Publications by authors named "Abdul Wahab"

353 Publications

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study.

Authors:

Br J Surg 2021 Mar 24. Epub 2021 Mar 24.

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.

Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty.

Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year.

Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.
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http://dx.doi.org/10.1093/bjs/znab101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995808PMC
March 2021

Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia.

Clin Exp Pediatr 2021 Mar 15. Epub 2021 Mar 15.

Dapertment of Biostatistics, Epidemiology and Population Health Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia.

Background: Acute respiratory infections (ARIs), especially pneumonia, remain a major cause of infant mortality worldwide. In Indonesia, pneumonia is the second most common cause of infant and toddler deaths. Exclusive breastfeeding and basic immunization can protect infants and children from contracting pneumonia.

Purpose: Our goal was to assess the risk factors for childhood pneumonia in regions with a high prevalence of pneumonia in Indonesia.

Methods: This case-control study was conducted between March and April 2019. A total of 176 infants and toddlers aged 10-59 months were enrolled and selected from among patients who visited the community health center. Cases of pneumonia were diagnosed clinically based on the World Health Organization (WHO) guidelines, and the control was non-pneumonia.

Results: The risk factors for the diagnosis of pneumonia included no or non-exclusive breastfeeding (odds ratio [OR], 7.95; 95% confidence interval [CI], 3.52-17.94), incomplete basic immunizations (OR, 4.47; 95% CI, 2.22-8.99), indoor air pollution (OR, 7.12; 95% CI, 3.03-16.70), low birth weight (OR, 3.27; 95% CI, 1.19-8.92), and a high degree of wasting (OR, 2.77; 95% CI, 1.06-7.17). Other variables such as nutritional status (HAZ), age, sex, and educational status of the mother were not risk factors for pneumonia.

Conclusion: No or non-exclusive breastfeeding, incomplete basic immunizations, indoor air pollution, a history of low birth weight, and severe malnutrition were risk factors for childhood pneumonia. Breastfeeding was the dominant factor, while sex modified the relationship between exclusive breastfeeding and the incidence of pneumonia.
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http://dx.doi.org/10.3345/cep.2020.00339DOI Listing
March 2021

Surgical Ciliated Cyst of the Left Maxilla - A Case Report of Unusual Pathogenesis.

Ann Maxillofac Surg 2020 Jul-Dec;10(2):479-483. Epub 2020 Dec 23.

Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.

Introduction: Surgical ciliated cyst (SCC) is a type of true epithelial lined antral cysts, which mostly occurs in maxilla from the sinonasal mucosa and gland, comprising 20% of all oral cysts in Japan. It is also called as postoperative maxillary cyst or postoperative paranasal cyst. The etiology is believed to be post trauma or surgery in the region of maxillary antrum.

Patient Concerns: Patient's concern is less evident in this cystic pathology, because this cyst even though an aggressive cyst, presents with fewer symptoms that can be uncomfortable to the patient or push them to seek medical attention. Often, this becomes an incidental finding during routine postoperative follow-up.

Rationale: The rationale behind this report is to emphasize even a traumatic extraction of tooth can damage the floor of the sinus and lead to the cyst formation.

Report: We report a case of SCC in a 76-year-old female of the left maxillary sinus possibly after a traumatic extraction of the tooth, for which enucleation of the cyst was done as a primary modality of treatment.

Diagnosis: Diagnosis was made after a computed tomography (CT) scan and incisional biopsy. Diagnosis of such rare cases poses a great challenge due to its paucity in etiology, and it often requires a CT scan that becomes an essential gold standard investigation.

Outcomes: Patient is currently under one year follow up and without any signs of recurrence.

Lessons: It should be acknowledged that tampering trauma or with sinus mucosa can trigger the formation of a SCC of the maxilla, and it should always be considered as a possible sequel after any procedure of such potential in the maxilla.
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http://dx.doi.org/10.4103/ams.ams_284_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944008PMC
December 2020

Impacts of water quality on Acropora coral settlement: The relative importance of substrate quality and light.

Sci Total Environ 2021 Feb 26;777:146079. Epub 2021 Feb 26.

Australian Institute of Marine Science, Townsville, 4810, Queensland, Perth 6009, Western Australia, Australia.

Coral larval settlement patterns are influenced by a vast array of factors; however, the relative roles of individual factors are rarely tested in isolation, leading to confusion about which are most crucial for settlement. For example, direct effects of the light environment are often cited as a major factor influencing settlement patterns, yet this has not been demonstrated under environmentally realistic lighting regimes in the absence of confounding factors. Here we apply programmable multispectral lights to create realistic light spectra, while removing correlating (but not obvious) factors that are common in laboratory settlement experiments. Using two common species of Acropora - key framework builders of the Great Barrier Reef - we find little evidence that light intensity or changes in the spectral profile play a substantial role in larval settlement under most environmentally realistic settings but can under more extreme or artificial settings. We alternatively hypothesise and provide evidence that chronic light conditions and recent sediment exposures that impact benthic substrates (e.g., crustose coralline algae) have a greater impact on settlement success. Under these conditions, there was a decrease of up to 74% settlement success. Management of water quality conditions that impact the quality of benthic-settlement substrates therefore should present a priority area of focus for improving coral recruitment.
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http://dx.doi.org/10.1016/j.scitotenv.2021.146079DOI Listing
February 2021

Coronavirus and its terrifying inning around the globe: The pharmaceutical cares at the main frontline.

Chemosphere 2021 Feb 16;275:129968. Epub 2021 Feb 16.

Department of Agronomy, University of Haripur, Khyber Pakhtunkhwa, Pakistan. Electronic address:

A novel coronavirus (2019-nCoV) is an acute life-threatening disease, emerged in China, which imposed a potentially immense toll in terms of public health emergency due to high infection rate and has a devastating economic impact that attracts the world's attention. After that, on January 30, 2020, it was officially declared as a global pandemic by World Health Organization (WHO). The International Committee on Taxonomy of Viruses (ICTV) recognized it as a Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and the disease named Coronavirus Disease-19 (COVID-19). Several studies have been ameliorated the active role of COVID-19 transmission, etiology, pathogenicity, and mortality rate as serious impact on human life. The symptoms of this disease may include fever, fatigue, cough and some peoples are severely prone to gastrointestinal infection. The elderly and seriously affected peoples are likely concerned with serious outcomes. In this review, we mainly aimed to provide a benchmark summary of the silent characteristics and findings of some candidates for antiviral drugs and immunotherapies such as plasma therapy, cytokine therapy, antibodies, intravenous immunoglobulin, and pharmaceutical health concerns that are related to this disease.
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http://dx.doi.org/10.1016/j.chemosphere.2021.129968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884917PMC
February 2021

Effects of conform, non-conform, and hybrid conformity toward stress distribution at the glenoid implant and cement: A finite element study.

Int J Artif Organs 2021 Mar 1:391398821999391. Epub 2021 Mar 1.

Medical Devices and Technology Centre, Institute of Human Centered Engineering, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia.

Glenoid conformity is one of the important aspects that could contribute to implant stability. However, the optimal conformity is still being debated among the researchers. Therefore, this study aims to analyze the stress distribution of the implant and cement in three types of conformity (conform, non-conform, and hybrid) in three load conditions (central, anterior, and posterior). Glenoid implant and cement were reconstructed using Solidwork software and a 3D model of scapula bone was done using MIMICS software. Constant load, 750 N, was applied at the central, anterior, and posterior region of the glenoid implant which represents average load for daily living activities for elder people, including, walking with a stick and standing up from a chair. The results showed that, during center load, an implant with dual conformity (hybrid) showed the best (Max Stress-3.93 MPa) and well-distributed stress as compared to other conformity (Non-conform-7.21 MPa, Conform-9.38 MPa). While, during eccentric load (anterior and posterior), high stress was located at the anterior and posterior region with respect to the load applied. Cement stress for non-conform and hybrid implant recorded less than 5 MPa, which indicates it had a very low risk to have cement microcracks, whilst, conform implant was exposed to microcrack of the cement. In conclusion, hybrid conformity showed a promising result that could compromise between conform and non-conform implant. However, further enhancement is required for hybrid implants when dealing with eccentric load (anterior and posterior).
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http://dx.doi.org/10.1177/0391398821999391DOI Listing
March 2021

Development patterns of necrophagous flies infesting rabbit carcasses decomposing in Mount Kapur Cave and its surrounding primary forest in Kuching, Sarawak.

Trop Biomed 2020 Jun;37(2):333-356

Faculty of Science, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia.

In addition to the scarcity of forensic entomology baseline data on oviposition of necrophagous insects and completion of their life cycles in the Borneo region, similar data derived from caves remain unreported. Since entomological baseline data can differ from one biogeoclimatic region to another, the lack of such data would limit the practical values of applying entomological evidence in estimating minimum postmortem interval (mPMI). Therefore, this present research that investigated oviposition and completion of life cycles of necrophagous flies infesting rabbit carcasses decomposing in Mount Kapur Cave and its surrounding forest habitat in Kuching, Sarawak merits forensic consideration. In general, 13 taxa of necrophagous flies were identified viz. Hypopygiopsis violacea, Hypopygiopsis fumipennis, Hemipyrellia ligurriens, Hemipyrellia tagaliana, Chrysomya megacephala, Chrysomya villeneuvi, Chrysomya rufifacies, Chrysomya chani, Chrysomya pinguis, Chrysomya nigripes, Ophyra spinigera and Ophyra chalcogaster, as well as unidentified Sarcophagidae. In addition, Hyp. violacea and Hyp. fumipennis were the two earlier necrophagous flies that oviposited in all rabbit carcasses decomposing in both habitats. While all these necrophagous flies were observed infesting carcasses in Mount Kapur Cave, Hem. ligurriens and Hem. tagaliana were not found infesting carcasses in the surrounding forest habitat. Complete life cycles for six and five different necrophagous fly species were successfully observed in Mount Kapur Cave and its surrounding forest habitat, respectively. Significant delay in oviposition, as well as longer durations for completing the life cycles in several necrophagous fly species were observed in Mount Kapur Cave when compared with those of surrounding forest habitat (p < 0.05). These findings deserve consideration as the first ever forensic empirical baseline data on oviposition and completion of life cycles for necrophagous flies in Sarawak as well as in a cave habitat, in view of its practical values for estimating mPMI for forensic practical caseworks.
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June 2020

Plasmodium falciparum protein kinase as a potential therapeutic target for antimalarial drugs development.

Trop Biomed 2020 Sep;37(3):822-841

Institute for Research in Molecular Medicine, Universiti Sains Malaysia.

Malaria is one of the most dangerous infectious diseases due to its high infection and mortality rates, especially in the tropical belt. Plasmodium falciparum (P. falciparum), the most virulent malaria parasite in humans, was recently reported to develop resistance against the final efficient antimalarial drug, artemisinin. Little is known about the resistance mechanisms, which further complicates the problem as a proper counteraction is unable to be taken. Hence, the understanding of drug mode of action and its molecular target is valuable knowledge that needs to be considered to develop the next generation of antimalarial drugs. P. falciparum protein kinase (Pf PK) is an attractive target for antimalarial chemotherapy due to its vital roles in all P. falciparum life stages. Moreover, overall structural differences and the presence of unique Pf PKs that are absent in human kinome, suggesting specific inhibition of Pf PK without affecting human cells is achievable. To date, at least 86 eukaryotic protein kinases have been identified in P. falciparum kinome, by which less than 40 were validated as potential targets at the erythrocytes stage. In this review, recent progress of the furthest validated Pf PKs; Pf Nek-1, Pf CDPK1, Pf CDPK4, Pf PKG, and Pf CLK-3 will be briefly discussed.
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http://dx.doi.org/10.47665/tb.37.3.822DOI Listing
September 2020

A robotic pill for oral delivery of biotherapeutics: safety, tolerability, and performance in healthy subjects.

Drug Deliv Transl Res 2021 Feb 19. Epub 2021 Feb 19.

Rani Therapeutics, LLC, 2051 Ringwood Ave, San Jose, CA, 95131, USA.

Biotherapeutics are highly efficacious, but the pain and inconvenience of chronic injections lead to poor patient compliance and compromise effective disease management. Despite innumerable attempts, oral delivery of biotherapeutics remains unsuccessful due to their degradation in the gastrointestinal (GI) environment and poor intestinal absorption. We have developed an orally ingestible robotic pill (RP) for drug delivery, which protects the biotherapeutic drug payload from digestion in the GI tract and auto-injects it into the wall of the small intestine as a safe, pain-free injection since the intestines are insensate to sharp stimuli. The payload is delivered upon inflation of a balloon folded within the RP, which deflates immediately after drug delivery. Here we present results from two clinical studies demonstrating the safety, tolerability and performance of the RP in healthy humans. In the first study, three versions of the RP (A, B and C) were evaluated, which were identical in all respects except for the diameter of the balloon. The RP successfully delivered a biotherapeutic (octreotide) in 3 out of 12 subjects in group A, 10 out of 20 subjects in group B and 16 out of 20 subjects in group C, with a mean bioavailability of 65 ± 9% (based on successful drug deliveries in groups A and B). Thus,  reliability of drug delivery with the RP ranged from 25 to 80%, with success rate directly related to balloon size. In a separate study, the deployment of the RP was unaffected by fed or fasting conditions suggesting that the RP may be taken with or without food. These promising clinical data suggest that biotherapeutics currently administered parenterally may be safely and reliably delivered via this versatile, orally ingestible drug delivery platform.
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http://dx.doi.org/10.1007/s13346-021-00938-1DOI Listing
February 2021

Antidepressant-like effect of ethanol in mice forced swimming test is mediated via inhibition of NMDA/nitric oxide/cGMP signaling pathway.

Alcohol 2021 May 11;92:53-63. Epub 2021 Feb 11.

Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

There is evidence for a dramatic relationship between depression and alcohol consumption. Depressed patients may abuse ethanol because this agent reduces the symptoms of depression. In the current study, we aimed to investigate the NMDA/nitric oxide/cGMP pathway in the antidepressant-like effect of ethanol in an animal model of behavioral despair. Animals were subjected to locomotor activity in an open-field test separately, followed by a forced swimming test. During the forced swimming test (FST), ethanol (2 and 2.5 g/kg) significantly decreased the immobility time without altering the locomotor activity of animals. The antidepressant-like effect of ethanol (2.5 g/kg) was reversed by co-administration of N-methyl-D-aspartate (NMDA, 75 mg/kg), L-arginine (750 mg/kg), or sildenafil (5 mg/kg). In contrast, co-administration of MK-801 (0.05 mg/kg), ketamine (1 mg/kg), and ifenprodil (0.5 mg/kg) as antagonists of NMDAR, and NG-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg), 7-nitroindazole (7-NI, 30 mg/kg), and methylene blue (10 mg/kg) as inhibitors of nitric oxide synthase (NOS), or 1H-[1,2,4]oxadiazole[4,3-a]quinoxalin-1-one (ODQ) (20 mg/kg), a nitric oxide/cyclic-guanosine monophosphate (NO-cGMP) inhibitor, with a subeffective dose of ethanol (1.5 g/kg), significantly decreased the immobility time in the FST. Furthermore, injection of ethanol 2.5 g/kg alone or 1.5 g/kg with a 7-NI subeffective dose, significantly decreased the nitrite levels in the hippocampus and prefrontal cortex. Hence, it is concluded that blockade of NMDA receptors and the nitric oxide/cyclic-guanosine monophosphate (NO-cGMP) pathway might be involved in the antidepressant-like effect of ethanol in mice.
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http://dx.doi.org/10.1016/j.alcohol.2021.01.005DOI Listing
May 2021

A tree-based multiclassification of breast tumor histopathology images through deep learning.

Comput Med Imaging Graph 2021 Apr 27;89:101870. Epub 2021 Jan 27.

Faculty of Computer Science and Information Technology, University of Malaya, 50603, Kuala Lumpur, Malaysia. Electronic address:

Worldwide, the burden of cancer is drastically increasing over the past few years. Among all types of cancers in women, breast cancer (BrC) is the main cause of unnatural deaths. For early diagnosis, histopathology (Hp) imaging is a gold standard for positive and detailed (at tissue level) diagnosis of breast tumor (BrT) compared to mammogram images. A large number of studies used BrT Hp images to solve binary or multiclassification problems using high computational resources. However, classification models' performance may be compromised due to the high correlation among various types of BrT in Hp images, which raises the misclassification rate. Thus, this paper aims to develop a tree-based BrT multiclassification model via deep learning (DL) to extract discriminative features to solve the multiclassification problem with better performance using less computational resources. The main contributions of this work are to create an ensemble, tree-based DL model that is pre-trained on the BreakHis dataset, and implementation of a misclassification reduction algorithm. The ensemble, tree-based DL model, extracts discriminative BrT features from Hp images. The target dataset (i.e., Bioimaging challenge 2015 breast histology) is small in size; thus, to avoid overfitting of the proposed model, pretraining is performed on the BreakHis dataset. Whereas, misclassification reduction algorithm is implemented to enhance the performance of the classification model. The experimental results show that the proposed model outperformed the existing state-of-the-art baseline studies. The achieved classification accuracy is ranging from 87.50 % to 100 % for four subtypes of BrT. Thus, the proposed model can assist doctors as the second opinion in any healthcare centre.
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http://dx.doi.org/10.1016/j.compmedimag.2021.101870DOI Listing
April 2021

ABO-Incompatible Living-Donor Kidney Transplantation in a Developing Country: A Multicenter Experience in Malaysia.

Transplant Proc 2021 Apr 22;53(3):856-864. Epub 2021 Jan 22.

Renal Division, Department of Medicine, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, Malaysia. Electronic address:

Malaysia has a low deceased-donor donation rate and has not embarked on a paired kidney exchange program; therefore, ABO-incompatible and HLA-incompatible transplantation remain the main contributor to the sustainability of the national kidney transplantation (KT) program. There were 26 cases of ABO-incompatible KTs performed from 2011 to 2018 in 3 major transplant centers, namely, Hospital Kuala Lumpur, University Malaya Medical Centre, and Prince Court Medical Centre. We collected perioperative and follow-up data through June 2019. The desensitization protocol varies and is center specific: the localized Japanese protocol and Swedish protocol with a target anti-A/B isoagglutinin titer of 16 or 32 on the day of transplant. The induction and tacrolimus-based maintenance protocol was nearly identical. The median follow-up time was 62.3 months (interquartile range, 37.0-79.7). Fifteen subjects had the highest predesensitization anti-A/B titer of ≥32 (57.7%). The acute cellular rejection and antibody-mediated rejection incidence were 12.5% (3 cases) and 8.3% (2 cases), respectively. Patient, graft, and death-censored graft survival rates were 96.2%, 92.3%, and 96.0%, respectively, 1 year post-living-donor KT (LDKT) and 96.2%, 87.2%, and 90.7%, respectively, 5 years post-LDKT. Our experience shows that ABO-incompatible LDKT using a suitable desensitization technique could be a safe and feasible choice for LDKT even with varied desensitization regimens for recipients with relatively high baseline isoagglutinin titers.
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http://dx.doi.org/10.1016/j.transproceed.2020.10.038DOI Listing
April 2021

Molecular detection of urogenital mollicutes in patients with invasive malignant prostate tumor.

Infect Agent Cancer 2021 Jan 20;16(1). Epub 2021 Jan 20.

Specialized Unit of Mycoplasmas, Laboratory of Molecular Microbiology, Vaccinology, and Biotechnology Development, Institut Pasteur de Tunis, University of Tunis El-Manar, Tunis, Tunisia.

Background: The etiology of prostate cancer (PCa) is multiple and complex. Among the causes recently cited are chronic infections engendered by microorganisms that often go unnoticed. A typical illustration of such a case is infection due to mollicutes bacteria. Generally known by their lurking nature, urogenital mollicutes are the most incriminated in PCa. This study was thus carried out in an attempt to establish the presence of these mollicutes by PCR in biopsies of confirmed PCa patients and to evaluate their prevalence.

Methods: A total of 105 Formalin-Fixed Paraffin-Embedded prostate tissues collected from 50 patients suffering from PCa and 55 with benign prostate hyperplasia were subjected to PCR amplification targeting species-specific genes of 5 urogenital mollicutes species, Mycoplasma genitalium, M. hominis, M. fermentans, Ureaplasma parvum, and U. urealyticum. PCR products were then sequenced to confirm species identification. Results significance was statistically assessed using Chi-square and Odds ratio tests.

Results: PCR amplification showed no positive results for M. genitalium, M. hominis, and M. fermentans in all tested patients. Strikingly, Ureaplasma spp. were detected among 30% (15/50) of PCa patients. Nucleotide sequencing further confirmed the identified ureaplasma species, which were distributed as follows: 7 individuals with only U. parvum, 5 with only U. urealyticum, and 3 co-infection cases. Association of the two ureaplasma species with PCa cases proved statistically significant (P < 0.05), and found to represent a risk factor. Of note, Ureaplasma spp. were mostly identified in patients aged 60 and above with prostatic specific antigen (PSA) level > 4 ng/ml and an invasive malignant prostate tumor (Gleason score 8-10).

Conclusions: This study uncovered a significant association of Ureaplasma spp. with PCa arguing in favour of their potential involvement in this condition. Yet, this finding, though statistically supported, warrants a thorough investigation at a much larger scale.
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http://dx.doi.org/10.1186/s13027-021-00344-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816065PMC
January 2021

Diabetic ketoacidosis: a canary in the mine for mental health disorders?

Intern Med J 2021 Jan 18. Epub 2021 Jan 18.

Department of Medicine - Western Campus, University of Melbourne, 176 Furlong Road St Albans VIC, 3021, Australia.

Background: Recurrent diabetic ketoacidosis (DKA) has been linked to mental health disorders, but less is known about single DKA episodes. Most studies are retrospective, lacking control groups.

Aims: Prospectively examine psychosocial factors in patients presenting with recurrent or single episode DKA and compare to people who have not had DKA.

Methods: Case-controlled study (consecutive adult DKA admissions April 2015 to December 2016) at Western Health, Melbourne. Data were prospectively collected regarding: diagnosed mental health disorders, likely depression (PHQ-9 questionnaire), diabetes distress (PAID questionnaire) and presence of adverse social factors. A control group without a history of DKA was also recruited.

Results: Of 123 patients admitted with DKA (164 consecutive episodes), 70 consented to participate and 73 age matched type 1 diabetes controls were recruited. Eleven of 18 (61%) with recurrent DKA had a diagnosed mental health disorder, versus 8 of 42 (19%) in the single episode group (p=0.016). The prevalence of likely depression using PHQ-9 was: recurrent 50%, single 40% and controls 22% (recurrent vs controls, p=0.036, single vs controls, p=0.053). Severe diabetes distress (PAID) was present in 47% of recurrent and 34% of single episode DKA (p=0.387). As a group, DKA patients had significantly more unemployment, illicit drug use and tobacco smoking, a lower level of formal education and less regular medical contact compared to controls.

Conclusions: Mental health disorders and adverse socio-economic factors appear to be common in patients with DKA. The diagnosis of DKA presents an excellent opportunity to screen for depression and offer appropriate intervention. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1111/imj.15214DOI Listing
January 2021

Single-Center Experience of Outcomes and Prescribing Patterns of IV Immunoglobulin Use in Critically Ill Patients.

Crit Care Explor 2021 Jan 11;3(1):e0314. Epub 2021 Jan 11.

Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.

Previous literature has not compared prescribing practices of IV immunoglobulin in medical ICU survivors and nonsurvivors. The objective of this study was to study IV immunoglobulin use in patients admitted to a medical ICU evaluating differences between hospital survivors and nonsurvivors in regards to level of evidence supporting use, prescribing patterns, and cost.

Design: Retrospective, observational study.

Setting: Single, academic medical center medical ICU.

Patients: Adults who received greater than or equal to 1 dose of IV immunoglobulin during their medical ICU admission from 2011 to 2018.

Interventions: Prescribing patterns, level of evidence supporting use, and cost.

Measurements And Main Results: A total of 389 patients received greater than or equal to 1 dose of IV immunoglobulin for 46 discrete indications and 36.5% of indications had low-quality data supporting use of IV immunoglobulin. The primary indication for IV immunoglobulin was hypogammaglobulinemia (35.5%) followed by antibody-mediated lung transplant rejection (15.4%). Nonsurvivors received lower median dosing (g/kg) and number of doses compared with survivors (0.4 g/kg [0.4-1 g/kg] vs 0.5 g/kg [0.4-1 g/kg] [ = 0.0003] and 1.0 [1-2] vs 2 [1-3] doses [ = 0.0001], respectively). Dosing was based on ideal body weight in 258 patients (66%). High-quality data supported IV immunoglobulin use in 15 patients (4%). The median cost per dose of IV immunoglobulin in nonsurvivors was $4,893 ($4,078-$8,155) versus $5,709 ($4,078-$10,602) in survivors ( = 0.04).

Conclusions: IV immunoglobulin is prescribed for many indications in the medical ICU with low-quality evidence supporting its use and dosing regimens are variable. Hospital survivors received a higher dose and greater number of doses of IV immunoglobulin compared with nonsurvivors. National guidelines are needed to help inform IV immunoglobulin utilization and reduce healthcare costs.
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http://dx.doi.org/10.1097/CCE.0000000000000314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803672PMC
January 2021

Effectiveness of Functional Family Therapy in a Non-Western Context: Findings from a Randomized-Controlled Evaluation of Youth Offenders in Singapore.

Fam Process 2021 Jan 15. Epub 2021 Jan 15.

Clinical and Forensic Psychology Service, Ministry of Social and Family Development, Singapore, Singapore.

This study is the first to evaluate Functional Family Therapy (FFT) in a non-Western culture. The effectiveness of FFT was examined in relation to three proximal outcomes relevant to youth offender rehabilitation: (i) mental well-being, (ii) family functioning, and (iii) probation completion. 120 youth probationers (M  = 16.2, SD = 1.33) were randomly assigned to receive either standard probation services-Treatment-As-Usual (TAU; n = 57)-or FFT in addition to TAU (FFT; n = 63). Data on psychometric measures of mental well-being and family functioning were obtained at (i) preprogram, (ii) postprogram, and (iii) at the end of probation. Probation completion data were obtained from casefile records. Mean mental well-being scores of the FFT group improved from pre- to post-treatment, and gains were maintained at follow-up. However, there was a nonsignificant trend for the FFT group showing higher rates of reliable change and clinical recovery on the mental well-being scale. There were no group differences in family functioning scores over time. However, there was a significant trend for the FFT group showing higher rates of reliable change and clinical recovery on the family functioning scale. Probation completion rates were 88.9% and 70.2% for the FFT and TAU groups, respectively. Youth in the FFT group were significantly more likely to complete probation successfully. The results support FFT's effectiveness in Singaporean youth offenders. At a broader level, the study findings support the cross-cultural effectiveness of FFT in, and transportability to, a non-Western culture.
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http://dx.doi.org/10.1111/famp.12630DOI Listing
January 2021

Corn Starch () Biopolymer Plastic Reaction in Combination with Sorbitol and Glycerol.

Polymers (Basel) 2021 Jan 12;13(2). Epub 2021 Jan 12.

Advanced Lightning Power and Energy Research (ALPER), Department of Electrical and Electronic Engineering, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.

The research included corn starch (CS) films using sorbitol (S), glycerol (G), and their combination (SG) as plasticizers at 30, 45, and 60 wt %, with a traditional solution casting technique. The introduction of plasticizer to CS film-forming solutions led to solving the fragility and brittleness of CS films. The increased concentration of plasticizers contributed to an improvement in film thickness, weight, and humidity. Conversely, plasticized films reduced their density and water absorption, with increasing plasticizer concentrations. The increase in the amount of the plasticizer from 30 to 60% showed a lower impact on the moisture content and water absorption of S-plasticized films. The S30-plasticized films also showed outstanding mechanical properties with 13.62 MPa and 495.97 MPa, for tensile stress and tensile modulus, respectively. Glycerol and-sorbitol/glycerol plasticizer (G and SG) films showed higher moisture content and water absorption relative to S-plasticized films. This study has shown that the amount and type of plasticizers significantly affect the appearances, physical, morphological, and mechanical properties of the corn starch biopolymer plastic.
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http://dx.doi.org/10.3390/polym13020242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828209PMC
January 2021

DNA sequences performs as natural language processing by exploiting deep learning algorithm for the identification of N4-methylcytosine.

Sci Rep 2021 Jan 8;11(1):212. Epub 2021 Jan 8.

Department of Electronics and Information Engineering, Jeonbuk National University, Jeonju, 54896, South Korea.

N4-methylcytosine is a biochemical alteration of DNA that affects the genetic operations without modifying the DNA nucleotides such as gene expression, genomic imprinting, chromosome stability, and the development of the cell. In the proposed work, a computational model, 4mCNLP-Deep, used the word embedding approach as a vector formulation by exploiting deep learning based CNN algorithm to predict 4mC and non-4mC sites on the C.elegans genome dataset. Diversity of ranges employed for the experimental such as corpus k-mer and k-fold cross-validation to obtain the prevailing capabilities. The 4mCNLP-Deep outperform from the state-of-the-art predictor by achieving the results in five evaluation metrics by following; Accuracy (ACC) as 0.9354, Mathew's correlation coefficient (MCC) as 0.8608, Specificity (Sp) as 0.89.96, Sensitivity (Sn) as 0.9563, and Area under curve (AUC) as 0.9731 by using 3-mer corpus word2vec and 3-fold cross-validation and attained the increment of 1.1%, 0.6%, 0.58%, 0.77%, and 4.89%, respectively. At last, we developed the online webserver http://nsclbio.jbnu.ac.kr/tools/4mCNLP-Deep/ , for the experimental researchers to get the results easily.
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http://dx.doi.org/10.1038/s41598-020-80430-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794489PMC
January 2021

Phylogenetic analysis suggests single and multiple origins of dihydrofolate reductase mutations in Plasmodium vivax.

Acta Trop 2021 Mar 3;215:105821. Epub 2021 Jan 3.

University of Edinburgh, UK; University of Surrey, United Kingdom. Electronic address:

Pyrimethamine was first introduced for the treatment of malaria in Asia and Africa during the early 1980s, replacing chloroquine, and has become the first line of drugs in many countries. In recent years, development of pyrimethamine resistance in Plasmodium vivax has become a barrier to effective malaria control strategies. Here, we describe the use of meta-barcoded deep amplicon sequencing technology to assess the evolutionary origin of pyrimethamine resistance by analysing the flanking region of dihydrofolate reductase (dhfr) locus. The genetic modelling suggests that 58R and 173L single mutants and 58R/117N double mutants are present on a single lineage; suggesting a single origin of these mutations. The triple mutants (57L/58R/117N, 58R/61M/117N and 58R/117N/173L) share the lineage of 58R/117N, suggesting a common origin. In contrast, the 117N mutant is present on two separate lineages suggesting that there are multiple origins of this mutation. We characterised the allele frequency of the P. vivax dhfr locus. Our results support the view that the single mutation of 117N and double mutations of 58R/117N arise commonly, whereas the single mutation of 173L and triple mutations of 57L/58R/117N, 58R/61M/117N and 58R/117N/173L are less common. Our work will help to inform mitigation strategies for pyrimethamine resistance in P. vivax.
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http://dx.doi.org/10.1016/j.actatropica.2020.105821DOI Listing
March 2021

pcPromoter-CNN: A CNN-Based Prediction and Classification of Promoters.

Genes (Basel) 2020 Dec 21;11(12). Epub 2020 Dec 21.

Department of Electronics and Information Engineering, Jeonbuk National University, Jeonju 54896, Korea.

A promoter is a small region within the DNA structure that has an important role in initiating transcription of a specific gene in the genome. Different types of promoters are recognized by their different functions. Due to the importance of promoter functions, computational tools for the prediction and classification of a promoter are highly desired. Promoters resemble each other; therefore, their precise classification is an important challenge. In this study, we propose a convolutional neural network (CNN)-based tool, the pcPromoter-CNN, for application in the prediction of promotors and their classification into subclasses σ70, σ54, σ38, σ32, σ28 and σ24. This CNN-based tool uses a one-hot encoding scheme for promoter classification. The tools architecture was trained and tested on a benchmark dataset. To evaluate its classification performance, we used four evaluation metrics. The model exhibited notable improvement over that of existing state-of-the-art tools.
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http://dx.doi.org/10.3390/genes11121529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767505PMC
December 2020

Flux model development and synthesis optimization for an enhanced GO embedded nanocomposite membrane through FFD and RSM approach.

Heliyon 2020 Nov 27;6(11):e05610. Epub 2020 Nov 27.

Department of Chemical Engineering, College of Engineering, Universiti Malaysia Pahang, Lebuhraya Tun Razak, 26300 Gambang, Kuantan, Pahang, Malaysia.

A two-level full factorial design was used to analyze several factors involved in PSF-GO-Pebax thin film nanocomposite membranes development. Permeate flux was chosen as a single response for four possible factors: Pebax selective layer concentration, amount of GO load to Pebax selective layer, Pebax-GO selective layer thickness, and amount of GO load to PSF substrate. The study is aimed at factors interaction and contribution towards the highest permeation flux via FFD and RSM approach. obtained from the ANOVA is 0.9937 with Pebax concentration as the highest contributing factor. Pebax concentration-amount of GO load to PSF substrate is the only interaction contributing to the highest flux. A regression analysis concluded the study with model development and an optimized condition for the membrane design.
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http://dx.doi.org/10.1016/j.heliyon.2020.e05610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708821PMC
November 2020

Effects of Sintering Temperature Variation on Synthesis of Glass-Ceramic Phosphor Using Rice Husk Ash as Silica Source.

Materials (Basel) 2020 Nov 28;13(23). Epub 2020 Nov 28.

Department of Physics, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Malaysia.

In this study, the authors attempted to propose the very first study on fabrication and characterization of zinc-boro-silicate (ZBS) glass-ceramics derived from the ternary zinc-boro-silicate (ZnO)(BO)(RHA) glass system through a conventional melt-quenching method by incorporating rice husk ash (RHA) as the silica (SiO) source, followed by a sintering process. Optimization of sintering condition has densified the sintered samples while embedded beta willemite (β-ZnSiO) and alpha willemite (-ZnSiO) were proven in X-ray diffraction (XRD) analysis. Field emission scanning electron microscopy (FESEM) has shown the distribution of willemite crystals in rhombohedral shape crystals and successfully form closely-packed grains due to intense crystallization. The photoluminescence (PL) spectra of all sintered ZBS glasses presented various emission peaks at 425, 463, 487, 531, and 643 nm corresponded to violet, blue, green, and red emission, respectively. The correlation between the densification, phase transformation, microstructure, and photoluminescence of ZnSiO glass-ceramic phosphor is discussed in detail.
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http://dx.doi.org/10.3390/ma13235413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731033PMC
November 2020

Improvement of Parent's awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention.

BMC Public Health 2020 Dec 1;20(1):1836. Epub 2020 Dec 1.

Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Background: Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11-13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability.

Methods: We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention.

Results: A total of 506 parents participated. Before receiving the structured-educational intervention, parents' awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent's awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p < 0.001). HPV vaccine's acceptability increased from 74.3 to 87.4% (p < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine's acceptability with OR 1.90 (95%CI:1.40-2.57) and OR 1.31(95%CI,1.05-1.63), respectively.

Conclusions: A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents' knowledge, perceptions and HPV vaccine acceptability.
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http://dx.doi.org/10.1186/s12889-020-09962-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708115PMC
December 2020

Quality measures of a multicentre universal newborn hearing screening program in Malaysia.

J Med Screen 2020 Nov 17:969141320973060. Epub 2020 Nov 17.

Unit Audiologi, Hospital Sungai Buloh, Ministry of Health Malaysia, Jalan Hospital, Sungai Buloh, Malaysia.

Objective: To evaluate and discuss the outcomes of the universal newborn hearing screening program conducted at four public hospitals in Malaysia.

Method: A retrospective analysis of the universal newborn hearing screening database from each hospital was performed. The database consisted of 28,432 and 30,340 screening results of babies born in 2015 and 2016, respectively. Quality indicators (coverage rate, referral rate, return for follow-up rate, and ages at screening and diagnosis) were calculated.

Results: Overall coverage rate across the four hospitals was 75% in 2015 and 87.4% in 2016. Over the two years, the referral rates for the first screening ranged from 2.7% to 33.93% with only one hospital achieving the recommended benchmark of <4% in both years. The return for follow-up rates for each participating hospital was generally below the recommended benchmark of ≥95%. The mean age at screening was 3.9 ± 1.2 days and 3.3 ± 0.4 days, respectively. The mean age at diagnosis for 70 infants diagnosed with permanent hearing loss was 4.7 ± 0.7 months in 2015 and 3.6 ± 0.9 months in 2016.

Conclusions: Quality measures for the universal newborn hearing screening program in four public hospitals in Malaysia were lower than the required standards. Nevertheless, some quality indicators showed statistically significant improvements over the two years. Next steps involve identifying and implementing the best practice strategies to improve the outcome measures and thus the quality of the program.
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http://dx.doi.org/10.1177/0969141320973060DOI Listing
November 2020

Highly Conductive Garnet-Type Electrolytes: Access to LiLaZrTaO Prepared by Molten Salt and Solid-State Methods.

ACS Appl Mater Interfaces 2020 Oct 14;12(43):48580-48590. Epub 2020 Oct 14.

The Polytechnic School, Ira A. Fulton Schools of Engineering, Arizona State University, Mesa, Arizona 85212, United States.

Tantalum-doped garnet (LiLaZrTaO, LLZTO) is a promising candidate to act as a solid electrolyte in all-solid-state batteries owing to both its high Li conductivity and its relatively high robustness against the Li metal. Synthesizing LLZTO using conventional solid-state reaction (SSR) requires, however, high calcination temperature (>1000 °C) and long milling steps, thereby increasing the processing time. Here, we report on a facile synthesis route to prepare LLZTO using a molten salt method (MSS) at lower reaction temperatures and shorter durations (900 °C, 5 h). Additionally, a thorough analysis on the properties, ., morphology, phase purity, and particle size distribution of the LLZTO powders, is presented. LLZTO pellets, either prepared by the MSS or the SSR method, that were sintered in a Pt crucible showed Li ion conductivities of up to 0.6 and 0.5 mS cm, respectively. The corresponding activation energy values are 0.37 and 0.38 eV, respectively. The relative densities of the samples reached values of approximately 96%. For comparison, LLZTO pellets sintered in alumina crucibles or with γ-AlO as sintering aid revealed lower ionic conductivities and relative densities with abnormal grain growth. We attribute these observations to the formation of Al-rich phases near the grain boundary regions and to a lower Li content in the final garnet phase. The MSS method seems to be a highly attractive and an alternative synthetic approach to SSR route for the preparation of highly conducting LLZTO-type ceramics.
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http://dx.doi.org/10.1021/acsami.0c14056DOI Listing
October 2020

Biomechanical evaluation of three different configurations of external fixators for treating distal third tibia fracture: Finite element analysis in axial, bending and torsion load.

Comput Biol Med 2020 Dec 17;127:104062. Epub 2020 Oct 17.

Medical Devices and Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310, Skudai, Johor, Malaysia; Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Group, School of Biomedical Engineering & Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, 81310, Skudai, Johor, Malaysia. Electronic address:

External fixators have been widely used in treating open fractures and have produced excellent outcomes, as they could successfully heal bones. The stability of external fixators lies greatly in their construction. Factors that associated with the stability of the external fixators includes stress, displacement, and relative micromotion. Three-dimensional (3D) models of bone and external fixators were constructed by using 3D modelling software, namely Materialise and SolidWorks, respectively. Three different configurations of external fixators namely Model 1, Model 2, and Model 3 were analysed. Three load cases were simulated to assess the abovementioned factors at the bone, specifically at the fracture site and at the external fixator. Findings showed that the double-cross configuration (Model 3) was the most promising in axial, bending, and torsion load cases as compared to the other two configurations. The no-cross configuration (Model 1) had the highest risk of complication due to high stress, relative micromotion, and displacement in the bending and torsion load cases. On the other hand, the single-cross configuration (Model 2) had the highest risk of complication when applied with axial load. In conclusion, the double-cross locking construct (Model 3) showed the biggest potential to be a new option for medical surgeons in treating patients associated with bone fracture. This new double-cross locking construct showed superior biomechanical stability as compared to single-cross and no-cross configurations in the axial, bending, and torsion load cases.
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http://dx.doi.org/10.1016/j.compbiomed.2020.104062DOI Listing
December 2020

Human Exfoliated Deciduous Teeth Stem Cells: Features and Therapeutic Effects on Neurogenerative and Hepatobiliary-Pancreatic Diseases.

Curr Stem Cell Res Ther 2020 Sep 17. Epub 2020 Sep 17.

Department of Biochemistry, School of Medicine, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Selangor 42610. Malaysia.

Stem cells can multiply into more cells with similar types in an undifferentiated form and differentiate into other types of cells. The great success and key essence of stem cell technology is the isolation of high-quality mesenchymal stem cells (MSCs) with high potency, either with multipotent or pluripotent property. In this line, stem cells from human exfoliated deciduous teeth (SHEDs) are highly proliferative stem cells from dental pulp and have multipoint differentiation capacity. These cells play a pivotal role in regenerative medicine, such as cell repair associated with neurodegenerative, hepatobiliary, and pancreatic diseases. In addition, stem cell therapy has been widely used to regulate immune response and repair of tissue lesions. This overview captured the differential biological characteristics, and the potential role of stem cell technology and paid special attention to human welfare SHEDs in eliminating the abovementioned diseases. This review provides further insights into stem cell technology by expanding the therapeutic potential of SHEDs in tissue engineering and cell organ repairs.
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http://dx.doi.org/10.2174/1574888X15999200918105623DOI Listing
September 2020

Big Brain Data Initiative in Universiti Sains Malaysia: Challenges in Brain Mapping for Malaysia.

Malays J Med Sci 2020 Jul 19;27(4):1-8. Epub 2020 Aug 19.

Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Universiti Sains Malaysia has started the Big Brain Data Initiative project since the last two years as brain mapping techniques have proven to be important in understanding the molecular, cellular and functional mechanisms of the brain. This Big Brain Data Initiative can be a platform for neurophysicians and neurosurgeons, psychiatrists, psychologists, cognitive neuroscientists, neurotechnologists and other researchers to improve brain mapping techniques. Data collection from a cohort of multiracial population in Malaysia is important for present and future research and finding cure for neurological and mental illness. Malaysia is one of the participant of the Global Brain Consortium (GBC) supported by the World Health Organization. This project is a part of its contribution via the third GBC goal which is influencing the policy process within and between high-income countries and low- and middle-income countries, such as pathways for fair data-sharing of multi-modal imaging data, starting with electroencephalographic data.
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http://dx.doi.org/10.21315/mjms2020.27.4.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444831PMC
July 2020

Susceptibility patterns of anaerobes isolated from clinical specimens in tertiary Hospital, Malaysia.

Malays J Pathol 2020 Aug;42(2):245-252

Hospital Sungai Buloh, Department of Pathology, Microbiology Unit, Selangor, Malaysia;.

Introduction: The susceptibility patterns of anaerobes are becoming less predictable due to the emergence of anaerobic resistance trends to antibiotics; hence increasing the importance of the isolation and antimicrobial susceptibility testing of anaerobes.

Materials And Methods: This study investigated the isolation of anaerobes from the clinical specimens of Hospital Sungai Buloh, Malaysia, from January 2015 to December 2015. All isolates were identified using the API 20A system (bioMérieux, France). Antimicrobial susceptibility testing was performed using the E-test (bioMérieux, France).

Results: The proportion of obligate anaerobes isolated from the clinical specimens was 0.83%. The Gram-positive anaerobes were most susceptible to vancomycin and imipenem, showing 100% sensitivity to these antimicrobials, followed by clindamycin (86.3%), penicillin (76.7%), and metronidazole (48.9%). Meanwhile, Gram-negative anaerobes were most susceptible to metronidazole (96%) followed by imipenem (89%), clindamycin (79%), and ampicillin (32%). The present study also showed that 3 out of 12 Bacteroides fragilis isolates were resistant to imipenem.

Conclusion: This study demonstrated the differences in the susceptibility patterns of anaerobes towards commonly used antimicrobials for the treatment of anaerobic infections. In summary, continuous monitoring of antimicrobial resistance trends among anaerobes is needed to ensure the appropriateness of treatment.
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August 2020

A finite element study: Finding the best configuration between unilateral, hybrid, and ilizarov in terms of biomechanical point of view.

Injury 2020 Nov 2;51(11):2474-2478. Epub 2020 Aug 2.

Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Group, School of Biomedical Engineering & Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia; Medical Devices and Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia. Electronic address:

In an open fracture, the external fixator is one of the definitive treatment options as it could provide the initial stabilisation of the fractured bone. Limited literature discussing on the biomechanical stability between unilateral, hybrid and Ilizarov configurations, principally in treating a femoral fracture. Thus, this study aims to analyse the biomechanical stability of different external fixators via the finite element method (FEM). The present study portrays that different configurations of fixators possess different biomechanical stability, hence leading to different healing rates and complication risks. For the methodology, three-dimensional models of three different external fixators were reconstructed where axial loads were applied on the proximal end of the femur, simulating the stance phase. From the results, the unilateral configuration provides better stability compared to the hybrid and Ilizarov, where it displaced the least with an average percentage difference of 50% for the fixator's frame and 23% for the bone. The unilateral configuration also produced the least interfragmentary movement (0.48 mm) as compared to hybrid (0.62 mm) and Ilizarov (0.61 mm) configurations. Besides, the strain and stress of the unilateral configuration were superior in terms of stability compared to the other two configurations. As a conclusion, the unilateral configuration had the best biomechanical stability as it was able to assist the bone healing process as well as minimising the risk of pin tract infection while treating a femoral fracture.
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http://dx.doi.org/10.1016/j.injury.2020.08.001DOI Listing
November 2020