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1.  Factor Structure and Reliability of the Malay Version of the Perceived Stress Scale among Malaysian Medical Students 
Background:
The Perceived Stress Scale 10 (PSS-10) is a validated and reliable instrument to measure global levels of perceived stress. This study aims to assess the internal consistency, reliability, and factor structure of the Malay version of the PSS-10 for use among medical students.
Methods:
The original English version of the PSS-10 was translated and back-translated into Malay language. The Malay version was distributed to 242 Bachelor of Medical Science students in a private university in Malaysia. Test–retest reliability was assessed in 70 students. An exploratory principal component factor analysis with varimax rotation was performed. Reliability was tested using the intraclass correlation coefficient (ICC).
Results:
All 242 students participated in the initial questionnaire study (validity and factor structure), and 70 students participated in the test–retest reliability of the study. Exploratory factor analysis yielded 2 factors that accounted for 57.8% of the variance. Cronbach’s alpha coefficients for the 2 factors were 0.85 and 0.70, respectively. The reliability test showed an ICC of 0.82 (95% CI: 0.70, 0.89).
Conclusion:
The Malay version of the PSS-10 showed adequate psychometric properties. It is a useful instrument for measuring stress among medical students in Malaysia.
PMCID: PMC3684234  PMID: 23785249
Malaysia; medical; psychological; reliability and validity; stress; students
2.  Inheritance of coronary artery disease in men: an analysis of the role of the Y chromosome 
Lancet  2012;379(9819):915-922.
Summary
Background
A sexual dimorphism exists in the incidence and prevalence of coronary artery disease—men are more commonly affected than are age-matched women. We explored the role of the Y chromosome in coronary artery disease in the context of this sexual inequity.
Methods
We genotyped 11 markers of the male-specific region of the Y chromosome in 3233 biologically unrelated British men from three cohorts: the British Heart Foundation Family Heart Study (BHF-FHS), West of Scotland Coronary Prevention Study (WOSCOPS), and Cardiogenics Study. On the basis of this information, each Y chromosome was tracked back into one of 13 ancient lineages defined as haplogroups. We then examined associations between common Y chromosome haplogroups and the risk of coronary artery disease in cross-sectional BHF-FHS and prospective WOSCOPS. Finally, we undertook functional analysis of Y chromosome effects on monocyte and macrophage transcriptome in British men from the Cardiogenics Study.
Findings
Of nine haplogroups identified, two (R1b1b2 and I) accounted for roughly 90% of the Y chromosome variants among British men. Carriers of haplogroup I had about a 50% higher age-adjusted risk of coronary artery disease than did men with other Y chromosome lineages in BHF-FHS (odds ratio 1·75, 95% CI 1·20–2·54, p=0·004), WOSCOPS (1·45, 1·08–1·95, p=0·012), and joint analysis of both populations (1·56, 1·24–1·97, p=0·0002). The association between haplogroup I and increased risk of coronary artery disease was independent of traditional cardiovascular and socioeconomic risk factors. Analysis of macrophage transcriptome in the Cardiogenics Study revealed that 19 molecular pathways showing strong differential expression between men with haplogroup I and other lineages of the Y chromosome were interconnected by common genes related to inflammation and immunity, and that some of them have a strong relevance to atherosclerosis.
Interpretation
The human Y chromosome is associated with risk of coronary artery disease in men of European ancestry, possibly through interactions of immunity and inflammation.
Funding
British Heart Foundation; UK National Institute for Health Research; LEW Carty Charitable Fund; National Health and Medical Research Council of Australia; European Union 6th Framework Programme; Wellcome Trust.
doi:10.1016/S0140-6736(11)61453-0
PMCID: PMC3314981  PMID: 22325189

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