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Fatal penetrating neck injury due to defective airbag inflator

Jothee S, Shafie MS, Mohd Nor F

Forensic Sci Int, 2018 Aug 31.
PMID: 30217665 DOI: 10.1016/j.forsciint.2018.08.038

We present a case of a fatal motor vehicle collision of a 22-year-old car driver, who died at the scene after losing control of his car, and subsequently collided with a tree by the roadside. The subsequent autopsy revealed penetrating injuries on the neck, severing the larynx, carotid artery, jugular vein and fracturing the cervical vertebrae. Internal examination showed the offending material to be a semi-cylindrical metal fragment, which had lodged within the paravertebral muscle. Examination of the car with the authorities found that the metal fragment originated from a defective airbag booster cannister, which shattered upon deployment.
Predicting sanitary landfill leachate generation in humid regions using ANFIS modeling

Abunama T, Othman F, Younes MK

Environ Monit Assess, 2018 Sep 20;190(10):597.
PMID: 30238169 DOI: 10.1007/s10661-018-6966-y

Landfill leachate is one of the sources of surface water pollution in Selangor State (SS), Malaysia. Leachate volume prediction is essential for sustainable waste management and leachate treatment processes. The accurate estimation of leachate generation rates is often considered a challenge, especially in developing countries, due to the lack of reliable data and high measurement costs. Leachate generation is related to several variable factors, including meteorological data, waste generation rates, and landfill design conditions. Large variations in these factors lead to complicated leachate modeling processes. The aims of this study are to determine the key elements contributing to leachate production and then develop an adaptive neural fuzzy inference system (ANFIS) model to predict leachate generation rates. Accuracy of the final model performance was tested and evaluated using the root mean square error (RMSE), the mean absolute error (MAE), and the correlation coefficient (R). The study results defined dumped waste quantity, rainfall level, and emanated gases as the most significant contributing factors in leachate generation. The best model structure consisted of two triangular fuzzy membership functions and a hybrid training algorithm with eight fuzzy rules. The proposed ANFIS model showed a good performance with an overall correlation coefficient of 0.952.
Fulltext Diabetic neuropathic cachexia in a young woman

Yusof NA, Idris NS, Zin FM

Korean J Fam Med, 2018 Nov 30.
PMID: 30497111 DOI: 10.4082/kjfm.17.0127

Profound weight loss with painful symmetrical peripheral neuropathy in diabetic patients was first described as diabetic neuropathic cachexia more than 4 decades ago. It is a distinct type of diabetic peripheral neuropathy that occurs in the absence of other microvascular and autonomic complications of diabetes. The mechanism and precipitating cause are unknown. It was reported to have good prognosis with spontaneous recovery within months to 2 years. However, it was frequently missed by clinicians because the profound weight loss is the most outstanding complaint, rather than the pain, numbness, or weakness. This often leads to extensive investigation to exclude more sinister causes of weight loss, particularly malignancy. We report a case of a young woman with well-controlled diabetes who presented with profound unintentional weight loss (26 kg), symmetrical debilitating thigh pain, and clinical signs of peripheral neuropathy. As the disease entity may mimic an inflammatory demyelinating cause of neuropathy, she was treated with a trial of intravenous immunoglobulin, which failed to give any significant benefit. However, she recovered after 6 months without any specific treatment, other than an antidepressant for the neuropathic pain and ongoing rehabilitation.
Fulltext Development of Highly Sensitive Immunosensor for Clenbuterol Detection by Using Poly(3,4-ethylenedioxythiophene)/Graphene Oxide Modified Screen-Printed Carbon Electrode

Talib NAA, Salam F, Sulaiman Y

Sensors (Basel), 2018 Dec 07;18(12).
PMID: 30544568 DOI: 10.3390/s18124324

Clenbuterol (CLB) is an antibiotic and illegal growth promoter drug that has a long half-life and easily remains as residue and contaminates the animal-based food product that leads to various health problems. In this work, electrochemical immunosensor based on poly(3,4-ethylenedioxythiophene)/graphene oxide (PEDOT/GO) modified screen-printed carbon electrode (SPCE) for CLB detection was developed for antibiotic monitoring in a food product. The modification of SPCE with PEDOT/GO as a sensor platform was performed through electropolymerization, while the electrochemical assay was accomplished while using direct competitive format in which the free CLB and clenbuterol-horseradish peroxidase (CLB-HRP) in the solution will compete to form binding with the polyclonal anti-clenbuterol antibody (Ab) immobilized onto the modified electrode surface. A linear standard CLB calibration curve with R² = 0.9619 and low limit of detection (0.196 ng mL-1) was reported. Analysis of milk samples indicated that this immunosensor was able to detect CLB in real samples and the results that were obtained were comparable with enzyme-linked immunosorbent assays (ELISA).
Fulltext Antibacterial and Antispore Activities of Isolated Compounds from Piper cubeba L

Alqadeeri F, Rukayadi Y, Abbas F, Shaari K

Molecules, 2019 Aug 26;24(17).
PMID: 31454974 DOI: 10.3390/molecules24173095

Piper cubeba L. is the berry of a shrub that is indigenous to Java, Southern Borneo, Sumatra, and other islands in the Indian Ocean. The plant is usually used in folk traditional medicine and is an important ingredient in cooking. The purpose of this study was to isolate and purify the bioactive compounds from P. cubeba L. fractions. In addition, the isolated compounds were tested for their antibacterial and antispore activities against vegetative cells and spores of Bacilluscereus ATCC33019, B. subtilis ATCC6633, B.pumilus ATCC14884, and B.megaterium ATCC14581. The phytochemical investigation of the DCM fraction yielded two known compounds: β-asarone (1), and asaronaldehyde (2) were successfully isolated and identified from the methanol extract and its fractions of P. cubeba L. Results showed that exposing the vegetative cells of Bacillus sp. to isolated compounds resulted in an inhibition zone with a large diameter ranging between 7.21 to 9.61 mm. The range of the minimum inhibitory concentration (MIC) was between 63.0 to 125.0 µg/mL and had minimum bactericidal concentration (MBC) at 250.0 to 500.0 µg/mL against Bacillus sp. Isolated compounds at a concentration of 0.05% inactivated more than 3-Log10 (90.99%) of the spores of Bacillus sp. after an incubation period of four hours, and all the spores were killed at a concentration of 0.1%. The structures were recognizably elucidated based on 1D and 2D-NMR analyses (1H, 13C, COSY, HSQC, and HMBC) and mass spectrometry data. Compounds 1, and 2 were isolated for the first time from this plant. In conclusion, the two compounds show a promising potential of antibacterial and sporicidal activities against Bacillus sp. and thus can be developed as an anti-Bacillus agent.
Fulltext Epigenetic Changes and Its Intervention in Age-Related Neurodegenerative Diseases

Mohd Murshid N, Aminullah Lubis F, Makpol S

Cell Mol Neurobiol, 2022 Apr;42(3):577-595.
PMID: 33074454 DOI: 10.1007/s10571-020-00979-z

Epigenetic mechanisms involving the modulation of gene activity without modifying the DNA bases are reported to have lifelong effects on mature neurons in addition to their impact on synaptic plasticity and cognition. Histone methylation and acetylation are involved in synchronizing gene expression and protein function in neuronal cells. Studies have demonstrated in experimental models of neurodegenerative disorders that manipulations of these two mechanisms influence the susceptibility of neurons to degeneration and apoptosis. In Alzheimer's disease (AD), the expression of presenilin 1 (PSEN1) is markedly increased due to decreased methylation at CpG sites, thus promoting the accumulation of toxic amyloid-β (Aβ) peptide. In Parkinson's disease (PD), dysregulation of α-synuclein (SNCA) expression is presumed to occur via aberrant methylation at CpG sites, which controls the activation or suppression of protein expression. Mutant Huntingtin (mtHTT) alters the activity of histone acetyltransferases (HATs), causing the dysregulation of transcription observed in most Huntington's disease (HD) cases. Folate, vitamin B6, vitamin B12, and S-adenosylmethionine (SAM) are vital cofactors involved in DNA methylation modification; 5-azacytidine (AZA) is the most widely studied DNA methyltransferase (DNMT) inhibitor, and dietary polyphenols are DNMT inhibitors in vitro. Drug intervention is believed to reverse the epigenetic mechanisms to serve as a regulator in neuronal diseases. Nevertheless, the biochemical effect of the drugs on brain function and the underlying mechanisms are not well understood. This review focuses on further discussion of therapeutic targets, emphasizing the potential role of epigenetic factors including histone and DNA modifications in the diseases.
Optimized fuzzy inference system to enhance prediction accuracy for influent characteristics of a sewage treatment plant

Ansari M, Othman F, El-Shafie A

Sci Total Environ, 2020 Jun 20;722:137878.
PMID: 32199382 DOI: 10.1016/j.scitotenv.2020.137878

Sewage treatment plants (STPs) keep sewage contamination within safe levels and minimize the risk of environmental disasters. To achieve optimum operation of an STP, it is necessary for influent parameters to be measured or estimated precisely. In this research, six well-known influent chemical and biological characteristics, i.e., biochemical oxygen demand (BOD), chemical oxygen demand (COD), Ammoniacal Nitrogen (NH3-N), pH, oil and grease (OG) and suspended solids (SS), were modeled and predicted using the Sugeno fuzzy logic model. The membership function range of the fuzzy model was optimized by ANFIS, the integrated Genetic algorithms (GA), and the integrated particle swarm optimization (PSO) algorithms. The results were evaluated by different indices to find the accuracy of each algorithm. To ensure prediction accuracy, outliers in the predicted data were found and replaced with reasonable values. The results showed that both integrated GA-FIS and PSO-FIS algorithms performed at almost the same level and both had fewer errors than ANFIS. As the GA-FIS algorithm predicts BOD with fewer errors than PSO-FIS and the aim of this study is to provide an accurate prediction of missing data, GA-FIS was only used to predict the BOD parameter; the other parameters were predicted by PSO-FIS algorithm. As a result, the model successfully could provide outstanding performance for predicting the BOD, COD, NH3-N, OG, pH and SS with MAE equal to 3.79, 5.14, 0.4, 0.27, 0.02, and 3.16, respectively.
Fulltext Effect of exposure to dust on lung function of cement factory workers

Noor H, Yap CL, Zolkepli O, Faridah M

Med J Malaysia, 2000 Mar;55(1):51-7.
PMID: 11072491 MyJurnal

Exposure to Portland cement dust has long been associated with the prevalence of respiratory symptoms and varying degrees of airway obstruction in man. Apart from respiratory diseases, it was also found to be the cause of lung and laryngeal cancer, gastrointestinal tumours and also dermatitis. This study was done to investigate the effect of dust exposure on ventilatory lung function of Portland cement factory workers in Rawang, Selangor. Spirometry tests of 62 male workers (exposed to total dust concentration of 10,180 micrograms/m3 and PM10 of 8049 micrograms/m3) and 70 subjects from UPM (exposed to mean total dust of 192 micrograms/m3 and PM10 of 177 micrograms/m3--controls) revealed significant differences in spirometry values between the groups. The workers showed i) significantly lower FEV1% and FEF25-75%, and higher FMFT, ii) reduced FEV1% with increasing level of dust exposure and iii) higher prevalence of respiratory symptoms. Therefore, we suggest that exposure to dust in the cement factory leads to higher incidence of respiratory symptoms and impaired lung function.
Fulltext Transient hyperthyroidism following L-asparaginase therapy for acute lymphoblastic leukemia

Fadilah SAW, Faridah I, Cheong SK

Med J Malaysia, 2000 Dec;55(4):513-5.
PMID: 11221167

The effect of L-asparaginase on the thyroid gland has not been well documented. We report the first two cases of hyperthyroidism associated with thyroid nodule following L-asparaginase therapy for acute lymphoblastic leukemia (ALL). The thyroid function abnormalities were not severe, short-lived and did not require specific therapy.
Volumetric breast density measurement: sensitivity analysis of a relative physics approach

Lau S, Ng KH, Abdul Aziz YF

Br J Radiol, 2016 Oct;89(1066):20160258.
PMID: 27452264 DOI: 10.1259/bjr.20160258

OBJECTIVE: To investigate the sensitivity and robustness of a volumetric breast density (VBD) measurement system to errors in the imaging physics parameters including compressed breast thickness (CBT), tube voltage (kVp), filter thickness, tube current-exposure time product (mAs), detector gain, detector offset and image noise.
METHODS: 3317 raw digital mammograms were processed with Volpara(®) (Matakina Technology Ltd, Wellington, New Zealand) to obtain fibroglandular tissue volume (FGV), breast volume (BV) and VBD. Errors in parameters including CBT, kVp, filter thickness and mAs were simulated by varying them in the Digital Imaging and Communications in Medicine (DICOM) tags of the images up to ±10% of the original values. Errors in detector gain and offset were simulated by varying them in the Volpara configuration file up to ±10% from their default values. For image noise, Gaussian noise was generated and introduced into the original images.
RESULTS: Errors in filter thickness, mAs, detector gain and offset had limited effects on FGV, BV and VBD. Significant effects in VBD were observed when CBT, kVp, detector offset and image noise were varied (p
Fulltext Neonatal group B beta-haemolytic streptococcal infection in Kuala Lumpur

Minhaj AA, Jamal F, Mohamed R

Med J Malaysia, 1980 Dec;35(2):117-21.
PMID: 7022149

First six cases of neonatal group B beta-haemolytic streptococcal sepsis in GHKL & Maternity Hospital K.L. were reported and in one third, it was fatal. Five of the cases were 'early - onset' type and one was 'late - onset' type. While maternal infant transmission of the disease is important in the 'early - onset' type, environmental sources of infection are also significant. No gestational age or birthweight is spared from the disease. Finally, there are cases of 'early - onset' GBS sepsis presenting like hyaline membrane disease of the newborn and it is important to find ways to distinguish them which so far has not been satisfactory.
Adolescents’ Perceptions Regarding Effective Tobacco Use Prevention Strategies for their Younger Counterparts: A Qualitative Study in Malaysia

Mohd Zin F, Hillaluddin AH, Mustaffa J

Asian Pac J Cancer Prev, 2016 Dec 01;17(12):5113-5119.
PMID: 28122443

Purpose:The present qualitative study explored adolescents’ perceptions regarding effective strategies to prevent adolescents from using tobacco products (TP). Apart from the commercial TPs, there has been emerging use of alternatives such as vapes, e-cigarettes and shisha. This unfortunate phenomenon continues despite the currently available preventive strategies. Thus, understanding of the perceptions of the current generation would be valuable to provide new insights. Methods: Purposive sampling was utilized to recruit 40 adolescents between the age of 15 and 16 years old attending public daily secondary schools. Eight focus group discussions were conducted among the TP users, ex-users and non-users. Data were analyzed using a thematic content analysis procedure with NVivo. Results: Among barriers with the currently available strategies were having teachers who smoke tobacco, addiction to nicotine and self-perceptions of being healthy. The content of any program should include knowledge on negative outcomes of using tobacco products and awareness of the legislation together with ways to overcome peer and family influence including improving self-efficacy and refusal skills. Strategies were suggested to be delivered using information technology which provides interactive learning and visual effects. Conclusions: Adolescents agreed that the content and delivery of tobacco use prevention strategies need to be revised to suit the current generation to ensure sustainability.
Fulltext Multiple Linear Regression for Reconstruction of Gene Regulatory Networks in Solving Cascade Error Problems

Salleh FH, Zainudin S, Arif SM

Adv Bioinformatics, 2017;2017:4827171.
PMID: 28250767 DOI: 10.1155/2017/4827171

Gene regulatory network (GRN) reconstruction is the process of identifying regulatory gene interactions from experimental data through computational analysis. One of the main reasons for the reduced performance of previous GRN methods had been inaccurate prediction of cascade motifs. Cascade error is defined as the wrong prediction of cascade motifs, where an indirect interaction is misinterpreted as a direct interaction. Despite the active research on various GRN prediction methods, the discussion on specific methods to solve problems related to cascade errors is still lacking. In fact, the experiments conducted by the past studies were not specifically geared towards proving the ability of GRN prediction methods in avoiding the occurrences of cascade errors. Hence, this research aims to propose Multiple Linear Regression (MLR) to infer GRN from gene expression data and to avoid wrongly inferring of an indirect interaction (A → B → C) as a direct interaction (A → C). Since the number of observations of the real experiment datasets was far less than the number of predictors, some predictors were eliminated by extracting the random subnetworks from global interaction networks via an established extraction method. In addition, the experiment was extended to assess the effectiveness of MLR in dealing with cascade error by using a novel experimental procedure that had been proposed in this work. The experiment revealed that the number of cascade errors had been very minimal. Apart from that, the Belsley collinearity test proved that multicollinearity did affect the datasets used in this experiment greatly. All the tested subnetworks obtained satisfactory results, with AUROC values above 0.5.
Fulltext Mammographic compression in Asian women

Lau S, Abdul Aziz YF, Ng KH

PLoS One, 2017;12(4):e0175781.
PMID: 28419125 DOI: 10.1371/journal.pone.0175781

OBJECTIVES: To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study.
METHODS: We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35-80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs.
RESULTS: Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2-11.0%, and caused no significant effects on image quality (p>0.05).
CONCLUSIONS: Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.
Fulltext Identification of troponin I and actin, alpha cardiac muscle 1 as potential biomarkers for hearts of electrically stimulated chickens

Amid A, Samah NA, Yusof F

Proteome Sci, 2012;10(1):1.
PMID: 22230661 DOI: 10.1186/1477-5956-10-1

In this study, proteomics methods have been used to study the effects of different currents and voltages used to stun chickens. Protein profiles of chicken hearts were constructed to detect differences in protein expression and modification. The different voltages studied were 10 V, 40 V and 70 V, while the currents examined were 0.25 A, 0.5 A, and 0.75 A. The profiles obtained from these stunning conditions were compared to the non-stunned (0 A, 0 V) sample.
Fulltext Estimating an EQ-5D value set for Malaysia using time trade-off and visual analogue scale methods

Yusof FA, Goh A, Azmi S

Value Health, 2012 Jan-Feb;15(1 Suppl):S85-90.
PMID: 22265073 DOI: 10.1016/j.jval.2011.11.024

OBJECTIVES: To estimate a EQ-5D value set for Malaysia by using time trade-off (TTO) and visual analogue scale (VAS) valuation methods.
METHODS: TTO and VAS valuations were obtained from face-to-face surveys of a convenience sample of patients, caregivers, and health professionals conducted at nine government hospitals in 2004 and 2005. Forty-five EQ-5D questionnaire health states were valued, divided into five sets of 15 health states. Analysis was conducted by using linear additive regression models applying N3 and D1 specifications. Model selection was based on criteria of coefficient properties, statistical significance, and goodness of fit.
RESULTS: One hundred fifty-two respondents were interviewed, yielding 2174 TTO and 2265 VAS valuations. Respondents found TTO valuations to be more difficult than VAS valuations, and there were more inconsistencies in TTO valuations. All the independent variables in the models were statistically significant and consistent with expected signs and magnitude, except for the D1 specification modeled on TTO valuations. The N3 model provided the best fit for the VAS valuation data, with a mean absolute error of 0.032.
CONCLUSION: This study provides a Malaysian EQ-5D questionnaire value set that can be used for cost-utility studies despite survey limitations.
Study site: convenience sampling from three categories of respondents (patients undergoing dialysis, patients’ carers, and dialysis center staff) from public hospitals
Trend analysis of a tropical urban river water quality in Malaysia

Othman F, M E AE, Mohamed I

J Environ Monit, 2012 Dec;14(12):3164-73.
PMID: 23128415 DOI: 10.1039/c2em30676j

Rivers play a significant role in providing water resources for human and ecosystem survival and health. Hence, river water quality is an important parameter that must be preserved and monitored. As the state of Selangor and the city of Kuala Lumpur, Malaysia, are undergoing tremendous development, the river is subjected to pollution from point and non-point sources. The water quality of the Klang River basin, one of the most densely populated areas within the region, is significantly degraded due to human activities as well as urbanization. Evaluation of the overall river water quality status is normally represented by a water quality index (WQI), which consists of six parameters, namely dissolved oxygen, biochemical oxygen demand, chemical oxygen demand, suspended solids, ammoniacal nitrogen and pH. The objectives of this study are to assess the water quality status for this tropical, urban river and to establish the WQI trend. Using monthly WQI data from 1997 to 2007, time series were plotted and trend analysis was performed by employing the first-order autocorrelated trend model on the moving average values for every station. The initial and final values of either the moving average or the trend model were used as the estimates of the initial and final WQI at the stations. It was found that Klang River water quality has shown some improvement between 1997 and 2007. Water quality remains good in the upper stream area, which provides vital water sources for water treatment plants in the Klang valley. Meanwhile, the water quality has also improved in other stations. Results of the current study suggest that the present policy on managing river quality in the Klang River has produced encouraging results; the policy should, however, be further improved alongside more vigorous monitoring of pollution discharge from various point sources such as industrial wastewater, municipal sewers, wet markets, sand mining and landfills, as well as non-point sources such as agricultural or urban runoff and commercial activity.
Fulltext Neurothekeoma palpebrae in association with multiple superficial angiomyxomas: Tegumental Angiomyxoma-Neurothekeoma syndrome (TAN syndrome)

Kah TA, Yong KC, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e67.
PMID: 24765328 DOI: 10.4081/cp.2011.e67

We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors' knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma.
Fulltext Canaliculitis in supernumerary puncta and canaliculi

Yong KC, Kah TA, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e59.
PMID: 24765320 DOI: 10.4081/cp.2011.e59

We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the left lower lid (0.5×0.5 mm) with inflamed overlying skin. Two puncta (0.5 mm apart) were noted. The outer punctum at the normal anatomical position was a cul-de-sac while the inner punctum it the caruncle was patent. We described the embryology leading to supernumerary puncta and canaliculi to explain the paradoxical patency of the abnormally located punctum as well as the pathomechanism leading to canaliculitis. The patient was treated with oral cloxacillin 500 mg, 6 hourly for 5 days; the cellulitis subsided after three days.
Fulltext Cross-culture adaptation and validation of the Indonesian version of the Hospital Survey on Patient Safety Culture (HSOPSC 2.0)

Suryani L, Letchmi S, Binti Moch Said F

Belitung Nurs J, 2022;8(2):169-175.
PMID: 37521894 DOI: 10.33546/bnj.1928

BACKGROUND: Hospital Survey on Patient Safety Culture (HSOPSC) is considered one of the most scientifically rigorous tools available with excellent psychometric properties. However, it is not yet available in an Indonesian version.
OBJECTIVE: This study aimed to determine the validity of the content and psychometric properties of HSOPSC 2.0 for use in Indonesian hospitals.
METHODS: The study was divided into three stages: translation, adaptation, and validation. Culture-adaptation was assessed using cognitive interviews with ten direct care nurses who worked in the hospital to evaluate their perceptions and the coherence of the translated items, response categories, and questionnaire directions. Content validity was also done by ten experts from academic and clinical settings. Finally, Confirmatory Factor Analysis (CFA) and reliability testing were conducted among 220 nurses from two Indonesian hospitals.
RESULTS: The cognitive test results indicated that the language clarity was 87.8 % and 84.5% for cultural relevance. The Content Validity Index (CVI) ranged between 0.73 to 1.00, while the construct validity results indicated that each factor had factor loadings above 0.4, from 0.47 to 0.65. The fit indices showed an acceptable fit for the data provided by the 10-factor model, with RMSEA = 0.052, SRMR = 0.089, and CFI = 0.87. The Pearson correlation coefficients between the ten subscales ranged from 0.276 to 0.579 (p < 0.05). The Cronbach's alpha for all sub-scales was more than 0.70, except for organizational learning - continuous improvement, response to error, and communication openness.
CONCLUSION: This study offers initial evidence of the psychometric properties of the Indonesian-HSOPSC 2.0. Future studies are needed to examine its psychometric features to improve generalizability. However, nurses and other healthcare professionals could use the tool to measure hospital patient safety culture in Indonesia.

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