Search Results (838)

This study investigates the impact of Time-of-Use (TOU) scheduling and battery energy storage systems (BESS) on voltage stability in a typical Malaysian medium-voltage distribution network with high photovoltaic (PV) system penetration. The analyzed network comprises 110 nodes connected via eight feeders to a pair of 132/11 kV, 15 MVA transformers, supplying a total load of 20.006 MVA. Each node is integrated with a 100 kW PV system, enabling up to 100% PV penetration scenarios. A hybrid mitigation strategy combining TOU-based load shifting and BESS was implemented to address voltage violations occurring, particularly during low-load night hours. Dynamic simulations using DIgSILENT PowerFactory were conducted under worst-case (no load and peak load) conditions. The novelty of this research is the use of real rural network data to validate a hybrid BESS–TOU strategy, supported by detailed sensitivity analysis across PV penetration levels. This provides practical voltage stabilization insights not shown in earlier studies. Results show that at 100% PV penetration, TOU or BESS alone are insufficient to fully mitigate voltage drops. However, a hybrid application of 0.4 MWh BESS with 20% TOU load shifting eliminates voltage violations across all nodes, raising the minimum voltage from 0.924 p.u. to 0.951 p.u. while reducing active power losses and grid dependency. A sensitivity analysis further reveals that a 60% PV penetration can be supported reliably using only 0.4 MWh of BESS and 10% TOU. Beyond this, hybrid mitigation becomes essential to maintain stability. The proposed solution demonstrates a scalable approach to enable large-scale PV integration in dense rural grids and addresses the specific operational characteristics of Malaysian networks, which differ from commonly studied IEEE test systems. This work fills a critical research gap by using real local data to propose and validate practical voltage mitigation strategies. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

This study explores the relationship between institutional shareholders and climate-related disclosure (CRD) and how sustainability committees influence this relationship among publicly listed Malaysian firms. For the analysis, 990 firm-year observations were studied from 198 highly polluting firms from 2021 to 2024. A strong CRD index was designed using the recognized climate reporting frameworks and well-grounded literature to assess the level of climate-related disclosure. Fixed-effects and hierarchical panel regression models show that CRD increases when institutional investor ownership increases, meaning firms with more institutional investors disclose more information on climate-related topics. In addition, a sustainability committee at the board level greatly improves this relationship by highlighting the positive impact of strong internal governance. As a result, such committees establish climate management and improve communication with investors, making the firm’s actions more transparent. The findings of this study are consistent with agency and legitimacy theories because institutional investors assist in monitoring firms’ environmental performance, and sustainability committees help the company maintain these standards internally. Further, this study helps grow the understanding of corporate governance (CG) and sustainability by pointing out that the presence of institutional owners and sustainability committees can promote openness about climate matters. Accordingly, these findings can guide policymakers, investors, and business leaders in boosting responsible environmental reporting and sustainable business practices in developing countries. Full article

Social media influencers have made materialism more accessible and desirable, shaping how followers view success, self-worth, and consumption. This study investigates the influence of materialistic messages promoted by lifestyle influencers on their followers’ emotions, self-concept, and consumer behavior, using Symbolic Interactionism as the theoretical framework. The research addresses three key questions: motivations for follower engagement, emotional effects of materialistic content, and how such messages appear to influence purchasing decisions. Using a qualitative approach, the study focuses on 15 Malaysian young adults who actively engage with lifestyle influencers. Data were analyzed using Braun and Clarke’s thematic analysis framework. Six key themes emerged: (1) admiration and aspiration; (2) feelings of inadequacy and envy; (3) rationalization of impulsive purchases; (4) symbolic consumption and self-identity; (5) emotional ambivalence; and (6) distancing and self-regulation. The findings suggest that influencers serve not only as marketing agents but as symbolic figures whose lifestyles become templates for success and self-worth. Participants engaged with this content in emotionally complex ways, simultaneously admiring and resisting the ideals presented. Their consumption behaviors appeared to be shaped by perceived social meanings attached to material goods. The study provides implications for media literacy programs, influencer marketing practices, and platform-level interventions that consider the emotional and identity-based dimensions of materialistic consumption. Full article

Obesity is a complex, diverse, and multifactorial disease that has become a significant public health concern. It is a modifiable risk factor for developing type 2 diabetes (T2D). The current classification systems rely on anthropometric measurements, such as body mass index (BMI), which cannot capture the physiopathological diversity of this disease. This study aimed to analyze the metabolic signatures of obesity and diabetes using ¹H-nuclear magnetic resonance (NMR). Obese patients with BMI ≥ 25 kg/m² (according to the Asian cut-off value) with different diabetes status scheduled to undergo metabolic-bariatric surgery at three hospitals were prospectively recruited for this study. Plasma samples of 111 obese patients and 26 healthy controls were analyzed by ¹H-NMR. When compared among groups with different diabetes statuses, four clusters with no differences in BMI but different metabolomics profiles were obtained. These clusters highlight intricate metabolic relationships associated with obesity and diabetes. This study demonstrated the benefits of using precision techniques like ¹H-NMR to better early detection, substantially decreasing the risk of developing T2D and its related complications. This study is the first to report on metabolic markers and altered metabolic profiles of T2D and prediabetes among obese Malaysians with a BMI cut-off value for the Asian population. Full article

Background: Influenza poses a significant threat to the health of Malaysians, particularly among the elderly population. It results in high levels of illness and mortality, becoming a financial burden on the government. Vaccination is widely recognised as the most effective measure for controlling the spread and impact of influenza. Objectives: This study sought to assess the knowledge, attitudes, and practices (KAP) regarding influenza and influenza vaccination among older adults attending primary healthcare centres in different states of Malaysia. Additionally, the study assessed the level of acceptance for a proposed free annual influenza vaccination program. Methods: A nationwide survey was conducted involving 672 older people aged 60 and above who visited nine primary healthcare centres in Malaysia. These centres were selected using proportionate to population size (PPS) sampling to ensure representation from each zone. Participants completed a validated self-reported questionnaire. Descriptive statistics were used to determine the levels of KAP, and a binomial logistic regression model was used to determine the predictors of acceptance for the proposed free annual vaccination program. Results: Most participants displayed a strong understanding of influenza illness (74.0%) and the vaccine (65.9%). Moreover, 76.4% of respondents exhibited a positive attitude towards influenza vaccination. However, the prevalence of good vaccination practices was relatively low, with only 29.2% of participants having a history of previous vaccination, and just 55.2% of these consistently practicing annual vaccination. The group acceptance rate for the proposed free annual influenza vaccination was 62.3%. Significant predictors of acceptance included a history of previous vaccination (good practice) (OR = 6.438, 95% CI = 1.16–35.71, p < 0.001), a positive attitude towards vaccines (OR = 21.98, 95% CI = 5.44–88.87, p = 0.033), and a good level of knowledge about the influenza vaccine (OR = 0.149, 95% CI = 0.03–0.79, p = 0.026). Conclusions: Increasing the uptake of influenza vaccination among the older population in Malaysia remains a significant challenge. It is recommended that a targeted, free annual influenza vaccination program be implemented for high-risk populations, particularly those with comorbidities and those who have shown greater receptiveness. In addition, health education strategies aimed at raising awareness and understanding of influenza should be prioritised. Strengthening epidemiological data collection and establishing systematic monitoring mechanisms are also essential to support these efforts. Full article

Background: Obesity is a global health problem associated with many chronic diseases. Nutrition education tools, such as graphic nutrition models, play a key role in the promotion of healthy eating habits. The purpose of this study was to compare selected nutrition models in plate form—MyPlate (USA), Harvard Healthy Eating Plate, the Eatwell Guide (UK), Malaysian Healthy Plate, and Polish Healthy Eating Plate—in terms of their structure, content, and effectiveness in improving diet quality and combating obesity. Methods: A comparative analysis of the selected models was carried out, focusing on their design, informational content, and compliance with dietary guidelines. A literature review was conducted in the PubMed and Embase databases. Results: The compared nutrition models are structurally similar but differ in the presence of additional information on the graphics, among other things. MyPlate and Malaysian Healthy Plate, compared to the other models, appear poor and lack recommendations on fats, beverages, and physical activity. The Eatwell Guide is distinguished by the proportion of each product group. Research indicates that plate models improve diet quality, but awareness of them in the public remains low. The Polish Healthy Eating Plate, while detailed, has not been empirically evaluated. Conclusions: Plate models are promising tools for nutrition education, but their effectiveness depends on adaptation to local conditions and ongoing educational efforts. It is necessary to conduct research evaluating the familiarity and effectiveness of the Polish Healthy Eating Plate in order to optimize the form of the message. Full article

Amid globalization and rising global temperatures, dehydration has emerged as a critical issue, especially for children who are more vulnerable due to their higher body surface-to-weight ratio. The issue is even more concerning given that adequate water intake is important for cognitive development, particularly in children since brain development is critical during early years. This study addressed this challenge by, first, designing a smart hydration device based on the Theory of Inventive Problem Solving (TRIZ). Then, this study proceeded with prototyping and testing the smart hydration device to promote increased daily water intake among Malaysian children. The device demonstrated improved water consumption and increased drinking frequency among children. Additionally, the children displayed improved cognitive performance. However, this study was limited to a specific age group and the device requires adult supervision for charging. Therefore, further research is necessary to tackle these limitations. Nevertheless, this smart device represents a promising step forward in fostering better hydration habits among children. Full article

Introduction: NEDD8 Ultimate Buster 1 (NUB1) is a regulator of the cell cycle and a prognostic marker in cancer patients. However, its role in breast cancer (BC) and its response to 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) treatment remain unclear. This study investigated NUB1’s predictive value in FEC treatment and its mechanistic interaction with the oestrogen receptor (ER) in BC. Methods: MDA-MB-231 and MCF-7 cells were treated with FEC and analysed via flow cytometry for cell cycle distribution. Western blotting assessed NUB1 and ERα expression, while immunohistochemistry was conducted on a retrospective cohort (n = 85) from Malaysian hospitals to evaluate the clinical significance of NUB1 expression. Results: FEC treatment induced S and G2 phase cell cycle arrest in MDA-MB-231 cells (p = 0.04 and p = 0.02, respectively), accompanied by NUB1 upregulation. In MCF-7 cells, G2/M arrest was observed (p = 0.01), with reduced ERα expression and increased NUB1 levels in both cell lines. Lower cytoplasmic NUB1 expression was associated with poorer overall survival (OS) (HR = 0.60; 95% CI = 0.32–1.11; p = 0.10). Patients with low NUB1 and low ER expression showed the worst OS outcomes. Discussion: NUB1 upregulation following FEC treatment led to cell cycle arrest in ER-negative cells, whereas ERα suppression failed to induce S-phase arrest in ER-positive cells. Low NUB1 expression predicted poorer OS and increased BC recurrence. Conclusions: By integrating in vitro and clinical data, this study suggests that NUB1 may serve as a predictive biomarker in FEC-treated breast cancer. Larger studies are needed to validate and establish NUB1’s predictive role in FEC-treated patients. Full article

Objective: The purpose of this study is to explore the factors influencing access to healthcare services among Type 2 Diabetes Mellitus (T2DM) patients enrolled in the PEKA B40 programme at a public health clinic in Melaka, Malaysia. It aims to examine how key dimensions—availability, accessibility, accommodation, and acceptance—affect patients’ experiences and the utilisation of diabetes-related healthcare services. This study also seeks to identify gaps and challenges within the current healthcare delivery system, particularly for low-income populations, to inform strategies for improving equitable and sustainable access to care. Methods: This study was conducted in a public health clinic in Melaka, Malaysia. Purposive sampling was used among T2DM patients under the “Health Care Scheme for Group B40” programme in a public health clinic in Melaka, Malaysia. The study included participants with at least a 6-month history of T2DM to ensure substantial experience in accessing healthcare services. Results: Fifteen patients participated in this study. Elderly individuals, retirees, and those with average incomes demonstrated higher healthcare service utilisation. Ethnic diversity was crucial, revealing its impact on health behaviours and healthcare-seeking patterns. Primary or secondary education levels among participants highlighted the necessity for targeted health literacy efforts. Conclusions: This study highlighted notable awareness and satisfaction among patients concerning the availability, accessibility, and accommodation of services, particularly emphasising the importance of geographical proximity in healthcare services. However, challenges faced by elderly individuals in accessing social support are also highlighted. The potential of enhancing the amenities of healthcare facilities to improve patient experiences is also reflected in our results. These insights provide evidence for the effectiveness of the Malaysian healthcare system in catering to a diverse demographic and can also be helpful in refining healthcare strategies and further optimising patient-centred care in Malaysia. Full article

Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR: 1.01, 95% CI: 0.80–1.29), undiagnosed hypertension (adjusted OR: 0.99, 95% CI: 0.81–1.22), undiagnosed hypercholesterolemia (adjusted OR: 0.99, 95% CI: 0.83–1.18), or obesity (adjusted OR: 1.08, 95% CI: 0.91–1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While a lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address the cultural and economic determinants of SSB intake, as well as future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs. Full article

Poly A (AATAAA > AATA--) [HBA2:c.*93_*94delAA] is a rare α-variant reported in our population. It is caused by 2 bp deletion (--AA) in the α2 poly A sequence, leading to a significant α–thalassaemia phenotype. Background/Objectives: This study describes the haematological parameters, phenotype, and genotype characteristics of AATA(--AA) in the Malaysian population. Methods: The study was carried out on 17 177 cases referred to the Institute for Medical Research, Malaysia, for further diagnosis of α-thalassaemia in a five-year period. Alpha-Gap and ARMS-PCR were performed to detect common α-thalassaemia, followed by HBA1 and HBA2 genes sequencing and multiplex ligation-dependent probe amplification (MLPA). Haematological parameters among various groups with the AATA(--AA) allele were presented in this study. Results: Thirty-two patients with AATA(--AA) displaying an α–thalassaemia-like phenotype were analysed. They comprised 22 (68.75%) AATA(--AA) carriers, 2 (6.25%) compounds with 3.7 deletion, 2 (6.25%) compounds with --SEA deletion, 1 (3.12%) AATA(--AA) homozygote, and 3 (9.37%) compounds of Hb Adana, Hb CS, and Hb Pakse with co-inheritance Hb E, respectively. Most of the patients with AATA(--AA) compounds with the α-variant exhibited a significant phenotype between moderate to severe thalassaemia, especially cases with compound α^−AAα/α^Adanaα. Conclusions: AATA(--AA) is a significant pathogenic variant that should be diagnosed to prevent significant thalassaemia phenotype or transfusion-dependent thalassaemia. Full article

Background/Objectives: Gestational weight gain (GWG) is a critical determinant of pregnancy outcomes; however, studies on factors contributing to suboptimal GWG in developing countries, including Malaysia, remain limited. Methods: This study employed an explanatory sequential mixed-methods design, with the quantitative phase conducted between January and March 2020, followed by the qualitative phase from July 2020 to March 2021 in Selangor. The qualitative phase aimed to explain the factors influencing suboptimal (inadequate and excessive) GWG identified in the quantitative phase. Inclusion criteria included Malaysian women aged 18 and above who had suboptimal GWG (either inadequate or excessive) from the quantitative phase. Exclusion criteria included women who refused participation. Of the 475 participants from the quantitative phase, 20 with suboptimal GWG were purposively selected for in-depth telephone interviews using a semi-structured interview protocol. Data were analysed using thematic analysis. Results: Three key themes emerged: (1) the impact of pre-pregnancy overweight and obesity, shaped by unhealthy lifestyles, social influences, and limited access to nutritious food and physical activity; (2) the management of diabetes during pregnancy, contributing to inadequate GWG due to psychological responses, restrictive behaviours, and barriers to dietary guidance; and (3) financial constraints in middle- and low-income households, leading to income vulnerability, financial crises, and food insecurity. Conclusions: This finding highlights the urgent need for targeted interventions to optimize GWG, emphasizing pre-pregnancy health optimization, enhanced diabetes management, and strategies to mitigate financial constraints and food insecurity among pregnant women. Full article

This study explores how system-based and cognitive-based factors affect platform trust and its role in the actual use of PayLater services (buy now, pay later or BNPL) in Indonesia and Malaysia. PayLater, a fintech innovation, provides fast and convenient payment options through online platforms. By incorporating platform trust into the technology acceptance model (TAM), the research investigates whether borrowing intention acts as a mediator between platform trust and actual usage. Utilizing a quantitative approach with purposive sampling, data were gathered from 106 respondents in Indonesia and 169 in Malaysia, with 62 and 85 respondents meeting the criteria, respectively. Partial least squares (PLS) analysis indicates notable differences in how Indonesian and Malaysian users perceive platform trust, while the effect of platform trust on borrowing intention remains consistent across both nations. Borrowing intention emerges as a crucial factor influencing the actual use of PayLater services. The results offer important insights into the adoption of fintech services in emerging markets, highlighting the significance of platform trust in shaping user behavior. This research provides practical suggestions for fintech providers to improve platform trust and user engagement in cross-country scenarios. Full article

While it has been pointed out that identity is complex, unfixed and intersectional in nature, many studies tend to be restricted by their very conceptualisation of identity, which projects a sense of purism and essentialism rooted in Global North epistemologies. In this article, we consider the concept of (diasporic) identity and discuss how labels and categories of identity often prescribed to a community can and should be deconstructed for social justice purposes. We demonstrate this by examining the translanguaging practices of six Malaysian and Singaporean speakers of English in relation to their identity perception and construction. Although these multilingual speakers seemed to regard their use of multiple languages as fixed and bounded, they all showed, to varying degrees, a flexible languaging approach. The findings also suggested a defiance of expected categories of identity defined by the Global North, such as racialised language use and diasporic identity. We suggest that these prescriptive named categories are not useful in describing identities and question the labels and categories used to construct ‘identity’. We conclude by arguing for an ‘oceanic’ approach to identity, one that emphasises the fluidity, interconnectedness and boundless potential of identity to challenge oppressive structures and contribute to a more just and equitable world. Full article