor mental health) reduced significantly (5/10 (IQR = 4-7) to 2/10 (IQR 1-6), p = .008).
CONCLUSION: This pilot evaluation suggests that MSM using Beyond-66 experience high completion (76%) and abstinence (74%) rates and increased motivation for abstinence and mental wellbeing scores. Further research is needed to design, develop, and deliver peer led interventions for MSM who are chemsex dependant.
METHODS: The study included 18 patients with confirmed mediastinal lymphadenopathy who were admitted in Chest Department, Cairo University in the period from December 2019 to December 2020. All patients were subjected to flexible bronchoscopy with conventional transbronchial needle aspiration (C-TBNA) and transbronchial forceps biopsy (LN-TBFB) from the enlarged mediastinal lymph node in the same procedure.
RESULTS: we found the technique of LN-TBFB safe with no serious complications. We were able to reach a diagnosis in 7/7 (100%) cases of sarcoidosis, 6/7 (85.7%) cases of malignant lymph nodes. We had three cases where the histopathology showed hyperactive follicular hyperplasia, and a single case of tuberculous lymphadenitis. C-TBNA was diagnostic in 71.4% of sarcoidosis cases, 42.9% of malignant cases, but failed to diagnose the one patient with tuberculous lymphadenitis.
CONCLUSION: Lymph node transbronchial forceps biopsy (LN-TBFB) was found to be safe and effective in the diagnosis of mediastinal lymphadenopathy. We strongly advocate the use of this minimally invasive technique for diagnosing pathologically enlarged mediastinal lymph nodes, as a last step before mediastinoscopy.
METHODS: A prospective longitudinal pilot study of mother-infant pairs was conducted on infants receiving routine immunizations in a mother and child clinic at a university hospital, in Kuala Lumpur, Malaysia. Mothers completed standardized questionnaires at 3- and 5-month postnatal visits. Maternal and infant full blood count, ferritin, and C-reactive protein (CRP) levels were measured at 3 months and for the infants repeated at 5 months. Infant anthropometric measurements were obtained at both visits. We conducted a univariate analysis to identify factors associated with ID and IDA.
RESULTS: Altogether, 91 mother-infant pairs were enrolled, with 88 completing the study. No infant had ID or IDA at 3 months; the lowest ferritin level was 16.6 µg/L. At 5 months, 5.9% (5/85) of infants had ID, and 2.4% (2/85) had IDA. Median (interquartile range) infant ferritin levels significantly declined from 113.4 (65.0-183.6) µg/L at 3 months to 50.9 (29.2-70.4) µg/L at 5 months, p
PURPOSE: We compared the frequencies of potentially functional CD38 gene single nucleotide polymorphisms rs1130169 (T > C) in 86 healthy controls and 90 colorectal cancer (CRC) cases to assess their association with cancer risk and CD38 gene expression.
RESULTS: The association between allele C rs1130169 and CRC risk was observed. Allele C was also significantly correlated with an increased CD38 mRNA level and CD38 positive cell percentages in peripheral blood of healthy controls that could be a possible explanation for CRC risk in C allele carriers. In peripheral blood of CRC patients CD38 mRNA and serum soluble CD38 protein levels significantly differed from those in healthy controls. Calculation of the CD38 full-length and with the third exon deletion mRNA ratio in corresponding samples showed that the mRNA isoform ratio was significantly higher in CRC cases than in controls. It suggests that alternative splicing regulates elevation of CD38 full-length mRNA level in peripheral blood of CRC patients. We also have observed higher expression levels of CD38 full-length mRNA in peripheral blood of CRC patients with lymph node metastases compared to patients without metastases.
CONCLUSION: This study indicated biological significance of rs1130169 variations that can alter differences in CRC risk by regulating CD38 gene expression.
MATERIALS AND METHODS: This consensus statement was formulated by a panel of five experts of primary care and specialist doctors. A lung cancer screening algorithm was proposed for implementation locally.
RESULTS: In an earlier pilot project collaboration, AI-assisted chest radiography had been incorporated into lung cancer screening in the community. Preliminary experience in the pilot project suggests that the system is easy to use, affordable and scalable. Drawing from experience with the pilot project, a standardised lung cancer screening algorithm using AI in Malaysia was proposed. Requirements for such a screening programme, expected outcomes and limitations of AI-assisted chest radiography were also discussed.
CONCLUSION: The combined strategy of AI-assisted chest radiography and complementary LDCT imaging has great potential in detecting early-stage lung cancer in a timely manner, and irrespective of risk status. The proposed screening algorithm provides a guide for clinicians in Malaysia to participate in screening efforts.
METHODS: A pilot cluster randomized controlled trial (cRCT) with qualitative interviews was conducted. Each primary care doctor was considered a cluster and randomized to either the control (usual practice) or intervention (DeSSBack) group. Patient outcomes including Roland-Morris Disability Questionnaire (RMDQ), Hospital Anxiety and Depression Scale, and a 10-point pain rating scale were measured at baseline and 2-month postintervention. The doctors in the intervention group were interviewed to explore feasibility and acceptability of using DeSSBack.
RESULTS: Thirty-six patients with nonspecific LBP participated in this study (intervention n = 23; control n = 13). Fidelity was poor among patients but good among doctors. The RMDQ and anxiety score had medium effect sizes of 0.718 and 0.480, respectively. The effect sizes for pain score (0.070) and depression score were small (0.087). There was appreciable acceptability and satisfaction with use of DeSSBack, as it was helpful in facilitating thorough and standardized management, providing appropriate treatment plans based on risk stratification, improving consultation time, empowering patient-centred care, and easy to use.
CONCLUSIONS: A future cRCT to evaluate the effectiveness of DeSSBack is feasible to be conducted in a primary care setting with minor modifications. DeSSBack was found useful by doctors and can be improved to enhance efficiency.
TRIAL REGISTRATION: The protocol of the cluster randomized controlled trial was registered at ClinicalTrials.gov (NCT04959669).
METHODS: The study involves conducting a global survey to fitness coaches, sports scientists, analysts, and physicians with experience in load monitoring within football. The research adheres to the principles of the Helsinki Declaration and complies with General Data Protection Regulation standards, with ethical approvals obtained from multiple Ethics Committees across various countries, including Tunisia. A consortium of professionals collaboratively crafted the survey instrument, dividing it into seven sections, each addressing specific aspects of workload monitoring in football. Survey reliability will undergo evaluation in a pilot study utilizing Cronbach's alpha and intraclass correlation coefficient. To ensure inclusivity, the survey will be translated into multiple languages, facilitating participation from diverse regions. As such, survey distribution will consider online platforms (such as social media) and email invitations, with a specific focus on engaging football clubs, federations, and professional networks. The targeted sample size will remain at 385 participants. Statistical analysis planning encompasses descriptive examination, exploration of variable relationships, hypothesis testing, and qualitative analyses of participant feedback and recommendations regarding load monitoring practices.
EXPECTED RESULTS: Expected outcomes include i) A comprehensive global overview of training and match load monitoring practices in football, ii) The identification of emerging trends, an improved understanding of training optimization processes, and iii) The development of practical recommendations to enhance player well-being and performance.
CONCLUSION: This study will contribute to the ongoing development of knowledge in the field of football workload monitoring.
METHODS: The dataset used in this study consist of ECG data collected from 45 ADHD, 62 ADHD+CD, and 16 CD patients at the Child Guidance Clinic in Singapore. The ECG data were segmented into 2 s epochs and directly used to train our 1-dimensional (1D) convolutional neural network (CNN) model.
RESULTS: The proposed model yielded 96.04% classification accuracy, 96.26% precision, 95.99% sensitivity, and 96.11% F1-score. The Gradient-weighted class activation mapping (Grad-CAM) function was also used to highlight the important ECG characteristics at specific time points that most impact the classification score.
CONCLUSION: In addition to achieving model performance results with our suggested DL method, Grad-CAM's implementation also offers vital temporal data that clinicians and other mental healthcare professionals can use to make wise medical judgments. We hope that by conducting this pilot study, we will be able to encourage larger-scale research with a larger biosignal dataset. Hence allowing biosignal-based computer-aided diagnostic (CAD) tools to be implemented in healthcare and ambulatory settings, as ECG can be easily obtained via wearable devices such as smartwatches.
OBJECTIVE: To examine the efficacy of the Motor Skill Occupational Therapy Intervention ON ASD (MOTION-ASD) and Cognitive Orientation Exercise (CO-EXC) programs to improve motor skills performance, self-care performance, and adaptive behaviors among preschool children with ASD.
DESIGN: Randomized controlled trial, two-group, triple-blinded, repeated-measures design Setting: University laboratory.
PARTICIPANTS: Thirteen preschool children with ASD (M age = 4.91 yr).
OUTCOMES AND MEASURES: The Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Brief Form, Assessment of Motor and Process Skills, and Vineland Adaptive Behavior Scales-Third Edition.
RESULTS: Children in the MOTION-ASD group showed significantly greater improvements in manual coordination and overall gross and fine manual skills than those in the CO-EXC group immediately after the intervention. Significant improvements in fine manual control, body coordination, overall motor skills, and self-care performance were made throughout both interventions and were retained at the posttest and the 4-wk follow-up.
CONCLUSIONS AND RELEVANCE: These findings provide supporting evidence that motor skills interventions involving fundamental skills and cognitive training may be a viable therapeutic option for treating children with ASD. The results also suggest that practitioners may consider providing structured and strategic motor skills interventions for preschool children with ASD. What This Article Adds: This study's rigorous tests of motor skills interventions support ways to manage motor difficulties in children with autism spectrum disorder (ASD). An intervention based on motor learning theory could benefit preschool children with ASD, especially in terms of manual coordination ability and overall gross and fine motor skills.
MATERIALS AND METHODS: The CKD-CHECK (CKD-CHECK EGFR Chart in Kidney disease) is a toolkit that was developed to auto-generate patients' eGFR trend using a line graph, displaying the trend visually over a year. It identifies patients with rapid CKD progression, triggers the doctors to order appropriate tests (proteinuria quantification or renal imaging) and helps in decision making (continued monitoring at primary care level or referral to nephrologist). The toolkit was piloted among medical officers practising in a hospital-based primary care clinic treating patients with eGFR<60ml/min/1.73m2 using an interventional before-after study design from February to May 2022. In the preintervention period, the CKD patients were managed based on standard practice. The doctors then used the CKDCHECK toolkit on the same group of CKD patients during the intervention period. The feasibility and acceptability of the toolkit was assessed at the end of the study period using the Acceptability of Intervention Measure (AIM) and Feasibility of Intervention Measure (FIM) questionnaires. All patients' clinical data and referral rate were collected retrospectively through medical files and electronic data systems. Comparison between the pre- and post-intervention group were analysed using paired t-test and McNemar test, with statistical significance p value of <0.05.
RESULTS: A total of 25 medical officers used the toolkit on 60 CKD patients. The medical officers found the CKD-CHECK toolkit to be highly acceptable and feasible in primary care setting. The baseline characteristics of the patients were a mean age of 72 years old, predominantly females and Chinese ethnicity. Majority of the CKD patients had diabetes mellitus, hypertension and dyslipidemia. The numbers of CKD rapid progressors was similar (26.7% in the preintervention group vs 33.3% in the post-intervention group). There were no significant differences in terms of proteinuria assessment and ultrasound kidney for CKD rapid progressors before and after the intervention. However, a significant number of CKD rapid progressors were referred to nephrologists after the use of CKD-CHECK toolkit (p=0.016).
CONCLUSIONS: CKD-CHECK toolkit is acceptable and feasible to be used in primary care. Preliminary findings show that the CKD-CHECK toolkit improved the primary care doctor's referral of rapid CKD progressors to nephrologists.
METHODS: This is a one-group pre-and post-intervention pilot study. It was conducted in Private and public higher education institutions around Malaysia. An online education game was created and used as the intervention. A self-administered questionnaire was administered to the participants during the pre-and post-intervention test to evaluate the online educational game on breast cancer awareness.
RESULTS: A total of 52 responses were collected. The mean age of the participants was 21.98 (SD = 1.896) years. The findings showed a statistically significant median increase (p
PATIENTS AND METHODS: In a pilot experimental study, six patients (10 hips) with early-stage non-traumatic ONFH were treated by core decompression, and concurrent injection of local DFO loaded on PLGA scaffold into the subchondral femoral head. Outcome measures were evaluated before the surgery and 12 and 24 months after the surgery and included visual analog scale (VAS) for pain, modified Merle d'Aubigné-Postel (MAP) score for hip function by MRI, and rate of osteonecrosis assessed by the modified.
RESULTS: The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P
OBJECTIVES: This paper is a pilot study designed to compare the effects of Bal Ex as a home-based VRT on the quality of life (EQ-5D), dizziness handicap (DHI) and mental health (DASS-21) against hospital-based VRT.
DESIGN: This was an assessor-blinded, randomized controlled pilot study where PPPD patients were randomly selected to undergo Bal Ex, the home-based VRT (intervention group) or hospital-based (control group) VRT. The participants were reviewed at 4 weeks and 12 weeks after the start of therapy to assess the primary endpoints using the subjective improvement in symptoms as reported by patients, changes in DHI scores, DASS-21 scores and EQ5D VAS scores.
RESULTS: Thirty PPPD patients successfully completed the study with 15 in each study group. Within 4 weeks, there were significant improvements in the total DHI scores as well as anxiety levels. By the end of 12 weeks, there were significant improvements in the DHI, DASS-21 and EQ5D. The degree of improvement between Bal Ex and the control was comparable.
CONCLUSION: VRT is an effective modality in significantly improving quality of life, dizziness handicap, depression, and anxiety levels within 3 months in PPPD. Preliminary results show Bal Ex is as effective as hospital-based VRT and should be considered as a treatment option for PPPD.
METHODS: A pilot study was conducted in four primary healthcare (PHC) centers in Malaysia. The model's key features included on-site HCV ribonucleic acid (RNA) testing using a shared GeneXpert® system; noninvasive biomarkers for cirrhosis diagnosis; and extended care to PWID referred from nearby PHC centers and outreach programs. The feasibility assessment focused on three aspects of the model: demand (i.e., uptake of HCV RNA testing and treatment), implementation (i.e., achievement of each step in the HCV care cascade), and practicality (i.e., ability to identify PWID with HCV and expedite treatment initiation despite resource constraints).
RESULTS: A total of 199 anti-HCV-positive PWID were recruited. They demonstrated high demand for HCV care, with a 100% uptake of HCV RNA testing and 97.4% uptake of direct-acting antiviral treatment. The rates of HCV RNA positivity (78.4%) and sustained virologic response (92.2%) were comparable to standard practice, indicating the successful implementation of the model. The model was also practical, as it covered non-opioid-substitution-therapy-receiving individuals and enabled same-day treatment in 71.1% of the participants.
CONCLUSIONS: The modified same-day test-and-treat model is feasible in improving HCV care for rural PWID. The study finding suggests its potential for wider adoption in HCV care for hard-to-reach populations.
MATRIALS AND METHODS: The conventional protocol and three microwave protocols of tissue processing were used in this study. A pilot study was done prior to the real run to determine the baseline timing for microwave protocol. The baseline timing was fixed at 2 minutes,30 minutes,5 minutes and 25 minutes. The processing time of the microwave protocol was adjusted from 62 minutes to 70 minutes to 77 minutes by increasing the dehydration and wax impregnation time while the time for tissue fixation and clearing remain the same throughout all the microwave protocols.
RESULTS: The group 2 microwave protocol produced the sections that is closely comparable to group 1 conventional protocol. The morphological quality of histopathology slides is best observed when the processing time of microwave protocol is 62 minutes.
CONCLUSION: The most appropriate microwave protocol for tissue processing is group 2 as the morphological quality of histopathology slides are more superior than that of group 1 with an overall percentage of 80% of satisfactory slides in group 2 and 76.68% in group 1.
METHODS: A cross-sectional study of patients with cancer was conducted in Hospital Kuala Lumpur between September and October 2020. Self-reported data from the patients were collected using face-to-face interviews. Detailed information about cancer-related OOP expenses including direct medical, direct non-medical, and productivity loss in addition to financial coping strategies were collected. Costs data were estimated and reported as average annual total costs per patient.
RESULTS: The mean total cost of cancer was estimated at MYR 7955.39 (US$ 1893.46) per patient per year. The direct non-medical cost was the largest contributor to the annual cost, accounting for 46.1% of the total cost. This was followed by indirect costs and direct medical costs at 36.0% and 17.9% of the total annual costs, respectively. Supplemental food and transportation costs were the major contributors to the total non-medical costs. The most frequently used financial coping strategies were savings and financial support received from relatives and friends.
CONCLUSION: This study showed that estimation of the total cost of cancer from the patient's perspective is feasible. Considering the significant impact of direct non-medical and indirect costs on the total costs, it is vital to conduct further exploration of its cost drivers and variations using a larger sample size.
METHODOLOGY: 88 university students with migraine symptoms are the target participants. 4 of 5 on the Migraine Screen Questionnaire, 5 of 7 on the International Classification of Headache Disorders 3rd edition (ICHD-3), and both genders aged 18-40 years will be included. The participants with a score of more than or equal to 5 on the visual aura rating scale, diagnosed with a secondary headache, pregnancy, medication for neurological and cardiorespiratory conditions, and unwilling to participate will be excluded. Based on the disability questionnaire, the participants will be randomly assigned to either of the three groups. The primary outcome is resting-state electroencephalography (EEG) brain, and the secondary outcomes are sleep quality, quality of life, and migraine pain level. The post-test assessments will be performed at week 6.
RESULT: After the primary EEG analysis using MATLAB, the amplitude, frequency, frequency band ratio, and power spectrum density will be analysed. Mixed design analysis and intention-to-treat analysis will be used to assess the efficacy of aerobic training.
DISCUSSION: Migraines can be unpredictable, sometimes occurring without symptoms. If underdiagnosed or over-looked, it encompasses a serious of long-term effects. Hence with appropriate intervention, the symptoms can be prevented from worsening. But there is an unmet need for evidence-based non-pharmacological approaches to complement pharmacotherapy in migraine prevention. Moreover, an exercise intervention may be more suitable for people with migraine considering their tendency toward inactivity. Although some studies developed exercise programs for untrained patients with migraine, the outcome was primarily in terms of exercise capacity rather than the primary characteristics and secondary brain wave/ sleep quality changes, indicating the need for this study.