This study aimed to evaluate the clinical manifestations and health risks associated with polycystic ovary syndrome (PCOS) and its impact on quality of life (QOL) in Pakistan. A detailed cross-sectional study was conducted on PCOS among women of reproductive age visiting the gynecology and obstetrics and endocrinology departments at primary and tertiary care hospitals located in Abbottabad, Kohat, and Islamabad. In total, 440 patients meeting the inclusion criteria were included. A checklist was specifically designed to identify symptoms and health risks, including adverse drug reactions, complications, irrational prescription or underprescription, and drug-drug interactions. The Short Form-12 questionnaire was used to evaluate the QOL of patients with PCOS. Data collected were analyzed for descriptive and inferential statistics using chi-square test, analysis of variance, and post hoc analysis. All patients exhibited the cardinal symptoms of PCOS, including obesity (n = 352, 80%), acne (n = 296, 67.3), hirsutism (n = 299, 68%), hyperglycemia (n = 278, 63.2%), and irregular menstruation (n = 316, 71.8%). Ultrasonography confirmed that 268 (61%) patients had multiple cysts of >10 mm in diameter. Patients with untreated PCOS exhibited a high prevalence of health risks including hypertension (n = 87, 19.8%), diabetes (n = 268, 60.9%), sleep apnea (n = 11, 2.5%), infertility (n = 146, 33.2%), increased endometrial thickness (n = 21, 4.8%), miscarriages (n = 68, 15.5%), high cholesterol level (n = 85, 19.3%), and hyperandrogenism (n = 342, 77.7%). Most patients exhibited low QOL scores (n = 374, 85%), with depression being the largest contributor to low QOL. Apart from novel results, this study found an association between depression and low QOL in patients with PCOS, suggesting the need for reviewing the management guidelines and psychological health assessment of women with PCOS.
The main feature of the present numerical model is to explore the behavior of Maxwell nanoliquid moving within two horizontal rotating disks. The disks are stretchable and subjected to a magnetic field in axial direction. The time dependent characteristics of thermal conductivity have been considered to scrutinize the heat transfer phenomena. The thermophoresis and Brownian motion features of nanoliquid are studied with Buongiorno model. The lower and upper disk's rotation for both the cases, same direction as well as opposite direction of rotation is investigated. The subsequent arrangement of the three dimensional Navier Stoke's equations along with energy, mass and Maxwell equations are diminished to a dimensionless system of equations through the Von Karman's similarity framework. The comparative numerical arrangement of modeled equations is further set up by built-in numerical scheme "boundary value solver" (Bvp4c) and Runge Kutta fourth order method (RK4). The various physical constraints, such as Prandtl number, thermal conductivity, magnetic field, thermal radiation, time relaxation, Brownian motion and thermophoresis parameters and their impact are presented and discussed briefly for velocity, temperature, concentration and magnetic strength profiles. In the present analysis, some vital characteristics such as Nusselt and Sherwood numbers are considered for physical and numerical investigation. The outcomes concluded that the disk stretching action opposing the flow behavior. With the increases of magnetic field parameter [Formula: see text] the fluid velocity decreases, while improving its temperature. We show a good agreement of the present work by comparing with those published in literature.
A three dimensional (3D) numerical solution of unsteady, Ag-MgO hybrid nanoliquid flow with heat and mass transmission caused by upward/downward moving of wavy spinning disk has been scrutinized. The magnetic field has been also considered. The hybrid nanoliquid has been synthesized in the presence of Ag-MgO nanoparticles. The purpose of the study is to improve the rate of thermal energy transmission for several industrial purposes. The wavy rotating surface increases the heat transmission rate up to 15%, comparatively to the flat surface. The subsequent arrangement of modeled equations is diminished into dimensionless differential equation. The obtained system of equations is further analytically expounded via Homotopy analysis method HAM and the numerical Parametric continuation method (PCM) method has been used for the comparison of the outcomes. The results are graphically presented and discussed. It has been presumed that the geometry of spinning disk positively affects the velocity and thermal energy transmission. The addition of hybrid nanoparticles (silver and magnesium-oxide) significantly improved thermal property of carrier fluid. It uses is more efficacious to overcome low energy transmission. Such as, it provides improvement in thermal performance of carrier fluid, which play important role in power generation, hyperthermia, micro fabrication, air conditioning and metallurgical field.
This study was aimed at exploring the impact of religiosity on purchase intention towards counterfeit products by investigating the mediating role of consumer attitude. This study investigated religiosity as an independent variable, attitude towards counterfeit as a mediator while predicting the purchase intentions of the consumers. A self-administered questionnaire using a five-point Likert scale was used to collect data from the sample of 420 respondents who were from twin cities (Rawalpindi and Islamabad) of Pakistan. Structural equation modeling technique was used to achieve the set objectives. The results reveal a statistically significant effect of religiosity along with the significant mediating role of consumer attitude and the significant moderating role of hedonic benefits while predicting the purchase intentions of the consumers. This study also provides important insights for the researchers and the practitioners.
Classification of human emotions based on electroencephalography (EEG) is a very popular topic nowadays in the provision of human health care and well-being. Fast and effective emotion recognition can play an important role in understanding a patient's emotions and in monitoring stress levels in real-time. Due to the noisy and non-linear nature of the EEG signal, it is still difficult to understand emotions and can generate large feature vectors. In this article, we have proposed an efficient spatial feature extraction and feature selection method with a short processing time. The raw EEG signal is first divided into a smaller set of eigenmode functions called (IMF) using the empirical model-based decomposition proposed in our work, known as intensive multivariate empirical mode decomposition (iMEMD). The Spatio-temporal analysis is performed with Complex Continuous Wavelet Transform (CCWT) to collect all the information in the time and frequency domains. The multiple model extraction method uses three deep neural networks (DNNs) to extract features and dissect them together to have a combined feature vector. To overcome the computational curse, we propose a method of differential entropy and mutual information, which further reduces feature size by selecting high-quality features and pooling the k-means results to produce less dimensional qualitative feature vectors. The system seems complex, but once the network is trained with this model, real-time application testing and validation with good classification performance is fast. The proposed method for selecting attributes for benchmarking is validated with two publicly available data sets, SEED, and DEAP. This method is less expensive to calculate than more modern sentiment recognition methods, provides real-time sentiment analysis, and offers good classification accuracy.
The building sector is one of the major contributors to greenhouse gas (GHG) emissions, which may impede the achievement of Malaysia's intended nationally determined contribution (INDC) by 2030. Therefore, this paper is aimed at identifying the underlying factors that affect working adults' willingness to pay (WTP) premium prices for green buildings. Data were collected from a total of 1198 respondents and analyzed using structural equitation modeling partial least square (SEM-PLS) to measure the willingness to pay for green buildings among working adults in Malaysia. The findings reveal that environmental literacy affects environmental belief as well as awareness of consequences among working adults in Malaysia. The findings also reveal that incentives for green building buyers have a significant impact on perceived behavioral control, while awareness of consequences has a significant influence on ascription of responsibility. However, the results reveal that awareness of consequences does not influence buyers' willingness to pay for green buildings. Moreover, the ascription of responsibility and perceived behavioral control have a significant effect on willingness to pay for green buildings. The findings of this study will help the concerned authorities to take appropriate steps to promote willingness to pay for green buildings, which will contribute significantly to the realization of INDC by 2030 as part of the Paris Agreement.
The flow of unprocessed sewage through municipal sewers is a great source of water contamination. This study aims to observe the pollutants removal efficiencies of walnut shells as an efficient low-cost adsorbent material compared to gravel materials as an anaerobic filter medium. Two models of the De-Centralized Wastewater Treatment System (DEWATS) were constructed. The wastewater flowing from toilets and handwashing places was connected to anaerobic filters filled with walnut shells and gravel. The efficiency of both filter media in the removal of biological oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), total dissolved solids (TDS), nitrate (NO3), and phosphate (PO43), pH and temperature were observed at the influent of the settler tank and then at the effluent of the collection tank (CT). Temperature and pH were within the acceptable limit of wastewater discharge. The results also indicated that the walnut shells filter media was more efficient at removing organic pollutants (TSS 94%, BOD5 88%, COD 85%, Nitrate 57%, phosphate 46%, and TDS 29%) than the gravel (TSS 81%, BOD5 82%, COD 84%, Nitrate 35%, phosphate 38%, and TDS 26%) at the successive stages. The average removal efficiency of the walnut shell was 88% while in the gravel case, it was 83%. The removal efficiency of walnut shell filters was extensively better over the complete experiment compared to gravel filters for the removal of pollutants, representing the high sorption capability of the walnut shell material. The results of this study show that the walnut shells may be a very useful substitute for other conventional fillers for anaerobic treatment in the anaerobic filter of DEWATS.
This study enhances quality control in sugar production by monitoring solution color, grain size, and moisture content. These critical characteristics often exhibit autocorrelation, which can cause false alarms during statistical monitoring. To address this, we integrated Long Short-Term Memory (LSTM) and Multioutput Least-Squares Support Vector Regression (MLS-SVR) models with Max-MCUSUM control charts. The machine learning models were utilized to minimize Mean Squared Error (MSE) and extract residuals free of autocorrelation before applying Phase I and Phase II process monitoring. Results demonstrate that both LSTM and MLS-SVR successfully mitigated data autocorrelation. In the observed dataset, the LSTM-based Max-MCUSUM chart identified more Phase II out-of-control signals than the MLS-SVR-based chart. While Phase I established initial statistical control, Phase II detected three out-of-control signals primarily driven by variances in solution color and grain size. Despite these minor deviations, multivariate process capability indices (MCp and MCpk > 1) confirm the overall production reliably meets strict quality standards. Ultimately, leveraging LSTM or MLS-SVR residual-based Max-MCUSUM charts provides a highly effective framework for managing continuous production quality and pinpointing areas for process optimization.
Knowledge hiding is a counterproductive workplace behavior that can undermine collaboration, organizational effectiveness, and healthcare quality. This study examined the behavioral mechanisms linking hypocritical leadership to knowledge hiding among nurses by investigating the sequential mediating roles of workplace incivility and workplace cheating behavior. Guided by social learning theory and behavioral integrity theory, a three-wave time-lagged survey was conducted among 299 registered nurses working in a tertiary healthcare hospital in Southern Punjab, Pakistan. Data were analyzed using Hayes' PROCESS Model 6 to evaluate direct and sequential mediation effects. The findings showed that hypocritical leadership was positively associated with workplace incivility and workplace cheating behavior. The direct association between leaders' hypocrisy and knowledge hiding was not statistically significant, whereas the indirect effects through workplace incivility and workplace cheating behavior were significant, indicating an indirect-only mediation. This suggests that the association between hypocritical leadership and knowledge hiding is established through intermediate behavioral mechanisms, while the direct effect is not statistically distinguishable from zero in this sample. Furthermore, the sequential mediation pathway from hypocritical leadership through workplace incivility and workplace cheating behavior to knowledge hiding was supported. These findings suggest that leadership hypocrisy is associated with a behavioral environment characterized by incivility and unethical workplace conduct, which in turn is related to employees' tendency to conceal knowledge. Promoting ethical leadership and respectful workplace interactions may be associated with a lower level of counterproductive workplace behaviors and may support a collaborative knowledge-sharing culture in healthcare organizations.
This study empirically investigates the effect of meat consumption on greenhouse gas emissions (carbon dioxide, methane, and nitrous oxide) in the USA. The impact of meat consumption on greenhouse gas emissions is examined by controlling for economic growth and energy consumption. The empirical analysis finds that all these variables are cointegrated for the long run. Moreover, meat consumption aggravates greenhouse gas emissions. Specifically, meat consumption (except for beef) has a U-shaped relationship with carbon emissions and an inverted U-shaped relationship with methane and nitrous oxide emissions. The causality analysis indicates a unidirectional causality running from meat consumption to greenhouse gas emissions. These empirical findings indicate that the US livestock sector has the potential to become more environmentally friendly with careful policy formulation and implementation.
Porphyromonas gingivalis is one of the major bacteria that causes periodontitis. Chronic periodontitis is a severe form of periodontal disease that ultimately leads to tooth loss. Virulence factors that contribute to periodontitis are secreted by Type IX Secretion System (T9SS). There are aspects of T9SS protein components that have yet to be characterised. Thus, the aim of this study is to investigate the phylogenetic relationship between members of 20 T9SS component protein families. The Bayesian Inference (BI) trees for 19 T9SS protein components exhibit monophyletic clades for all major classes under Bacteroidetes with strong support for the monophyletic clades or its subclades that is consistent with phylogeny exhibited by the constructed BI tree of 16S rRNA. The BI tree of PorR is different from the 19 BI trees of T9SS protein components as it does not exhibit monophyletic clades for all major classes under Bacteroidetes. There is strong support for the phylogeny exhibited by the BI tree of PorR which deviates from the phylogeny based on 16S rRNA. Hence, it is possible that the porR gene is subjected to horizontal transfer as it is known that virulence factor genes could be horizontally transferred. Seven genes (porR included) that are involved in the biosynthesis of A-LPS are found to be flanked by insertion sequences (IS5 family transposons). Therefore, the intervening DNA segment that contains the porR gene might be transposed and subjected to conjugative transfer. Thus, the seven genes can be co-transferred via horizontal gene transfer. The BI tree of UgdA does not exhibit monophyletic clades for all major classes under Bacteroidetes which is similar to the BI tree of PorR (both are a part of the seven genes). Both BI trees also exhibit similar topology as the four identified clusters with strong support and have similar relative positions to each other in both BI trees. This reinforces the possibility that porR and the other six genes might be horizontally transferred. Other than the BI tree of PorR, the 19 other BI trees of T9SS protein components also exhibit evidence of horizontal gene transfer. However, their genes might undergo horizontal gene transfer less frequently compared to porR because the intervening DNA segment that contains porR is easily exchanged between bacteria under Bacteroidetes due to the presence of insertion sequences (IS5 family transposons) that flank it. In conclusion, this study can provide a better understanding about the phylogeny of T9SS protein components.
Medical professionalism is now more crucial than ever. Recently, more and more misconduct among doctors widely portrayed and unashamedly publicized by the popular press. Medical Schools in Malaysia are working hard to rectify their weaknesses so that their products are competent and professional doctors. Cyberjaya University College of Medical Sciences (CUCMS) certainly views this matter seriously and has incorporated professionalism training or as we call it Affective Domain Training into the curriculum implemented in all phases of the medical education. An example is the innovative inclusion of Community Project in the curriculum of undergraduate psychiatry. Although it started off with wanting to get students involved in creating awareness amongst the public about mental illness, but through it, students attained exposure in leadership, team-working and communication skills as well as what it means to be altruistic, to work under stress, to be empathic and many more. The students themselves enjoyed it. Although the down side include extra time, money and manpower, it can be safely concluded that having a community project in psychiatry undergraduate curriculum or other specialties for that matter could be an innovative and enjoyable way to nurture medical professionalism.
The present study is aimed to study the host-guest inclusion complexation of the naturally occurring cyclodextrins (CDs), namely; (α-CD,β-CD, and γ-CD) with mitiglinide (MIT).
Slum children are at risk for serious mental health problems because of their economic and social
environments. Little is known about their mental health. This cross sectional study was carried out to
know the extent of mental health problems among slum-dweller children in Dhaka city, Bangladesh. One
hundred and twenty students of four different primary schools were selected. In the first stage of the study,
socio-demographic data as well as information about mental health problems were collected through
socio-demographic questionnaire and validated Bengali version of Rutter B2 scale respectively, from the
teachers of the schools. In the second stage, all the students were assessed again personally by the both
authors with the help of Diagnostic and Statistical Manual of Mental Disorders- fourth edition (DSMIV).
High prevalence of mental health problems was found among slum children (70.8%). Emotional,
conduct and undifferentiated disorders were detected in 14.17%, 45.83% and 10.83%, respectively.
Conduct disorder was 3.23 times more prevalent in the children than was emotional disorder. It was more
prevalent in boys than in girls (57.90% vs 34.90%). Significant relationships were found among gender
and emotional disorder (p < 0.030), father’s employment status and undifferentiated disorder (p < 0.010),
substance abuse by father and child’s emotional disorder(p
Schizophtrenia is a chronic mental disorder that is characterized by perceptual,
thinking, cognitive, and behavioural disturbances. One of the important symptoms
of schizophrenia is auditory hallucinations. In this case report, we discussed a
31-year-old Rohigya refugee man who had his penis totally amputated. The auditory
hallucinations instructed him to do so. He was rushed to Universiti Kebangsaan
Malaysia Medical Centre (UKMMC) for the immediate surgical treatment. After
his condition was stabilized, he was admitted to the psychiatric ward for further
observation and medical treatment. Some issues related to psychosocial, economic
and politic were discussed which made this case unique. Patient was treated
with medication sulpride and was referred to the Urology Surgeon for further
management.
The aim of this paper is to interrogate the principle of heat gain by the Overall Thermal Transfer Value
(OTTV) through residential building facades. This study proposes three façade configurations as case
studies to determine their capability of achieving the OTTV set by the current residential standards.
Utilising the OTTV formula provided by the Malaysian Standards, the OTTV of each case study was
calculated using parameters including Window-to-Wall Ratio (WWR), Shading Coefficient (SC), U-values
and solar absorption (α). Results showed that each of the façade generated OTTV exceeding the regulation
of 50 Wm-2. The study uncovered the increase in WWR leading to the increase in OTTV. The OTTV
increased alongside window areas due primarily to the high amount of heat gained through windows,
a constituent component of OTTV. Simultaneously, high Shading Coefficient (SC) and U-values were
found to cause the high amount of solar heat gained through windows. The result underpins the impacts
of high solar heat gain particularly from windows of a building envelope on OTTV. Recommendations
for improvement of OTTV of the residential façades are also discussed..
In this work, two types of controller were designed for the nonlinear air blower system PT326 used at
the Instrumentation Laboratory Faculty Electrical Engineering, UiTM, Shah Alam. This work began with
collection of data from the experimental work. Once the S-shape of the system response was obtained,
the procedure of getting the process dead time, τD and time constant τC was applied to the S-shape form.
By determining these two values, the optimum values of PI and PID controllers can be calculated. From
the acquired data, the simulation model was developed in MATLAB/Simulink R2013a software using
the transfer function obtained from the open-loop control system. The modelling system is based on
the transfer function of open-loop air blower system PT326 before the design state of finding a suitable
controller can be suggested. The controller design of PI and PID was obtained using the first method
Ziegler-Nichols tuning rules. The result from the simulation shows that the Ziegler-Nichols first tuning
rules can be applied in designing the PI and PID controller based on S-shape response obtained in
open-loop test.
Teenage pregnancy is associated with maternal and neonatal morbidity. Some postulate that it is due to biological immaturity, while others postulate that it is due to inadequate antenatal care. The objective of this study is to compare the maternal and neonatal outcome between married and unmarried teenage mothers. A retrospective study was conducted from 2009 to 2012, where mothers aged below 20 year old were included. Maternal and neonatal outcome was assessed. A total of 750 patients aged below 20 year old delivered at Hospital Ampang. The trend of teenage pregnancy decreased from 3.1% in 2009 to 2.2% in 2012. A total of 578 (77.1%) mothers were married, while 172 (22.9%) were unmarried. Being unmarried was significantly associated with unbooked (p<0.001), preterm birth (p= 0.00468), and lower birth weight (p< 0.0001, and unpaired T-Test with 95% CI -0.2607 to -0.0933). However there is no significant difference in the number of mothers with hypertensive disease (p= 0.88428), diabetes in pregnancy (p= 0.39602), mode of delivery (p= 0.055 vaginal delivery, p = 0.4419 caesarean section, and p= 0.9097 instrumental deliveries) and NICU admission (p= 0.3779) between the two groups. Unmarried teenage pregnancy is associated with a lack of antenatal care, preterm birth, and lower birth weight compared to their married counterpart.
Keywords: Marital status, pregnancy outcome, teenage pregnancy
The incident of beach pollution in Batu Ferringhi in year 2014 has created a major concern over water
quality at the tourists’ haven. In order to understand advection and dispersion of pollutants in the area,
a coastal hydrodynamic model of Batu Ferringhi beach was developed in this study by taking into
consideration its wind, tide, coastal current and riverine runoff. The model was calibrated and validated
through observations from adjacent coastal monitoring stations. Simulation was then carried out to
investigate scenario of the constituent water quality which originates from the three rivers in the vicinity.
Results showed high concentrations of water quality parameters observed near the headland towards the
northeast of the study area, with intermittent patchy escape which may retain more than one-third the
initial concentrations, weighted by the river discharge. Even more worrying is that localised trapping of
up to three-quarter the initial weighted concentrations also occurs at the beach, owing to the interactions
between river flow and longshore current.
Accidental injuries are one of the leading causes of morbidity and mortality
worldwide. Approximately 1.25 million lives are cut short because of road traffic
accident every year. As the incidences of emergencies is steadily increasing in recent
years, it is important to ensure that individuals are adequately trained to deal with such
events including university students. First aid is given to preserve life and minimize the
consequences of injury and illness until help is obtained from health care practitioners.
This study aimed to assess the level of knowledge, awareness and attitude related to
first aid among IIUM Kuantan campus students. (Copied from article).