Unmasking domestic violence: Examining victim and perpetrator characteristics and injury patterns in Kuching, Sarawak.

INTRODUCTION: Domestic violence (DV) is a pervasive social and public health issue affecting millions globally, regardless of age, gender or socioeconomic background. Understanding victim and perpetrators' characteristics as well as the DV injury patterns are essential for developing targeted interventions and prevention strategies. Although past DV studies have often focused on female victims, it is increasingly recognised that DV affects a significant proportion of male victims as well. This study aimed to comprehensively examine both male and female DV victims and perpetrators, as well as the anatomical regions affected in DV cases in Kuching, Sarawak, so that a deeper understanding of DV within this community can be enhanced. MATERIALS AND METHODS: This prospective, observational study was conducted from March 2021 to March 2023, involving adult DV victims aged 18 years and above admitted to the One Stop Crisis Center (OSCC) of Sarawak General Hospital. Data were collected from the OSCC clerking sheet, focusing on the victims, perpetrators and the violence characteristics. RESULTS: A total of 133 DV victims were analysed, with 25.6% being male victims. Although majority of the perpetrators in cases involving male victims were male perpetrators, there was a significantly higher number of female perpetrators in these male DV cases (i.e., 5 out of 34 cases,14.7%) compared to in female DV cases (4 out of 99 cases, 4.0%) (p = 0.05). The commonest type of relationship between the victims and perpetrators was spouses or ex-spouses (56.4%). Male victims had more cases involving weapons (67.6%) compared to female victims (26.3%), p < 0.001. The most affected anatomical region was the head and neck (63.9%) region although no significant differences were observed. CONCLUSION: The study reveals that DV affects individuals across all societal classes and income groups. Although weapons were used more frequently in male DV cases, other injury characteristics and affected anatomical regions were not significantly different between genders, suggesting female perpetrators can inflict similar injuries as male perpetrators. Subgroup analysis showed that the majority of male victims faced abuse from their children or grandchildren, hinting at hidden geriatric abuse, that should be unmasked and treated as a separate entity.

Computational Screening of a Single-Atom Catalyst Supported by Monolayer Nb2S2C for Oxygen Reduction Reaction.

The search for high-performance catalysts to improve the catalytic activity for an oxygen reduction reaction (ORR) is crucial for developing a proton exchange membrane fuel cell. Using the first-principles method, we have performed computational screening on a series of transition metal (TM) atoms embedded in monolayer Nb2S2C to enhance the ORR activity. Through the scaling relationship and volcano plot, our results reveal that the introduction of a single Ni or Rh atom through substitutional doping into monolayer Nb2S2C yields promising ORR catalysts with low overpotentials of 0.52 and 0.42 V, respectively. These doped atoms remain intact on the monolayer Nb2S2C even at elevated temperatures. Importantly, the catalytic activity of the Nb2S2C doped with a TM atom can be effectively correlated with an intrinsic descriptor, which can be computed based on the number of d orbital electrons and the electronegativity of TM and O atoms.

Standards for clinical trials for treating TB.

BACKGROUND: The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice.METHODS: A global panel of experts participated in a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached.RESULTS: Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.CONCLUSION: These standards should improve the efficiency and effectiveness of evidence generation, as well as the translation of research into policy and practice.

Teaching clinical toxinology in medical schools: The need, challenges and opportunities.

Clinical toxinology is an essential subject that should be included in undergraduate medical curricula. By equipping students with the knowledge and skills to identify and treat venomous animals and use antivenom appropriately reduces the risk of medical negligence and delays in treating and transporting these patients. Unfortunately, given the packed curriculum of undergraduate medical programs, it is important to focus on providing students with essential knowledge and skills to function as competent house officers. Student-centered learning approaches, such as gamification and community service projects, can be effective in enhancing learning and promoting awareness of appropriate toxin-related public measures.

Healthcare service quality measurement in Malaysia: A scoping review.

INTRODUCTION: Although healthcare service industry has been thriving in Malaysia, the types of healthcare service quality models used in past research as well as their key messages had not been explored. A scoping review was performed to determine the validated healthcare service quality models, the key messages of these past studies and potential research gaps that should be addressed in future studies. MATERIALS AND METHODS: Relevant, peer-reviewed, Englishlanguage articles on healthcare service quality in Malaysia were independently searched by the authors using the SCOPUS and EMERALD databases. Articles that do not directly address healthcare service quality within the Malaysian setting were excluded. Additional articles were identified from the reference lists of the selected articles and from Google search engine. A total of 43 out of 2,749 articles were selected. RESULTS: Most of these studies (28 out of the 43 articles, 65.1%) in this scoping review used either the original or a modified version of SERVQUAL instrument to measure healthcare service quality. Significant positive relationships between tangibles, assurance and empathy with patient satisfaction were identified. As SERVQUAL primarily measures the functional dimension of service quality, this suggests that past studies on Malaysian healthcare services emphasised heavily on the functional dimension of healthcare service quality. Functional dimension refers to the expressive performance on how the healthcare service is rendered whereas technical dimension refers to the types of services rendered as well as its safety and efficacy. CONCLUSION: A pertinent research gap identified in this review is the lack of studies that measure both technical and functional dimensions comprehensively. Future research should adopt a more holistic (incorporating both technical dimension and functional dimension) measurement of healthcare service quality.

The effect of vacancy defects on the electromechanical properties of monolayer NiTe2 from first principles calculations.

The electromechanical properties of monolayer 1-T NiTe2 under charge actuation were investigated using first-principles density functional theory (DFT) calculations. Monolayer 1-T NiTe2 in its pristine form has a work area density per cycle of up to 5.38 MJ m-3 nm upon charge injection and it can generate a strain and a stress of 1.51% and 0.96 N m-1, respectively. We found that defects in the form of vacancies can be exploited to modulate the electromechanical properties of this material. The presence of Ni-vacancies can further enhance the generated stress by 22.5%. On the other hand, with Te-vacancies, it is possible to improve the work area density per cycle by at least 145% and also to enhance the induced strain from 1.51% to 2.92%. The effect of charge polarity on the contraction and expansion of monolayer 1T-NiTe2 was investigated. Due to its excellent environmental stability and good electromechanical properties, monolayer NiTe2 is considered to be a promising electrode material for electroactive polymer (EAP) based actuators.

Impact of direct-acting antiviral treatment of hepatitis C on the quality of life of adults in Ukraine.

BACKGROUND: Direct-acting antivirals (DAAs) are highly effective in achieving sustained virologic response among those with chronic hepatitis C virus (HCV) infection. Quality of life (QOL) benefits for an HCV-infected population with high numbers of people who inject drugs and people living with HIV (PLHIV) in Eastern Europe have not been explored. We estimated such benefits for Ukraine. METHODS: Using data from a demonstration study of 12-week DAA conducted in Kyiv, we compared self-reported QOL as captured with the MOS-SF20 at study entry and 12 weeks after treatment completion (week 24). We calculated domain scores for health perception, physical, role and social functioning, mental health and pain to at entry and week 24, stratified by HIV status. RESULTS: Among the 857 patients included in the final analysis, health perception was the domain that showed the largest change, with an improvement of 85.7% between entry and week 24. The improvement was larger among those who were HIV negative (104.4%) than among those living with HIV (69.9%). Other domains that showed significant and meaningful improvements were physical functioning, which improved from 80.5 (95% CI 78.9-82.1) at study entry to 89.4 (88.1-90.7) at 24 weeks, role functioning (64.5 [62.3-66.8] to 86.5 [84.9-88.2]), social functioning (74.2 [72.1-76.2] to 84.8 [83.2-86.5]) and bodily pain (70.1 [68.2-72.0] to 89.8 [88.5-91.1]). Across all domains, QOL improvements among PLHIV were more modest than among HIV-negative participants. CONCLUSION: QOL improved substantially across all domains between study entry and week 24. Changes over the study period were smaller among PLHIV.

The many reasons of poor performance/more pertinent reasons for poor student performance.

No abstract available.

Revisiting the Kittel's model of antiferroelectricity: phase diagrams, hysteresis loops and electrocaloric effect.

We revisit the Kittel's model of antiferroelectricity by extending the model to study the phase transitions, hysteresis loop behaviors and electrocaloric effect (ECE) of antiferroelectrics (AFEs). By considering both the first- and second-order AFEs, explicit expressions for the physical and staggered polarizations of AFEs in the stable states are derived. We also obtain the analytical solutions for describing the dielectric susceptibilities of AFEs in the AFE and paraelectric (PE) phases. Coercive fields in AFE are also derived and studied. To verify the usefulness of the Kittel's model of antiferroelectricity, we apply the model to systematically investigate the phase transitions, hysteresis loops and ECEs of PbZrO3(PZO). By adopting appropriate values of the Kittel's parameters for first-order transition, analytical and numerical results are obtained and discussed. Our results show that PZO exhibits a complex temperature (T)-electric field (E) phase diagram, consisting of the AFE, ferroelectrics, ferrielectric, PE and mixed phases. TheT-Ephase diagram is qualitatively agreed with the new AFE model that was derived based on symmetry by Tolédano and Khalyavin (2019Phys. Rev.B99024105). We found that the calculated zero-field dielectric susceptibility is qualitatively and quantitatively agreed with experimental results. We show that the polarizations and dielectric susceptibilities of PZO in heating and cooling deviate from each other, as expected for the first-order materials. Our calculated results also reveal that the ECE in PZO has an electro-heating of ΔT≈ +6.5 °C and an electro-cooling of ΔT≈ -4.0 °C, respectively, which are comparable to the experimental results.

The SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER): Study Design and Protocol.

BACKGROUND: The SINgapore GERiatric intervention study to reduce cognitive decline and physical frailty (SINGER) randomised controlled trial (RCT) uses a multidomain lifestyle interventions approach, shown to be effective by the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial, to delay cognitive decline. OBJECTIVE: To investigate the efficacy and safety of the SINGER multidomain lifestyle interventions in older adults at risk for dementia to delay cognitive decline. PARTICIPANTS: 1200 participants between 60-77 years old, with Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score ≥6, fulfilling at least one of the following LIBRA index for diet, cognitive activity, physical activity and a Montreal Cognitive Assessment (MoCA) score ≥18, ≤27 points, will be recruited across Singapore. METHODS: SINGER is a 2-year multi-site RCT consisting of multidomain interventions: dietary advice, exercise, cognitive training, and vascular risk factors management. Participants will be randomised into either the Self-Guided Intervention (SGI; general lifestyle and health information and resources) or Structured Lifestyle Intervention (SLI) group. The SLI comprises diet training (6 group and 3 individual sessions over 12 months); exercise (supervised: 1-hour twice weekly for 6 months, unsupervised: 2-3/week for the rest of the study duration); cognitive sessions (15-30 minutes/session, 3/week for 6 months, together with 10 workshops in 24 months). Vascular management takes place every 3-6 months or otherwise as specified by study physicians. The primary outcome is global cognition measured using the modified Neuropsychological Battery assessing performance in various domains, such as episodic memory, executive function and processing speed. Secondary outcome measures include: domain-specific cognition and function, imaging evidence of brain and retinal changes, incidence and progression of chronic diseases, blood biomarkers, quality of life, mental health and cost-benefit analysis. CONCLUSIONS: SINGER is part of the Worldwide-FINGERS international network, which is at the forefront of harmonizing approaches to effective non-pharmacological interventions in delaying cognitive decline in older adults at risk of dementia. By establishing the efficacy of multidomain interventions in preventing cognitive decline, SINGER aims to implement the findings into public health and clinical practices by informing policy makers, and guiding the design of community- and individual-level health promotion initiatives.

Types and risk factors of ambulance accidents: A scoping review.

BACKGROUND: A scoping review was conducted to map out the common research focusses on ambulance accidents, their key findings and some of the major knowledge gaps in this area. MATERIALS AND METHODS: Relevant, peer-reviewed, Englishlanguage articles on land ambulance accidents were independently searched by the authors using the MEDLINE and CINAHL databases. Anecdotal reports, testimonies and stories in trade or popular magazines and other grey literature were excluded. Articles that do not directly address ambulance accidents were also excluded. Additional articles were identified from the reference lists of the selected articles and from Google search engine. RESULTS: From an initial yield of 879 articles, 19 articles were included. Most of these articles were published from 2001 - 2005 (5 articles, 26.3%) and 2006 - 2010 (5 articles, 26.3%). Eighteen articles (78.3%) are original articles (18 articles, 78.3%) and another one article is a review article. Most of these articles focused on (1) the types of collisions and (2) the risk factors of ambulance accidents. Nine risk factors were identified to have contributed to ambulance accidents: (1) driving in urban areas (2) driving on dry road (3) the use of lights & sirens (4) the failure to use restraints (5) driving for emergency use (6) back seating (7) at road intersection (8) driver's previous records of accidents and (9) interfacility transfer. The two most common risk factors studied were (1) the use of lights & sirens and (2) driving at intersection. CONCLUSIONS: Most of the above risk factors can be mapped into three categories of risk factors: task-related factors, vehicle-related factors and environment-related factors. The category of risk factors least studied is the category of driver-related factors.

Development of a validated instrument on socio-cultural and religious influences during menstruation in Malaysia.

INTRODUCTION: Although menstruation is a physiological process, it is shrouded with socio-cultural and religious beliefs. Healthcare providers should be aware that these influences may affect how women perceive their menstrual disorders. The primary objective of this study was to develop a validated questionnaire measuring the sociocultural and religious beliefs during menstruation. METHODS: In the first stage, a preliminary list of items measuring socio-cultural and religious beliefs during menstruation was generated. In the second stage, exploratory factor analysis was performed. Finally, confirmatory factor analysis using reflective measurement model and structural equation modelling was performed using partial least squares. The practices of these beliefs were included as mediating effect. Biological symptoms of menstruation were added in as another factor. RESULTS: A total of 400 female students from the Universiti Malaysia Sarawak, Malaysia were recruited. A preliminary list of 22 items was first generated. From the confirmatory factor analysis, two factors were iteratively removed due to poor factor loadings. Four factors were retained, i.e., i) "religious beliefs"; ii) "unpleasant (or dirty) nature of menstruation"; iii) "personal restrictions (dietary and behavior)"; and iv) "restrictions of interactions with male gender". In structural equation modelling, only 2 factors, i.e., the practices of "personal restrictions (dietary and behavioural)" and "restriction of interactions with males" had significant negative impact on quality of life. CONCLUSION: Menstruation should not be viewed purely from a biological lens as there are layers of sociocultural and religious beliefs surrounding it.

A first-principles study of two-dimensional NbSe2H/g-ZnO van der Waals heterostructures as a water splitting photocatalyst.

Based on first-principles calculations, we propose a new two-dimensional (2D) van der Waals (vdW) heterostructure that can be used as a photocatalyst for water splitting. The heterostructure consists of vertically stacked 2D NbSe2H and graphene-like ZnO (g-ZnO). Depending on the stacking orders, we identified two configurations that have high binding energies with an energy band gap of >2.6 eV. These 2D systems form a type-II heterostructure which enables the separation of photoexcited electrons and holes. The presence of a strong electrostatic potential difference across the 2D NbSe2H and g-ZnO interface is expected to suppress the electron-hole recombination leading to an enhancement in the efficiency of the photocatalytic activity. Our study also shows that the 2D NbSe2H/g-ZnO vdW heterostructure has good thermodynamic properties for water splitting. Furthermore, the optical absorption of the 2D NbSe2H/g-ZnO vdW heterostructure extends into the visible light region. Our results suggest that the 2D NbSe2H/g-ZnO vdW heterostructure is a promising photocatalytic material for water splitting.

High resolution front-side visualization of charge stored in EEPROM with scanning nonlinear dielectric microscopy (SNDM).

By exposing floating gates of EEPROM memory cells with frontside sample preparation, scanning nonlinear dielectric microscopy (SNDM) succeeded in reading back the data stored in the memory cells with a 250 nm node size. At an optimized voltage bias of AC = 3 V and DC = 1 V, a clear signal contrast between programmed and erased cells is obtained. The high resolution SNDM signal reveals the details of bowling-pin shape structure of memory cells, providing high confidence in data assignment during forensic applications. Such high resolution also makes SNDM a promising technique for newer generation devices with smaller node size.

Targeted amplification and MinION nanopore sequencing of key azole and echinocandin resistance determinants of clinically relevant Candida spp. from blood culture bottles.

The objective of the study was to evaluate the use of targeted multiplex Nanopore MinION amplicon re-sequencing of key Candida spp. from blood culture bottles to identify azole and echinocandin resistance associated SNPs. Targeted PCR amplification of azole (ERG11 and ERG3) and echinocandin (FKS) resistance-associated loci was performed on positive blood culture media. Sequencing was performed using MinION nanopore device with R9.4.1 Flow Cells. Twenty-eight spiked blood cultures (ATCC strains and clinical isolates) and 12 prospectively collected positive blood cultures with candidaemia were included. Isolate species included Candida albicans, Candida glabrata, Candida krusei, Candida parapsilosis, Candida tropicalis and Candida auris. SNPs that were identified on ERG and FKS genes using Snippy tool and CLC Genomic Workbench were correlated with phenotypic testing by broth microdilution (YeastOne™ Sensititre). Illumina whole-genome-sequencing and Sanger-sequencing were also performed as confirmatory testing of the mutations identified from nanopore sequencing data. There was a perfect agreement of the resistance-associated mutations detected by MinION-nanopore-sequencing compared to phenotypic testing for acquired resistance (16 with azole resistance; 3 with echinocandin resistance), and perfect concordance of the nanopore sequence mutations to Illumina and Sanger data. Mutations with no known association with phenotypic drug resistance and novel mutations were also detected.

A first-principles comparative study of lithium, sodium, potassium and calcium storage in two-dimensional Mg2C.

Two-dimensional (2D) materials have recently emerged as potential candidates for high-capacity lithium-ion batteries anode materials because of their compelling physicochemical and structural properties. In the present study, we use first-principles calculations to investigate the performance of 2D Mg2C as anode materials for Li, Na, K and Ca-ions batteries. The calculated average open-circuit voltage are 0.37, 0.50, 0.03 and 0.06 eV vs Li, Na, K, Ca. No significant structural deformations are observed on the 2D Mg2C upon the adsorption of Li, Na, K or Ca and the metallic characteristic of the 2D Mg2C is retained. The metallic behaviour of both pristine and adsorbed Mg2C ensures the desirable electric conductivity, implying the advantages of 2D Mg2C for batteries. The Na and K atoms show an extremely high diffusivity on the 2D Mg2C with a low energy barrier of 0.08 and 0.04 eV respectively, which is about an order of magnitude smaller than that of Li atom. For the Na and K atoms, the theoretical storage capacity can reach up to 1770 mAh g-1, nearly two times that of the Li atom of 885 mAh g-1. Our study suggests that the 2D Mg2C is a promising anode material which offers a fast ion diffusion and high storage capacity.

Association Between Minimum Inhibitory Concentration, Beta-lactamase Genes and Mortality for Patients Treated With Piperacillin/Tazobactam or Meropenem From the MERINO Study.

INTRODUCTION: This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial. METHODS: Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations. RESULTS: In total, 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam nonsusceptible breakpoint (MIC >16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% confidence interval [CI] 2.8-87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3%-15%) and 8% (95% CI 2%-15%) for the original PA population and the post hoc MA populations, which reduced to 5% (95% CI -1% to 10%) after excluding strains with piperacillin/tazobactam MIC values >16 mg/L. Isolates coharboring extended spectrum ß-lactamase (ESBL) and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-day mortality of 14% (95% CI 2%-28%). CONCLUSIONS: After excluding nonsusceptible strains, the 30-day mortality difference from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA coharboring ESBLs suggests that meropenem remains the preferred choice for definitive treatment of ceftriaxone nonsusceptible Escherichia coli and Klebsiella.

Rich antiferroelectric phase diagram of antiferroelectric-ferroelectric superlattices: internal electric field- and interface induced phase transitions.

We propose a thermodynamic model to the study the antiferroelectric (AFE) phase transitions in antiferroelectric-ferroelectric (AFE-FE) superlattices in which the coupling at the interface between two layers is mediated by local polarizations. Phase diagram of the AFE layer in term of the degree of interfacial effect λ and temperature T involving ferrielectric (FI) and ferroelectric (FE) phases is investigated. These two phases are stabilized by the interfacial effect and internal electric field. AFE thickness L AFE versus T phase diagram is also constructed. Intermediate regions of two-phase coexistence (IM) emerge in the λ-T and L AFE-T phase diagrams, if certain interface properties λ and layer thickness L AFE criteria are met. These IM regions are metastable states, which exist as a transition state between two phases. A tricritical point locates at the boundaries across the FI, IM and FE phases is found in the L AFE-T phase diagram. Competition among the internal electric field due to the electrostatic coupling, the FE ordering arises from the interfacial effect and the antiferroelectric ordering within the AFE layer giving rises to the rich AFE phase diagram.

Clinical evaluation of serological IgG antibody response on the Abbott Architect for established SARS-CoV-2 infection.

OBJECTIVE: This study aimed to evaluate the diagnostic performance of the Abbott Architect SARS-CoV-2 IgG assay in COVID-19 patients. METHODS: Residual sera from 177 symptomatic SARS-CoV-2-positive patients and 163 non-COVID-19 patients were tested for antibody with the Abbott SARS-CoV-2 IgG assay (Abbott Diagnostics, Chicago, USA). Clinical records for COVID-19 patients were reviewed to determine the time from onset of clinical illness to testing. RESULTS: Specificity of the assay was 100.0% (95%CI: 97.1-100.0%). The clinical sensitivity of the assay varied depending on time from onset of symptoms, increasing with longer periods from the onset of clinical illness. The clinical sensitivity at ≤6 days was 8.6% (7/81; 95%CI: 3.8-17.5%), at 7-13 days 43.6% (17/39; 95%CI: 28.2-60.2%), at 14-20 days 84.0% (21/25; 95%CI: 63.1-94.7%), and at ≥21 days 84.4% (27/32; 95%CI: 66.5-94.1%). Clinical sensitivity was higher in the ≥14-day group compared to <14 days. There were no differences between the 14-20-day and ≥21-days groups; the combined clinical sensitivity for these groups (≥14 days) was 84.2% (49/57; 71.6-92.1%). CONCLUSION: The Abbott SARS-CoV-2 IgG test has high specificity. Clinical sensitivity was limited in the early stages of disease but improved from 14 days after the onset of clinical symptoms.