Methods: A cross sectional survey was conducted among people with diabetes in Malaysia and Singapore. Participants attending the primary health clinic for the treatment of diabetes were approached to participate in this survey. Data on demographics, health status and beliefs to health were collected and compared.
Results: A total of 673 respondents were included in the study. Most of the respondents reported to have access to the Internet, with a high ownership of mobile phones (99.3%). However, only one in every three respondents sought information online. Younger individuals (≤50 years) and those with higher education more likely to seek information using mobile devices. Respondents in Singapore reported to be more likely to use mobile devices to monitor their health as compared to respondents in Malaysia. However, most respondents would seek health information from their healthcare professionals' especially physicians.
Conclusion: There was limited differences in the health-seeking behaviour among the respondents from both countries, suggesting for a need to identify for more effective means of distribution of health related information.
METHODS: This study utilised a simulated client method. A research assistant, acting as a simulated client, visited community pharmacies in the Klang Valley, Malaysia to consult the pharmacists on the treatment of a cough experienced by his father. Upon leaving the pharmacy premise, the simulated client entered the pharmacist's responses in a data collection form which was structured based on pharmacy mnemonics for the response to symptoms, OBRA'90 on counselling elements, the five practice principles of pharmaceutical care by the American Pharmacists Association and literature review. Visits to the community pharmacies were conducted from September to October 2018.
RESULTS: The simulated client visited a total of 100 community pharmacies. None of these community pharmacists practised adequate patients' data collection, with only a low proportion who practised all the components studied under medication information evaluation (13%), formulating a drug therapy plan (15%) and monitoring and modifying the plan (3%). Of the 100 community pharmacists, 98 recommended treatment but none of them provided all the counselling elements studied in implementing the drug therapy plan.
CONCLUSION: The present study showed that community pharmacists within the Klang Valley, Malaysia were not providing adequate pharmaceutical care services to patients seeking self-medication for a cough. Such practice may compromise patient safety if inappropriate medicines or advice are given.
METHODS: A total of 256 Ross 308 one-day-old broilers (42.28±0.16 g) were randomly allocated in a 2×2 factorial arrangement to 32 pens with eight chicks per cage. Birds were fed one of four dietary treatments as follows: i) positive control (PCN; energy sufficient diet); ii) negative control (NCN; energy-deficient diet, -100 ME kcal/kg); iii) PCL (PCN plus 0.05% emulsifier); and iv) NCL (NCN plus 0.05% emulsifier). Growth performance was evaluated weekly whereas assessments for the carcass traits, digestibility, some blood metabolites, ileal morphology, and meat quality were measured on d 21 and d 35.
RESULTS: Birds fed the NCL diet had higher (p<0.05) body weights, daily gains, daily feed intake, and improved feed efficiency over the entire 35-day period. Improvements (p<0.05) for the ileal digestibility of crude fat, energy, and dry matter commensurate with longer (p<0.05) villus heights were also observed with emulsifiers in the NCL and PCL diets. For the carcass measurements, only the liver weights were increased (p<0.05) with emulsifiers in the supplemented groups. For blood metabolites, higher (p<0.05) lipase levels were noticed with emulsifiers in the NCL and PCL diets. In addition, marginal reductions (p = 0.076; p = 0.095, respectively) were also noted with emulsifiers for the total cholesterol and triglyceride contents on d 35. Regarding meat quality, breast muscle yellowness was increased (p<0.05) with emulsifier use in supplemented groups.
CONCLUSION: Our results suggest that emulsifier supplementation at 0.05% in diets could potentially improve the growth performance and nutrient digestibility of broilers over 35 days. This could compensate for the lower growth performance that could be recorded with fat-incorporated lower-energy diets.
OBJECTIVE: To assess the impact of a three-week UDP program onstrength, power, and proprioceptive measures.
DESIGN: Matched-group, pre- post design.
SETTING: National Sports Institute.
PARTICIPANTS: Twenty-one international-level female field hockey athletes.
INTERVENTIONS: Two 45 min UDP sessions were incorporated into each week of a three week training program (total 6 sessions).
MAIN OUTCOME MEASURES: One-repetition maximum strength, lower limb power, 20 m running speed, and proprioception tests were performed before and after the experimental period.
RESULTS: Substantial improvements in running sprint speed at 5- (4.4 ± 2.6%; Effect Size [ES]: 0.88), 10- (2.1 ± 1.9%; ES: 0.51), and 20-m (1.0 ± 1.6%; ES: 0.23) were observed in the UDP group. Squat jump performance was also clearly enhanced when compared to the control group (3.1 ± 6.1%; ES: 0.23). Small but clear improvements in maximal strength were observed in both groups.
CONCLUSION: A three week UDP can elicit clear enhancements in running sprint speed and concentric-only jump performance. These improvements are suggestive of enhanced explosive strength and are particularly notable given the elite training status of the cohort and relatively short duration of the intervention. Thus, we would reiterate the statement by Gruber and colleagues (2004) that sensorimotor training is a "highly efficient" modality for improving explosive strength.
METHODS: ALPHA is an ongoing, international, phase 3, randomised, double-blind, placebo-controlled trial evaluating danicopan as add-on therapy to ravulizumab or eculizumab. Eligible patients were adults (age ≥18 years) with PNH and clinically significant extravascular haemolysis (haemoglobin ≤9·5 g/dL; absolute reticulocyte count ≥120 × 109/L) on ravulizumab or eculizumab for at least 6 months. Patients were randomly assigned (2:1) to danicopan or placebo added to ravulizumab or eculizumab for 12 weeks using an interactive response technology system. Randomisation was stratified based on transfusion history, haemoglobin, and patients enrolled from Japan. The initial oral danicopan dose was 150 mg three times a day; escalation to 200 mg three times a day was permitted based on clinical response. The infusion dose level of eculizumab (every 2 weeks) ranged from 900 mg to 1500 mg, and for ravulizumab (monthly or every 8 weeks) ranged from 3000 mg to 3600 mg. The primary endpoint was change in haemoglobin concentration from baseline to week 12. Here we present the protocol-prespecified interim analysis, planned when approximately 75% of participants were randomly assigned to treatment and completed or discontinued at 12 weeks. This trial is registered with ClinicalTrials.gov (NCT04469465).
FINDINGS: Individuals were randomly assigned between Dec 16, 2020, and Aug 29, 2022. At data cutoff (June 28, 2022), 73 individuals were randomly assigned, received treatment, and were analysed for safety (danicopan, n=49; placebo, n=24). The protocol-prespecified interim efficacy analysis set included the first 63 participants (danicopan, n=42; placebo, n=21). At week 12, danicopan plus ravulizumab or eculizumab increased haemoglobin versus placebo plus ravulizumab or eculizumab (least squares mean [LSM] change from baseline: danicopan, 2·94 g/dL [95% CI 2·52 to 3·36]; placebo, 0·50 g/dL [-0·13 to 1·12]; LSM difference, 2·44 g/dL [1·69 to 3·20]; p<0·0001). Grade 3 adverse events in the danicopan group were increased alanine aminotransferase (two [4%] of 49 patients), leukopenia (one [2%]), neutropenia (two [4%]), cholecystitis (one [2%]), COVID-19 (one [2%]), increased aspartate aminotransferase (one [2%]), and increased blood pressure (one [2%]), and in the placebo group were anaemia (one [4%] of 24 patients), thrombocytopenia (one [4%]), and asthenia (one [4%]). The serious adverse events reported in the danicopan group were cholecystitis (one [2%] patient) and COVID-19 (one [2%]) and in the placebo group were anaemia and abdominal pain, both in one (4%) patient. There were no serious adverse events related to study drug or deaths reported in the study.
INTERPRETATION: These primary efficacy and safety results show that danicopan as add-on treatment to ravulizumab or eculizumab significantly improved haemoglobin concentrations at week 12 with no new safety concerns, suggesting an improved benefit-risk profile in patients with PNH and clinically significant extravascular haemolysis.
FUNDING: Alexion, AstraZeneca Rare Disease.
METHODS: 1812 biopsy-proven NAFLD patients across nine countries in Asia assessed between 2006 and 2019 were pooled into a curated clinical registry. Demographic, metabolic and histological differences between non-obese and obese NAFLD patients were evaluated. The performance of Fibrosis-4 index for liver fibrosis (FIB-4) and NAFLD fibrosis score (NFS) to identify advanced liver disease across the varying obesity subgroups was compared. A random forest analysis was performed to identify novel predictors of fibrosis and steatohepatitis in non-obese patients.
FINDINGS: One-fifth (21.6%) of NAFLD patients were non-obese. Non-obese NAFLD patients had lower proportions of NASH (50.5% vs 56.5%, p = 0.033) and advanced fibrosis (14.0% vs 18.7%, p = 0.033). Metabolic syndrome in non-obese individuals was associated with NASH (OR 1.59, 95% CI 1.01-2.54, p = 0.047) and advanced fibrosis (OR 1.88, 95% CI 0.99-3.54, p = 0.051). FIB-4 performed better than the NFS score (AUROC 81.5% vs 73.7%, p