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Time series modelling and forecasting commuting accident and association with meteorological parameters in Johor Bahru and Kuala Lumpur, Malaysia (2015-2019)
(2024-12)
Hanafi, Nur Sujaihah
Introduction: In tropical countries such as Malaysia, rainfall and temperature serve as primary meteorological parameters that potentially increase the risk of road traffic accidents (RTAs). The working population in major cities is particularly vulnerable, especially during commuting hours, resulting in a surge of commuting accidents. However, research evidence utilizing objective measures, such as time series data, to model the association between meteorological factors and commuting accidents or even the RTAs in general, particularly within the Malaysian context are substantially limited. Therefore, this study aims to model the association between rainfall and temperature with commuting accidents and forecast their future occurrence. Methods: This study employed retrospective secondary data on RTAs, rainfall, and temperature from Kuala Lumpur and Johor Bahru from 1 January 2015 to 31 December 2019. In the first phase, the outcome variable was the number of RTAs among the working population. A quasi-Poisson regression model was utilized to investigate the influence of different temporal factors on the outcome variable. Its association with temperature and rainfall was then examined using a combination of Hurdle Negative Binomial (HNB) regression and Distributed lag non-linear models (DLNM). The second phase focused on the number of commuting accidents as an outcome variable, defined as RTAs involving the working population during commuting hours (7:00 am to 8:00 pm). A combined approach using time-stratified case-crossover design and DLNM was implemented to investigate the association between temperature and rainfall with commuting accidents and subsequently, an ARIMA model was employed to forecast their future incidence. Results: In phase one, 11,877 and 8833 workers were involved in 11,531 and 8632 RTAs over five years in Kuala Lumpur and Johor Bahru, respectively. The majority of workers were male (> 75%) and aged 15-44 years (> 70%). The time of day, divided into two time zones, was significantly associated with RTAs among workers. The incidence risk ratio (IRR) was highest during T3 (12:00 pm - 5:59 pm) compared to T1 (12:00 am – 5:59 am) and during PEAK 2 (4:30 pm-7:30 pm) compared to OTHER (12:00 am – 7:29 am, 7:31 pm – 11:59 pm) in both cities. In Kuala Lumpur, workers had higher RTA risk during weekdays compared to weekend (IRR of 1.18, 95% CI: 1.10, 1.27). Weeks comprising of three or more school holiday showed a reduced RTA risk in both cities (Kuala Lumpur: IRR 0.78, 95% CI: 0.69-0.88; Johor Bahru: IRR 0.83, 95% CI: 0.72-0.95). Lower temperatures significantly affected RTA occurrence, peaking at 22°C in Kuala Lumpur (OR 1.46, 95% CI 1.10-1.94) and 26°C in Johor Bahru (OR 1.36, 95% CI 1.04-1.78). The strongest lag effect of extremely low temperature (23°C) was at lag 0, and for extremely high temperature, it was delayed up to 16 hours in Kuala Lumpur (36°C) and 24 hours for Johor Bahru (34°C). Rainfall intensity increased RTA odds, with the most pronounced effects at lag 9-hour and 12-hour in Kuala Lumpur and Johor Bahru, respectively. In phase two, 8941 and 6548 commuting accidents were recorded in Kuala Lumpur and Johor Bahru from 1 January 2015 to 31 December 2019. Kuala Lumpur showed a significant inverse linear association between daily maximum temperature and commuting accidents, with the highest odds at 28°C (OR 1.76, 95% CI 1.14-2.72), while Johor Bahru had a non-significant positive association, peaking at 35°C (OR 1.21, 95% CI 0.63-2.32). No significant association between rainfall and commuting accidents was observed in both cities. The best forecasting model for Kuala Lumpur was a regression with ARIMA (1,1,1) error, with a weekly daily minimum temperature utilized as regressor. In Johor Bahru, ARIMA (1,1,1) was identified as the best fitted model. Both models indicated no substantial changes in the projected trajectory of weekly commuting accidents during 2020. Conclusion: The study findings elucidate the association between temperature, rainfall, and their lag effect with RTAs among the working population, and subsequently on commuting accidents, underscoring the significance of incorporating meteorological parameters in public health policy related to occupational safety and health, urban planning, and road safety. These insights can also inform targeted intervention and enhance the preparedness of urban workers for extreme weather events resulting from climate change.
Household air pollution and childhood bronchial asthma new onset risk in Kota Bharu Kelantan: the determinants and modelling
(2024-12)
Ibrahim, Muhammad Naim
Background: Rapid urbanisation and industrialisation have led to increasing environmental pollution, heightening children's vulnerability to bronchial asthma (BA). Environmental factors, including rising household product consumption and poorly regulated outdoor pollution, play a key role in this trend. Despite the growing risk, locally focused studies on household-related contributors to childhood BA remain limited. Therefore, this study aims to elucidate the relationship between household air pollution and the risk of childhood BA onset in Kota Bharu, Kelantan. It includes the development, validation, and reliability analysis of the HAPBAC-Checklist, as well as identifying the determinants of childhood BA onset and modelling them. Methodology: The study was conducted through two phases, from March 2023 to April 2024. The first phase involved the development and validation of the HAPBAC-Checklist, which included four stages: 1) the development of the checklist 2) content validation 3) face validation and 4) reliability analysis (kappa agreement analysis). Then, the second phase employed a case-control study involving 194 children; 97 newly diagnosed BA cases and 97 controls, in Kota Bharu, Kelantan. Data were collected using the HAPBAC-Checklist and air quality measurements. Descriptive analysis and logistic regression identified factors linked to childhood BA new onset, which were then used to develop accurate predictive models. Results: The final validated HAPBAC-Checklist consists of five domains (sociodemographic, family history of atopy, child’s medical history, household attributes, and outdoor attributes) with 59 items. The I-CVI scores indicated good relevancy (value ranged from 0.83 to 1.00), and the S-CVI value was satisfactory (value of 0.94). The I-FVI (at least 0.83) and the S-FVI (value of 0.96) indicating the checklist was easily understood. The kappa analysis for reliability testing for five domains combined was 0.88 (95% CI: 0.81, 0.95; p<0.001). A case-control study found that case group had a higher proportion of indoor smoking, indoor pets, new wooden furniture, and other household attributes. As for outdoor, the case group had a higher proportion vehicle near their homes, use outdoor wood stoves, and live closer to pollution sources such as major roads and garbage burning. Air quality measurements indicated higher pollutant levels among households in the case group. Multiple logistic regression revealed the significant determinants were younger age (AdjOR: 0.67, 95% CI: 0.50, 0.89; p=0.007), mother with history of atopy (AdjOR: 5.18, 95% CI: 1.54, 17.38; p=0.009), and sibling with history of atopy (AdjOR: 4.88, 95% CI: 1.51, 15.78; p=0.008); Household attributes: indoor smoking (AdjOR: 5.64, 95% CI: 1.95, 16.29; p=0.001), indoor pets (AdjOR: 3.65, 95% CI: 1.21, 11.04; p=0.022), recent home painting (AdjOR: 9.25, 95% CI: 1.56, 54.91; p=0.014), poorly ventilated kitchens (AdjOR: 12.28, 95% CI: 2.80, 53.87; p=0.001), frequent frying (AdjOR: 14.15, 95% CI: 3.01, 66.48; p=0.001), wood stove use indoor (AdjOR: 17.84, 95% CI: 1.29, 247.20; p=0.032) and fragrance indoor (AdjOR: 7.54, 95% CI: 2.23, 25.51; p=0.001); Outdoor attributes: proximity to main roads (AdjOR: 0.99, 95% CI: 0.98, 0.99; p=0.001) and nearby livestock or outdoor pets (AdjOR: 5.62, 95% CI: 1.82, 17.38; p=0.003); and air quality measurement: elevated levels of indoor PM10 (AdjOR: 1.03, 95% CI: 1.02, 1.05; p<0.001) and Aspergillus spores (AdjOR: 1.08, 95% CI: 1.01, 1.16; p=0.048). The predictive model developed from these 14 determinants showed an excellent fit (ROC curve = 0.947; 95% CI: 0.92, 0.97), effectively predicting childhood BA onset. Conclusion: The HAPBAC-Checklist is a novel tool specifically tailored to address locally identified household and outdoor factors influencing BA. The widespread determinants underscore the urgent need to prevent childhood BA. This study recommends policies promoting healthier living environments, incentives for safer practices, stricter regulation of household products, and health advocacy on key risk factors.
Attitude and needs toward geriatric care among primary care doctors in Malaysia: A mixed methods study
(2024-12)
Azmi, Mohd Ikhwan
Background: Primary care doctors (PCD) are pivotal in an ageing society. They must possess the appropriate attitudes in offering effective care to the older persons. Their need to deliver effective geriatric care must also be addressed to ensure they are equipped to provide high-quality care to the older persons. Therefore, this study sought to determine the attitudes of PCDs toward geriatric care and its associated factors and to explore the needs of PCDs in delivering geriatric care in Malaysia. Method: This convergent mixed-method study was conducted between December 2022 and November 2024. The quantitative method was a cross-sectional of 328 PCDs in Malaysia and used convenience sampling. While the qualitative method was an in-depth interview of 11 PCDs. This study included doctors who had worked for at least six months in a primary care setting. Doctors who did not attend to older persons were excluded from the study. For the quantitative method, the University of California Los Angeles - Geriatric Attitude Scale questionnaire was administered online. Simple and multiple linear regression analyses were used to determine associated factors. For the qualitative method, in-depth interviews were conducted among participants recruited from the quantitative study. The interviews were transcribed and analysed using thematic analysis. Result: Primary Care Doctors’ attitudes towards geriatric care in Malaysia were positive. Being a family medicine specialist (Adj. B 0.25; 95% CI: 0.13, 0.37, p ≤ 0.001) and those who perceived to have administrative support for geriatric care services (Adj. B 0.15; 95% CI: 0.06, 0.24, p = 0.001) were associated with a positive attitude. From the qualitative study, three major themes were found regarding PCDs' needs in geriatric care: “education and awareness needs,” “administrative and operational needs,” and “support system needs.” Conclusion: This study emphasizes the need for PCDs to have periodic and specialized training in geriatric care and highlights the administrative support necessary to deliver geriatric care. The community must also fully support them in delivering comprehensive geriatric care, including interagency collaboration in delivering the care service. Targeted strategies can be used to cultivate a supportive and understanding environment for PCDs, which, in turn, will positively impact their attitudes and fulfil their needs toward delivering comprehensive geriatric care.
Mechanism Of Actions Of Bilimbi Fractions And Its Natural Compounds In Stimulating Brown Adipocyte Differentiation
(2024-03)
Fauzi, Farah Binti Md
Averrhoa bilimbi, or bilimbi, is one of the medicinal plants in the ayurvedic medicine system with various pharmacological activities. The bilimbi leaves were mainly reported for their traditional uses in treating hyperglycemia, diabetes, and related disorders. In previous studies, hexane bilimbi fractions have demonstrated promising anti-obesity properties by stimulating brown adipocyte differentiation. Similarly, major natural compounds of the bilimbi fractions, including phytol and squalene, have also been reported to possess browning activity. However, our understanding of this mechanism of action is still limited to date. To that end, this study focused on a series of transcriptional and translational studies to elucidate the mechanism of action of bilimbi fractions and their corresponding natural compounds in stimulating brown adipocyte differentiation. In the present study, hexane bilimbi fractions (f7, f8, and f9) and their natural compounds (phytol and squalene) substantially stimulated brown adipocyte differentiation at 50 μg/ml and 100 μm, respectively, on the cell-based assay. Based on qrt-pcr analysis, treatment with bilimbi fractions, phytol, and squalene significantly induced the brown-adipocyte marker genes of ucp-1, prdm16, and pgc1-α. Correspondingly, a higher protein expression of cidea, the brown-adipocyte-specific protein marker, was exhibited on a translational level via immunofluorescence assay. The treatment led to the co- development of myotubes and brown adipocytes upon gene knockdown of prdm16. Interestingly,
Translation And Communication Model Of Chinese Literature: A Case Study Of Cultural Communication Of English Translation Of Li Bai’S Selected Poems
(2024-11)
Chang, Hongjing
Translation acts as a vital bridge in intercultural communication. However, significant inequalities persist in the international communication of translated literature, including english translations of chinese literature. At present, most studies focus on isolated elements of translation and communication (tc) within chinese literature, leaving the translation and communication model for chinese literature—especially classical chinese poetry—yet to be fully developed. This study aims to investigate the translation and communication model of chinese literature in the west taking li bai’s poetry as an example. Quantitative analysis was applied to data obtained from the translation and communication questionnaire, the reader response questionnaire on translations of classical chinese poetry, and the worldcat database, while qualitative analysis was conducted on data from interviews and english translations of li bai’s poetry. Additionally, both quantitative and qualitative analyses were applied to data from the jastor database, amazon, and goodreads websites.