The current paper is a response to the Wiley, McAllister, Davidson, and Marshall lead article regarding the application of the World Report on Disability (WRD) to people with communication disorders. The current paper directly addresses recommendation 5 (improvement of human resource capacity) and indirectly addresses recommendations 7, 8, and 9 (related to improving local knowledge and data on communicative disabilities) indirectly. The paper describes Malaysia's initiatives in the early 1990s, in developing its local professional capacity to provide services for people with communication disorders (PWCD). It charts the history of development of a local undergraduate entry-level degree program for speech-language pathology (SLP) from the point of conceptualization to full execution. The article provides glimpses to the processes and challenges faced by Universiti Kebangsaan Malaysia as the pioneer university in the South East Asia region to undertake the training and education of the SLP profession and highlights relevant issues faced by newly introduced professions in a country where resources and practice traditions were previously unavailable. It underscores the important role played by government institutions and an international professional network in driving forward-looking policies to implement and sustain the program.
We present an unusual neonatal fungal infection, Hansenula anomala in a very low birthweight infant who underwent abdominal surgery for an omphalocele. Despite treatment with adequate doses of amphotericin B, the yeast continued to grow from the blood culture, and was only eradicated with the use of oral ketoconazole.
Facilitative playback-based subjective measures offer a more reliable evaluation of the vocal fold vibration than those derived from direct inspection of video playback. One of the measures is a Nyquist plot, which presents the analyzed cycle-to-cycle vibratory information in a graphical form. While the potential is evident, the information of the features of the Nyquist plot, which the evaluation is based on, is still incomplete. The current identified features and their vibratory behaviors may be inadequate to guarantee accurate interpretation of the findings. The present study aims to address this issue by examining the features of the Nyquist plot and their vibratory behaviors. A total of 56 young normophonic speakers, that is, 20 males and 36 females were recruited as the participants. Each of them underwent laryngeal high-speed videoendoscopy to record the images of the vocal fold vibration, which were then analyzed to generate the Nyquist plots. The features were identified by inspecting the properties of the plot points forming the Nyquist plots. For each identified feature, its vibratory behaviors were examined. The results revealed four features: rim contour depicting the longitudinal phase difference; left edge shape signifying the glottal configuration, phase closure, and closed phase duration; rim width and rim pattern visualizing the regularity of glottal areas and the regularity of the intracycle variations, respectively. The findings present a more complete reference of the features and their vibratory behaviors that is pertinent for the Nyquist plot interpretation.
We aimed to identify factors contributing to ineffective prevention of thalassaemia in Malaysia by studying events leading to the births of children with transfusion-dependent thalassaemia (TDT) including their parents' reproductive choices.
The rhizomes of Alpinia pahangensis Ridley yielded a new bis-labdanic diterpene for which the name pahangensin A (1) was proposed along with a new labdane diterpene, pahangensin B (2). Their structures were elucidated by spectroscopic methods including, 1D and 2D NMR techniques and LCMS-IT-TOF analysis. Pahangensin A (1) was found to be an antibacterial agent against Staphylococcus aureus, Bacillus cereus and Bacillus subtilis with MIC values less than 100 μg/mL, respectively. Pahangensin B (2) exhibited antibacterial activity (MIC <100 μg/mL) against B. cereus.
Despite its clear advantages, laryngeal high-speed videoendoscopy (LHSV) has not yet been accepted as a routine imaging tool for the evaluation of vocal fold vibration due to the unavailability of methods to effectively analyze the huge number of images from the LHSV recording. Recently, a promising LHSV-based analysis method has been introduced. The ability of this analysis method in studying the vocal fold vibratory behaviors had been substantially demonstrated. However, some practical aspects of its clinical applications still require further attention. Most fundamental is that the criteria for the measurement input ie, a segment of interest (SOI), which has not been fully defined. Particularly, the length of the SOI and the location along the sample, where it needs to be selected require further confirmation. Meanwhile, the analysis using any options of a well-delineated glottal area demands verification. Without clear criteria for the SOI, it is difficult to demonstrate the relevance of this analysis method in clinical voice assessment. Therefore, the aim of the present study is to establish the criteria for the SOI, which involved the investigations on the length of the SOI and the location along the sample, where it needs to be selected, as well as the use of any options of a well-delineated glottal area for analysis. The participants in the present study consisted of 36 young normophonic females. The methods involved LHSV recording of the images of the vibrating vocal folds. The captured images were then analyzed using the method. The LHSV-based measures from the analyses were compared according to the specified procedures of each investigation. Results indicated that 2000 frames should be used as the SOI length. The SOI could be selected at any location along the sample as long as well-delineated glottal areas were observed. With the current findings, a more conclusive measurement protocol is available to ensure reliable LHSV-based measures. The findings further support this analysis method for clinical application, which in turn promote LHSV as a reliable laryngeal imaging tool in clinical setting.
This study was designed to develop language-specific stimuli for the assessment of resonance and to obtain nasalance scores using the newly developed speech stimuli in Mandarin. Gender and age influences on nasalance scores for each of the stimulus were also examined. Participants recruited were typically developing Mandarin-speaking ethnic Chinese children aged 6;00-7;11 growing up in Malaysia. Perceptual ratings of nasality were made based on the GOS.SP.ASS.'98 (revised) for children while nasalance scores were recorded for each stimulus using the Nasometer II (Model 6400). Fifty Mandarin-speaking children (24 males and 26 females) were recruited. None of the participants were perceived with abnormal nasality on the three stimuli. The mean nasalance scores for the Mandarin stimuli were 16.08% (SD = 2.57, 95% CI = 15.35-16.81) for the Oral passage, 25.20% (SD = 3.63, 95% CI = 24.17-26.23) for the Oral-Nasal passage and 55.44% (SD = 4.17, 95% CI = 54.25-56.63) for the Nasal passage. No significant age- and gender-related differences were observed for all the three stimuli. This is the first set of Mandarin stimuli and nasalance norms for Mandarin-speaking children in Malaysia. The influence of phonetic content on nasalance is supported. Findings call for language-specific normative nasalance data and careful selection of stimuli for the assessment of resonance.
Proliferative Diabetic Retinopathy (PDR) is a severe retinal disease that threatens diabetic patients. It is characterized by neovascularization in the retina and the optic disk. PDR clinical features contain highly intense retinal neovascularization and fibrous spreads, leading to visual distortion if not controlled. Different image processing techniques have been proposed to detect and diagnose neovascularization from fundus images. Recently, deep learning methods are getting popular in neovascularization detection due to artificial intelligence advancement in biomedical image processing. This paper presents a semantic segmentation convolutional neural network architecture for neovascularization detection. First, image pre-processing steps were applied to enhance the fundus images. Then, the images were divided into small patches, forming a training set, a validation set, and a testing set. A semantic segmentation convolutional neural network was designed and trained to detect the neovascularization regions on the images. Finally, the network was tested using the testing set for performance evaluation. The proposed model is entirely automated in detecting and localizing neovascularization lesions, which is not possible with previously published methods. Evaluation results showed that the model could achieve accuracy, sensitivity, specificity, precision, Jaccard similarity, and Dice similarity of 0.9948, 0.8772, 0.9976, 0.8696, 0.7643, and 0.8466, respectively. We demonstrated that this model could outperform other convolutional neural network models in neovascularization detection.
A new genus from Borneo, Borneocola Y.Y.Sam, is described here. The genus currently contains eight species previously classified as members of the Scaphochlamys Baker. The finding is based on the results of the morphological and molecular studies of Scaphochlamys throughout its geographical range and its closely allied sister groups, Distichochlamys M.F.Newman and Myxochlamys A.Takano & Nagam. Borneocola is nested within the tribe Zingibereae and its monophyly is strongly supported by both ITS and matK sequence data. The genus is characterised by several thin, translucent and marcescent floral bracts, absence of coloured streaks on the labellum and capitate stigma with two dorsal knobs. The genus is distributed in northwest Borneo and all species are very rare and highly endemic.
The inhibition of carbohydrate-hydrolyzing enzymes in human digestive organs is crucial in controlling blood sugar levels, which is important in treating type 2 diabetes. In the current study, pahangensin A (1), a bis-labdanic diterpene characterized previously in the rhizomes of Alpinia pahangensis Ridl., was identified as an active dual inhibitor for α-amylase (IC50 =114.80 μm) and α-glucosidase (IC50 =153.87 μm). This is the first report on the dual α-amylase and α-glucosidase inhibitory activities of a bis-labdanic diterpene. The Lineweaver-Burk plots of compound 1 indicate that it is a mixed-type inhibitor with regard to both enzymes. Based on molecular docking studies, compound 1 docked in a non-active site of both enzymes. The dual inhibitory activity of compound 1 makes it a suitable natural alternative in the treatment of type 2 diabetes.
The conventional susceptible-infectious-recovered (SIR) model tends to magnify the transmission dynamics of infectious diseases, and thus the estimated total infections and immunized population may be higher than the threshold required for infection control and eradication. The study developed a new SIR framework that allows the transmission rate of infectious diseases to decline along with the reduced risk of contact infection to overcome the limitations of the conventional SIR model. Two new SIR models were formulated to mimic the declining transmission rate of infectious diseases at different stages of transmission. Model A utilized the declining transmission rate along with the reduced risk of contact infection following infection, while Model B incorporated the declining transmission rate following recovery. Both new models and the conventional SIR model were then used to simulate an infectious disease with a basic reproduction number (r0) of 3.0 and a herd immunity threshold (HIT) of 0.667 with and without vaccination. Outcomes of simulations were assessed at the time when the total immunized population reached the level predicted by the HIT, and at the end of simulations. Further, all three models were used to simulate the transmission dynamics of seasonal influenza in the United States and disease burdens were projected and compared with estimates from the Centers for Disease Control and Prevention. For the simulated infectious disease, in the initial phase of the outbreak, all three models performed expectedly when the sizes of infectious and recovered populations were relatively small. As the infectious population increased, the conventional SIR model appeared to overestimate the infections even when the HIT was achieved in all scenarios with and without vaccination. For the same scenario, Model A appeared to attain the level predicted by the HIT and in comparison, Model B projected the infectious disease to be controlled at the level predicted by the HIT only at high vaccination rates. For infectious diseases with high r0, and at low vaccination rates, the level at which the infectious disease was controlled cannot be accurately predicted by the current theorem. Transmission dynamics of infectious diseases with herd immunity can be accurately modelled by allowing the transmission rate of infectious diseases to decline along with the reduction of contact infection risk after recovery or vaccination. Model B provides a credible framework for modelling infectious diseases with herd immunity in a randomly mixed population.
Malaysia conducted the first BMT in the country in 1987. Since then, there have been 1155 transplantations performed in a total of eight transplant centres. A majority of the transplantations were allogeneic, including myeloablative and nonmyeloablative. A vast majority of donors are HLA identical siblings. The mean age of transplanted patients was 26 years. The major reason for transplantation was hematological malignancies. The overall survival was 60% for allogeneic transplantation and 52% for autologous transplantation. The most common cause of death in transplanted patients was the underlying disease followed by infection-related complications. Currently, the government is expanding the existing public cord blood bank as well as the local donor registry.
This study examined the influence of cariogenic environments on the surface roughness of ion-releasing restorative materials (IRMs). Custom-made stainless steel molds with holes of 5 mm × 2mm were used to fabricate 60 disc-shaped specimens of each of the following materials: Activa Bioactive (AV), Beautifil Bulk Restorative (BB), Cention N (Bulk-fill) (CN), and Filtek Z350XT (FZ) (Control). Baseline surface roughness (Ra) measurements were obtained using an optical 3D measurement machine (Alicona Imaging GmbH, Graz, Austria). The specimens were then randomly divided into five subgroups (n=12) and exposed to 10 ml of the following mediums at 37°C: distilled water (DW), demineralization solution (DM), remineralization solution (RM), pH cycling (PC) and air (AR) (control). Ra measurements were again recorded after one week and one month, followed by statistical evaluations with two-way analysis of variance (ANOVA) to determine interactions between materials and mediums. One-way ANOVA and post hoc Games Howell tests were performed for intergroup comparisons at a significance level of 0.05. Mean Ra values ranged from 0.085 ± 0.004 (µm) to 0.198 ± 0.001 µm for the various material-medium combinations. All IRMs showed significant differences in Ra values after exposure to the aqueous mediums. The smoothest surfaces were observed in the AR for all materials. When comparing materials, AV presented the roughest surfaces for all mediums. All IRM materials showed increased surface roughness over time in all cariogenic environments but were below the threshold value for bacterial adhesion, except for AV 1-month post immersion with pH cycling. Therefore, besides AV, the surface roughness of IRMs did not deteriorate to an extent that it is clinically relevant.
Traumatic brain injury (TBI) is one of the common injuries when the human head receives an impact due to an accident or fall and is one of the most frequently submitted insurance claims. However, it is often always misused when individuals attempt an insurance fraud claim by providing false medical conditions. Therefore, there is a need for an instant brain condition classification system. This study presents a novel classification architecture that can classify non-severe TBI patients and healthy subjects employing resting-state electroencephalogram (EEG) as the input, solving the immobility issue of the computed tomography (CT) scan and magnetic resonance imaging (MRI). The proposed architecture makes use of long short term memory (LSTM) and error-correcting output coding support vector machine (ECOC-SVM) to perform multiclass classification. The pre-processed EEG time series are supplied to the network by each time step, where important information from the previous time step will be remembered by the LSTM cell. Activations from the LSTM cell is used to train an ECOC-SVM. The temporal advantages of the EEG were amplified and able to achieve a classification accuracy of 100%. The proposed method was compared to existing works in the literature, and it is shown that the proposed method is superior in terms of classification accuracy, sensitivity, specificity, and precision.
Under the new development model, the digital economy has become a new engine to promote the green development of the economy and achieve the goal of "double carbon." Based on panel data from 30 Chinese provinces and cities from 2011 to 2021, the impact of the digital economy on carbon emissions was empirically studied by constructing a panel model and a mediation model. The results show that firstly, the effect of the digital economy on carbon emissions is a non-linear inverted "U" shaped relationship, and this conclusion still holds after a series of robustness tests; secondly, the results of the benchmark regression show that economic agglomeration is an essential mechanism through which the digital economy affects carbon emissions and that the digital economy can indirectly suppress carbon emissions through economic agglomeration. Finally, the results of the heterogeneity analysis show that the impact of the digital economy on carbon emissions varies according to the level of regional development, and its effect on carbon emissions is mainly in the eastern region, while its impact on the central and western regions is weaker, indicating that the impact effect is primarily in developed regions. Therefore, the government should accelerate the construction of new digital infrastructure and implement the development strategy of the digital economy according to local conditions to promote a more significant carbon emission reduction effect of the digital economy.
Thalassaemia is a public health problem in multi-ethnic Malaysia which mainly affects the Malays, Kadazan-Dusuns and Chinese. This study, the first in Malaysia, aims to evaluate the acceptability of prenatal diagnosis and abortion among Malaysian parents who have a child or children with thalassaemia major and the socio-demographic factors affecting their decision-making. A pre-structured questionnaire was distributed to parents of children with thalassaemia major. Response rate for completed surveys was 99.1 %. Out of 116 respondents, the majority (83/71.6 %) were agreeable for prenatal diagnosis, but only 33 (28.4 %) agreed to both prenatal diagnosis followed by termination of affected foetuses. Of parents who declined abortion, 77.6 % cited religious restriction as the main reason, and their religious background was a significant factor (p = 0.001), with 73.4 % of Muslim participants against termination compared to 25 % of Christians and 13.3 % of Buddhists. Gender, age, highest education level and number of children affected with thalassaemia were non-significant predictors in decision-making regarding abortion. The acceptance rate for termination of foetuses with thalassaemia major in Malaysia is low especially among the Muslims due to religious non-permissibility. Therefore, scholarly deliberations among the Malaysian Muslim religious authorities that result in a supportive stance in this issue may contribute to a more successful prevention programme.
Getting employees to share their creative ideas has long been recognized as a vital source of organizational effectiveness. This research uses the conservation of resources theory to investigate how employee's creative idea sharing is affected by abusive supervision. Data for this research was collected from 209 employees and their immediate supervisors of generic nurses and medical dispensers of Southern Punjab public sector hospitals working under the Ministry of national health services regulation and Coordination. Data were then analyzed with the AMOS software package for simple regression and moderated mediation. This study found that with the increase in abusive supervision, employees develop cheating behavior, diminishing probability of sharing their creative ideas with coworkers. Along these lines, organizational justice moderates this relationship and attenuates the negative indirect effect of abusive supervision on creative idea sharing. The researchers recommended that organizations should develop training programs or coaching sessions for leaders to make them equip with essential interpersonal skills that can eradicate abusive supervision. Research implications, limitations, and future research directions are also discussed.
Polymeric based composites have gained considerable attention as potential candidates for advanced radiation shielding applications due to their unique combination of high-density, radiation attenuation properties and improved mechanical strength. This study focuses on the comprehensive characterisation of polymeric based composites for radiation shielding applications. The objective of this study was to evaluate the physical, mechanical and microstructural properties of tungsten carbide-based epoxy resin and tungsten carbide cobalt-based epoxy resin for its efficiency in shielding against gamma-rays ranging from 0.6 up to 1.33 MeV. Polymeric composites with different weight percentages of epoxy resin (40 wt%, 35 wt%, 30 wt%, 25 wt%, 20 wt%, 15 wt% and 10 wt%) were fabricated, investigated and compared to conventional lead shield. The attenuation of the composites was performed using NaI (Tl) gamma-ray spectrometer to investigate the linear and mass attenuation coefficients, half value layer, and mean free path. High filler loadings into epoxy resin matrix (90% filler/10% epoxy) exhibited excellent gamma shielding properties. Mechanical properties, such as hardness were examined to assess the structural integrity and durability of the composites under various conditions. The fabricated composites showed a good resistance, the maximum hardness was attributed to composites with small thickness. The high loading of fillers in the epoxy matrix improved the microhardness of the composites. The distribution of the filler powder within the epoxy matrix was investigated using FESEM/EDX. The results revealed the successful incorporation of tungsten carbide and cobalt particles into the polymer matrix, leading to increased composite density and enhanced radiation attenuation. The unique combination of high-density, radiation attenuation, and improved mechanical properties positions polymeric based composites as promising candidates for radiation protection field.
Over the past decades, the amount of waste has dramatically increased worldwide due to rapid population growth and urbanization. Inefficient waste collection and transportation, known as the waste collection vehicle routing problem (WCVRP), negatively impacts economic, environmental, and social dimensions. This issue has drawn considerable attention from local and national governments. There is an urgent need for sustainable practices in waste collection and transportation. This paper conducts an exhaustive literature review on the WCVRP. The review covers various aspects, including waste types, common model characteristics, objective functions, solution methods, datasets and case studies. The analysis indicates a need for further research on underrepresented waste types, such as medical waste (MW). It also stresses the importance of incorporating more model characteristics to better capture the complexities of real-world scenarios. Moreover, there is a lack of multiple objectives optimization models that concurrently address economic, environmental, and social dimensions, in line with sustainable development goals. Additionally, there is insufficient research on hybrid algorithms, especially regarding their application to uncertainty management and advanced techniques. Finally, the use of hybrid testing is restricted, highlighting the need for diverse tests to validate solution methods under various real-world conditions. This study outlines a roadmap for decision-makers in the WCVRP domain, offering opportunities for the evolution of more efficient, adaptable, and sustainable waste collection and transportation systems.Implications: The discussion of WCVRP is an urgent global concern in waste management that requires immediate attention. Through a multi-dimensional evaluation of the research papers, this review paper provides recommendations for future research and practice in WCVRP. Initially, while urban solid waste has received significant attention, other categories remain insufficiently examined. Future research should focus on efficient collection and transportation strategies for these types. Then, although common characteristics are well-explored, this review emphasizes the need for further investigation into lesser-studied characteristics and vehicle types in WCVRP models. Next, current models predominantly prioritize cost and public health exposure risk minimization. There is a necessity for more holistic approaches that incorporate multiple objectives, particularly those crucial for achieving sustainable development goals. Moreover, hybrid algorithms have emerged as efficient solutions, yet advanced technologies coupled with uncertainty management strategies remain underutilized, presenting significant potential to address the evolving complexities of WCVRP. Finally, the study highlights the importance of datasets and case studies in validating WCVRP models. Hybrid tests enable researchers to comprehensively evaluate WCVRP solutions, providing insight into their performance under various conditions. In conclusion, these implications offer a roadmap for advancing WCVRP research and guiding practical strategies to contribute to the development of more efficient, adaptable, and sustainable waste collection and transportation systems.