The Third National Health and Morbidity Survey (NHMS III) 2006: nutritional status of adults aged 18 years and above

1Department of Nutrition Research, Institute for Public Health, Ministry of Health, Kuala Lumpur; 2Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor; 3Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur; 4Epidemiology and Biostatistics Unit, Institute for Medical Research,Kuala Lumpur; 5Clinical Epidemiology Unit, Clinical Research Centre, Ministry of Health, Kuala Lumpur; 6Department of Paediatrics, Universiti Kebangsaan Malaysia, Kuala Lumpur; 7Department of Community Health and Family Medicine, Faculty of Medicine, International Islamic University, Kuantan The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 to determine the nutritional status of a nationally representative sample of Malaysian adults aged 18 years and above. Body weight, height and waist circumference measurements were taken by trained health nurses according to a standard procedure (WHO, 1998). Body Mass Index (BMI) was determined among 33,055 eligible adults, while risk of abdominal obesity based on waist circumference (WC) was obtained from 32,900 individuals. In addition, peripheral muscle wasting was determined using calf circumference (CC) among 4,282 older individuals aged 60 years and above. The national prevalence of normal BMI (BMI 18.5-24.9 kg/m2) was 48.4% (47.7–49.0)*. The prevalence of underweight (BMI <18.5 kg/m2) was 8.5% (8.2–8.9), being higher in rural areas {9.8% (9.2–10.4)} than in urban areas {7.8% (7.4–8.3)}. Meanwhile, 29.1% (28.6–29.7) of the adults were overweight (BMI 25.0-29.9 kg/m2). Among the ethnic groups, Indians had the highest prevalence of overweight followed by Malays and Chinese. In addition, 14.0% (13.6–14.5) of the adults were obese (BMI >30.0 kg/m2). Women had higher obesity prevalence at 17.4% (16.7–18.0) than men at 10.0% (9.5–10.5). In terms of ethnic groups, Indians and Malays had higher obesity prevalence than other groups. By occupation category, housewives showed the highest prevalence of obesity at 20.3% (19.4–21.3). The prevalence of abdominal obesity (WC for women >88 cm and men >102 cm) was 17.4% (16.9-17.9), with women showing higher prevalence {26.0% (25.2-26.8)} than men {7.3% (6.7-7.6}. The prevalence of older persons with peripheral muscle wasting (calf circumference for women < 27.3 cm and men < 30.1 cm) was 19.9% (18.5–21.6), with a higher prevalence of men {23.7% (21.6-25.9)} than women {16.8% (15.1-18.5)} at risk of malnutrition according to this indicator. In comparison, the present national prevalence of underweight of 8.5% was three times lower than that (25.2%) reported in the NHMS II in 1996. In contrast, the prevalence of overweight hasof 14.0% in this study and 12.7% in the MANS were approximately three times the level of 4.4% found in 1996 (NHMS III). This alarming trend calls for serious re-examination of public health programmes for more effective reduction of obesity among Malaysian adults. increased from 16.6% in the NMHS II to 29.1% in the present study. The latter is comparable with the finding of 27.4% reported in another nationally representative sample involving over 5,000 adults namely, the Malaysian Adults Nutrition Survey (MANS) conducted in 2003. It is noted that obesity prevalence of 14.0% in this study and 12.7% in the MANS were approximately three times the level of 4.4% found in 1996 (NHMS III). This alarming trend calls for serious re-examination of public health programmes for more effective reduction of obesity among Malaysian adults

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Tumor Region Localization in H&E Breast Carcinoma Images Using Deep Convolutional Neural Network

Digital pathology incorporates the acquisition, management, sharing and interpretation of pathology information in a digital environment. The field of digital pathology is currently regarded as one of the most promising avenues of diagnostic medicine. Many computer-aided detection and diagnostic algorithms has been developed to assist pathologists in their daily clinical routine, with varying degree of success. These include cell detection and counting, tissue classification and cancer grading, among others. Deep learning, or more specifically, deep convolutional neural network, is a machine learning algorithm that has also gained a lot of attention recently due to their ability to achieve state-of-the-art accuracy. In this paper we have constructed and expanded the deep model network to localize tumor regions in histology images of breast carcinoma. We proposed our own deep convolutional neural network with lesser hardware requirement using 64×64×3 input patch. Our proposed method is able to provide reliable tumor region localization, visually and objectively, based on very limited training dataset

Cells Detection and Segmentation in ER-IHC Stained Breast Histopathology Images

In this paper, we present our recent work on cells detection and segmentation in estrogen receptor immunohistochemistry (ER-IHC)-stained breast carcinoma images. The proposed cell detection and segmentation is very useful in the predictive scoring of hormone receptor status in ER-IHC stained whole-slide images, which helps pathologists to decide whether a patient should be offered hormonal therapy or other treatments. The proposed method is based on deep convolutional neural network, followed by watershed-based post-processing. The cell detection results are compared and evaluated objectively against the ground truth provided by our collaborating pathologists. The cell segmentation results, on the other hand, are evaluated visually by overlaying the computer segmented boundaries on the ER-IHC images for comparison. The automated cell detection algorithm recorded precision and recall rates of 95% and 91% respectively. The very promising performances for both the detection and segmentation paves the way for an automated system for hormone receptor scoring in ER-IHC stained whole-slide breast carcinoma image

Effects of Betahistine on Vestibulo-Ocular Reflex in normal healthy adults: a randomized double-blind, placebo-controlled trial

Introduction Vertigo, or the perception of a spinning sensation, is a common symptom experienced by patients who are referred to Otorhinolaryngology clinics. Betahistine is a medication that has been widely used to treat vertigo and its accompanying symptoms. However, the effects of this medication on the vestibulo-ocular reflex (VOR) are still unknown. Initially, it was assumed that betahistine should be discontinued prior to any vestibular tests, particularly the video head impulse test (vHIT). Method Thirty young healthy adults were randomly divided into two equal groups for this randomized double-blind clinical study (betahistine 24 mg and placebo). Baseline pure-tone audiometry (PTA), tympanometry, and VOR measurements were taken, followed by experimental measurements at one hour, four hours, eight hours, and 24 hours after consumption. The video head impulse test (vHIT) was used to determine the VOR. Result Betahistine had no statistically significant effect on vestibulo-ocular reflex gain (F(4,140) = 0.601, p = 0.662). The gain variability across repetitive head impulses remained constant over time. Conclusions Betahistine has no effect on the vestibulo-ocular reflex. As a result, this medication can be taken prior to the vHIT procedure

Modeling of Stochastic Temperature and Heat Stress Directly Underneath Agrivoltaic Conditions with Orthosiphon Stamineus Crop Cultivation

This paper presents the field measured data of the ambient temperature profile and the heat stress occurrences directly underneath ground-mounted solar photovoltaic (PV) arrays (monocrystalline-based), focusing on different temperature levels. A previous study has shown that a 1degC increase in PV cell temperature results in a reduction of 0.5% in energy conversion efficiency; thus, the temperature factor is critical, especially to solar farm operators. The transpiration process also plays an important role in the cooling of green plants where, on average, it could dissipate a significant amount of the total solar energy absorbed by the leaves, making it a good natural cooling mechanism. It was found from this work that the PV system's bottom surface temperature was the main source of dissipated heat, as shown in the thermal images recorded at 5-min intervals at three sampling times. A statistical analysis further showed that the thermal correlation for the transpiration process and heat stress occurrences between the PV system's bottom surface and plant height will be an important factor for large scale plant cultivation in agrivoltaic farms

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies