Background: Work-related musculoskeletal disorders (WRMSDs) remain a major cause of occupational disability and productivity loss worldwide. Traditional statistical methods have identified numerous associated factors; however, they often struggle to capture complex non-linear relationships and interactions across multiple domains of risk. Machine learning (ML) offers an alternative analytical approach for modelling such multidimensional relationships. Methods: Following the PRISMA 2020 guidelines (PROSPERO: CRD420250605234), literature searches were conducted in Web of Science, Scopus, and PubMed for studies published between 2020 and 2025. Eligible studies applied ML methods to identify factors associated with WRMSDs using cross-sectional study designs. Included studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Results: Ten studies met the inclusion criteria, representing workers from healthcare, transport, manufacturing, and service sectors across Asia, Africa, and Europe. Frequently applied ML algorithms included random forest, support vector machine, and artificial neural networks, demonstrating strong internal discriminative performance (area under the receiver operating characteristic curve: 0.80–0.99), although the absence of external validation in several studies suggests a potential risk of overfitting. Commonly identified factors included age, sex, awkward posture, vibration exposure, prolonged working hours, stress, and burnout. Psychosocial factors, including post-traumatic stress disorder, job stress, and depression, were ranked among the most influential predictors within ML models. Conclusions ML models demonstrate strong capability in discriminating WRMSDs risk and identifying multidimensional risk factors compared with traditional statistical approaches. These models highlight complex interrelationships between ergonomic and psychosocial exposures. Future research should incorporate external validation, objective exposure measurements, and standardized ML reporting frameworks to enhance methodological transparency and generalizability.

Prevalens Simptom Muskuloskeletal dan Faktor-Faktor Yang Mempengaruhinya dalam kalangan Pegawai Perubatan yang Mengendali Mesin Ultrabunyi Pranatal di Klinik Kesihatan di negeri Selangor pada tahun 2024 Pengenalan Masalah muskuloskeletal dalam kalangan pengendali mesin ultrabunyi merupakan isu yang telah diketengahkan oleh negara-negara luar tetapi kurang mendapat perhatian di Malaysia. Kajian ini dijalankan untuk mendapatkan maklumat prevalens simptom muskuloskeletal dalam kalangan pengendali mesin ultrabunyi dan mengkaji faktor-faktor yang mempengaruhinya. Metodolog iKajian keratan rentas ini melibatkan pegawai perubatan yang bertugas di klinik-klinik kesihatan di negeri Selangor yang melakukan pengimbasan janin untuk pesakit pranatal di unit Kesihatan Ibu dan Anak. Pengumpulan data telah dilakukan antara bulan Mei 2024 sehingga bulan Julai 2024 menggunakan pensampelan mudah yang melibatkan 84 responden yang memberikan persetujuan untuk menjawab kajian soal selidik dalam talian. Hasil Prevalens simptom muskuloskeletal yang berlaku sekurang-kurangnya selama 24 jam dalam 12 bulan yang lalu yang berkait dengan penggunaan mesin ultrabunyi ialah 29.8%, di mana peramal penting dalam model akhir yang dikenal pasti menggunakan model regresi logistik berganda ialah stres tempat kerja bagi domain skala stres tempat kerja (OR 10.95 (95% SK 1.94, 61.69), p = 0.007)); ketidakselesaan transduser bagi domain stesen kerja dan organisasi (OR 7.85 (95% SK 2.17, 28.37), p = 0.002)); dan jumlah pesakit dalam sehari bagi domain tugasan dan beban kerja (OR 4.24 (95% SK 1.15, 15.62), p = 0.030)). Kesimpulan Stres di tempat kerja ialah peramal paling kuat mempengaruhi simptom muskuloskeletal dalam kalangan pengendali mesin ultrabunyi, ini diikuti oleh ketidakselesaan dalam penggunaan transduser ultrabunyi, dan akhir sekali ialah jumlah pesakit yang lebih ramaidiperiksa dalam tempoh sehari

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours commonly found in the gastrointestinal tract, particularly in the stomach, but they can mimic gynaecological tumours. We report the case of a 56 -year-old postmenopausal woman who presented with a right adnexal pelvic mass. Computed tomography (CT) revealed a large, lobulated pelvic mass with liver lesions. Pan - endoscopy showed normal findings, and her tumour markers were within normal limits. Based on these findings, the gynaecological oncology team proceeded with a laparotomy and tumour debulking, diagnosing the pelvic mass as likely ovarian in origin. Intraoperatively, the mass was found to originate from the stomach and extend posteriorly to the transverse colon. An en -bloc resection with primary anastomosis was performed and histopathology confirmed a high -risk GIST. The patient made a good post -operative recovery and was scheduled for adjuvant chemotherapy at her follow -up visit. This case highlights the importance of considering GIST as a differential diagnosis in postmenopausal women presenting with an abdominopelvic mass that may mimic an ovarian tumour

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours commonly found in the gastrointestinal tract, particularly in the stomach, but they can mimic gynaecological tumours. We report the case of a 56 -year-old postmenopausal woman who presented with a right adnexal pelvic mass. Computed tomography (CT) revealed a large, lobulated pelvic mass with liver lesions. Pan - endoscopy showed normal findings, and her tumour markers were within normal limits. Based on these findings, the gynaecological oncology team proceeded with a laparotomy and tumour debulking, diagnosing the pelvic mass as likely ovarian in origin. Intraoperatively, the mass was found to originate from the stomach and extend posteriorly to the transverse colon. An en -bloc resection with primary anastomosis was performed and histopathology confirmed a high -risk GIST. The patient made a good post -operative recovery and was scheduled for adjuvant chemotherapy at her follow -up visit. This case highlights the importance of considering GIST as a differential diagnosis in postmenopausal women presenting with an abdominopelvic mass that may mimic an ovarian tumour

Introduction: Accurate diagnosis of thyrotoxicosis, a condition resulting from excessive thyroid hormone activity, is essential for appropriate management. However, access to diagnostic tools such as thyrotropin receptor antibody (TRAb) assays and thyroid ultrasonography remains limited in resource-constrained settings, highlighting the need for cost-effective alternatives. Recent studies suggest that the free triiodothyronine to free thyroxine (FT3/FT4) ratio may serve as a potential biomarker for differentiating the causes of thyrotoxicosis. Methodology: This cross-sectional study evaluated the FT3/FT4 ratio in newly diagnosed thyrotoxicosis patients aged ≥18 years recruited from Hospital Tengku Ampuan Rahimah, Hospital Banting, Klinik Kesihatan Pelabuhan Klang, and Klinik Kesihatan Pandamaran between February and December 2025. All participants underwent thyroid function testing (FT3, FT4, and TSH) and autoantibody assessment (TRAb and anti-thyroid peroxidase [anti-TPO]). Diagnostic performance of the FT3/FT4 ratio for Graves’ disease was assessed using receiver operating characteristic (ROC) curve analysis. Results: Fifty-eight patients were included, of whom 58.6% were diagnosed with Graves’ disease. Patients with Graves’ disease had significantly higher FT3 levels (median 16.8 pmol/L; IQR 10.9–25.7) compared to those with non-Graves’ thyrotoxicosis (median 8.3 pmol/L; IQR 5.3–13.5; p <0.001), with similar trends observed for FT4 levels (p <0.001). However, the FT3/ FT4 ratio did not differ significantly between groups (p >0.05), with an overall ROC AUC of 0.572, indicating poor discriminatory ability. Subgroup analysis based on FT4 levels improved performance; at FT4 <30 pmol/L, the FT3/FT4 ratio demonstrated 75.0% sensitivity, 91.7% specificity, and 87.5% diagnostic accuracy at a cutoff of 0.3445 (AUC = 0.813; 95% CI: 0.570–1.000; p = 0.069). No significant association was observed between the FT3/FT4 ratio and TRAb or anti-TPO. Conclusion The FT3/FT4 ratio has limited overall diagnostic utility but may provide adjunctive value in selected biochemical contexts, particularly in settings with limited access to immunological testing.
Diagnosis, Differential ; Thyroxine ; Triiodothyronine ; Thyrotoxicosis ; Cross-Sectional Studies

Introduction: The disregard for hip flexion force when designing foot-operated equipment poses a potential threat to non-compliance with ergonomics principles, ultimately impacting occupational health. Nevertheless, there is a noticeable lack of studies focusing on the hip flexion strength of Malaysian adults in a standing position. This paper aimed to measure the maximum force of hip flexion strength and formulate a regression model for Malaysian young adults in a standing posture. Materials and methods: The experiment invited sixty Malaysian adults aged 20 to 26 years old. A digital force gauge (Mark-10, USA) was used to measure the hip flexion force. A regression model was developed to determine the influence of gender, body mass, body height, thigh length, and thigh circumference on the hip flexion force. Results: The results of this study found that the means of hip flexion force for the male and female participants were 192.8 N and 126.0 N, respectively. The regression model concluded that gender is the most significant factor influencing hip flexion force (p<0.01). The body mass, body height, thigh length, and thigh circumference positively correlate to hip flexion force. However, these correlations were not statistically significant (p>0.05). Conclusion: This study concluded that the relationship between anthropometric parameters and hip flexion force is not always straightforward and can be influenced by various factors. To gain a more comprehensive picture of hip flexion, it is essential to consider other potential factors such as muscle mass, neuromuscular control, and joint mechanics.

Environmental Factors Contributing to Stunting among Under Six Years Old Children: A Scoping Review IntroductionStunting among young children is a serious public health issue worldwide. Stunting is also one of the major risk factors for poor physical and mental development of these children. It is known that children’s health and wellbeing are a result of exposure to unhealthy environment and a lack of stimulating activities especially in the low- and middle-income countries ultimately leading to the increase in the number of stunted children. This scoping review aims to identify environmental factors that contribute to stunting less than six years old children.MethodsIn this review, PRISMA-ScR checklist to search Scopus, PubMed, and Web of Science databases. We included all original articles published between 2018 and 2022 and written in the English Language using combination of primary keyword (child*) and its MeSH and synonyms for population, and two secondary keywords (environ*) for exposure and (stunt*) for outcome as searching strategy. By using PRISMA extension for scoping reviews, 65 articles were reviewed and finally 25 eligible studies were included.ResultsThe included studies showed that lack of cleanwater access, poor sanitation, and poor hygiene practice were associated with higher risk of stunting among these children. Improper solid waste management, area of residence and type of housing, poor quality of cooking fuels and poor air quality, presence of intestinal parasitic infection and increased blood lead levels, were also noted as potential environmental factors that affect stunting.ConclusionsInvestment in infrastructure to provide safe and clean water and adequate sanitation facilities in communities with expanded health promotion activities focusing on hygiene practices and waste management may thus stunting and improve children’s health outcome.

Kimia Obesogen dan Obesiti Kanak-kanak sebagai Ancaman Kesihatan Awam: Satu Ulasan Naratif PengenalanObesiti dalam kalangan kanak-kanak ialah isu kesihatan global yang semakin meningkat dengan prevalens yang tinggi, termasuk di Malaysia. Faktor persekitaran seperti pendedahan kepada bahan kimia obesogen dipercayai menyumbang kepada peningkatan risiko obesiti. Ulasan naratif ini bertujuan untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak secara mendalam bagi menyokong pembangunan strategi pencegahan yang lebih berkesan.MetodologiUlasan naratif ini dijalankan menggunakan pangkalan data PubMed, Google Scholar, Web of Science, dan Scopus untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak. Kata kunci yang relevan digunakan untuk mengenal pasti artikel yang memenuhi skop kajian. Artikel tambahan diperoleh melalui rujukan silang daripada artikel yang dipilih dalam carian awal.Hasil KajianObesogen ialah bahan kimia eksogen yang mengganggu fungsi metabolik, mempromosikan pengumpulan lemak, dan meningkatkan risiko obesiti dalam kalangan kanak-kanak, terutamanya melalui mekanisme seperti gangguan adipogenesis, penurunan kadar metabolik basal, dan perubahan kawalan selera makan. Kajian menunjukkan hubungan yang signifikan antara pendedahan pranatal kepada bahan kimia seperti phthalate dan PFAS dengan peningkatan indeks jisim badan (BMI) dan risiko obesiti kanak-kanak. Kajian eksperimen turut mengesahkan bahawa obesogen seperti BPA dan phthalate mempromosikan adipogenesis dan gangguan metabolik dalam model haiwan dan sel manusia, memberikan bukti kukuh tentang peranan obesogen terhadap obesiti kanak-kanak.KesimpulanPendedahan kepada obesogen kimia memberi kesan negatif terhadap obesiti kanak-kanak. Oleh itu, tindakan segera melalui kawalan bahan kimia dan pendidikan awam amat diperlukan. Penyelidikan lanjutan dan perubahan polisi global juga perlu dilaksanakan bagi memastikan masa depan yang lebih sihat untuk generasi akan datang.

Impact of Compensation on Job Satisfaction Among Healthcare Workers: A Systematic Review Introduction Job satisfaction among healthcare workers is crucial for workforce retention, organizational stability, and healthcare delivery. Compensation, including salary, incentives, and fringe benefits, is a key driver of job satisfaction. This systematic review examines the impact of compensation on the job satisfaction of healthcare workers, providing actionable insights for improving healthcare organizations. Methods This systematic review followed PRISMA guidelines. A comprehensive search of PubMed, ProQuest, and Web of Science was conducted to identify studies published between 2015 and January 2024. Inclusion criteria focused on research examining the relationship between compensation and job satisfaction among healthcare workers. 12 studies met the inclusion criteria. Data were extracted, synthesized, and analyzed to identify themes related to compensation and job satisfaction. Results The review identified compensation as a key predictor of job satisfaction among healthcare workers. Despite its significance, widespread dissatisfaction and low satisfaction with compensation were reported across studies. Salary emerged as a critical factor, influencing satisfaction through its role in recognition of value and perceived equity. Incentives, particularly performance-based financing, demonstrated the potential to improve satisfaction by linking monetary rewards to performance metrics, although their effectiveness depended on robust organizational support. Fringe benefits, particularly opportunities for professional development, were found to enhance job satisfaction. Geographic and occupational differences were observed, with higher dissatisfaction in resource-limited settings and variations by location, nationality, and role. These findings highlight the multifaceted impact of compensation on satisfaction. Conclusions Equitable compensation strategies must address salary, incentives, and fringe benefits. Regular evaluations, stakeholder engagement, and benchmarking against sector standards are essential steps to enhance job satisfaction, retention, and care quality across diverse healthcare settings.