Malay Ethnicity Research Articles

A cross-sectional study on the dietary patterns of multiethnic Malaysian preschoolers and their sociodemographic determinants.

Early childhood is a critical developmental stage where established dietary patterns can impact lifelong health outcomes. This study investigates dietary patterns and their relationships with sociodemographic factors among Malaysian preschoolers. A total of 643 preschoolers of Malay, Indian, Chinese and other ethnicities participating in South East Asian Nutrition Surveys (SEANUTS II) were included. Dietary intake was assessed using a single triple-pass 24-h dietary recall method. Dietary patterns were derived using principal component analysis and their association with sociodemographic factors was determined using complex sampling logistic regressions. Five dietary patterns were identified: "healthy eating," "wholegrains and starchy vegetables," "high salt and sugar," "Western food," and "sugary drinks and legumes". Having older siblings was inversely associated with a "healthy eating" pattern (adjusted OR: 0.54, 95% CI: 0.33-0.87). Malay ethnicity was associated with higher odds of adhering to the "high salt and sugar" pattern (adjusted OR: 4.12, 95% CI: 2.20-7.75). Meanwhile, children living in urban areas (adjusted OR: 1.76, 95% CI: 1.03-3.01), those from middle-income families (adjusted OR: 3.20, 95% CI: 1.38-7.40) and whose fathers were overweight (adjusted OR: 2.79, 95% CI: 1.58-4.94) showed a higher association with "Western food" pattern. Conversely, children whose mothers had overweight were less likely to adhere to the "Western food" pattern (adjusted OR: 0.50, 95% CI: 0.30-0.83). Older age was significantly associated with a greater likelihood of the "sugary drinks and legumes" pattern (adjusted OR: 3.99, 95% CI: 1.75-9.06). There was no significant association between "wholegrains and starchy vegetables" pattern with sociodemographic characteristics (all p > 0.05). These findings suggest that ethnicity, age, residence area, having older siblings, parental weight status and household income level are associated with dietary patterns among multiethnic preschoolers in Malaysia. Thus, these sociodemographic characteristics should be considered when designing targeted dietary strategies and interventions for preschoolers.

Time to wound closure in facial soft tissue injuries following road traffic accidents.

The 6-hour (6-h) time to wound closure was a controversial issue as studies have shown that time was not a substantial factor. Wounds in the face are often considered to have a lower infection risk. Despite this, the cause of injury was not extensively discussed in relation to this context. The primary objective was to investigate the association between the 6-h time to wound closure and wound complications following emergency management of facial soft tissue injuries (STIs). Additionally, the secondary objective was to explore other factors contributing to wound complications. A retrospective record review was conducted in our hospital in Kuala Lumpur, Malaysia, from 1 January 2017 to 31 December 2021. Medical records of patients with facial STIs due to road traffic accidents were included. Simple random sampling was used to select records meeting inclusion criteria. Data on demographic, injury, and treatment characteristics were collected using a standardized proforma. Descriptive, univariate and multivariate analyses were performed, including chi-square tests and binary logistic regression. A total of 295 patient records were included, with most patients being males (77.3%) and of Malay ethnicity (54.9%). The median age was 31.0 years. Majority of patients were treated within 6 h of injury (93.9%). Complications were documented in 6.1% of cases, including wound dehiscence and infection. Multivariate analysis revealed a significant association between 6-h time to closure and wound complications (OR: 7.53, 95% CI: 1.90-29.81, p = 0.004). Grade of surgeon on duty (OR: 4.61, 95% CI: 1.25-16.95, p = 0.02) and diabetes mellitus (OR: 6.12, 95% CI: 1.23-30.38, p = 0.03) were also shown to have a statistically significant association with wound complications. A 6-h time to wound closure, grade of surgeon on duty and diabetes mellitus were three major factors involved in facial wound complications following road traffic accidents.

#683 Utility of urinary soluble CD163 as a novel biomarker for the detection of IgA nephropathy

Abstract Background and Aims IgA nephropathy (IgAN) is an immune mediated disease and a leading cause of biopsy proven glomerulonephritis (GN) worldwide. CD163 is a membrane protein localised on the surface of monocytes and macrophages. Its soluble form, sCD163, produced by enzymatic splitting of the ectodomain of inflammatory cells when activated, is found in increased concentrations in acute inflammatory diseases such as sepsis and vasculitis. Urinary sCD163 levels have also been reported to be a useful biomarker of glomerular inflammation in lupus nephritis (LN) and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Yet, few studies have evaluated the role of urinary sCD163 as a biomarker in IgAN, and comparing it across different GN subtypes. This study aims to explore the utility of urinary sCD163 as a non-invasive biomarker for IgAN, and across different immune mediated GN types. Method This is a retrospective and prospective cohort study from a single tertiary hospital. Frozen urine samples from patients with GN and healthy controls from the Asian Kidney Disease Study and Singapore Kidney Function Study respectively were utilised for the retrospective cohort. The prospective cohort consists patients with biopsy-proven IgAN recruited from May to December 2023 with informed consent taken. Urinary sCD163 was measured using enzyme-linked immunosorbent assay (ELISA). Univariate analyses were performed and urinary sCD163 values were plotted on receiver-operating characteristic (ROC) curve and the area under the curve (AUC) was calculated. This study obtained Institutional Ethics Board Approval (DSRB 2022/00698). Categorical variables were represented by n (%). Continuous variables with a parametric distribution were represented by their means ± standard deviation, non-parametric variables were expressed as their medians with interquartile ranges. Chi-square test and ANOVA were performed between categorical variables, while a student's t-test was performed for continuous variables. P-value of < 0.05 was taken as statistically significant. A ROC curve was performed for sCD163 values in IgAN and controls, and the AUC calculated. Results In total, urine samples of 59 subjects were analysed (IgAN n = 10; LN n = 5; healthy controls n = 44). There were 30 male subjects (50.8%) and 29 female subjects (49.2%). Median age was 41.0 (IQR 31.0-52.0) years. Median serum creatinine was 78.0 (IQR: 60.0-91.0) µmol/L. Mean urine sCD163 value was 0.32 (±0.19) ng/ml. There were no baseline differences in demographics, comorbidities and medication between groups. Prospective cohort patients with IgAN were more likely to have received steroids (p = 0.03), and there were no patients of the Malay Ethnicity in the prospective cohort (p = 0.05). Median urine protein (g/day) in IgAN was 0.66 (IQR 0.16 to 3.29)¸ 0.159 in LN (IQR 0.09 to 0.26) and 0.12 in controls (IQR 0.07 to 0.20). Using Mann-Whitney U test to compare median proteinuria between IgAN and controls showed significant difference (p = 0.001), whereas median proteinuria between IgAN and LN was not statistically significant (p = 0.08). On univariate analysis compared to healthy controls, IgAN patients had a significantly higher serum creatinine (p = 0.04), compared to LN patients against controls (p = 0.30). Urine sCD163 levels were significantly higher in IgAN patients compared to controls (0.54 ± 0.26, p = 0.02). Patients with LN do not have a significant urinary sCD163 level difference compared to controls (0.21 ± 0.20, p = 0.40), which also correlates with creatinine and degree of proteinuria. There were no other significant baseline differences against controls. On the ROC curve for IgAN patients, urine sCD163 of 0.38 ng/ml has a 70% sensitivity, and 75% specificity in distinguishing IgAN against controls (AUC 0.77; 95% CI: 0.59-0.96, p = 0.008). For LN, urine SCD163 did not distinguish between LN and controls (AUC 0.29; 95% CI: 0.000-0.58, p = 0.12). Conclusion Urine sCD163 is elevated in patients with IgAN compared to controls and LN. Urine sCD163 is useful in the diagnosis of IgAN. A urine sCD163 level of 0.38 ng/ml has a 70% sensitivity and 75% specificity in identifying IgAN against healthy subjects.

Findings from the 2019 nationally representative oral health survey for adults in Singapore.

The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS). A multi-stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face-to-face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC-AAP classifications. Weighted analysis was performed to adjust for oversampling, non-response and post-stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries. Six hundred and sixty-three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1-2-room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC-AAP classification, the prevalence of moderate-severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease. Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio-economic gradient in the distribution of tooth loss, untreated dental caries and moderate-to-severe periodontitis was observed.

The Evolution of Anorexia Nervosa in Singapore: A 30-year Demographic Analysis

IntroductionNew prevalence and time trend data from various Asian countries show that Eating Disorders (ED) are increasingly common in Asia. (Youl-Ri Kim. Int J Eat Disord. Dec 2020). A recent study estimating the prevalence of ED in Singapore found an alarming 6.2% screened positive for a clinical ED diagnosis, 19.5% were screened to be at high risk, and estimated the point prevalence of Anorexia Nervosa (AN) to be 0.9%. (Chua SN et al. Int J Eat Disord. Jan 2021). The ED unit in Singapore General Hospital (SGH) was set up in 2003 as a National Treatment Programme for patients with ED. Two local studies have been published to date on the demographics and clinical profile of patients with AN. The first study examined 126 patients from 1994 – 2002 (HY Lee et al. Singapore Med J 2005; 46(6): 275-281). The second study reported on 271 cases from our SGH ED unit from 2003-2010 (Kuek et al. SIngapore Med J 2015; 56(6): 324-328). There have been no further studies in the last decade.Objectives1.Study the demographics and clinical profile of patients who presented with AN to our ED unit from 2011-20222.Compare our data with the 2 previous studies and examine for any changes and trends in the past 30 years.MethodsWe conducted a review of the ED unit new case registry at SGH from 2011-2022. A total of 910 patients were diagnosed with AN at presentation. The data was analysed with approval from the hospital instituitional review board.ResultsA total of 910 cases presented with AN over 12 years. Comparing with the 2 previous studies, the number of new cases each year has continued to increase from <15 in the 1990s to hit a peak of 109 per year in 2022. 94% were females, with a mean presenting age of 19. 79.2% were Chinese, 5.2% were Indians and 2.9% were of Malay ethnicity. The Malay population continue to be under-represented whereas other ethnic groups continue to be over-represented, increasing from 3.2% to 7% in the previous studies to 11.1%. Referrals were mainly from tertiary healthcare intuitions accounting for 41.4% of cases. Self-referrals have decreased over the last decade whereas referrals from primary care has increased. The mean presenting body mass index (BMI) was 15.9. Compared to a previous study, there was a significant increase in presenting BMI (15.9+/- 0.78 vs 14.4 +/- 1.77, p value 0.0074).ConclusionsThe number of new cases of AN has seen an almost 10-fold increase in the last 30years. The Malay ethnicity continues to be under-represented – more research is needed if they are somehow culturally protected or if they are not coming forth for treatment. Majority of referrals are from tertiary healthcare institutions but referrals from primary care have increased, reflecting a possible increase in awareness amongst primary care doctors. The mean presenting BMI has increased – hopefully reflecting an increase in ED awareness such that patients are coming forward earlier for treatment.Disclosure of InterestNone Declared

Stigma towards mental health disorders - Has anything changed?

IntroductionStigma towards mental disorders has been shown to be a major obstacle to recovery and quality of life among people with psychiatric disorders. Despite significant advances in the treatment of mental disorders, stigma remains concerning to patients, caregivers, and healthcare professionals. Singapore is a city state in South-East Asia with a multi-ethnic population. A nation-wide campaign launched in 2018, Beyond the Label, focusing on addressing stigma and promoting social inclusion for persons with mental health conditions.ObjectivesThe aims of the current study were to (i) establish the dimensions of stigma and examine its correlates in the general population of Singapore using a vignette approach, and (ii) examine whether there was any change in stigma levels from 2016 to 2023.MethodsData for the current study comes from an ongoing nation-wide, cross-sectional study of mental health literacy conducted in Singapore since September 2022. The study population comprises Singapore Residents aged 18–65 years who are currently living in Singapore. Respondents were randomly assigned and presented a vignette describing one of seven specific disorders: alcohol abuse, dementia, depression, depression with suicidality, gambling disorder, obsessive-compulsive disorder, and schizophrenia. Stigma was assessed using Personal and Perceived scales of the Depression Stigma Scale (DSS) (Griffiths et al. Br J Psychiatry; 2004 185 342-349), and the Social Distance scale (SDS) (Link et al. Am J Public Health 1999; 89 1328–1333).Results2500 respondents who completed the survey were included in the current analysis. The mean age of the respondents was 42.8 years. A three-factor model comprising ‘weak-not-sick’, ‘dangerous/undesirable’, and ‘social distance’ provided acceptable fit. Multivariable linear regression analyses revealed that younger age, female gender, students, and dementia vignette were significantly associated with lower weak-not-sick scores while Malay and Indian ethnicity, lower education, and alcohol abuse and gambling disorder vignette were significantly associated with higher weak-not-sick scores. Those of Malay and Indian ethnicities and those with a family member or close friend who had problems similar to the person in the vignette were significantly associated with lower social distance scores.A significant decrease (p<0.001) in all three factor scores was observed from 2016 to 2023 (Table 1).Table 1.Mean stigma scores over time20162023FactorsMean (SD)Mean (SD)Weak-not-sick10.2 (2.1)9.5 (2.3)Dangerous/undesirable11.6 (2.8)11.2 (2.7)Social distance12.0 (3.1)11.6 (3.0)ConclusionsOur study found a significant decrease in stigma from 2016 to 2023 in the Singapore population which indicates the positive impact of anti-stigma initiatives in Singapore. Interventions must be co-developed with males, older adults, and those with a lower education to further reduce stigma in this multi-ethnic population.Disclosure of InterestNone Declared

Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study

Aim This study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions. Methods We surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimensional scores were converted to utility scores using the Malaysian value set. A confirmatory factor analysis longitudinal model was constructed. The utility and visual analog scale (VAS) scores were evaluated for validity (convergent, known-group, responsiveness), and measurement equivalence of the three language versions. Results 200 HFrEF patients (mean age = 61 years), predominantly male (74%) of Malay ethnicity (55%), completed the admission and discharge EQ-5D-5L questionnaire in Malay (49%), English (26%) or Chinese (25%) languages. 173 patients (86.5%) were followed up at 1-month post-discharge (1MPD). The standardized factor loadings and average variance extracted were ≥ 0.5 while composite reliability was ≥ 0.7, suggesting convergent validity. Patients with older age and higher New York Heart Association (NYHA) class reported significantly lower utility and VAS scores. The change in utility and VAS scores between admission and discharge was large, while the change between discharge and 1MPD was minimal. The minimal clinically important difference for utility and VAS scores was ±0.19 and ±11.01, respectively. Malay and English questionnaire were equivalent while the equivalence of Malay and Chinese questionnaire was inconclusive. Limitation This study only sampled HFrEF patients from two teaching hospitals, thus limiting the generalizability of results to the entire heart failure population. Conclusion EQ-5D-5L is a valid questionnaire to measure health-related quality of life and estimate utility values among HFrEF patients in Malaysia. The Malay and English versions of EQ-5D-5L appear equivalent for clinical and economic assessments.

Prevalence of diabetic kidney disease and the associated factors among patients with type 2 diabetes in a multi-ethnic Asian country

The actual prevalence of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D) in Malaysia is unknown. We aimed to determine the prevalence of DKD and its associated risk factors among T2D patients in Malaysia. An analytical cross-sectional study was conducted using the year 2022 clinical audit dataset from the National Diabetes Registry. DKD was defined as albuminuria, a decreased glomerular filtration rate, or both. Among 80,360 patients, 62.2% were female, 68.4% were Malay, and the mean age was 61.4 years. A total of 56.7% (95% CI 56.4–57.1%) of patients were found to have DKD. Increasing age, male sex, Malay ethnicity, longer duration of diabetes, overweight, obesity, hypertension, diabetic retinopathy, diabetic foot ulcer, nontraumatic lower-extremity amputation, ischaemic heart disease, stroke, insulin, higher numbers of antihypertensive agents, antiplatelet agents, poorer HbA1c control, higher systolic blood pressure, non-achievement of triglyceride target, and non-attainment of HDL-cholesterol goal were independent risk factors associated with DKD. Clinicians, program managers, and health policymakers should target modifiable factors to manage DKD and prevent its progression to end-stage kidney disease in Malaysia.

Angiotensin-Converting Enzyme Genetic Polymorphism rs4343 as Risk of Diabetic Nephropathy in Jambi-Malay Population

Background: Diabetic nephropathy (DN) is one of the frequent complications of type II diabetes mellitus (T2DM) in Jambi province. Controlling blood glucose and blood pressure does not guarantee DN prevention, since genetic factors may also contribute to this disease. Multi-ethnic studies showed that one of the strongest genetic factors associated with DN was single nucleotide polymorphism rs4343 of angiotensin-converting enzyme (ACE) gene. Study regarding phenotype-genotype association of ACE rs4343 and DN has not yet been performed in Jambi Province, which is dominated by Malay ethnicity. This study was conducted to reveal the association between ACE rs4343 and the risk of DN in the Jambi-Malay population.Materials and methods: This was a cross-sectional study involving 75 subjects (44 with DN and 31 without DN) who suffered from T2DM and hypertension. DN was defined as albumin to creatinine ratio (ACR) ≥30 mg/g. Genotyping was performed with one-step tetra amplification refractory mutation system-polymerase chain reaction (PCR) using specific primer for ACE rs4343. Bivariate and multivariate analyses were performed to analyze the genetic risk for DN.Results: The bivariate analysis showed the proportion of DN subjects was higher than non-DN within the AG genotype (11:1) than within the AA (33:30) genotype. This difference was statistically significant (p=0.012; OR (95% CI): 10.00 (1.22-82.15)). Multivariate analysis showed that AG genotype (p=0.047; OR (95% CI): 10.04 (1.03-97.31)) and uncontrolled blood pressure (p=0.001; OR (95% CI): 6.72 (2.08-21.71)) were the risk factors of DN in the Jambi-Malay population.Conclusion: Polymorphism of ACE rs4343 is a risk factor of DN in the Jambi-Malay Population.Keywords: rs4343, angiotensin-converting enzyme gene, diabetic nephropathy, Malay, Jambi

Prevalence of Transfusion-transmissible Infections in Blood Donors: A Private Hospital Experience

Introduction: Blood transfusion, a vital component of established medical protocols, has the potential to save lives and enhance well-being. Nonetheless, it carries inherent risks, with transfusion-transmissible infections (TTIs) remaining a global public health concern. Vigilant monitoring of TTI prevalence among blood donors and understanding of evolving patterns are crucial safety endeavours. The objective of this study was to assess the prevalence of TTIs and their patterns among blood donors within a private hospital’s transfusion service. Methods: This retrospective study involved TTI testing results of blood donations at Normah Medical Specialist Centre (NMSC) in Kuching, Sarawak, spanning a decade from 2010 to 2019. Results: A total of 7329 blood donors contributed 16,085 blood units (2010 – 2019). Among them, 353 donors exhibited reactivity to TTIs, resulting in a prevalence of 4.81%. The majority of reactive donors were male (87.3%), of Malay ethnicity (62.6%), and first-time donors (73.9%). The prevalence rates were highest for HCV (2.69%), followed by HBV (1.41%), HIV (0.42%), and syphilis (0.39%). Both HBV and HCV demonstrated declining prevalence trends, while the prevalence of HIV and syphilis remained consistently low. The response to notification of positivity among reactive donors stood at a mere 4.0%, and the seroconversion rate among repeat donors reached 36.9%. No significant disparities in prevalence or response rates were observed between first-time and repeat donors. Conclusions: The prevalence of TTIs within NMSC’s blood donor populace remains relatively low, though not negligible. The responsiveness of reactive donors to notifications displayed considerable deficiencies.

Pseudomonas Keratitis Predominance in Government Hospitals in Johor, Malaysia

Introduction: Keratitis is an eye-threatening condition, which requires immediate treatment, due to the rapid progression when the infection caused by Pseudomonas aeruginosa. This study aimed to describe the socio-demographic factors and risk factors related to Pseudomonas keratitis in selected six government hospitals in Johor, Malaysia. Methods: An 18 months cross-sectional study was conducted among bacterial keratitis patients from six government hospitals offering ophthalmology services in Johor, Malaysia. The cases were confirmed through a positive culture of Pseudomonas aeruginosa. All data on socio-demographic factors, risk factors, and symptoms were recorded using a data collection form and analysed using the Statistical Package for Social Sciences (SPSS) software version 26. Results: Fifty-five patients were diagnosed with Pseudomonas keratitis in this study. The majority of patients were males (65.5%) with a mean age of 41.22 years old. The majority of patients were of Malay ethnicity (60.0%). More than a quarter of cases are involved in office-oriented jobs (n=14, 25.5%). The major risk factors in this study were contact-lens usage (n=25, 45.5%), trauma (n=20, 36.4%), ophthalmic steroid usage (n=16, 29.1%), ocular surface disease (n=12, 21.8%) and previous eye surgery (n=4, 7.3%). This study found underlying medical illness (p=0.036) and ocular surface disease (p=0.051) are significantly associated with Pseudomonas keratitis. Conclusion: The present study is the first study in Malaysia focusing on Pseudomonas keratitis. This study provides additional information on the epidemiology data of keratitis in Malaysia. Future studies shall be extended to all government hospitals in Malaysia to obtain better insight on the disease burden of keratitis especially on Pseudomonas keratitis.

Maternal height, and ethnicity and birth weight: A retrospective cohort study of uncomplicated term vaginal deliveries in Malaysia.

Small for gestational age (SGA) and large for gestational age (LGA) are designations given to neonates based solely on birthweight, with no distinction made for maternal height. However, there is a possibility that maternal height is significantly correlated with neonatal birthweight, and if so, SGA and LGA cutoffs specific to maternal height may be a more precise and useful tool for clinicians. To explore this possibility, we analyzed the association between maternal height and ethnicity and neonate birthweight in women with low-risk, 37- to 40-week gestation, singleton pregnancies who gave birth vaginally between 2010 and 2017 (n = 354,488). For this retrospective cohort study, we used electronic obstetric records obtained from the National Obstetrics Registry in Malaysia. National Obstetric Registry (NOR) data were used to calculate the 10th and 90th birthweight percentiles for each maternal height group by gestational age and neonatal sex. Multiple linear regression models, adjusted for maternal age, weight, parity, gestational age, and neonatal sex, were used to examine the association between neonate birthweight and maternal ethnicity and height. The following main outcome measures were assessed: small for gestational age (<10th percentile), large for gestational age (>90th percentile), and birthweight. The median height was 155 cm (IQR, 152-159), with mothers of Chinese descent being the tallest (median (IQR): 158 cm (154-162)) and mothers of Orang Asli (Indigenous) descent the shortest (median (IQR): 151 cm (147-155)). The median birthweight was 3000 g (IQR, 2740-3250), with mothers of Malay and Chinese ethnicity and Others having, on average, the heaviest babies, followed by other Bumiputeras (indigenous) mothers, mothers of Indian ethnicity, and lastly, mothers of Orang Asli ethnicity. For infants, maternal age, height, weight, parity, male sex, and gestational age were positively associated with birthweight. Maternal height had a positive association with neonate birthweight (B = 7.08, 95% CI: 6.85-7.31). For ethnicity, compared with neonates of Malay ethnicity, neonates of Chinese, Indian, Orang Asli, and other Bumiputera ethnicities had lower birthweights. Birthweight increases with maternal height among Malaysians of all ethnicities. SGA and LGA cutoffs specific to maternal height may be useful to guide pregnancy management.

Frequencies of HLA-B alleles in Indonesian Malay Ethnic

BackgroundThe HLA-B alleles have been used as a marker to predict drug-induced adverse reactions and as a major contributor to hypersensitivity reactions. We examined the feasibility of HLA-B alleles as pharmacogenomic markers of drug-induced hypersensitivity in an Indonesian Malay Ethnic. MethodsFifty-eight Indonesian individuals of Malay ethnicity were enrolled in this study. HLA-B alleles were determined using reverse sequence-specific oligonucleotide probe coupled with xMAP technology. ResultsHLA-B*15:02 (15.52%), HLA-B*35:05 (9.48%), and HLA-B*07:05 (7.76%) were frequent alleles in the Indonesian Malay ethnic populations. We discovered at least eight pharmacogenomics markers of drug-induced hypersensitivity: HLA-B*15:02, HLA-B*15:21, HLA-B*13:01, HLA-B*35:05, HLA-B*38:02, HLA-B*51:01, HLA-B*57:01, and HLA-B*58:01. HLA-B*15:02 was in the same serotype group with HLA-B*15:21, which is a B-75 serotype associated with genetic predisposition for carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis. The Indonesian population, represented by Malay, Javanese, and Sundanese ethnicities, was similar to South East Asian, Han Chinese, and Taiwanese populations based on HLA-B*15:02 frequency as the most common allele found in Malay ethnics. ConclusionWe provided valuable information on the frequency of drug hypersensitivity-associated HLA-B alleles in Indonesian Malay ethnic population, which can improve treatment safety.

Accelerometer-measured 24-hour movement behaviours over 7 days in Malaysian children and adolescents: A cross-sectional study.

Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions. Data came from the South-East Asia Community Observatory health surveillance cohort, 2021-2022. Children aged 7-18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity. The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9-8.4) hours/day asleep, 12.4 (95% CI = 12.2-12.7) hours/day inactive, 2.8 (95% CI = 2.7-2.9) hours/day in LPA, and 33.0 (95% CI = 31.0-35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics. Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia.

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

BackgroundDepression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.ObjectivesThis study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.MethodsA repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students’ sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.ResultsThe prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.ConclusionsThis study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group’s specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

Continuity and Change of Silat Pelintau as a Cultural Heritage of the Tamiang Community in Aceh Tamiang Regency

Silat Pelintau is a traditional art of the Tamiang Malay ethnic community which originates from local wisdom and then became a performing art and underwent changes in function and use. Specifically, this research aims to determine the exact continuity and changes of Silat Pelintau in the Tamiang Malay community over several periods in Aceh Tamiang Regency. The research method used is descriptive qualitative. The continuity and changes of silat pelintau in the Tamiang Malay Ethnic community have connected periods within a certain period of time up to the present. The continuity of Silat Pelintau itself starts from colonialism, independence, the New Order, and up to the present.

Empathy Levels Among Healthcare Professionals: An Asian Multi-professional Cross-Sectional Study.

The aim of the study was to measure empathy in healthcare professionals in Singapore and to compare the scores between the different professions: doctors, nurses, and allied health professionals. An online survey questionnaire was conducted using the Jefferson Scale of Empathy (JSE) from July 2019 to January 2020. The total JSE score was calculated and compared among the different groups. Multiple linear regression was performed to assess predictors of total empathy scores for groups with statistically lower scores. The survey was completed by 4,188 healthcare professionals (doctors (n=569, 13.6%), nurses (n=3032, 72.4%), and allied health professionals (n=587, 14.0%)) out of the 9,348-strong survey population, with a response rate of 44.8%. The study revealed a mean empathy score (SD) of 103.6 (15.6) for the cohort. The mean empathy score (SD) was 112.3 (14.7), 101.3 (15.2), and 107.0 (15.0), respectively for doctors, nurses, and allied health professionals. These were statistically significantly different among the groups (p< 0.0001), with nurses scoring significantly lower than either doctors (p< 0.0001) or allied health professionals (p< 0.0001). Multiple linear regression showed that age < 30 years old, male gender, Malay ethnicity, and working in a hospital setting were associated with significantly lower empathy scores in the nursing group. Nurses in Singapore had significantly lower empathy scores compared to doctors and allied health professionals. Further research on the underlying causes should be undertaken and measures to improve empathy among Singapore nursing staff should be explored and implemented.

Malay, Akit, and Chinese ethnic languages: a study of cross-cultural communication in Indonesia

The cross-cultural communication of ethnic Malays, Akit, and Chinese in Selatpanjang City is very interesting to study because it reveals communication patterns and degrees of harmony (Dewi et al., 2023; Murni, 2021). This study of cross-cultural interactions contains a variety of problems, ranging from those that have a personal effect to those that have a social impact. This study focused on the language characteristics implied in cross-cultural communication between ethnic Malays, Akit, and Chinese in Selatpanjang City. This study aims to explain the characteristics of ethnic Malay, Akit, and Chinese by analyzing their ability to convey verbal messages and ethnic characters. This research design is in a qualitative form that aims to describe, explore, find, reveal, and explain the aspects studied holistically. Data collection is carried out through in-depth observations and interviews. The data is analyzed with steps that include reduction, categorization, description, analysis, discussion, and inference. Based on the results of the research and discussion above, several conclusions can be drawn. First, the language characteristics of the three ethnicities are influenced by their respective socio-cultural backgrounds. Second, the cross-cultural communication between the Malays, Akit, and Chinese ethnicities shows the character of their respective ethnicities.

The Transformation of The Swing Procession: From Hereditary Tradition to The Modern Era

The tradition of riding ayun in ethnic Malays in West Kalimantan is one form of cultural preservation that has undergone a significant transformation in the face of the modern era. This study aims to describe changes in the meaning, implementation, and interpretation of the swing riding tradition in the context of the modern era. The research method used is a qualitative method with an analytical descriptive study approach. Data was collected through observation and interviews with local communities who still preserve the tradition of riding Ayun. The results showed that the tradition of swinging rose experienced changes in meaning, implementation, and interpretation. The influence of technology and globalization plays an important role in this change. Technology enables the use of social media and event planning apps to make it easier for families planning traditional events to ride the swing. In addition, technology also allows the use of modern equipment in the implementation of traditions, such as the use of audio-visual equipment to display information about the tradition of swinging or documentation of the birth of a baby. On the globalization side, the tradition of swinging can become better known in different parts of the world through social media platforms and websites. This can help in expanding the appreciation of this tradition on a global level. This research suggests that cultural transformation can occur in hereditary traditions such as swing rides. Therefore, cultural preservation needs to be done in the right way so that the tradition remains relevant and can be passed on to the next generation. In addition, the study also shows that technology and globalization can play an important role in cultural preservation. Therefore, there needs to be an effort to leverage technology and global connectivity to promote and preserve local culture.

Complexity of consumer acceptance to alternative protein foods in a multiethnic Asian population: A comparison of plant-based meat alternatives, cultured meat, and insect-based products

Alternative protein foods can be manufactured from various sources, including plants, insects, and cultured meat. Asia is a unique consumer market, with diverse ethnicities and culinary traditions that may impact consumer acceptance of these emerging protein products. Yet, few studies have compared various alternative protein foods within a multi-ethnic Asian population. We examined how sociodemographic factors were associated with alternative protein food acceptance and investigated the attitudes of individuals towards consuming plant-based meat alternatives, cultured meat, and insect-based products. Adult Singaporeans (n = 1224) from the Multi-Ethnic Cohort 2 study (75 % Chinese, 15 % Indian, 10 % Malay) were surveyed. Hierarchical ordinal regression was used to identify the sociodemographic and attitudinal factors of consumption intent and price sensitivity. Consumption intent for plant-based meat alternatives was the highest, followed by cultured meat, and insect-based products. The perception of un-naturalness was the strongest barrier to consumption intent and this perception was strongest for cultured meat, followed by insect-based products, and plant-based meat alternatives. Males and those more familiar with the products were more willing to consume alternative protein foods, whereas ethnic Malays were less willing. Attitudinal factors that were unique to specific types of alternative protein foods were concerns over zoonotic diseases (plant-based meat alternatives), distrust in gene technology (cultured meat), food neophobia and animal welfare (insect-based products). Participants were willing to pay more for alternative protein foods if they had concerns over drug residues in meat. Our findings suggest that differential strategies may be needed to promote acceptance of different types of alternative protein foods.