E-cigarette use and perception among Malaysian: findings from text-mining analytics

Introduction: E-cigarette use among adults are steadily increasing over the past few years. It is highlighted by the significant increases in online search queries and sharing of information through social media, such as Twitter. However, little attention has been given on understanding the reasons that led to e-cigarette use among Malaysian. In particular, study that leverage the opportunity to extract critical information from textual data in social media by using text mining technique. It is the aim of this paper to share the potential use of such technique by providing overview of processes and examples of the insights derived from the analysis. Methods: In this study, the textual analytics was used to identify topics and extract meanings from social media posts, in this case Twitter. The messages posted by Malaysian users from 2012 to early 2017 containing any of the selected keywords or phrase (i.e., #vape, #ecig, #vaping, #ejuice, #vapemalaysia) were collected using its search application programming interface (API). A total of 4211 messages containing original tweets were retrieved. Results: The result from the text mining analytics show that mainly there were three themes emerged on the reasons of e-cigarette use, namely: the sense of being part of a bigger community, e-cigarette is perceived more fun as compared to smoking conventional cigarette, and flavour of e-liquid. The result also shows that there was a spike on Twitter activity in 2015, where the topic on vape community were mostly posted. Discussion: The three themes identified in this study reveal initial reactions of public to Malaysian Government initiatives to regulate e-cigarette. It is believed that such findings would allow the government and medical practitioners to better understand public knowledge levels and identify current misunderstandings

Role of coping mechanisms to psychosocial stress in early development of hypertension in young adults: a pilot study

Hypertension is a major risk factor for cardiovascular diseases, one of the leading causes of death worldwide. Prehypertension is a precursor of hypertension, with high prevalence in young adults. Psychosocial stress can be one of the modifiable risk factors for hypertension. The objective of the study is to assess the relationship between coping mechanism to psychosocial stress and early hypertension in young prehypertensive, mild essential hypertensive and normotensive subjects. A comparative cross-sectional pilot study was conducted in 36 young adults aged less than 45 years. The pulse rate, the blood pressure, and the body mass index of the respondents were recorded. Psychosocial stress was measured by plasma cortisolfollowing an acute mental stress test; and the level of stress and the coping strategies were assessed by using validated stress questionnaires. Approximately fourty four percent of subjects had normotension and 55.56% had prehypertension and mild hypertension.Prehypertension and mild hypertension were associated with high plasma cortisol level (p=0.032), and a high body mass index (p=0.004). Maladaptive coping strategy was found to be associated with high stress scores (p=0.019). The relationship between stress and cortisol was not significant, though a higher cortisol level was noted in the high blood pressure group. Higher cortisol levels and greater BMIs were associated with prehypertension and mild hypertension in young adults. These findings are useful for future research in this area, and the continuation of the study is important in the hope to yield a more significant picture

Perceived risk and benefits of online health information among parents in Malaysia

In the last decade, studies show that the use of the Internet to access health-related information is rapidly increasing, despite the questionable quality of health information provided on various online sources. Searching for health related information is often aimed at self-healing or self-improvement of health quality and improving the health quality of other people in our care, such as our children or other family members. Despite the increased use of the Internet to access health information, there is limited research examining how perceived risk and self-efficacy may affect how one perceived the benefits they may obtain from searching health information online, especially among parents in developing countries such as Malaysia. The study shows the significant association between parents' perceived risk and perceived self-efficacy on the benefits of searching for health information online. The data was analyzed using Partial Least Square (PLS) technique. The study also found a positive association between perceived benefits of seeking health information online and their satisfaction with the information retrieved. The Goodness of Fit (GoF) of the model developed in this study is 0.809, which exceeds the cut-off value of 0.36 and shows that the model performs well

Mislabelling of nicotine content in electronic cigarette liquids in Malaysia: implications on public health

Electronic cigarette (e-cig) is a battery-operated device which vaporises nicotine solution into a form of inhalable aerosol. The level of nicotine in the liquid for e-cig (e-liquid) may vary and the typical nicotine concentration reported is between 6 to 24 mg of per ml. Based on the National Electronic Cigarette Survey (NECS) 2016, 83.9% of e-cig adult users in Malaysia preferred eliquid with 6 mg/ml nicotine. In Malaysia, nicotine in products other than tobacco is regulated under the Poisons Act 1952, restricting its sale by licensed health professionals only. However, the sale of e-liquid containing nicotine is widespread and vapers are not assured of the accuracy of content versus that on the label of the e-liquid bottle. OBJECTIVE: To determine the actual nicotine concentration in selected e-liquid brands marketed in Malaysia. Methods: Samples (81 brands) obtained from respondents of the NECS 2016 were analysed using gas chromatography mass spectrometry (GC-MS) in selective ion mode (SIM) at a certified laboratory. Results: 15 samples labelled as no or zero nicotine were found to contain nicotine. Nine samples contained level of nicotine higher than what their labels indicated. Interestingly, 57 samples had nicotine concentrations that were lower than that indicated on the labels. The nicotine concentration percentage difference between labelled and result from analysis was found to be as low as from -99.16% to -1.28% in 64 samples, while in 4 samples the difference was higher; 0.083% to 163.0%, and the remaining 13 samples had no mention of nicotine concentration on their labels. Conclusion: Significant discrepancy was detected in nicotine concentration between the labelled and analysed values among the collected e-liquid samples. Strict regulation and enforcement is needed for e-cig liquids to ensure safety of users and compliance to current regulations on nicotine

National E-cigarette Survey (NECS) 2016 in Malaysia method and population characteristic

E-cigarette and vape (ECV) use has become a worldwide phenomenon since 2010. This study aims to determine the prevalence of ever user, current user and factors associated with ECV use among Malaysian adults. This will provide evidence for policy makers to formulate appropriate measures towards regulation of ECV in Malaysia and can become a reference for other similar countries. Method: Complex sampling design was used to represent 19 million of Malaysian adult household. Samples were stratified by states and urbanity. Sampling units were districts, enumeration blocks and living quarters. All adults from the selected houses were invited to participate in this survey. Analysis was done using sampling weight and complex sampling analysis. Results: A total of 4,288 individual responded in this survey. Majority of the respondents were at 25-44 years of age group (44%), completed at least secondary level of education (69%), of Malay ethnicity (73%), Muslim (79%) and married (68%). Male and female were equally represented. Seventy two percent of the respondents were from the urban residential area (n=2,123). The prevalence of current ECV users was 3.2%, with an estimated number of 602,122 in the population. The prevalence was 3.3% and 2.9% in urban and rural respectively. ECV users were common among 18-24 years old, male and those with tertiary level education. Discussion: This study able to represent Malaysia and results can be used to guide healthcare managers to manage e-cigarette use in the country

Translation and content validation of Bahasa Malaysia version of the food insecurity experience scale (FIES)

INTRODUCTION: Food insecurity can be defined as the limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire foods in socially unacceptable ways. Food insecurity is recognized as a public health issue worldwide where it is clearly described under the Sustainable Development Goals (SDGs) number 2: End hunger and achieve food security. To understand the complexity, multifaceted nature of food insecurity in Malaysia needs established tool and adequate data. This study aimed to translate and validate the English version of Food Insecurity Experience Scale (FIES) into Bahasa Melayu (BM) by adopting the guideline of the World Health Organization (WHO) on questionnaire translation. METHODS Two forward and backward translations involving experts in food insecurity study and experts in language were done as stipulated in a guideline. Content validity by the experts and face validity by the target population were conducted as part of validation process. RESULT Content Validity Index (CVI) and FactorialValidity Index (FVI) was done to analyses content validity. RESULTS The harmonized BM version of FIES was produced with 100% CVI. However, FVI was inconsistent. Hence a factor analysis should be done to asses the full degree of FVI. CONCLUSION The full validation study of BM version FIES especially construct and criterion validity needed to be done before it is widely used to measure food insecurity in the population specifically Malaysian population

Chronic organic arsenic induced liver ultra structural damage

Introduction: Inorganic arsenic is one of the environmental toxins that has been associated with increased risk of cardiovascular diseases and vascular contributions to liver diseases. It has generally been thought to be more toxic than organic arsenic. In human liver, inorganic arsenic promotes vascular remodelling, portal fibrosis and hypertension. The purpose of the current study was to determine whether chronic exposure to organic arsenic impair liver ultrastructure as in inorganic arsenic exposure. Materials and Methods: Twenty eight male SpragueDawley rats were divided into 2 groups with their own control group. They received oral intubation of monosodium- methylarsonate (MSMA) at 63.30 mg/kg body weight for 4 and 6 months duration respectively while the control groups received distilled water. The liver of euthanized rats were perfused- fixed with glutaraldehyde for transmission electron microscopy processing. Results: TEM revealed a marked reduction in the number of mitochondria in both treatment groups. Some typical features of apoptosis are present with pyknotic nuclei of hepatocytes and disintegrated hepatic cytoplasm in 4- month groups. The microvilli of hepatocyte are almost completely absent with the presence of many fibre bundles (collagen fibres) widening the space of Disse. In 6-month treatment group, disintegrated cytoplasms are more prominent with degrading mitochondria of varying stages. Liver sinusoidal endothelial cells (LSEC) of 6-month treatment group are noted to have chromatin condensation with few caveolae seen. Conclusion: Chronic exposure of MSMA leads to necrotic changes of hepatocytes and apoptotic changes in LSEC and collagenisation in the space of Disse

Relationship between coping mechanisms to psychosocial stress with blood pressure in young adults: a pilot study

Background: Hypertension is a major risk factor for cardiovascular diseases, one of the leading causes of death worldwide. Prehypertension is a precursor of hypertension, with high prevalence in young adults. Psychosocial stress can be one of the modifiable risk factors for hypertension. The objective of the study is to assess the relationship between coping mechanism to psychosocial stress and the blood pressure of young adults. Methods: A comparative crosssectional pilot study was conducted in 36 young adults aged less than 45 years. The pulse rate, blood pressure and body mass index of the respondents were recorded. Psychosocial stress was measured by plasma cortisol following an acute mental stress test; and the level of stress and the coping strategies to stress were assessed using validated Malay Version questionnaires: DASS- 21 and Brief R-COPE questionnaires. Results: Forty four percent of subjects had normotension and fifty six percent had above-normal blood pressure (prehypertension and mild hypertension). Subjects with above-normal blood pressure were associated with high plasma cortisol levels (p = 0.032), and high body mass indexes (BMI) (p = 0.004). Maladaptive coping strategy was found to be associated with high stress scores (p = 0.019). The relationship between stress and cortisol was not significant, though a higher cortisol level was noted in the high blood pressure group. Conclusion: In conclusion, higher cortisol levels and greater BMIs were associated with above-normal blood pressure in young adults. These findings are useful for future research in this area, and the continuation of this study will hopefully yield a more significant relationship

Liver Sinusoidal Endothelial Cell (LSEC) isolation following a liver perfusion technique

Introduction: Liver perfusion has been the standard method to digest and isolate liver cells including liver sinusoidal endothelial cells (LSEC). Poor cannulating skills through portal vein results in a waste of animal resource. Familiarization of both liver perfusion technique and adhering strictly to aseptic technique during cell handling ensure high cell yield, minimum morphology disruption and cell contamination. We aimed to present a method of liver perfusion procedure followed by the isolation of LSEC. Materials and method: The study was conducted with the approval of IACUC committee. Seven Sprague Dawley rats underwent these procedures under anaesthesia. Liver perfusion was done as previously described. Briefly, LSEC were isolated by liberase enzyme perfusion of the liver, isopycnic sedimentation in a two- step Percoll gradient and selective adherence. The purification and cultivation of LSEC was evaluated by light and electron microscopy. Results: Purity and viability of LSEC after selective adherence was 80.5 ± 3.5% and ≥ 95 %, respectively. The average concentration of the cells ranged from 32 - 75 x 106 per 400 gm rat. After 8 hours of culture, LSEC monolayers were contaminated with less than 5% of other cells. Conclusion: This method is reliable and reproducible for the isolation of LSEC to enable the study of structure and function of these cells in vitro. However, improvement on the perfusion skills and isolation technique are vital to ensure better cell purity

Comparison of flow gap-related artefact and its time acquisition in between phase contrast and time of flight (TOF) MR cerebral venography In 3T MR

Introduction: Cerebral magnetic resonance venography (MRV) is known as a non-invasive tool to investigate the intracranial disease. Commonly used techniques for patient with contraindication to intravenous contrast media are Time of Flight (TOF) and phase contrast (PC). We herein interest to compare which techniques causing more flow gap-related artefact and less time consuming. Material and method: A prospective cross-sectional study in which 31 healthy volunteers with age group between 18-35-year-old were recruited during this 20-month study period. They were imaged on 3 Tesla MR at Radiology Department of International Islamic University Malaysia using a standardized parameter for PC and TOF MRV. The images were post-processed using maximum intensity projection (MIP). The intracranial venous system was divided into 7 vessels groups which include superior sagittal sinus (SSS), inferior sagittal sinus, straight sinus, transverse sinus (TS), sigmoid sinus, internal cerebral vein and vein of Galen. They were assessed by a neuroradiologist for any flow-gap related artefact. Time acquisition for both studies were also compared. Results: PC MRV shows significant lesser evidence of flow-gap related artefact than TOF MRV in SSS (P = 0.001) and TS (P = 0.002). No significant differences in other veins (P > 0.05). However, PC MRV significantly took longer acquisition time with mean of 5.25 minutes in comparing with TOF MRV which only took about 4.21 minutes to complete the study. Conclusion: PC MRV is a better tool than TOF MRV for assessing the intracranial cerebral veins and should be utilized more in the future for better accuracy of diagnosis despite its relatively longer acquisition time