Exploring the Need for Mobile Application in Stroke Management by Informal Caregivers: A Qualitative Study.

BACKGROUND: Mobile health (mHealth) has been considered as a prominent concept in digital health and is widely used and easily accessible. Periodic follow-up visits, previously planned procedures, and rehabilitation services for stroke survivors have been cut down during the recent COVID-19 pandemic. Therefore, in this qualitative study we aimed to explore the need for a mobile application in stroke management by informal caregivers. METHODS: A phenomenological qualitative study was conducted from November 2020 to June 2021. Thirteen respondents were recruited from two public rehabilitation centers in Kota Bharu, Kelantan, Malaysia. In-depth interviews were conducted. A comprehensive representation of perspectives from the respondents was achieved through purposive sampling. The interviews were conducted in the Kelantanese dialect, recorded, transcribed, and analyzed by using thematic analysis. RESULTS: Thirteen participants were involved in the interviews. All of them agreed with the need for a mobile application in stroke management. They believed the future stroke application will help them to seek information, continuous stroke home care, and help in the welfare of caregivers and stroke patients. CONCLUSIONS: The current study revealed two themes with respective subthemes that were identified, namely, self-seeking for information and reasons for using a stroke mobile application in the future. This application helps in reducing healthcare costs, enhancing the rehabilitation process, facilitating patient engagement in decision making, and the continuous monitoring of patient health.

Harmonized-Multinational qEEG norms (HarMNqEEG).

This paper extends frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific variance, increasing qEEG nuisance variance. We ameliorate these weaknesses. (i) Create lifespan Riemannian multinational qEEG norms for cross-spectral tensors. These norms result from the HarMNqEEG project fostered by the Global Brain Consortium. We calculate the norms with data from 9 countries, 12 devices, and 14 studies, including 1564 subjects. Instead of raw data, only anonymized metadata and EEG cross-spectral tensors were shared. After visual and automatic quality control, developmental equations for the mean and standard deviation of qEEG traditional and Riemannian DPs were calculated using additive mixed-effects models. We demonstrate qEEG "batch effects" and provide methods to calculate harmonized z-scores. (ii) We also show that harmonized Riemannian norms produce z-scores with increased diagnostic accuracy predicting brain dysfunction produced by malnutrition in the first year of life and detecting COVID induced brain dysfunction. (iii) We offer open code and data to calculate different individual z-scores from the HarMNqEEG dataset. These results contribute to developing bias-free, low-cost neuroimaging technologies applicable in various health settings.

Progress in Clinical Neurosciences, Cognitive Neurosciences, Clinical Psychology, Neurotechnology and Brain Mapping in Malaysia.

Last year, there was an increase in the amount of manpower in Malaysia, especially in terms of the numbers of neurosurgeons, cognitive neuroscientists and clinical psychologists. One way to increase the number of cognitive neurotechnologists in the country in 2021 is to allow neuroscientists to register as neurotechnologists with the Malaysian Board of Technologists (MBOT). The Malaysian Brain Mapping project has risen from its humble beginnings as an initiative of the Universiti Sains Malaysia Brain Mapping Group in 2017. There is currently a proposal for its entry into the national arena via the Precision Medicine Initiative with the Academy Science Malaysia, the Ministry of Science, Technology and Innovation, Ministry of Higher Education and Ministry of Health. The current Malaysian Government's Science, Technology, Innovation and Economy (STIE) plan was launched in 2020, leading to the establishment of neurotechnology as one of 10 STIE drivers.

Malaysia and COVID-19: In Data We Trust

In pandemic situations, data becomes more critical. Since the start of the COVID-19 pandemic in early November 2019, we have seen a significant increase in the number of dashboards tracking COVID-19 cases. Preferably, data should be available in tabular formats, such as comma-separated values easily downloadable from the data.world website (https://data.world/), GitHub (https://github.com/) or the Ministry of Health Malaysias official COVID-19 resource centre. v) Responsible agencies must vet the data to ensure reliability and validity. The Wellcome Trust and the Bill & Melinda Gates Foundation mandated that funding recipients share data from research related to COVID-19 (13). ii) Researchers must provide a list of their COVID-19 research projects and links to access and download the data. iii) Researchers must provide a COVID-19 data dictionary and adequate metadata. iv) Researchers must document the data-wrangling process so that it is reproducible. v) Researchers must indicate to the human ethics committee that their COVID-19 data will be shared and will not be destroyed within a specific time. Specifically, data from COVID-19 surveillance will enable epidemiologists, physicians and health workers to: i) enable rapid detection, isolation, testing and management of cases;ii) monitor trends in COVID-19 deaths;iii) identify, follow up with and quarantine contacts;iv) detect and contain clusters and outbreaks, especially among vulnerable populations;v) guide the implementation and adjustment of targeted control measures while enabling the safe resumption of economic and social activities;vi) evaluate the pandemics impact on healthcare systems and society;vii) monitor longer-term epidemiologic trends and the evolution of the SARS-CoV-2;and virus;and viii) contribute to the understanding of the cocirculation of the SARS-CoV-2 virus, influenza and other respiratory viruses and pathogens.

Detailed Anatomical Volumetric Study of Deep Nuclei of Brain and Other Structures Between Parkinson's Disease Patients Who Had Deep Brain Stimulation and Control Group.

BACKGROUND: Deep brain stimulation (DBS) was pioneered by Neuroscience team of Hospital Universiti Sains Malaysia (HUSM) nearly a decade ago to treat advanced medically refractory idiopathic Parkinson's disease (IPD) patients. OBJECTIVES: Brain volume reduction occurs with age, especially in Parkinson plus syndrome or psychiatric disorders. We searched to define the degree of volume discrepancy in advanced IPD patients and correlate the anatomical volumetric changes to motor symptoms and cognitive function. METHODS: We determined the magnetic resonance imaging (MRI)-based volumetry of deep brain nuclei and brain structures of DBS-IPD group and matched controls. RESULTS: DBS-IPD group had significant deep nuclei atrophy and volume discrepancy, yet none had cognitive or psychobehavioural disturbances. Globus pallidus volume showed positive correlation to higher mental function. CONCLUSION: The morphometric changes and clinical severity discrepancy in IPD may imply a more complex degenerative mechanism involving multiple neural pathways. Such alteration could be early changes before clinical manifestation.

Modelling COVID-19 Scenarios for the States and Federal Territories of Malaysia.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease, which has become pandemic since December 2019. In the recent months, among five countries in the Southeast Asia, Malaysia has the highest per-capita daily new cases and daily new deaths. A mathematical modelling approach using a Singular Spectrum Analysis (SSA) technique was used to generate data-driven 30-days ahead forecasts for the number of daily cases in the states and federal territories in Malaysia at four consecutive time points between 27 July 2021 and 26 August 2021. Each forecast was produced using SSA prediction model of the current major trend at each time point. The objective is to understand the transition dynamics of COVID-19 in each state by analysing the direction of change of the major trends during the period of study. The states and federal territories in Malaysia were grouped in four categories based on the nature of the transition. Overall, it was found that the COVID-19 spread has progressed unevenly across states and federal territories. Major regions like Selangor, Kuala Lumpur, Putrajaya and Negeri Sembilan were in Group 3 (fast decrease in infectivity) and Labuan was in Group 4 (possible eradication of infectivity). Other states e.g. Pulau Pinang, Sabah, Sarawak, Kelantan and Johor were categorised in Group 1 (very high infectivity levels) with Perak, Kedah, Pahang, Terengganu and Melaka were classified in Group 2 (high infectivity levels). It is also cautioned that SSA provides a promising avenue for forecasting the transition dynamics of COVID-19; however, the reliability of this technique depends on the availability of good quality data.

The Performance of Malaysian Journal of Medical Sciences in 2020 and the Impact of COVID-19 on the Trend of Manuscript Submissions.

In this Editorial, we report on the trend of manuscript submissions during the peak of COVID-19 pandemic in 2020. The total monthly new manuscript submissions from 2018 to 2020 were compared to examine the overall trends in submission and publication activities. Apart from that, we also report on the changes in the journal's administration and the external recognition received by the journal.

Malaysia and COVID-19: In Data We Trust.

The recent spike of transmissibility of COVID-19 was evident by a large number of COVID-19 cases and apparent quick spread of SARS-CoV-2 in the state of Sabah, Selangor and Negeri Sembilan in Malaysia. The question remains as to what are the main contributory factors for the impending COVID-19 second wave in Malaysia and why the current surveillance system fails to show signs of the impending second - or the third - COVID-19 wave. In public health surveillance, data are the ultimate indicator, and in the era of big data and the Industrial Revolution 4.0, data has become a valuable commodity. The COVID-19 data keeper must fulfil some criteria to ensure COVID-19 data are useful. Researchers are obligated to share their COVID-19 data responsibly. The surveillance for COVID-19 is paramount, and the guidelines such as the one published by the World Health Organization 'Public health surveillance for COVID-19: interim guidance' must be referred to. Data must be taken seriously and shared to enable scientists, clinicians, epidemiologists and public health experts fight COVID-19.

COVID-19 Pandemic and Its Impact on Neurosurgery Practice in Malaysia: Academic Insights, Clinical Experience and Protocols from March till August 2020.

The newly discovered coronavirus disease 2019 (COVID-19) is an infectious disease introduced to humans for the first time. Following the pandemic of COVID-19, there is a major shift of practices among surgical departments in response to an unprecedented surge in reducing the transmission of disease. With pooling and outsourcing of more health care workers to emergency rooms, public health care services and medical services, further in-hospital resources are prioritised to those in need. It is imperative to balance the requirements of caring for COVID-19 patients with imminent risk of delay to others who need care. As Malaysia now approaches the recovery phase following the pandemic, the crisis impacted significantly on neurosurgical services throughout the country. Various emergency measures taken at the height of the crisis may remain as the new normal in the provision of neurosurgical services and practices in Malaysia. The crisis has certainly put a strain on the effective delivery of services and as we approach the recovery era, what may have been a strain may prove to be a silver lining in neurosurgical services in Malaysia. The following details are various measures put in place as the new operational protocols for neurosurgical services in Malaysia.

A Critical Appraisal of COVID-19 in Malaysia and Beyond.

When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.