BACKGROUND: Epidemiological studies conducted in various parts of the world have clearly demonstrated that metabolic syndrome (MetS) is an increasing global health problem, not only in Western societies but also in Asian populations. Web-based and mobile phone-based self-management applications have been proven to be effective in improving self-management behaviour of patients with MetS components (i.e., diabetes or hypertension). However, evidence is lacking in terms of their effectiveness specifically for patients with MetS. The aim of this pilot study is to evaluate the feasibility and potential effectiveness of the EMPOWER-SUSTAIN Self-Management e-Health Intervention in improving activation and self-management behaviours among patients with MetS. This paper presents the study protocol.
METHODS: A pilot randomised controlled trial will be conducted in a university primary care clinic. A total of 232 patients aged 18-60 years with MetS will be recruited; 116 will be randomised to receive the EMPOWER-SUSTAIN intervention for 6 months, and another 116 patients will continue with usual care. The EMPOWER-SUSTAIN intervention is a multifaceted chronic disease management strategy based on the Chronic Care Model and persuasive technology theory. It consists of training primary care physicians, nurses and patients to use the EMPOWER-SUSTAIN web-based self-management mobile app, strengthening the patient-physician relationship and reinforcing the use of relevant clinical practice guidelines to guide management and prescribing. The primary outcome is the mean change in patient activation score using the Patient Activation Measure short form Malay version (PAM-13-M) questionnaire. The secondary outcomes include the changes in waist circumference, body mass index, blood pressure, patient physical activity level, eating behaviour, perception of chronic illness care, satisfaction with patient-physician interaction, and perceived absolute 10-year cardiovascular disease risk. Feasibility of implementing the intervention will be evaluated. This includes acceptability of the intervention, estimating the likely rate of participant recruitment and retention, appropriateness of the outcome measures, calculation of sample size, and the intervention's potential effectiveness.
CONCLUSION: To our knowledge, this is the first study in Malaysia that aims to determine the feasibility of a multifaceted e-health intervention, as well as to indicate more useful aspects of this intervention for further exploration in a larger trial.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT04120779. Registered on 9 October 2019, protocol version 1.
This report describes Thismia belumensis Siti-Munirah & Suhaimi-Miloko, a novel species of achlorophyllous herb discovered in the Royal Belum State Park, Peninsular Malaysia. This new species is unlike any previously described species of Thismia. In particular, T. belumensis possesses a unique annulus, which has been expanded and modified into a cucullate (hood-like) structure. This structure covers the apical floral tube and has an opening on one side facing a thickened part of the annulus, and the off-centre floral aperture confers a zygomorphic symmetry to the flower, indicating T. belumensis is more similar to Thismia labiata J.J.Sm. This morphological detail makes this new species distinct from all other described species of Thismia. In this report, we provide descriptions, illustrations, colour plates, and the provisional conservation status of Thismia belumensis.
The technical feasibility of TiO2-photocatalysis towards palm oil mill effluent (POME) treatment is well-proven in previous studies. As a continuity, current study evaluated the strengths, weaknesses, opportunities and threats (SWOT) in a concise manner, subsequently discussed its practicality in palm oil industry of Malaysia. Indeed, TiO2-photocatalysis displays a promising technical feasibility in treating POME, but its wide application is economically-suppressed. It is positing that biological-based treatments (including the existing open-ponding system) are more likely to be employed as the major treating approach for POME over TiO2-photocatalysis. This is particularly true as biological-based treatments offer better performance index for concentrated POME with comparatively lower treatment cost and technicality needed. Furthermore, it is also prevailed with high biogas generability, therefore being irreplaceably benchmarked for POME treatment in Malaysia. Instead of replacing biological treatment entirely, the adoption of TiO2-photocatalysis as complementing tertiary treatment for biological-treated-POME is more practical, bestowed to its robust organic-mineralizing feature for low concentration POME. Such integrated system is expected to augment the POME degradation efficiency, hence effectively preserve the environment from POME pollution.
Ethics is a philosophical branch of inquiry that reasons between what is right and wrong. The moral philosophy of Socrates, Aristotle, and Plato from ancient Greek became the basis of most of the western ethics. These days, ethics can be divided based on its inquiries for example, normative, descriptive, metaethics, and applied ethics or based on its theories like utilitarianism, emotivism, and universal ethics. In context with applied ethics that examines issues involving emerging technologies, this study will look into the ethics of Malaysian stem cell technology based on written literature. It was mainly to identify Malaysian literature on stem cell ethics through conventional search since the mainstream international database indicated an obvious shortage. The critical review of this literature will facilitate in the understanding of unique position of Malaysia towards stem cell and its ethics in reference to the limited number. Despite the limitation, this can be a preliminary study urging for more inquiries and exploration to fulfil the multiple perspectives in ethics such as the diversity of Malaysian ethics, the impact of ethics in stem cell regulation in Malaysia, and if western contemporary ethics influences Malaysian ethics particularly involving stem cell technology.
Conference abstract:
Hypertension is the leading cause of mortality worldwide. It is highly prevalent throughout the world. Even in regions liike South-East Asia (SEA) which has been perceived to be less prone to cardiovascular diseases, the prevalence of hypertension has been reported to be around 35% (1). Awareness and control of hypertension in SEA is also low, both being less than 50% each (2).Control of hypertension is an interplay between patients, doctors and system factors. One of the reasons for poor control of hypertension is resistant hypertension. Resistant hypertension is defined as blood presure that remains above goal despite being on three concurrent anti-hypertensive medications preferbaly one of which is a diuretic (3).True resistant hypertension should be differiented from secondary hypertension and pseudo-resistant hypertension. Resistant hypertension is almost always multi-factorial in aetiology. The exact prevalence of resistant hypertenion even in developed countries is not known It has been estimated that it is as high as 20-30% in clinical trial patients (4)Not many studies about resistant hypertension have been done in SEA but one done in an outpatient clinic in Thailand found it to be 7.82% Another study also done in a primary care clinc in Malaysia on 1217 patients with hypertension found the prevalence of resistant hypertension to be 8.8%. (6) Here it was found that the presence of chronic kidney disease was more likely to be associated with resistant hypertension (odds ratio [OR] 2.89, 95% confidence interval [CI] 1.56-5.35). Other factors like increasing age, female gender, presence of diabetes, obesity and left ventricular hypertrophyage which have been found to be predictors of resistant hypertension in other studies in the west were not seen in this study. There are various reasons for these findingsBut whatever the factors are that are associated with uncontrolled hypertension, the task is to sort out true resistant hypertension from pseudo-resistant hypertension and secondary casues of hypertension which may be treatable. A concerted effort is needed to reduce the BP in resistant hypertension. Failure to do so would mean a substantal increase in CV risk for the patient.
The present study aims to investigate the susceptibility status of Aedes albopictus, Culex quinquefasciatus, and Cx. vishnui collected from a pig farm in Tanjung Sepat, Selangor, toward 11 insecticides representing the classes of organochlorines, carbamates, organophosphates, and pyrethroids. The results of a World Health Organization adult mosquito bioassay revealed that Ae. albopictus, Cx. quinquefasciatus, and Cx. vishnui exhibited different susceptibility toward various insecticides. Overall, pyrethroids were able to induce rapid knockdown for all test mosquito species. The pyrethroids lambdacyhalothrin and etofenprox were able to cause high mortality (> 80%) of all 3 species. The findings of the present study will benefit local authorities in selecting appropriate dosage of insecticides to be used in mosquito control in this area.
Malaysia is one of the countries that is well known for its palm oil based products and exports all over the world. Over the years, palm oil mill has been rising at alarming rate in Malaysia, causing palm oil-based wastes to increase especially palm oil mill effluent (POME). POME in Malaysia are channelled into water bodies such as rivers after treated mostly with conventional biological method. However, with current technologies and knowledge, conventional POME treatments are seen to be outdated and require major improvements as greenhouse gaseous are emitted to the environment as well as being less cost effective. Integrated systems that combine two or more conventional methods are introduced and reviewed to provide insights on the advantages and disadvantages of the system if it is to be implemented in real life plant. Integrated systems that focus on combining conventional methods are compiled and reviewed specifically for POME treatment. Among the integrated methods that are reviewed includes biological with membrane, adsorption with magnetic field exposure, adsorption with membrane and electrocoagulation with membrane. The systems are seen to give excellent color, chemical oxygen demand (COD) and total suspended solids (TSS) removal with average of higher than 90%. Reduction in space utilization, improved treatment time as well as simplified operating system were reported when integrated systems are applied as compared to conventional treatment of POME.
Six species are recognised in the genus Lefroyothrips, including one new species from Australia. The metascutal chaetotaxy of two of these species is unique amongst Thripidae. New distribution records given here indicate that four of the species are widely distributed: L. pictus across tropical Africa, L. lefroyi from northern India to Taiwan, L. fasciatus from Malaysia to northern Australia and New Guinea, and L. varatharajani from southern India to New Caledonia and northern Australia. An illustrated key is provided to the six known species in this genus.
We found a uniquely colored dicroglossid frog of the genus Occidozyga from western Sarawak, East Malaysia. It is divergent from other congeners in morphology and mtDNA sequences. In a molecular phylogeny, this species is the sister lineage to the continental species O. lima and O. martensii with weak support. The species is small with SVL 16-18 mm in males and 18-19 mm in females, without dorsolateral fold but with transverse wrinkles on dorsum, tips of fingers lacking disks but of toes with disks, only first and second toes webbed to disks, and orange-brown dorsum with dark brown band. We thus describe it as a new species.
Chroesthes is a small genus that includes three species from Peninsular Malaysia: Chroesthes faizaltahiriana Siti-Munirah sp. nov., C. lanceolata (T. Anderson) B.Hansen and C. longifolia (Wight) B.Hansen. Chroesthes faizaltahiriana, recently discovered in the State of Kelantan, is described and illustrated. This species is similar to the common species C. longifolia, but is distinguished mainly by its inflorescence type, calyx shape and its flowers being bright orange instead of dark purple internally. Chroesthes lanceolata is a new record for Peninsular Malaysia and has only been collected once. Following the IUCN Red List Categories and Criteria, these three species are assessed (national scale assessment) as Critically Endangered (C. faizaltahiriana and C. lanceolata) and Least Concern (C. longifolia).
Gamelan in general is categorized as a group of gongs. This traditional Malay gamelan ensemble is in a slendro scale i.e. five notes per octave. The rhythms, pitch, duration and loudness classify the various groups of gongs such as bonang, kenong, gender, peking and gambang. The cast bronze peking, kenong and bonang were chosen from a range of Malay gamelan ensemble from Universiti Malaysia Sarawak (UNIMAS), Universiti Putra Malaysia (UPM), Universiti Kebangsaan Malaysia (UKM) and Universiti Teknologi Mara (UiTM). The sounds were recorded by PicoScope Oscilloscope. The PicoScope software displays waveform and spectrum in time and frequency domain respectively. The peking lowest and highest frequencies from UiTM were 293 Hz and 1867 Hz, from UPM were 644 Hz and 1369 Hz, from UKM were 1064 Hz and 2131 Hz and from UNIMAS were 1072 Hz and 2105 Hz respectively. The kenong lowest and highest frequencies from UiTM were 259 Hz and 463 Hz, from UPM were 294 Hz and 543 Hz, from UKM were 300 Hz and 540 Hz and from UNIMAS were 293 Hz and 519 Hz respectively. The fundamental frequencies of bonang from UPM were higher than that of UKM, UiTM and UNIMAS. The harmonics were not successive but interrupted by another frequency. The harmonics of each bonang was similar except for gamelan from UKM.
Multiple dinoflagellate species from the genus Karlodinium have been well known to form massive and toxic blooms that consequently cause fish kills in many coastal waters around the world. Karlodinium australe is a mixotrophic and potentially ichthyotoxic species associated with fish kills. Here, we investigated phagotrophy of K. australe (isolate KaJb05) established from a bloom event in the West Johor Strait, Malaysia, using several prey species (phytoplankton, zooplankton, and larval fish). The results showed that K. australe ingested relatively small prey cells of co-occurring microalgae by direct engulfment, while it fed on larger prey cells of microalgae by tube feeding. The results of animal exposure bioassays using rotifer (Brachionus plicatilis), brine shrimp (Artemia salina), and larval fish (Oryzias melastigma) demonstrated that phagotrophy (in terms of the trophic mode of the dinoflagellate), or micropredation (in terms of the mechanism of lethal effects on prey), played a more important role than the toxicity did in causing the lethal effects of K. australe on these aquatic animals under low cell densities of K. australe, while the mortalities of animals observed in the exposure to cell lysates of K. australe were solely caused by the toxicity. A comparison of the lethal effects between K. australe and K. veneficum revealed that the lethal effect of K. australe on rotifers was much stronger than that of K. veneficum at all cell densities applied in the experiments and the more "aggressive" micropredation of K. australe is suggested to explain the difference in lethal effect between K. austale and K. veneficum. Our results may explain why K. australe exhibited fish killings during moderate blooms at cell densities < 2.34 × 106 cells L-1, whereas K. veneficum was observed to cause massive fish kills only if the cell density was above 107 cells L-1. We believe these findings provide new insights into the ecological consequences of phagotrophy exhibited in some mixotrophic and harmful algae such as species of Karlodinium and of HAB events in general.
The Soil and Water Assessment Tool (SWAT) ecohydrological model was utilized to simulate fecal contamination in the 1937 km2 Selangor River Watershed in Malaysia. The watershed conditions posed considerable challenges owing to data scarcity and tropical climate conditions, which are very different from the original conditions that SWAT was developed and tested for. Insufficient data were compensated by publicly available data (e.g., land cover, soil, and weather) to run SWAT. In addition, field monitoring and interviews clarified representative situations of pollution sources and loads, which were used as input for the model. Model parameters determined by empirical analyses in the USA (e.g., surface runoff, evapotranspiration, and temperature adjustment for bacteria die-off) are thoroughly discussed. In particular, due consideration was given to tropical climate characteristics such as intense rainfall, high potential evapotranspiration, and high temperatures throughout the year. As a result, the developed SWAT successfully simulated fecal contamination ranging several orders of magnitude along with its spatial distribution (i.e., Nash-Sutcliffe Efficiency (NSE) = 0.64, Root Mean Square Error-Observations Standard Deviation Ratio (RSR) = 0.64 at six mainstem sites, and NSE = 0.67 and RSR = 0.57 at 12 major tributaries). Moreover, mitigation countermeasures for future worsening of fecal contamination (i.e., E.coli concentration > 20,000 CFU/100 mL for 690 days during nine years at a raw water intake point for Kuala Lumpur [KL] residents) were analyzed through scenario simulations, thereby contributing to discussing effective watershed management. The results propose improving decentralized sewage treatment systems and treating chicken manure with effective microorganisms in order to guarantee water safety for KL residents (i.e., E.coli concentrations <20,000 CFU/100 mL throughout the period, considering Malaysian standards). Accordingly, this study verified the applicability of SWAT to simulate fecal contamination in areas that are difficult to model and suggests solutions for watershed management based on quantitative evidence.
Today, more accidents reported in school, resulting not only minor injuries but also severe injuries such as fire in schools, mercury spills and falling from high places. The study was aimed at measuring the level of occupational safety and health practices in schools. The study was conducted at 205 schools in Kelantan, Malaysia. This study is a semi-quantitative study using observation method. Data collection is conducted based on Hazard Identification, Risk Assessment and Risk Control (HIRARC) Guidelines provided by the Department of Occupational Safety and Health, Malaysia. Hazard identification, risk assessment and risk control are determined using the HIRARC form. The findings were measured by determining the discrete data according to the number of low, medium and high-risk levels found. The study found that there were two dominant hazards namely physical hazard and ergonomic hazard. Therefore, the management should increase and improve classroom safety awareness to ensure safety and health of all occupants.
This study develops an oil spill environmental vulnerability model for predicting and mapping the oil slick trajectory pattern in Kota Tinggi, Malaysia. The impact of seasonal variations on the vulnerability of the coastal resources to oil spill was modelled by estimating the quantity of coastal resources affected across three climatic seasons (northeast monsoon, southwest monsoon and pre-monsoon). Twelve 100 m3 (10,000 splots) medium oil spill scenarios were simulated using General National Oceanic and Atmospheric Administration Operational Oil Modeling Environment (GNOME) model. The output was integrated with coastal resources, comprising biological, socio-economic and physical shoreline features. Results revealed that the speed of an oil slick (40.8 m per minute) is higher during the pre-monsoon period in a southwestern direction and lower during the northeast monsoon (36.9 m per minute). Evaporation, floating and spreading are the major weathering processes identified in this study, with approximately 70% of the slick reaching the shoreline or remaining in the water column during the first 24 h (h) of the spill. Oil spill impacts were most severe during the southwest monsoon, and physical shoreline resources are the most vulnerable to oil spill in the study area. The study concluded that variation in climatic seasons significantly influence the vulnerability of coastal resources to marine oil spill.
Meliponiculture, the keeping of domesticated stingless bees such as Geniotrigona thoracica (Smith, 1857) (Hymenoptera: Apidae), is an increasingly popular agricultural industry in Malaysia. This study reports the soldier fly (Diptera: Stratiomyidae) species of the genus Hermetia colonizing stingless bee colonies in Malaysia. The larvae were reared in the laboratory to the adult stage and identified through molecular and morphological approaches. Hermetia illucens (Linnaeus, 1758) and Hermetia fenestrata de Meijere, 1904 (Diptera: Stratiomyidae) were identified from the sample provided. Earlier records of stratiomyids in stingless bee nests were misidentified as H. illucens. This paper represents the first identified record of H. fenestrata colonizing a "spoiled" stingless bee colony. In addition, adult and larval morphological differences between both species and the roles of both species in bee nest decomposition are discussed.
This study analyzes the performance of two PV modules, amorphous silicon (a-Si) and crystalline silicon (c-Si) and predicts energy yield, which can be seen as facilitation to achieve the target of 35% reduction of greenhouse gases emission by 2030. Malaysia Energy Commission recommends crystalline PV modules for net energy metering (NEM), but the climate regime is a concern for output power and efficiency. Based on rainfall and irradiance data, this study aims to categorize the climate of peninsular Malaysia into rainy and dry seasons; and then the performance of the two modules are evaluated under the dry season. A new mathematical model is developed to predict energy yield and the results are validated through experimental and systematic error analysis. The parameters are collected using a self-developed ZigBeePRO-based wireless system with the rate of 3 samples/min over a period of five days. The results unveil that efficiency is inversely proportional to the irradiance due to negative temperature coefficient for crystalline modules. For this phenomenon, efficiency of c-Si (9.8%) is found always higher than a-Si (3.5%). However, a-Si shows better shadow tolerance compared to c-Si, observed from a lesser decrease rate in efficiency of the former with the increase in irradiance. Due to better spectrum response and temperature coefficient, a-Si shows greater performance on output power efficiency (OPE), performance ratio (PR), and yield factor. From the regression analysis, it is found that the coefficient of determination (R2) is between 0.7179 and 0.9611. The energy from the proposed model indicates that a-Si yields 15.07% higher kWh than c-Si when luminance for recorded days is 70% medium and 30% high. This study is important to determine the highest percentage of energy yield and to get faster NEM payback period, where as of now, there is no such model to indicate seasonal energy yield in Malaysia.
Coeliccia junis sp. nov. (holotype male from Borneo, Sarawak, Bintulu Division, Planted Forest Project, Bukit Mina Wildlife Corridor, "Day 4" stream near Bukit Nyegoh and Bukit Jugam, near small brown water pool, 10 viii 2018, deposited in the Naturalis Biodiversity Center, Leiden, the Netherlands) and Coeliccia roberti sp. nov. (holotype male from Borneo, Sarawak, Miri Division, Lambir Hills National Park, small stream on Oil Well Trail, 22 iv 2011, deposited in the Naturalis Biodiversity Center, Leiden, the Netherlands) are described from Borneo. Both new species belong to the Coeliccia membranipes-group and bring the number of named species known from the group from Borneo to nine and the total number of named species from Borneo currently placed in Coeliccia to 15. Coeliccia junis is only known from a small area in Sarawak, C. roberti is also known from Brunei. Both species are considered likely to be closely allied with C. macrostigma Laidlaw.
During a taxonomic revision of species in the genus Stegonotus Duméril et al., 1854, we re-examined over 90% of all known museum specimens from this taxon. Of the five specimens available to us from the island of Borneo, three are clearly distinct from the other two. The latter are from the lowland rainforest in Sarawak, Malaysia, which includes the type locality of S. borneensis, and therefore these specimens retain that name. We here describe the other three, which include the paratype of S. borneensis, as a new species from Sabah, Malaysia. The new species can be differentiated from S. borneensis and all other species of Stegonotus by the combination of a high number of ventrals ( 210) combined with a low number of subcaudals ( 70), a short tail (indicated by a low subcaudal ratio of 0.25), 17-17-15 dorsal scale rows, a snout-scale ratio of 1/4-1/3, the "gull wing +" condition of the rostral, the number of supralabials touching the eye, and a dorsal color pattern featuring a dark gray-brown head offset from a lighter-brown rest of the body. The number of subcaudals in the holotype of the new species is only 21% of the number of ventrals, the lowest proportion in the genus. The new species is found at elevations above 1000 m in the cool, montane habitats of the Crocker Range and around the foot of Mt. Kinabalu, Southeast Asia's tallest mountain, from where it has been known but taxonomically unrecognized since at least the 1880s.