Validation of Malay version body self-image questionnaire among Malaysia's young adults

Introduction: It is undeniable that how an individual perceive their appearance brings substantial impact on their quality of life, in terms of their social life, self-esteem and others. The problem has increased the awareness of researchers worldwide to further explore in this area. Body Self-Image Questionnaire is developed to measure body image perceptions; nonetheless, due to the cultural, language and environmental differences between western and eastern population, the validity and reliability need to be established before it can be used. Objectives: To determine the validity and reliability of the Malay version Body Self-Image Questionnaire among young adults in Malaysia, and to determine the invariance of the translated Malay version of Body Self-Image Questionnaire among gender in young adults in Malaysia. Methods: A cross-sectional study involved web-based survey was employed in this study among young adults in Malaysia. The study had 2 phases: Phase 1 exploratory factor analysis (EFA) and Phase 2 confirmatory factor analysis (CFA) and multi-group analysis. Participants were recruited using snowball sampling method. Descriptive, exploratory factor analysis, confirmatory factor analysis and multi group analysis were applied in the statistical analysis. Results: A total of 688 respondents participated in this study, Phase 1 EFA consisted 188 respondents; Phase 2 CFA and multi-group analysis consisted 500 respondents. For Phase 1 study, the majority of the respondents were female (67%), Malay (93.6%), single (80.9%) and students (56.4%). Results for EFA showed factor loading of all the items ranged from 0.329 to 0.921, and communalities ranged from 0.338 to 0.780. The final measurement modelusing CFA had fit indices: CFI = 0.927, TLI = 0.913, SRMR = 0.075, RMSEA = 0.053 (90%CI: 0.047, 0.060), CF fit = 0.203. The fit indices were within the acceptable range. The composite reliability ranged from 0.736 to 0.857. For multi group analysis, weak measurement invariance was achieved but not strong and strict measurement invariance. Conclusion: The results of EFA retained all the items and re-grouped them into 4 factors. The final model for Confirmatory Factor Analysis showed good model fit, valid and reliable after removing six items. The translated Malay version of Body Self-Image Questionnaire consisted of four factors with 21 items. The Measurement of Invariance test’s results among gender showed that gender is invariant in the measurement models. The questionnaire is valid and reliable to be used among young adults in Malaysia. Keywords: Body Self-Image Questionnaire, young adults, Malaysia, validity, reliabilit

Parents’ stress level at Neonatal Intensive Care Unit Hospital USM

Medically fragile infants are born into families regardless of races, religious, cultural background, socio economical status and nationality. The undesirable and unexpected event of having own child admitted to Neonatal Intensive Care Unit (NICU) causes stress to parents that is characterized by uncertainty and fear. This study aims to assess the level of stress among parent whose infant admitted to NICU and factors contributing to parental stress. A cross-sectional, descriptive study was conducted in 104 respondents whose infant admitted to NICU Hospital Universiti Sains Malaysia using convenience sampling method. Respondents were surveyed using a structured self-administered questionnaire. The questionnaire consisted 26 questions and respondents evaluated each questions on a five- point Likert scale. Data were analyzed using IBM SPSS Statistics version 20.0. Chi- Square test and Fisher’s Exact Test were used to analyze the data. A p-value of equal or less than 0.05 was considered significant. 104 respondents participated in this study. Respondents generally reported low (60.6%) to moderate (36.5%) level of stress when their infant admitted to NICU. Mothers perceived higher level of stress than fathers when their child admitted to NICU by showing significant difference with p-value of 0.002. Although there was no significant association between educational level and overall stress of parents (p= 0.280), there was significant mean difference between educational level and parental stress on subscales of infant appearance and behavior (p= 0.010). On the other hand, there was no significant association between gestational age and stress experienced by parents of infant admitted to NICU with p-value 0.204. There was also no significant difference between length of stay and stress of parents when their infant admitted to NICU (p= 0.180). The results warrant a need to increase awareness of health care providers especially for nurses towards stress of parents. Health care professionals must be attuned to individual differences of parents and be alert of likelihood for gender differences in stress responses between fathers and mothers. Good communication skill is also important as effective communication helps to relieve parental stress, too. It is essential to remove sources of parental stress that ultimately impaired parent infant bonding and lead to child vulnerability in future

Study of early changes in intraocular pressure following phacoemulsification

: To evaluate early postoperative changes in intraocular pressure (IOP) following phacoemulsification and intraocular lens (IOL) implantation. Method: This retrospective and observational study included 100 patients with normal IOP underwent uneventful standard phacoemulsification procedure for senile cataracts at Sarawak General Hospital over a period of six months from July 2017 to December 2017. Patient's data were retrieved from Eye Clinic records. All patients were checked for IOP with Goldmann tonometry during pre-operative assessment and one month postoperatively. Patients with pre-existing IOP related ocular disease or intraocular surgery were excluded. Effects of age, gender, comorbidity of diabetes mellitus and hypertension, eye laterality, ocular axial length and pre-operative IOP on post-operative IOP reduction were analysed. Results: Phacoemulsification was found to reduce IOP by mean of 1.07 mmHg, which was statistically significant (P < 0.001). A larger IOP reduction was seen in cases with a higher pre-operative IOP (P 0.05). Conclusion: Phacoemulsification had a significant IOP-lowering effect in normal subjects, in particular in higher pre-operative IOP. There was no correlation between age, gender, comorbidity of diabetes mellitus or hypertension, eye laterality, and ocular axial length to IOP reduction following hacoemulsification

Endothelin-1 supports clonal derivation and expansion of cardiovascular progenitors derived from human embryonic stem cells

Coronary arteriogenesis is a central step in cardiogenesis, requiring coordinated generation and integration of endothelial cell and vascular smooth muscle cells. At present, it is unclear whether the cell fate programme of cardiac progenitors to generate complex muscular or vascular structures is entirely cell autonomous. Here we demonstrate the intrinsic ability of vascular progenitors to develop and self-organize into cardiac tissues by clonally isolating and expanding second heart field cardiovascular progenitors using WNT3A and endothelin-1 (EDN1) human recombinant proteins. Progenitor clones undergo long-term expansion and differentiate primarily into endothelial and smooth muscle cell lineages in vitro, and contribute extensively to coronary-like vessels in vivo, forming a functional human–mouse chimeric circulatory system. Our study identifies EDN1 as a key factor towards the generation and clonal derivation of ISL1+ vascular intermediates, and demonstrates the intrinsic cell-autonomous nature of these progenitors to differentiate and self-organize into functional vasculatures in vivo

Data-Driven Analysis of COVID-19 Reveals Persistent Immune Abnormalities in Convalescent Severe Individuals

Severe SARS-CoV-2 infection can trigger uncontrolled innate and adaptive immune responses, which are commonly associated with lymphopenia and increased neutrophil counts. However, whether the immune abnormalities observed in mild to severely infected patients persist into convalescence remains unclear. Herein, comparisons were drawn between the immune responses of COVID-19 infected and convalescent adults. Strikingly, survivors of severe COVID-19 had decreased proportions of NKT and Vδ2 T cells, and increased proportions of low-density neutrophils, IgA+/CD86+/CD123+ non-classical monocytes and hyperactivated HLADR+CD38+ CD8+ T cells, and elevated levels of pro-inflammatory cytokines such as hepatocyte growth factor and vascular endothelial growth factor A, long after virus clearance. Our study suggests potential immune correlates of “long COVID-19”, and defines key cells and cytokines that delineate true and quasi-convalescent states

Genetic Drivers of Heterogeneity in Type 2 Diabetes Pathophysiology

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P \u3c 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care

Genetic drivers of heterogeneity in type 2 diabetes pathophysiology

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P &lt; 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.</p

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe