Universiti Kebangsaan Malaysia Research Articles

Microbial Contamination of Extended Use Ophthalmic Drops in Ophthalmology Clinic.

PurposeThe objectives of this study were to determine the prevalence of microbial contamination of multi-user preserved ophthalmic drops (POD) in Ophthalmology Outpatient Clinic (OOC), to compare the rate of contamination between the dropper tip and the residual contents in the bottle, and to identify the contaminating organisms.MethodsThis was an observational cross-sectional study using a convenience sampling method conducted in the OOC of Universiti Kebangsaan Malaysia Medical Center, Malaysia. The samples of POD bottles were divided into groups obtained after 14 days (T14) and after 30 days (T30) of use. The contamination rate at the dropper tip and in the residual contents was determined and the contaminating organisms were identified.ResultsA total of 140 of 149 extended-use POD bottles were included. The prevalence of contamination was 30%. There was a statistically significant difference in the rate of contamination between samples T14 and T30 (19% and 11%, respectively; p=0.046). Proparacaine and tropicamide showed higher contamination rates in the T14 samples (p=0.027 and p=0.497, respectively) than in the T30 samples. The site of contamination was higher at the dropper tip than in the residual contents (p>0.05). Coagulase-negative Staphylococcus species were the most frequently identified contaminants (89%).ConclusionThe dropper tip was more contaminated than the residual contents, and coagulase-negative Staphylococcus species, which are common commensal flora of the ocular conjunctiva and skin, were the most frequently identified organisms.

Perceptions of Mentors and Mentees towards the Mentoring System at the Universiti Kebangsaan Malaysia Medical Centre

Mentoring is a relationship between mentors and mentees focused on the career success and advancement of mentees. It is crucial to review and evaluate the mentoring system in place in any given institution to identify potential issues. This study aimed to ascertain the perception of mentors and mentees towards mentoring system at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This cross-sectional study involved 382 UKMMC medical students from Year-2 to Year-5, and 35 UKMMC lecturers. Data were collected by sending validated questionnaires through Google Forms to all 819 students via the Facebook groups of UKM medical students. The questionnaires for mentors were distributed to all 78 lecturers through their respective emails. Both mentors and mentees showed positive perceptions towards the mentoring system with a total score of 110/144 (76%) and 51/64 (80%), respectively. Year-2 and Year-3 mentees showed higher perception compared to Year-4. Mentees supervised under pre-clinical mentors and female mentors had higher perceptions compared to clinical mentors and male mentors. Respondents reported suggestions for improving the content and structure of the mentoring system, the need for additional training of mentors (especially on how to approach the mentees), retaining the same mentors and mentees pairing throughout the mentees’ education, and reviewing the assessment method. The study findings may help further in improving the mentoring system of UKMMC. Mentoring is a challenging task. Medical schools must assign mentoring due importance in regular training for all levels of mentors by welltrained trainers. The implementation of awards and incentives for institutional mentors may motivate them further.

BREAKFAST CONSUMPTION PATTERNS, KNOWLEDGE, ATTITUDE, PRACTICE AND BARRIERS AMONG MALAYSIAN UNIVERSITY STUDENTS

Breakfast is the most important meal of the day. However, university students tend to skip breakfast due to their hectic lifestyles. Therefore, the patterns, knowledge, attitude, practice (KAP), and barriers of breakfast consumption were investigated in this study via questionnaires among 396 students of Universiti Kebangsaan Malaysia. Results showed that only 35.9% of students had breakfast between 6 to 7 days per week. Chinese students had a significantly higher (p<0.001) breakfast consumption compared with other groups. These results were consistent with the KAP scores in which Chinese students had the highest scores compared to their counterparts. However, the overall KAP scores were still at moderate levels with significant (p<0.001) positive correlations were found between knowledge and attitude (r=0.421), knowledge and practice (r=0.166), and attitude and practice (r=0.443). Malay students acknowledged the high cost of breakfast as a significant (p=0.03) barrier for breakfast consumption compared to other groups. No significant difference (p>0.05) was shown in other parameters. In conclusion, the frequency of breakfast consumption among the students was still low. The focus should be emphasized on practical strategies to address the barrier and encourage behavioral change for the students.

KESAN PERANG DUNIA PERTAMA (1914-1918) TERHADAP NEGERI-NEGERI MELAYU BERSEKUTU (NNMB)

The outbreak of World War I in 1914 appears to have been dragged Malaya,particularly Federated Malays States (FMS) into the mire of the war itself. Various implications have emerged out of it and hence, influenced the development of the political, economic and social sectors of FMS. Therefore, this paper will be analyzing the changes that took place in FMS from 1914 to 1918. In addition, this paper also will be looking on how the British dealt with the issues and problems occurred during the World War I in FMS within the time frame. Based on historical theme, this research depends on qualitative method. This research uses materials and resources obtained from the National Archives of Malaysia, National Library of Malaysia, Main Library of University of Malaya (MU), Tun Sri Lanang Library of Universiti Kebangsaan Malaysia (UKM), Sultan Abdul Samad Library of Universiti Putra Malaysia (UPM) and Hamzah Sendut Library of Universiti Sains Malaysia (USM). The study revealed and found that indeed the First World War had a negative impact on the political, economic and social sectors in FMS duringthis war. In fact, it also showed that the British managed to address the issues and problems that occurred through the cooperation of all parties in the FMS.

The Big-Five Personality Traits and Quality of Life in Elderly Malaysian Patients with Diabetes Mellitus: A Cross-Sectional Study

While diabetes mellitus is highly prevalent in the elderly population with significant impact on quality of life (QOL), we yet to know much about how personality traits affect QOL in this patient population. A cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Centre with the aim to determine the relationship between personality traits and QOL among the elderly (aged ≥60 years) with diabetes mellitus. Sociodemographic and clinical information were obtained. QOL was assessed using the WHO Quality of Life-BREF (WHOQOLBREF) questionnaire and personality traits were assessed using the Big Five Inventory (BFI) questionnaire. Depression and anxiety were measured with Beck Depression Inventory-II (BDI-II) and Generalized Anxiety Disorder 7-item (GAD-7) scale, respectively, and controlled for in all analyses. There were in total 170 study participants (median age=69.0 years; IQR: 65.0-73.0; 51.2% male). In stepwise linear regression models, higher conscientiousness scores (β=0.156; P=0.044) and lower neuroticism scores (β=-0.176; P=0.028) were associated with greater QOL in the physical health domain. Higher extraversion scores (β=0.209; P=0.001) and higher conscientiousness scores (β=0.248; P<0.001) were associated with greater QOL in the psychological health domain. Higher agreeableness scores (β=0.286; P<0.001) were associated with greater QOL in the social relationship domain. Finally, higher agreeableness scores (β=0.327; P<0.001) and lower neuroticism scores (β=-0.223; P=0.001) were associated with greater QOL in the environment domain. Personality traits were closely associated with all domains of QOL among elderly patients with diabetes mellitus. Premorbid personality may have important role in moderating the impact of diabetes mellitus on the lives of elderly patients.

Clinical Characteristics, Predictors and Outcome of Children with Complicated Parapneumonic Effusion: A Single Centre Experience

Parapneumonic effusions (PPE) is a complication of bacterial pneumonia. Factors that contribute to complicated PPE remain uncertain. This study was aimed to describe the characteristics, clinical predictors and outcome of children with parapneumonic effusion (PPE) in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A retrospective study on children with PPE who were admitted to UKMMC between January 2010 to December 2017 was conducted. Patients were categorised into 2 groups: simple and complicated PPE. Of 45 patients recruited, 20 (44.4%) patients had simple PPE and 25 (55.6%) had complicated PPE. Their median age was 32 months (IQR 16-63). The most common isolated organism was Streptococcus pneumoniae (61.9%), followed by Mycoplasma pneumoniae (19.0%) and Staphylococcus aureus (4.8%). Only 11.1% of patients received pneumococcal vaccination. There was no statistical significant difference in clinical features between simple and complicated PPE. Only 62.2% patients had ultrasound thorax done. Majority (95.0%) of patients with simple PPE were successfully treated with intravenous antibiotics alone. Sixty percent of patients with complicated PPE needed surgical intervention. Mean length of hospital stay for simple PPE was 10 (4.0) days and complicated PPE was 28 (16.5) days. In conclusion, clinical features could not predict complicated PPE. Use of ultrasound thorax as the main investigation tool for diagnosis and staging should be emphasised. Antibiotics therapy alone is effective therapy for simple PPE, while in complicated PPE, larger prospective studies are required to investigate which children benefit significantly from more intensive intervention.

Impact of CD34+ Stem Cell Dose on Engraftment Period in Allogeneic Peripheral Blood Stem Cell Transplanted Patients

Haematopoietic progenitor stem cells acquired from the peripheral blood have been increasingly used to treat patient with haematological malignancy. The success of the allogeneic peripheral blood stem cell transplantation (PBSCT) is significantly dependent on amount of CD34+ stem cell infused which will determine the rate of the haematopoietic recovery and engraftment. This study was aimed to correlate the amount of CD34+ cell infused with the period of engraftment. This retrospective study was conducted on 62 patients with haematopoietic malignancy who have received PBSCT at Universiti Kebangsaan Malaysia Medical Centre from year 2011 to 2015. The impact of CD34+ stem cell infusion on neutrophil and platelet engraftment and obtaining complete chimerism was studied. Patients were divided into two groups based on the amount of CD34+ stem cell. Group A consisted of 9 patients and infused with <5x106 cells/kg CD34+ cell while Group B consisted of 53 patients and infused with ≥5x106 cells/kg CD34+ stem cell. Data were collected and analysed. Group B patients were significantly associated with faster neutrophil engraftment: 12 (10-14) days while group A were 15 (10-21) days, (p=0.002). Platelet engraftment was also faster in group B: 17(12-25) days compared to group A: 18 (15-30) days. Complete chimerism in group B occurred in 30 (15-90) days and in group A was 60 (30-240) days. Platelet engraftment (p=0.149) and complete chimerism (p=0.021) were not significantly influenced by the CD34+ cell count. This study has shown that infusion of ≥5x106 cells/kg CD34+ stem cell shorten the time to haematopoietic engraftment particularly of neutrophilic engraftment.

Adaptation and Validation of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) Questionnaire into Bahasa Malaysia

BackgroundCommunication adjustment from patients’ perspective is paramount to ensure optimization of voice rehabilitation post laryngectomy. Very few specific self-rating tools exist with the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) having the most evidence regarding validity, reliability and clinical utility. ObjectivesThis study aimed to translate and validate a Bahasa Malaysia version of SECEL (mSECEL) using a validated framework of transcultural adaptation. MethodsThis cross-sectional study was conducted in the Otorhinolaryngology, Department of Universiti Kebangsaan Malaysia Medical Centre from February 2019 to May 2020. The mSECEL was produced following a rigorous forward and backward translation. Eighty-three laryngectomees (78 male, five female) using various methods of alaryngeal communication (47 voice prosthesis, 29 electrolarynx, three esophageal speech and four pen and paper), completed the mSECEL and mVHI-10 before head and neck and flexible laryngoscopic examinations. The mSECEL was repeated in 2 weeks via telephone interview or clinic visit. Its reliability was assessed using intraclass correlation. The Pearson product-moment correlation test was used to analyze correlation between the mSECEL and mVHI-10. ResultsThe mSECEL questionnaire showed strong internal consistency with the Cronbach alpha of >0.90 for total score, Environmental and Attitude subscale. The test-retest reliability for total mSECEL score was high with the intraclass correlation of 0.97. There was a highly significant positive correlation between the mSECEL total score and mVHI-10 (P < 0.001). Items in the General subscale showed poorer internal consistency with Cronbach alpha ranging 0.55-0.46 and poor correlation with mVHI-10. ConclusionsThe Bahasa Malaysia version of the SECEL measure is a valid and reliable instrument to evaluate communication perception after laryngectomy. Future studies should consider subscale validation and further abbreviation of its items to make this measure clinically relevant.

Catheter-Related Bloodstream Infections and Catheter Colonization among Haemodialysis Patients: Prevalence, Risk Factors, and Outcomes.

Introduction Catheter-related bloodstream infection (CRBSI) and catheter colonization (CC) are two complications among haemodialysis (HD) patients that lead to increased morbidity and mortality. This study aims to evaluate the prevalence of CRBSI and CC among HD patients registered at Universiti Kebangsaan Malaysia Medical Centre and to identify the factors involved by focusing on the demographic profile of the patients as well as their clinical characteristics and outcomes. Method This is a retrospective study of end-stage renal disease patients with suspected CRBSI during the period from 1 January 2016 to 31 December 2018. Data on patients who fulfilled the blood culture criteria for CRBSI and CC diagnosis were further analysed for clinical manifestations, comorbidities, history of dialysis, catheter characteristics, and microbiological culture results. The outcomes of CRBSI and CC were also assessed. Findings. In the 3-year period under study, there were 496 suspected CRBSI cases with a total of 175 events in 119 patients who fulfilled the inclusion criteria. During that time, the percentage of patients who experienced CRBSI and CC was 4.2% and 4.8%, respectively. The majority of the cohort consisted of male (59.4%), Malay ethnicity (75%), and patients on a tunnelled dialysis catheter (83%). Patients who were fistula naïve and had an internal jugular catheter were more common in the CRBSI group than in the CC group. The predominant microorganisms that were isolated were Gram-positive organisms. In terms of clinical presentation and outcome, no differences were found between the CRBSI and CC groups. Patients with Gram-negative bacteraemia, high initial c-reactive protein, and catheter salvation were likely to have poor outcomes. Recurrence of CRBSI occurred in 31% of the cohort. Neither catheter salvation nor antibiotic-lock therapy were associated with the recurrence of CRBSI. On the other hand, the femoral vein catheter site was associated with risk of recurrence. The overall mortality rate was 1.1%. Discussion. From the analysis, it was concluded that clinical assessment and positive culture are crucial in diagnosing CRBSI with or without peripheral culture. This study provides essential information for the local setting which will enable healthcare providers to implement measures for the better management of CRBSI.

METAFORA AL-’ISTICA:RAT AL-TAMTHI:LIYYAT DALAM HADIS RASULULLAH S.A.W

The Ahadith of Rasulullah s.a.w are jawamic al-kalim that possess special and distinct language features. Scholars since the classical time have paid great attention to balaghah al-hadith {Hadith rhetoric). However, a specific study on balaghah al-hadith was only found after the publication of the book al-Majazat al-Nabawiyyah by al-Sharif al-Radiyy (359 – 406H). He collected as many as 360 Ahadith of the Prophet s.a.w in his book while explaining the features of al-Isticarah as well as the beauty of the language and the uniqueness and fineness of its literature. Besides this book, the discussion about balaghah al-hadith can also be found in the book al-Fa’iq Fi Gharib al-Hadith by al-Zamakhshariyy and Hadith commentary books like cUmdah al-Qari by Imam Badruddin al-cAyni. Based on the study, the author finds that researches that had been done for Master’s and Ph.D. studies at Universiti Malaya, Universiti Kebangsaan Malaysia dan Universiti Islam Antarabangsa Malaysia mainly concentrated on balaghah al-Qur’an and only very few that touched on balaghah al-hadith. Looking at this situation, this study attempts to analyze al-’Istica:rat al-Tamthi:liyyat in several selected Ahadith from the book Riyad al-Salihin. One of the objectives of the analysis is to see more closely the uniqueness of al-’Istica:rat al-Tamthi:liyyat in the Ahadith of Rasulullah s.a.w. and its effectiveness in delivering the meaning and message to the audience. The findings from this research will hopefully be able to contribute to the development and lead to a greater appreciation of the knowledge of Hadith as well as Arabic rhetoric in Malaysia.

Knowledge, attitude and practice towards salt intake and health among non-academic staff of Universiti Kebangsaan Malaysia: A pilot study

Background: Over the years, global salt intake has increased and has resulted in the escalation of cardiovascular diseases and hypertension. The lack of knowledge, as well as poor attitude and practice, are the main reasons that have led to high salt intake. Therefore, this study aims to evaluate the knowledge, attitude and practice (KAP) towards salt intake and health among non-academic staff of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM). Methodology: This cross-sectional study was conducted among the non-academic staff of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM). The respondents were recruited using stratified random sampling technique with an informed consent. A validated questionnaire to test the knowledge, attitude and practice (KAP) towards salt intake and health by the Ministry of Health Malaysia was converted into a Google form and the link was emailed to 118 participants. A total of 33 responses were obtained for evaluation. The significant values were set as P &lt; 0.05. Results: It was observed that female participants had better attitudes towards salt intake and health compared to males (p = 0.044). Also, individuals with higher education levels had better attitudes towards salt intake and health, compared to those with lower education levels (p=0.009). However, knowledge and practice of salt intake and health bore no significant results when considering gender, education level and age. Discussion and Conclusion: Overall, this study has identified sociodemographic characteristics as contributing factors towards individuals’ attitude on salt intake and health. This may provide a crucial foundation in the development of cost-effective healthcare programs to widen knowledge, create awareness and promote a healthy lifestyle by reducing salt intake and further reduce the prevalence of non-communicable diseases.

Knowledge, attitude and practice towards salt intake and health among non-academic staff of Universiti Kebangsaan Malaysia: A pilot study

Background: Over the years, global salt intake has increased and has resulted in the escalation of cardiovascular diseases and hypertension. The lack of knowledge, as well as poor attitude and practice, are the main reasons that have led to high salt intake. Therefore, this study aims to evaluate the knowledge, attitude and practice (KAP) towards salt intake and health among non-academic staff of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM). Methodology: This cross-sectional study was conducted among the non-academic staff of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM). The respondents were recruited using stratified random sampling technique with an informed consent. A validated questionnaire to test the knowledge, attitude and practice (KAP) towards salt intake and health by the Ministry of Health Malaysia was converted into a Google form and the link was emailed to 118 participants. A total of 33 responses were obtained for evaluation. The significant values were set as P &lt; 0.05. Results: It was observed that female participants had better attitudes towards salt intake and health compared to males (p = 0.044). Also, individuals with higher education levels had better attitudes towards salt intake and health, compared to those with lower education levels (p=0.009). However, knowledge and practice of salt intake and health bore no significant results when considering gender, education level and age. Discussion and Conclusion: Overall, this study has identified sociodemographic characteristics as contributing factors towards individuals’ attitude on salt intake and health. This may provide a crucial foundation in the development of cost-effective healthcare programs to widen knowledge, create awareness and promote a healthy lifestyle by reducing salt intake and further reduce the prevalence of non-communicable diseases.

The Best Online Tools Based on Media Preference Reflected by Health Information Received on Social Media amongst Diabetic Patients in Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia.

BackgroundDiabetes mellitus has become a major public health problem globally. Social media could be useful in assisting clinical practice and sharing health-related information to improve self-management and to promote a positive behavioural change. This study aims to develop a guide on the best online tools by determining the media preference reflected by health-related information received from social media amongst diabetic patients in Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia, Kuala Lumpur.MethodsThis study was conducted cross-sectional on 174 respondents, who were selected by using a simple random sampling method. Socio-demographic data and the use of the internet and media for health-related information were obtained via questionnaires.ResultsThe most preferred social media used for searching and sharing health-related information was WhatsApp (73.6%), followed by Facebook (67.8%), Instagram (18.4%) and Twitter (17.2%). The social media preference related to socio-demographic data of age was statistically significant (P < 0.002), which had a medium effect. Furthermore, the media preference was not significantly related to health-related information searched or shared on social media and the frequency of usage.ConclusionIndeed, the social media have been an essential media platform to enhance public awareness concerning public health. This calls for evolution to further enhance the use of social media amongst healthcare practitioners to emphasise health promotion and empower the patients to play an active role in their healthcare. This study provides a guideline for the medical researchers, practitioners or healthcare providers in choosing WhatsApp as an online medium to communicate with diabetic patients in the future, specifically in Malaysia.

Association between fruit and vegetable intake and body mass index of postgraduate students at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia

Background: The Malaysian Dietary Guidelines recommended that at least two servings of fruits and three servings of vegetables be consumed daily. However, is there a relationship between daily fruit and vegetable intake and body mass index (BMI)? The aim of this study was to identify the relationship between fruit and vegetable intake and BMI among postgraduate students in the health sciences. Methodogy: A cross-sectional study was conducted at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia. 44 postgraduate students from the 2019/2020 batch of health sciences took partn in this study. Respondents were asked to complete three parts of the questionnaire: socio-demographic data, anthropometric measurements, and self-administered questions. Results: The majority of respondents are female (n=44, 77.3%), and they are mainly Malay (n=22, 50.0%). The average BMI of all respondents is 23.76±4.83. This study found that majority of respondents did not meet the recommended daily fruit (n=31, 70.5%) and vegetable intake (n=23, 52.3%). Discussion: The study discovered a significant relationship (p&lt;0.05) between age and daily vegetable intake. However, there was no significant relationship (p&gt;0.05) between gender, age, BMI, waist circumference, and daily fruit intake. Moreover, neither daily fruit nor vegetable intake predicted changes in BMI. Conclusion: This study found that the consumption of fruits and vegetables among postgraduate students was unsatisfactory and lower than recommended guidelines.

Association between fruit and vegetable intake and body mass index of postgraduate students at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia

Background: The Malaysian Dietary Guidelines recommended that at least two servings of fruits and three servings of vegetables be consumed daily. However, is there a relationship between daily fruit and vegetable intake and body mass index (BMI)? The aim of this study was to identify the relationship between fruit and vegetable intake and BMI among postgraduate students in the health sciences. Methodogy: A cross-sectional study was conducted at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia. 44 postgraduate students from the 2019/2020 batch of health sciences took partn in this study. Respondents were asked to complete three parts of the questionnaire: socio-demographic data, anthropometric measurements, and self-administered questions. Results: The majority of respondents are female (n=44, 77.3%), and they are mainly Malay (n=22, 50.0%). The average BMI of all respondents is 23.76±4.83. This study found that majority of respondents did not meet the recommended daily fruit (n=31, 70.5%) and vegetable intake (n=23, 52.3%). Discussion: The study discovered a significant relationship (p&lt;0.05) between age and daily vegetable intake. However, there was no significant relationship (p&gt;0.05) between gender, age, BMI, waist circumference, and daily fruit intake. Moreover, neither daily fruit nor vegetable intake predicted changes in BMI. Conclusion: This study found that the consumption of fruits and vegetables among postgraduate students was unsatisfactory and lower than recommended guidelines.

Survival Analysis and Prognostic Factors for Prostate Cancer Patients at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur

Prostate cancer is the third commonest type of cancer in Malaysian men with the incidence of 1,807 in 2018 compared to 1,186 cases reported in 2014. Prostate cancer is also known to cause disease, economic burden and lead to significant financial implications for the healthcare system. This study aimed to measure the rate of survival and to determine the prognostic factors for prostate cancer patients at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur. This was a retrospective study design involving prostate cancer patients who had been diagnosed and had sought treatment at Universiti Kebangsaan Malaysia Medical Centre from 2008 to 2017. Data were obtained from the patients’ medical records based on TRUS biopsy. The study period was from July 2017 to December 2018. Survival probabilities were estimated using Kaplan-Meier, and differences were compared using the log-rank test. The adjusted hazard ratio (HR) for variables was estimated after fitting the Cox proportion hazard model. Patients' death status due to prostate cancer was the endpoint of the survival analysis. A total of 283 patients’ data were analysed. Total five-year and ten-year survival rates of prostate cancer patients were 77.8 and 65.5%, respectively, regardless of the stage and treatment. The predictor factors for survival age were ≥75 years (HR = 8.49, 95% C.I: 1.16-62.13), Gleason score ≥8 (HR = 2.36, 95% C.I: 1.18-4.73) and cancer metastasis complications (HR = 5.26, 95% C.I: 2.88-9.63). Survival rates and prognostic factors of prostate cancer in the study were almost similar to those in nearby countries in the region. Preventive actions such as prostate cancer screening, early detection of cancer and early treatment should be empowered to improve the survival rate of prostate cancer patients in this hospital.

Tissue-Engineered Hydroxyapatite Bone Scaffold Impregnated with Osteoprogenitor Cells Promotes Bone Regeneration in Sheep Model.

Managing massive bone defects, a great challenge to orthopaedics reconstructive surgery. The problem arise is the supply of suitable bone is limited with many complications. Tissue-engineered hydroxyapatite bone (TEHB) scaffold impregnated with osteoprogenitor cells developed as an alternative to promote bone regeneration. This animal protocol has been approved by Universiti Kebangsaan Malaysia Animal Ethical Committee. The TEHB scaffold prepared from hydroxyapatite using gel casting method. A total of six adolescent female sheep were chosen for this study. Later, all the sheep were euthanized in a proper manner and the bone harvested for biomechanical study. Bone marrow was collected from iliac crest of the sheep and bone marrow stem cells (BMSCs) isolated and cultured. BMSCs then cultured in osteogenic medium for osteoprogenitor cells development and the plasma collected was seeded with osteoprogenitor cells mixed with calcium chloride. Bone defect of 3cm length of tibia bone created from each sheep leg and implanted with autologous and TEHB scaffold in 2 different groups of sheep. Wound site was monitored weekly until the wound completely healed and conventional X-ray performed at week 1 and 24. Shear test was conducted to determine the shear force on the autologous bone and TEHB scaffold after implantation for 24weeks. All of the sheep survived without any complications during the study period and radiograph showed new bone formation. Later, the bone harvested was for biomechanical study. The highest shear force for the autologous group was 13MPa and the lowest was 5MPa while for the scaffold group, the highest was 10MPa and the lowest was 3MPa. Although, proximal and distal interface of autologous bone graft shows higher shear strength compared to the TEHB scaffold but there is no significant difference in both groups, p value > 0.05. Histologically in both proximal and distal interface in both arms shows bone healing and woven bone formation. TEHB scaffold impregnated with osteoprogenitor cells has the potential to be developed as a bone substitute in view of its strength and capability to promote bone regeneration.

Preface

Due to recent pandemic, 2021 4th International Conference on Advanced Materials, Intelligent Manufacturing and Automation (AMIMA 2021) was held virtually online during April 02-04, 2021. The decision to hold the virtual conference was made in compliance with many restrictions and regulations that were imposed by countries around the globe. Such restrictions were made to minimize the risk of people contracting or spreading the COVID-19 through physical contact. There were 80 individuals who attended this on-line conference, represented many countries including Singapore, Australia, Algeria and India.AMIMA2021 is to bring together innovative academics and industrial experts in the field of Advanced Materials, Intelligent Manufacturing and Automation to a common forum. Featured with invited speeches and paper presentations, AMIMA 2021 welcomes submission of researches concerning any branch of Materials and Manufacturing. Scholars at home and abroad are welcome to submit articles and participate in the conference.During the conference, the conference model was divided into three sessions, including oral presentations, keynote speeches, and online Q&A discussion. In the first part, some scholars, whose submissions were selected as the excellent papers, were given about 5-10 minutes to perform their oral presentations one by one. Then in the second part, keynote speakers were each allocated 30-45 minutes to hold their speeches. In the second part, we invited four professors as our keynote speakers. Assoc. Prof. Guoming Zhao, from Shandong University of Science and Technology, China. He has been conducted research on Separation and purification process of heterogeneous catalysis and related products. And then we had Assoc. Prof. Guanqun Gong, from China University of Mining and Technology, China. Prof. Shengle Ren, from Quzhou University, China. He devoted in Automation; digital design and simulation; control system and other related research areas. Lastly, we were glad to invite Assoc. Prof. Md. Akhtaruzzaman, from the National University of Malaysia, Malaysia. Their insightful speeches had triggered heated discussion in the third session of the conference. Every participant praised this conference for disseminating useful and insightful knowledge.The proceedings are a compilation of the accepted papers and represent an interesting outcome of the conference. Topics include but are not limited to the following areas: Advanced Materials, Intelligent Manufacturing, Automation and other related topics. All the papers have been through rigorous review and process to meet the requirements of International publication standard.We would like to acknowledge all of those who supported AMIMA 2021. The help and contribution of each individual and institution was instrumental in the success of the conference. In particular, we would like to thank the organizing committee for its valuable inputs in shaping the conference program and reviewing the submitted papers.We sincerely hope that the AMIMA 2021 turned out to be a forum for excellent discussions that enabled new ideas to come about, promoting collaborative research. We are sure that the proceedings will serve as an important research source of references and knowledge, which will lead to not only scientific and engineering findings but also new products and technologies.Committee of AMIMA 2021Committee member Committee ChairAssoc. Prof. Guanqun Gong, China University of Mining and Technology, ChinaInternational Technical CommiteeProf. Shengle Ren, Quzhou University, ChinaAssoc. Prof. Xingrong Zheng, Longdong University, ChinaAssoc. Prof. Md. Akhtaruzzaman, The National University of Malaysia, MalaysiaAssoc. Prof. Guanqun Gong, China University of Mining and Technology, ChinaOrganising CommitteeProf. Seeram Ramakrishna, National University of Singapore, SingaporeProf. Benmoussat Abderrahim, CUTAM University of Tamanrasset, AlgeriaProf. Dr. Yusri Bin Yusof, Universiti Tun Hussein Onn Malaysia (UTHM), MalaysiaAssoc. Prof. Yung-Yao Chen, National Taipei University of Technology, Taiwan, ChinaAssoc. Prof. Xiumei Tian, Guangzhou Medical University, ChinaAssoc. Prof. Nilofar Asim, Universiti Kebangsaan Malaysia, MalaysiaAssoc. Prof. Lei Chen, Wuhan University, ChinaAssoc. Prof. Mamoun Alazab, Darwin University, AustraliaDr. Peiyu Wang, Peking University, ChinaDr. Wei Liu, Henan Polytechnic University, ChinaDr. Soh-Fong LIM, University Malaysia Sarawak, MalaysiaDr. David Chua Sing Ngie, University Malaysia Sarawak, MalaysiaDr. Zulkeflee Abdullah, Universiti Teknikal Malaysia Melaka, Malaysia

Collaborative Environmental Science Courses: Bridging between Undergraduate Research into Energy Issues in Malaysia and the United States

With support from the EnviroLab Asia initiative at the Claremont Colleges, I redeveloped my Environmental Chemistry course for undergraduates to focus on environmental issues in Asia. I collaborated with a colleague from the Universiti Kebangsaan Malaysia (UKM) who was teaching a similar course for master’s-level students in Bangi, Malaysia. Our students worked on projects together comparing different aspects of renewable energy in the two countries. At the end of the semester, my students traveled to UKM for a symposium with my colleague’s students and continued working on their research projects to turn them into publishable papers. The Claremont Colleges students greatly benefited from both the academic and cultural learning that occurred during our travel. I am currently developing a network of faculty at universities in Asia-Pacific Economic Cooperation (APEC) economies who have their students work on data-gathering and/or analysis projects that can be useful for policymaking by the APEC Energy Working Group.

Reviewer Acknowledgements

Journal of Agricultural Studies (JAS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JAS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 1Ahmed Mohamed Elbeltagi, Mansoura University, EgyptAi-Ping Wu, Hunan Agricultural University, ChinaAlessandra M. Lima Naoe, Federal University of Tocantins, BrazilAlexandra-Nadia Cirdei, Technical University of Civil Engineering of Bucharest, RomaniaAlexandru Ioan Apahidean, UASVM, RomaniaAna Daniela Lopes, Universidade Paranaense, BrazilAnca-Luiza Stanila, ICPA, RomaniaAngel Ramon Sanchez Delgado, Universidade federal Rural do Rio de Janeiro, BrazilArnaud Z. Dragicevic, IRSTEA, FranceBenard Kiplangat Rop, University of Nairobi, KenyaCleber Duarte, University of Guararapes, BrazilDarwin Pangaribuan, University of Lampung, IndonesiaEben von Well, Agricultural Research Council, South AfricaEric Krawczyk, University of Michigan, USAEric Owusu Danquah, CSIR-Crops Research Institute, GhanaFábio Cassola, UNICAMP, BrazilFernando Coelho Eugenio, Federal University of Santa Maria, BrazilGuitong Li, China Agricultural University, ChinaHabu Saleh Hamisu, National Horticultural Research Institute, NigeriaHedayatollah K. Soureshjani, Ferdowsi University of Mashhad, IranJanerson Jose Coelho, Universidade Federal Rural de Pernambuco, BrazilJoão Manoel da Silva, Universidade Federal de Alagoas, BrazilJorge A. López, University Tiradentes, BrazilMahyar Gerami, Sana Institute of Higher Education, IranMaría Elena Estrada Martínez, Universidad Metropolitana, EcuadorMaría Francisca Perera, ITANOA, EEAOC-CONICET, ArgentinaMariana Esteves, Luiz de Queiroz College of Agriculture University of Sao Paulo, BrazilMd. Sadique Rahman, Sher-e-Bangla Agricultural University, BangladeshNeha Jha, Massey University New Zealand, New ZealandNkemkanma Vivian Agi, Rivers State University Port Harcourt, NigeriaOlga Mykhailenko, National University of Pharmacy, UkraineOscar Mitsuo Yamashita, Universidade do Estado de Mato Grosso, BrazilRaul Pașcalău, BUASVM, RomaniaSaiful Irwan Zubairi, Universiti Kebangsaan Malaysia (UKM), MalaysiaSamir Neggaz, Université Oran, AlgeriaSarir Ahmad, Abdul Wali Khan University, PakistanShakirudeen Abimbola Lawal, University of Cape Town, South AfricaShubha Kumari, ICAR-RCER, IndiaSomaia Alkhair, Alzaeim Alazhari University, SudanSybelle Mesquita Silva, Universidade Federal de Alagoas, BrazilToncho Gospodinov Penev, Trakia University, BulgariaUtkarsh R. Moon, Mahatma Gandhi College of Science, IndiaWossenie Shibabaw Mebratie, Bahir Dar University, EthiopiaZakaria Fouad Abdallah, National Research Centre, EgyptZhao Chen, Clemson University, USA Richard WilliamsEditorial AssistantJournal of Agricultural Studies--------------------------------------Macrothink Institute5348 Vegas Dr.#825Las Vegas, Nevada 89108United StatesPhone: 1-702-953-1852 ext.521Fax: 1-702-420-2900Email 1: jas@macrothink.orgEmail 2: jas@macrothink.comURL: http://jas.macrothink.org