Patient's satisfaction towards healthcare services and its associated factors at the highest patient loads government primary care clinic in Pahang.

INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic. MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders. RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services. CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

Nematic Correlation Length in Iron-Based Superconductors Probed by Inelastic X-Ray Scattering.

Nematicity is ubiquitous in electronic phases of high-T_{c} superconductors, particularly in the Fe-based systems. We used inelastic x-ray scattering to extract the temperature-dependent nematic correlation length ξ from the anomalous softening of acoustic phonon modes in FeSe, underdoped Ba(Fe_{0.97}Co_{0.03})_{2}As_{2}, and optimally doped Ba(Fe_{0.94}Co_{0.06})_{2}As_{2}. In all cases, we find that ξ is well described by a power law (T-T_{0})^{-1/2} extending over a wide temperature range. Combined with the previously reported Curie-Weiss behavior of the nematic susceptibility, these results point to the mean-field character of the nematic transition, which we attribute to a sizable nematoelastic coupling that is likely detrimental to superconductivity.

Agreement between body weight perception and body weight status among late adolescents in Kuantan, Malaysia.

OBJECTIVES: Body weight perception may determine the practice of proper weight management. The objective of this study was to measure the agreement between body weight perception and actual body weight status and its associated factors among late adolescents in Kuantan, Malaysia. METHODS: A cross-sectional study was conducted from April to October 2018 among 479 adolescents aged 17-19 years old from seven institutions of higher learning in Kuantan. Body weight status was described as body mass index (BMI). Weight and height were measured, and BMI was calculated. Validated, self-administered Figure Rating Scale (FRS) questionnaires were used. Agreement between BMI and body weight perception was calculated using Kappa statistics. Logistic regression was employed to examine the association between body weight perception and sociodemographic variables. RESULTS: More than one-third (35.3%) of the respondents misjudged their own body weight. More than one third of the respondents (38.7%) who were underweight, misperceived themselves as having normal weight whilst 31.7% of obese respondents identified themselves as overweight. The agreement between body weight perception and body mass index was moderate (k0.46, p<0.01). CONCLUSION: Body weight perception was in moderate agreement with actual weight in late adolescents. Accurate body weight perception is an important factor in late adolescent's weight management behaviour. Hence, health education related to body weight management should be emphasized among this age group.

Phononic Helical Nodal Lines with PT Protection in MoB_{2}.

While condensed matter systems host both fermionic and bosonic quasiparticles, reliably predicting and empirically verifying topological states is only mature for Fermionic electronic structures, leaving topological Bosonic excitations sporadically explored. This is unfortunate, as Bosonic systems such as phonons offer the opportunity to assess spinless band structures where nodal lines can be realized without invoking special additional symetries to protect against spin-orbit coupling. Here we combine first-principles calculations and meV-resolution inelastic x-ray scattering to demonstrate the first realization of parity-time reversal symmetry protected helical nodal lines in the phonon spectrum of MoB_{2}. This structure is unique to phononic systems as the spin-orbit coupling present in electronic systems tends to lift the degeneracy away from high-symmetry locations. Our study establishes a protocol to accurately identify topological Bosonic excitations, opening a new route to explore exotic topological states in crystalline materials.

Observation of Double Weyl Phonons in Parity-Breaking FeSi.

Condensed matter systems have now become a fertile ground to discover emerging topological quasiparticles with symmetry protected modes. While many studies have focused on fermionic excitations, the same conceptual framework can also be applied to bosons yielding new types of topological states. Motivated by Zhang et al.'s recent theoretical prediction of double Weyl phonons in transition metal monosilicides [Phys. Rev. Lett. 120, 016401 (2018)PRLTAO0031-900710.1103/PhysRevLett.120.016401], we directly measure the phonon dispersion in parity-breaking FeSi using inelastic x-ray scattering. By comparing the experimental data with theoretical calculations, we make the first observation of double Weyl points in FeSi, which will be an ideal material to explore emerging bosonic excitations and its topologically nontrivial properties.

Programmatic mapping to determine the size and dynamics of sex work and injecting drug use in Mauritius.

HIV in Mauritius is in a concentrated phase. Most HIV infection is among key populations (KPs) including female sex workers (FSW), people who inject drugs (PWID), men who have sex with men (MSM), and transgender sex workers (TGSW). The objective of this research was to use geographical mapping to determine the precise locations, typologies and population estimates of each KP in Mauritius. From May to July 2014 a programmatic mapping approach determined national estimates and information on the specific locations, "hotspots", frequented by KPs in Mauritius. Data were collected through multiple levels of activity. Key informants provided information about hotspots where KPs congregated and were actively engaged in risky behaviours. Validation of hotspots was done by engaging KPs. A total of 17 248 KP members were estimated spread over 1 964 hotspots in Mauritius. The largest KP was PWID with an estimate of 7 598 (range: 4 091-6 223), followed by 6 223 (range: 5 090-7 456) FSWs, spread over 694 and 731 hotspots respectively. A total of 2 020 (range: 1 595-2 446) MSM and 294 geographic MSM hotspots, and 1 407 TGSWs (range: 1 165-1 649) distributed over 245 hotspots. This research provided Mauritius with validated KPs size estimations and provided the first national data on KP hotspots and operational dynamics. The use of these data will strengthen HIV prevention, intervention, and programme planning in the country through focusing efforts to systematically target high-risk areas.

Ultrafast energy- and momentum-resolved dynamics of magnetic correlations in the photo-doped Mott insulator Sr2IrO4.

Measuring how the magnetic correlations evolve in doped Mott insulators has greatly improved our understanding of the pseudogap, non-Fermi liquids and high-temperature superconductivity. Recently, photo-excitation has been used to induce similarly exotic states transiently. However, the lack of available probes of magnetic correlations in the time domain hinders our understanding of these photo-induced states and how they could be controlled. Here, we implement magnetic resonant inelastic X-ray scattering at a free-electron laser to directly determine the magnetic dynamics after photo-doping the Mott insulator Sr2IrO4. We find that the non-equilibrium state, 2 ps after the excitation, exhibits strongly suppressed long-range magnetic order, but hosts photo-carriers that induce strong, non-thermal magnetic correlations. These two-dimensional (2D) in-plane Néel correlations recover within a few picoseconds, whereas the three-dimensional (3D) long-range magnetic order restores on a fluence-dependent timescale of a few hundred picoseconds. The marked difference in these two timescales implies that the dimensionality of magnetic correlations is vital for our understanding of ultrafast magnetic dynamics.

Synthesis, molecular docking and anti-inflammatory screening of novel quinoline incorporated pyrazole derivatives using the Pfitzinger reaction II.

In continuation of our study of novel quinolines with anti-inflammatory activity using the Pfitzinger reaction, several new quinoline derivatives were synthesized and tested for their anti-inflammatory and ulcerogenic effect. A docking study on the COX-2 binding pocket was carried out for the target compounds to rationalize the possible selectivity of them against COX-2 enzyme. The most active compounds (5a, 8a and 11a) were found to be superior to celecoxib. Compound 11a demonstrated the highest anti-inflammatory activity as well as the best binding profiles into the COX-2 binding site. Moreover, compounds 9c, 9e, 10a and 11a were devoid of ulcerogenic activity.

Tuning magnetic coupling in Sr2IrO4 thin films with epitaxial strain.

We report x-ray resonant magnetic scattering and resonant inelastic x-ray scattering studies of epitaxially strained Sr2IrO4 thin films. The films were grown on SrTiO3 and (LaAlO3)0.3(Sr2AlTaO6)0.7 substrates, under slight tensile and compressive strains, respectively. Although the films develop a magnetic structure reminiscent of bulk Sr2IrO4, the magnetic correlations are extremely anisotropic, with in-plane correlation lengths significantly longer than the out-of-plane correlation lengths. In addition, the compressive (tensile) strain serves to suppress (enhance) the magnetic ordering temperature TN, while raising (lowering) the energy of the zone-boundary magnon. Quantum chemical calculations show that the tuning of magnetic energy scales can be understood in terms of strain-induced changes in bond lengths.

Crystal-field splitting and correlation effect on the electronic structure of A2IrO3.

The electronic structure of the honeycomb lattice iridates Na(2)IrO(3) and Li(2)IrO(3) has been investigated using resonant inelastic x-ray scattering (RIXS). Crystal-field-split d-d excitations are resolved in the high-resolution RIXS spectra. In particular, the splitting due to noncubic crystal fields, derived from the splitting of j(eff)=3/2 states, is much smaller than the typical spin-orbit energy scale in iridates, validating the applicability of j(eff) physics in A(2)IrO(3). We also find excitonic enhancement of the particle-hole excitation gap around 0.4 eV, indicating that the nearest-neighbor Coulomb interaction could be large. These findings suggest that both Na(2)IrO(3) and Li(2)IrO(3) can be described as spin-orbit Mott insulators, similar to the square lattice iridate Sr(2)IrO(4).

Order-disorder charge density wave instability in the kagome metal (Cs,Rb)V3Sb5.

The origin of the charge density wave phases in the kagome metal compound AV3Sb5 is still under great scrutiny. Here, we combine diffuse and inelastic x-ray scattering to identify a 3-dimensional precursor of the charge order at the L point that condenses into a CDW through a first order phase transition. The quasi-elastic critical scattering indicates that the dominant contribution to the diffuse precursor is the elastic central peak without phonon softening. However, the inelastic spectra show a small broadening of the Einstein-type phonon mode on approaching TCDW. Our results point to the situation where the Fermi surface instability at the L point is of order-disorder type with critical growth of quasi-static domains. The experimental data indicate that the CDW consists on an alternating Star of David and trihexagonal distortions and its dynamics goes beyond the classical weak-coupling scenario and is discussed within strong-electron phonon coupling and non-adiabatic models.

Signature of spin-phonon coupling driven charge density wave in a kagome magnet.

The intertwining between spin, charge, and lattice degrees of freedom can give rise to unusual macroscopic quantum states, including high-temperature superconductivity and quantum anomalous Hall effects. Recently, a charge density wave (CDW) has been observed in the kagome antiferromagnet FeGe, indicative of possible intertwining physics. An outstanding question is that whether magnetic correlation is fundamental for the spontaneous spatial symmetry breaking orders. Here, utilizing elastic and high-resolution inelastic x-ray scattering, we observe a c-axis superlattice vector that coexists with the 2[Formula: see text]2[Formula: see text]1 CDW vectors in the kagome plane. Most interestingly, between the magnetic and CDW transition temperatures, the phonon dynamical structure factor shows a giant phonon-energy hardening and a substantial phonon linewidth broadening near the c-axis wavevectors, both signaling the spin-phonon coupling. By first principles and model calculations, we show that both the static spin polarization and dynamic spin excitations intertwine with the phonon to drive the spatial symmetry breaking in FeGe.

Softening of a flat phonon mode in the kagome ScV6Sn6.

Geometrically frustrated kagome lattices are raising as novel platforms to engineer correlated topological electron flat bands that are prominent to electronic instabilities. Here, we demonstrate a phonon softening at the kz = π plane in ScV6Sn6. The low energy longitudinal phonon collapses at ~98 K and q = [Formula: see text] due to the electron-phonon interaction, without the emergence of long-range charge order which sets in at a different propagation vector qCDW = [Formula: see text]. Theoretical calculations corroborate the experimental finding to indicate that the leading instability is located at [Formula: see text] of a rather flat mode. We relate the phonon renormalization to the orbital-resolved susceptibility of the trigonal Sn atoms and explain the approximately flat phonon dispersion. Our data report the first example of the collapse of a kagome bosonic mode and promote the 166 compounds of kagomes as primary candidates to explore correlated flat phonon-topological flat electron physics.

Large spin-wave energy gap in the bilayer iridate Sr3Ir2O7: evidence for enhanced dipolar interactions near the mott metal-insulator transition.

Using resonant inelastic x-ray scattering, we observe in the bilayer iridate Sr3Ir2O7, a spin-orbit coupling driven magnetic insulator with a small charge gap, a magnon gap of ≈92 meV for both acoustic and optical branches. This exceptionally large magnon gap exceeds the total magnon bandwidth of ≈70 meV and implies a marked departure from the Heisenberg model, in stark contrast to the case of the single-layer iridate Sr2IrO4. Analyzing the origin of these observations, we find that the giant magnon gap results from bond-directional pseudodipolar interactions that are strongly enhanced near the metal-insulator transition boundary. This suggests that novel magnetism, such as that inspired by the Kitaev model built on the pseudodipolar interactions, may emerge in small charge-gap iridates.

Characterization of agar extracted from Gracilaria species collected along Tanzanian coast.

The study was conducted to investigate the effect of spatial variation, alkali treatment and the volume of extractant on yield and gel strength of agar for three Gracilaria species (G. salicornia, G. edulis and G. corticata) collected from the Tanzanian coast (Dar es Salaam, Tanga and Zanzibar). Treated and untreated G. corticata showed the highest yield (27 ± 0.7 % and 26.2 ± 1.3 % for treated and untreated, respectively), followed by G. salicornia then G. edulis. G. salicornia collected from Zanzibar showed the highest mass yield (22.9 ± 4.3 % for treated) followed by those collected from Tanga. Varying the volume for extraction showed no significant difference in mass yield where the p-value was >0.05. The highest gel strength was recorded from treated G. salicornia collected from Tanga (495 ± 29.5 gcm-2). Gel strength varied significantly between species. Spatial variability showed a significant difference in gel strength; the sample collected from Tanga showed the highest gel strength, followed by Zanzibar then Dar es Salaam. The variation due to the volume of distilled water used for extraction showed no significant difference in gel strength at a p-value >0.05. The highest gel strength was recorded at the volume of 1500 mL (467.5 ± 98.4 gcm-2), and the smallest gel strength was recorded at 500 mL. In all cases, there was a significant difference in mass yield and gel strength between treated and untreated samples. G. salicornia showed promising results as a local source of agar as it showed the highest gel strength though it produced an intermediate amount of agar. Based on the finding of this study, the volume of extraction of agar should be maintained as 1000 mL because by increasing the volume of extraction from 1000 mL to 1500 mL, the agar yield and gel strength don't change significantly. Agar yield and gel strength of Gracilaria species (G. salicornia, G. edulis and G. corticata) can be improved by alkali treatment, but further study is needed to determine the optimum amount and concentration of alkali to be used that will produce maximum yield and gel strength.

Relaxed complex scheme and molecular dynamics simulation suggests small molecule inhibitor of human TMPRSS2 for combating COVID-19.

As the coronavirus disease 19 (COVID-19) pandemic continues to pose a health and economic crisis worldwide, the quest for drugs and/or vaccines against the virus continues. The human transmembrane protease serine 2 (TMPRSS2) has attracted attention as a target for drug discovery, as inhibition of its catalytic reaction would result in the inactivation of the proteolytic cleavage of the SARS-CoV-2 S protein. As a result, the inactivation prevents viral cell entry to the host's cell. In this work, we screened and identified two potent molecules that interact and inhibit the catalytic reaction by using computational approaches. Two docking screening experiments were performed utilizing the crystal structure and holo ensemble structure obtained from molecular dynamics in bound form. There is enhancement and sensitivity of docking results to the holo ensemble as compared to the crystal structure. Compound 1 demonstrated a similar inhibition value to nafamostat by interacting with catalytic triad residues His296 and Ser441, thereby disrupting the already established hydrogen bond interaction. The stability of the ligand-TMPRSS2 complexes was studied by molecular dynamics simulation, and the binding energy was re-scored by using molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) binding free energy. The obtained compounds may serve as an initial point toward the discovery of potent TMPRSS2 inhibitors upon further in vivo validation.Communicated by Ramaswamy H. Sarma.

Discovery of conjoined charge density waves in the kagome superconductor CsV3Sb5.

The electronic instabilities in CsV3Sb5 are believed to originate from the V 3d-electrons on the kagome plane, however the role of Sb 5p-electrons for 3-dimensional orders is largely unexplored. Here, using resonant tender X-ray scattering and high-pressure X-ray scattering, we report a rare realization of conjoined charge density waves (CDWs) in CsV3Sb5, where a 2 × 2 × 1 CDW in the kagome sublattice and a Sb 5p-electron assisted 2 × 2 × 2 CDW coexist. At ambient pressure, we discover a resonant enhancement on Sb L1-edge (2s→5p) at the 2 × 2 × 2 CDW wavevectors. The resonance, however, is absent at the 2 × 2 × 1 CDW wavevectors. Applying hydrostatic pressure, CDW transition temperatures are separated, where the 2 × 2 × 2 CDW emerges 4 K above the 2 × 2 × 1 CDW at 1 GPa. These observations demonstrate that symmetry-breaking phases in CsV3Sb5 go beyond the minimal framework of kagome electronic bands near van Hove filling.

Six-reflection meV-monochromator for synchrotron radiation.

An in-line monochromatization scheme suitable for 10-40 keV synchrotron radiation is presented based on the use of six crystal reflections that achieves meV and sub-meV bandwidths with high efficiency. The theoretical spectral efficiency surpasses all previous multicrystal designs and approaches that of single room-temperature back-reflecting crystals. This article presents the designs of two such devices along with their theoretical and measured performances.

Extended phonon collapse and the origin of the charge-density wave in 2H-NbSe2.

We report inelastic x-ray scattering measurements of the temperature dependence of phonon dispersion in the prototypical charge-density-wave (CDW) compound 2H-NbSe2. Surprisingly, acoustic phonons soften to zero frequency and become overdamped over an extended region around the CDW wave vector. This extended phonon collapse is dramatically different from the sharp cusp in the phonon dispersion expected from Fermi surface nesting. Instead, our experiments, combined with ab initio calculations, show that it is the wave vector dependence of the electron-phonon coupling that drives the CDW formation in 2H-NbSe2 and determines its periodicity. This mechanism explains the so far enigmatic behavior of CDW in 2H-NbSe2 and may provide a new approach to other strongly correlated systems where electron-phonon coupling is important.

Structural and microscopic relaxations in glycerol: an inelastic x-ray scattering study.

The THz dynamics of liquid glycerol has been probed by inelastic x-ray scattering at different pressure spanning the 0.66-3 Kbar range. A comparison with ultrasound absorption results available in literature leads us to identify the presence of two different relaxations, a structural (slow) relaxation and a microscopic (fast) one. Although the former has been already thoroughly studied in glycerol by lower frequency spectroscopic techniques, no hints on the latter are so far available in literature. We observe that the characteristic timescale of this fast relaxation ranges in the sub-picosecond, tends to decrease with increasing the wave-vector and seems rather insensitive to pressure changes. Finally, the timescale and strength of the fast relaxation have a direct link revealing the microscopic, single particle, nature of the involved process.