Household catastrophic healthcare expenditure and impoverishment due to rotavirus gastroenteritis requiring hospitalization in Malaysia.

BACKGROUND: While healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking. OBJECTIVES: We assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia. METHODS: A two-year prospective, hospital-based study was conducted from 2008 to 2010 in an urban (Kuala Lumpur) and rural (Kuala Terengganu) setting in Malaysia. All children under the age of 5 years admitted for acute gastroenteritis were included. Patients were screened for rotavirus and information on healthcare expenditure was obtained. RESULTS: Of the 658 stool samples collected at both centers, 248 (38%) were positive for rotavirus. Direct and indirect costs incurred were significantly higher in Kuala Lumpur compared with Kuala Terengganu (US$222 Vs. US$45; p<0.001). The mean direct and indirect costs for rotavirus gastroenteritis consisted 20% of monthly household income in Kuala Lumpur, as compared with only 5% in Kuala Terengganu. Direct medical costs paid out-of-pocket caused 141 (33%) households in Kuala Lumpur to experience catastrophic expenditure and 11 (3%) households to incur poverty. However in Kuala Terengganu, only one household (0.5%) experienced catastrophic healthcare expenditure and none were impoverished. The lowest income quintile in Kuala Lumpur was more likely to experience catastrophic payments compared to the highest quintile (87% vs 8%). The concentration index for out-of-pocket healthcare payments was closer to zero at Kuala Lumpur (0.03) than at Kuala Terengganu (0.24). CONCLUSIONS: While urban households were wealthier, healthcare expenditure due to gastroenteritis had more catastrophic and poverty impact on the urban poor. Universal rotavirus vaccination would reduce both disease burden and health inequities in Malaysia

Omega-3 polyunsaturated fatty acids favourably modulate cardiometabolic biomarkers in type 2 diabetes: a meta-analysis and meta-regression of randomized controlled trials

BACKGROUND: Randomized controlled trials (RCTs) suggest that supplementation with omega-3 polyunsaturated fatty acids (n-3PUFAs) may favourably modify cardiometabolic biomarkers in type 2 diabetes (T2DM). Previous meta-analyses are limited by insufficient sample sizes and omission of meta-regression techniques, and a large number of RCTs have subsequently been published since the last comprehensive meta-analysis. Updated information regarding the impact of dosage, duration or an interaction between these two factors is therefore warranted. The objective was to comprehensively assess the effect of n-3PUFAs supplementation on cardiometabolic biomarkers including lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control, in people with T2DM, and identify whether treatment dosage, duration or an interaction thereof modify these effects. METHODS: Databases including PubMed and MEDLINE were searched until 13th July 2017 for RCTs investigating the effect of n-3PUFAs supplementation on lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control. Data were pooled using random-effects meta-analysis and presented as standardised mean difference (Hedges g) with 95% confidence intervals (95% CI). Meta-regression analysis was performed to investigate the effects of duration of supplementation and total dosage of n-3PUFAs as moderator variables where appropriate. RESULTS: A total of 45 RCTs were identified, involving 2674 people with T2DM. n-3PUFAs supplementation was associated with significant reductions in LDL [ES: - 0.10, (95% CI - 0.17, - 0.03); p = 0.007], VLDL (ES: - 0.26 (- 0.51, - 0.01); p = 0.044], triglycerides (ES: - 0.39 (- 0.55, - 0.24; p ≤ 0.001] and HbA1c (ES: - 0.27 (- 0.48, - 0.06); p = 0.010]. Moreover, n-3PUFAs supplementation was associated with reduction in plasma levels of TNF-α [ES: - 0.59 (- 1.17, - 0.01); p = 0.045] and IL-6 (ES: - 1.67 (- 3.14, - 0.20); p = 0.026]. All other lipid markers, indices of glycaemic control, inflammatory parameters, and blood pressure remained unchanged (p > 0.05). CONCLUSIONS: n-3PUFAs supplementation produces favourable hypolipidemic effects, a reduction in pro-inflammatory cytokine levels and improvement in glycaemia. Neither duration nor dosage appear to explain the observed heterogeneity in response to n-3PUFAs. Trial registration This trial was registered at http://www.crd.york.ac.uk as CRD42016050802

Off-Street Vehicular Fog for Catering Applications in 5G/B5G: A Trust-based Task Mapping Solution and Open Research Issues

One of the key enablers in serving the applications requiring stringent latency in 5G networks is fog computing as it is situated closer to the end users. With the technological advancement of vehicles’ on-board units, their computing capabilities are becoming robust, and considering the underutilization of the off-street vehicles, we envision that the off-street vehicles can be an enormously useful computational source for the fog computing. Additionally, clustering the vehicles would be advantageous in order to improve the service availability. As the vehicles become highly connected, trust is needed especially in distributed environments. However, vehicles are made from different manufacturers, and have different platforms, security mechanisms, and varying parking duration. These lead to the unpredictable behavior of the vehicles where quantifying trust value of vehicles would be difficult. A trust-based solution is necessary for task mapping as a task has a set of properties including expected time to complete, and trust requirements that need to be met. However, the existing metrics used for trust evaluation in the vehicular fog computing such as velocity and direction are not applicable in the off-street vehicle fog environments. In this paper, we propose a framework for quantifying the trust value of off-street vehicle fog computing facilities in 5G networks and forming logical clusters of vehicles based on the trust values. This allows tasks to be shared with multiple vehicles in the same cluster that meets the tasks’ trust requirements. Further, we propose a novel task mapping algorithm to increase the vehicle resource utilization and meet the desired trust requirements while maintaining imposed latency requirements of 5G applications. Results obtained using iFogSim simulator demonstrate that the proposed solution increases vehicle resource utilization and reduces task drop noticeably. This paper presents open research issues pertaining to the study to lead..

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns

Identification of two novel powdery mildew resistance loci, Ren6 and Ren7, from the wild Chinese grape species Vitis piasezkii

Descriptive statistics of the phenotypic scores within the base mapping population 11-373. Powdery mildew symptoms in the field were evaluated in two subsequent years. Greenhouse, in vitro experiments and the qPCR-based molecular assay were carried out with three to four biological replicates of each seedling plant in 2014. (DOCX 14ย�kb

Internet Addiction among Secondary School Students in Klang Valley, Malaysia: What is the Association with Depressive Symptoms, Anxiety Symptoms, and SelfEsteem?

Introduction: Internet addiction is becoming a global problem and has been associated with mental health issues such as depression and anxiety. There is a strong need for local research, given the recent rise of mental health issues amongst children and adolescents in Malaysia, as well as lack of research in this field locally. Methods: This study assessed the prevalence of internet addiction, and its association with internetrelated factors, depressive symptoms, anxiety symptoms, and self-esteem, amongst selected secondary school students in the Klang Valley, Malaysia. In a cross-sectional study, 199 adolescents were conveniently chosen from six randomly selected secondary schools within Klang Valley. Subjects completed a demographic questionnaire, as well as Malay versions of the Internet Addiction Test (MVIAT), Children’s Depression Inventory (CDI), Depression Anxiety Stress Scales-21 anxiety subscale (DASS-21) and Rosenberg Self-Esteem Scale (RSES). Multiple logistic regression analysis was carried out. Results: This study found that 49.2% of students were addicted to the internet. Significant factors associated with internet addiction were spending longer hours online during the holidays (OR 1.20, CI 1.01-1.35), easy access to a computer (OR 4.01, CI 1.50 - 10.76), confiding on the internet (OR 4.07, CI 1.49-11.13), severe level of anxiety (OR 3.63, CI 1.04-12.73) and high depression scores (OR 1.10, CI 1.01-1.20). Contrary to previous studies, self-esteem was not found to be significantly associated with internet addiction. Conclusion: This study has important implications in relation to clinical practice, research, and policy-making in Malaysia

Open-access mega-journals: A bibliometric profile

In this paper we present the first comprehensive bibliometric analysis of eleven open-access mega-journals (OAMJs). OAMJs are a relatively recent phenomenon, and have been characterised as having four key characteristics: large size; broad disciplinary scope; a GoldOA business model; and a peer-review policy that seeks to determine only the scientific soundness of the research rather than evaluate the novelty or significance of the work. Our investigation focuses on four key modes of analysis: journal outputs (the number of articles published and changes in output over time); OAMJ author characteristics (nationalities and institutional affiliations); subject areas (the disciplinary scope of OAMJs, and variations in sub-disciplinary output); and citation profiles (the citation distributions of each OAMJ, and the impact of citing journals). We found that while the total output of the eleven megajournals grew by 14.9% between 2014 and 2015, this growth is largely attributable to the increased output of Scientific Reports and Medicine. We also found substantial variation in the geographical distribution of authors. Several journals have a relatively high proportion of Chinese authors, and we suggest this may be linked to these journals’ high Journal Impact Factors (JIFs). The mega-journals were also found to vary in subject scope, with several journals publishing disproportionately high numbers of articles in certain sub-disciplines. Our citation analsysis offers support for Björk & Catani’s suggestion that OAMJs’s citation distributions can be similar to those of traditional journals, while noting considerable variation in citation rates across the eleven titles. We conclude that while the OAMJ term is useful as a means of grouping journals which share a set of key characteristics, there is no such thing as a “typical” mega-journal, and we suggest several areas for additional research that might help us better understand the current and future role of OAMJs in scholarly communication

Protective Effects of Orlistat on Lipid Profile, Cardiac Oxidative Stress Biomarkers and Histology in High-fat Diet-induced Obese Rats

Introduction: Orlistat is a widely used drug in treating obesity as it promotes weight reduction. The aim of this study was to determine the protective effects of orlistat (10 mg/kg/day) on cardiovascular parameters and oxidative stress biomarkers in high-fat diet (HFD)-induced obese rats. Methods: Twenty-four male rats Sprague Dawley rats were divided into three groups and fed with normal diet (N), HFD and HFD with orlistat (HFD+O). Orlistat was administered daily by oral gavage and after six weeks, all rats were sacrificed. Results: Administration of orlistat along with HFD (HFD+O) has brought significant decreases in Lee obesity index and LDL level compared to HFD group. Activities of cardiac superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were significantly higher, whereas level of oxidised LDL was significantly lower in HFD+O group compared to HFD group. HFD group had significantly higher necrotic patch area in myocardium while minimal histological changes were seen in HFD+O group. Conclusion: This study may suggest that administration of orlistat at 10 mg/kg/day for 6 weeks may have protective effects against the changes on Lee obesity index, lipid profiles, cardiac oxidative stress biomarkers and histology of myocardium in HFD-induced obese rats possibly through its hypolipidaemic and antioxidant actions

Assessing Forest Carbon Accumulation Potential Across Different Treatments using Field Inventory Data

Deforestation and forest degradation lead to an increase in the level of carbon in the atmosphere and disrupted the global carbon cycle. The tropical forest has received a lot of interest since it contributes around 60% of the total global forest carbon. By enhancing carbon sink, tropical forests have a great potential in mitigating climate change. Assessing aboveground biomass (AGB) and carbon stock through field inventories is crucial for this purpose as it provides the most accurate result. The research was conducted at Danum Valley Conservation Area and INFAPRO in Sabah, Malaysia. An earlier study over 35 years ago at this site suggests that restored forests accrue AGB at twice the rate of regenerating forests, though the cause of this difference between treatments is unclear. Thus, this study will focus on three principal study sites which are restored, naturally regenerating and old-growth forests to determine the forest’s potential to sequester and store carbon in the forest ecosystem. These three sites were chosen because it is a well-established plot from the earlier inventory over the last seven years. The field measuring method is a non-destructive methodology. Tree parameters such as diameter at breast height (DBH), tree height and tree species diversity were collected for calculating AGB using a species-specific allometric equation. Results showed a positive correlation between tree species, diameter at breast height, and biomass/carbon stock across three different forest treatments. The active restoration increases up to 151% carbon stock whilst the old-growth forest increased by 34% and natural regeneration increased by 73%, which active restoration can be the best solution for forest treatment. The outcome of this study will increase the ability of forest authorities and the Malaysian government to effective monitoring of carbon stock for establishing reliable standard guidelines in measuring deforestation and forest degradation toward achieving sustainable forest management