Browse publications by year: 2014

  1. Marciano BE, Huang CY, Joshi G, Rezaei N, Carvalho BC, Allwood Z, et al.
    J. Allergy Clin. Immunol., 2014 Apr;133(4):1134-41.
    PMID: 24679470 DOI: 10.1016/j.jaci.2014.02.028
    BACKGROUND: Severe combined immunodeficiency (SCID) is a syndrome characterized by profound T-cell deficiency. BCG vaccine is contraindicated in patients with SCID. Because most countries encourage BCG vaccination at birth, a high percentage of patients with SCID are vaccinated before their immune defect is detected.

    OBJECTIVES: We sought to describe the complications and risks associated with BCG vaccination in patients with SCID.

    METHODS: An extensive standardized questionnaire evaluating complications, therapeutics, and outcomes regarding BCG vaccination in patients given a diagnosis of SCID was widely distributed. Summary statistics and association analysis was performed.

    RESULTS: Data on 349 BCG-vaccinated patients with SCID from 28 centers in 17 countries were analyzed. Fifty-one percent of the patients had BCG-associated complications, 34% disseminated and 17% localized (a 33,000- and 400-fold increase, respectively, over the general population). Patients receiving early vaccination (≤1 month) showed an increased prevalence of complications (P = .006) and death caused by BCG-associated complications (P < .0001). The odds of experiencing complications among patients with T-cell numbers of 250/μL or less at diagnosis was 2.1 times higher (95% CI, 1.4-3.4 times higher; P = .001) than among those with T-cell numbers of greater than 250/μL. BCG-associated complications were reported in 2 of 78 patients who received antimycobacterial therapy while asymptomatic, and no deaths caused by BCG-associated complications occurred in this group. In contrast, 46 BCG-associated deaths were reported among 160 patients treated with antimycobacterial therapy for a symptomatic BCG infection (P < .0001).

    CONCLUSIONS: BCG vaccine has a very high rate of complications in patients with SCID, which increase morbidity and mortality rates. Until safer and more efficient antituberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications.

    MeSH terms: BCG Vaccine/adverse effects*; BCG Vaccine/immunology; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Risk; Vaccination/adverse effects; Vaccination/legislation & jurisprudence; Comorbidity; Prevalence; Severe Combined Immunodeficiency/diagnosis; Severe Combined Immunodeficiency/epidemiology*; Severe Combined Immunodeficiency/therapy; Hematopoietic Stem Cell Transplantation; Kaplan-Meier Estimate
  2. Hakimi H, Kawai S, Kawazu S
    Trop Parasitol, 2014 Jan;4(1):20-4.
    PMID: 24754022 DOI: 10.4103/2229-5070.129154
    Malaria is the most important parasitic disease with global concern. Plasmodium knowlesi recently has emerged from its natural simian host as a significant cause of human malaria, particularly in Malaysian Borneo. Therefore, it has been added as the fifth human Plasmodium specie which is widely distributed in Southeast Asia. Recent developments of new molecular tools enhanced our understanding about the key features of this malaria parasite. Here, we review some of the ways in which molecular approaches might be used for epidemiology of P. knowlesi and finally lead to an efficient control of malaria.
    MeSH terms: Animals; Asia, Southeastern; Borneo; Humans; Malaria; Parasites; Parasitic Diseases; Plasmodium knowlesi
  3. Hudson LN, Newbold T, Contu S, Hill SL, Lysenko I, De Palma A, et al.
    Ecol Evol, 2014 Dec;4(24):4701-35.
    PMID: 25558364 DOI: 10.1002/ece3.1303
    Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species' threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project - and avert - future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups - including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems - We make site-level summary data available alongside this article. The full database will be publicly available in 2015.
    MeSH terms: Amphibians; Animals; Birds; Mammals; Reptiles; Ecosystem; Biodiversity
  4. Ruiz Estrada, Mario Arturo
    This paper proposes a new multidimensional graphical model to monitoring the GDP
    growth rates in real prices behavior and the GDP formation accumulation from any
    country in the short and long run through the uses of “the Multi-Dimensional Radar
    Mapping Model (MDRM- Model).” Hence, the MDRM-Model is based on the plotting of
    different coordinates that represents a large number of GDP growth rates in real prices
    on the top of a large number of perimeters. Each perimeter represents different periods
    of time in our analysis. In our case, we are using the Multi-Dimensional Radar Mapping
    coordinate system (MDRM-Coordinate System) to build the MDRM-Model respectively.
    Moreover, the MDRM-Model can facilitate the visualization of different GDP growth rates
    in real prices simultaneously in different periods of time (years) or spaces (countries) that
    follows a logical order into the same graphical space. The MDRM-Model was applied on
    the economies of People’s Republic of China (PRC) and U.S. to analyze the process of
    GDP formation accumulation in the last past forty years in both economies.
  5. Alharazy SM, Kong N, Saidin R, Gafor AH, Maskon O, Mohd M, et al.
    Angiology, 2014 Mar;65(3):225-6.
    PMID: 23564021 DOI: 10.1177/0003319713483544
    MeSH terms: Acute-Phase Proteins; Contrast Media/adverse effects*; Female; Humans; Kidney Diseases/chemically induced*; Male; Proto-Oncogene Proteins/blood*; Biomarkers/blood*; Coronary Angiography/adverse effects*; Renal Insufficiency, Chronic/complications*; Lipocalins/blood*; Acute Kidney Injury/chemically induced*; Acute Kidney Injury/prevention & control*; Lipocalin-2
  6. Kuldas S, Satyen L, Ismail HN, Hashim S
    Psychol Belg, 2014 Aug 08;54(4):350-373.
    PMID: 30479408 DOI: 10.5334/
    The capacity limitation of working memory is a widely recognised determinant of human learning. A cognitive load exceeding the capacity hampers learning. Cognitive load can be controlled by tailoring an instructional design to levels of learner prior knowledge. However, such as design does not necessarily motivate to use the available capacity for better learning. The present review examines literatures on the effects of instructional design, motivation, emotional state, and expertise level on cognitive load and cognitive effort, which ultimately affect working memory performance and learning. This examination suggests further studies on the effects of motivation and negative emotional states on the use of working memory. Prospective findings would help better explain and predict individual differences in the use of working memory for cognitive learning and task performance.
    MeSH terms: Cognition; Emotions; Humans; Individuality; Learning; Memory, Short-Term; Motivation; Prospective Studies; Task Performance and Analysis; Knowledge
  7. Al-Jadi AM, Kanyan Enchang F, Mohd Yusoff K
    Turk J Med Sci, 2014;44(5):733-40.
    PMID: 25539538
    BACKGROUND/AIM: To examine, for the first time, the effect of a selected Malaysian honey and its major components on the proliferation of cultured fibroblasts.

    MATERIALS AND METHODS: Honey and some of its components, which include the sugars, the proteins, the hydrogen peroxide produced, and the phenolics, were exposed to cultured fibroblasts. The MTT colorimetric assay was used to assess cell viability and proliferation.

    RESULTS: The stimulatory effect of honey on fibroblast proliferation was observed to be time- and dose-dependent. The continuous production of hydrogen peroxide by the honey-glucose oxidase system also acts to stimulate cell proliferation in a time- and dose-dependent manner. The presence of phenolics with antioxidant properties, on the other hand, renders protection to the cells against the toxic effect of hydrogen peroxide. However, the presence of a growth factor-like substance in honey could not be ascertained.

    CONCLUSION: For the first time, honey and its major components were shown to exert stimulatory effects on cultured fibroblasts. Honey is therefore potentially useful in medicinal practices.

    MeSH terms: Anti-Bacterial Agents/pharmacology; Antioxidants; Cells, Cultured; Colorimetry; Fibroblasts*; Cell Proliferation; Hydroxybenzoates
  8. Tan SA, Goya L, Ramanathan S, Sulaiman SF, Alam M, Navaratnam V
    Food Res. Int., 2014 Oct;64:387-395.
    PMID: 30011665 DOI: 10.1016/j.foodres.2014.06.040
    Extract from papaya leaves, a waste material from fruit farms in Malaysia was previously reported to possess remarkable antioxidative activities. In this study, papaya leaf extract was separated into fractions of different polarities [petroleum ether (PE), ethyl acetate (EA), n-butanol (NB) and water (W) fractions]. The aim of this research was to determine the most active fraction in terms of its chemopreventive effects towards oxidative stress and the chemical constituents involved. The cytoprotective nature of the papaya fractions was observed against t-BOOH-induced oxidative stress on HepG2 liver cell line. ROS assay indicated that only PE and EA effectively reduced the increment of radical due to the pro-oxidant, t-BOOH. Nevertheless, PE was a stronger ROS scavenger by demonstrating ROS reducing activity in a dose-dependent manner to the basal level. This fraction was also found to inhibit cell death caused by t-BOOH toxicity, attenuating lactate dehydrogenase enzyme leakage by more than 90% (p<0.05). In addition, gene expression of phase II antioxidant enzymes (hmox-1 and nqo-1) and their transcription factor (nrf-2) were shown to be upregulated upon PE treatment during a time-course study. A GC-MS fingerprint of the active fraction was subsequently obtained with standardization using the marker compound; α-tocopherol, a well known antioxidant. However, this pure compound was not as effective as its corresponding PE concentrations in ROS reduction. Hence, PE of papaya leaf extract was a strong antioxidant and cytoprotectant with tremendous potential to be harnessed into the next therapeutic remedy against oxidative stress of the liver.
  9. Ng SP, Lai OM, Abas F, Lim HK, Tan CP
    Food Res. Int., 2014 Oct;64:919-930.
    PMID: 30011735 DOI: 10.1016/j.foodres.2014.08.045
    The rheological properties, microstructure, textural properties, colour and droplet size distribution of mayonnaise-like emulsion models prepared using 10-30wt.% of palm olein-based diacylglycerol (POL-DAG) oil were compared with those of the control (100wt.% VCO) model. There were significant (P<0.05) differences in the particle size distribution of the oil droplets, the textural properties, and the rheological properties of the various emulsion models. The rheological analysis included the determination of the flow curves, yield stress, thixotropy, apparent viscosity, and viscoelastic parameters. The concentrated oil-in-water (O/W) emulsion with 30wt.% POL-DAG substitution exhibited high thixotropy. The POL-DAG content had a substantial effect on the rheological properties of yield stress, storage modulus (G') and loss modulus (G″). The pseudoplastic behaviour of the emulsions was demonstrated. The size of the particles in the 30% POL-DAG-substituted emulsion was dramatically increased after one day and 30days of storage. All of the emulsion samples with POL-DAG substituted for VCO showed a relatively non-uniform bimodal droplet size distribution after one day of storage. In general, substitution of 10-20wt.% POL-DAG oil is appropriate for preparing O/W emulsions that had flow curves and textural properties similar to those of the control sample.
  10. Thanigasalam T, Reddy SC, Chinna K
    International Eye Science, 2014;14:1367-1372.
    DOI: 10.3980/j.issn.1672-5123.2014.08.01
    AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.
    METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
    RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture (3.6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction (ICCE) and phacoemulsification converted to extracapsular cataract extraction (ECCE) were significantly associated with more complications (P<0.001). The visual outcome was significantly poor in patients with complications (P<0.001).
    CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.
    MeSH terms: Adult; Aged; Cataract Extraction*; China/ethnology; Female; Hospitals, District; Humans; India/ethnology; Malaysia/ethnology; Male; Retrospective Studies; Prevalence; Phacoemulsification*
  11. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.

    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.

    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.

    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.

    MeSH terms: Cost-Benefit Analysis; Gingival Diseases; Humans; Outpatients; Periodontal Diseases; Periodontitis; Prospective Studies; Health Care Costs; Public Sector; Quality-Adjusted Life Years; Critical Pathways; Uncertainty
  12. Aljunid S, Maimaiti N, Ahmed Z, Muhammad Nur A, Md Isa Z, Azmi S, et al.
    Value Health Reg Issues, 2014 May;3:146-155.
    PMID: 29702920 DOI: 10.1016/j.vhri.2014.04.008
    OBJECTIVE: To assess the cost-effectiveness of introducing pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in the National Immunization Programme of Malaysia. This study compared introducing PHiD-CV (10 valent vaccine) with current no vaccination, as well as against the alternative 13-valent pneumococcal conjugate vaccine (PCV13).

    METHODS: A lifetime Markov cohort model was adapted using national estimates of disease burden, outcomes of pneumococcal disease, and treatment costs of disease manifestations including pneumonia, acute otitis media, septicemia, and meningitis for a hypothetical birth cohort of 550,000 infants. Clinical information was obtained by review of medical records from four public hospitals in Malaysia from the year 2008 to 2009. Inpatient cost from the four study hospitals was obtained from a diagnostic-related group-based costing system. Outpatient cost was estimated using clinical pathways developed by an expert panel. The perspective assessed was that of the Ministry of Health, Malaysia.

    RESULTS: The estimated disease incidence was 1.2, 3.7, 70, and 6.9 per 100,000 population for meningitis, bacteremia, pneumonia, and acute otitis media, respectively. The Markov model predicted medical costs of Malaysian ringgit (RM) 4.86 billion (US $1.51 billion) in the absence of vaccination. Vaccination with PHiD-CV would be highly cost-effective against no vaccination at RM30,290 (US $7,407) per quality-adjusted life-year gained. On comparing PHiD-CV with PCV13, it was found that PHiD-CV dominates PCV13, with 179 quality-adjusted life-years gained while saving RM35 million (US $10.87 million).

    CONCLUSIONS: It is cost-effective to incorporate pneumococcal vaccination in the National Immunization Programme of Malaysia. Our model suggests that PHiD-CV would be more cost saving than PCV13 from the perspective of the Ministry of Health of Malaysia.

    MeSH terms: Cost-Benefit Analysis; Diagnosis-Related Groups; Haemophilus influenzae; Hospitals, Public; Humans; Immunization; Infant; Inpatients; Malaysia; Medical Records; Meningitis; Otitis Media; Outpatients; Pneumococcal Infections; Pneumonia; Polysaccharides; Streptococcus pneumoniae; Vaccination; Cohort Studies; Incidence; Bacteremia; Cost Savings; Cost of Illness; Vaccines, Conjugate; Sepsis; Critical Pathways; Pneumococcal Vaccines
  13. Blebil AQ, S Sulaiman SA, A Hassali M, Dujaili JA, Zin AM
    Value Health Reg Issues, 2014 May;3:19-23.
    PMID: 29702926 DOI: 10.1016/j.vhri.2013.09.001
    OBJECTIVES: Assessment of nicotine withdrawal symptoms is an essential part of tobacco dependence treatment. This study aimed to evaluate the psychometric properties of a Malay translated version of the Minnesota Nicotine Withdrawal Scale (MNWS).

    METHODS: The original scale was translated into Malay following the standard guidelines proposed for translation studies. The reliability and validity of the Malay version scale were evaluated on the basis of data collected from 133 participants. The Cronbach's alpha coefficient was calculated to assess the reliability. To validate the psychometric properties of the scale, factor analysis and construct validity were used. This study was conducted at the Quit Smoking Clinic at Penang General Hospital, Penang, Malaysia.

    RESULTS: The translated scale has excellent reliability, with total Cronbach's alpha of 0.91. The test-retest reliability for the scale presented an excellent reliability and stability of the translated scale with Spearman's rank correlation coefficient (r = 0.876; P < 0.001). There was a significant positive correlation between the exhaled carbon monoxide level, Fagerstrom Test for Nicotine Dependence total score, and number of cigarettes smoked per day and the MNWS total score (r = 0.72, 0.68, and 0.68, respectively; P < 0.001). A principal-components analysis with orthogonal rotation yielded a unidimensional model that includes all the items of the MNWS.

    CONCLUSIONS: The Malay version of the MNWS is a reliable and valid measure of withdrawal symptoms as well as the smoking urge, and it is applicable to clinical practice and research study.

    MeSH terms: Carbon Monoxide; Factor Analysis, Statistical; Hospitals, General; Malaysia; Minnesota; Nicotine; Psychometrics; Rotation; Smoke; Smoking; Substance Withdrawal Syndrome; Tobacco Use Disorder; Translating; Translations; Reproducibility of Results; Tobacco Products
  14. Dilokthornsakul P, Chaiyakunapruk N, Jeanpeerapong N, Lee TA
    Value Health Reg Issues, 2014 May;3:222-228.
    PMID: 29702931 DOI: 10.1016/j.vhri.2014.04.013
    OBJECTIVES: To evaluate whether there are differences in propensity score (PS) and treatment effects estimated using conventional and calendar time-specific PS (CTS-PS) approaches.

    METHODS: A retrospective database analysis at a university-affiliated hospital in Thailand was used. Diabetic patients receiving glucose-lowering medications from July 2008 to June 2011 were included. Patients were categorized into those exposed and not exposed to thiazolidinediones (TZDs). PSs were estimated by using conventional PS and CTS-PS. In the CTS-PS, PS was separately estimated for three specific calendar time periods. Patients were matched 1:1 using caliper matching. The outcomes were cardiovascular and all-cause hospitalizations. The TZD and non-TZD groups were compared with Cox proportional hazard models.

    RESULTS: A total of 2165 patients were included. The average conventional PS was 0.198 (95% confidence interval [CI] 0.195-0.202), while the average PS in the CTS-PS approach was 0.212 (0.206-0.218), 0.180 (0.173-0.188), and 0.205 (0.197-0.213) for July 2008 to June 2009, July 2009 to June 2010, and July 2010 to June 2011, respectively. The average difference in PS was 0.012 (P < 0.001), -0.009 (P ≤ 0.002), and 0.000 (P = 0.950) in the three calendar time periods. The adjusted hazard ratios of the conventional PS-matched cohort were 0.97 (95% CI 0.39-2.45) and 0.97 (95% CI 0.78-1.20) for CVD-related and all-cause hospitalizations, while the adjusted hazard ratios of the CTS-PS-matched cohort were 1.11 (95% CI 0.43-2.88) and 1.12 (95% CI 0.91-1.39), respectively.

    CONCLUSION: CTS-PS is different from PS estimated by using the conventional approach. CTS-PS should be considered when a pattern of medication use has changed over the study period.

  15. Siti Norashikin MT, Ghosh S, Chatterjee R, Rajikin MH, Chatterjee A
    Reprod. Med. Biol., 2014 Jul;13(3):135-141.
    PMID: 29699157 DOI: 10.1007/s12522-013-0174-9
    Purpose: The present study aims to investigate the effects of nicotine on the endometrial decidual growth and levels of estrogen and progesterone in pseudopregnant rats.

    Methods: Pseudopregnancy (pc) was induced in cyclic Sprague-Dawley rats by sterile mating. Subcutaneous injection of nicotine tartrate (7.5 mg/kg/day) was scheduled from day 1 through day 5, day 5 through day 9 or day 1 through day 9 of pc. In another group of pseudopregnant rats, concomitant treatment of nicotine tartrate concurrently with progesterone (2 mg/day) was scheduled from day 1 through day 9 pc. Control groups received subcutaneous injections of vehicle only. Endometrial decidualization was induced on day 5 pc. On day 10 pc, animals were sacrificed.The degree of decidual growth and circulating levels of estrogen and progesterone were measured.

    Results: The decidual growth in all the first three nicotine-treated groups of animals was significantly reduced, particularly in the animals treated with nicotine from day 1 through day 9 pc. Plasma estrogen levels were significantly elevated in animals treated with nicotine from day 1 through day 9 pc. Conversely, levels of plasma progesterone were found to be significantly attenuated in the same group of nicotine-treated animals compared to controls. Exogenous replacement of progesterone, however, caused a higher degree of endometrial decidualization compared to the nicotine-treated group but it was slightly less than when compared to control.

    Conclusions: In conclusion, nicotine-induced progesterone deficiency with a corresponding elevation of estrogen may possibly attenuate the degree of endometrial decidualization in pseudopregnant rats.

    MeSH terms: Animals; Decidua; Endometrium; Estrogens; Female; Injections, Subcutaneous; Nicotine; Embryo Implantation; Pregnancy; Progesterone; Pseudopregnancy; Rats, Sprague-Dawley; Control Groups; Rats
  16. Shi H, Jiang B, Wei Sim JD, Chum ZZ, Ali NB, Toh MH
    Mil Med, 2014 Oct;179(10):1158-65.
    PMID: 25269135 DOI: 10.7205/MILMED-D-14-00064
    A case-control study among Singapore Armed Forces' newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as "cases" (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as "controls" (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education-OR = 2.75), father's employment at nonmanagerial/professional jobs (OR = 1.52), mother's employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 hours or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.
    MeSH terms: Alcohol Drinking; Educational Status; Employment; Ethnic Groups; Family; Fathers; Feeding Behavior; Humans; Income; India/ethnology; Life Style; Malaysia/ethnology; Male; Military Personnel*; Mothers; Obesity/etiology*; Obesity/genetics; Occupations; Singapore; Sleep/physiology; Smoking; Socioeconomic Factors; Time Factors; Exercise/physiology; Body Mass Index; Case-Control Studies; Diabetes Complications; Young Adult; Pediatric Obesity/complications
  17. Edwards DP, Magrach A, Woodcock P, Ji Y, Lim NT-, Edwards FA, et al.
    Ecol Appl, 2014;24(8):2029-49.
    PMID: 29185670 DOI: 10.1890/14-0010.1
    Strong global demand for tropical timber and agricultural products has driven large-scale logging and subsequent conversion of tropical forests. Given that the majority of tropical landscapes have been or will likely be logged, the protection of biodiversity within tropical forests thus depends on whether species can persist in these economically exploited lands, and if species cannot persist, whether we can protect enough primary forest from logging and conversion. However, our knowledge of the impact of logging and conversion on biodiversity is limited to a few taxa, often sampled in different locations with complex land-use histories, hampering attempts to plan cost-effective conservation strategies and to draw conclusions across taxa. Spanning a land-use gradient of primary forest, once- and twice-logged forests, and oil palm plantations, we used traditional sampling and DNA metabarcoding to compile an extensive data set in Sabah, Malaysian Borneo for nine vertebrate and invertebrate taxa to quantify the biological impacts of logging and oil palm, develop cost-effective methods of protecting biodiversity, and examine whether there is congruence in response among taxa. Logged forests retained high species richness, including, on average, 70% of species found in primary forest. In contrast, conversion to oil palm dramatically reduces species richness, with significantly fewer primary-forest species than found on logged forest transects for seven taxa. Using a systematic conservation planning analysis, we show that efficient protection of primary-forest species is achieved with land portfolios that include a large proportion of logged-forest plots. Protecting logged forests is thus a cost-effective method of protecting an ecologically and taxonomically diverse range of species, particularly when conservation budgets are limited. Six indicator groups (birds, leaf-litter ants, beetles, aerial hymenopterans, flies, and true bugs) proved to be consistently good predictors of the response of the other taxa to logging and oil palm. Our results confidently establish the high conservation value of logged forests and the low value of oil palm. Cross-taxon congruence in responses to disturbance also suggests that the practice of focusing on key indicator taxa yields important information of general biodiversity in studies of logging and oil palm.
    MeSH terms: Agriculture*; Animals; Conservation of Natural Resources/methods*; Environmental Monitoring/methods; Malaysia; Forestry*; Arecaceae/physiology*; Biodiversity*; Rainforest*
  18. Sirkhazi M, Sarriff A, Aziz NA, Almana F, Arafat O, Shorman M
    World J Oncol, 2014 Dec;5(5-6):196-203.
    PMID: 29147403 DOI: 10.14740/wjon850w
    Background: Knowing local spectrum and sensitivity for bacterial isolates causing febrile neutropenia is important as starting an appropriate empirical antibiotic therapy is considered a medical emergency in these high-risk patients.

    Methods: A retrospective study of a total of 106 microbiologically febrile episodes in hospitalized adult neutropenic cancer patients, who were admitted from May 2009 to May 2013, at King Fahad Specialist Hospital, Dammam, Saudi Arabia, was conducted.

    Results: Among 106 microbiologically documented febrile neutropenic episodes, the majority of malignancies were solid tumors accounting for 53.8% (57/106) and hematological malignancies accounted for 46.23% (49/106). The most common malignancies were non-Hodgkin's lymphoma 19.81% (21/106) followed by acute myeloid leukemia 15.09% (16/106), then colorectal cancer 13.21% (14/106), pancreatic cancer and acute lymphoblastic leukemia accounting for 5.66% (6/106) each, multiple myeloma 4.72% (5/106), gall bladder cancer 3.77% (4/106), and lung cancer 2.83% (3/106). A total of 138 bacterial isolates were identified. The overall prevalence of gram-negative bacteria was 65.94% (91/138) and for gram-positive bacteria was 34.06% (47/138). The most common bacterial isolation sites were blood 33.32% (46 isolates), urine 29.71% (41 isolates), wound 19.55% (27 isolates), body fluids 9.41% (13 isolates) and sputum 7.96% (11 isolates). The most predominant pathogens were Escherichia coli 30.43 (42/138), Klebsiella pneumonia 14.49% (20/138), Staphylococcus aureus 13.04% (18/138), Sptreptococcus spp. 7.25% (10/138), Pseudomonas spp. 7.25% (10/138), Enterococcus spp. 5.80% (8/138), Staphylococcus spp. 4.35% (6/138), Corynebacterium spp. 3.62% (5/138), Enterobacter spp. 3.62% (5/138), Acinobacter spp. 2.90% (4/138), Serratia marcescens 2.17% (3/138), Proteus mirabilis 1.45% (2). Aeromonas hydrophylia, Citrobacter freundii, Providencia stuartii, Sphingomonas paucimobilis and Stenotropomonas multipholia contributed to 0.72% with one isolate each. For gram-negative Escherichia coli and Klebsiella pneumonia, the extended-spectrum beta-lactamases producers (ESBLs) rates were 38% and 22.22% respectively. For Pseudomonas aerugenosa imipenem-cilastatin resistance rate was 18.84%. For gram-positive bacteria, methicillin-resistant Staphylococcus aureus (MRSA) rate was 28.62%. The vancomycin-resistant Enterococci (VRE) rate was 1.18%.

    Conclusion: Gram-negative bacteria were more prevalent as a cause of infection in adult cancer patients with febrile neutropenia at our institution, with Escherichia coli and Klebsiella pneumonia with high ESBLs rates being the most common pathogens. Blood stream infections followed by urinary tract infections were the most common sites of infection. The use of initial antibiotic therapy in febrile neutropenic episodes should be based on local bacterial spectrum and susceptibility/sensitivity patterns to prevent treatment failure with increased morbidity and mortality.

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