METHODS: The development and validation process in this study consisted of four stages: Stage One involved item pool generation, Stage Two focused on content and face validation, Stage Three encompassed data collection, and Stage Four included the assessment of the psychometric properties of the RESQ. This final stage was conducted through Exploratory Factor Analysis (EFA; n = 275) and Confirmatory Factor Analysis (CFA; n = 313) to evaluate convergent validity, discriminant validity, and composite reliability.
RESULTS: The initial item pool generated 60 items, whereby 42 items were retained after the content validity evaluation process by the panel of experts. Next, EFA analysis suggested 31 items distributed across seven factors. Lastly, psychometric properties of RESQ with 26 items were established through CFA (GFI = 0.91, CFI = 0.97, RMSEA = 0.04, TLI = 0.96, X²/df = 1.52) and other psychometrics evidence.
CONCLUSION: Based on the collected psychometrics evidence, RESQ is a valid questionnaire to evaluate the commitment of recreational sports users. The newly developed questionnaire allows sports organizations to assess the factors influencing sport commitment among recreational sports users. Based on the results of RESQ, sport programmes can be tailored made to optimize sports engagement and promote continued commitment.
METHODS: A cluster-randomized controlled trial was conducted with 180 participants from 12 schools, randomly assigned to intervention or control groups. The intervention group participated in a 90-minute educational session, with follow-up assessments at baseline, and at 1, 3, and 6 months' post-intervention, using validated Arabic questionnaires. Data analysis was performed using SPSS version 22.0, with Generalized Estimating Equations (GEE) applied to assess differences within and between groups over time. Statistical significance was set at P
METHODS: The study was conducted in 3 stages. Stage 1 involved a qualitative focus group discussion with 6 experts to gather perspectives on modifying the exercise program. Stage 2 used a Delphi approach with another 6 experts to validate the program. In Stage 3, a feasibility study was conducted with 20 eligible patients (out of 23 initially enrolled) at a traditional Chinese medicine hospital, using a single-group pre- and posttest design. The strenuousness of the adapted exercise was assessed through heart rate (HR) and rating of perceived exertion (RPE). Its effects were measured using the Global Pain Scale (GPS), the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), the Tampa Kinesiophobia-11 Scale, and the Timed Up and Go test. Patient satisfaction and feedback were also collected.
RESULTS: The modified program, consisting of 9 movements and taking 30 min to complete, was validated by experts as suitable, safe, and effective for practice. HR and RPE measurements confirmed it as a low-intensity exercise and not strenuous for the study population. The program significantly improved back pain and mindfulness in the feasibility study, with most participants expressing satisfaction with the protocol.
CONCLUSION: Experts and participants affirmed that the program was appropriate and satisfactory for older patients with primary osteoporosis, particularly those with back pain. Further high-quality randomized controlled trials are needed to validate its effectiveness.
MATERIALS AND METHODS: We conducted a retrospective cross-sectional study on the VNS done in Malaysia. We included DRE patients from all age groups who underwent VNS from 1st January 2000 to 31st December 2022. We analysed the efficacy of VNS for patients with at least one year of implantation.
RESULTS: A total of 62 implantations were performed from 2000 to 2022. Most patients (52.5%) had implantation at <18 years old, 54.0% had focal seizures, 34.4% had Lennox Gastaut Syndrome and 23.0% had developmental epileptic encephalopathy. A total of 22.6%, 42.8%, and 63.3% of patients achieve ≥ 50% seizure reduction at three months, six months, and one-year post-implantation, respectively. At their last follow-up, 73.5% of patients had ≥ 50% seizure reduction. The majority of responders were at a current intensity of ≥ 2mA (98.0%) and 81.6% were at a duty cycle of ≥35%. No significant difference was found between responders and non-responders by age at implantation, duration of epilepsy, and seizure type.
CONCLUSION: VNS is effective for patients with refractory epilepsy in Malaysia with two-third achieving more than 50% seizure reduction at one year and the last follow-up.
MATERIALS AND METHODS: In this case-control study, we examined 294 patients over the age of 18 who were using synthetic cathinones and opioids. All patients underwent electrocardiography and transthoracic echocardiography.
RESULTS: Our study involved 183 patients using synthetic cathinones and 111 patients reporting opioid use. The average age of the patients was 32.4 ± 8.5 years. In patients using synthetic cathinones, electrocardiography showed a lengthening in the average duration of the ventricular QRS complex (70.5 ± 13.3 ms vs. 69.6 ± 11.7 ms), T wave (154.1 ± 27.5 ms vs. 140.4 ± 24.1 ms), and QT interval (338.2 ± 28.5 ms vs. 334.8 ± 33.5 ms), as well as a shortening of the P wave (79.1 ± 12.2 ms vs. 82.6 ± 14.4 ms) and PQ interval (146.4 ± 19.6 ms vs. 148.3 ± 20.1 ms). Echocardiography confirmed left ventricular hypertrophy in 10.9% of the synthetic cathinones group and 17.1% of the opioid group. Transmitral left ventricular diastolic dysfunction was diagnosed in 23.5% of patients in both groups. Additionally, 31.1% of patients using synthetic cathinones and 44.1% of those using opioids had a reduced ejection fraction on echocardiography.
CONCLUSION: In patients using synthetic cathinones the QT interval was longer compared to those using opioids. The ejection fraction was lower in the opioid group. Electrocardiographic and echocardiographic screening should be conducted for all patients with post-acute withdrawal syndrome to prevent life-threatening arrhythmias and heart failure.
MATERIALS AND METHODS: A retrospective record review was carried out, utilising secondary data obtained from the TB registry of Selangor and Wilayah Persekutuan Kuala Lumpur. All registered DR-TB cases between 2016 and 2020 that met the study criteria were analysed descriptively using SPSS software version 27.
RESULTS: Of 443 cases of registered DR-TB over 5 years, 430 cases fulfilled the study criteria. The prevalence of DR-TB increased from 0.27 to 1.79 per 100,000 population between 2016 and 2020. The average age was 40.96 years, majority were males (70.7%), Malaysian (79.3%), with Malays comprising 50.2%. Most patients had up to secondary school education (51.9%), married (57.0%), employed (53.3%) and 34.9% were smokers. For clinical characteristics, 23.5% had diabetes, and 10.9% were HIVpositive. Retreatment cases accounted for half the total, and 83.9% had positive smear results. Minimal chest X-ray lesions were observed in 54.4% of cases. The majority (66.7%) received supervised treatment from healthcare providers after being diagnosed with DR-TB, and 37.4% had more than one anti-TB resistance. Favourable treatment outcomes were observed in 56.7% of cases, while 42.1% had unfavourable outcomes, mainly due to loss to follow-up (49.7%), death (42.6%) and treatment failure (7.7%).
CONCLUSION: The rising cases of DR-TB call for comprehensive public health interventions and stakeholder commitment to reduce its occurrence and transmission. These findings provide valuable guidance for policymakers in strengthening DR-TB control and prevention strategies.
METHODOLOGY: This was a cross-sectional study involving SLE patients who visited our institute between January 2020 and June 2021. A review of the medical records and face-to-face interviews were conducted to obtain sociodemographics, SLE disease characteristics and the intervals from the first symptoms to the diagnosis. Health-seeking behaviours were assessed by asking about the patients' first action during the initial symptoms and were divided into: (i) seeking professional health personnel; (ii) self-treatment; and (iii) the use of the internet as a primary source of information. Diagnostic delays were defined as the interval between initial symptoms and SLE diagnosis of more than 6 months. Low-level disease activity state (LLDAS) at 12 months was assessed from the medical records. Univariate and multivariate logistic regression analysis was subsequently conducted to determine factors associated with diagnostic delays.
RESULTS: Among the 154 patients included in the study, 24% (n = 37) had delayed diagnosis. The delay was significantly higher among the Indian versus Malay versus Chinese (42.9% vs 28% vs 10.8%, p = 0.037). Patients with rash tend to have delayed diagnosis (37.8% vs 22.2%, p = 0.08) while fewer patients with frothy urine had delayed diagnosis (8.1% vs 21.4%, p = 0.09). No significant association was found between health-seeking behaviours and diagnostic delays. The rate of LLDAS at 12 months was significantly lower among patients with delayed diagnosis (43.2% vs 70.0%, p = 0.006). Chinese ethnicity remained the only significant factor associated with lesser diagnostic delays in the multivariate analysis, with OR 0.30 (CI 0.09-0.93), p = 0.037.
CONCLUSION: There were ethnic disparities in the early diagnosis of SLE in Malaysia, with Indian patients having a longer interval between the first symptom and diagnosis while the Chinese were associated with lower diagnostic delays. Early diagnosis predicted early attainment of LLDAS, suggesting that prompt recognition of the initial SLE symptoms is important.
METHODS: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors.
RESULTS: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk.
CONCLUSIONS: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC.
METHODS: A case-control study was nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 2008 incident invasive breast cancer cases (estrogen receptor (ER)+, n = 1622; ER-, n = 386), matched 1:1 to controls, were included in the analysis. Women were predominantly postmenopausal at blood collection (77%); postmenopausal women included users and non-users of postmenopausal hormone therapy (HT). Serum OPG was quantified with an electrochemiluminescence assay. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression.
RESULTS: The associations between OPG and ER+ and ER- breast cancer differed significantly. Higher concentrations of OPG were associated with increased risk of ER- breast cancer (top vs. bottom tertile RR = 1.93 [95% CI 1.24-3.02]; p trend = 0.03). We observed a suggestive inverse association for ER+ disease overall and among women premenopausal at blood collection. Results for ER- disease did not differ by menopausal status at blood collection (p het = 0.97), and we observed no heterogeneity by HT use at blood collection (p het ≥ 0.43) or age at breast cancer diagnosis (p het ≥ 0.30).
CONCLUSIONS: This study provides the first prospective data on OPG and breast cancer risk by hormone receptor subtype. High circulating OPG may represent a novel risk factor for ER- breast cancer.