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To explore the concepts of healthy eating and to identify the barriers and facilitating factors for dietary behaviour change in adolescents.
A qualitative study involving twelve focus groups.
Two secondary schools in the district of Hulu Langat in Selangor, Malaysia.
Seventy-two adolescents aged 13–14 years.
Adolescents had some understanding regarding healthy eating and were able to relate healthy eating with the concepts of balance and moderation. The adolescents’ perceptions of healthy and unhealthy eating were based on food types and characteristics, cooking methods and eating behaviours. Facilitators for healthy eating were parents’ control on adolescents’ food choices, feeling concern about own health and body, being influenced by other’s health condition, and knowledge of healthy or unhealthy eating. On the other hand, barriers for healthy eating were the availability of food at home and school, taste and characteristics of foods, and lack of knowledge on healthy or unhealthy foods.
The findings contribute to a better understanding of the adolescents’ concept of healthy eating, as well as the facilitators and barriers to practising healthy eating. Future interventions should include a method of promoting the immediate benefits of healthy eating, the way to cope with environmental barriers for healthy eating, and increasing the availability of healthy food choices at home and in the school environment. The health and nutrition education programmes should also focus on educating parents, as they can be role models for adolescents to practise more healthful behaviours.
Flow-induced vibration (FIV) of an elastically mounted circular cylinder with an attached splitter plate in uniform flow is studied numerically via a stabilized space–time finite element method. The Reynolds number based on the cylinder diameter
and the free-stream speed is restricted to 150. The ratio of the density of the body to that of the fluid, for the major part of the study, is 10. Two different reduced speeds are defined to quantify the compliance of the elastic support and flexibility of the splitter plate, respectively:
based on the natural frequency of the spring–mass system and
based on the fundamental natural frequency of the plate. Flow past a stationary cylinder (
) with a flexible splitter plate of length
is studied at different values of
. The vibration response of the plate exhibits lock-in with various eigenmodes of the plate in different ranges of
. The onsets of these lock-in regions are abrupt and hysteretic. The elastically mounted cylinder, without the splitter plate, undergoes large-amplitude vortex-induced vibration (VIV) for
. These large-amplitude oscillations are a consequence of synchronization, wherein the vortex shedding frequency locks in to the cylinder oscillation frequency. A rigid splitter plate attached to the cylinder reduces significantly the peak amplitude during VIV. Increasing the length of the plate from
only marginally affects the peak amplitude. It, however, leads to a wider range of lock-in. Unlike the case of an isolated cylinder, the lock-in and desynchronization regimes are not well demarcated in the presence of the splitter plate. Further, galloping is observed beyond a critical value of
; the amplitude of vibration increases with an increase in
while the vibration frequency is relatively low and remains nearly constant. Increase in plate length delays, in terms of
, the onset of galloping. It is also found that the flexibility of the plate affects the maximum oscillation amplitude in the VIV regime. It also dictates the presence/absence of galloping. The system behaves similar to an isolated cylinder for a very flexible plate. The response is devoid of galloping, but relatively large amplitude of oscillation is observed during lock-in. The behaviour of the cylinder with a stiff plate is similar to that with the rigid one. The galloping instability sets in when the flexibility of the plate is less than a certain value (
, approximately for
). The VIV and galloping are separated by a range of
in which the flow is either steady, for longer plates, or exhibits very weak vortex shedding. In the VIV regime, the plate tip and cylinder vibrate in phase for low
; their motion is out of phase for larger
. The change in phase is also associated with change in the frequency of vibration. At low
, the frequency of vibration is close to the first natural frequency of the system, while at high
it becomes closer to the second natural frequency. The vibration amplitude of the cylinder is close to maximum in the VIV regime for
. Computations for various
, are utilized to determine optimal flexibility that leads to minimal FIV. The effect of the length of the flexible splitter plate, mass ratio and damping ratio is studied. A strategy is proposed to utilize the computations from various combinations of
to choose the appropriate flexibility of the attached splitter plate to minimize FIV.
Industrialization has transformed Malaysia into an emerging economy that is on its way to becoming a high-income or a developed one. This is a straightforward argument, and the association between industrialization and wealth creation is almost a truism even. Viewed from this perspective, Penang is one of the most industrialized, and economically advanced states in the Malaysian federation. This chapter seeks to look at the journey that Penang undertook to industrialize as part of the larger Malaysian economy, and how this has improved incomes and virtually eliminated poverty in the last 40 years or so.
This journey commenced under Lim Chong Eu's stewardship of the Gerakan state government after the 1969 elections. One of the objectives of this chapter is to look at how Lim Chong Eu made that transition possible. Another objective of this chapter is to simplify this very complex story by linking Penang's industrialization with the country's broader journey to economic development, and to offer an insight into the dynamics of the socio-economic and political choices that were “on the table”.
Part I: The National Context
a. Import-Substituting Industrialization and Growth
Independent Malaya inherited a characteristically colonial export economy, where primary commodity exports, particularly rubber, tin, timber, and iron ore made up a very significant portion of the GDP. In 1960, exports contributed 55 percent of the GDP (Malaysia. 1965:24). Thus, the fall in price of rubber and the sluggish growth of other primary commodities for much of the 1960s posed a very serious challenge to the economy.
Diversification of the economy was clearly the way forward. After outlining the challenges and opportunities facing the newly independent nation and the long-term objectives of the country's development, the First Malaysia Plan that followed the Second Malaya Plan reiterated that the most important resolution was “the need for economic diversification, which includes both agricultural diversification and industrialization” (Malaysia.1965: 15). However, agricultural diversification would have needed a prolonged gestation period.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Herein, we present the fabrication and characterization of Gd:PbI2 thin films from low-cost material using a cost-effective spin-coating technique by taking the Gd content as 1.0, 2.0, and 3.0 wt% in PbI2. Single-phase and good crystallinity films oriented along the c-axis were confirmed by X-ray diffraction and FT-Raman spectroscopy. Size of crystallites increased with Gd concentration and was estimated to be in the range of 16–32 nm. Determination of morphology and size of grains (50–103 nm), and elemental confirmation were carried out by SEM/EDX analysis. Optical transparency of fabricated films was found to be in the range of 72–92%. The energy gap is reduced from 2.31 to 2.05 eV; this makes Gd:PbI2 films highly applicable in solar cells. The stable value of refractive index is estimated to be in the range of 1.85–2.3. Dielectric constant was observed to be reduced with doping and in the range of 2.5–35, and ac conductivity was also reduced by doping; however, both were enhanced with frequency. The values of χ(1), χ(3), and n(2) are found to be in the range of 0.15 to 2.5, 8 × 10−14 to 6.5 × 10−9, and 5 × 10−12 to 4 × 10−8, respectively.
Recently, interest in integrated assembly sequence planning (ASP) and assembly line balancing (ALB) began to pick up because of its numerous benefits, such as the larger search space that leads to better solution quality, reduced error rate in planning, and expedited product time-to-market. However, existing research is limited to the simple assembly problem that only runs one homogenous product. This paper therefore models and optimizes the integrated mixed-model ASP and ALB using Multi-objective Discrete Particle Swarm Optimization (MODPSO) concurrently. This is a new variant of the integrated assembly problem. The integrated mixed-model ASP and ALB is modeled using task-based joint precedence graph. In order to test the performance of MODPSO to optimize the integrated mixed-model ASP and ALB, an experiment using a set of 51 test problems with different difficulty levels was conducted. Besides that, MODPSO coefficient tuning was also conducted to identify the best setting so as to optimize the problem. The results from this experiment indicated that the MODPSO algorithm presents a significant improvement in term of solution quality toward Pareto optimal and demonstrates the ability to explore the extreme solutions in the mixed-model assembly optimization search space. The originality of this research is on the new variant of integrated ASP and ALB problem. This paper is the first published research to model and optimize the integrated ASP and ALB research for mixed-model assembly problem.
The aim of this study was to provide a comprehensive overview of the evolution of health technology assessment (HTA) in Malaysia over the past decade.
We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation.
Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated.
HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.
We report Electrically reduced graphene oxide (GO) and n-type Si heterostructure junction-based photovoltaic cell. The transition of the insulating properties of GO to that of semi-conducting was achieved by applying electric voltages using 5, 10, and 15 V biasing. The photovoltaic device I–V characteristics corresponding to the increasing (5–15 V) reduction voltages, obtained on exposure of 25 mW/cm2 visible light, showed approximately same fill factor with increased efficiency. The maximum efficiency of 1.12% was observed under ultraviolet light exposure for photovoltaic cell consisting GO reduced using 15 V reduction voltage. GO was synthesized using the modified Hummers’ technique and characterized by X-ray diffraction (XRD), ultraviolet–visible (UV-Vis) spectroscopy, Fourier transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). The GO characteristic XRD peak corresponding to plane (001) was observed at 9.16°. The UV-Vis spectrum for GO displayed an absorption peak at 228.5 nm, and the corresponding Tauc plot analysis provided a band gap of 4.74 eV. The FTIR analysis showed presence of C=O (1713 cm−1), C=C (1627 cm−1), C–OH (1418 cm−1), C–O–C (1252 cm−1), C–O (1030 cm−1), and C–H (827 cm−1) functional groups in GO.
Dromedary camels have been shown to be the main reservoir for human Middle East respiratory syndrome (MERS) infections. This systematic review aims to compile and analyse all published data on MERS-coronavirus (CoV) in the global camel population to provide an overview of current knowledge on the distribution, spread and risk factors of infections in dromedary camels. We included original research articles containing laboratory evidence of MERS-CoV infections in dromedary camels in the field from 2013 to April 2018. In general, camels only show minor clinical signs of disease after being infected with MERS-CoV. Serological evidence of MERS-CoV in camels has been found in 20 countries, with molecular evidence for virus circulation in 13 countries. The seroprevalence of MERS-CoV antibodies increases with age in camels, while the prevalence of viral shedding as determined by MERS-CoV RNA detection in nasal swabs decreases. In several studies, camels that were sampled at animal markets or quarantine facilities were seropositive more often than camels at farms as well as imported camels vs. locally bred camels. Some studies show a relatively higher seroprevalence and viral detection during the cooler winter months. Knowledge of the animal reservoir of MERS-CoV is essential to develop intervention and control measures to prevent human infections.
The main aim was to examine the effect of bit depth on computed tomography (CT) number for high-density materials. Analysis of the CT number for high-density materials using 16-bit scanners will extend the CT scale that currently exists for 12-bit scanners and thus will be beneficial for use in CT–electron density (ED) curve in radiotherapy treatment planning system (TPS). Implementation of this extended CT scale will compensate for tissue heterogeneity during CT–ED conversion in treatment planning.
Materials and methods
An in-house built phantom with 10 different metal samples was scanned using 80, 100 and 120 kVp in two different CT scanners. A region of interest was set at the centre of the material and the mean CT numbers together with data deviation were determined. Dosimetry calculation was performed by applying a direct anterior beam on 12-bit, 12-bit extended and 16-bit.
High-density materials (>4·34 g cm−3) in 16-bit depth provide disparities up to 44% compared to Siemens’ 12-bit extended. Influence of tube voltage showed a significant difference (p<0·05) in both bit depth and CT number of the gold and amalgam saturated in 16-bit depth. A 120 kVp energy illustrated a low variation on CT number for different scanners, but dosimetry calculation showed significant disparities at the metal interface in 12-bit, 12-bit extended and 16-bit.
High-density materials require 16-bit scanners to obtain CT number to be implemented in treatment planning in radiotherapy. This also suggests that proper tube voltage together with correct CT–ED resulted in accurate TPS algorithm calculation.
Sol–gel spin coating is applied to fabricate the pure and different concentrations of aluminum (Al)-doped ZnO films on high-quality silicon substrates. All films are showing high crystallinity in X-ray diffraction study, and lattice constants were obtained using PowderX software. The value of crystallite size was found in range of 20–40 nm. EDX/SEM mapping was performed for 2 wt% Al-doped ZnO film, which shows the presence of Al and its homogeneous distribution in the film. SEM investigation shows nanorods morphology all over the surface of films, and the dimension of nanorods is found to increase with Al doping. The E(g)dire. values were estimate in range of 3.25–3.29 eV for all films. Linear refractive index was found in range of 1.5–2.75. The χ1 value is found in range of 0.13–1.4 for all films. The χ3 values are found in range of 0.0053 × 10−10 to 6.24 × 10−10 esu for pure and doped films. The n2 values were also estimated. These studies clearly showed that the properties of ZnO have been enriched by Al doping, and hence doped films are more appropriate for optoelectronic applications.
In India, there is a lack of information about the adequate daily dose of vitamin D3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6–16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 (sd 2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 (SD 9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD 30·0)nmol/l), followed by 1000 IU (46·8 (SD 22·5)nmol/l) and 600 IU (36·5 (SD 18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.
To determine the degree of food environment policies that have been implemented and supported by the Malaysian Government, in comparison to international best practice, and to establish prioritised recommendations for the government based on the identified implementation gaps.
The Healthy Food-Environment Policy Index (Food-EPI) comprises forty-seven indicators of government policy practice. Local evidence of each indicator was compiled from government institutions and verified by related government stakeholders. The extent of implementation of the policies was rated by experts against international best practices. Rating results were used to identify and propose policy actions which were subsequently prioritised by the experts based on ‘importance’ and ‘achievability’ criteria. The policy actions with relatively higher ‘achievability’ and ‘importance’ were set as priority recommendations for government action.
Twenty-six local experts.
Majority (62 %) of indicators was rated ‘low’ implementation with no indicator rated as either ‘high’ or ‘very little, if any’ in terms of implementation. The top five recommendations were (i) restrict unhealthy food marketing in children’s settings and (ii) on broadcast media; (iii) mandatory nutrition labelling for added sugars; (iv) designation of priority research areas related to obesity prevention and diet-related non-communicable diseases; and (v) introduce energy labelling on menu boards for fast-food outlets.
This first policy study conducted in Malaysia identified a number of gaps in implementation of key policies to promote healthy food environments, compared with international best practices. Study findings could strengthen civil society advocacies for government accountability to create a healthier food environment.
Herein, we report the detailed optoelectronic characteristics of low cost fabricated pristine and 1, 5, 10, and 15 wt% Mg-doped ZnO films on the FTO substrate (MZO/FTO) through the spin coating technique. High crystallinity and single phase of the film were confirmed by X-ray diffraction investigation. The average crystallite size was in the range of 46–78 nm. Homogeneous distribution of Mg doping in ZnO was approved by elemental mapping analysis. The fiber-like surface morphology was confirmed by the scanning electron microscopy analysis. Optical transparency was observed in the range of 40–80% for the fabricated films. The optical band gaps for direct and indirect transitions obtained from Tauc’s relation are in the range of 3.103–3.283 eV and 2.423–2.968 eV, respectively. It is also observed that the energy gap of MZO films decreases with an increase in Mg doping from 1 to 15%. The respective stable values of absorption and refractive indices are obtained in the range of ∼0.036–0.088 and ∼1.71–2.1. The linear and nonlinear optical susceptibilities as well as the nonlinear refractive index values were calculated. Additionally, Z-scan measurement was carried out at 532 nm wavelength. The nonlinear absorption coefficient and the imaginary part of third-order nonlinear susceptibility were estimated and corresponding values are obtained in the range of 0.35–123 (×10−5) cm/W and 0.084–29.7 (×10−8) e.s.u., respectively. Moreover, the optical limiting threshold values were obtained in the range of 2.57–6.34 kJ/cm2. The MZO/FTO films are showing strong optical limiting behavior compared to pristine. The output results suggest that MZO films are better contenders for optoelectronic applications.
Lactoperoxidase (LPO) is an antimicrobial protein present in milk that plays an important role in natural defence mechanisms during neonatal and adult life. The antimicrobial activity of LPO has been commercially adapted for increasing the shelf life of dairy products. Immobilization of LPO on silver nanoparticles (AgNPs) is a promising way to enhance the antimicrobial activity of LPO. In the current study, LPO was immobilized on AgNPs to form LPO/AgNP conjugate. The immobilized LPO/AgNP conjugate was characterized by various biophysical techniques. The enhanced antibacterial activity of the conjugate was tested against E. coli in culture at 2 h intervals for 10 h. The results showed successful synthesis of spherical AgNPs. LPO was immobilized on AgNPs with agglomerate sizes averaging approximately 50 nm. The immobilized conjugate exhibited stronger antibacterial activity against E. coli in comparison to free LPO. This study may help in increasing the efficiency of lactoperoxidase system and will assist in identifying novel avenues to enhance the stability and antimicrobial function of LPO system in dairy and other industries.
The quadrotor aerial robot is a complex system and its dynamics involve nonlinearity, uncertainty, and coupling. In this paper, an adaptive backstepping sliding mode control (ABSMC) is presented for stabilizing, tracking, and position control of a quadrotor aerial robot subjected to external disturbances. The developed control structure integrates a backstepping and a sliding mode control approach. A sliding surface is introduced in a Lyapunov function of backstepping design in order to further improve robustness of the system. To attenuate a chattering problem, a saturation function is used to replace a discontinuous sign function. Moreover, to avoid a necessity for knowledge of a bound of external disturbance, an online adaptation law is derived. Particle swarm optimization (PSO) algorithm has been adopted to find parameters of the controller. Simulations using a dynamic model of a six degrees of freedom (DOF) quadrotor aerial robot show the effectiveness of the approach in performing stabilization and position control even in the presence of external disturbances.