Objectives: Although antimicrobial resistance (AMR) disproportionately affects low- and middle-income countries (LMICs), primary clinical data on AMR burden from LMICs are lacking, particularly from the Pacific Islands. We adapted recent World Health Organization methodology to measure the impact of third-generation cephalosporin (3GC) resistance on mortality and excess length of hospital stay among inpatients with Enterobacterales bloodstream infection (BSI) in Fiji. Methods: We conducted a prospective cohort study of inpatients with Enterobacterales BSIs at Colonial War Memorial Hospital in Suva. We collected demographic, clinical, and microbiological data, and we stored bacterial isolates for confirmatory testing and molecular genomics in Melbourne, Australia. We employed cause-specific Cox proportional hazards models to estimate the effect of 3GC-resistance on hazard of in-hospital mortality and discharge alive (competing outcomes), and we used multistate modelling to estimate the excess length of hospital stay associated with 3GCR. Results: From July 2020 to February 2021, we identified 162 consecutive Enterobacterales BSIs, and 66 (40.7%) were 3GC resistant. The crude mortality rates for patients with 3GC-susecptible and 3GC-resistant BSIs were 16.7% (16 of 96) and 30.3% (20 of 66), respectively. Also, 3GC resistance was not associated with either in-hospital mortality (aHR, 1.67; 95% CI, 0.80–3.49) or discharge alive (aHR, 0.75; 95% CI, 0.50–1.12). However, patient comorbidities and acuity of illness were associated with in-hospital mortality. Furthermore, 3GC-resistance was associated with an increased length of stay of 2.6 days (95% CI, 2.5–2.8). Overall, 3GC-resistance was more common among patients with hospital-associated than community-acquired infection, but genomics did not identify clonal transmission. Conclusions: Among patients with Enterobacterales BSIs, mortality was relatively high, and 3GC resistance was common. Also, 3GC resistance was associated with increased hospital length of stay but not with in-hospital mortality after adjusting for potential confounders. Accurate estimates of the burden of AMR are important, especially from LMICs. Such knowledge can inform policy decisions, guide allocation of limited resources, and assist the evaluation of future interventions to address AMR.

Environmental surface testing was performed to search for evidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) environmental contamination by an asymptomatic SARS-CoV-2 carrier with persistently high viral loads under isolation. No evidence of environmental contamination was found. Further studies are needed to measure environmental contamination by SARS-CoV-2 carriers and to determine reasonable isolation periods.

Over the last two decades, levels of childhood overweight and obesity have increased considerably in Malaysia, such that the country now has the highest prevalence of obesity in Asia. The preschool years are a key time for establishing healthy behaviours; hence, there is a need for effective interventions aimed at early childhood. The ToyBox Study is an intervention to prevent obesity in preschoolers that has previously been conducted successfully in six different countries but to date not outside Europe. Therefore, we conducted a feasibility study to determine whether the ToyBox Study methodology could be successfully adapted and applied in Malaysia.

The ToyBox Study Malaysia was conducted in 15 kindergartens in Kuala Lumpur and suburbs in Selangor and 7 kindergartens in Sarawak (Borneo), Malaysia. All participating kindergartens were funded by Jabatan Kemajuan Masyarakat (KEMAS), the Community Development Department, Ministry of Rural and Regional Development.The existing ToyBox resources and questionnaires were translated into Bahasa Malaysia and the materials were adapted to suit local culture. Theory of change workshops and focus groups were conducted with parents, caregivers, teachers, cooks and government officers in order to help develop the implementation model. Train-the-trainer and teacher training sessions were organised before the study commenced.

The study was a randomised controlled trial that compared the ToyBox Study with kindergarten usual practice, over a period of one year. The ToyBox Study specifically targeted four energy balance related behaviours, namely; eating healthy snacks and meals, making water the preferred drink, increasing physical activity and reducing sedentary behaviour. Food frequency questionnaires were used to assess food intake. Accelerometry was used to measure physical activity. Weight, height and waist circumference were also measured. All measurements were made at baseline and post-intervention. Equipment such as soft mats and drinking water stations were supplied where needed. Parents, caregivers and teachers were provided with relevant materials, newsletters and tip cards and encouraged to participate and act as role models. They also completed project evaluation surveys.

If successful, it is envisaged that the ToyBox Study Malaysia will be adopted by other kindergartens in Malaysia, with the intention of helping Malaysian children and their families to achieve healthy energy balance related behaviours that will benefit their health and reduce obesity risk in the long-term.

The objective of the present study is to summarise trends in under- and over-nutrition in pregnant women on the Thailand–Myanmar border. Refugees contributed data from 1986 to 2016 and migrants from 1999 to 2016 for weight at first antenatal consultation. BMI and gestational weight gain (GWG) data were available during 2004–2016 when height was routinely measured. Risk factors for low and high BMI were analysed for <18·5 kg/m2 or ≥23 kg/m2, respectively. A total of 48 062 pregnancies over 30 years were available for weight analysis and 14 646 pregnancies over 13 years (2004–2016) had BMI measured in first trimester (<14 weeks’ gestational age). Mean weight at first antenatal consultation in any trimester increased over the 30-year period by 2·0 to 5·2 kg for all women. First trimester BMI has been increasing on average by 0·5 kg/m2 for refugees and 0·6 kg/m2 for migrants, every 5 years. The proportion of women with low BMI in the first trimester decreased from 16·7 to 12·7 % for refugees and 23·1 to 20·2 % for migrants, whereas high BMI increased markedly from 16·9 to 33·2 % for refugees and 12·3 to 28·4 % for migrants. Multivariate analysis demonstrated low BMI as positively associated with being Burman, Muslim, primigravid, having malaria during pregnancy and smoking, and negatively associated with refugee as opposed to migrant status. High BMI was positively associated with being Muslim and literate, and negatively associated with age, primigravida, malaria, anaemia and smoking. Mean GWG was 10·0 (sd 3·4), 9·5 (sd 3·6) and 8·3 (sd 4·3) kg, for low, normal and high WHO BMI categories for Asians, respectively.

The interactions between copper (Cu++) and cyanide (CN−) with 1,1′-dimethyl-4,4′-bipyridinium ion (paraquat) on phytotoxicity to Chlorella pyrenoidosa Chick, IAC 251, were determined by measuring chlorophyll absorbance at 434 and 670 mμ. Cu++ inhibited phytotoxicity and CN− accelerated paraquat activity with highly significant mutually antagonistic interactions occurring between Cu++ (2 ppm) and CN− (16 ppm) at paraquat levels to 2 ppm.

The present study examined the speech production of three-year-old Korean–English bilingual (KEB) children. English and Korean stops, as well as front vowels in both languages, were compared acoustically among the KEB children, then also measured against those of their age-equivalent monolingual counterparts. Evidence of distinctive phonetic categorization in bilingual children was more salient in vowels than in stops. Vowels and stops produced by the bilingual children were not significantly different from those of their monolingual counterparts. The findings suggest that, similar to other language domains, two linguistic systems are apparent in the phonetic production component of three-year-old KEB children, but that phonetic distinctiveness in production may not emerge holistically in an across-the-board fashion, appearing earlier in vowels than stops. Thus, the phonetic production systems of the two languages may develop with only limited interaction in simultaneous KEB children exposed to two languages at an early age.

Despite widespread mungbean [Vigna radiata (L.) Wilczek] consumption in Indonesia, few molecular studies have been carried out on accessions and available data are minimal. In this study, we used 30 newly developed simple sequence repeat (SSR) markers designed from the mapped sequence scaffolds of the Korean Sunhwanokdu and Gyeonggijaerae 5 mungbean genomes. These markers were used to examine loci in 83 mungbean accessions collected from diverse geographical areas in Indonesia. A total of 107 alleles were detected among the accessions with 29 polymorphic markers. However, the mean of polymorphic information content (0.33) value and diversity index (0.38) value was indicative of low genetic diversity in this germplasm. The mungbean population structure was not clearly differentiated and the number of subpopulations was unclear. Neighbour-joining tree analysis revealed that the genetic cluster did not reflect the geographical origin of the accessions. Interestingly, the most agriculturally improved varieties were genetically similar to some landraces from one of the main mungbean-producing regions. These newly developed SSR markers could be useful for detecting genetic variability as a basis for establishing a conservation strategy for mungbean germplasm with the aim of enhancing Indonesian breeding programmes.

‘Healthy Twin’ is a twin family study extension of the existing Korean Twin-Family Register. Healthy Twin recruits adult like-sex twins over the age of 30 and their adult family members. Healthy Twin protocols are primarily tailored to the study of the quantitative trait loci of complex traits as well as to the role of environment in the etiology of complex diseases. A full-length survey is underway, including questionnaires, health examinations and the collection of biological specimens. So far, 820 individuals (169 twin pairs and their families) have participated in the survey and 1068 individual twins (608 twin pairs) have replied to the mailed zygosity questionnaire as of July 2006. The first phase (2005–2006) of Healthy Twin will recruit 1550 individuals (including about 380 twin pairs), and the second phase a proposed 1500 to 2500 additional participants. We report study protocols and zygosity and the distribution of family size of the study participants.

Recently, for many health economics researchers, empirical estimation of the monetary valuation of a quality-adjusted life year (QALY) has become an important endeavour. Different philosophical and practical approaches to this have emerged. On the one hand, there is a view that, with health-care budgets set centrally, decision-making bodies within the system can iterate, from observation of a series of previous decisions, towards the value of a QALY, thus searching for such a value. Alternatively, and more consistent with the approach taken in other public sectors, individual members of the public are surveyed with the aim of directly eliciting a preference-based – also known as a willingness-to-pay-based (WTP-based) – value of a QALY. While the former is based on supply-side factors and the latter on demand, both in fact suffer from informational deficiencies. Sole reliance on either would necessitate an acceptance or accommodation of chronic inefficiencies in health-care resource allocation. On the basis of this observation, this paper makes the case that in order to approach optimal decision making in health-care provision, a framework incorporating and thus, to a degree, reconciling these two approaches is to be preferred.

The purpose of this study was to conduct an acoustic examination of the obstruent stops produced by Korean–English bilingual children in connection with the question of whether bilinguals establish distinct categories of speech sounds across languages. Stop productions were obtained from ninety children in two age ranges, five and ten years: thirty Korean–English bilinguals, thirty monolingual Koreans and thirty monolingual English speakers. Voice-Onset-Time (VOT) lag at word-initial stop and fundamental frequency (f0) in the following vowel (hereafter vowel-onset f0) were measured. The bilingual children showed different patterns of VOT in comparison to both English and Korean monolinguals, with longer VOT in their production of Korean stop consonants and shorter VOT for English. Moreover, the ten-year-old bilinguals distinguished all stop categories using both VOT and vowel-onset f0, whereas the five-year-olds tended to make stop distinctions based on VOT but not vowel-onset f0. The results of this study suggest that bilingual children at around five years of age do not yet have fully separate stop systems, and that the systems continue to evolve during the developmental period.

The phonetic characteristics of canonical babbling produced by Korean- and English-learning infants were compared with consonant and vowel frequencies observed in infant-directed speech produced by Korean- and English-speaking mothers. For infant output, babbling samples from six Korean-learning infants were compared with an existing English babbling database (Davis & MacNeilage, 1995). For ambient language comparisons, consonants and vowels in ten Korean and ten English infant-directed speech (IDS) samples were analyzed. The two infant groups demonstrated similar consonant patterns, but showed different vowel patterns from one another. For both languages, infant vowel patterns were related to those of ambient language IDS. Ambient language patterns were manifested in infant vowel output, perhaps because vowels are more perceptually and motorically available in the input and output capacities of babbling infants.

This study compared segmental distribution patterns for consonants and vowels in English infant-directed speech (IDS) and adult-directed speech (ADS). A previous study of Korean indicated that segmental patterns of IDS differed from ADS patterns (Lee, Davis & MacNeilage, 2008). The aim of the current study was to determine whether such differences in Korean are universal or language-specific. Results indicate that consonant distribution patterns of English IDS were significantly different from English ADS. Speakers who used IDS produced fewer fricatives, affricates, nasals and liquids, but more stops and glides, than speakers who used ADS. In terms of vowels, IDS speakers produced more high-back vowels /u Ʊ/ and /ɔI/ diphthongs than ADS speakers. These results indicate both general trends and language-specific segmental distribution patterns in IDS. When compared to previous findings on ADS and IDS in Korean, these results for English give support to a more general assertion that segmental distribution patterns in IDS seem to be mediated by linguistic and cultural factors across languages.