Purpose: Adjuvant radiotherapy (RT), while effective in reducing cancer recurrence and improving survival rates, often comes with radiation toxicity that can adversely affect the patient’s quality of life (QoL). Evaluating toxicity after RT is crucial because it helps to identify and manage adverse effects that can significantly impact a patient’s QoL. By monitoring toxicity, we can adjust treatment plans to mitigate these effects, improve patient comfort, and ensure a better overall outcome. Therefore this study aimed to evaluate and compare QoL following 3D-conformal hypofractionated RT in breast cancer patients. Methods: We included twenty-one Malaysian women with unilateral breast cancer treated with lumpectomy (n=15) or mastectomy (n=6) followed by 3D-conformal hypofractionated RT. QoL was evaluated using the EORTC QLQ-BR45 questionnaire before, during, and after RT. Results: During RT, there was a significant increase in the mean score of the breast symptoms scale compared to baseline (p=0.002), with the most common symptoms being skin problems, followed by swelling and oversensitivity. However, these symptoms were generally mild for most patients. The other quality of life scales remained stable during RT. Post-RT, most QoL scales showed improvements compared to both baseline and during RT, with significant enhancements in the mean breast symptoms score and breast satisfaction score (all p<0.05). Conclusion: Radiotherapy negatively impacted the QoL of our breast cancer patients, specifically on the breast symptoms scale. However, these symptoms improved after 4 months, resulting in high breast satisfaction and indicating a near-excellent cosmetic outcome. Future studies with larger cohorts are essential to validate these findings, as the small sample size (n=21 at baseline; n=13 post-RT) may have limited the detection of more subtle changes

Objective: The present study addressed the shortcomings of strictly defined criterion and survey-based approaches of previous smoking susceptibility measures and accordingly, developed and validated two scales, Smoking Susceptibility Measure (SSM) and Anti-Smoking Awareness Scale (ASAS). Methods: Firstly, the generation of SSM and ASAS items followed an extensive literature review, expert opinions and agreement, resulting in the retention of eight items for SSM and seven items for ASAS to administer them on a large sample (n=312). Average inter-item correlations, corrected item-total correlations, and internal consistency reliabilities of the measures fall within the recommended ranges. The data were found suitable to factorize the sample through exploratory factor analysis. To determine the structural validity of the measures, confirmatory factor analysis (CFA) was done, and the data had an adequate model fit for unifactorial solution. Multi-group CFA revealed that both measures can be applied in the same way across age and sex of the participants. Results: An inverse association of school connectedness with smoking susceptibility and positive association with anti-smoking awareness reflected the convergent validity of the measures. Hierarchical regression analysis showed that smoking susceptivity was negatively predicted by anti-smoking awareness and school connectedness whereas, positively predicted by self-esteem of the participants. Conclusion The SSM and ASAS were found to be psychometrically sound tools to objectively measure never-smoking youths’ smoking susceptibility and anti-smoking awareness, targeting effective intervention strategies to prevent adolescents and young adults from being a regular smoker.

This report describes an approach to recover SARS-CoV-2 RNA from rapid antigen test kit (RTK-antigen) cassettes for whole-genome sequencing (WGS). RNA samples were recovered from 33 RTK-antigen cassettes for WGS, with 18 samples achieving more than 80% genome coverage. This work provides a proof-of-concept that positive RTK-antigen cassettes can be safely transported, stored and subjected to WGS, enabling swift identification of circulating variants.

Objective: The COVID-19 pandemic disrupted disease surveillance systems globally, leading to reduced notifications of other infectious diseases. This study aims to estimate the impact of the COVID-19 pandemic on the infectious disease surveillance system in Klang district, Selangor state, Malaysia. Methods: Data on notifiable diseases from 2014 to 2022 were sourced from the Klang District Health Office. The 11 diseases with more than 100 notifications each were included in the study. For these 11 diseases, a negative binomial regression model was used to explore the effect of the pandemic on case notifications and registrations by year, and a quasi-Poisson regression model was used to explore the changes by week. Results: The results showed a reduction in the number of notifications and registrations for all 11 diseases combined during the pandemic compared with previous years. Changes between expected and observed notifications by week were heterogeneous across the diseases. Discussion: These findings suggest that restrictive public health and social measures in Klang district may have impacted the transmission of other infectious diseases during the COVID-19 pandemic. The differential impact of the pandemic on disease notifications and reporting highlights the large ancillary effects of restrictive public health and social measures and the importance of building resilience into infectious disease surveillance systems.

Objective: The present study addressed the shortcomings of strictly defined criterion and survey-based approaches of previous smoking susceptibility measures and accordingly, developed and validated two scales, Smoking Susceptibility Measure (SSM) and Anti-Smoking Awareness Scale (ASAS). Methods: Firstly, the generation of SSM and ASAS items followed an extensive literature review, expert opinions and agreement, resulting in the retention of eight items for SSM and seven items for ASAS to administer them on a large sample (n=312). Average inter-item correlations, corrected item-total correlations, and internal consistency reliabilities of the measures fall within the recommended ranges. The data were found suitable to factorize the sample through exploratory factor analysis. To determine the structural validity of the measures, confirmatory factor analysis (CFA) was done, and the data had an adequate model fit for unifactorial solution. Multi-group CFA revealed that both measures can be applied in the same way across age and sex of the participants. Results: An inverse association of school connectedness with smoking susceptibility and positive association with anti-smoking awareness reflected the convergent validity of the measures. Hierarchical regression analysis showed that smoking susceptivity was negatively predicted by anti-smoking awareness and school connectedness whereas, positively predicted by self-esteem of the participants. Conclusion The SSM and ASAS were found to be psychometrically sound tools to objectively measure never-smoking youths’ smoking susceptibility and anti-smoking awareness, targeting effective intervention strategies to prevent adolescents and young adults from being a regular smoker.

Background and Objectives: Auditory sensory gating deficits are abnormalities in patients with autism spectrum disorder (ASD) that may lead to sensory processing difficulties. It is particularly difficult for children with ASD to distinguish multiple auditory stimuli, which hinders them from focusing on a single auditory stimulus and separating unnecessary sounds. Suppression of otoacoustic emission (OAE) is an approach used to identify sensory gating deficits in the general population, specifically for children with ASD. This study aimed to investigate the suppression effect of various types of sound suppressors to measure their sensory gating capacity in children with ASD. Subjects and Methods: Twenty children including 10 with ASD and 10 normally developing children aged 6-12 years were recruited for this study. One accessible ear was exposed to transient-evoked OAE, whereas the other was exposed to suppressor tones. Contralateral suppressors included white noise, Quranic recitations, environmental noise, and natural sound. The magnitude of OAE suppression was determined from the difference between the OAE amplitude with and without the masker (in dB sound pressure levels) for all sound types. The sound with the highest suppression effect was determined using effect size calculation and repeated-measures analysis of variance at a 95% confidence level. A high suppression effect may suggest a high sensory gating performance, whereas low suppression may indicate low sensory gating performance. Results: Based on the analysis, the sound with the highest suppression effect was that of the waterfall. The suppression results were supported by descriptive analysis findings and effect-size calculations. Conclusions This study provides a better understanding of the alternative sound stimuli, besides the standard white noise tone, for the assessment of sensory gating deficits among children with ASD. Sounds with a high suppression effect have the potential to be used as sound therapy interventions for children with ASD as part of rehabilitation and therapy.

Purpose: This study aims to assess the effectiveness of enteral versus parenteral feeding in patients after esophagectomy. Methods: This a prospective cohort study of post-esophagectomy intensive care unit (ICU) patients over 12 months in the National Cancer Institute, Malaysia. Early enteral feeding followed the Enhanced Recovery After Surgery protocol, and parenteral nutrition (PN) was considered if there was a risk for conduit ischemia. It compared the effectiveness of enteral versus PN following esophagectomy, and assessed the correlations between biochemical nutritional markers and hospital lengths of stay or ventilation days. Results: It included two cohorts receiving PN (n=11) or enteral nutrition (EN) (n=11) following elective esophagectomy. Preoperative weight, body mass index, and Subjective Global Assessment were higher in the EN group (P=0.033, P=0.021, P=0.031, respectively). Nutritional interruption occurred more frequently in the EN group (63.7%) compared to the PN group (P=0.001). Mean levels of energy and protein received were 93.1 kcal/kg and 1.4 g/kg for PN versus 92.4 kcal/kg and 1.2 g/kg for EN (P=0.893, P=0.036). The median lengths of ICU stay (P=0.688) and postoperative stay (P=0.947) between groups showed no significant difference. In addition, 30-day mortality (P=0.214) and other postoperative complications (P>0.05) were comparable in the two groups. Conclusion Early initiation of supplementary PN due to significant interruption in EN led to higher protein intake compared to the EN group. However, there were no significant differences in postoperative outcomes, including 30-day mortality, ICU length of stay, and ventilation days. PN ensures adequate nutritional intake, especially in terms of protein delivery, without adversely affecting postoperative recovery and clinical outcomes.