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  1. Raja MAG, Katas H, Amjad MW
    Asian J Pharm Sci, 2019 Sep;14(5):497-510.
    PMID: 32104477 DOI: 10.1016/j.ajps.2018.12.005
    Upon the discovery of RNA interference (RNAi), canonical small interfering RNA (siRNA) has been recognized to trigger sequence-specific gene silencing. Despite the benefits of siRNAs as potential new drugs, there are obstacles still to be overcome, including off-target effects and immune stimulation. More recently, Dicer substrate siRNA (DsiRNA) has been introduced as an alternative to siRNA. Similarly, it also is proving to be potent and target-specific, while rendering less immune stimulation. DsiRNA is 25-30 nucleotides in length, and is further cleaved and processed by the Dicer enzyme. As with siRNA, it is crucial to design and develop a stable, safe, and efficient system for the delivery of DsiRNA into the cytoplasm of targeted cells. Several polymeric nanoparticle systems have been well established to load DsiRNA for in vitro and in vivo delivery, thereby overcoming a major hurdle in the therapeutic uses of DsiRNA. The present review focuses on a comparison of siRNA and DsiRNA on the basis of their design, mechanism, in vitro and in vivo delivery, and therapeutics.
  2. Iqbal DM, Wong LS, Kong SY
    Materials (Basel), 2021 Apr 23;14(9).
    PMID: 33922871 DOI: 10.3390/ma14092175
    The rapid development of the construction sector has led to massive use of raw construction materials, which are at risk of exhaustion. The problem is aggravated by the high demand for cement as binding powder and the mass production of clay bricks for construction purposes. This scenario has led to high energy consumption and carbon emissions in their production. In this regard, bio-cementation is considered a green solution to building construction, because this technology is environmentally friendly and capable of reducing carbon emissions, thus slowing the global warming rate. Most of the previously published articles have focused on microbiologically induced calcium carbonate precipitation (MICP), with the mechanism of bio-cementation related to the occurrence of urea hydrolysis as a result of the urease enzymatic activity by the microbes that yielded ammonium and carbonate ions. These ions would then react with calcium ions under favorable conditions to precipitate calcium carbonate. MICP was investigated for crack repair and the surface treatment of various types of construction materials. Research on MICP for the production of binders in construction materials has become a recent trend in construction engineering. With the development of cutting edge MICP research, it is beneficial for this article to review the recent trend of MICP in construction engineering, so that a comprehensive understanding on microbial utilization for bio-cementation can be achieved.
  3. Kunyahamu MS, Daud A, Jusoh N
    PMID: 33924182 DOI: 10.3390/ijerph18084381
    Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers' obesity and whether different health-care job categories are related to workers' obesity. This study aimed to determine the prevalence of obesity among HCWs and the association between various HCW job categories and obesity. A cross-sectional study was conducted by analyzing secondary data from the 2019 annual cardiovascular health screening program, which included information regarding all government health-care workers in the east coast region of Peninsular Malaysia. The subject's body mass index (BMI) was categorized according to WHO criteria. Only 43% of the subjects had a normal BMI, while 33.1% were categorized as overweight, and 21.1% were obese. Different HCWs' job categories were shown to be significantly associated with their obesity status, with nurses apparently having a higher risk of being obese (Adj OR = 1.91, 95% CI 1.45, 2.53, p-value < 0.001). This study's results require further exploration of HCWs' working condition factors and for different job categories that contribute to obesity. Public health intervention programs to combat obesity should be implemented that primarily target HCW groups at the highest risk of obesity.
  4. Hartono RK, Hamid SA, Hafizurrachman M
    Acta Med Indones, 2020 Apr;52(2):111-117.
    PMID: 32778624
    BACKGROUND: it cannot be ascertained whether an individual with poor physical function is at an increased risk of Non-Communicable Diseases (NCDs), thus the aim of this study is to examine this potential relationship.

    METHODS: in this study, a fixed retrospective cohort design has been conducted by using data from the Indonesia Family Life Survey (IFLS) in 2007 and 2014. A total of 6,863 respondents who were not diagnosed with NCD by medical personnel in 2007 were successfully traced. After being controlled for covariates, the association between NCD type and poor physical function was measured by using the Adjusted Risk Ratio (ARR) and Population Attributable Risk (PAR).

    RESULTS: respondents with poor physical function were at a significantly increased of being diagnosed with stroke (ARR: 6.9, 95%CI: 4.3-10.9), diabetes (ARR: 3.1, 95%CI: 2.4-4.1), or heart disease (ARR: 3.2, 95%CI: 2.4-4.5). The PAR score of respondents with diabetes was 0.006, meaning 0.6% of diabetes cases are attributed to poor physical function and can therefore be prevented if people maintain good physical function.

    CONCLUSION: poor physical function can be assessed to identify risk of diabetes, heart disease, and stroke. Healthcare personnel should provide education programs that inform patients on the importance of maintaining a healthy physical ability.

  5. Wan Yunus F, Tan XZ, Romli MH
    Games Health J, 2020 Dec;9(6):415-424.
    PMID: 33301386 DOI: 10.1089/g4h.2019.0077
    Sleep deprivation and emotional problems such as stress, anxiety, and depression commonly occur in university students. Exercise is beneficial to ameliorate those problems; however, university students are not serious to take up physical activity. Commercially available exergame such as Xbox® 360 Kinect is one of the alternatives. This study aims at investigating the feasibility and the potential efficacy of using Xbox 360 Kinect game among health care undergraduate students. A pilot two-armed parallel randomized controlled trial was implemented. A total of 36 undergraduate students was recruited and randomly allocated into the intervention group (playing Xbox 360 Kinect) or the control group (continue with normal daily routine). The intervention group received 30 minutes of Xbox Kinect activity, three times per week for 6 weeks. Information on psychology (Depression, Anxiety, and Stress Scale-21) and sleep (Functional Outcome Sleep Questionnaire-30) status was collected at pre- and post-experiment. The researcher-developed feasibility questionnaire was given to the participants in the intervention group at post-experiment. Repeated-measures analysis of variance was used to investigate within-between group comparison, and significance value was set at p ≤ 0.05. The analysis found potential improvement on sleep (p = 0.039) and psychological health (p = 0.002-0.067). The intervention protocol is feasible and highly accepted by the participants. The required optimum amount of dosage, sample size, and the use of outcome measures are suggested from the findings. This pilot and feasibility study supports the use of Xbox 360 Kinect games in practice and to be implemented for future research.
  6. Nazir MU, Yasin I, Tat HH
    Heliyon, 2021 Jul;7(7):e07613.
    PMID: 34368481 DOI: 10.1016/j.heliyon.2021.e07613
    This study aims to examine the effect of destination image, perceived risk, and perceived constraints on the behavioral intention of international tourists to revisit Pakistan. The study also seeks to assess the destination image's mediating role in the relationship between perceived risks, perceived constraints, and behavioral intention. A quantitative study with Partial least square structural equation modeling was used to investigate the research Hypothesis. The data was collected from international tourists who were in Pakistan or who had visited Pakistan. The findings revealed that perceived risks and perceived constraints negatively impact destination image and behavioral intention. On the other hand, destination image has a positive impact on behavior. Moreover, the study also proved the mediating effect of destination image among the relations of perceived risks, perceived constraints, and behavioral intention. These findings indicate that sometimes it is difficult for destinations to overcome constraints, so destination managers should provide value-added services for substitutes. A positive destination image can overcome risks and constraints, so destination managers should also promote destinations besides mitigating risks. Literature has discussed the mediating effect of destination image in different contexts. However, studies are scarce investigating destination image's effect in alleviating perceived constraints and perceived risks through negotiation mechanisms.
  7. Harith HH, Mohd MF, Nai Sowat S
    Appl Ergon, 2021 Sep;95:103455.
    PMID: 33991852 DOI: 10.1016/j.apergo.2021.103455
    Manual harvesting is still prevalent in the agricultural industry. Accordingly, it is one of the largest contributors toward work-related musculoskeletal disorder. The cutting task in oil palm harvesting uses a long pole and involves repetitive and forceful motion of the upper limbs. Exoskeleton technology is increasingly explored to assist manual tasks performance in manufacturing and heavy industries, mainly for reducing discomfort and injuries, and improving productivity. This paper reports an initial investigation on the feasibility of using an upper limb exoskeleton to assist oil palm harvesting tasks. Previous studies highlighted that exoskeletons for agricultural activities should be adaptable to changing field tasks, tools and equipment. The immediate difference in the activity of three muscles were analyzed for a range of harvesting-simulated tasks. Lower activities were observed for tasks involving overhead work when using the prototype. Nevertheless, users' feedback highlighted that its design should be optimized for better acceptance.
  8. Rafiq MT, A Hamid MS, Hafiz E
    J Multidiscip Healthc, 2021;14:2161-2168.
    PMID: 34408430 DOI: 10.2147/JMDH.S317896
    Purpose: This study aimed to investigate the effectiveness of progressive resistance strength training of the lower limb rehabilitation protocol (LLRP) on body mass index (BMI), quality of life, and functional capacity in patients with knee osteoarthritis (OA) who were overweight and obese.

    Patients and Methods: Fifty-six patients were allocated into either the Rehabilitation Protocol Group (RPG) or the Control Group (CG) by a computer-generated random number. The patients in the RPG performed the strengthening exercises of the LLRP and followed the instruction of daily care (IDC). The patients in the CG only followed the IDC as a usual care. Gait Speed Test, quality of life, and BMI were taken at pre-test and post-test measurements. Paired samples t-test and two way mixed analysis of variance were used to analyze the change of BMI within and compare the difference of BMI between the groups, respectively. Wilcoxon signed ranked test and Mann-Whitney U-test were used to analyze the changes of quality of life and functional capacity within and compare the differences of quality of life and functional capacity between the groups, respectively.

    Results: The patients in the RPG reported a significant reduction in BMI (p = 0.025), improvement in quality of life (p ≤ 0.001), and functional capacity (p ≤ 0.001) within group. The patients in the CG also reported a significant improvements in quality of life (p < 0.05). The improvement in quality of life score was greater in the patients with RPG than the CG (p = 0.053).

    Conclusion: The progressive resistance strength training of LLRP is effective in terms of reducing BMI, improving quality of life and functional capacity.

    Trial Registration: Name: Iranian Registry of Clinical Trials. Number: IRCT20191221045846N3. Enrollment of first participant: 27-07-2020.

  9. Nawawi KNM, Belov M, Goulding C
    Eur J Nutr, 2020 Aug;59(5):2237-2248.
    PMID: 31520160 DOI: 10.1007/s00394-019-02074-6
    INTRODUCTION: There is growing evidence that a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) improves symptoms in irritable bowel syndrome (IBS) patients. We aimed to retrospectively investigate the effects of this diet in Irish IBS cohort over a 12-month follow-up period, including after re-introduction of the high FODMAP foods.

    METHODS: All the tertiary referrals seen by an FODMAP-trained dietician were reviewed (2013-2016). Patients were evaluated for IBS symptoms by a questionnaire (four-point Likert scale). Subsequently, advice regarding the low FODMAP diet was given. Symptoms' response was assessed at 3-, 6-, and 12-month follow-up, by use of the same questionnaire. Re-introduction of high FODMAP foods was aimed to commence at the subsequent follow-up.

    RESULTS: A total of 164 patients were identified. Thirty-seven patients were excluded due to failure to attend for follow-up. Hundred and twenty-seven patients (77% patients, of which 85% were female) completed the initial 3-month follow-up. Forty-five percent (74/164) and twenty-five percent (41/164) of the patients had continued follow-up at 6 and 12 months, respectively. Of the 127 patients who returned for follow-up, their commonest baseline symptoms were lethargy (92%), bloating (91%), flatulence (91%), and abdominal pain (89%). All symptoms were significantly improved at the initial follow-up (p 

  10. Aris A, Sulaiman S, Che Hasan MK
    Enferm Clin, 2021 04;31 Suppl 2:S10-S15.
    PMID: 33849138 DOI: 10.1016/j.enfcli.2020.10.006
    This study aimed to investigate the effects of music on physiological outcomes for post-operative TKA patients in the recovery unit. Fifty-six patients from Hospital Melaka were randomized equally into intervention (IG) and control groups (CG). IG received the usual care and listened to selected music for 60min, while the CG received only the usual care. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiration rate (RR) and oxygen saturation (SpO2) were measured on arrival and after 10, 20, 30, and 60min in the recovery unit. A significant difference between groups was observed in RR upon arrival (U=276.5, p=0.029) and after 10min (U=291, p=0.45). Meanwhile, there were significant differences in DBP (F=3.158, p=0.032), RR (χ2=15.956, p=0.003) and SpO2 (χ2=14.084, p=0.007) over time in the IG. Overall, listening to music immediately after TKA has an effect on DBP, RR, and SpO2.
  11. Redzuan Abd Razak, Lokman Md Isa, Afzan Mat Yusuf, Syamsul Ahmad Ariffin, Refaudeen Muhammad Razali, Azantee Yazmie Abd Wahab, et al.
    IIUM Medical Journal Malaysia, 2018;17(102):143-148.
    MyJurnal
    The expression product of VASA gene is widely conserved germ line marker and participates to regulate the development of reproductive system and spermatogenesis in healthy man. Azoospermic is a condition which the man is unable to produce any sperm cells for reproduction activity. This condition produced has bad impact to the man since the ability to produce their own progeny will be interrupted or blocked forever. Not only the family bloodline of the man would be ended, the psychological issue like shamefulness and low self-esteem occurs. In Islam, seeking knowledge is an obligatory to Muslims in order to solve problems and improve lives. Thus to unveil the problem of azoospermic man we aimed to determine the level of VASA gene expression in samples of testes cells of non-obstructive azoospermic (NOA) and compare it with sperms of healthy man. Samples were taken from three NOA patients by testicular sperm extraction (TESE) to obtain testicular biopsies. Testicular cells were isolated and cultured in supplemented knockout DMEM media. VASAgene expression was determined by reverse transcriptase polymerase chain reaction (RT-PCR). The VASA gene expression from sperm of healthy man was also determined for comparison purpose. It was demonstrated that the addition of growth factor significantly increased SSC-like cells colony formation in tissues obtained from NOA patients. No VASA expression was detected in spermatogonial-like stem cells culture on day 1, 7, 14 and 21 in each of the azoospermic samples. Our findings shown VASA gene was not expressed in spermatogenesis in vitroculture that might be associated with the abnormal differentiation of primordial germ cells that lead to male infertility. Islam also teaches us to not have feelings of despair and for problems that we are facing but to find the solution and consider the problem as a test from the Almighty. All the tests should be handled with strong believe since only Allah (SWT) knows what the best for us and each of the tests will have justified wisdom and benefits which we as human being are unable to realise thoroughly.
  12. Alsaleh M, Abdul-Rahim AS, Abdulwakil MM
    J Environ Manage, 2021 Sep 15;294:112960.
    PMID: 34116310 DOI: 10.1016/j.jenvman.2021.112960
    This study examined the impact of worldwide governance indicators on the sustainability of the bioenergy industry in selected European countries for the period 1996-2018. Applying the Fixed Effect (FE) Model, the results reveal that the bioenergy industry can significantly grow by improving the quality of worldwide governance indicators in European countries, especially in Western European Countries (WEC). Government effectiveness, rule of law, regulatory quality, and voice and accountability are found to be increasing the growth of the bioenergy industry. Precisely, the results further show that the magnitude of the effect of government effectiveness, voice and accountability, and Gross Domestic Product (GDP) on bioenergy output is higher in Western European Countries (WEC) as compared to the Central and Eastern European Countries (CEEC). Also, the findings further elaborate that the significant positive impact of regulatory quality and rule of law on bioenergy output is higher in CEEC countries compared to the WEC countries. The finding implies that the growth of the bioenergy industry in European countries can be effectively increased by improving the practice and quality of worldwide governance indicators. The study recommends for European countries to increase the efficiency of worldwide governance in their bioenergy industry to increase the sustainability of bioenergy production and reduce Dioxide Carbon (CO2) emissions. Policymakers in these countries should also invest more in worldwide governance to increase its effectiveness and transparency in the bioenergy industry. The authorities should equally emphasize the effectiveness and transparency of worldwide governance indicators to attain bioenergy security and lessen the dependence on fossil fuels.
  13. Jaafar NF, Ramli ME, Mohd Salleh R
    Trop Life Sci Res, 2020 Jul;31(2):1-17.
    PMID: 32922666 DOI: 10.21315/tlsr2020.31.2.1
    Clitoria ternatea is a herbaceous plant with many health benefits. Extraction is crucial to obtain its bioactive components which contribute to its antioxidant properties. Therefore, this study was conducted to find an optimum extraction condition of C. ternatea flower on total phenolic content (TPC) and antioxidant activity (2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical-scavenging activity) as well as to determine its total flavonoid content (TFC) and anthocyanin content based on the optimum extraction condition generated by Response Surface Methodology (RSM)-Design Expert 7.1.5. TPC, TFC and total anthocyanin of C. ternatea were conducted by Folin Ciocalteu (FC), calorimetric assay and pH differential method, respectively. The ranges of selected independent variables were ethanol concentration (30°C-90% v/v), time (60-120 min) and temperature (30°C-70°C). The optimum extraction condition was obtained at 39.62% v/v ethanol concentration, 90 min and 44.24°C. However, these values were slightly adjusted according to the convenience of equipment to operate in which ethanol concentration was adjusted to 37% v/v, time remain at 90 min and temperature at 45°C. The predicted values of TPC and DPPH radical scavenging activity were 41.60 mg GAE/g dry samples and 68.12% inhibition and were experimentally verified to be 41.17 ± 0.5 mg GAE/g dry samples and 63.53 ± 0.95% inhibition of TPC and DPPH radical scavenging activity respectively. This result has showed RSM can optimise TPC and radical scavenging activity of C. ternatea. Upon the optimum condition, the TFC determined was 187.05 ± 3.18 mg quercetin/g dried sample which was higher than TPC and the total anthocyanin content was 28.60 ± 0.04 mg/L. Hence, the extractable phenolic, flavonoid and anthocyanin compounds indicated that C. ternatea is a good source of natural antioxidant.
  14. Shafiullah M, Khalid U, Chaudhry SM
    World Econ, 2021 May 07.
    PMID: 34230757 DOI: 10.1111/twec.13130
    This paper makes an innovative contribution to the extant literature by analysing the determinants of economic stimulus packages implemented by governments in response to the COVID-19 pandemic. In particular, we explore whether stock market declines observed in many countries can predict the size of COVID-19 stimulus packages. Moreover, we explore whether a country's level of income can augment the underlying relationship between stock market declines and stimulus packages. The findings reveal that a larger stock market decline results in a larger stimulus package; however, this effect is only observed in countries that have an income level greater than the mean and/or median per capita gross domestic product (GDP). Moreover, our results show that monetary policy is more responsive to a stock market decline than fiscal policy. Thus, our results underscore the importance of international donor agencies such as the World Bank and International Monetary Fund (IMF) in supporting less affluent countries in coping with the adverse impacts of the COVID-19 pandemic on their economies.
  15. Faridah Ismail, Azantee Yazmie Abdul Wahab, Raja Arif Shah Raja Ismail, Muhammad Lokman Md Isa, Redzuan Nul Hakim Abdul Razak, Hussin Muhammad
    MyJurnal
    Oxidative stress induced by excessive and unopposed levels of reactive oxygen species in male reproductive system results in impaired sperm quality, fertilization capacity and poor embryo development. Our goal is to assess the potential effects of Aquilaria malaccensis(AM) leaves, a plant with strong antioxidant property on early embryo development in vitroand embryo quality following fertilization with cyclophosphamide (CP) exposed rat sperm. Materials and Methods:Twenty four male Sprague Dawley rats were allocated into eight groups of three rats (n = 3): control, CP only (200 mg/kg), AM only (100 mg/kg, 300 mg/kg and 500 mg/kg) and CP + AM (100 mg/kg, 300 mg/kg and 500 mg/kg). Animals were sacrificed after 63 days of treatment and sperm from caudal epididymis were taken for in vitrofertilization (IVF) with oocytes from untreated female. Fertilization, embryo division and embryo morphology were examined at 8 and 48 hours post insemination and compared between groups. Statistical evaluations were performed using Chi-Square test and Fisher’s exact test and p-value
  16. Muhammad Zayyid M, Saidatul Saadah R, Adil AR, Rohela M, Jamaiah I
    Trop Biomed, 2010 Dec;27(3):442-6.
    PMID: 21399584 MyJurnal
    This is a survey of 120 children for scabies and head lice infestations in a welfare home in Pulau Pinang. Children from this welfare home (Rumah Kanak-Kanak Taman Bakti, Kepala Batas, Pulau Pinang) were randomly selected. Majority of them were Malays (72.5%) and the rest were Indians. The infestation rates were highest in the 10-12 years age group with 46% and 70% for scabies and head lice respectively. Head lice was more commonly seen in girls (65%) than boys (29%). Scabies was more commonly seen in boys (50%) than girls (16%). Overall prevalence rate for scabies was 31% and for head lice infestation was 49%.
  17. Ranjha MMAN, Kanwal R, Shafique B, Arshad RN, Irfan S, Kieliszek M, et al.
    Molecules, 2021 Aug 12;26(16).
    PMID: 34443475 DOI: 10.3390/molecules26164893
    Different parts of a plant (seeds, fruits, flower, leaves, stem, and roots) contain numerous biologically active compounds called "phytoconstituents" that consist of phenolics, minerals, amino acids, and vitamins. The conventional techniques applied to extract these phytoconstituents have several drawbacks including poor performance, low yields, more solvent use, long processing time, and thermally degrading by-products. In contrast, modern and advanced extraction nonthermal technologies such as pulsed electric field (PEF) assist in easier and efficient identification, characterization, and analysis of bioactive ingredients. Other advantages of PEF include cost-efficacy, less time, and solvent consumption with improved yields. This review covers the applications of PEF to obtain bioactive components, essential oils, proteins, pectin, and other important materials from various parts of the plant. Numerous studies compiled in the current evaluation concluded PEF as the best solution to extract phytoconstituents used in the food and pharmaceutical industries. PEF-assisted extraction leads to a higher yield, utilizes less solvents and energy, and it saves a lot of time compared to traditional extraction methods. PEF extraction design should be safe and efficient enough to prevent the degradation of phytoconstituents and oils.
  18. Abdullah MA, Ibrahim MAR, Shapiee MNA, Zakaria MA, Mohd Razman MA, Muazu Musa R, et al.
    PeerJ Comput Sci, 2021;7:e680.
    PMID: 34497873 DOI: 10.7717/peerj-cs.680
    This study aims at classifying flat ground tricks, namely Ollie, Kickflip, Shove-it, Nollie and Frontside 180, through the identification of significant input image transformation on different transfer learning models with optimized Support Vector Machine (SVM) classifier. A total of six amateur skateboarders (20 ± 7 years of age with at least 5.0 years of experience) executed five tricks for each type of trick repeatedly on a customized ORY skateboard (IMU sensor fused) on a cemented ground. From the IMU data, a total of six raw signals extracted. A total of two input image type, namely raw data (RAW) and Continous Wavelet Transform (CWT), as well as six transfer learning models from three different families along with grid-searched optimized SVM, were investigated towards its efficacy in classifying the skateboarding tricks. It was shown from the study that RAW and CWT input images on MobileNet, MobileNetV2 and ResNet101 transfer learning models demonstrated the best test accuracy at 100% on the test dataset. Nonetheless, by evaluating the computational time amongst the best models, it was established that the CWT-MobileNet-Optimized SVM pipeline was found to be the best. It could be concluded that the proposed method is able to facilitate the judges as well as coaches in identifying skateboarding tricks execution.
  19. Mustapa MAC, Amin L, Mahadi Z
    Pharmacogenomics J, 2020 12;20(6):801-812.
    PMID: 32457399 DOI: 10.1038/s41397-020-0167-0
    Pharmacogenomics (PGx) testing, which aims to identify the genes that affect our responses to drugs, has been favoured by healthcare professionals as a means of maximising drug efficacy and improving the safety and cost-effectiveness of healthcare. Support from the public is needed to determine the successful development of this technology and its implementation in society. Therefore, the objective of this paper was to analyse factors that influence stakeholders' intentions to adopt pharmacogenomic testing in Malaysia. A validated instrument was administered through face-to-face interviews with a total of 421 adult respondents who were stratified according to 2 stakeholder groups: healthcare providers (n = 221) and patients/family members (n = 200). The data were then analysed using SPSS® version 24 software and the advanced multivariate statistical approach of Partial Least Square (PLS) path modelling in order to analyse the complex relationships among variables. Results of the studies indicated that the Malaysian stakeholders had a high amount of trust in the key players (mean score of 5.31), perceived high benefits (mean score of 5.53) and claimed to have high intentions of adopting PGx (mean score of 5.39). The majority of the predictors have significant direct relationships with the intention to adopt PGx, with the exception of moral concerns. Perceived benefits appeared to be the most important direct predictor of the intention to adopt PGx testing (ß = 0.371, P 
  20. Arif NMNA, Roslan NS, Ismail SB, Nayak RD, Jamian MR, Mohamad Ali Roshidi AS, et al.
    PMID: 34444193 DOI: 10.3390/ijerph18168446
    Medical training is intensive and predisposes students to psychological distress and burnout. Unaddressed burnout in medical training may persist in the internship phase and impact the quality of patient care. While some associations have been established, the link between some individual factors and training characteristics with distress and burnout in medical training remained unclear. In this study, we aim to examine the prevalence of psychological distress and burnout, and its association with gender, training phase, funding status, cumulative grade points average (CGPA), and coping strategies among medical students. The study applied a multicenter cross-sectional study design and convenience sampling on medical students from two medical schools from Malaysia and India. We used a self-reporting instrument that includes demographic details, the 12-item General Health Questionnaire (GHQ), the Copenhagen Burnout Inventory (CBI), and the Brief Coping Orientation to Problems Experienced (Brief COPE). A total of 748 medical students participated in the study. The prevalence of psychological distress, personal-related, work-related, and patient-related burnout were 33.0%, 56.1%, 35.0%, and 26.2%, respectively. Being male, clinical year, self-funded, and having a CGPA of more than 3.50 predicted psychological distress and burnout with mixed results. Maladaptive coping mechanisms consistently predicted the risk of psychological distress and burnout by more than two times. The findings indicate that primary and secondary mental health interventions have a role in medical training. A systematic intervention should incorporate coping skills training alongside institutional-targeted intervention.
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