METHODS: We conducted cognitive interviews (n = 645) in three iterative waves of data collection across 19 countries during March 2022-March 2023, with participants of diverse sex, gender, age and geography. Interviewers used a semi-structured field guide to elicit narratives from participants about their questionnaire item interpretation and response processes. Local study teams completed data analysis frameworks, and we conducted joint analysis meetings between data collection waves to identify question failures.

FINDINGS: Overall, we observed that participants were willing to respond to even the most sensitive questionnaire items on sexual biography and practices. We identified issues with the original questionnaire that (i) affected the willingness (acceptability) and ability (knowledge barriers) of participants to respond fully; and/or (ii) prevented participants from interpreting the questions as intended, including poor wording (source question error), cultural portability and very rarely translation error. Our revisions included adjusting item order and wording, adding preambles and implementation guidance, and removing items with limited cultural portability.

MATERIALS AND METHODS: This study was conducted retrospectively by reviewing records of pancreatic cancer patients hospitalized between January 2011 and December 2018 across multiple health centres in Malaysia. Using Cox proportional hazards regression analysis, several prognostic factors were identified.

RESULTS: The study revealed that being Chinese, having a family history of pancreatic cancer, having hepatitis C, presenting with jaundice, experiencing pale stools, having a palpable mass in the abdomen, the presence of ascites, receiving palliative care and end-of-life care were associated with higher mortality risk. Conversely, being female, having hypertension, and higher haemoglobin levels were linked to decreased mortality risk.

MATERIALS AND METHODS: A single-blinded Randomized Controlled Clinical Trial was conducted at the IKN between January 2023 and June 2023. The estimated sample size was 120 participants. A sequential numbering system assigned a unique identifier to each participant until a total of 120 participants were recruited, with 60 participants in both the intervention and control groups. The intervention group received chemotherapy counselling using a newly developed module. QoL and depression were assessed at multiple time points using a validated questionnaire. Data were analysed using SPSS version 26, with independent tests and two-way repeated measures ANOVA. A p-value < 0.05 was considered significant, and partial eta squared was used to measure effect size.

RESULT: Overall, in age distribution, the intervention group had the highest percentage of participants in the 41-60 years category (40.0%), whereas the control group had the highest percentage of participants aged ≥61 years (38.3%). The counselling module was effective in improving QoL and depression among participants at baseline and for three consecutive follow-ups following interventions. The QoL showed improvement in all four domains in the intervention group, which were Physical Health (p < 0.001), Psychological (p < 0.001), Social Relationship (p < 0.001), and Environment (p = 0.001). There was also a moderate effect reduction on depression (p < 0.001).

MATERIALS AND METHODS: A retrospective review was conducted on patients who underwent ICCE at Hospital Melaka, Malaysia, from January 2014 to December 2023.

RESULTS: A total of 143 ICCE surgeries were performed on 135 patients. Most patients were male (n=88, 65.2%), with females comprising 34.8% (n=47). Most surgeries were performed on patients aged 60-69 years (n=48, 35.5%), followed by those aged 50-59 years (n=31, 23.0%) and 70-79 years (n=28, 20.7%). Incidence was lower among patients below 50 years and above 80 years. In terms of ethnicity, the highest incidence was among Malays (n=77, 57.0%), followed by Chinese (n=42, 31.1%) and Indians (n=15, 11.1%). The leading cause of ICCE was senile cataract with weak zonular support (n=58, 40.6%), followed by trauma (n=33, 23.1%), intraoperative complications (n=30, 21.0%), congenital cataracts (n=14, 9.8%), pseudoexfoliation (n=4, 2.8%), and lens-induced glaucoma (n=4, 2.8%). Post-surgery, 76 patients (53.1%) were left aphakic. Among those receiving IOL implants, 21.0% (n=30) had anterior chamber IOL, 14.7% (n=21) received an iris-claw IOL, and 11.2% (n=16) had a scleral-fixated IOL. Twelve weeks after IOL implantation, 60.9% (n=39) achieved good visual acuity of 6/12 or better, while 17.2% (n=11) had moderate vision (6/18 to 6/36), and 21.9% (n=14) had poor vision (worse than 6/60).

MATERIALS AND METHODS: A cross-sectional study was conducted with 244 occupational therapy practitioners; 43 males; and 181 females. The level of empathy and listening style were assessed using the Jefferson Scale of Empathy Health Professional version and Listening Styles Profile- Revised questionnaires. Data were collected using Google Form. Analysis data were done using IBM SPSS Statistical Software version 26.

RESULTS: Statistical analysis showed that Malaysia occupational therapists preferred perspective taking (mean 55.67, Standard Deviation, SD 10.54) in empathy and the analytical listening in listening styles approach (mean 34.71, SD 6.76). In addition, there was a moderate to strong significant correlation between the level of empathy and listening styles (r= 0.419 to 0.648, p<0.05). Furthermore, there is significant difference between listening styles and empathy in relation to gender (male>female) p=0.001-0.038), race (Indian higher than Malay and Chinese) and areas of practice (paediatric higher than psychiatric) (p= 0.016 to 0.039).

MATERIALS AND METHODS: We conducted a retrospective cohort study of HL patients treated from January 1, 2006, to December 31, 2018, with follow-up until December 31, 2021. Data on demographics, clinical features, treatments, and outcomes were analyzed. OS and PFS were estimated using the Kaplan-Meier method.

RESULTS: Among 126 patients, the median follow up was 41 months. Most were male (55.6%) and of Malay ethnicity (97.6%). Nodular sclerosis was the predominant histology (52.4%), with 77.8% presenting with advanced-stage disease. All patients received chemotherapy, while 23.1% underwent combined modality therapy either with radiotherapy or immunotherapy. Post-treatment, only 34.1% achieved complete response. The 3-year OS and PFS rates were 74.9% and 59.5%, respectively-relatively lower than rates reported in developed countries. Independent adverse prognostic factors for OS and PFS included advanced-stage disease, bulky disease, elevated erythrocyte sedimentation rate.

MATERIALS AND METHODS: A total of 160 individuals were selected, comprising 80 psoriasis patients and 80 controls, matched for age, gender, ethnicity, marital status, education levels, and prevalence of comorbidities. Cognitive function was assessed using the VCAT. The relationship between cognitive impairment and various disease-related factors, including psoriasis severity measured using Psoriasis Area Severity Index (PASI scores), disease duration, and the presence of psoriatic arthropathy, was examined.

RESULTS: The mean VCAT scores for the psoriasis and control groups were 25.38 (SD = 3.18) and 25.94 (SD = 2.67), respectively, with no significant difference between the two groups (p = 0.227). While most cognitive domains showed no significant differences, the VCAT attention sub-score was significantly lower in psoriasis patients (p < 0.05). There was no significant association between psoriasis and cognitive impairment. No significant association was found between cognitive function and PASI scores nor psoriatic arthropathy. A negative association was found between disease duration and VCAT scores, suggesting longer disease duration correlates with lower cognitive function (p = 0.05).

MATERIALS AND METHODS: A cross-sectional study was conducted on 543 HCWs from the KOSPEN WOW ("Komuniti Sihat Pembina Negara" or "Healthy Community Builds the Nation-Wellness of Workers") database in three district health offices (DHOs) under the Selangor State Health Department in Malaysia. To estimate the office-based Globorisk model, factors such as age, sex, current smoking status, systolic blood pressure (SBP), and body mass index (BMI) were included. Data analysis employed were Pearson chi-square test, Fisher's exact test, Welch's t-test and binary logistic regression.

RESULTS: Among 543 participants, 453 (83.4%) were female, 439 (80.8%) were Malay with mean (SD) age of 44.4 (4.38). Majority of moderate-high CVDs risk identified among primary HCWs was male with 26 (86.7%), Malay with 25 (83.3%), and non-clinical group with 17 (56.7%). The prevalence of low CVDs risk was 94.5% (95% CI: 92.2-96.2) and 5.5% (95% CI: 3.8-7.8) for the moderate-high risk category. Factors associated with moderate-high CVDs risk were job category with non-clinical group (95% CI: 1.43, 6.85), elevated blood glucose (95% CI: 3.25, 19.41) and anxiety symptom (95% CI: 1.46, 13.86).

MATERIALS AND METHODS: A single-centre case-control study was conducted in which patients admitted with stroke and healthy controls were recruited with consent. EEG was performed within 48 hours of admission for stroke patients and during outpatient assessments for controls. The EEG signals were pre-processed, analysed for spectral power using MATLAB, and plotted as topoplots.

RESULTS: A total of 194 participants were included and equally divided into patients with ischemic stroke and controls. The mean age of our study cohort was 55.11 years (SD±13.12), with a median National Institute of Health Stroke Scale (NIHSS) score of 6 (IQR 4-6) and lacunar stroke was the most common subtype (49.5%). Spectral analysis, with subsequent topographic brain mapping, highlighted clustering of important channels within the beta, alpha, and gamma bands.

OBJECTIVE: This study aims to compare the effects of computerized Acugraph-guided acupuncture versus manually selected acupuncture as adjuncts to physiotherapy in managing KOA.

METHODS: A randomized, double-blind controlled trial will be conducted with 50 participants diagnosed with mild to moderate KOA. Participants will be randomly assigned to one of two groups: Group 1 Comp-AcuPhysio (n = 25), receiving Acugraph-guided acupuncture with physiotherapy, or Group 2 Man-AcuPhysio (n = 25), receiving manually selected acupuncture with physiotherapy. Both groups will undergo 12 weekly treatment sessions, each lasting 60 minutes. Outcome measures, including the Knee Injury and Osteoarthritis Outcome Score, active knee flexion range, Timed Up and Go test, Visual Analog Scale for pain, Short Form-36 health survey, and Personal Integrated Energetics score, will be assessed at baseline and immediately post-intervention. An intention-to-treat analysis will be applied. Changes from baseline to 12 weeks will be analyzed using repeated measures analysis of variance for both within-group and between-group comparisons.

RESULTS: This study will provide a definitive assessment of the effectiveness of computerized Acugraph-guided acupuncture compared to manually selected acupuncture as supplementary treatments alongside KOA physiotherapeutic rehabilitation.

CONCLUSION: This trial will offer insights into how incorporating technology-driven approaches, such as Acugraph, with physiotherapy can enhance the customization and effectiveness of KOA management, leading to improved clinical outcomes. These results could advocate for the integration of technological tools in acupuncture to boost treatment precision and efficacy for KOA.

METHODS: This questionnaire development study involved four phases: (i) exploring and understanding the subject matter, (ii) questionnaire development, (iii) content validity testing, and lastly, (iv) field-testing of the questionnaire. For the field-testing phase, a cross-sectional self-administered survey of JoinCT was conducted among cancer patients with various socio-demographic backgrounds and medical conditions. Besides content validity, Cronbach's alpha was used to evaluate the internal consistency of domains, and confirmatory factor analysis was used to evaluate the model fit of the JoinCT framework.

METHODS: Clinical data, including age at symptom onset, was collected from 289 patients who presented to our multidisciplinary clinic from 2016 until 2024. A least squares linear regression model was constructed from the logarithm of approximated incidence and the logarithm of age. Population incidence was approximated by adjusting the absolute numbers of patients in 5 year groups by the size of the general population in the respective age group.

RESULTS: A linear relationship between log of incidence versus log of age was observed, with a slope of 4.57 (95% CI, 3.3-5.8) and an r2 value of 0.93, suggesting a 6-step process.

METHODS: Patients aged 18 years or older with SLE were followed up from May 1, 2013, to Dec 31, 2020 in a prospective, multinational, longitudinal cohort study. Patients were recruited from 25 centres in 12 countries. Multi-failure time-to-event analyses were used to assess the effect of sustained LLDAS on irreversible damage accrual (primary outcome; measured with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) and flare (key secondary outcome; measured with the SELENA Flare Index), with dose exposure and threshold effects studied. Sustained LLDAS or remission were defined as two or more consecutive visits over at least 3 months in the respective state. This study is registered with ClinicalTrials.gov, NCT03138941.

FINDINGS: 3449 patients were followed up for a median of 2·8 years (IQR 1·1-5·6), totalling 37 662 visits. 3180 (92·2%) patients were women, and 3031 (87·9%) were of Asian ethnicity. 2506 (72·7%) patients had sustained LLDAS at least once. Any duration of sustained LLDAS or remission longer than 3 months was associated with reduced damage accrual (LLDAS: hazard ratio 0·60 [95% CI 0·51-0·71], p<0·0001; remission: 0·66 [0·57-0·76], p<0·0001) and flare (LLDAS: 0·56 [0·51-0·63], p<0·0001; remission: 0·66 [0·60-0·73], p<0·0001), and increasing durations of sustained LLDAS corresponded to increased protective associations. Sustained DORIS remission or steroid-free remission were less attainable than LLDAS.

INTERPRETATION: We observed significant protective associations of LLDAS and remission against damage accrual and flare, establish a threshold of 3 months sustained LLDAS or remission as protective, and demonstrate deepening protection with longer durations of sustained LLDAS or remission.

MATERIALS AND METHODS: All patients admitted to medical wards with blood stream infection during the period January 2021 to June 2021 were enrolled. Identification of organisms and antimicrobial susceptibility testing were obtained. Information regarding the severity of the bacteremia was collected by assessing if the patient needed inotropes, mechanical ventilation or renal replacement therapy. Data on comorbidities which were the presence of end-stage renal failure, diabetic mellitus and immunosuppression were collected.

RESULTS: Total of 269 cases were screened. Out of these 104 communities acquired cases were included. The pathogens frequently isolated were gram negative organisms most commonly Escherichia coli (43%) and Klebsiella species (30%). Staphylococcus aureus accounts for the majority of gram-positive organisms. Only two out of 20 Staphylococcus aureus were methicillin resistant. Bulkholderia pseudomallei accounts for 7.8% cases. All Burkholderia pseudomallei isolates were sensitive to cotrimoxazole. Escherichia coli (46%) isolates demonstrated a higher resistance pattern to Augmentin compared to klebsiella species (17.4%). The overall mortality rate was 22%, with higher rates for those critically ill (39%). Patients with Enterobacteriaceae infection showed no difference in outcome between the groups of patients according to sensitivity to Augmentin and cefotaxime. These groups of patients who were critically ill did not demonstrate any significant difference in terms of resistance pattern to Augmentin (p = 0.3) and cefotaxime (p = 0.7). Patients who are aged 65 or older have a significantly more resistant pattern to Augmentin and cefotaxime.

OBJECTIVE: The main objective of this paper is to develop a robust algorithm to extract respiration rate using the contactless displacement sensor.

METHODS: In this study, chest movements were used as an indicative of inspiration and expiration to measure respiratory rate using the contactless displacement sensor. The contactless optical signals were recorded from 32 healthy subjects in four different controlled breathing conditions: rest, coughing, talking and hand movement to obtain the motion artifacts that the patients may have in the emergency department. The Empirical mode decomposition (EMD) algorithm was used to derive continuous RR signal from the contactless optical signal.

RESULTS: The analysis showed that there is a good correlation (0.9702) with RMSE of 0.33 breaths per minutes between the contact respiration rate and contactless respiration rate using empirical mode decomposition method.

OBJECTIVE: We investigated if exposure of women to the Dutch famine during childhood and adolescence was associated with an unhealthy lifestyle later in life.

DESIGN: We studied 7,525 women from the Prospect-EPIC cohort, recruited in 1993-97 and aged 0-18 years during the Dutch famine. An individual famine score was calculated based on self-reported information about experience of hunger and weight loss. We investigated the association between famine exposure in early life and four lifestyle factors in adulthood: smoking, alcohol consumption, physical activity level and a Mediterranean-style diet.

RESULTS: Of the 7,525 included women, 46% were unexposed, 38% moderately exposed and 16% severely exposed to the Dutch famine. Moderately and severely exposed women were more often former or current smokers compared to women that did not suffer from the famine: adjusted prevalence ratio 1.10 (95% CI: 1.05; 1.14) and 1.18 (1.12; 1.25), respectively. They also smoked more pack years than unexposed women. Severely exposed women were more often physically inactive than unexposed women, adjusted prevalence ratio 1.32 (1.06; 1.64). Results did not differ between exposure age categories (0-9 and 10-17 years). We found no associations of famine exposure with alcohol consumption and no dose-dependent relations with diet.

METHODS: The medical records of 24 patients who underwent repeat MUS surgery at a single tertiary center from January 2004 to February 2014 were reviewed. The types of MUS used for the repeat surgey were transobturator, retropubic and single incision slings. Objective cure was defined as no demonstrable involuntary leakage of urine during increased abdominal pressure in the absence of a detrusor contraction observed during filling cystometry, and subjective cure was defined as a negative response to Urogenital Distress Inventory six (UDI-6) question 3 during follow-up between 6 months and 1 year postoperatively. The change in the inclination angle between the urethra and pubic axis was measured with introital ultrasonography and the cotton swab test performed.

RESULTS: The objective and subjective cure rates were 79.2 % and 75 %, respectively. There were no differences in demographics between the patients with failure of surgery and those with successful surgery. Significant independent risk factors for failure of repeat MUS surgery were a change in cotton swab angle at rest and straining of <30° (OR 4.6, 95 % CI 2.5 - 7.9°), a change in inclination angle of <30° (OR 4.6, 95 % CI 2.5 - 7.9°), intrinsic sphincter deficiency (OR 3.4, 95 % CI 1.8 - 6.1) and a mean urethral closure pressure of <60 cm H2O (OR 2.9, 95 % CI 1.5 - 4.5). In one patient the bladder was perforated.

METHODS: This is a retrospective study on 750 women seen at a tertiary urogynecological unit who had undergone a standardized interview, clinical examination, and 4D TPUS. Univariate and multivariate logistic regression analyses were undertaken to study the association between examination findings and symptoms of OD. This study was approved by the local human research ethics committee (Nepean Blue Mountains Local Health District Human Research Ethics Committee, IRB approval no. 13-16).