Progression In Recognising Diversity, Fostering Inclusiveness and Equality in Malaysia

Men and women are both inherently equal; the issue is that they do not always have equal rights in practice, but the supporting pieces of evidence are limited. The Malaysian Constitution, which guarantees civil rights and equality, includes state institutions dedicated to maintaining gender equality and policies designed to that end. However, adverse reports criticised the judicial system and emphasised fair chances for all, supporting and appreciating differences, and ensuring equal access. Anti-discriminatory practices are a contentious subject, but there must be an assessment to see if today's youth have retained a memory of the past and a sense of good values and proper mechanisms for peaceful coexistence in the pursuit of social equity and diversity and inclusivity in Malaysia. The opportunities for Malaysia to promote human rights, eliminate gender-based violence and injustice are more excellent now than they have been in the country's history. The study's intriguing results are directly linked to practice and lead to several other routes for further investigation

Incomplete LU preconditioner for FMM implementation

An incomplete LU (ILU) preconditioner using the near-field matrix of the fast multipole method (FMM) is investigated to increase the efficiency of the iterative conjugate gradient squared (CGS) solver. Unlike the conventional LU, ILU requires no fill ins, and hence no extra memory and CPU time in computing the LU decomposed preconditioner. It is shown that, due to the nature of the near-field matrix, ILU preconditioning decreases the number of iterations dramatically. © 2000 John Wiley & Sons, Inc. Microwave Opt Technol Lett 26: 265–267, 2000.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35044/1/18_ftp.pd

The Moderating Effect of Gender Differences between Mentoring and Individuals’ Career

This study was conducted to examine the effect of mentoring program and gender differences on individuals’ career using 153 usable questionnaires gathered from employees who work in one public university in Sarawak, Malaysia. Outcomes of hierarchical regression analysis showed two important findings: firstly, interaction between formal mentoring and gender differences positively and significantly correlated with individuals’ career. Secondly, interaction between informal mentoring and gender differences positively and significantly correlated with individuals’ career. This result confirms that gender differences do act as a moderating variable in the mentoring model of the organizational sample. In addition, implications and discussion are elaborated

Analytical study of nonlinear phase shift through stimulated Brillouin scattering in single mode fiber with the pump power recycling technique.

We present a theoretical study of nonlinear phase shift through stimulated Brillouin scattering in single mode optical fiber. Analytical expressions describing the nonlinear phase shift for the pump and Stokes waves in the pump power recycling technique have been derived. The dependence of the nonlinear phase shift on the optical fiber length, the reflectivity of the optical mirror and the frequency detuning coefficient have been analyzed for different input pump power values. We found that with the recycling pump technique, the nonlinear phase shift due to stimulated Brillouin scattering reduced to less than 0.1 rad for 5km optical fiber length and 0.65 reflectivity of the optical mirror, respectively, at an input pump power equal to 30mW

Frequency modulation response due to the intensity modulation of fiber-grating Fabry–Perot lasers

A comprehensive study on the small-signal frequency modulation (FM) characteristics of a fiber-grating Fabry–Perot (FGFP) laser is numerically conducted. Fiber Bragg grating (FBG) is used as a wavelength selective element to control the properties of the laser output by controlling the external optical feedback (OFB) level. In addition to the external OFB level, the effect of other parameters such as temperature, injection current, cavity volume, nonlinear gain compression factor, linewidth enhancement factor, and fiber-grating (FG) parameters on FM characteristics of the laser are investigated. The study is performed by modifying a set of rate equations that are solved by considering the effects of external OFB and ambient temperature (T) variations. The temperature dependence (TD) of FM characteristics is calculated according to TD of laser parameters instead of using well-known Pankove relationship. Results show that the optimum external fiber length (Lext) is 3.1 cm and the optimum range of working temperature for FGFP laser is within ± 2 °C from the FBG reference temperature (To). Also, it is shown that antireflection (AR) coating reflectivity and the linewidth enhancement factor have no significant effect on the FM response. The FM spectra peak amplitude is less than 5 dB with 5 mW output power. Good temperature stability is also obtained

A stabilized tunable dual wavelength erbium-doped fiber laser with equal output power

Tunable dual-wavelength erbium-doped fiber laser with good stability is experimentally demonstrated. Output power of as high as +5.26 dBm is obtained in dual ring configuration. Both laser output can be tuned to as closed as 0.8 nm spacing between each other, with tuning range of 31.33 nm. The stability of both outputs was tested that results in less than ±0.8 dB and ±0.01 nm in power and wavelength fluctuation, respectively

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication