Browse publications by year: 2019

  1. Horiguchi T, Masui Y, Zan MSD
    Sensors (Basel), 2019 Mar 27;19(7).
    PMID: 30934806 DOI: 10.3390/s19071497
    Distributed strain and temperature can be measured by using local Brillouin backscatter in optical fibers based on the strain and temperature dependence of the Brillouin frequency shift. The technique of analyzing the local Brillion backscatter in the time domain is called Brillouin optical time domain reflectometry (BOTDR). Although the best spatial resolution of classic BOTDR remains at around 1 m, some recent BOTDR techniques have attained as high as cm-scale spatial resolution. Our laboratory has proposed and demonstrated a high-spatial-resolution BOTDR called phase-shift pulse BOTDR (PSP-BOTDR), using a pair of probe pulses modulated with binary phase-shift keying. PSP-BOTDR is based on the cross-correlation of Brillouin backscatter and on the subtraction of cross-correlations obtained from the Brillouin scatterings evoked by each phase-modulated probe pulse. Although PSP-BOTDR has attained 20-cm spatial resolution, the spectral analysis method of PSP-BOTDR has not been discussed in detail. This article gives in-depth analysis of the Brillouin backscatter and the correlations of the backscatters of the PSP-BOTDR. Based on the analysis, we propose new spectral analysis methods for PSP-BOTDR. The analysis and experiments show that the proposed methods give better frequency resolution than before.
    MeSH terms: Heart Rate; Laboratories; Temperature; Optical Fibers; Physical Phenomena
  2. Wang T, Sun Z, Lim JP, Yu Y
    Libyan J Med, 2019 Dec;14(1):1597327.
    PMID: 30935302 DOI: 10.1080/19932820.2019.1597327
    Many undergoing in vitro fertilization-embryo transfer (IVF-ET) procedures treatments have been tried for older infertile patients, but still can not reverse the aging effect on oocyte, and infertility treatment is expensive, even for people in developed countries. The study aimed to compare outcomes following the application of luteal phase ovulation induction (LPOI) and ultra-short gonadotropin-releasing hormone agonist (GnRH-a) protocols in patients aged more than 40 years undergoing IVF-ET and to examine the effectiveness and feasibility of LPOI. A total of 266 IVF-ET cycles in 155 patients aged 40 years and over were retrospectively analyzed. Of these patients, 105 underwent the ultra-short GnRH-a protocol (GnRH-a group) and 50 underwent LPOI (LPOI group). Various clinical outcomes were compared between these two groups using either t-tests or the chi-square test. The study showed patients in the LPOI group required a higher dosage of human menopausal gonadotropin and a lower dosage of recombinant follicle stimulating hormone than those in the GnRH-a group. Furthermore, though the total dosage of gonadotropin was higher in the LPOI, its cost was lower. Finally, fertilization rates were higher and high-quality embryo rates were lower in the LPOI group, and the live birth rate of LPOI group is higher than (GnRH-a group) . These between-group differences were all significant (P
    MeSH terms: Adult; Age Factors; Embryo Transfer/methods*; Female; Fertilization in Vitro*; Humans; Gonadotropin-Releasing Hormone/agonists*; Luteal Phase/physiology*; Maternal Age; Ovulation Induction/methods*; Retrospective Studies
  3. Yang Y, Swierczak A, Ibahim M, Paiva P, Cann L, Stevenson AW, et al.
    Radiother Oncol, 2019 04;133:93-99.
    PMID: 30935588 DOI: 10.1016/j.radonc.2019.01.006
    BACKGROUND: Synchrotron microbeam radiation therapy (MRT) is a new, evolving form of radiotherapy that has potential for clinical application. Several studies have shown in preclinical models that synchrotron MRT achieves equivalent tumor control to conventional radiotherapy (CRT) but with significantly reduced normal tissue damage.

    METHODS: To explore differences between these two modalities, we assessed the immune cell infiltrate into EMT6.5 mammary tumors after CRT and MRT.

    RESULTS: CRT induced marked increases in tumor-associated macrophages and neutrophils while there were no increases in these populations following MRT. In contrast, there were higher numbers of T cells in the MRT treated tumors. There were also increased levels of CCL2 by immunohistochemistry in tumors subjected to CRT, but not to MRT. Conversely, we found that MRT induced higher levels of pro-inflammatory genes in tumors than CRT.

    CONCLUSION: Our data are the first to demonstrate substantial differences in macrophage, neutrophil and T cell numbers in tumors following MRT versus CRT, providing support for the concept that MRT evokes a different immunomodulatory response in tumors compared to CRT.

    MeSH terms: Animals; Female; Macrophages/immunology; Macrophages/radiation effects; Mammary Neoplasms, Experimental/immunology*; Mammary Neoplasms, Experimental/radiotherapy*; Mice, Inbred BALB C; Neutrophils/immunology; Neutrophils/radiation effects; Radiotherapy/instrumentation; Radiotherapy/methods; T-Lymphocytes/immunology; T-Lymphocytes/radiation effects; Synchrotrons; Chemokine CCL2/immunology; Chemokine CCL2/metabolism; Cell Line, Tumor; Mice
  4. Nor Hanipah Z, Hsin MC, Liu CC, Huang CK
    Surg Obes Relat Dis, 2019 May;15(5):696-702.
    PMID: 30935839 DOI: 10.1016/j.soard.2019.01.016
    BACKGROUND: Laparoscopic loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) is a new metabolic procedure. Our initial data on type 2 diabetes (T2D) remission after LDJB-SG were promising.

    OBJECTIVES: The aim of this study was to look at our intermediate outcomes after LDJB-SG.

    SETTING: An academic medical center.

    METHODS: A prospective analysis of T2D patients who underwent LDJB-SG between October 2011 and October 2014 was performed. Data collected included baseline demographic, body mass index, fasting blood glucose, glycosylated hemoglobin, C-peptide, resolution of co-morbidities, and postoperative complications.

    RESULTS: A total of 163 patients with minimum of follow-up >1 year were enrolled in this study (57 men and 106 women). The mean age and body mass index were 47.7 (±10.7) years and a 30.2 (±5.1) kg/m2, respectively. There were 119 patients on oral hypoglycemic agents only, 29 patients were on oral hypoglycemic agents and insulin, 3 patients were on insulin only, and the other 12 patients were not on diabetic medication. Mean operation time and length of hospital stay were 144.7 (± 45.1) minutes and 2.4 (± 1.0) days, respectively. Seven patients (3.6%) needed reoperation due to bleeding (n = 1), anastomotic leak (n = 2), sleeve strictures (n = 2), and incisional hernia (n = 2). At 2 years of follow-up, there were 56 patients. None of the patients were on insulin and only 20% of patients were on oral hypoglycemic agents. Mean body mass index significantly dropped to 22.9 (±5.6) kg/m2 at 2 years. The mean preoperative fasting blood glucose, glycosylated hemoglobin, and C-peptide levels were 174.7 mg/dL (± 61.0), 8.8% (±1.8), and 2.6 (±1.7) ng/mL, respectively. The mean fasting blood glucose, glycosylated hemoglobin, and C-peptide at 2 years were 112.5 (±60.7) mg/dL, 6.4% (±2.0), and 1.5 (±0.6) ng/mL, respectively. No patient needed revisional surgery because of dumping syndrome, marginal ulcer, or gastroesophageal reflux disease at the last follow up period.

    CONCLUSION: At 2 years, LDJB-SG is a relatively safe and effective metabolic surgery with significant weight loss and resolution of co-morbidities.

    MeSH terms: Diabetes Mellitus, Type 2/surgery*; Duodenum/surgery*; Female; Gastrectomy/methods*; Hemoglobin A, Glycosylated/metabolism; Humans; Jejunum/surgery*; Male; Middle Aged; Laparoscopy/methods*; Postoperative Complications/prevention & control; Prospective Studies; Remission Induction; Weight Loss; Body Mass Index
  5. Narasimhan M, Allotey P, Hardon A
    BMJ, 2019 Apr 01;365:l688.
    PMID: 30936087 DOI: 10.1136/bmj.l688
    Manjulaa Narasimhan and colleagues argue that there is a pressing need for a clearer conceptualisation of self care to support health policy
    MeSH terms: Decision Making; Delivery of Health Care/methods*; Humans; Human Rights; Models, Theoretical*; Primary Health Care/methods; Self Care*; Patient-Centered Care/methods; Reproductive Health Services; Healthcare Disparities
  6. Remme M, Narasimhan M, Wilson D, Ali M, Vijayasingham L, Ghani F, et al.
    BMJ, 2019 Apr 01;365:l1228.
    PMID: 30936210 DOI: 10.1136/bmj.l1228
    Michelle Remme and colleagues argue that if costs to users are considered and their financing is right, self care interventions for sexual and reproductive health can improve equity and efficiency
    MeSH terms: Cost-Benefit Analysis; Delivery of Health Care/economics*; Humans; Self Care/economics*; Health Care Costs; Universal Coverage/economics; Reproductive Rights/economics*; Healthcare Disparities; Reproductive Health/economics*
  7. Alamaary MS, Haron AW, Ali M, Hiew MWH, Adamu L, Peter ID
    Vet World, 2019 Jan;12(1):34-40.
    PMID: 30936651 DOI: 10.14202/vetworld.2019.34-40
    Aim: Different types of extenders have a variety of components which show the tolerance effect on sperm protection during freezing procedures. In the present study, we have examined the impact of the extenders HF-20 and Tris, which were locally manufactured, and they are competing with commercial extenders INRA Freeze® (IMV Technologies, France) and EquiPlus Freeze® (Minitube, Germany) on the quality of horses frozen semen.

    Materials and Methods: A total of 15 ejaculates from three healthy stallions were collected and cryopreserved in the same environment. Each semen sample collected was divided into four equal parts and processed. All samples were analyzed before and after freezing for motility, viability, plasma membrane integrity, and morphology. Furthermore, twenty mares were inseminated using post-thawed semen.

    Results: There were no differences observed among all extenders in all the parameters before freezing. Sperm cryopreserved using HF-20 showed better motility, viability, and plasma membrane integrity than Tris extender. The Tris extender showed the most inferior quality of post-thawed semen between all the extenders. HF-20, INRA Freeze®, and EquiPlus Freeze® extenders revealed the same capacity of semen preservation in vitro and in vivo.

    Conclusion: HF-20 extender has the same quality as INRA Freeze® and EquiPlus Freeze® that can be considered as one of the best extenders for the semen cryopreservation in horses. In contrast, Tris extender needs some degree of improvement.

    MeSH terms: Animals; Cell Membrane; Female; France; Freezing; Germany; Horses; Male; Semen; Semen Preservation; Spermatozoa; Cryopreservation
  8. Alrubaiee G, Baharom A, Faisal I, Hayati KS, Mohd Daud S, Basaleem HO
    BMC Nurs, 2019;18:10.
    PMID: 30936778 DOI: 10.1186/s12912-019-0333-3
    Background: Nosocomial infections remain a global health problem and they are considered as one of the leading causes of increased morbidity and mortality. In-service training courses related to infection control measures can help nurses to make informed and therapeutic decisions which could prevent or reduce the incidence of nosocomial infections. This study protocol is of a hospital-based trial to develop, implement and evaluate an educational module on nosocomial infection control among nurses in public hospitals in Yemen. This study is currently ongoing and at the analysis stage.

    Methods: A three-arm single-blinded randomized community hospital-based trial was conducted to evaluate the effectiveness of a newly developed nosocomial infection control educational module among nurses in public hospitals in Yemen. To ensure effective delivery and acquisition of knowledge, the Situated Learning Theory was applied during the course of the intervention. A total of 540 Yemeni in-ward nurses, who had three years nursing diploma and at least a year of working experience in the selected public hospitals were recruited in this study. The hospitals were the unit of randomization whereby eight hospitals were assigned randomly to intervention and waitlist groups. Intervention group-1 (n = 180) received an educational module supported by audio-video CD and a training course for eight weeks. Intervention group-2 (n = 180) was given only the educational module with audio-video CD (without the training course). The waitlist group received no intervention during the period of data collection but they will be given the same training and learning materials after the completion of the study.

    Discussion: This study contributes to the lack of a nosocomial infection control educational module for nurses in Yemen. It is hoped that the educational module will serve as an effective approach to increase the nurses' knowledge and improve their practices regarding nosocomial infection control measures and hence decrease the prevalence of nosocomial infections in the future.

    Trial registration: ID: ISRCTN19992640, Date of registration: 20/6/2017. This study protocol was retrospectively registered.

  9. Zyoud SH, Khaled SM, Kawasmi BM, Habeba AM, Hamadneh AT, Anabosi HH, et al.
    BMC Nurs, 2019;18:11.
    PMID: 30936779 DOI: 10.1186/s12912-019-0336-0
    Background: Medication errors (MEs) are unintended failures in the drug treatment process that can occur during prescription, dispensing, storing, preparation or administration of medications. High alert medications (HAMs) are defined as those medications that bear the highest risk of causing significant patient harm when used incorrectly, either due to their serious adverse events or to a narrow therapeutic window. Nurses are responsible for administration of HAMs; incorrect administration can have a significant clinical outcome. This study aimed to assess the level of knowledge of HAMs among nurses in government hospitals in West Bank, Palestine.

    Methods: A cross-sectional study was conducted in 2015, in West Bank, Palestine. Data were collected via a face to face interview questionnaire, which was taken from a previous study. Data were collected by convenient sampling. The questionnaire consisted of four parts: demographic characteristics of the nurses, drug administration knowledge (10 true-false questions), drug regulation knowledge (10 true-false questions), and self-evaluation.

    Results: A total of 280 nurses participated in the study; these nurses were working in the emergency room (ER), intensive care unit (ICU), paediatric or medical ward. The response rate was 93%. Nurses were found to have insufficient knowledge about HAMs; 67.1% of participants had a score of less than 70%, with a mean total score of 59.9 ± 15.1. Factors associated with sufficient knowledge among nurses were HAMs training and ICU training, both with p-values of 0.002. Nurses with a master degree, those working in the ICU ward, head nurses, and male nurses were the most knowledgeable groups, with a p-values

  10. Umat C, Abdul Wahat NH, Che Ross S, Goh BS
    J Otol, 2019 Mar;14(1):17-21.
    PMID: 30936897 DOI: 10.1016/j.joto.2018.11.004
    Objectives: This study examined the quality of life (QoL) of the parents and siblings of hearing-impaired children with cochlear implants (CIs).

    Design: This is a cross-sectional, questionnaire-based study. The questionnaire consists of three sub-domains - interaction, emotional well-being and support for the hearing-impaired child and the overall QoL -- and two open-ended questions for participants to provide comments and suggestions to enhance their family's QoL. A total of 63 questionnaires were e-mailed or mailed to families who met the inclusion criteria.

    Setting: The study was conducted under the Center for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur.

    Participants: A total of 79 parents and 23 siblings from 44 families of children with CI participated in this study.

    Main outcome measures: The mean score for each of the sub-domain and the overall QoL for both subject groups were computed. The answers for the open-ended questions were listed and organized into themes.

    Results: There were significant correlations between the overall QoL score and each of the test domains for the parents' group (p 

  11. Rajagopal N, Kawase T, Mohammad AA, Seng LB, Yamada Y, Kato Y
    Asian J Neurosurg, 2019 4 3;14(1):15-27.
    PMID: 30937003 DOI: 10.4103/ajns.AJNS_158_18
    Brainstem cavernomas (BSCs) are angiographically occult, benign low flow vascular malformations that pose a significant surgical challenge due to their eloquent location. The present study includes an extensive review of the literature and three illustrative cases of BSC with emphasis on the timing of surgery: surgical approaches, usage of intraoperative monitoring, and complication avoidance. A systematic search was performed using the PubMed database was from January 1, 1999, to June 2018. The relevant articles were reviewed with particular attention to hemorrhage rates, timing of surgery, indications for surgery, surgical approaches, and outcome. Along with this, a retrospective analysis of three cases of symptomatic BSC, who were operated for the same, during the year 2018 in our institute was conducted. All the three patients presented with at least 1 episode of hemorrhage before surgery. Of these, one patient was operated immediately due to altered sensorium whereas the other two were operated after at least 4 weeks of the hemorrhagic episode. The patients who were operated in the subacute phase of bleed were seen to have liquefaction of hematoma, thus providing a good surgical demarcation and thereby reduced surgery-related trauma to the surrounding eloquent structures. Two patients improved neurologically during the immediate postoperative period, whereas one had transient worsening of neurological deficits during the immediate postoperative period in the form of additional cranial nerve palsies which completely improved on follow-up after 2 months. Radical resection is recommended in all patients with symptomatic BSCs. Surgery should be considered after the first or the second episode of hemorrhage as multiple rebleeds can cause exacerbation of deficits and sometimes mortality as well. Considering surgical timing, anywhere between 4 and 6 weeks or the subacute phase of the hemorrhage is considered appropriate. The aims of surgical intervention must be to improve preoperative function, minimize surgical morbidity and to reduce hemorrhagic rates. In spite of the significant surgical morbidity associated with BSCs, appropriate patient selection, meticulous surgical planning with adjuncts such as intraoperative monitoring and neuronavigation will go a long way in avoidance of major postoperative complications.
    MeSH terms: Attention; Brain Stem; Cranial Nerve Diseases; Follow-Up Studies; Hemangioma, Cavernous; Hematoma; Hemorrhage; Humans; Postoperative Complications; Postoperative Period; Retrospective Studies; Monitoring, Intraoperative; Patient Selection; Neuronavigation; PubMed; Vascular Malformations
  12. Balakrishnan B, Rus RM, Chan KH, Martin AG, Awang MS
    Asian J Neurosurg, 2019 4 3;14(1):201-205.
    PMID: 30937035 DOI: 10.4103/ajns.AJNS_49_18
    Context: Postconcussion syndrome (PCS) is a set of symptoms occurred after a mild traumatic brain injury (MTBI). Aims: This study aims to determine the prevalence of PCS in a young adult population from a single Neurological Centre in Malaysia's East Coast and to evaluate the factors associated with PCS in MTBI patients.

    Settings and Design: This was a cross-sectional study conducted in a Neurological Centre at Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia, from January 2016 to December 2016.

    Subjects and Methods: A total of 209 patients; 133 males and 76 females, in the age range of 16-84 years, were randomly recruited for this study. All the selected patients were subjected to the checklist for diagnosis of PCS as per International Statistical Classification of Diseases and Related Health Problems 10th edition classification at a 2-week interval.

    Statistical Analysis Used: Descriptive statistic and Multivariable Logistic Regression Model were used for frequency and percentage analyses of categorical variables, using SPSS version 23.0.

    Results: Only 20 patients were identified with PCS. There were more female (70%) patients with PCS than the male (30%) patients. The prevalence of PCS for 2 weeks, 3 and 6 months since injuries were 9.6%, 8.1%, and 8.1% respectively. Majority (80%) of the patients were found to have PCS due to road traffic accidents, while the remaining were attributed to assault (15%), and falls (5%). Among the sample population, 25% were smokers, while 10% of them had either skull fracture or premorbidity.

    Conclusion: Less than 10% of patients with MTBI had PCS after 6 months' following trauma. None of the variables tested were significant factors for the development of PCS symptoms.

    MeSH terms: Accidental Falls; Accidents, Traffic; Adolescent; Adult; Aged; Aged, 80 and over; Brain Concussion; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Skull Fractures; Prevalence; Logistic Models; Crime Victims; Post-Concussion Syndrome; International Classification of Diseases; Young Adult; Checklist
  13. Bin Samsuddin MF, Bin Omar MA
    Asian J Neurosurg, 2019 4 3;14(1):283-285.
    PMID: 30937055 DOI: 10.4103/ajns.AJNS_332_17
    Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that poses tremendous challenges to effective therapy. MPNSTs are among the most challenging mesenchymal malignancies to treat with poor prognosis. They usually affect young and middle-aged adults, tend toward early metastasis, and often demonstrate resistance to chemotherapy. We present a case of a 23-year-old female who initially presented with the right temporal swelling for 1 month associated with constitutional symptom which progressively worsening. The right craniotomy and excision biopsy were done with histopathological examination results suggestive of MPNST. Thorax-abdominal-pelvic computed tomography and magnetic resonance imaging further revealed multiple metastatic lesions involving spine, retroperitoneal, pelvic, chest wall, and lungs. This case illustrates the typical presentation of MPNST with its known poorly outcome.
    MeSH terms: Adult; Biopsy; Craniotomy; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Neurilemmoma; Prognosis; Sarcoma; Tomography, X-Ray Computed; Nerve Sheath Neoplasms; Thoracic Wall; Young Adult
  14. Seng LB, Yasuhiro Y, Rajagopal N, Mohammad AA, Takao T, Kyosuke M, et al.
    Asian J Neurosurg, 2019 4 3;14(1):295-299.
    PMID: 30937059 DOI: 10.4103/ajns.AJNS_157_18
    The motor evoked potential (MEP) monitoring is routinely used as an adjunct in the microsurgical clipping of anterior circulation. We describe a case of unruptured basilar tip aneurysm treated with microsurgical clipping developed loss in MEP recording of the left abductor pollicis brevis (APB) following clipping of basilar tip aneurysm. A 58-year-old man was referred to the Fujita Health University Banbuntane-Hotokukai Hospital, Nagoya, Aichi, Japan, with incidental finding of unruptured 6.5 mm basilar tip saccular aneurysm. He underwent right anterior temporal approach of basilar tip aneurysm clipping. The internal carotid artery (ICA) was mobilized laterally to allow direct visualization of the neck of the basilar tip aneurysm. Following the application of temporary clip and subsequently permanent clip at the neck of the aneurysm, the MEP signal was lost in the left APB. The temporary clip was immediately removed. Dual-image videoangiography (DIVA) showed a filling defect in the right ICA and a branch of middle cerebral artery (MCA). The MEP was absent for about 23 minutes and the amplitude improved to only 75% of the baseline recording at 38 minutes till the end of the surgery. A repeat DIVA showed good flow within the right ICA and MCA. Glasgow coma score was 15/15 on postoperative day 1 and there was no gross motor or sensory deficit except right oculomotor nerve palsy with complete recovery at 6 months follow-up. This is the first reported ICA occlusion due to its mobilization in microsurgical clipping of basilar tip aneurysm. The use of neuromonitoring especially MEP is essential even in the posterior circulation aneurysm surgery especially when excessive manipulation of the ICA is unavoidable. When performing intraoperative angiography for aneurysm surgery, it is prudent to detect any filling defect within the surrounding vessels.
    MeSH terms: Angiography; Carotid Artery, Internal; Intracranial Aneurysm; Coma; Follow-Up Studies; Humans; Japan; Male; Middle Aged; Surgical Instruments; Universities; Oculomotor Nerve Diseases; Evoked Potentials, Motor; Middle Cerebral Artery; Incidental Findings
  15. El-Sayed ZA, Abramova I, Aldave JC, Al-Herz W, Bezrodnik L, Boukari R, et al.
    World Allergy Organ J, 2019;12(3):100018.
    PMID: 30937141 DOI: 10.1016/j.waojou.2019.100018
    Background: X-linked agammaglobulinemia is an inherited immunodeficiency recognized since 1952. In spite of seven decades of experience, there is still a limited understanding of regional differences in presentation and complications. This study was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to better understand regional needs, challenges and unique patient features.

    Methods: A survey instrument was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to collect both structured and semi-structured data on X-linked agammaglobulinemia. The survey was sent to 54 centers around the world chosen on the basis of World Allergy Organization participation and/or registration in the European Society for Immunodeficiencies. There were 40 centers that responded, comprising 32 countries.

    Results: This study reports on 783 patients from 40 centers around the world. Problems with diagnosis are highlighted by the reported delays in diagnosis>24 months in 34% of patients and the lack of genetic studies in 39% of centers Two infections exhibited regional variation. Vaccine-associated paralytic poliomyelitis was seen only in countries with live polio vaccination and two centers reported mycobacteria. High rates of morbidity were reported. Acute and chronic lung diseases accounted for 41% of the deaths. Unusual complications such as inflammatory bowel disease and large granular lymphocyte disease, among others were specifically enumerated, and while individually uncommon, they were collectively seen in 20.3% of patients. These data suggest that a broad range of both inflammatory, infectious, and autoimmune conditions can occur in patients. The breadth of complications and lack of data on management subsequently appeared as a significant challenge reported by centers. Survival above 20 years of age was lowest in Africa (22%) and reached above 70% in Australia, Europe and the Americas. Centers were asked to report their challenges and responses (n = 116) emphasized the difficulties in access to immunoglobulin products (16%) and reflected the ongoing need for education of both patients and referring physicians.

    Conclusions: This is the largest study of patients with X-linked agammaglobulinemia and emphasizes the continued morbidity and mortality of XLA despite progress in diagnosis and treatment. It presents a world view of the successes and challenges for patients and physicians alike. A pivotal finding is the need for education of physicians regarding typical symptoms suggesting a possible diagnosis of X-linked agammaglobulinemia and sharing of best practices for the less common complications.

  16. Alias H, Mohd Nazi NA, Lau Sie Chong D
    Front Pediatr, 2019;7:73.
    PMID: 30937299 DOI: 10.3389/fped.2019.00073
    Background: Low physical activity (PA) level has been reported among survivors of childhood acute lymphoblastic leukemia (ALL). The present study was performed to determine the level of participation in general PA and physical education in school (PES) among children with ALL who completed intensive chemotherapy and identify possible barriers that influence adherence to PA and PES. Methods: A cross-sectional, single-center study was conducted over 1 year in a tertiary pediatric hematology and oncology referral center in Kuala Lumpur, Malaysia. A total of 47 children with ALL aged 7-18 years old who were off-treatment and attended school on a regular basis were recruited. A modified structured questionnaire adapted from the Youth Risk Behavior Surveillance System, Division of Adolescent and School Health, the Centers for Disease Control and Prevention (CDC) was used to assess the children's level of PA and PES participation. Results: Among the 47 children will ALL included herein, 11 (23.4%) were physically active for at least 60 min a day for 5 days or more, following CDC recommendations. The median duration from completion of intensive chemotherapy was 4.95 years (25th, 3.29; 75th, 7.95). Younger age at study entry (median, 8.7 years old vs. 12.2 years old) and younger age at diagnosis (median, 2.9 years old vs. 4.3 years old) were significantly associated with higher PA level. Almost all children (45/47, 95.7%) participated in PES. Barriers to non-participation in PES mainly included exhaustion or fear of injury. Conclusions: Majority of the children with ALL included herein had low levels of daily PA after intensive chemotherapy. Nonetheless, their participation in PES was encouraging. PA should thus be promoted during and after cessation of ALL treatment to prevent long-term health risks and improve overall quality of life.
    MeSH terms: Adolescent; Centers for Disease Control and Prevention (U.S.); Child; Cross-Sectional Studies; Fear; Hematology; Humans; Malaysia; Physical Education and Training; Quality of Life; Surveys and Questionnaires; Referral and Consultation; Risk-Taking; School Health Services; School Nursing; Schools; United States; Exercise; Survivors; Precursor Cell Lymphoblastic Leukemia-Lymphoma
  17. Qureshi MI, Yusoff RM, Hishan SS, Alam AF, Zaman K, Rasli AM
    Environ Sci Pollut Res Int, 2019 May;26(15):15496-15509.
    PMID: 30937745 DOI: 10.1007/s11356-019-04866-z
    The natural catastrophic events largely damage the country's sustainability agenda through massive human fatalities and infrastructure destruction. Although it is partially supported the economic growth through the channel of "Schumpeter creative destruction" hypothesis, however, it may not be sustained in the long-run. This study examined the long-run and causal relationships between natural disasters (i.e., floods, storm, and epidemic) and per capita income by controlling FDI inflows and foreign aid in the context of Malaysia, during the period of 1965-2016. The study employed time series cointegration technique, i.e., autoregressive distributed lag (ARDL)-bounds testing approach for robust inferences. The results show that flood, storm, and epidemic disasters substantially decrease the country's per capita income, while FDI inflows and foreign aid largely supported the country's economic growth in the short-run. These results are disappeared in the long-run, where flood and storm disasters exhibit the positive association with the economic growth to support the Schumpeter creative destruction hypothesis. The foreign aid decreases the per capita income and does not maintain the "aid-effectiveness" hypotheses in a given country. The causality estimates confirmed the disaster-led growth hypothesis, as the causality estimates running from (i) storm to per capita income, (ii) epidemic to per capita income, and (iii) storm to foreign aid. The results emphasized for making disaster action plans to reduce human fatalities and infrastructure for sustainable development.
    MeSH terms: Disaster Planning; Humans; Income; International Cooperation; Malaysia; Floods; Economic Development/statistics & numerical data*; Policy
  18. Mahlia TMI, Ismail N, Hossain N, Silitonga AS, Shamsuddin AH
    Environ Sci Pollut Res Int, 2019 May;26(15):14849-14866.
    PMID: 30937750 DOI: 10.1007/s11356-019-04563-x
    Due to global warming and increasing price of fossil fuel, scientists all over the world have been trying to find reliable alternative fuels. One of the most potential candidates is renewable energy from biomass. The race for renewable energy from biomass has long begun and focused on to combat the deteriorating condition of the environment. Palm oil has been in the spotlight as an alternative of bioenergy sources to resolve fossil fuel problem due to its environment-friendly nature. This review will look deep into the origins of palm oil and how it is processed, bioproducts from this biomass, and oil palm biomass-based power plant in Malaysia. Palm oil is usually processed from oil palm fruits and other parts of the oil palm plant are candidates for raw material of bioproduct generation. Oil palm biomass can be turned into three subcategories: bioproduct, biofuels, and biopower. Focusing on biofuel, the biodiesel from palm oil will be explored in detail and its implication in Malaysia as one of the biggest producers of oil palm in the world will also be emphasized comprehensively. The paper presents the detail of a schematic flow diagram of a palm oil mill process of transforming oil palm into crude palm oil and it wastes. This paper will also discuss the current oil palm biomass power plants in Malaysia. Palm oil has been proven itself as a potential alternative to reduce negative environmental impact of global warming.
    MeSH terms: Malaysia; Power Plants*; Waste Management; Biomass; Biofuels*
  19. Loh HH, Lim LL, Loh HS, Yee A
    J Diabetes Investig, 2019 Nov;10(6):1490-1501.
    PMID: 30938074 DOI: 10.1111/jdi.13054
    AIMS/INTRODUCTION: Although patients with type 1 diabetes are medically exempt, many insist on fasting during Ramadan. Multiple daily insulin injections (MDI), premixed insulin and continuous subcutaneous insulin infusion (CSII) are commonly used. To date, little is known about the safety of Ramadan fasting in these patients.

    MATERIALS AND METHODS: We pooled data from 17 observational studies involving 1,699 patients treated with either CSII or non-CSII (including premixed and MDI) regimen. The study outcomes were the frequencies of hypoglycemia, hyperglycemia and/or ketosis. Given the lack of patient-level data, separate analyses for premixed and MDI regimen were not carried out.

    RESULTS: The CSII-treated group (n = 203) was older (22.9 ± 6.9 vs 17.8 ± 4.0 years), and had longer diabetes duration (116.7 ± 66.5 vs 74.8 ± 59.2 months) and lower glycated hemoglobin (7.8 ± 1.1% vs 9.1 ± 2.0%) at baseline than the non-CSII-treated group (n = 1,496). The non-CSII-treated group had less non-severe hypoglycemia than the CSII-treated group (22%, 95% CI 13-34 vs 35%, 95% CI 17-55). Of the non-CSII-treated group, 7.1% (95% CI 5.8-8.5) developed severe hypoglycemia, but none from the CSII-treated group did. The non-CSII-treated group was more likely to develop hyperglycemia (12%, 95% CI 3-25 vs 8.8%, 95% CI 0-31) and ketosis (2.5%, 95% CI 1.0-4.6 vs 1.6%, 95% CI 0.1-4.7), and discontinue fasting (55%, 95% CI 34-76 vs 31%, 95% CI 9-60) than the CSII-treated group.

    CONCLUSIONS: The CSII regimen had lower rates of severe hypoglycemia and hyperglycemia/ketosis, but a higher rate of non-severe hyperglycemia than premixed/MDI regimens. These suggest that appropriate patient selection with regular, supervised fine-tuning of the basal insulin rate with intensive glucose monitoring might mitigate the residual hypoglycemia risk during Ramadan.

    MeSH terms: Diabetes Mellitus, Type 1/drug therapy*; Drug Administration Schedule; Fasting; Humans; Hypoglycemia/prevention & control*; Hypoglycemic Agents/administration & dosage*; Insulin/administration & dosage*; Insulin Infusion Systems; Islam; Prognosis; Safety
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