Patient's satisfaction towards healthcare services and its associated factors at the highest patient loads government primary care clinic in Pahang.

INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic. MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders. RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services. CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

Signature of spin-phonon coupling driven charge density wave in a kagome magnet.

The intertwining between spin, charge, and lattice degrees of freedom can give rise to unusual macroscopic quantum states, including high-temperature superconductivity and quantum anomalous Hall effects. Recently, a charge density wave (CDW) has been observed in the kagome antiferromagnet FeGe, indicative of possible intertwining physics. An outstanding question is that whether magnetic correlation is fundamental for the spontaneous spatial symmetry breaking orders. Here, utilizing elastic and high-resolution inelastic x-ray scattering, we observe a c-axis superlattice vector that coexists with the 2[Formula: see text]2[Formula: see text]1 CDW vectors in the kagome plane. Most interestingly, between the magnetic and CDW transition temperatures, the phonon dynamical structure factor shows a giant phonon-energy hardening and a substantial phonon linewidth broadening near the c-axis wavevectors, both signaling the spin-phonon coupling. By first principles and model calculations, we show that both the static spin polarization and dynamic spin excitations intertwine with the phonon to drive the spatial symmetry breaking in FeGe.

Softening of a flat phonon mode in the kagome ScV6Sn6.

Geometrically frustrated kagome lattices are raising as novel platforms to engineer correlated topological electron flat bands that are prominent to electronic instabilities. Here, we demonstrate a phonon softening at the kz = π plane in ScV6Sn6. The low energy longitudinal phonon collapses at ~98 K and q = [Formula: see text] due to the electron-phonon interaction, without the emergence of long-range charge order which sets in at a different propagation vector qCDW = [Formula: see text]. Theoretical calculations corroborate the experimental finding to indicate that the leading instability is located at [Formula: see text] of a rather flat mode. We relate the phonon renormalization to the orbital-resolved susceptibility of the trigonal Sn atoms and explain the approximately flat phonon dispersion. Our data report the first example of the collapse of a kagome bosonic mode and promote the 166 compounds of kagomes as primary candidates to explore correlated flat phonon-topological flat electron physics.

Order-disorder charge density wave instability in the kagome metal (Cs,Rb)V3Sb5.

The origin of the charge density wave phases in the kagome metal compound AV3Sb5 is still under great scrutiny. Here, we combine diffuse and inelastic x-ray scattering to identify a 3-dimensional precursor of the charge order at the L point that condenses into a CDW through a first order phase transition. The quasi-elastic critical scattering indicates that the dominant contribution to the diffuse precursor is the elastic central peak without phonon softening. However, the inelastic spectra show a small broadening of the Einstein-type phonon mode on approaching TCDW. Our results point to the situation where the Fermi surface instability at the L point is of order-disorder type with critical growth of quasi-static domains. The experimental data indicate that the CDW consists on an alternating Star of David and trihexagonal distortions and its dynamics goes beyond the classical weak-coupling scenario and is discussed within strong-electron phonon coupling and non-adiabatic models.

Discovery of conjoined charge density waves in the kagome superconductor CsV3Sb5.

The electronic instabilities in CsV3Sb5 are believed to originate from the V 3d-electrons on the kagome plane, however the role of Sb 5p-electrons for 3-dimensional orders is largely unexplored. Here, using resonant tender X-ray scattering and high-pressure X-ray scattering, we report a rare realization of conjoined charge density waves (CDWs) in CsV3Sb5, where a 2 × 2 × 1 CDW in the kagome sublattice and a Sb 5p-electron assisted 2 × 2 × 2 CDW coexist. At ambient pressure, we discover a resonant enhancement on Sb L1-edge (2s→5p) at the 2 × 2 × 2 CDW wavevectors. The resonance, however, is absent at the 2 × 2 × 1 CDW wavevectors. Applying hydrostatic pressure, CDW transition temperatures are separated, where the 2 × 2 × 2 CDW emerges 4 K above the 2 × 2 × 1 CDW at 1 GPa. These observations demonstrate that symmetry-breaking phases in CsV3Sb5 go beyond the minimal framework of kagome electronic bands near van Hove filling.

Characterization of agar extracted from Gracilaria species collected along Tanzanian coast.

The study was conducted to investigate the effect of spatial variation, alkali treatment and the volume of extractant on yield and gel strength of agar for three Gracilaria species (G. salicornia, G. edulis and G. corticata) collected from the Tanzanian coast (Dar es Salaam, Tanga and Zanzibar). Treated and untreated G. corticata showed the highest yield (27 ± 0.7 % and 26.2 ± 1.3 % for treated and untreated, respectively), followed by G. salicornia then G. edulis. G. salicornia collected from Zanzibar showed the highest mass yield (22.9 ± 4.3 % for treated) followed by those collected from Tanga. Varying the volume for extraction showed no significant difference in mass yield where the p-value was >0.05. The highest gel strength was recorded from treated G. salicornia collected from Tanga (495 ± 29.5 gcm-2). Gel strength varied significantly between species. Spatial variability showed a significant difference in gel strength; the sample collected from Tanga showed the highest gel strength, followed by Zanzibar then Dar es Salaam. The variation due to the volume of distilled water used for extraction showed no significant difference in gel strength at a p-value >0.05. The highest gel strength was recorded at the volume of 1500 mL (467.5 ± 98.4 gcm-2), and the smallest gel strength was recorded at 500 mL. In all cases, there was a significant difference in mass yield and gel strength between treated and untreated samples. G. salicornia showed promising results as a local source of agar as it showed the highest gel strength though it produced an intermediate amount of agar. Based on the finding of this study, the volume of extraction of agar should be maintained as 1000 mL because by increasing the volume of extraction from 1000 mL to 1500 mL, the agar yield and gel strength don't change significantly. Agar yield and gel strength of Gracilaria species (G. salicornia, G. edulis and G. corticata) can be improved by alkali treatment, but further study is needed to determine the optimum amount and concentration of alkali to be used that will produce maximum yield and gel strength.

Relaxed complex scheme and molecular dynamics simulation suggests small molecule inhibitor of human TMPRSS2 for combating COVID-19.

As the coronavirus disease 19 (COVID-19) pandemic continues to pose a health and economic crisis worldwide, the quest for drugs and/or vaccines against the virus continues. The human transmembrane protease serine 2 (TMPRSS2) has attracted attention as a target for drug discovery, as inhibition of its catalytic reaction would result in the inactivation of the proteolytic cleavage of the SARS-CoV-2 S protein. As a result, the inactivation prevents viral cell entry to the host's cell. In this work, we screened and identified two potent molecules that interact and inhibit the catalytic reaction by using computational approaches. Two docking screening experiments were performed utilizing the crystal structure and holo ensemble structure obtained from molecular dynamics in bound form. There is enhancement and sensitivity of docking results to the holo ensemble as compared to the crystal structure. Compound 1 demonstrated a similar inhibition value to nafamostat by interacting with catalytic triad residues His296 and Ser441, thereby disrupting the already established hydrogen bond interaction. The stability of the ligand-TMPRSS2 complexes was studied by molecular dynamics simulation, and the binding energy was re-scored by using molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) binding free energy. The obtained compounds may serve as an initial point toward the discovery of potent TMPRSS2 inhibitors upon further in vivo validation.Communicated by Ramaswamy H. Sarma.

DFT and TD-DFT studies for optoelectronic properties of coumarin based donor-π-acceptor (D-π-A) dyes: applications in dye-sensitized solar cells (DSSCS).

A series of six coumarin based dye derivatives were investigated and their geometry and optoelectronic properties elucidated for suitability in dye-sensitized solar cells (DSSCs) using TD-DFT/B3LYP with 6-31G basis set. D-π-A schemes were developed by attaching various donors and acceptors to coumarin dye (CM) to calculate changes in their photovoltaic properties. D2-CM-A2 and D4-CM-A4 showed less dihedral angle because of the low steric effect between donor and connector. The D1-CM-A1 and D2-CM-A2 results of intramolecular charge transfer were higher because of low bond length and a strong group of electron donors. The results revealed that LUMO energies of D1-CM-A1, D2-CM-A2, D3-CM-A3 and D4-CM-A4 were higher than the conduction band edge of TiO2 electrode (-4.0 eV) suggesting that these dyes will inject the electrons into the conduction band of the semiconductor. In addition, the light harvest efficiency (LHE), open-circuit voltage (VOC) and band energy gap (Eg) values are calculated in the gas phase, as well as in the solvent phase. This study shows that D1-CM-D1 and D2-CM-A2 derivatives have better properties for application in the DSSCs.

Theoretical studies of optoelectronic and photovoltaic properties of D-A polymer monomers by Density Functional Theory (DFT).

In this research article, the new donor-acceptor (D-A) monomers developed using 4-methoxy-9-methyl-9 H-carbazole (MMCB) as electron donors and various electron acceptors. DFT and TD-DFT methods at the level of B3LYP with a 6-311 G basis set in a gas and chloroform solvent were used to calculate electronic and optoelectronic properties. To dissect the relationship between the molecular and optoelectronic structures, the impacts of specific acceptors on the geometry of molecules and optoelectronic properties of these D-A monomers were discussed. The calculations are also carried out on HOMO-LUMO, atomic orbital densities. The calculated band gap E g of the monomers considered increases 3,6-MMCB-OCP ≈ 3,6-MMCB-BCO < 3,6-MMCB-SDP < 3,6-MMCB-SCP < 3,6-MMCB-TCP < 3,6-MMCB-TDP < 3,6-MMCB-BCS < 3,6-MMCB-BCT in both in the gas and solvent phases. Subsequently, the optoelectrical properties of E HOMO , E LUMO , E opt , and E B energies were critically updated. Compared to different monomers, the far lower E g of the 3,6-MMCB-OCP and 3,6-CB-BCO has shown optoelectronic applications in organic solar cells like BHJ.

Theoretical design of low bandgap donor-acceptor (D-A) monomers for polymer solar cells: DFT and TD-DFT study.

Endeavors have been made to construct new donor-acceptor (D-A) monomers utilizing 9 H-carbazole (CB) as electron donors and different electron acceptors. All estimations were finished using DFT and TD-DFT, and B3LYP level with a 6-311 G basis set in the gas and chloroform solvent. The impacts of the distinctive acceptors on the geometry of molecules and optoelectronic properties of these D-A monomers were discussed to dissect the connection connecting the molecular structures and the optoelectronic properties. Likewise, the HOMO - LUMO energies, atomic orbital densities are calculated theoretically. Notwithstanding the charge transfer measure between the carbazole electron donor unit and the electron acceptor one is upheld by breaking down the optical spectra of the acquired monomers and the restriction of involved HOMO and LUMO. The outcomes show that the D-A monomers, CB-ODP, CB-TDP, and CB-SDP, are acceptable for optoelectronic applications in organic solar cells like BHJ.

van der Waals driven anharmonic melting of the 3D charge density wave in VSe2.

Understanding of charge-density wave (CDW) phases is a main challenge in condensed matter due to their presence in high-Tc superconductors or transition metal dichalcogenides (TMDs). Among TMDs, the origin of the CDW in VSe2 remains highly debated. Here, by means of inelastic x-ray scattering and first-principles calculations, we show that the CDW transition is driven by the collapse at 110 K of an acoustic mode at qCDW = (2.25 0 0.7) r.l.u. The softening starts below 225 K and expands over a wide region of the Brillouin zone, identifying the electron-phonon interaction as the driving force of the CDW. This is supported by our calculations that determine a large momentum-dependence of the electron-phonon matrix-elements that peak at the CDW wave vector. Our first-principles anharmonic calculations reproduce the temperature dependence of the soft mode and the TCDW onset only when considering the out-of-plane van der Waals interactions, which reveal crucial for the melting of the CDW phase.

In silico study of the inhibition of SARS-COV-2 viral cell entry by neem tree extracts.

The outbreak of COVID-19, caused by SARS-COV-2, is responsible for higher mortality and morbidity rates across the globe. Until now, there is no specific treatment of the disease and hospitalized patients are treated according to the symptoms they develop. Efforts to identify drugs and/or vaccines are ongoing processes. Natural products have shown great promise in the treatment of many viral related diseases. In this work, using in silico methods, bioactive compounds from the neem tree were investigated for their ability to block viral cell entry as spike RBD-ACE2 inhibitors. Azadirachtin H, quentin and margocin were identified as potential compounds that demonstrated viral cell entry inhibition properties. The structural re-orientation of azadirachtin H was observed as the mechanism for viral cell entry inhibition. These compounds possessed good pharmacodynamic properties. The proposed molecules can serve as a starting point towards developing effective anti-SARS-COV-2 drugs targeting the inhibition of viral cell entry upon further in vitro and in vivo validation.

Cation-π interactions drive hydrophobic self-assembly and aggregation of niclosamide in water.

The beneficial medicinal effects of niclosamide have been reported to be hampered by poor aqueous solubility and so a higher concentration dosage is required. In this work, we have studied the aggregation properties of niclosamide in water by varying the number of monomers. We have employed all-atom classical molecular dynamics simulation in order to explore such properties. The equilibrium structure exists in an aggregated state with structural rearrangements of the stacking units. Niclosamide monomers tend to form clusters in an orderly manner and tend to aggregate in parallel and antiparallel orientations of the phenyl rings as the monomers are increased in number from 4 to 9. Upon increasing the size from 9 to 14, and from 49 to 150, a considerable dominance of the metastable parallel arrangement is observed, resulting in the formation of a closely packed cluster with hydrophobic contacts. The metastable conformation self-arranges to a T-shape before forming a stable planar antiparallel displaced conformation. The aggregated π-π parallel and cation-π antiparallel clusters in water exist in a ß-conformer. We further observed that formation of a stable cluster aggregate entails the formation of an intermediate metastable cluster that disperses in solution forming a large stable cluster. We also discovered that movement of the water is faster in less aggregated clusters and as the cluster size increases, the mobility rate becomes much slower.

An infant with kwashiorkor: The forgotten disease.

Undernutrition remains a major public health concern, especially in developing countries. Despite being rich in resources, Malaysia is still home to children suffering from severe undernutrition. This paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper weaning which was overlooked. This case highlights the importance of recognizing the early signs of kwashiorkor to allow for early referrals for proper management and prevent its possible complications.

Nematic Correlation Length in Iron-Based Superconductors Probed by Inelastic X-Ray Scattering.

Nematicity is ubiquitous in electronic phases of high-T_{c} superconductors, particularly in the Fe-based systems. We used inelastic x-ray scattering to extract the temperature-dependent nematic correlation length ξ from the anomalous softening of acoustic phonon modes in FeSe, underdoped Ba(Fe_{0.97}Co_{0.03})_{2}As_{2}, and optimally doped Ba(Fe_{0.94}Co_{0.06})_{2}As_{2}. In all cases, we find that ξ is well described by a power law (T-T_{0})^{-1/2} extending over a wide temperature range. Combined with the previously reported Curie-Weiss behavior of the nematic susceptibility, these results point to the mean-field character of the nematic transition, which we attribute to a sizable nematoelastic coupling that is likely detrimental to superconductivity.

Agreement between body weight perception and body weight status among late adolescents in Kuantan, Malaysia.

OBJECTIVES: Body weight perception may determine the practice of proper weight management. The objective of this study was to measure the agreement between body weight perception and actual body weight status and its associated factors among late adolescents in Kuantan, Malaysia. METHODS: A cross-sectional study was conducted from April to October 2018 among 479 adolescents aged 17-19 years old from seven institutions of higher learning in Kuantan. Body weight status was described as body mass index (BMI). Weight and height were measured, and BMI was calculated. Validated, self-administered Figure Rating Scale (FRS) questionnaires were used. Agreement between BMI and body weight perception was calculated using Kappa statistics. Logistic regression was employed to examine the association between body weight perception and sociodemographic variables. RESULTS: More than one-third (35.3%) of the respondents misjudged their own body weight. More than one third of the respondents (38.7%) who were underweight, misperceived themselves as having normal weight whilst 31.7% of obese respondents identified themselves as overweight. The agreement between body weight perception and body mass index was moderate (k0.46, p<0.01). CONCLUSION: Body weight perception was in moderate agreement with actual weight in late adolescents. Accurate body weight perception is an important factor in late adolescent's weight management behaviour. Hence, health education related to body weight management should be emphasized among this age group.

Phonon dispersion of Mo-stabilized γ-U measured using inelastic x-ray scattering.

We have measured the room-temperature phonon spectrum of Mo-stabilized γ-U. The dispersion curves show unusual softening near the H point, q = [1/2, 1/2, 1/2], which may derive from the metastability of the γ-U phase or from strong electron-phonon coupling. Near the zone center, the dispersion curves agree well with theory, though significant differences are observed away from the zone center. The experimental phonon density of states is shifted to higher energy compared to theory and high-temperature neutron scattering. The elastic constants of γ-UMo are similar to those of body-centered cubic elemental metals.

Phononic Helical Nodal Lines with PT Protection in MoB_{2}.

While condensed matter systems host both fermionic and bosonic quasiparticles, reliably predicting and empirically verifying topological states is only mature for Fermionic electronic structures, leaving topological Bosonic excitations sporadically explored. This is unfortunate, as Bosonic systems such as phonons offer the opportunity to assess spinless band structures where nodal lines can be realized without invoking special additional symetries to protect against spin-orbit coupling. Here we combine first-principles calculations and meV-resolution inelastic x-ray scattering to demonstrate the first realization of parity-time reversal symmetry protected helical nodal lines in the phonon spectrum of MoB_{2}. This structure is unique to phononic systems as the spin-orbit coupling present in electronic systems tends to lift the degeneracy away from high-symmetry locations. Our study establishes a protocol to accurately identify topological Bosonic excitations, opening a new route to explore exotic topological states in crystalline materials.

Observation of Double Weyl Phonons in Parity-Breaking FeSi.

Condensed matter systems have now become a fertile ground to discover emerging topological quasiparticles with symmetry protected modes. While many studies have focused on fermionic excitations, the same conceptual framework can also be applied to bosons yielding new types of topological states. Motivated by Zhang et al.'s recent theoretical prediction of double Weyl phonons in transition metal monosilicides [Phys. Rev. Lett. 120, 016401 (2018)PRLTAO0031-900710.1103/PhysRevLett.120.016401], we directly measure the phonon dispersion in parity-breaking FeSi using inelastic x-ray scattering. By comparing the experimental data with theoretical calculations, we make the first observation of double Weyl points in FeSi, which will be an ideal material to explore emerging bosonic excitations and its topologically nontrivial properties.

Programmatic mapping to determine the size and dynamics of sex work and injecting drug use in Mauritius.

HIV in Mauritius is in a concentrated phase. Most HIV infection is among key populations (KPs) including female sex workers (FSW), people who inject drugs (PWID), men who have sex with men (MSM), and transgender sex workers (TGSW). The objective of this research was to use geographical mapping to determine the precise locations, typologies and population estimates of each KP in Mauritius. From May to July 2014 a programmatic mapping approach determined national estimates and information on the specific locations, "hotspots", frequented by KPs in Mauritius. Data were collected through multiple levels of activity. Key informants provided information about hotspots where KPs congregated and were actively engaged in risky behaviours. Validation of hotspots was done by engaging KPs. A total of 17 248 KP members were estimated spread over 1 964 hotspots in Mauritius. The largest KP was PWID with an estimate of 7 598 (range: 4 091-6 223), followed by 6 223 (range: 5 090-7 456) FSWs, spread over 694 and 731 hotspots respectively. A total of 2 020 (range: 1 595-2 446) MSM and 294 geographic MSM hotspots, and 1 407 TGSWs (range: 1 165-1 649) distributed over 245 hotspots. This research provided Mauritius with validated KPs size estimations and provided the first national data on KP hotspots and operational dynamics. The use of these data will strengthen HIV prevention, intervention, and programme planning in the country through focusing efforts to systematically target high-risk areas.