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Playing-Related Musculoskeletal Disorders Among Classical Piano Students at Tertiary Institutions in Malaysia: Proportion and Associated Risk Factors

Ling CY, Loo FC, Hamedon TR

Med Probl Perform Art, 2018 06;33(2):82-89.
PMID: 29868681 DOI: 10.21091/mppa.2018.2013

Musicians are prone to performance injuries due to the nature of musical practice, and classical pianists are among the groups at high risk for playing-related musculoskeletal disorders (PRMDs). With the growing number of classical pianists in Malaysia, this study aimed to investigate the proportion of PRMDs occurring among classical piano students in tertiary institutions in Malaysia. Associations between gender, practice habits, diet, sports involvement, and PRMD were investigated. A survey was conducted among classical piano students (n=192) at tertiary institutions of Kuala Lumpur and Selangor. Results showed that 35.8% (n=68) students reported having PRMD. The shoulder was the most commonly affected body site, followed by the arm, finger, and wrist. Pain, fatigue, and stiffness were the most cited symptoms by those who suffered from a PRMD. Chi-square analysis showed a significant relationship between the occurrence of PRMD and practice hours (p=0.031), the habit of taking breaks during practice (p=0.045), physical cool-down exercises (p=0.037), and special diet (p=0.007). Multivariate logistic regression analyses confirmed the independent correlation between PRMDs and the lack of taking a break during practice, physical cool-down exercises, and special diet. Because PRMDs are reported at various severity levels, this study should increase awareness of PRMD among classical piano students and encourage injury prevention in musicians in the future to ensure long-lasting music careers.
Knowledge of Playing-Related Musculoskeletal Disorders Among Classical Piano Students at Tertiary Institutions in Malaysia

Ling CY, Loo FC, Hamedon TR

Med Probl Perform Art, 2016 12;31(4):201-204.
PMID: 27942698

Performance injuries among musicians have been widely discussed for decades. However, despite the growing number of classical pianists, this is still a new issue in Malaysia. Therefore, this study aimed to investigate the level of knowledge of playing-related musculoskeletal disorders (PRMDs) among tertiary music students in Malaysia. A survey was conducted among classical piano students at tertiary institutions of Kuala Lumpur and Selangor. Out of 192 respondents, 76% knew that piano playing can cause PRMDs. Slightly over three-quarters of respondents (77.1%) learned about PRMDs from music educators. The survey revealed that the belief in "no pain, no gain" was still ingrained in their minds, as 50.5% respondents believed that pain experienced while playing the piano was normal and 51.6% of them considered that pain must be experienced to improve their piano skill. The respondents were also scored on questions on terminologies of pianist injury and specific PRMD examples: 7.8% of respondents scored high in the questions on the general terminology, while 99.5% of them scored low in the questions on the specific examples of PRMDs. This finding indicated a lack of knowledge of specific musicians' injuries among classical piano students. The attitudes to pain and the level of understanding of the significance of potential injuries indicate that increasing PRMD awareness and introducing courses on PRMD prevention at tertiary institutions are warranted.
Spatio-temporal patterns of dengue in Malaysia: combining address and sub-district level

Ling CY, Gruebner O, Krämer A, Lakes T

Geospat Health, 2014 Nov;9(1):131-40.
PMID: 25545931

Spatio-temporal patterns of dengue risk in Malaysia were studied both at the address and the sub-district level in the province of Selangor and the Federal Territory of Kuala Lumpur. We geocoded laboratory-confirmed dengue cases from the years 2008 to 2010 at the address level and further aggregated the cases in proportion to the population at risk at the sub-district level. Kulldorff's spatial scan statistic was applied for the investigation that identified changing spatial patterns of dengue cases at both levels. At the address level, spatio-temporal clusters of dengue cases were concentrated at the central and south-eastern part of the study area in the early part of the years studied. Analyses at the sub-district level revealed a consistent spatial clustering of a high number of cases proportional to the population at risk. Linking both levels assisted in the identification of differences and confirmed the presence of areas at high risk for dengue infection. Our results suggest that the observed dengue cases had both a spatial and a temporal epidemiological component, which needs to be acknowledged and addressed to develop efficient control measures, including spatially explicit vector control. Our findings highlight the importance of detailed geographical analysis of disease cases in heterogeneous environments with a focus on clustered populations at different spatial and temporal scales. We conclude that bringing together information on the spatio-temporal distribution of dengue cases with a deeper insight of linkages between dengue risk, climate factors and land use constitutes an important step towards the development of an effective risk management strategy.
7-Methoxyglycomaurin: a new carbazole alkaloid from Glycosmis rupestris

Rahmani M, Ling CY, Sukari MA, Ismail HB, Meon S, Aimi N

Planta Med, 1998 Dec;64(8):780.
PMID: 17253329
Chemopreventive activity of methanol extract of Melastoma malabathricum leaves in DMBA-induced mouse skin carcinogenesis

Kooi OK, Ling CY, Rodzi R, Othman F, Mohtarrudin N, Suhaili Z, et al.

Afr J Tradit Complement Altern Med, 2014;11(4):66-70.
PMID: 25392583

BACKGROUND: Melastoma malabathricum L. Smith (family Melastomaceae) is a shrub that has been used by the Malay practitioners of traditional medicine to treat various types of ailments. The present study aimed to determine the chemopreventive activity of methanol extract of M. malabathricum leaves (MEMM) using the standard 7,12-dimethylbenz(α)anthracene (DMBA)/croton oil-induced mouse skin carcinogenesis model.
MATERIALS AND METHODS: In the initiation phase, the mice received a single dose of 100µl/100 µg DMBA (group I-V) or 100µl acetone (group VI) topically on the dorsal shaved skin area followed by the promotion phase involving treatment with the respective test solutions (100 µl of acetone, 10 mg/kg curcumin or MEMM (30, 100 and 300mg/kg)) for 30 min followed by the topical application of tumour promoter (100µl croton oil). Tumors were examined weekly and the experiment lasted for 15 weeks.
RESULTS: MEMM and curcumin significantly (p<0.05) reduced the tumour burden, tumour incidence and tumour volume, which were further supported by the histopathological findings.
CONCLUSION: MEMM demonstrated chemoprevention possibly via its antioxidant and anti-inflammatory activities, and the action of flavonoids like quercitrin.
Fulltext Nonlinear time series analysis of state-wise COVID-19 in Malaysia using wavelet and persistent homology

Phang P, Ling CY, Liew SH, Razak FA, Wiwatanapataphee B

Sci Rep, 2024 Nov 11;14(1):27562.
PMID: 39528569 DOI: 10.1038/s41598-024-79002-0

The nonlinear progression of COVID-19 positive cases, their fluctuations, the correlations in amplitudes and phases across different regions, along with seasonality or periodicity, pose challenges to thoroughly examining the data for revealing similarities or detecting anomalous trajectories. To address this, we conducted a nonlinear time series analysis combining wavelet and persistent homology to detect the qualitative properties underlying COVID-19 daily infection numbers at the state level from the pandemic's onset to June 2024 in Malaysia. The first phase involved investigating the evolution of daily confirmed cases by state in the time-frequency domain using wavelets. Subsequently, a topological feature-based time series clustering is performed by reconstructing a higher-dimensional phase space through a delay embedding method. Our findings reveal a prominent 7-day periodicity in case numbers from mid-2021 to the end of 2022. The state-wise daily cases are moderately correlated in both amplitudes and phases during the Delta and Omicron waves. Biweekly averaged data significantly enhances the detection of topological loops associated with these waves. Selangor demonstrates unique case trajectories, while Pahang shows the highest similarity with other states. This methodological framework provides a more detailed understanding of epidemiological time series data, offering valuable insights for preparing for future public health crises.
Fulltext Fish consumption pattern among adults of different ethnics in Peninsular Malaysia

Ahmad NI, Wan Mahiyuddin WR, Tengku Mohamad TR, Ling CY, Daud SF, Hussein NC, et al.

Food Nutr Res, 2016;60:32697.
PMID: 27534846 DOI: 10.3402/fnr.v60.32697

Understanding different patterns of fish consumption is an important component for risk assessment of contaminants in fish. A few studies on food consumption had been conducted in Malaysia, but none of them focused specifically on fish consumption. The objectives of this study were to document the meal pattern among three major ethnics in Malaysia with respect to fish/seafood consumption, identify most frequently consumed fish and cooking method, and examine the influence of demographic factors on pattern of fish consumption among study subjects.
Fulltext The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress

Baker P, Smith JP, Garde A, Grummer-Strawn LM, Wood B, Sen G, et al.

Lancet, 2023 Feb 11;401(10375):503-524.
PMID: 36764315 DOI: 10.1016/S0140-6736(22)01933-X

Despite increasing evidence about the value and importance of breastfeeding, less than half of the world's infants and young children (aged 0-36 months) are breastfed as recommended. This Series paper examines the social, political, and economic reasons for this problem. First, this paper highlights the power of the commercial milk formula (CMF) industry to commodify the feeding of infants and young children; influence policy at both national and international levels in ways that grow and sustain CMF markets; and externalise the social, environmental, and economic costs of CMF. Second, this paper examines how breastfeeding is undermined by economic policies and systems that ignore the value of care work by women, including breastfeeding, and by the inadequacy of maternity rights protection across the world, especially for poorer women. Third, this paper presents three reasons why health systems often do not provide adequate breastfeeding protection, promotion, and support. These reasons are the gendered and biomedical power systems that deny women-centred and culturally appropriate care; the economic and ideological factors that accept, and even encourage, commercial influence and conflicts of interest; and the fiscal and economic policies that leave governments with insufficient funds to adequately protect, promote, and support breastfeeding. We outline six sets of wide-ranging social, political, and economic reforms required to overcome these deeply embedded commercial and structural barriers to breastfeeding.
Fulltext Introduction of Aedes aegypti mosquitoes carrying wAlbB Wolbachia sharply decreases dengue incidence in disease hotspots

Hoffmann AA, Ahmad NW, Keong WM, Ling CY, Ahmad NA, Golding N, et al.

iScience, 2024 Feb 16;27(2):108942.
PMID: 38327789 DOI: 10.1016/j.isci.2024.108942

Partial replacement of resident Aedes aegypti mosquitoes with introduced mosquitoes carrying certain strains of inherited Wolbachia symbionts can result in transmission blocking of dengue and other viruses of public health importance. Wolbachia strain wAlbB is an effective transmission blocker and stable at high temperatures, making it particularly suitable for hot tropical climates. Following trial field releases in Malaysia, releases using wAlbB Ae. aegypti have become operationalized by the Malaysian health authorities. We report here on an average reduction in dengue fever of 62.4% (confidence intervals 50-71%) in 20 releases sites when compared to 76 control sites in high-rise residential areas. Importantly the level of dengue reduction increased with Wolbachia frequency, with 75.8% reduction (61-87%) estimated at 100% Wolbachia frequency. These findings indicate large impacts of wAlbB Wolbachia invasions on dengue fever incidence in an operational setting, with incidence expected to further decrease as wider areas are invaded.