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Fulltext Paddy grading using thermal imaging technology

Azman, N., Jamil, N., Bejo-Khairunniza, S.

International Food Research Journal, 2016;23(101):245-248.
MyJurnal

Rice production depends on good quality of paddy. In this research, the capability of thermal
imaging to determine the quality of paddy based on the properties used in a Deduction Schedule
namely moisture content, immature condition and foreign material is presented. First, the
heating and cooling treatment was applied to the samples. FLIR E60 thermal camera was used
to acquire images of the sample. Therefore, each samples were represented by a thermal index
calculated based on the average value of pixels in the thermal image. Results of the experiment
have shown that highly significant relationship were exist between thermal index and maturity
stage and moisture content of paddy with r = -0.948 and 0.896, respectively. It also worked
well in detecting foreign material (chaff) at 25s after cooling. The method gave accurate results
with 92% for moisture content determination, 90% for maturity stage prediction and 100% for
chaff detection.
Fulltext Simulation of COVID-19 outbreaks via Graphical User Interface (GUI)

Mohd Jamil N, Rosli N, Muhammad N

J Public Health Res, 2021 Sep 24;11(1).
PMID: 34558879 DOI: 10.4081/jphr.2021.2130

BACKGROUND: This research aimed to model the outbreak of COVID-19 in Malaysia and develop a GUI-based model.
DESIGN AND METHODS: The model is an improvement of the susceptible, infected, recovery, and death (SIRD) compartmental model. The epidemiological parameters of the infection, recovery, and death rates were formulated as time dependent piecewise functions by incorporating the control measures of lockdown, social distancing, quarantine, lockdown lifting time and the percentage of people who abide by the rules. An improved SIRD model was solved via the 4th order Runge-Kutta (RK4) method and 14 unknown parameters were estimated by using Nelder-Mead algorithm and pattern-search technique. The publicly available data for COVID-19 outbreak in Malaysia was used to validate the performance of the model. The GUI-based SIRD model was developed to simulate the number of active cases of COVID-19 over time by considering movement control order (MCO) lifted date and the percentage of people who abide the rules.
RESULTS: The simulator showed that the improved SIRD model adequately fitted Malaysia COVID-19 data indicated by low values of root mean square error (RMSE) as compared to other existing models. The higher the percentage of people following the SOP, the lower the spread of disease. Another key point is that the later the lifting time after the lockdown, the lower the spread of disease.
CONCLUSIONS: These findings highlight the importance of the society to obey the intervention measures in preventing the spread of the COVID-19 disease.
Fulltext Imperata cylindrica sp as Novel Silica-Based Heterogeneous Catalysts for Transesterification of Palm Oil Mill Sludge

Ngaini Z, Shahrom FD, Jamil N, Wahi R, Ahmad ZA

J Oleo Sci, 2016 Jun 1;65(6):507-15.
PMID: 27181252 DOI: 10.5650/jos.ess16014

Biodiesel from palm oil mill sludge (POMS) was prepared in the presence of novel silica-based heterogeneous catalysts derived from Imperata cylindrica sp. Imperatacid and Imperatabase are two types of heterogeneous catalysts derived from Imperata cylindrica sp and characterized using scanning electron microscopy, Energy Dispersive X-ray, Brunauer-Emmett-Teller surface area and pore size measurement. Imperatacid has particle size of 43.1-83.9 µm while Imperatabase in the range of 89-193 µm. Imperatacid was conveniently applied in esterification step to afford > 90 wt% oil in 1:3 (oil/methanol) and 10 wt% catalyst, followed by transesterification with 1 wt% Imperatabase and 1:1 (oil/methanol) for 1 h at 65°C to afford 80% biodiesel with higher percentage of methyl palmitate (48.97%) and methyl oleate (34.14%) compare to conventional homogeneous catalyst. Reusability of the catalyst up to three times afforded biodiesel ranging from 78-80% w/w. The biodiesel was demonstrated onto alternative diesel engine (Megatech(®)-Mark III) and showed proportional increased of torque (ɽ) to biodiesel loading.
Fulltext An Improved Vulnerability Exploitation Prediction Model with Novel Cost Function and Custom Trained Word Vector Embedding

Hoque MS, Jamil N, Amin N, Lam KY

Sensors (Basel), 2021 Jun 20;21(12).
PMID: 34202977 DOI: 10.3390/s21124220

Successful cyber-attacks are caused by the exploitation of some vulnerabilities in the software and/or hardware that exist in systems deployed in premises or the cloud. Although hundreds of vulnerabilities are discovered every year, only a small fraction of them actually become exploited, thereby there exists a severe class imbalance between the number of exploited and non-exploited vulnerabilities. The open source national vulnerability database, the largest repository to index and maintain all known vulnerabilities, assigns a unique identifier to each vulnerability. Each registered vulnerability also gets a severity score based on the impact it might inflict upon if compromised. Recent research works showed that the cvss score is not the only factor to select a vulnerability for exploitation, and other attributes in the national vulnerability database can be effectively utilized as predictive feature to predict the most exploitable vulnerabilities. Since cybersecurity management is highly resource savvy, organizations such as cloud systems will benefit when the most likely exploitable vulnerabilities that exist in their system software or hardware can be predicted with as much accuracy and reliability as possible, to best utilize the available resources to fix those first. Various existing research works have developed vulnerability exploitation prediction models by addressing the existing class imbalance based on algorithmic and artificial data resampling techniques but still suffer greatly from the overfitting problem to the major class rendering them practically unreliable. In this research, we have designed a novel cost function feature to address the existing class imbalance. We also have utilized the available large text corpus in the extracted dataset to develop a custom-trained word vector that can better capture the context of the local text data for utilization as an embedded layer in neural networks. Our developed vulnerability exploitation prediction models powered by a novel cost function and custom-trained word vector have achieved very high overall performance metrics for accuracy, precision, recall, F1-Score and AUC score with values of 0.92, 0.89, 0.98, 0.94 and 0.97, respectively, thereby outperforming any existing models while successfully overcoming the existing overfitting problem for class imbalance.
Fulltext Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review

Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H

Biomed Res Int, 2016;2016:9305025.
PMID: 27525281

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were "postural control," "balance," "gait performance," "diabetes mellitus," and "diabetic peripheral neuropathy." Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults.
The relationship between vitamin D status and muscle strength in young healthy adults from sunny climate countries currently living in the northeast of Scotland

Jamil NA, Gray SR, Fraser WD, Fielding S, Macdonald HM

Osteoporos Int, 2017 04;28(4):1433-1443.
PMID: 28083666 DOI: 10.1007/s00198-016-3901-3

The current study examined the relationship between vitamin D status and muscle strength in young healthy adults: residents (>6 months) and newcomers (0-3 months), originally from sunny climate countries but currently living in the northeast of Scotland. Our longitudinal data found a positive, albeit small, relationship between vitamin D status and knee extensor isometric strength.
INTRODUCTION: Vitamin D has been suggested to play a role in muscle health and function, but studies so far have been primarily in older populations for falls prevention and subsequent risk of fractures.
METHODS: Vitamin D status was assessed in a healthy young adults from sunny climate countries (n = 71, aged 19-42 years) with 56% seen within 3 months of arriving in Aberdeen [newcomers; median (range) time living in the UK = 2 months (9-105 days)] and the remainder resident for >6 months [residents; 23 months (6-121 months)]. Participants attended visits every 3 months for 15 months. At each visit, fasted blood samples were collected for analysis of serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), carboxy-terminal collagen crosslinks (CTX) and N-terminal propeptide of type I collagen (P1NP). Maximal voluntary contractions (MVC) were performed for grip strength (both arms) and for maximal isometric strength of the knee extensors (right knee).
RESULTS: There were small seasonal variations in 25(OH)D concentrations within the newcomers and residents, but no seasonal variation in bone turnover markers. There was a positive, albeit small, association between 25(OH)D and knee extensor maximal isometric strength. Mixed modelling predicted that for each 1 nmol/L increase in 25(OH)D, peak torque would increase by 1 Nm (p = 0.04).
CONCLUSIONS: This study suggests that vitamin D may be important for muscle health in young adults migrating from sunnier climates to high latitudes, yet the potential effect is small.
Clinical outcomes and risk factors for SARS-CoV-2 breakthrough cases following vaccination with BNT162b2, CoronaVac, or ChAdOx1-S: A retrospective cohort study in Malaysia

Tamim H, Hashim R, Jamil N, Chong LY, Johari Z

Heliyon, 2024 Apr 30;10(8):e29574.
PMID: 38699728 DOI: 10.1016/j.heliyon.2024.e29574

BACKGROUND: The SARS-CoV-2 pandemic drove global vaccination. However, breakthrough infections raised concerns about vaccine performance, leading the World Health Organization (WHO) to recommend investigations thereof. This study aimed to evaluate the clinical outcomes (time to breakthrough infection, intensive care unit [ICU] admission, and in-hospital mortality) of hospitalised patients with SARS-CoV-2 breakthrough infection. This was the primary outcome and the risk factors associated with its severity were the secondary outcomes.
METHODS: This retrospective cohort study at a multispecialty tertiary hospital in Selangor, Malaysia included 200 fully adult vaccinated patients, with confirmed SARS-CoV-2 infection, admitted from September 2021 to February 2022. Participants were selected by simple random sampling. Infection severity was categorised as CAT 2-3 (mild-moderate) and 4-5 (severe-critical).
RESULTS: The time to breakthrough infection was significantly longer for BNT162B2 recipients (128.47 ± 46.21 days) compared to CoronaVac (94.09 ± 48.71 days; P = 0.001) and ChAdOx1-S recipients (90.80 ± 37.59 days; P = 0.019). No significant associations were found between SARS-CoV-2-related ICU admission, mortality, and the vaccines. Multivariable analysis identified vaccine type, variant of concern, ethnicity, and hypertension as significant predictors of severity. BNT162b2 and ChAdOx1-S recipients had significantly (81 % and 74 %, respectively) lower odds of CAT 4-5 infection compared to CoronaVac recipients. Indian patients had a significantly (83 %) lower chance of CAT 4-5 infection compared to Malay patients. Patients with breakthrough infections during the Omicron period had a significantly (58 %) lower risk of CAT 4-5 compared to those in the Delta period. The CAT 4-5 risk was significantly (nearly threefold) higher in hypertensive patients.
CONCLUSION: The results support the Malaysian Ministry of Health's recommended booster three months after primary vaccination and the WHO's recommended heterologous booster following CoronaVac. Certain ethnic groups, hypertensive patients, and viral variants may require attention in future pandemics.
Fulltext Essential oil composition and antimicrobial activities of two closely related species, Alpinia mutica Roxb. and Alpinia latilabris Ridl., from Peninsular Malaysia

Ibrahim H, Sivasothy Y, Syamsir DR, Nagoor NH, Jamil N, Awang K

ScientificWorldJournal, 2014;2014:430831.
PMID: 24987733 DOI: 10.1155/2014/430831

The essential oils obtained by hydrodistillation of the unripe and ripe fruits of Alpinia mutica Roxb. and Alpinia latilabris Ridl. were analysed by capillary GC and GC-MS. The oils were principally monoterpenic in nature. The unripe and ripe fruit oils of A. mutica were characterized by camphor (21.0% and 15.8%), camphene (16.6% and 10.2%), β-pinene (8.6% and 13.5%), and trans,trans-farnesol (8.0% and 11.2%), respectively. The oils of the unripe and ripe fruits were moderately active against Staphylococcus aureus, Bacillus subtilis, Trichophyton mentagrophytes, and Trichophyton rubrum. 1,8-Cineole (34.2% and 35.9%) and β-pinene (20.2% and 19.0%) were the two most abundant components in the unripe and ripe fruit oils of A. latilabris. The oil of the unripe fruits elicits moderate activity against Staphylococcus aureus and Trichophyton mentagrophytes while Candida glabrata was moderately sensitive to the oil of the ripe fruits.
Psychological and work-related factors predicting work engagement in Malaysian employees

Chan CMH, Wong JE, Wee LH, Jamil NA, Yeap LLL, Swarna Nantha Y, et al.

Occup Med (Lond), 2020 Sep 09;70(6):400-406.
PMID: 32537649 DOI: 10.1093/occmed/kqaa107

BACKGROUND: Past research on work engagement has focused almost exclusively on either psychological or work-related factors in almost wholly separate literature. There is therefore a need to examine how these factors collectively influence work engagement.
AIMS: To determine levels of work engagement and to identify psychological and work-related characteristics predicting work engagement in employees in Malaysia.
METHODS: We recruited 5235 employees from 47 public and private organizations in Malaysia who responded to an online health survey. We assessed work engagement with the 9-item Utrecht Work Engagement Scale (UWES-9) and psychological distress using the 6-item Kessler scale. We performed multiple linear regression to determine predictors of work engagement.
RESULTS: Employee mean age was 33.8 years (standard deviation [SD] ± 8.8). The mean work engagement score on the UWES-9 was 3.53 (SD ± 0.94). Eleven of 18 variables on multiple regression predicted work engagement, F(18, 4925) = 69.02, P < 0.001, R2 = 0.201. Factors that predicted higher work engagement were age, marital status, education level, job type, job permanency, longer sleep duration, lower psychological distress and no history of workplace bullying.
CONCLUSIONS: Key factors associated with poorer work engagement in Malaysian employees include inadequate sleep, psychological distress and a history of workplace bullying. These are modifiable factors that individuals and employers can target to improve work engagement, ideally tailored according to occupational type.
Fulltext A Preliminary Survey of Species Composition of Termites (Insecta: Isoptera) in Samunsam Wildlife Sanctuary, Sarawak

Jamil N, Ismail WNW, Abidin SS, Amaran MA, Hazali R

Trop Life Sci Res, 2017 Jul;28(2):201-213.
PMID: 28890771 MyJurnal DOI: 10.21315/tlsr2017.28.2.15

A survey on termite species composition was conducted in Samunsam Wildlife Sanctuary, Sarawak in February 2015. Overall 19 species of termite belonging to 13 genera and 8 subfamilies was found in the sanctuary. It was recorded the subfamily of Termitinae had the highest number of species (6 species, equal to 31.58% of total species), followed by Nasutermitinae (3 species, 15.79%), Macrotermitinae, Amitermitinae, Rhinotermitinae, Coptotermitinae, (2 species, 10.53% respectively), and Heterotermitinae, Termitogetoninae (1 species, 5.26% respectively). Since this rapid survey is the first termite assemblage representation in Samunsam Wildlife Sanctuary, the preliminary result may serve as the baseline data for termite composition in the area. Therefore, a whole coverage for the area within this sanctuary would definitely increase the number of termite species found in the sanctuary.
Fulltext The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis

Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, et al.

PLoS Negl Trop Dis, 2018 02;12(2):e0006263.
PMID: 29415036 DOI: 10.1371/journal.pntd.0006263

BACKGROUND: Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity.
METHODS: We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI).
FINDINGS: We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity.
CONCLUSION: This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection.
Fulltext Determinants of cloud computing integration and its impact on sustainable performance in SMEs: An empirical investigation using the SEM-ANN approach

Al-Sharafi MA, Iranmanesh M, Al-Emran M, Alzahrani AI, Herzallah F, Jamil N

Heliyon, 2023 May;9(5):e16299.
PMID: 37251849 DOI: 10.1016/j.heliyon.2023.e16299

Although extant literature has thoroughly investigated the incorporation of cloud computing services, examining their influence on sustainable performance, particularly at the organizational level, is insufficient. Consequently, the present research aims to assess the factors that impact the integration of cloud computing within small and medium-sized enterprises (SMEs) and its subsequent effects on environmental, financial, and social performance. The data were collected from 415 SMEs and were analyzed using a hybrid SEM-ANN approach. PLS-SEM results indicate that relative advantage, complexity, compatibility, top management support, cost reduction, and government support significantly affect cloud computing integration. This study also empirically demonstrated that SMEs could improve their financial, environmental, and social performance by integrating cloud computing services. ANN results show that complexity, with a normalized importance (NI) of 89.14%, is ranked the first among other factors affecting cloud computing integration in SMEs. This is followed by cost reduction (NI = 82.67%), government support (NI = 73.37%), compatibility (NI = 70.02%), top management support (NI = 52.43%), and relative advantage (NI = 48.72%). Theoretically, this study goes beyond examining the determinants affecting cloud computing integration by examining their impact on SMEs' environmental, financial, and social performance in a comprehensive manner. The study also provides several practical implications for policymakers, SME managers, and cloud computing service providers.
On the resistance of new lightweight block ciphers against differential cryptanalysis

Chan YY, Khor CY, Khoo BT, Teh JS, Teng WJ, Jamil N

Heliyon, 2023 Apr;9(4):e15257.
PMID: 37095966 DOI: 10.1016/j.heliyon.2023.e15257

Many recently proposed lightweight block ciphers lack security evaluation against generic cryptanalytic attacks such as differential cryptanalysis. In this paper, we contribute towards security evaluation efforts by investigating four lightweight Feistel-based block ciphers including SLIM, LBC-IoT, SCENERY, and LCB. SLIM claims resistance to differential cryptanalysis since, using a heuristic technique, its designers could only find a 7-round differential trail. Despite having no analysis of security against attacks such as differential cryptanalysis, the designers of LBC-IoT and LCB claimed that their ciphers are secure. Meanwhile, the designers of SCENERY claim that the best 11-round differential trail for the cipher has a probability of 2 - 66 . To substantiate these claims, we propose attacks on all four ciphers based on differential cryptanalysis. We presented practical key recovery attacks on SLIM which can retrieve the final round key for up to 14 rounds with a time complexity of 232. LBC-IoT was found to be weaker against differential cryptanalysis despite sharing many similarities with SLIM, whereby a key recovery attack of up to 19 rounds is possible with time complexity 231. For SCENERY, we found a differential trail of up to 12 rounds with probability 2 - 60 , which was used as the distinguisher for a 13-round key recovery attack. We also discovered that LCB's design lacks nonlinearity, allowing us to easily derive deterministic differential trails regardless of the number of rounds. This flaw allowed us to perform a trivial distinguishing attack using a single known ciphertext. By using a different S-box to address this flaw, LCB is now more resilient to differential cryptanalysis than SLIM and LBC-IoT when using the same number of rounds. Our paper presents new independent cryptanalysis results for these ciphers.
A systematic review of behaviour change techniques in pharmacist-delivered self-management interventions towards patients with chronic obstructive pulmonary disease

Jamil N, Zainal ZA, Alias SH, Chong LY, Hashim R

Res Social Adm Pharm, 2023 Aug;19(8):1131-1145.
PMID: 37202279 DOI: 10.1016/j.sapharm.2023.05.006

BACKGROUND: Self-management interventions often employ behaviour change techniques in order to produce desired target behaviours that are necessary for day-to-day living with a chronic disease. Despite the large number of self-management interventions for patients with chronic obstructive pulmonary disease (COPD), previously reported interventions have been typically delivered by healthcare providers other than the pharmacist.
OBJECTIVE: This systematic review examined the components of pharmacists-delivered COPD self-management interventions according to an established taxonomy of behaviour change techniques (BCTs).
METHODS: A systematic search was conducted on PubMed, ScienceDirect, OVID, and Google Scholar from January 2011 to December 2021 for studies of pharmacist-delivered self-management interventions in COPD patients.
RESULTS: A total of seventeen studies of intervention were eligible for inclusion in the narrative review. Interventions were educational and were delivered individually and face-to-face for the first session. Across studies, pharmacists spent an average of 35 min on the first meeting and had an average of 6 follow-up sessions. Recurrent BCTs in pharmacist interventions were "Information on the health consequence", "Feedback on behaviour", "Instruction on how to perform a behaviour", "Demonstration of the behaviour" and "Behavioural practice/rehearsal".
CONCLUSIONS: Pharmacists have provided interventions towards improving health behaviours, especially on adherence and usage of inhaler devices for patients with COPD. Future self-management interventions should be designed using the identified BCTs for the improvement of COPD self-management and disease outcomes.
Is there any association between body mass index and severity of dengue infection?

Zulkipli MS, Rampal S, Bulgiba A, Peramalah D, Jamil N, See LLC, et al.

Trans R Soc Trop Med Hyg, 2021 07 01;115(7):764-771.
PMID: 33587144 DOI: 10.1093/trstmh/trab021

BACKGROUND: Dengue, an acute infectious disease caused by a flavivirus, is a threat to global health. There is sparse evidence exploring obesity and the development of more severe dengue cases in adults. With increasing prevalence of obesity in areas with a high risk of dengue infection, obesity may increase the burden and mortality related to dengue infection. Our study aimed to determine the association between obesity and the development of more severe dengue infection in primary healthcare settings and whether these associations were modified by dengue fever phase.
METHODS: A cohort study was conducted among laboratory-confirmed dengue patients aged >18 y in the central region of Peninsular Malaysia from May 2016 to November 2017. We collected demographic, clinical history, physical examination and laboratory examination information using a standardized form. Dengue severity (DS) was defined as either dengue with warning signs or severe dengue. Participants underwent daily follow-up, during which we recorded their vital signs, warning signs and full blood count results. Incidence of DS was modeled using mixed-effects logistic regression. Changes in platelet count and hematocrit were modeled using mixed-effects linear regression. The final multivariable models were adjusted for age, gender, ethnicity and previous dengue infection.
RESULTS: A total of 173 patients were enrolled and followed up. The mean body mass index (BMI) was 37.4±13.75 kg/m2. The majority of patients were Malay (65.9%), followed by Chinese (17.3%), Indian (12.7%) and other ethnic groups (4.1%). A total of 90 patients (52.0%) were male while 36 patients (20.8%) had a previous history of dengue infection. BMI was significantly associated with DS (adjusted OR=1.17; 95% CI 1.04 to 1.34) and hematocrit (%) (aβ=0.09; 95% CI 0.01 to 0.16), but not with platelet count (x103/µL) (aβ=-0.01; 95% CI -0.84 to 0.81). In the dose response analysis, we found that as BMI increases, the odds of DS, hematocrit levels and platelet levels increase during the first phase of dengue fever.
CONCLUSION: Higher BMI and higher hematocrit levels were associated with higher odds of DS. Among those with high BMI, the development of DS was observed during phase one of dengue fever instead of during phase two. These novel results could be used by clinicians to help them risk-stratify dengue patients for closer monitoring and subsequent prevention of severe dengue complications.
In vitro antiproliferative and antioxidant activities of the extracts of Muntingia calabura leaves

Zakaria ZA, Mohamed AM, Jamil NS, Rofiee MS, Hussain MK, Sulaiman MR, et al.

Am J Chin Med, 2011;39(1):183-200.
PMID: 21213408

The in vitro antiproliferative and antioxidant activities of the aqueous, chloroform and methanol extracts of Muntingia calabura leaves were determined in the present study. Assessed using the 3,(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) (MTT) assay, the aqueous and methanol extracts of M. calabura inhibited the proliferation of MCF-7, HeLa, HT-29, HL-60 and K-562 cancer cells while the chloroform extract only inhibited the proliferation of MCF-7, HeLa, HL-60 and K-562 cancer cells. Interestingly, all extracts of M. calabura, which failed to inhibit the MDA-MB-231 cells proliferation, did not inhibit the proliferation of 3T3 (normal) cells, indicating its safety. All extracts (20, 100 and 500 μg/ml) were found to possess antioxidant activity when tested using the DPPH radical scavenging and superoxide scavenging assays with the methanol, followed by the aqueous and chloroform, extract exhibiting the highest antioxidant activity in both assays. The total phenolic content for the aqueous, methanol and chloroform extracts were 2970.4 ± 6.6, 1279.9 ± 6.1 and 2978.1 ± 4.3 mg/100 g gallic acid, respectively. In conclusion, the M. calabura leaves possess potential antiproliferative and antioxidant activities that could be attributed to its high content of phenolic compounds, and thus, needs to be further explored.
Fulltext The EMPOWER-SUSTAIN e-Health Intervention to improve patient activation and self-management behaviours among individuals with metabolic syndrome in primary care: study protocol for a pilot randomised controlled trial

Daud MH, Ramli AS, Abdul-Razak S, Isa MR, Yusoff FH, Baharudin N, et al.

Trials, 2020 Apr 05;21(1):311.
PMID: 32248825 DOI: 10.1186/s13063-020-04237-x

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.
Fulltext Targeted Primary and Secondary Preventive Strategies for Depression among Malaysian Pharmacy Students

A Wahab I, Goh KW, Zainal ZA, Mohamed Yusof NS, Huri HZ, Jacob SA, et al.

Int J Environ Res Public Health, 2022 Aug 05;19(15).
PMID: 35954990 DOI: 10.3390/ijerph19159629

The global depression burden has remained a challenge throughout the pre- and post-pandemic era. The pandemic effect has led to the spiraling of mental disorders among young people who will be the next generation of leaders. This study aims to identify university students’ sociodemographic, psychosocial and academic backgrounds and performance associated with depression symptoms for the development of primary and secondary preventive strategies for mental health. A cross-sectional study was conducted using an online questionnaire distributed to 19 institutions in Malaysia offering a Bachelor of Pharmacy degree program. The self-rated Depression Anxiety Stress Scale (DASS-42) was used to assess depression symptoms. Pearson’s chi-square test and Fisher’s exact test were used to assess the investigated variables with depression symptoms. Independent T-test and one-way ANOVA were used to compare means of depression score across variables. Binary logistic regression was employed to examine the relationship between the investigated variables and depression symptoms. A total of 610 pharmacy students participated, of which 47% (n = 289/610) were having depression symptoms. Students who smoke nicotine and those who have separated parents, family history of mental illness, and poor academic performance were associated with depression symptoms (p < 0.05). Differences in geographical areas, race and religion also showed significant associations with depression symptoms. Parental marital status, poor academic performance, history of mental illness and comorbidities were statistically predicting depression symptoms (p < 0.05). Primary preventive strategies allowing students to harness healthy coping skills for stress, nicotine-free campaigns and a holistic curriculum are warranted. Secondary measures on mindfulness and compassion skills activities to benefit students who experienced early life crises are highly recommended. Enforcing these targeted strategies in collaboration with health and social sectors should be the primary agenda of universities to ensure their uptake.
Fulltext Design, development, utility and usability testing of the EMPOWER-SUSTAIN Self-Management Mobile App© among primary care physicians and patients with metabolic syndrome

Daud MH, Yusoff FH, Abdul-Razak S, Baharudin N, Mohamed-Yassin MS, Badlishah-Sham SF, et al.

Digit Health, 2023;9:20552076231176645.
PMID: 37312957 DOI: 10.1177/20552076231176645

OBJECTIVE: This study aimed to design, develop, assess and refine the EMPOWER-SUSTAIN Self-Management Mobile App© among primary care physicians (PCP) and patients with metabolic syndrome (MetS) in primary care.
METHODOLOGY: Using the software-development-life-cycle (SDLC) iterative model, storyboard and wireframe were drafted; and a mock prototype was designed to illustrate the content and function graphically. Subsequently, a working prototype was developed. Qualitative studies using the 'think-aloud' and cognitive-task-analysis methods were conducted for the utility and usability testing. Topic guide was based on the 10-Nielsen's-Heuristic-Principles. Utility testing was conducted among PCP in which they 'thought-aloud' while performing tasks using the mobile app. Usability testing was conducted among MetS patients after they were given the app for 3 weeks. They 'thought-aloud' while performing tasks using the app. Interviews were audio- and video-recorded, and transcribed verbatim. Thematic content analysis was performed.
RESULT: Seven PCP and nine patients participated in the utility and usability testing, respectively. Six themes (efficiency of use, user control and freedom, appearance and aesthetic features, clinical content, error prevention, and help and documentation) emerged. PCP found the mobile app attractive and relevant sections were easy to find. They suggested adding 'zoom/swipe' functions and some parts needed bigger fonts. Patients commented that the app was user-friendly, has nice interface, and straightforward language. It helped them understand their health better. Based on these findings, the mobile app was refined.
CONCLUSION: This app was produced using a robust SDLC method to increase users' satisfaction and sustainability of its use. It could potentially improve self-management behaviour among MetS patients in primary care.
Fulltext Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Ngah NF, Muhamad NA, Mohamed SO, Abdul Aziz RA, Ma'amor NH, Ahmad Tarmidzi NA, et al.

Int J Ophthalmol, 2023;16(5):712-720.
PMID: 37206185 DOI: 10.18240/ijo.2023.05.07

AIM: To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis, treatment, and best practices of diabetic macular edema (DME). The experts' panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula. The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.
METHODS: On two different occasions, a panel of 14 retinal specialists from Malaysia, together with an external expert, responded to a questionnaire on management of DME. A consensus was sought by voting after compiling, analyzing and discussion on first-phase replies on the round table discussion. A recommendation was deemed to have attained consensus when 12 out of the 14 panellists (85%) agreed with it.
RESULTS: The terms target response, adequate response, nonresponse, and inadequate response were developed when the DME patients' treatment responses were first characterized. The panelists reached agreement on a number of DME treatment-related issues, including the need to classify patients prior to treatment, first-line treatment options, the right time to switch between treatment modalities, and side effects associated with steroids. From this agreement, recommendations were derived and a treatment algorithm was created.
CONCLUSION: A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.

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