Universiti Malaysia Sarawak

Intravenous ketamine is increasingly used for refractory and super-refractory status epilepticus (RSE/SRSE), yet its efficacy and optimal use remain uncertain. We therefore aimed to synthesize the available evidence to quantify the effectiveness of ketamine in achieving seizure cessation and to explore differences in treatment characteristics between patients who respond and those who do not. We conducted a systematic review and meta-analysis to estimate the pooled seizure cessation rate associated with intravenous ketamine. Secondary analyses compared ketamine initiation timing, dosing, and infusion duration between patients who achieved seizure cessation (responders) and those who did not (nonresponders). Fourteen studies comprising 388 adult patients (249 responders, 139 nonresponders) were included. The pooled seizure cessation rate with ketamine was 64% (95% CI 49%-76%) with moderate heterogeneity (I 2 = 54.1%). Sensitivity analysis showed no single study substantially influenced results, supporting robustness. Responders received ketamine earlier (3.2 ± 2.6 days) than non-responders (4.3 ± 2.6 days), mean difference of -0.90 days (95% CI: -1.31 to -0.49; p < 0.0001). The mean maintenance dose was 2.5 ± 1.4 mg/kg/hr (responders: 2.5 ± 1.3; nonresponders: 2.6 ± 1.4), with no significant difference between groups (mean difference -0.14 mg/kg/hr; 95% CI -0.45 to 0.18; p = 0.39). Infusion duration averaged 5.0 ± 4.2 days in both groups, with no significant difference (mean difference -0.07 days; 95% CI -1.02 to 0.88; p = 0.88). Ketamine discontinuation due to adverse events was rare (0.7%, 3/55 patients). Intravenous ketamine demonstrates consistent effectiveness and safety as an adjunctive therapy in RSE/SRSE. However, the timing of initiation cannot be reliably linked to improved clinical outcomes given current methodological limitations and heterogeneity across studies. Future prospective research using standardized definitions and rigorous temporal data collection is needed to clarify whether the timing of ketamine initiation independently influences therapeutic success and to define its optimal integration within established status epilepticus (SE) treatment algorithms. The systematic review was registered (June 7, 2024) with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42024549523).

Abstract Growing attention to sustainable materials has positioned engineered bamboo as a promising material in contemporary product and fashion design. However, negative consumer perceptions continue to hinder its wider adoption, as bamboo is often associated with low cost and low durability products. Guided by Mere Exposure Theory, this study examines how exhibition exposure influences consumer perception and willingness to pay for bamboo based products. A quantitative survey was conducted among 135 visitors to an exhibition in Sarawak. The analysis employed descriptive statistics, correlation tests, and multiple regression models to evaluate how visual and tactile exposure influence consumer evaluation and economic intention. The results indicate that perceived durability (β = 0.50) and aesthetic appeal (β = 0.45) are the strongest predictors of willingness to pay, effectively offsetting price sensitivity even among lower income consumer groups. Although environmental sustainability is widely recognized as a positive attribute, it functions more as an expected feature than a primary purchase driver. The findings further reveal a functional perception gap in which consumers appreciate the aesthetic qualities of bamboo based products but remain uncertain about their practical durability. These results extend the application of Mere Exposure Theory in sustainable design contexts and highlight the importance of experiential exhibition environments in shaping consumer acceptance of bio based materials.

This study examines how financial technology influences the sustainability of MSME’s in West Kalimantan, with particular attention to how digital payment convenience acts as a moderating factor in this relationship. The sample in this research consists of 200 MSMEs. The sample technique used in this study was random sampling. The data used in this research is primary data collected through questionnaires. The analytical tool used in this research is SEM (Structural Equation Modeling). The research results show that digital financial inclusion and ease of digital payment have a significant positive effect on the business sustainability of MSMEs, while digital financial innovation and digital financial literacy do not affect MSME business sustainability. Ease of digital payment can moderate the relationship between digital financial literacy and MSME business sustainability. The total effect results also show that Ease of Digital Payment can strengthen the relationship between Digital Financial Literacy and MSME Business Continuity.

Tropical peatland forests are significant sources and sinks of greenhouse gases (GHG), yet the relative contributions of soil and tree stem fluxes have remained poorly quantified, particularly CH4 and N2O fluxes across gradients of nutrient availability. We conducted simultaneous measurements of CO2, CH4 and N2O fluxes from both soil and tree stems using soil and stem chamber in two contrasting tropical peat swamp forests: a nutrient-rich in Quistococha, Peru and a nutrient-poor in Maludam, Sarawak, Malaysia. Our results showed higher soil CO2, CH4 and N2O fluxes from Quistococha nutrient-rich forest. Tree stem respiration was consistently higher in the nutrient-poor forest across all dominant species in both forests. Tree stem CH4 fluxes exhibited distinct patterns, with significantly higher emissions from the nutrient-rich forest, while displaying species-specific behaviour among dominant tree species. Mauritia flexuosa palm stems in Quistococha showed high emission of CH4 from stems with potential CH4 sinks from specific species from both forests. N2O emissions were also species-specific and higher from the nutrient-rich forest, with negligible fluxes observed from the species in the nutrient-poor forest. From stem fluxes to tree fluxes upscaling, we found that the majority of total ecosystem GHG flux originated from soil with minimal contribution from the dominant tree species. In conclusion, these findings highlighted tree stems from tropical peatland can act as sources and sinks and that nutrient availability influence on the magnitude of greenhouse gas emissions.

This research examines the multifaceted experiences of Early Career Researchers (ECRs) navigating the increasingly globalized landscape of atmospheric chemistry. Drawing upon collective insights from the ECR Scientific Steering Committee and quantitative data from a survey of 180 ECRs across 40 countries, we investigate their primary motivations, challenges, and opportunities. Key obstacles identified include systemic difficulties in securing funding and resources, achieving sustainable work–life balance, and uncertainty around long-term career prospects, often compounded by precarious employment conditions. While globalization offers significant avenues for international collaboration, data sharing, and knowledge exchange, it concurrently presents challenges such as heightened competition, visa restrictions, regional disparities, and the risk of inequitable research practices. Despite these hurdles, ECRs are driven by a strong interest in their field, a desire to make a tangible impact on societal concerns, and the appeal of a supportive community. This research offers actionable insights focused on 4 key pillars: (i) strengthening mentoring programs; (ii) reforming funding mechanisms for improved accessibility and equity; (iii) providing targeted skill development workshops; and (iv) promoting equitable collaborations and advancing the decolonization of research practices. To foster a supportive, inclusive, and sustainable environment for the next generation of atmospheric scientists, this work underscores the urgent need for systemic change and sustained collaborative action by networks such as International Global Atmospheric Chemistry (IGAC), as well as by senior researchers, academic institutions, and funding agencies.The research presented is published as Maximilien Desservettaz, Martin Otto Paul Ramacher, Simone Thirstrup Andersen, Cybelli Barbosa, Sebastian Diez, Hannah Bryant, Tamryn Hamilton, Stephanie Schneider, Karn Vohra, Yuanzhe Li, Sachin Mishra, Nor Diana Abdul Halim, Shahid Uz Zaman, Flossie Brown, Shyno Susan John, Pravash Tiwari, William Apondo, Emily Matthews; A new generation of Early Career Researchers in atmospheric chemistry: Navigating a globalized scientific landscape. Elementa: Science of the Anthropocene 3 January 2025; 13 (1): 00064. doi: https://doi.org/10.1525/elementa.2025.00064.

Nitrogen dioxide (NO₂) and sulphur dioxide (SO₂) are key urban air pollutants affecting air qualityand public health. While emission reduction policies aim to improve air quality, their spatialpatterns and long-term trends in conurbation areas remain uncertain. This study examines NO₂ andSO₂ trends in major Malaysian conurbations from 2019 to 2023, focusing on land use and urbanactivities. While conurbations are primarily urban, they exhibit diverse land use patterns, fromhigh-traffic commercial zones to industrial hubs, influencing air pollution differently. Continuousair quality monitoring data from Klang Valley, Johor Bahru, George Town, Kota Kinabalu, andKuching were analysed using statistical and geostatistical techniques to assess temporal and spatialtrends. Findings reveal that NO₂ concentrations are highest in traffic dense urban centres, whereasSO₂ levels are more prominent in industrial and port areas. Seasonal variations, including monsooneffects and transboundary haze, also influence pollution levels. The study highlights theheterogeneous nature of air quality trends across conurbations, emphasising the need for localisedair pollution control strategies. By integrating land use planning with targeted mitigation measures,policymakers can better manage urban air quality while addressing region-specific pollutionsources.

Societal Impact Statement The global coffee industry, supporting 25 million smallholder farmers, is vulnerable to climate change. Diversifying the coffee species portfolio beyond Arabica and robusta is a promising intervention. Liberica coffee could provide adaptive capacity, although its climate parameters for cultivation are poorly known. This study pioneers climate niche analysis for cultivated Liberica, benchmarking it against its indigenous populations and Arabica coffee. Our analyses show that cultivated Liberica grows in warmer, wetter and less seasonal climates than its wild counterparts and exhibits distinct climate tolerances from Arabica. The results provide intelligence for integrating Liberica as a resource for a climate‐resilient coffee portfolio. Summary To secure the global coffee sector against climate change, diversification beyond the market‐dominant Arabica ( C. arabica ) and robusta ( C. canephora ) could become a critical adaptation strategy for many farmers. This contribution provides the first comprehensive analysis of the cultivated (fundamental) niche of Liberica ( C. liberica ) to identify optimal climate parameters and suitable locations for cultivation. Environmental niche profiling was applied to a global dataset of wild (realised) and cultivated (fundamental) occurrences to quantify climate parameters for this species. This was supported by a species distribution model (SDM) for Liberica in Upper West Africa and an in‐depth analysis of this coffee species in Malaysia, under current and future climate projections. Niche modelling for wild Arabica was used to provide a climate parameter benchmark for wild Liberica. Our research demonstrates that the cultivated climate niche of Liberica extends beyond its wild niche, enabling farming in warmer, wetter and less seasonal climates. Critically, the study reveals that some of the major cultivation areas, such as Sarawak (Malaysia), operate at the edge of the cultivated niche. These findings expand our understanding of key climate parameters for Liberica, providing a data‐driven guide for its integration into farming systems and breeding work. While confirming its promise as a climate‐resilient crop species, realising the potential of Liberica will require targeted research and development to overcome its known agronomic and processing challenges.

The human gut microbiota is essential for supporting the host's health and immune system. Imbalances in this microbiota, known as dysbiosis, are associated with numerous inflammatory and autoimmune diseases. Despite extensive research on bacterial components, the significant modulatory role of eukaryotic gut inhabitants, particularly intestinal parasites, remains largely overlooked. While traditionally viewed as pathogens, emerging evidence highlights a profound duality in their role, suggesting they are integral and active modulators of the gut microbiota and challenging the conventional view of parasitism. For instance, helminths often induce microbial diversity and promote the expansion of anti-inflammatory microbes. Conversely, pathogenic protozoa are generally associated with reduced microbial diversity, fostering the growth of pathobionts and leading to significant gut dysbiosis. However, these interactions are highly context-dependent, and a comprehensive understanding is hindered by varied findings and limited data, particularly concerning protozoan infections. Furthermore, while mechanistic evidence is robust, human intervention studies remain limited. This narrative review synthesises the complex interrelationship between intestinal parasites and the human gut microbiota, distinguishing the distinct dynamics of helminthic and protozoan infections. Specifically, this review examines the inherent duality of intestinal parasites by investigating parasite-specific factors, including species, parasite burden, and coinfections, which can impact gut microbial composition and function. Ultimately, this review provides a comprehensive framework for understanding the profound influence of the gut ecosystem, shifting the paradigm beyond solely pathogenic views.