Caesarean delivery rates are still increasing, and reliable predictors of adverse outcomes at a subsequent trial of scar are important as they guide decision-making on the best mode of delivery. We aimed to evaluate whether there are any predictors for caesarean delivery and neonatal admission, following trial of labour after one lower transverse caesarean section.
The extraction of relevant wavelengths from a large dataset of Near Infrared Spectroscopy (NIRS) is a significant challenge in vibrational spectroscopy research. Nonetheless, this process allows the improvement in the chemical interpretability by emphasizing the chemical entities related to the chemical parameters of samples. With the complexity in the dataset, it may be possible that irrelevant wavelengths are still included in the multivariate calibration. This yields the computational process to become unnecessary complex and decreases the accuracy and robustness of the model. In multivariate analysis, Partial Least Square Regression (PLSR) is a method commonly used to build a predictive model from NIR spectral data. However, in the PLSR method and common commercial chemometrics software, there is no standard wavelength selection procedure applied to screen the irrelevant wavelengths. In this study, a new robust wavelength selection procedure called the modified VIP-MCUVE (mod-VIP-MCUVE) using Filter-Wrapper method and input scaling strategy is introduced. The proposed method combines the modified Variable Importance in Projection (VIP) and modified Monte Carlo Uninformative Variable Elimination (MCUVE) to calculate the scale matrix of the input variable. The modified VIP uses the orthogonal components of Partial Least Square (PLS) in investigating the informative variable in the model by applying the amount of variation both in X and y{SSX,SSY}, simultaneously. The modified MCUVE uses a robust reliability coefficient and a robust tolerance interval in the selection procedure. To evaluate the superiority of the proposed method, the classical VIP, MCUVE, and autoscaling procedure in classical PLSR were also included in the evaluation. Using artificial data with Monte Carlo simulation and NIR spectral data of oil palm (Elaeis guineensis Jacq.) fruit mesocarp, the study shows that the proposed method offers advantages to improve model interpretability, to be computationally extensive, and to produce better model accuracy.
This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. Faecal samples were collected from 1,330 participants from seven states of Malaysia and examined by wet mount and formalin-ether sedimentation methods while demographic, socioeconomic and environmental information was collected using a pre-tested questionnaire. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged ≤ 12 years compared to their older counterparts. Multivariate logistic regression identified age of ≤ 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river, and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Based on a multilocus genotyping approach (including tpi, gdh and bg gene sequences), 69 isolates were identified as assemblage A, and 69 as assemblage B. No association between the assemblages and presence of symptoms was found. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.
We aimed to evaluate and determine the effect of diabetes mellitus (DM) on overall survival (OS) and cancer-specific survival (CSS) in early stage cervical cancer (CC) patients. Patients with primary cervical cancer and newly diagnosed were selected from ten different cancer specialist hospitals of Malaysia. Patients' demographic and clinical data were obtained for the prognostic analysis. Kaplan-Meier method was used to estimate patients' survival time (CSS and OS) with DM status and values were compared using the log-rank test. A total of 19,785 newly diagnosed CC patients were registered during 2010-2016, among them only 16,946 (85.6%) with primary CC tumor. There was no difference in treatment modality between DM and non-DM patients. However intergroup assessment showed that type 2DM have significantly higher rate of mortality in both overall mortality (28.3%) and CC-specific (11.7%) as compared to Type 1DM (17.3%; 5.5%) and non DM patients (12.7%; 9.1%) (p
Twenty-five traditional and thirty-four geometric morphometric comparisons were carried out on pure and reciprocal crosses of Pangasianodon hypophthalmus (Sauvage, 1878) and Clarias gariepinus (Burchell, 1822). Thirty fish samples each of the C. gariepinus (CH), P. hypophthalmus (PH), Pangapinus (♀PH × ♂CG) and the two distinct morphotypes of the Clariothalmus (♀CG × ♂PH) (Clarias-like and Panga-like) between the ages of four and six months were used for this study. Phenotypically, the Clarias-like Clariothalmus and the Pangapinus progenies were indistinguishable from their maternal parents while the Panga-like Clariothalmus was a phenotypic intermediary of the putative parents but looks more closely to the paternal parent. Hence, both univariate proportion and multivariate analysis of the collected data successfully separated the different fishes into three multivariate spaces. The analysis of the dendrogram with complete linkage and Euclidean distance further showed the close relationship of the isolated Panga-like Clariothalmus progenies to the paternal parent, however, Clarias-like Clariothalmus and the Pangapinus were completely intermingled with their maternal parents. The most important index of discrimination of these fishes into different multivariate spaces was the fin characteristic which showed 100% exclusive ranges for the individual groups in many cases.
The COVID-19 pandemic has disrupted the lives of all including university students. With the preventive measures to reduce the transmission of COVID-19, all face-to-face teaching and learning are converted to e-learning. The COVID-19 pandemic and the implementation of e-learning may influence these students' mental conditions. This study aimed to determine the association of factors with mental health status (depression, anxiety and stress) among university students in Malaysia. Study participants were tertiary education students from both the private and public universities in Malaysia. Participants were recruited via university emails and social media. The survey was administered via the online REDCap platform, from April to June 2020, during the movement control order period in the country. The questionnaire captured data on socio-demographic characteristics, academic information, implementation of e-learning, perception towards e-learning and COVID-19; as well as DASS 21 to screen for depression, anxiety and stress. The levels of stress, anxiety and depression were 56.5% (95% CI: 50.7%, 62.1%), 51.3% (95% CI: 45.6%, 57.0%) and 29.4% (95% CI: 24.3%, 34.8%) respectively. Most participants had good perception towards e-learning but negative perception on COVID-19. From the multivariate analysis, participants with positive perception on COVID-19 were protective towards stress (aOR: 0.96; 95% CI: 0.92, 0.99), anxiety (aOR: 0.94, 95% CI: 0.90, 0.98) and depression (aOR: 0.95; 95% CI: 0.91, 0.99). Older students were 14% (aOR: 0.86, 95% CI: 0.79, 0.94) and 11% (aOR: 0.89: 95% CI: 0.80, 0.99) less likely for anxiety and depression, respectively. Students originated from the Malay ethnicity had higher odds (aOR: 1.93; 95% CI: 1.05, 3.56) for depression. These findings demonstrated that the mental status of university students was greatly affected during the COVID-19 pandemic. Timely and credible information should be disseminated to alleviate their negative perception towards COVID-19.
Tropical peat swamp forest (PSF) is one of the most endangered ecosystems in the world. However, the impacts of
anthropogenic activities in PSF and its conversion area towards fish biodiversity are less understood. This study
investigates the influences of water physico-chemical parameters on fish occurrences in peat swamp, paddy field and
oil palm plantation in the North Selangor peat swamp forest (NSPSF), Selangor, Malaysia. Fish and water samples were
collected from four sites located in the peat swamps, while two sites were located in the paddy field and oil palm plantation
areas. Multivariate analyses were used to determine the associations between water qualities and fish occurrences in
the three habitats. A total of 1,382 individual fish, belonging to 10 families, 15 genera and 20 species were collected.
The family Cyprinidae had the highest representatives, followed by Bagridae and Osphronemidae. The most abundant
species was Barbonymus schwanefeldii (Bleeker 1854), while the least abundant was Wallago leerii Bleeker, 1851. The
paddy field and oil palm plantation area recorded significantly higher fish diversity and richness relative to peat swamp
(p<0.05). The water physico-chemical parameters, such as pH, DO, NH3
-N, PO4, SO4
, and Cl2 showed no significant
difference between paddy field and oil palm plantation (p>0.05), but was significantly different from the peat swamp
(p<0.05). However, no water quality parameter was consistently observed to be associated with fish occurrences in all
of the three habitats, but water temperature, NH3
-N, Cl2, SO4
, and EC were at least associated with fish occurrences in
two habitats studied. This study confirmed that each habitat possess different water quality parameters associated with
fish occurrences. Understanding all these ecological aspects could help future management and conservation of NSPSF.
Oil palm is the major crop grown and cultivated in various Asian countries such as Malaysia, Indonesia and Thailand.
The core of oil palm trunk (COPT) consists of high sugar content, hence suitable for synthesis of fine chemicals and
biofuels. Increase of sugar content was reported previously during prolonged COPT storage. However, until now, there
has been no report on protein profiles during storage. Therefore, in this study, protein expression of the COPT during the
storage period of one to six weeks was investigated using sodium dodecyl sulphate polyacrylamide gel electrophoresis
(SDS-PAGE) coupled with optical density quantification and multivariate analyses for measuring differentially expressed
proteins. Accordingly, protein bands were subjected to tryptic digestion followed by tandem mass spectrometry (nanoLCMS/MS)
protein identification. The results from SDS-PAGE showed consistent protein bands appearing across the biological
replicates ranging from 10.455 to 202.92 kDa molecular weight (MW) regions. The findings from the principal component
analysis (PCA) plot illustrated the separation pattern of the proteins at weeks 4 and 5 of storage, which was influenced
mainly by the molecular weights of 14.283, 25.543, 29.757, 30.549, 31.511, 34.585 and 84.395 kDa, respectively. The
majority of these proteins are identified as those involved in stress- and defense-related, disease resistance, as well
as gene/protein expression processes. Indeed, these proteins were mostly upregulated during the later storage period
suggesting that long-term storage may influence the molecular regulation of COPT sap.
Outliers in the X-direction or high leverage points are the latest known source of multicollinearity. Multicollinearity is a nonorthogonality of two or more explanatory variables in multiple regression models, which may have important influential impacts on interpreting a fitted regression model. In this paper, we performed Monte Carlo simulation studies to achieve two main objectives. The first objective was to study the effect of certain magnitude and percentage of high leverage points, which are two important issues in tending the high leverage points to be collinearity-enhancing observations, on the multicollinarity pattern of the data. The second objective was to investigate in which situations these points do make different degrees of multicollinearity, such as moderate or severe. According to the simulation results, high leverage points should be in large magnitude for at least two explanatory variables to guarantee that they are the cause of multicollinearity problems. We also proposed some practical Lower Bound (LB) and Upper Bound (UB) for High Leverage Collinearity Influential Measure (HLCIM) which is an essential measure in detecting the degree of multicollinearity. A well-known example is used to confirm the simulation results.
A field experiment was conducted from June to December, 2013 to study the genetic diversity of 15 modern T. Aman rice
varieties of Bangladesh (Oryza sativa L.) with a view to assess the superior genotype in future hybridization program
for developing new rice varieties that is suitable for the target environment. Analysis of variance for each trait showed
significant differences among the varieties. High heritability associated with high genetic advance in percent of mean
was observed for plant height and thousand seed weight which indicated that selection for these characters would be
effective. Hence, thrust has to be given for these characters in future breeding program to improve the yield trait in rice.
Multivariate analysis based on 10 agronomic characters indicated that the 15 varieties were grouped into four distant
clusters. The inter cluster distance was maximum between cluster II and cluster IV. The highest intra-cluster distance was
found in cluster IV. Based on positive value of vector 1 and vector 2, plant height and 1000-seed weight had maximum
contribution towards genetic divergence. From the results, it can be concluded that the varieties BRRI dhan40, BRRI
dhan44, BRRI dhan46, BRRI dhan49 and BINA dhan7 may be selected for future hybridization program.
ir quality has deteriorated in urban areas as a result of increased anthropogenic activities. Quantitative information on the influence of meteorological conditions on several pollutants in a tropical climate is still lacking. Real-time ozone (O3) and nitrogen dioxide (NO2) levels were measured nearby selected schools in Malaysia to examine the impact of meteorological factors on monitoring pollutants. The results showed the overall 10 min average concentrations of the main parameters during school holiday were 24 ppb (O3) and 33 ppb (NO2) while during school day the overall 10 min average concentrations were 26 ppb (O3) and 51 ppb (NO2). Although there are no minimum requirements for short-term exposure by MAAQG, if compared to 1 h average requirements, all concentrations were still below the suggested values. Regarding spatial distribution, a different trend in pollutant concentration among the schools was observed because of the influence of temperature (AT) and wind speed (WS). The results were verified by Pearson correlation, where significant correlations (p<0.01) were determined between air pollutants and meteorological factors, which were temperature, wind speed and relative humidity. Meanwhile, the distribution of O3 was moderately correlated with NO2. However, the results of multivariate analysis indicate that temperature and relative humidity had the most significant influence on the formation of O3. In summary, the results of this study showed that all precursors and meteorological parameters contribute to the production of O3. Hence, reducing O3 precursors, which are emitted by vehicles, is essential to lessening the exposure to O3
Forecasting a multiple seasonal data is differ from a usual seasonal data since it contains more than one cycle in a
data. Multiple linear regression (MLR) models have been used widely in load forecasting because of its usefulness in the
forecast a linear relationship with other factors but MLR has a disadvantage of having difficulties in modelling a nonlinear
relationship between the variables and influencing factors. Neural network (NN) model, on the other hand, is a good
model for modelling a nonlinear data. Therefore, in this study, a combination of MLR and NN models has proposed this
combination to overcome the problem. This hybrid model is then compared with MLR and NN models to see the performance
of the hybrid model. RMSE is used as a performance indicator and a proposed graphical error plot is introduce to see the
error graphically. From the result obtained this model gives a better forecast compare to the other two models.
Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.
Prediction of mortality in patients with community-acquired pneumonia (CAP) can be assessed using clinical severity scores on admission to hospital. The clinical benefit of such tools is untested in Asian countries. The aim of this study was to determine the early adverse prognostic factors in patients hospitalized with CAP in Malaysia and to assess the usefulness of the British Thoracic Society (BTS) severity criteria.
OBJECTIVE: The Asthma Insights and Reality in Asia-Pacific (AIRIAP) survey collected detailed information on asthma severity and management in the urban centres of eight areas of the Asia-Pacific region. This study compared asthma morbidity and management practices in these areas.
METHODOLOGY: Following recruitment, face-to-face interviews were completed with 2323 adults with diagnosed asthma, who had current symptoms or were using asthma medication. Comparisons between areas were made for asthma severity, asthma burden and management practices.
RESULTS Asthma severity varied significantly between areas (P < 0.01), with Vietnam and mainland China reporting the most cases with severe, persistent symptoms. Severity of asthma was significantly associated with advancing age and a lower level of education in a multivariate analysis (P < 0.001). The total use of acute healthcare for asthma was significantly associated with increased asthma severity. Work absence due to asthma was highest in the Philippines (46.6%) and lowest in South Korea (7.5%). The use of inhaled corticosteroids was associated with age in a non-linear manner. There was significant variation among countries in usage of inhaled corticosteroids, from 1.3% in South Korea to 29.0% in Taiwan (P < 0.00001). A peak flow meter was owned by a total of 7.7% of respondents, and overall, 17.9% of adults had a written action plan for asthma management.
CONCLUSIONS: Within the Asia-Pacific region, asthma in adults differs significantly in disease severity, management and treatment according to area of residence. International recommendations on the management of asthma are generally not being followed.
Study site: urban areas in several countries in Asia-Pacific region (via random street interception, random door-to-door recruitment, or telephone recruitment)
PURPOSE: The aim of this study was to determine the socio-demographic, clinical and psychological factors influencing the quality of life (QOL) in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS).
METHODS: This was a cross-sectional study on 271 patients with HIV infection attending an HIV clinic in Kota Bharu, Malaysia. Participants completed the Malay version of the Functional Assessment of HIV Infection (FAHI) and Malay Hospital Anxiety Depression Scale (HADS).
RESULTS: The patients functioned satisfactorily in the physical domain. They were mostly impaired in the social domain. Those who acquired the HIV infection via a heterosexual route seemed to have a significantly lower social well-being, while those who acquired HIV via drug injection were not associated with losses in the overall QOL or any of its domains. Non-disclosure paradoxically had a greater effect on social well-being. About 38% had possible anxiety, depression or both, and these emotional disturbances were significantly associated with total FAHI and its five domains.
CONCLUSIONS: Psychological and social well-beings were more affected than physical well-being in out-patients with HIV infection in Kota Bharu, Malaysia. The study suggests that the patients with HIV infection should receive better psycho-education and psychological intervention.
Study site: Infectious Disease clinic, Hospital Raja Perempuan Zainab II, Kota Bharu Kelantan, Malaysia
BACKGROUND: The aim of the study was to obtain norms of the SF-36v2 health survey and the association of summary component scores with socio-demographic variables in healthy households of tuberculosis (TB) patients.
DESIGN: All household members (18 years and above; healthy; literate) of registered tuberculosis patients who came for contact tracing during March 2010 to February 2011 at the respiratory clinic of Penang General Hospital were invited to complete the SF-36v2 health survey using the official translation of the questionnaire in Malay, Mandarin, Tamil and English. Scoring of the questionnaire was done using Quality Metric's QM Certified Scoring Software version 4. Multivariate analysis was conducted to uncover the predictors of physical and mental health.
RESULTS: A total of 649 eligible respondents were approached, while 525 agreed to participate in the study (response rate = 80.1 %). Out of consenting respondents, 46.5 % were male and only 5.3 % were over 75 years. Internal consistencies met the minimum criteria (α > 0.7). Reliability coefficients of the scales were always less than their own reliability coefficients. Mean physical component summary scale scores were equivalent to United States general population norms. However, there was a difference of more than three norm-based scoring points for mean mental component summary scores indicating poor mental health. A notable proportion of the respondents was at the risk of depression. Respondents aged 75 years and above (p = 0.001; OR 32.847), widow (p = 0.013; OR 2.599) and postgraduates (p < 0.001; OR 7.865) were predictors of poor physical health while unemployment (p = 0.033; OR 1.721) was the only predictor of poor mental health.
CONCLUSION: The SF-36v2 is a valid instrument to assess HRQoL among the households of TB patients. Study findings indicate the existence of poor mental health and risk of depression among family caregivers of TB patients. We therefore recommend that caregivers of TB patients to be offered intensive support and special attention to cope with these emotional problems.
Study site: Respiratory clinic, Hospital Pulau Pinang, Malaysia
OBJECTIVES: Despite the health-enhancing benefits of physical activity, a large segment of the Malaysian population does not engage in regular physical activity at the recommended level. This study aimed to determine physical activity patterns and the associated sociodemographic correlates of physical activity.
STUDY DESIGN: Data on physical activity were obtained from the National Health and Morbidity Survey (NHMS) 2011, a nationally representative, population-based cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of Malaysian adults aged 16 years and above.
METHODS: A total of 19,145 adults aged 16 years and above were recruited, and face-to-face interviews were conducted using the International Physical Activity Questionnaire (IPAQ), short version. The correlates for physical activity were identified using multivariate analysis.
RESULTS: In this study, 64.3% (95%CI: 63.1-65.5) of Malaysian adults aged 16 and above were physically active, but overall physical activity levels decreased with advancing age. Men, rural residents, 'other' ethnic groups, and married women were more likely to demonstrate higher levels of physical activity.
CONCLUSION: Approximately 65% of Malaysian adults were physically active. However, it is recommended that health promotions for active lifestyles should be targeted to the least active segments, which constitute more than a quarter of the Malaysian population.
KEYWORDS: Correlates; IPAQ; Malaysian adults; Physical activity; Sociodemographic
Study name: National Health and Morbidity Survey (NHMS-2011)
OBJECTIVE: This article examines the trends in morbidities and healthcare utilisation in Malaysian older people aged 60 years and above.
STUDY DESIGN: This is a repeated cross-sectional study.
METHODS: Data from three nation-wide community-based surveys, which were conducted in 1996, 2006, and 2015 were analysed. Multivariate analysis was performed for 2015 data to identify factors associated with healthcare utilisation.
RESULTS: Analysis noted increasing trends in the prevalence of diabetes, hypertension, hypercholesterolaemia and obesity from 1996 to 2015. Decreasing trends were noted in the prevalence of current smokers and drinkers over this 20-year period, whereas health service utilisation increased with age in all surveys. In 2015, both inpatient and outpatient care are significantly associated with increasing age and diabetes.
CONCLUSIONS: Increasing trends of health problems and healthcare utilisation were observed among older people in Malaysia. Policymakers should plan for appropriate resources to meet the challenges of an ageing population in Malaysia.
Study name: National Health and Morbidity Survey (NHMS-1996, NHMS-2006, NHMS-2015)
Older patients are at an increased risk of developing adverse drug reactions (ADR). Of particular concern are the oldest old, which constitute an increasingly growing population. Having a validated clinical tool to identify those older patients at risk of developing an ADR during hospital stay would enable healthcare staff to put measures in place to reduce the risk of such an event developing. The current study aimed to (1) develop and (2) validate an ADR risk prediction model.