LAND SNAKES OF MEDICAL SIGNIFICANCE IN MALAYSIA

The range of snakes of medical significance in Malaysia currently encompasses four families of snakes (Natricidae, Elapidae, Pythonidae and Viperidae). There are limited data on the distribution of snakes in the country. The following account is based on available published information on snakes recorded from Peninsular Malaysia, Labuan, Sabah and Sarawak. This book should be viewed as a guide, especially for healthcare professionals, to identify and manage snake related injuries in Malaysia. Information on the snake species listed here is based on the local data and those from neighbouring countries. Due to their geographical proximity, snakes occurring in Peninsular Malaysia are genetically closer to those from Thailand and Singapore, while those on Sabah and Sarawak are naturally closer to populations from Brunei Darussalam, Kalimantan and islands of the southern Philippines

Effect of Cangrelor on Infarct Size in ST-Segment Elevation Myocardial Infarction Treated By Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial)

Background: The administration of intravenous cangrelor at reperfusion achieves faster onset of platelet P2Y12 inhibition than oral ticagrelor and has been shown to reduce myocardial infarct (MI) size in the pre-clinical setting. We hypothesized that the administration of cangrelor at reperfusion will reduce MI size and prevent microvascular obstruction (MVO) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Methods: This was a Phase 2, multi-center, randomized, double-blind, placebo controlled clinical trial conducted between November 2017 to November 2021 in six cardiac centers in Singapore (NCT03102723). Patients were randomized to receive either cangrelor or placeboinitiated prior to the PPCI procedure on top of oral ticagrelor. The key exclusion criteria included: presenting <6 hours of symptom onset, prior MI and stroke or transient ischemic attack; on concomitant oral anticoagulants; and a contraindication for cardiovascular magnetic resonance (CMR). The primary efficacy endpoint was acute MI size by CMR within the first week expressed as percentage of the left ventricle mass ( %LVmass). MVO was identified as areas of dark core of hypoenhancement within areas of late gadolinium enhancement. The primary safety endpoint was Bleeding Academic Research Consortium (BARC)-defined major bleeding in the first 48 hours. Continuous variables were compared by Mann-Whitney U test [reported as median (1st quartile- 3rd quartile)] and categorical variables were compared by Fisher's exact test. A 2-sided P<0.05 was considered statistically significant. Results: Of 209 recruited patients, 164 patients (78% ) completed the acute CMR scan. There were no significant differences in acute MI size [placebo: 14.9 (7.3 - 22.6) %LVmass versus cangrelor: 16.3 (9.9 - 24.4)%LVmass, P=0.40] or the incidence [placebo: 48% versus cangrelor: 47%, P=0.99] and extent of MVO [placebo:1.63 (0.60 - 4.65)%LVmass versus cangrelor: 1.18 (0.53 - 3.37)%LVmass, P=0.46] between placebo and cangrelor despite a two-fold decrease in platelet reactivity with cangrelor. There were no BARC-defined major bleeding events in either group in the first 48 hours. Conclusions: Cangrelor administered at time of PPCI did not reduce acute MI size or prevent MVO in STEMI patients given oral ticagrelor despite a significant reduction of platelet reactivity during the PCI procedure

Development and validation of a physical activity games playability scale

For the past three decades, the prevalence of childhood obesity has been on the rise and correspondingly engagement time in sedentary activities has escalated. In contrast, interest, and participation rates in physical education classes are declining. Fun and interesting physical activity (PA) games could help to prevent the decline and possibly reverse inactivity. The purpose of this study was to develop and validate a Physical Activity Playability Scale (PAGPS) in order to provide more detailed “game information” assisting end users (e.g., policy makers, PE teachers, et al.) in choosing the “best possible” children’s PA games. A two-stage development and validation process was employed for this study. Five content experts (N=5) were recruited to draft and develop the PAGPS scale. By applying the heuristic approach, content experts selected, reviewed, commented, evaluated, and eventually determined the relevant PA games factors/subscales, which helped in establishing the content validity evidence for the PAGPS. Ten factors that were identified to represent game domain were Fun, Social, Cognitive, Physical, Skills, Game Structure, Language, Environment, Game Difficulty, and Player’s Characteristics, and a total of 116 items were developed for these factors. Two hundred PE teachers (N=200) were recruited in Malaysia to further determine the most suitable items for the PAGPS. Principal Component Analysis (PCA) was chosen to systematically trim the large amount of variables but maintain as much of the information from the PAGPS (draft) data set. A six-factor construct (with 99 items), including fun and social, cognitive, physical and skills, games structure and environment, game difficulty and player’s characteristics and language were confirmed for the PAGPS. Rasch Analysis, an item response theory approach, was then chosen for the item reduction process by taking advantage of the analysis (i.e., invariance, ability to locate all facets on a same scale, and additive) over the classical testing theory based approach. Items were deleted based upon three criterions: goodness-of-fit statistics, item difficulty (logits), and content balance. As a result, four shorter PAGPS versions were created, with 51-item, 36-item, 28-item and 20-item, respectively. The 51-item version was chosen because of its high correlation (r = .98) with the original 99-item version and its balanced content coverage. Cronbach’s alpha analysis was also performed to determine the internal structural consistency. Ten Malaysian PA games were selected to validate the 51-item PAGPS (Game Rating Scale), including One-Leg, Kali-Tui, Blind Man’s Bluff, Simon Says, Eagle and Hen, Hopscotch, Police and Thief, Duck Duck Goose, Monkey in the Middle, and Mr. Wolf. Sixty children (N=60) consisting of two age-groups (Grade 2: n= 30, Grade 5: n= 30) were recruited to play all ten PA games, their reactions towards each game were video-recorded for rating purposes. Ten raters (N=10) scored each PA game video (10 videos for Grade 2 and 10 videos for Grade 5, respectively) using the 51-item PAGPS. The rating scores were analyzed for inter-rater reliability evidence, discriminant evidence (P and K coefficient), and game descriptive statistics (validity evidence). Inter-rater reliability was found to be within a good range of .70-.91, P coefficient from .15-1.00 and K coefficient from -.70-1.00. Together, reliability evidence (i.e., internal structure reliability and inter-rater reliability) and validity evidence (content validity, discriminant validity and games’ descriptive statistics) provided preliminary support for the psychometric quality of the PAGPS (Game Rating Scale). This study also illustrated that, with a combination of the convent balance, Rasch analysis can be used effectively for item reduction while maintaining the psychometric properties of the original measure. More PA researchers should take advantage of this method when developing and constructing measures

Cross-Cultural Adaptation of the Urdu Version of Rosenbaum Concussion Knowledge and Attitude Survey—Student Version

Evaluating athletes’ knowledge and attitude towards sports-related concussions is important. However, there is limited research involving South Asian athletes, partly due to the lack of a valid and reliable tool. This study, therefore, aimed to translate and validate the Rosenbaum Concussion Knowledge and Attitude Survey—Student Version (RoCKAS-ST), an established tool used to measure knowledge and attitude towards concussion, into Urdu. RoCKAS-ST was translated into Urdu using the standard guidelines and then completed by 369 athletes participating in contact sports at different universities in Pakistan. Confirmatory factor analysis was performed on the Concussion Attitude Index (CAI) items to examine the underlying factorial structure. Construct validity of CAI factors was also investigated using convergent and discriminant validity. The results showed that the Urdu version of RoCKAS-ST is a valid tool for evaluating Urdu-speaking athletes’ knowledge and attitudes towards concussions and is thus suitable for evidence-based concussion awareness interventions

The Athletic Religious Faith Scale: Part II—Development and Initial Validation

The Athletic Religious Faith Scale (ARFS) is an instrument measuring religious faith in a sporting context. This study validated the ARFS using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to reach a final version of the scale. Using the EFA, seven domains were classified: religious coping (9 items), religious psychological effects (5 items), dependence on faith (5 items), religious mental healing (6 items), flow (4 items), athletic identity (4 items), and religious dietary practices (7 items). Using CFA, all construct factor loadings were over 0.5. Composite reliability and Cronbach’s alpha values indicated adequate reliability (0.81–0.94) for all ARFS domains. The convergent validity and discriminant validity of all constructs were also established. Overall, the ARFS is a reliable and valid assessment tool for measuring religious faith in athletes. The ARFS could potentially be used with athletes of various religious affiliations in different countries, cultures, and sporting contexts

Understanding Players&rsquo; Sportspersonship Attitude, Expectancy-Related Beliefs, and Subjective Task Values in Field Hockey: An Integrated Approach

(1) Background: The purpose of this study was to examine the relationship between expectancy-value components and attitudes toward sportspersonship among Malaysian adolescent field hockey players. This study also examined the effect of expectancy beliefs, task values, and sportspersonship attitude on the motivation of adolescent field hockey players by gender and age group. (2) Methods: The Malay versioned Expectancy Value Model Questionnaire and the Malay versioned Multidimensional Sportspersonship Orientations Scale were administered on 730 respondents (&micro; = 15.46 &plusmn; 1.83 years). (3) Results: The expectancy values and attainment value (r = 0.894), utility value and attainment value (r = 0.833) were highly correlated. There was no significant gender difference in expectancy, task values, and sportspersonship attitude dimensions. The main effect of age group was significant on task values: F (2724) = 4.19; p = 0.01. The difference was indicated between age groups of 15&ndash;16 years and 12&ndash;14 years (p = 0.02, d = 0.014) under task values variable. (4) Conclusions: There is no significant relationships between sportspersonship attitude (MSOS-M) and of expectancy beliefs and task values (EVMQ-M). To conclude, female and younger players demonstrate lower expectancy beliefs, task values, and sportspersonship attitudes than male and older field hockey players

Psychometrics' Properties of Sports Commitment Questionnaire-2 among Racquet Sports Athletes in Malaysia

Background. Sports psychologists believe sports commitment is important to indicate the desire to continue or cease participation in sports from a psychosocial perspective. The Sports Commitment Questionnaire-2 (SCQ-2) has been developed and validated to investigate athletes’ commitment in sports settings in Western countries but not in Malaysia. Hence, it is essential to establish instrument validity before being widely used in Malaysia, especially among athletes.Objectives. This study aimed to evaluate the psychometric properties of the Sports Commitment Questionnaire-2 (SCQ-2) among Malaysian racquet sports athletes.Methods. This is a cross-sectional study, a total of 416 players (245 males/ 171 females, µ age=29.94±11.47) completed the SCQ-2 (Scanlan et al., 2016) consisting of 58 items measuring ten factors and two dimensions of sports commitment. We examined the psychometric properties of SCQ-2, by conducting Confirmatory Factor Analysis and examined discriminant validity and composite reliability (CR).Results. Initial fit indices of the hypothesized measurement model did not achieve satisfactory fit. But, after further model modification i.e., deleting 3 items resulted in good data fit (CFI=0.90, RMSEA=0.05, TLI=0.90, X²/df=2.14). Discriminant validity also met the suggested cutoff value (Conclusion. The SCQ-2 showed adequate validity and reliability which enable sports practitioners to access athletes' commitment in a sports context

Future Military Force Possibilities Study, 2001-2021: Korea, Australia, Japan: a Strategic Decision of National Security Evolution.

This study describes the evolution of a possible future for Asia 2001-2021. It envisions the realization of two longstanding US goals: peaceful political unification of Taiwan and the People’s Republic of China, and, peaceful Korean unification. Nothing dramatic occurs on the global front, no major wars break out, and both economic and technological change are evolutionary rather than revolutionary. In short, we develop an example of what Herman Kahn called a “surprise free” scenario. The officer-students in the first class of the Systems Engineering and Integration (SEI- 1) curriculum developed the above scenario in detail for Korea, Australia and Japan. They are responsible for Chapters 3, 4 and 5, which describe the evolution of Korean unificationAustralian efforts to cement protective relations with the United States and others with interests in a peaceful, free Asiaand the “coming out of the penalty box” by Japan as she rides her reinvigorated economy and takes increasing responsibility for her own defense