Displaying publications 81 - 100 of 750 in total

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  1. Sopian NA, Jalaludin J, Abu Bakar S, Hamedon TR, Latif MT
    PMID: 33806616 DOI: 10.3390/ijerph18052575
    This study aimed to assess the association of exposure to particle-bound (PM2.5) polycyclic aromatic hydrocarbons (PAHs) with potential genotoxicity and cancer risk among children living near the petrochemical industry and comparative populations in Malaysia. PM2.5 samples were collected using a low-volume sampler for 24 h at three primary schools located within 5 km of the industrial area and three comparative schools more than 20 km away from any industrial activity. A gas chromatography-mass spectrometer was used to determine the analysis of 16 United States Environmental Protection Agency (USEPA) priority PAHs. A total of 205 children were randomly selected to assess the DNA damage in buccal cells, employing the comet assay. Total PAHs measured in exposed and comparative schools varied, respectively, from 61.60 to 64.64 ng m-3 and from 5.93 to 35.06 ng m-3. The PAH emission in exposed schools was contributed mainly by traffic and industrial emissions, dependent on the source apportionment. The 95th percentiles of the incremental lifetime cancer risk estimated using Monte Carlo simulation revealed that the inhalation risk for the exposed children and comparative populations was 2.22 × 10-6 and 2.95 × 10-7, respectively. The degree of DNA injury was substantially more severe among the exposed children relative to the comparative community. This study reveals that higher exposure to PAHs increases the risk of genotoxic effects and cancer among children.
  2. Ling SL, Nik Jaafar NR, Tan KA, Bahar N, Baharudin A, Ahmad Tajjudin AI
    PMID: 33807598 DOI: 10.3390/ijerph18052592
    In recent years, increased interest in Internet Gaming Disorder has led to the development of the Internet Gaming Disorder Scale-Short Form. Translation and subsequent validation of such a scale are important for cross-cultural use. The aim of the present study was to examine the psychometric properties (factor structure, reliability, and validity) of the Malay Version of the Internet Gaming Disorder Scale-Short Form using a sample of Malaysian undergraduates. The present sample included 137 Malaysian undergraduates. Participants completed a self-administered online survey containing demographic items, the Malay Version of the Internet Gaming Disorder Scale-Short Form, the Problematic Online Gaming Questionnaire-Short Form, and the Malay Version of the Internet Addiction Test. The present findings confirm the one-factor model of the Malay Version of the Internet Gaming Disorder Scale-Short Form. Good reliability, as measured by Cronbach alpha, was found for the Malay Version of the Internet Gaming Disorder Scale-Short Form. The Malay Version of the Internet Gaming Disorder Scale-Short Form has demonstrated concurrent validity by significantly correlating with the Problematic Online Gaming Questionnaire-Short Form as well as demonstrated convergent validity with respect to the Malay Version of the Internet Addiction Test. The Malay Version of the Internet Gaming Disorder Scale-Short Form is a reliable and valid tool for assessing Internet Gaming Disorder in Malaysian undergraduates. As more research is still needed to confirm the status of Internet Gaming Disorder as a formal disorder, it is hoped that the Malay Version of the Internet Gaming Disorder Scale-Short Form can facilitate future research examining antecedents and consequences of Internet Gaming Disorder in a Malaysian setting.
  3. Iftikhar M, Qureshi MI, Qayyum S, Fatima I, Sriyanto S, Indrianti Y, et al.
    PMID: 33808837 DOI: 10.3390/ijerph18063207
    This research article investigates the effect of organisational climate and technology usage on employees' physiological and emotional health damage resulting from face-to-face bullying and cyberbullying at the workplace. Furthermore, we investigated emotional intelligence as a coping strategy to moderate employee physiological and emotional health damage. The research used a quantitative research design. A five-point Likert-scale questionnaire was used to collect data from a multistage sample of 500 officials from Pakistan's four service sectors. Results revealed that organisational climate and technology usage are negatively related to face-to-face bullying and cyberbullying at the workplace. At the same time, workplace bullying adversely affects an employee's emotional and physiological health. However, emotional intelligence can reduce an employee's emotional health damage due to workplace bullying. Thus, we suggest incorporating emotional intelligence training at the workplace to minimise the devastating effects of face-to-face bullying and cyberbullying on employees' physical and emotional health.
  4. Han H, Lho LH, Raposo A, Radic A, Ngah AH
    PMID: 33809470 DOI: 10.3390/ijerph18063034
    Muslim tourism is one of the most rapidly developing sectors in the international tourism industry. Nevertheless, halal food performance and its relationship with international Muslim traveler decision-making and behaviors have not been sufficiently examined. The present research explored the influence of halal food performance, which encompasses availability, health/nutrition, accreditation, and cleanness/safety/hygiene factors, on the Muslim traveler retention process at a non-Islamic destination. A survey methodology with a quantitative data analytic approach was employed to achieve research goals. Our findings indicated that halal food performance increased destination trust and destination attachment, which in turn influenced Muslim traveler retention. Additionally, the efficacy of the higher-order framework of halal food performance was defined. Both destination trust and attachment mediated the effect of halal food performance on retention. A halal-friendly destination image included a moderating influence on the retention process. The effectiveness of the proposed theoretical framework for explicating Muslim traveler behaviors was uncovered. This research better introduces the importance of halal food performance and its attributes for the elicitation of Muslim traveler approach responses and behaviors at a non-Islamic destination to researchers and practitioners.
  5. Shiraishi E, Takae S, Faizal AM, Sugimoto K, Okamoto A, Suzuki N
    PMID: 33810525 DOI: 10.3390/ijerph18073466
    In vitro fertilization (IVF) is a hallmark of reproductive medicine. However, the inconclusive outcome leads to marital disharmonies; thus, the choices of gamete donation and surrogacy (GD/S) are often offered. In restricted countries, the child-rearing choice through foster/adoption care is promising, but the uptake remains low. We explore the current reproductive services and adoption scenarios in Asian countries to delineate this issue. The web and literature search using PubMed and Ichushi was conducted in Japanese and English using the keywords "adoption", "foster care", "reproductive medicine", including the interview with the respective Asian clinicians. We found that an established adoption system was seen in China, Malaysia, and the Philippines, mainly due to the restriction of GD/S. Although GD/S were allowed in Thailand, Singapore, and India, the different local affordability of IVF cost led to various adoption system scenarios. Nevertheless, the country's economic aspect does influence the establishment of adoption care, mainly due to financial support from local government. Otherwise, the significant barrier was the cultural/religious background leading to low adoption rates. We concluded that the adoption option should always be highlighted as an alternative strategy as it synergistically contributes to children's and infertile couples' welfare.
  6. Abdullah B, Singh S
    PMID: 33810309 DOI: 10.3390/ijerph18073441
    Surgical treatment of the inferior turbinates is required for hypertrophic inferior turbinates refractory to medical treatments. The main goal of surgical reduction of the inferior turbinate is to relieve the obstruction while preserving the function of the turbinate. There have been a variety of surgical techniques described and performed over the years. Irrespective of the techniques and technologies employed, the surgical techniques are classified into two types, the mucosal-sparing and non-mucosal-sparing, based on the preservation of the medial mucosa of the inferior turbinates. Although effective in relieving nasal block, the non-mucosal-sparing techniques have been associated with postoperative complications such as excessive bleeding, crusting, pain, and prolonged recovery period. These complications are avoided in the mucosal-sparing approach, rendering it the preferred option. Although widely performed, there is significant confusion and detachment between current practices and their basic objectives. This conflict may be explained by misperception over the myriad of available surgical techniques and misconception of the rationale in performing the turbinate reduction. A comprehensive review of each surgical intervention is crucial to better define each procedure and improve understanding of the principle and mechanism involved.
  7. Ismail CAM, Deris ZZ, Bakar RA, Ismail N
    PMID: 33802184 DOI: 10.3390/ijerph18062834
    Despite modern medicine, there is an increasing trend for cases of the bacterial infection leptospirosis, and this has led to the exploration of alternative medicines from various sources including plants. The aim of this study was to investigate the in vitro anti-leptospiral activity of Phyllanthus amarus extracts alone and combined with penicillin G, ceftriaxone, and doxycycline. Antimicrobial susceptibility testing was performed using the microdilution broth technique upon methanol extract (ME), aqueous extract (AE), and antibiotics against the Leptospira interrogans serovars Australis, Bataviae, Canicola, and Javanica, to determine minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs). The results were analyzed using an ELISA microplate reader combined with microscopic analysis. Synergy testing using a checkerboard assay was performed to determine the fractional inhibitory concentration index values of extracts combined with antibiotics against leptospires. Scanning electron microscopy (SEM) was used to investigate morphological changes of leptospires caused by potential anti-leptospiral agents alone and combined with antibiotics. The MICs and MBCs for P. amarus extracts ranged from 100 to 400 µg/mL for AEs and from 400 to 800 µg/mL for MEs. Penicillin G was the most effective anti-leptospiral drug, with MICs and MBCs ranging from <0.01 to 0.78 and <0.01 to 3.13 µg/mL, respectively, followed by ceftriaxone, with both MICs and MBCs ranging from 0.05 to 0.78 µg/mL, and doxycycline, with MICs and MBCs ranging from 0.39 to 3.13 µg/mL and 12.5 to 25 µg/mL, respectively. Combinations of P. amarus extracts and antibiotics did not show synergistic effects on all tested Leptospira serovars, with some combinations demonstrating antagonistic effects. SEM analysis, however, showed distorted Leptospira surfaces. P. amarus AE performed better anti-leptospiral activity than P. amarus ME. The morphological effects of P. amarus extract alone and its combination with antibiotic on Leptospira cells revealed promising anti-leptospiral properties.
  8. Al-Mutairi KA, Yap CK
    PMID: 33801910 DOI: 10.3390/ijerph18062798
    The heavy metal (HM) pollution in sediment is of serious concern, particularly in the Red Sea environment. This study aimed to review and compile data on the concentrations of four HMs (Cd, Cu, Pb, and Zn) in the coastal surface sediments from the Red Sea, mainly from Saudi Arabia, Egypt, and Yemen, published in the literature from 1992 to 2021. The coastal sediments included those from mangrove, estuaries, and intertidal ecosystems. It was found that the mean values of Cd, Cu, Pb, and Zn in coastal Red Sea sediments were elevated and localized in high human activity sites in comparison to the earth upper continental crust and to reference values for marine sediments. From the potential ecological risk index (PERI) aspect, 32 reports (47.1%) were categorized as 'considerable ecological risk' and 23 reports (33.8%) as 'very high ecological risk'. From the human health risk assessment (HHRA) aspect, the non-carcinogenic risk (NCR) values (HI values < 1.0) of Cd, Cu, Pb, and Zn represented no NCR for the ingestion and the dermal contact routes for sediments from the Red Sea countries. The reassessment of the HM data cited in the literature allowed integrative and accurate comparisons of the PERI and HHRA data, which would be useful in the management and sustainable development of the Red Sea area, besides being a helpful database for future use. This warrants extensive and continuous monitoring studies to understand the current and the projected HM pollution situation and to propose possible protective and conservative measures in the future for the resource-rich Red Sea ecosystem.
  9. Verasoundarapandian G, Wong CY, Shaharuddin NA, Gomez-Fuentes C, Zulkharnain A, Ahmad SA
    PMID: 33572432 DOI: 10.3390/ijerph18041671
    The globe is presently reliant on natural resources, fossil fuels, and crude oil to support the world's energy requirements. Human exploration for oil resources is always associated with irreversible effects. Primary sources of hydrocarbon pollution are instigated through oil exploration, extraction, and transportation in the Arctic region. To address the state of pollution, it is necessary to understand the mechanisms and processes of the bioremediation of hydrocarbons. The application of various microbial communities originated from the Arctic can provide a better interpretation on the mechanisms of specific microbes in the biodegradation process. The composition of oil and consequences of hydrocarbon pollutants to the various marine environments are also discussed in this paper. An overview of emerging trends on literature or research publications published in the last decade was compiled via bibliometric analysis in relation to the topic of interest, which is the microbial community present in the Arctic and Antarctic marine environments. This review also presents the hydrocarbon-degrading microbial community present in the Arctic, biodegradation metabolic pathways (enzymatic level), and capacity of microbial degradation from the perspective of metagenomics. The limitations are stated and recommendations are proposed for future research prospects on biodegradation of oil contaminants by microbial community at the low temperature regions of the Arctic.
  10. Zahri KNM, Zulkharnain A, Sabri S, Gomez-Fuentes C, Ahmad SA
    PMID: 33669826 DOI: 10.3390/ijerph18042050
    In the present age, environmental pollution is multiplying due to various anthropogenic activities. Pollution from waste cooking oil is one of the main issues facing the current human population. Scientists and researchers are seriously concerned about the oils released from various activities, including the blockage of the urban drainage system and odor issues. In addition, cooking oil is known to be harmful and may have a carcinogenic effect. It was found that current research studies and publications are growing on these topics due to environmental problems. A bibliometric analysis of studies published from 2001 to 2021 on cooking oil degradation was carried out using the Scopus database. Primarily, this analysis identified the reliability of the topic for the present-day and explored the past and present progresses of publications on various aspects, including the contributing countries, journals and keywords co-occurrence. The links and interactions between the selected subjects (journals and keywords) were further visualised using the VOSviewer software. The analysis showed that the productivity of the publications is still developing, with the most contributing country being the United States, followed by China and India with 635, 359 and 320 publications, respectively. From a total of 1915 publications, 85 publications were published in the Journal of Agricultural and Food Chemistry. Meanwhile, the second and third of the most influential journals were Bioresource Technology and Industrial Crops and Products with 76 and 70 total publications, respectively. Most importantly, the co-occurrence of the author's keywords revealed "biodegradation", "bioremediation", "vegetable oil" and "Antarctic" as the popular topics in this study area, especially from 2011 to 2015. In conclusion, this bibliometric analysis on the degradation of cooking oil may serve as guide for future avenues of research in this area of research.
  11. Wong RR, Lim ZS, Shaharuddin NA, Zulkharnain A, Gomez-Fuentes C, Ahmad SA
    PMID: 33562609 DOI: 10.3390/ijerph18041512
    Diesel acts as a main energy source to complement human activities in Antarctica. However, the increased expedition in Antarctica has threatened the environment as well as its living organisms. While more efforts on the use of renewable energy are being done, most activities in Antarctica still depend heavily on the use of diesel. Diesel contaminants in their natural state are known to be persistent, complex and toxic. The low temperature in Antarctica worsens these issues, making pollutants more significantly toxic to their environment and indigenous organisms. A bibliometric analysis had demonstrated a gradual increase in the number of studies on the microbial hydrocarbon remediation in Antarctica over the year. It was also found that these studies were dominated by those that used bacteria as remediating agents, whereas very little focus was given on fungi and microalgae. This review presents a summary of the collective and past understanding to the current findings of Antarctic microbial enzymatic degradation of hydrocarbons as well as its genotypic adaptation to the extreme low temperature.
  12. Nakasone R, Ashina M, Abe S, Tanimura K, Van Rostenberghe H, Fujioka K
    PMID: 33805292 DOI: 10.3390/ijerph18073520
    Heme oxygenase (HO) is the rate-limiting enzyme in the heme catabolic pathway, which degrades heme into equimolar amounts of carbon monoxide, free iron, and biliverdin. Its inducible isoform, HO-1, has multiple protective functions, including immune modulation and pregnancy maintenance, showing dynamic alteration during perinatal periods. As its contribution to the development of perinatal complications is speculated, two functional polymorphisms of the HMOX1 gene, (GT)n repeat polymorphism (rs3074372) and A(-413)T single nucleotide polymorphism (SNP) (rs2071746), were studied for their association with perinatal diseases. We systematically reviewed published evidence on HMOX1 polymorphisms in perinatal diseases and clarified their possible significant contribution to neonatal jaundice development, presumably due to their direct effect of inducing HO enzymatic activity in the bilirubin-producing pathway. However, the role of these polymorphisms seems limited for other perinatal complications such as bronchopulmonary dysplasia. We speculate that this is because the antioxidant or anti-inflammatory effect is not directly mediated by HO but by its byproducts, resulting in a milder effect. For better understanding, subtyping each morbidity by the level of exposure to causative environmental factors, simultaneous analysis of both polymorphisms, and the unified definition of short and long alleles in (GT)n repeats based on transcriptional capacity should be further investigated.
  13. Abu Aisheh YI, Tayeh BA, Alaloul WS, Jouda AF
    PMID: 33805581 DOI: 10.3390/ijerph18073553
    Infrastructure projects are the foundation for essential public services and have an influential position in societal development. Although the role of infrastructure projects is substantial, they can involve complexities and safety issues that lead to an unsafe environment, and which impacts the project key stakeholders. Therefore, this study aimed to evaluate the barriers to implementing occupational safety in infrastructure projects in the Gaza Strip, which cause serious threats and reduce project performance. To evaluate the barriers, 39 items were highlighted and modified as per the construction context and environment, and which later were distributed in the form of a questionnaire, to get feedback from consultants and contractors. The analysis shows that in the safety policy barriers group, consultants and contractors both ranked the item "a contractor committed to an occupational safety program is not rewarded" first. In the management barriers group, consultants and contractors both ranked the item "safety engineer does not have significant powers, such as stopping work when needed" in the first place. In the behavior and culture barriers group, consultants and contractors both ranked the item "workers who are not committed to occupational safety are not excluded" in the first place. Overall, both consultants and contractors shared the same viewpoint in classifying the barriers in the working environment. The outcome of this study is beneficial for Palestinian construction industry policymakers, so they can monitor the highlighted barriers in on-going infrastructure projects and can modify the safety guidelines accordingly.
  14. Kamaluddin MR, Mahat NA, Mat Saat GA, Othman A, Anthony IL, Kumar S, et al.
    PMID: 33803514 DOI: 10.3390/ijerph18063113
    The escalating trend of murder victim concealment worldwide appears worrying, and literature does not reveal any specific study focusing on victim concealment amongst convicted male Malaysian murderers. Therefore, this study was aimed at investigating the psychological traits that may underlie the act of murder concealment in Malaysia via mixed method approaches. Male murderers (n = 71) from 11 prisons were selected via purposive sampling technique. In the quantitative analysis, a cross-sectional study design using the validated questionnaire was used. The questionnaire contained murder concealment variables and four Malay validated psychometric instruments measuring: personality traits, self-control, aggression, and cognitive distortion. The independent sample t-tests revealed the significantly higher level of anger in murderers who did not commit concealment acts (8.55 ± 2.85, p < 0.05) when compared with those who did so (6.40 ± 2.64). Meanwhile, the Kruskal-Wallis H test revealed that anger and the personality trait of aggressiveness-hostility significantly varied across the different groups of murder concealment acts (p < 0.05). The qualitative data obtained via the in-depth interviews revealed two important themes for the murderers to commit murder concealment acts: (1) fear of discovery and punishment and (2) blaming others. These findings discussed from the perspectives of the murderers within the context of criminology and psychology may provide the first ever insight into the murder concealment acts in Malaysia that can benefit the relevant authorities for crime prevention and investigation efforts.
  15. Grondys K, Ślusarczyk O, Hussain HI, Androniceanu A
    PMID: 33920916 DOI: 10.3390/ijerph18084183
    The subject matter of the article relates to the assessment of the perception of selected types of risk in economic activities of the SME sector, which change their intensity as a result of the outbreak of the COVID-19 pandemic. The current economic downturn is unprecedented and involves many companies and industries that have faced new, previously unknown challenges and threats. The objective of the article is to identify the most important risks and their resources based on the empirical research carried out in small and medium-sized enterprises in Poland. The formulated objective was accomplished using the data collection method, i.e., the survey and reports on the condition of the SME sector in Poland as well as statistical data analysis methods, i.e., structure index and the analysis of variance, using the SPSS system. The process of primary data collection was carried out by means of an electronic survey among selected enterprises of the SME sector, conducting business activities in Poland. In the study, the employment factor was taken into account as a determinant of the perception and assessment of the intensity of selected risks arising from the economic activity in the Polish market in the conditions of the current economic downturn. On the basis of the obtained results, the impact of market, economic, financial and operational risks, depending on their intensity, on the functioning of micro-, small and medium-sized enterprises was identified. Based on the analysis of variance, the effect of the size of the company on the level of individual risks was also examined. As a result of the observations made, it was established that, during the pandemic, the level and type of risk is similar in all the surveyed enterprises. They are most often threatened by strong competition in the industry, an increase in energy prices and insufficient profit. The overall results of the empirical research indicate the importance and the need to manage the key threats to the Polish SME sector.
  16. Loganathan T, Chan ZX, de Smalen AW, Pocock NS
    PMID: 32722563 DOI: 10.3390/ijerph17155376
    Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants' views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are unable to work legally and are subject to deportation. Despite this, we found that insufficient SRH information and contraceptive access are provided, as these are seen to encourage promiscuity. Pregnancy, rather than sexually transmitted infection prevention, is a core concern among migrant women, the latter of which is not adequately addressed by private providers. Abortions are often seen as the only option for pregnant migrants. Unsafe abortions occur which are linked to financial constraints and cultural disapproval, despite surgical abortions being legal in Malaysia. Pregnant migrants often delay care-seeking, and this may explain poor obstetric outcomes. Although health facilities for gender-based violence are available, non-citizen women face additional barriers in terms of discrimination and scrutiny by authorities. Migrant women face extremely limited options for SRH services in Malaysia and these should be expanded.
  17. Ibrahim MI, Zubair IU, Shafei MN, Ahmad MI, Yaacob NM
    PMID: 32824040 DOI: 10.3390/ijerph17165916
    The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third (p = 0.006) and sixth weeks (p < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third (p < 0.001) and sixth weeks (p < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.
  18. Rochmah TN, Wulandari A, Dahlui M, Ernawaty, Wulandari RD
    PMID: 32824872 DOI: 10.3390/ijerph17166010
    Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY.
  19. Chua BL, Karim S, Lee S, Han H
    PMID: 32872267 DOI: 10.3390/ijerph17176276
    This study investigated restaurant customers' perceived importance of key factors in accordance with dining occasions and restaurant segments. Our investigation into restaurant selection and situational factors present two types of empirical evidence regarding customers' choice of restaurant. First, menu price was customers' top priority in restaurant selections for full-service, quick-casual, and quick-service restaurants. Second, restaurant customers rated the importance level of restaurant selection criteria differently according to eating-out occasions. The importance of menu price was greatest for both quick meal/convenience and social occasion, brand reputation was the most important factor for business necessity, and word-of-mouth recommendation was greatest for celebration.
  20. Cheng TH, Sie YD, Hsu KH, Goh ZNL, Chien CY, Chen HY, et al.
    PMID: 32646021 DOI: 10.3390/ijerph17134904
    Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses.
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