COVID-19 Pandemic Fatigue and Its Sociodemographic, Mental Health Status, and Perceived Causes: A Cross-Sectional Study Nearing the Transition to an Endemic Phase in Malaysia.

This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.

Gut Microbiota Composition in Prediabetes and Newly Diagnosed Type 2 Diabetes: A Systematic Review of Observational Studies.

Evidence of gut microbiota involvement in regulating glucose metabolism and type 2 diabetes mellitus (T2DM) progression is accumulating. The understanding of microbial dysbiosis and specific alterations of gut microbiota composition that occur during the early stages of glucose intolerance, unperturbed by anti-diabetic medications, is especially essential. Hence, this systematic review was conducted to summarise the existing evidence related to microbiota composition and diversity in individuals with prediabetes (preDM) and individuals newly diagnosed with T2DM (newDM) in comparison to individuals with normal glucose tolerance (nonDM). A systematic search of the PubMed, MEDLINE and CINAHL databases were conducted from inception to February 2021 supplemented with manual searches of the list of references. The primary keywords of "type 2 diabetes", "prediabetes", "newly-diagnosed" and "gut microbiota" were used. Observational studies that conducted analysis of the gut microbiota of respondents with preDM and newDM were included. The quality of the studies was assessed using the modified Newcastle-Ottawa scale by independent reviewers. A total of 18 studies (5,489 participants) were included. Low gut microbial diversity was generally observed in preDM and newDM when compared to nonDM. Differences in gut microbiota composition between the disease groups and nonDM were inconsistent across the included studies. Four out of the 18 studies found increased abundance of phylum Firmicutes along with decreased abundance of Bacteroidetes in newDM. At the genus/species levels, decreased abundance of Faecalibacterium prausnitzii, Roseburia, Dialister, Flavonifractor, Alistipes, Haemophilus and Akkermansia muciniphila and increased abundance of Lactobacillus, Streptococcus, Escherichia, Veillonella and Collinsella were observed in the disease groups in at least two studies. Lactobacillus was also found to positively correlate with fasting plasma glucose (FPG), HbA1c and/or homeostatic assessment of insulin resistance (HOMA-IR) in four studies. This renders a need for further investigations on the species/strain-specific role of endogenously present Lactobacillus in glucose regulation mechanism and T2DM disease progression. Differences in dietary intake caused significant variation in specific bacterial abundances. More studies are needed to establish more consistent associations, between clinical biomarkers or dietary intake and specific gut bacterial composition in prediabetes and early T2DM.