For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak.
Disease patterns among outpatients seen at static and travelling dispensaries, as well as among hospital admissions and hospital deaths are compared between 1959 and 1974. While disease patterns of patients seen by travelling dispensaries show no change, patients seen by static dispensaries and hospital admissions in 1974 show a marked relative decline in infective and parasitic diseases and an increase in accidents, poisonings and violence. Causes of death in hospitals in 1974 were different, there being relative increases in diseases of early infancy, diseases of circulatory system, neoplasms, and accidents, poisonings, violence while infective and parasitic diseases, and diseases of the digestive system declined.
The prevalence of goitre was investigated in a sample from six longhouses and five primary schools located at varying degrees of remoteness along the Tinjar river, Sarawak. Together with this, a survey was made on the type of salt used by the households. The main ethnic groups in these communities were the Kenyah/Kayan and the Iban. The overall prevalence of palpable goitre detected from the age group 5-14 years were 71.7 percent and 77.0 percent for males and females respectively and 77.7 percent for females aged 15 years and above. The prevalence for both Iban and Kenyah/Kayan of either sex and for all age groups varied from 63.4 percent to 80.4 percent. The prevalence at each location did not differ significantly. On questioning 126 households, only 9 (7.1 percent) used iodized salt whilst 74 (58.7 percent) households used only uniodized coarse salt and 7 (5.6 percent) used only uniodized fine salt. The remaining 36 (28.6 percent) households used both fine and coarse uniodized salt. Undoubtedly at this point in time legislation on "table" salt iodization must be interpreted to mean not only the iodization of fine table salt, but in the case of the rural longhouse communities as are found in the Tinjar area, the iodization of coarse salt as well.
Four areas of differing remoteness were studied to determine the prevalence of goitre in the Keningau Division of Sabah. These areas were Keningau town, the Biah Resettlement Scheme, the Dalit subdistrict and the Pagalunggan subdistrict. The predominant ethnic group in these areas is the Murut. The overall endemicity of goitre for the study population was 76.5% for females aged 15 years and above. There was a significant correlation between the incidence of goitre and the remoteness of an area. The Dalit subdistrict has the highest incidence of goitre (82.6%) followed by the Pagalunggan subdistrict (77.8%), the majority of these goitre cases being classified as grade 2 (visible goitres). These were the two most remote areas in the study. In contrast, Keningau town, the least remote area has the lowest incidence of goitre (62.5%) with most of the goitres being relatively small. With regards to salt usage in the Dalit subdistrict, only 3.0% used iodised salt; 28.0% used fine salt; 3.6% used coarse salt and 65.5% used both fine and coarse salt. In the Pagalunggan subdistrict, all females used uniodised salt with 17.6% using fine salt, 20% using coarse salt and the remainder using both fine and coarse salt. As yet, there is no legislation for the iodisation of salt in Sabah. It is clear that all types of salt need to be iodised and adequately distributed to deprived areas, particularly inland areas.
The surgical approach for the correction of residual velopharyngeal insufficiency requiring secondary surgery at Chang Gung Memorial Hospital is the modified Furlow palatoplasty with pharyngeal flap (mFP-PF). The aim of this study was to describe the mFP-PF technique and to determine the results obtained with regard to improvements in velopharyngeal function in patients undergoing this surgery. This retrospective analysis included 58 non-syndromic patients treated during the period 1992-2015 who complained of hypernasal speech after primary cleft palate repair and failed postoperative speech therapy. All of them underwent mFP-PF surgery. Preoperative and postoperative perceptual speech assessment results were obtained. The male to female ratio in the study group was 1.2:1, and the mean patient age at the time of surgery was 8.27 years. The patients underwent nasoendoscopic examination and the velar closing ratio was categorized as 0.1-0.4 in 53.4% and 0.5-0.7 in 46.6%. The assessment of speech after mFP-PF showed statistically significant changes for all perceptual speech outcomes. The incidence of repeat surgery was 3.4%. This study revealed that 96.6% of patients did not require second surgery for velopharyngeal insufficiency. Further studies on obstructive sleep apnoea in post-mFP-PF patients and improvements to the surgical technique should be considered.
INTRODUCTION: Sexual intercourse among Malaysian adolescents is a major concern, especially with the worry of HIV/AIDS. This study was done to determine the prevalence of sexual intercourse among secondary school students aged 12 to 19 years in Negeri Sembilan, Malaysia.
METHODS: This is a cross-sectional school survey conducted on 4,500 adolescent students based on a structured questionnaire. Data were collected using the self-administered questionnaire (translated version of the Youth Risk Behaviour Surveillance in Bahasa Malaysia).
RESULTS: The study showed that 5.4 percent of the total sample were reported to have had sexual intercourse. The proportion among male students who had had sex was higher (8.3 percent) compared with female students (2.9 percent). The mean age at first sexual intercourse was 15 years. One percent of students reported that they had been pregnant or had made someone else pregnant. Adolescent sexual intercourse was significantly associated with (1) socio-demographical factors (age, gender); (2) environmental factors (staying with parents); and (3) substance use (alcohol use, cigarette smoking, drug use), even after adjustment for demographical factors. The survey showed that 20.8 percent of respondents had taken alcohol, 14.0 percent had smoked cigarettes, 2.5 percent had tried marijuana, 1.2 percent had tried ecstasy pills, 2.6 percent had tried glue sniffing, 0.7 percent had tried heroin, and 0.7 percent had intravenous drugs.
CONCLUSION: Prevalence of sexual intercourse among Malaysian adolescents was relatively low compared to developed countries. However, certain groups of adolescents tend to be at higher risk of engaging in sexual intercourse. This problem should be addressed early by targeting these groups of high-risk adolescents.
The onset of menstruation is part of the maturation process. However, variability in menstrual cycle characteristics and menstrual disorders are common. The purpose of this study was to determine the menstrual characteristics of adolescent females and factors associated with it.
Zirconia toughened alumina (ZTA) is a promising advanced ceramic material for a wide range of applications that are subjected to dynamic loading. Therefore, the investigation of dynamic compressive strength, fracture toughness and hardness is essential for ZTA ceramics. However, the relationship between these mechanical properties in ZTA has not yet been established. An example of this relationship is demonstrated using ZTA samples added with MgO prepared through conventional sintering. The microstructure and mechanical properties of ZTA composites were characterized. The hardness of ZTA composites increased for ≤0.7 wt.% MgO due to the pinning effect of MgO and decrease of the porosity in the microstructure. Oppositely, the fracture toughness of ZTA composites continuously decreased due to the size reduction of Al2O3 grains. This is the main reason of deteriorate of dynamic compressive strength more than 0.2 wt.% of MgO addition. Therefore, the SHPB test shows the improvement of the dynamic compressive strength only up to a tiny amount (0.2 wt.% of MgO addition) into ZTA ceramics.
The presence of chloride ion as an environmental pollutant is having a devastating and irreversible effect on aquatic and terrestrial ecosystems. To ensure safe and clean drinking water, it is vital to remove this substance using non-toxic and eco-friendly methods. This study presents a novel and highly efficient Ag NPs-modified bentonite adsorbent for removing chloride ion, a common environmental pollutant, from drinking water using a facile approach. The surface chemical properties and morphology of the pristine Na-bentonite and Ag NPs-Modified bentonite were characterized by field emission scanning electron microscopy (FESEM) and X-ray spectroscopy (EDX), X-Ray diffraction (XRD), Fourier transform infrared (FTIR), and zeta potential (ζ). To achieve maximum chloride ion removal, the effects of experimental parameters, including adsorbent dosage (1-9 g/L), chloride ion concentration (100-900 mg/L), and reaction time (5-25 h), were examined using the Response Surface Methodology (RSM). The chloride ion removal of 90% was obtained at optimum conditions (adsorbent dosage: 7 g/L, chloride ion concentration: 500 mg/L, and reaction time: 20 h). The adsorption isotherm and kinetics results indicated that the Langmuir isotherm model and pseudo-second-order kinetics were found suitable to chloride ion removal. Additionally, the regeneration and reusability of the Ag NPs-modified bentonite were further studied. In the regeneration and reusability study, the Ag NPs-modified bentonite has shown consistently ≥90% and ≥87% chloride ion removal even up to 2 repeated cycles, separately. Thus, the findings in this study provided convincing evidence for using Ag-NPs modified bentonite as a high-efficiency and promising adsorbent to remove chloride ion from drinking water.
The first cooperative study of the Asian Pacific bone marrow transplantation group included 75 patients with early leukemia who received human leukocyte antigen-matched sibling bone marrow transplants and were randomized into granulocyte colony-stimulating factor and control groups. The selected patients were registered from 10 centers in six countries and areas within Asia (Beijing, Taipei, Hong Kong, Japan, Korea, and Malaysia). The incidence of grades II-IV acute graft-vs.-host disease was 22.2%, and the 2-year survival rate was 62.7%. The period of protective isolation (27.1-66.7 days), period of hospitalization (38.6-130.5 days), and medical costs for 4 months (US $10,300-US $80,803) varied considerably. Good cooperation, i.e., low rate of protocol violation or rapid and precise presentation of case reports, was obtained.
Sodium phenoxide is a potentially promising hydrogen storage material due to its high hydrogen capacity and enhanced thermodynamic properties. Nevertheless, efficient catalysts are still lacking due to the high kinetic barrier for the reversible hydrogen uptake and release of sodium phenoxide. In the current work, a comparative study on the catalytic hydrogenation of sodium phenoxide was conducted. To our delight, a simple yet effective ruthenium-based catalyst was identified to respond aggressively to hydrogen in the solid-state hydrogenation of sodium phenoxide even at room temperature. The activity was enhanced by 6 fold with the as-synthesized 5.0% Ru/TiO2 catalyst as compared to that with commercial 5.0% Ru/Al2O3, respectively, under the same conditions.
Many species of birds gradually adapt to urbanization and colonize cities successfully. However, their nest site selection and competitive relationship in an urban community remain little known. Understanding the impact of urbanization on birds and the competitive relationship has important implications for the conservation and management of wildlife in urban ecosystems. Here, we undertook a systematic study to quantify nests in all species of birds in an urbanizing area of Nanchang, China. A total of 363 nests were detected in surveys including 340 nests of 16 bird species and 23 unidentified species nests. We mainly analyzed 5 dominant breeding birds with a sample size of >10 during the two breeding seasons (From April to July in 2016 and 2017), which included the light-vented bulbul, Chinese blackbird, scaly-breasted munia, spotted dove and grey-capped greenfinch. Most birds (93.66%) nested in the tree of artificial green belts, which seems to be the best breeding habitat for urban birds. Our results suggested that birds' breeding success relies on the trade-off between the benefit and the expense of specific stresses from habitats. The nest site selection of birds is also affected by the life habit of urban predators. Furthermore, competition among species can influence their distributions and utilization of environmental resources when birds nest in cities. We confirmed that the niche differentiation of five bird species in an urban environment makes them coexist successfully by utilizing various resources.
The lack of efficient hydrogen storage material is one of the bottlenecks for the large-scale implementation of hydrogen energy. Here, a series of new hydrogen storage materials, i.e., anilinide-cyclohexylamide pairs, are proposed via the metallation of an aniline-cyclohexylamine pair. DFT calculations show that the enthalpy change of hydrogen desorption (ΔHd) can be significantly tuned from 60.0 kJ per mol-H2 for the pristine aniline-cyclohexylamine pair to 42.2 kJ per mol-H2 for sodium anilinide-cyclohexylamide and 38.7 kJ per mol-H2 for potassium anilinide-cyclohexylamide, where an interesting correlation between the electronegativity of the metal and the ΔHd was observed. Experimentally, the sodium anilinide-cyclohexylamide pair was successfully synthesised with a theoretical hydrogen capacity of 4.9 wt%, and the hydrogenation and dehydrogenation cycle can be achieved at a relatively low temperature of 150 °C in the presence of commercial catalysts, in clear contrast to the pristine aniline-cyclohexylamine pair which undergoes dehydrogenation at elevated temperatures.
Pot experiments were conducted to investigate the influence of biochar addition and the mechanisms that alleviate Cd stress in the growth of tobacco plant. Cadmium showed an inhibitory effect on tobacco growth at different post-transplantation times, and this increased with the increase in soil Cd concentration. The growth index decreased by more than 10%, and the photosynthetic pigment and photosynthetic characteristics of the tobacco leaf were significantly reduced, and the antioxidant enzyme activity was enhanced. Application of biochar effectively alleviated the inhibitory effect of Cd on tobacco growth, and the alleviation effect of treatments is more significant to the plants with a higher Cd concentration. The contents of chlorophyll a, chlorophyll b, and carotenoids in the leaves of tobacco plants treated with biochar increased by 9.99%, 12.58%, and 10.32%, respectively, after 60 days of transplantation. The photosynthetic characteristics index of the net photosynthetic rate increased by 11.48%, stomatal conductance increased by 11.44%, and intercellular carbon dioxide concentration decreased to 0.92. Based on the treatments, during the growth period, the antioxidant enzyme activities of tobacco leaves comprising catalase, peroxidase, superoxide dismutase, and malondialdehyde increased by 7.62%, 10.41%, 10.58%, and 12.57%, respectively, after the application of biochar. Our results show that biochar containing functional groups can effectively reduce the effect of Cd stress by intensifying the adsorption or passivation of Cd in the soil, thereby, significantly reducing the Cd content in plant leaves, and providing a theoretical basis and method to alleviate soil Cd pollution and effect soil remediation.
A divergent synthesis of skeletally distinct arboridinine and arborisidine was achieved. The central divergent strategy was inspired by the divergent biosynthetic cyclization mode of arboridinine and arborisidine and their hidden topological connection. The branch point was reached through a Michael and Mannich cascade process. A site-selective intramolecular Mannich reaction was developed to construct the tetracyclic core of arboridinine, while a site-selective intramolecular α-amination of ketone was used to access the tetracyclic core of arborisidine. A strategic Peterson olefination through intramolecular nucleophile delivery was able to set up the exocyclic olefin of arboridinine.
Whole-genome sequencing across multiple samples in a population provides an unprecedented opportunity for comprehensively characterizing the polymorphic variants in the population. Although the 1000 Genomes Project (1KGP) has offered brief insights into the value of population-level sequencing, the low coverage has compromised the ability to confidently detect rare and low-frequency variants. In addition, the composition of populations in the 1KGP is not complete, despite the fact that the study design has been extended to more than 2,500 samples from more than 20 population groups. The Malays are one of the Austronesian groups predominantly present in Southeast Asia and Oceania, and the Singapore Sequencing Malay Project (SSMP) aims to perform deep whole-genome sequencing of 100 healthy Malays. By sequencing at a minimum of 30× coverage, we have illustrated the higher sensitivity at detecting low-frequency and rare variants and the ability to investigate the presence of hotspots of functional mutations. Compared to the low-pass sequencing in the 1KGP, the deeper coverage allows more functional variants to be identified for each person. A comparison of the fidelity of genotype imputation of Malays indicated that a population-specific reference panel, such as the SSMP, outperforms a cosmopolitan panel with larger number of individuals for common SNPs. For lower-frequency (<5%) markers, a larger number of individuals might have to be whole-genome sequenced so that the accuracy currently afforded by the 1KGP can be achieved. The SSMP data are expected to be the benchmark for evaluating the value of deep population-level sequencing versus low-pass sequencing, especially in populations that are poorly represented in population-genetics studies.
Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.