The study of Helicobacter pylori in Malaysia has given several important insights into the epidemiology of the infection and pathogenesis of disease. Malaysia has a multiracial Asian population with three major Asian races living together-Malay, Chinese, and Indian. Races remain fairly distinct because of a paucity of interracial marriages. The "Racial Cohort Hypothesis" proposes that the infection occurs within racial groups rather than between. As such, the high prevalence among Indians (> 50%) and Chinese (40-50%) reflects the high prevalence in their countries of origin even though migration had taken place more than two generations before. The Malays have a comparatively low prevalence of about 10-20%. Despite the high prevalence of H. pylori, the Indians have a low gastric cancer incidence of less than 10 per 100 000 per year. This is in contrast to the Chinese who has an incidence in excess of 20 per 100 000 per year. We have called this the "Indian Enigma." The reason for this enigma is unclear and is the result of interaction between bacterial virulence factors, host susceptibility, and environmental factors. Phylogenetically, Chinese bacterial strains are distinct from Indians and Malays and are predominantly hpEastAsia/hsp EAsia. CagA EPIYA motifs among Chinese belong predominantly to the more virulent ABD motif. There is no clear distinguishing profile among host genetic factors. Environmental factors particularly diet may play an important role. Indians consume chilies and curries, which may be gastro protective, whereas Chinese consume more preserved and salted foods, which are thought to be carcinogenic.
The paper is based on original empirical research into the lifestyle migration of European migrants, primarily British, to Thailand and Malaysia, and of Hong Kong Chinese migrants to Mainland China. We combine strong structuration theory (SST) with Heideggerian phenomenology to develop a distinctive approach to the interplay between social structures and the lived experience of migrants. The approach enables a rich engagement with the subjectivities of migrants, an engagement that is powerfully enhanced by close attention to how these inner lives are deeply interwoven with relevant structural contexts. The approach is presented as one that could be fruitfully adopted to explore parallel issues within all types of migration. As is intrinsic to lifestyle migration, commitment to a better quality of life is central to the East Asian migrants, but they seek an uncomplicated, physically enhanced texture of life, framed more by a phenomenology of prosaic well-being than of self-realization or transcendence. In spite of possessing economic and status privileges due to their relatively elite position within global structures the reality for a good number of the lifestyle migrants falls short of their prior expectations. They are subject to particular kinds of socio-structural marginaliszation as a consequence of the character of their migration, and they find themselves relatively isolated and facing a distinct range of challenges. A comparison with research into various groups of migrants to the USA brings into relief the specificities of the socio-structural positioning of the lifestyle migrants of the study. Those East Asian migrants who express the greatest sense of ease and contentment seem to be those who have responded creatively to the specific challenges of their socio-structural situation. Often, this appears to have been achieved through understated but active involvements with their new settings and through sustaining focused transnational connections and relationships.
Road safety in rural mountainous areas is a major concern as mountainous highways represent a complex road traffic environment due to complex topology and extreme weather conditions and are associated with more severe crashes compared to crashes along roads in flatter areas. The use of crash modelling to identify crash contributing factors along rural mountainous highways suffers from limitations in data availability, particularly in developing countries like Malaysia, and related challenges due to the presence of excess zero observations. To address these challenges, the objective of this study was to develop a safety performance function for multi-vehicle crashes along rural mountainous highways in Malaysia. To overcome the data limitations, an in-depth field survey, in addition to utilization of secondary data sources, was carried out to collect relevant information including roadway geometric factors, traffic characteristics, real-time weather conditions, cross-sectional elements, roadside features, and spatial characteristics. To address heterogeneity resulting from excess zeros, three specialized modelling techniques for excess zeros including Random Parameters Negative Binomial (RPNB), Random Parameters Negative Binomial - Lindley (RPNB-L) and Random Parameters Negative Binomial - Generalized Exponential (RPNB-GE) were employed. Results showed that the RPNB-L model outperformed the other two models in terms of prediction ability and model fit. It was found that heavy rainfall at the time of crash and the presence of minor junctions along mountainous highways increase the likelihood of multi-vehicle crashes, while the presence of horizontal curves along a steep gradient, the presence of a passing lane and presence of road delineation decrease the likelihood of multi-vehicle crashes. Findings of this study have significant implications for road safety along rural mountainous highways, particularly in the context of developing countries.
A cross-sectional study design was created, using the Index of Perceived Community Resilience (IPCR) and Buckner's Index of Cohesion (BIC) to survey 386 flood evacuees from six communities in Kelantan, Malaysia, in 2015. The respondents were mostly female (54.7%); lived in basic housing (95.6%); average income (55.9%); secondary level schooling (81.1%); not involved with community organisations (95.1%), volunteering activities (91.2%), or emergency teams (96.9%); inexperience with injury during flooding (94%); experienced the emergency disaster (61.6%); and their mean age was 49 years old. Overall, respondents scored a high level of community disaster resilience (CDR) (mean 3.9) and social cohesion (mean 3.79). Also, respondents' housing type, event of injury during disaster, volunteering in post-disaster activities, and emergency team participation were significantly associated with CDR (p = 0.001-0.002), organisational involvement (p = 0.016), and emergency disaster experience (p = 0.028) were significantly associated with social cohesion. The Pearson correlation coefficient results mostly showing a moderate, weak, and one with a strong relationship. There is a strong relationship between community participation (CDR) in events and BIC variables (r = 0.529, p = 0.001). Other analysis shows a moderate but significant relationship with BIC; is open to ideas (r = 0.332, p = 0.001); community has similar values/ideas (r = 0.421, p = 0.001); sense of pride (r = 0.389, p = 0.001); strong leadership (r = 0.339, p = 0.001); positive change (r = 0.484, p = 0.001); and able to handle problems (r = 0.454, p = 0.001). Overall, the results show that respondents had high levels of CDR and social cohesion, while the demographic characteristics show the impact of CDR and social cohesion. In conclusion, the data gives original insight into the level of association between social cohesion and disaster resilience, which could be used as a building block in sustainable disaster recovery. There is a need to explore this further on programmes designed to improve social cohesion across communities.
Epigenetic processes, including DNA methylation (DNAm), are among the mechanisms allowing integration of genetic and environmental factors to shape cellular function. While many studies have investigated either environmental or genetic contributions to DNAm, few have assessed their integrated effects. Here we examine the relative contributions of prenatal environmental factors and genotype on DNA methylation in neonatal blood at variably methylated regions (VMRs) in 4 independent cohorts (overall n = 2365). We use Akaike's information criterion to test which factors best explain variability of methylation in the cohort-specific VMRs: several prenatal environmental factors (E), genotypes in cis (G), or their additive (G + E) or interaction (GxE) effects. Genetic and environmental factors in combination best explain DNAm at the majority of VMRs. The CpGs best explained by either G, G + E or GxE are functionally distinct. The enrichment of genetic variants from GxE models in GWAS for complex disorders supports their importance for disease risk.
Children aged 2 to 6 years are in a crucial period of growth development, during which it is important for them to attain specific cognition related to concentration and attention so that they can perform well in school later in life. Various factors influence children's cognition during this crucial period. However, to date, only a limited number of studies have examined the cognitive performance of underprivileged children living in poverty, particularly indigenous children (also known as Orang Asli children in Malaysia). Therefore, this cross-sectional study aimed to determine the associations between sociodemographic factors, nutritional factors (body composition and hemoglobin), and environmental factors (home environment and parasitic infections) with cognitive performance among Orang Asli children in Negeri Sembilan, Malaysia. The participants were 269 children (51% boys, 49% girls) aged 2 to 6 years (M = 4.0, SD = 1.2 years) and their mothers, from 14 Orang Asli villages. Face-to-face interviews were conducted with the mothers, and the children's cognitive performance, operationalized as working memory index (WMI), processing speed index (PSI), and cognitive proficiency index (CPI), was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). The children's weight and height were measured, and their blood and stool samples were collected to assess hemoglobin level and parasitic infections, respectively. Multiple linear regression analysis showed that the father's years of education (β = 0.262-0.342, p < 0.05), availability of learning materials at home (β = 0.263-0.425, p < 0.05), and responsiveness of the parent to the child (β = 0.192-0.331, p < 0.05) were consistently associated with all three cognitive indices (WMI, PSI, and CPI). A holistic approach involving parents, communities, and government agencies should be established to improve the cognitive performance of these underprivileged children.
：The aim of this paper is to examine the impact of local government competition and environmental regulation intensity on regional innovation performance and its regional heterogeneity. Based on the theoretical mechanism of the aforementioned variables, this study uses the Chinese provincial panel data from 2001 to 2016. We use the super-efficiency data envelopment analysis (SE-DEA) to evaluate regional innovation performance. To systematically examine the impact of local government competition and environmental regulation intensity on regional innovation performance, we build a panel date model using the feasible generalized least squares (FGLS) method. The results indicate that: the regional innovation performance can be significantly improved through technological spillover; local governments compete for foreign direct investment (FDI) to participate in regional innovative production. Moreover, improvements in environmental regulation intensity enhance regional innovation performance through the innovation compensation effect. Our results show that the local governments tend to choose lower environmental regulation intensity to compete for more FDI, which has an inhibitory effect on regional innovation performance. Furthermore, due to regional differences in factor endowments, economic reforms and economic development levels in Chinese provinces, there exists a significant regional consistency in the impact of local government competition and environmental regulation intensity on regional innovation performance. Therefore, institutional arrangements and incentive constraints must be adopted to enhance regional innovation performance as well as to guide and foster the mechanism of green innovation competition among local governments. At the same time, considering the regional heterogeneity of local government competition and environmental regulation intensity affecting regional innovation performance, policy makers should avoid the "one-size-fits-all" strategy of institutional arrangements.
This study was designed to optimize the culture conditions of juvenile Epinephelus fuscoguttatus (Forsskål, 1775) under laboratory conditions. To this effect, the rate of oxygen consumption was monitored as an index of stress under different temperature, salinity, pH, photoperiod, and urea concentrations. The result obtained after 12 h of exposure suggests the preference of the juvenile E. fuscoguttatus to a temperature range of 15-25 °C and salinity of 30 ppt. Based on this study, temperature was found to be the most lethal as 100% mortality was observed after 6 h in fish exposure to temperatures above the optimal (≥ 30 °C). However, the oxygen consumption rate was similar under the different pH, photoperiod, and urea concentration tested. It was concluded that water temperature was most critical in terms of respiration physiology of the juvenile E. fuscoguttatus given the range and levels of environmental factors tested in this study.
This study investigates the effects of aircraft cabin pressure on intracranial pressure (ICP) elevation of a pneumocephalus patient. We propose an experimental setup that simulates the intracranial hydrodynamics of a pneumocephalus patient during flight. It consists of an acrylic box (skull), air-filled balloon [intracranial air (ICA)], water-filled balloon (cerebrospinal fluid and blood) and agarose gel (brain). The cabin was replicated using a custom-made pressure chamber. The setup can measure the rise in ICP during depressurization to levels similar to that inside the cabin at cruising altitude. ΔICP, i.e. the difference between mean cruising ICP and initial ICP, was found to increase with ICA volume and ROC. However, ΔICP was independent of the initial ICP. The largest ΔICP was 5 mmHg; obtained when ICA volume and ROC were 20 ml and 1,600 ft/min, respectively. The postulated ICA expansion and the subsequent increase in ICP in pneumocephalus patients during flight were successfully quantified in a laboratory setting. Based on the quantitative and qualitative analyses of the results, an ICA volume of 20 ml and initial ICP of 15 mmHg were recommended as conservative thresholds that are required for safe air travel among pneumocephalus patients. This study provides laboratory data that may be used by doctors to advise post-neurosurgical patients if they can safely fly.
Soil-transmitted helminthiasis is a common problem in communities with poor socio-environmental conditions. This study was undertaken to identify important socio-environmental predictors of soil-transmitted helminthiasis in Bachok, a rural community in Kelantan for the development and implementation of an effective prevention and control program. Of 363 children randomly sampled, 38.8% were infected with soil-transmitted helminthiasis. Risk predictors of soil-transmitted helminthiasis found to be significant after adjustment included poor household hygiene score and large household size. The probability of being infected was 0.58 amongst children with both of these risk factors.
The Sulu-Sulawesi Sea, with neighboring Indonesian Seas and South China Sea, lies at the center of the world's tropical marine biodiversity. Encircled by 3 populous, developing nations, the Philippines, Indonesia and Malaysia, the Sea and its adjacent coastal and terrestrial ecosystems, supports ca. 33 million people, most with subsistence livelihoods heavily reliant on its renewable natural resources. These resources are being impacted severely by rapid population growth (> 2% yr-1, with expected doubling by 2035) and widespread poverty, coupled with increasing international market demand and rapid technological changes, compounded by inefficiencies in governance and a lack of awareness and/or acceptance of some laws among local populations, particularly in parts of the Philippines and Indonesia. These key root causes all contribute to illegal practices and corruption, and are resulting in severe resource depletion and degradation of water catchments, river, lacustrine, estuarine, coastal, and marine ecosystems. The Sulu-Sulawesi Sea forms a major geopolitical focus, with porous borders, transmigration, separatist movements, piracy, and illegal fishing all contributing to environmental degradation, human suffering and political instability, and inhibiting strong trilateral support for interventions. This review analyzes these multifarious environmental and socioeconomic impacts and their root causes, provides a future prognosis of status by 2020, and recommends policy options aimed at amelioration through sustainable management and development.
This article is based on the findings of the Global International Waters Assessment (GIWA) Subregion 53, Bay of Bengal. It introduces the Subregion. The wide disparity in development indicators in the Bay of Bengal Subregion (BOBSR) is presented. The large population of poor people living in South Asia is presented as a factor that needs special attention. The article focuses on the 3 geographic sites selected for detailed analysis: i) the Ganges-Brahmaputra-Meghna river systems; ii) the Merbok Estuary mangroves, Malaysia; and iii) the Sunderbans mangroves, Bangladesh. Integrated water management based upon regional cooperation among Bangladesh, India and Nepal holds opportunities for mutual benefit. Policy options are proposed. For mangrove ecosystems, the impacts of urbanization in Malaysia and the unmanaged expansion of shrimp farming in Bangladesh are analyzed. Improved governance was seen to hold promise for enhancing economic benefits from shrimp farming while safeguarding the natural ecological system. However, these measures need to be a part of national efforts to achieve the UN Millennium Development Goals.
Periophthalmodon schlosseri is an amphibious and obligatory air-breathing teleost, which is extremely tolerant to environmental ammonia. It actively excretes NH(4)(+) in ammonia loading conditions. For such a mechanism to operate efficaciously the fish must be able to prevent back flux of NH(3). P. schlosseri could lower the pH of 50 volumes (w/v) of 50% seawater in an artificial burrow from pH 8.2 to pH 7.4 in 1 day, and established an ambient ammonia concentration of 10 mmol l(-1) in 8 days. It could alter the rate of titratable acid efflux in response to ambient pH. The rate of net acid efflux (H(+) excretion) in P. schlosseri was pH-dependent, increasing in the order pH 6.0<7.0<8.0<8.5. Net acid flux in neutral or alkaline pH conditions was partially inhibited by bafilomycin, indicating the possible involvement of a V-type H(+)-ATPase. P. schlosseri could also increase the rate of H(+) excretion in response to the presence of ammonia in a neutral (pH 7.0) external medium. Increased H(+) excretion in P. schlosseri occurred in the head region where active excretion of NH(4)(+) took place. This would result in high concentrations of H(+) in the boundary water layer and prevent the dissociation of NH(4)(+), thus preventing a back flux of NH(3) through the branchial epithelia. P. schlosseri probably developed such an 'environmental ammonia detoxification' capability because of its unique behavior of burrow building in the mudflats and living therein in a limited volume of water. In addition, the skin of P. schlosseri had low permeability to NH(3). Using an Ussing-type apparatus with 10 mmol l(-1) NH(4)Cl and a 1 unit pH gradient (pH 8.0 to 7.0), the skin supported only a very small flux of NH(3) (0.0095 micromol cm(-2) min(-1)). Cholesterol content (4.5 micromol g(-1)) in the skin was high, which suggests low membrane fluidity. Phosphatidylcholine, which has a stabilizing effect on membranes, constituted almost 50% of the skin phospholipids, with phosphatidyleserine and phsophatidylethanolamine contributing only 13% and 15%, respectively. More importantly, P. schlosseri increased the cholesterol level (to 5.5 micromol g(-1)) and altered the fatty acid composition (increased total saturated fatty acid content) in its skin lipid after exposure to ammonia (30 mmol l(-1) at pH 7.0) for 6 days. These changes might lead to an even lower permeability to NH(3) in the skin, and reduced back diffusion of the actively excreted NH(4)(+) as NH(3) or the net influx of exogenous NH(3), under such conditions.
The present paper is the third and concluding part of a study of the secondary school population of two of Malaysia's thirteen states, Penang and Selangor. Since completion of the two earlier papers, the research team has investigated the pattern and nature of drug use among the equivalent population in a third state, Kelantan, and has again found essentially the same pattern of results: youthful drug use is most clearly related to precocious self-assertion, and a set of beliefs and attitudes about drugs and drug taking, and is largely unrelated to indicators of social deprivation or personal problems. The significance of this repeated finding in Kelantan is that, in this much more rural and traditional state, adult and established patterns of drug use had historically differed considerably from those found in the two more urban and cosmopolitan states of Penang and Selangor. Our findings indicate that the new pattern of drug use by youth has transcended the older cultural differences between the states, and is in turn explained by a more universally familiar set of characteristics in adolescent development.
Those Malaysian secondary schoolchildren who have ever used an illicit drug do not differ significantly in terms of social class background, ethnicity or rural/urban location, from the majority of their contemporaries who have not used drugs. The cross-sectional data show a rapid secular trend towards the sexes being equally involved in drug use. Significant differences between ever and never users are, however, found in their attitudes towards drug taking and their beliefs about the properties of drugs, although both groups share the same rather negative image of the typical drug user. Thus, drug users have accepted some of the attitudes towards drug issues which are normative in the non-user group, whilst developing other attitudes which are consistent with their continuing use. It is argued that adolescent drug abuse in Malaysia is not to be linked specifically with social deprivation, but should be seen as being part of the life style of particular groups in all strata of society.
This study used path analysis to assess the chances of survival of babies in a neonatal intensive care unit in Lansing, Michigan, USA. Two paths to neonatal survival were identified and the variables accounted for 20% of the variance in gestational age. The first path showed that prior infant losses were negatively correlated with gestational age while in the second path, gestational age showed negative relationships with pre-pregnancy weight and household job worries.