Induced pluripotent stem cell-based therapy for treating genetic disorders has become an interesting field of research in recent years. However, there is a paucity of information regarding the applicability of induced pluripotent stem cells in dental research. Recent advances in the use of induced pluripotent stem cells have the potential for developing disease-specific iPSC lines in vitro from patients. Indeed, this has provided a perfect cell source for disease modeling and a better understanding of genetic aberrations, pathogenicity, and drug screening. In this paper, we will summarize the recent progress of the disease-specific iPSC development for various human diseases and try to evaluate the possibility of application of iPS technology in dentistry, including its capacity for reprogramming some genetic orodental diseases. In addition to the easy availability and suitability of dental stem cells, the approach of generating patient-specific pluripotent stem cells will undoubtedly benefit patients suffering from orodental disorders.
The task of identifying firearms from forensic ballistics specimens is exacting in crime investigation since the last two decades. Every firearm, regardless of its size, make and model, has its own unique 'fingerprint'. These fingerprints transfer when a firearm is fired to the fired bullet and cartridge case. The components that are involved in producing these unique characteristics are the firing chamber, breech face, firing pin, ejector, extractor and the rifling of the barrel. These unique characteristics are the critical features in identifying firearms. It allows investigators to decide on which particular firearm that has fired the bullet. Traditionally the comparison of ballistic evidence has been a tedious and time-consuming process requiring highly skilled examiners. Therefore, the main objective of this study is the extraction and identification of suitable features from firing pin impression of cartridge case images for firearm recognition. Some previous studies have shown that firing pin impression of cartridge case is one of the most important characteristics used for identifying an individual firearm. In this study, data are gathered using 747 cartridge case images captured from five different pistols of type 9mm Parabellum Vektor SP1, made in South Africa. All the images of the cartridge cases are then segmented into three regions, forming three different set of images, i.e. firing pin impression image, centre of firing pin impression image and ring of firing pin impression image. Then geometric moments up to the sixth order were generated from each part of the images to form a set of numerical features. These 48 features were found to be significantly different using the MANOVA test. This high dimension of features is then reduced into only 11 significant features using correlation analysis. Classification results using cross-validation under discriminant analysis show that 96.7% of the images were classified correctly. These results demonstrate the value of geometric moments technique for producing a set of numerical features, based on which the identification of firearms are made.
Most democratic countries hold inquiries into disasters. One of their key functions is to establish the cause of an event and to learn lessons in order to prevent a recurrence. In addition, they offer an opportunity for communal catharsis, permitting the public to vent anger, distress and frustration and to exert pressure for policy changes. Malaysia has experienced six landmark socio-technical disasters since 1968, which resulted in the proposal or amendment of various safety/emergency acts and regulations. The authors used a grounded theory approach utilising a constant comparative method to analyse the recommendations made by the inquiries into these events. Data indicate that social and technical recommendations comprise 85 and 15 per cent, respectively, of the total recommendations made by the inquiry committees. This paper offers suggestions for improving the management of inquiry tribunals, as they will remain a valuable source of information for society and corporations to learn from past incidents.
The dynamics of a periodically delta-kicked Hamiltonian system moving at low speed (i.e., at speed much less than the speed of light) is studied numerically. In particular, the trajectory of the system predicted by Newtonian mechanics is compared with the trajectory predicted by special relativistic mechanics for the same parameters and initial conditions. We find that the Newtonian trajectory, although close to the relativistic trajectory for some time, eventually disagrees completely with the relativistic trajectory, regardless of the nature (chaotic, nonchaotic) of each trajectory. However, the agreement breaks down very fast if either the Newtonian or relativistic trajectory is chaotic, but very much slower if both the Newtonian and relativistic trajectories are nonchaotic. In the former chaotic case, the difference between the Newtonian and relativistic values for both position and momentum grows, on average, exponentially. In the latter nonchaotic case, the difference grows much slower, for example, linearly on average.
The "golden ratio" is considered as a universal facial aesthetical standard. Researcher's opinion that deviation from golden ratio can result in development of facial abnormalities.
At present, there is no consensus in the scientific community regarding the ability for human papillomavirus (HPV) infections to establish latency. Based on animal studies, a model of papillomavirus latency has been proposed in which papillomaviruses can be retained in the basal epithelial stem cell pool as latent infections and periodically induced to reactivate when the stem cell divides and one daughter cell is committed to terminal differentiation and induction of the viral life cycle. Tissue resident memory T-cells are hypothesized to control these periodic reactivation episodes and thus limit their duration. In this paper, evidence from human studies consistent with this model of papillomavirus latency is reviewed. Given the strong circumstantial evidence supporting a natural history of HPV infection which includes a immunologically controlled latent state, the longer term implications of HPV latency on a highly infected and aging population may warrant a more serious evaluation.
E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery.
This generic qualitative study explores the perspective of Malaysian teachers regarding the constraints of the current school-based sexual and reproductive health education in secondary schools of Klang-Valley Malaysia. For this study, in-depth interviews were conducted with twenty eight science teachers of government schools. The majority of participants named the teaching strategy and capacity of teachers, the lack of co-operation from the school and parents, limited resources in teaching and students themselves as some of the challenges. We concluded that if sexual health education is to be effective, it needs to be provided by people who have some specialized training. The teachers should be trained to teach sexual reproductive health education classes at the basic level, and in-service training for teachers already in the field should be intensified. Local adaptation to culture, language, religion, and so forth is often necessary.
BACKGROUND: A previous systematic review reported that increase in patients' medication cost-sharing reduced patients' adherence to medication. However, a study among patients with medication subsidies who received medication at no cost found that medication nonadherence was also high. To our knowledge, no study has evaluated the influence of different medication payment schemes on patients' medication adherence.
OBJECTIVE: This study aims to review research reporting the influence of payment schemes and their association with patients' medication adherence behavior.
METHODS: This study was conducted using systematic review of published articles. Relevant published articles were located through three electronic databases Medline, ProQuest Medical Library, and ScienceDirect since inception to February 2015. Included articles were then reviewed and summarized narratively.
RESULTS: Of the total of 2,683 articles located, 21 were included in the final analysis. There were four types of medication payment schemes reported in the included studies: 1) out-of-pocket expenditure or copayments; 2) drug coverage or insurance benefit; 3) prescription cap; and 4) medication subsidies. Our review found that patients with "lower self-paying constraint" were more likely to adhere to their medication (adherence rate ranged between 28.5% and 94.3%). Surprisingly, the adherence rate among patients who received medication as fully subsidized was similar (rate between 34% and 84.6%) as that of other payment schemes. The studies that evaluated patients with fully subsidized payment scheme found that the medication adherence was poor among patients with nonsevere illness.
CONCLUSION: Although medication adherence was improved with the reduction of cost-sharing such as lower copayment, higher drug coverage, and prescription cap, patients with full-medication subsidies payment scheme (received medication at no cost) were also found to have poor adherence to their medication. Future studies comparing factors that may influence patients' adherence to medication among patients who received medication subsidies should be done to develop strategies to overcome medication nonadherence.
KEYWORDS: drug cost; medication adherence; medication payment scheme
Perception of healthcare providers who worked with family medicine specialists (FMSs) could translate into the effectiveness of primary healthcare delivery in daily practices. This study examined perceptions of public healthcare providers/professionals (PHCPs) on FMSs at public health clinics throughout Malaysia. This was a cross-sectional study in 2012-2013 using postal method targeting PHCPs from three categories of health facilities, namely health clinics, health offices and hospitals. A structured questionnaire was developed to assess PHCP's perception of FMS's clinical competency, safety practice, ethical and professional values, and research involvement. It consists of 37 items with Likert scale of strongly disagree (a score of 1) to strongly agree (a score of 5). Interaction and independent effect of the independent variables were tested and adjusted means score were reported. The participants' response rate was 58.0% (780/1345) with almost equal proportion from each of the three public healthcare facilities. There were more positive perceptions than negative among the PHCPs. FMSs were perceived to provide effective and safe treatment to their patients equally disregards of patient's social background. However, there were some concerns of FMSs not doing home visits, not seeing walk-in patients, had long appointment time, not active in scientific research, writing and publication. There were significant differences in perception based on a respondent's health care facility (p research and writing for publication.
The U.S. National Science Foundation-funded (DEB 1022720) 'All Cypriniformes Species Inventory' was initiated in 2010 and will be completed in 2015. It has accelerated the rate of discovery and description of cypriniform fishes, expanded our knowledge of the phylogenetic relationships of cypriniforms, increased the capacity for systematic research in other countries through student training and establishing long-term collaborations, including conferences in Thailand in 2012, Brunei in 2013, Burundi in 2013, and Malaysia in 2014, led to the formation of the Asian Society of Ichthyologists, and made available large numbers of specimens and tissues of freshwater fishes, including many species never before collected, in permanent collections in foreign and U.S. institutions.
It is believe that 80% industrial of carbon dioxide can be controlled by separation and storage technologies which use the blended ionic liquids absorber. Among the blended absorbers, the mixture of water, N-methyldiethanolamine (MDEA) and guanidinium trifluoromethane sulfonate (gua) has presented the superior stripping qualities. However, the blended solution has illustrated high viscosity that affects the cost of separation process. In this work, the blended fabrication was scheduled with is the process arranging, controlling and optimizing. Therefore, the blend's components and operating temperature were modeled and optimized as input effective variables to minimize its viscosity as the final output by using back-propagation artificial neural network (ANN). The modeling was carried out by four mathematical algorithms with individual experimental design to obtain the optimum topology using root mean squared error (RMSE), R-squared (R(2)) and absolute average deviation (AAD). As a result, the final model (QP-4-8-1) with minimum RMSE and AAD as well as the highest R(2) was selected to navigate the fabrication of the blended solution. Therefore, the model was applied to obtain the optimum initial level of the input variables which were included temperature 303-323 K, x[gua], 0-0.033, x[MDAE], 0.3-0.4, and x[H2O], 0.7-1.0. Moreover, the model has obtained the relative importance ordered of the variables which included x[gua]>temperature>x[MDEA]>x[H2O]. Therefore, none of the variables was negligible in the fabrication. Furthermore, the model predicted the optimum points of the variables to minimize the viscosity which was validated by further experiments. The validated results confirmed the model schedulability. Accordingly, ANN succeeds to model the initial components of the blended solutions as absorber of CO2 capture in separation technologies that is able to industries scale up.
Halophilic cellulases from the newly isolated fungus, Aspergillus terreus UniMAP AA-6 were found to be useful for in situ saccharification of ionic liquids treated lignocelluloses. Efforts have been taken to improve the enzyme production through statistical optimization approach namely Plackett-Burman design and the Face Centered Central Composite Design (FCCCD). Plackett-Burman experimental design was used to screen the medium components and process conditions. It was found that carboxymethylcellulose (CMC), FeSO4·7H2O, NaCl, MgSO4·7H2O, peptone, agitation speed and inoculum size significantly influence the production of halophilic cellulase. On the other hand, KH2PO4, KOH, yeast extract and temperature had a negative effect on enzyme production. Further optimization through FCCCD revealed that the optimization approach improved halophilic cellulase production from 0.029 U/ml to 0.0625 U/ml, which was approximately 2.2-times greater than before optimization.
The aim of this open label crossover study was to investigate the effects of Nigella sativa on reproductive health and metabolic profile of perimenopausal women in Rawang, Malaysia.
BACKGROUND: Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists' involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers' views on the integration of pharmacists within private GP clinics in Malaysia.
METHODS: A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10.
RESULTS: A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists' role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs' resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs' reluctance were perceived as barriers to integration.
CONCLUSION: This study provides insights into consumers' perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed.
KEYWORDS: Malaysia; general practitioners; health care consumer; pharmacist integration; private clinic
The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of developing best management practices, coordinating research and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis (UC) with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis and management of Crohn's disease (CD). The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses and treatment availability. It does not intend to be all-comprehensive and future revisions are likely to be required in this ever-changing field.
Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.
Critical appraisal refers to the skill of reading a piece of research in a very objective and structured way. It allows for the reader to assess the quality and validity of the evidence put forward. With the emphasis on evidence-based practice in the medical profession, the ability to critically appraise the literature should be instilled into medical students. Currently, the push to encourage research shows great effort in the medical curriculum, through the incorporation of elective research programmes, by many medical institutions. But how ready are the students to even understand the research literature, let alone conduct a research? The current system throws these students into 'the deep end' of research conduct without equipping them with the tools necessary to do so. Very often this becomes a problem that snowballs through specialist training right up to the practice of medicine. The possibilities and means of introducing the skills of critical appraisal via the curriculum should be explored. In this age of self-directed and problem-based learning, a purely didactic teaching method of "how to read the literature" is surely outdated. The concept should be integrated into medical teaching, including within the implementation of the PBL system, in both the clinical and non-clinical settings, and by the introduction of the 'journal club' concept. Training of the trainers should also be considered. With the early training of critical appraisal, it can hopefully become an unconscious competence of medical graduates, who not only can produce quality research, but also able to identify quality information.
The new-found popularity of generalism as a political force has emphasized the need to clarify the essential philosophy that underpins its practice, teaching, and research. Drawing on the example of Sir James Mackenzie, the author seeks to clarify certain essential issues that need to be emphasized if we are to promote and develop general practice as a distinct academic discipline. Dissatisfaction, uncertainty about our role, and continuing contact with real people seems to be essential to continuing creativity.