Browse publications by year: 2020

  1. Belton B, Little DC, Zhang W, Edwards P, Skladany M, Thilsted SH
    Nat Commun, 2020 11 16;11(1):5804.
    PMID: 33199697 DOI: 10.1038/s41467-020-19679-9
    Recent literature on marine fish farming brands it as potentially compatible with sustainable resource use, conservation, and human nutrition goals, and aligns with the emerging policy discourse of 'blue growth'. We advance a two-pronged critique. First, contemporary narratives tend to overstate marine finfish aquaculture's potential to deliver food security and environmental sustainability. Second, they often align with efforts to enclose maritime space that could facilitate its allocation to extractive industries and conservation interests and exclude fishers. Policies and investments that seek to increase the availability and accessibility of affordable and sustainable farmed aquatic foods should focus on freshwater aquaculture.
    MeSH terms: Animals; Fisheries; Fishes; Food Supply; Fresh Water; Goals; Humans; Aquaculture
  2. Yusoff FM, Kajikawa M, Takaeko Y, Kishimoto S, Hashimoto H, Maruhashi T, et al.
    Sci Rep, 2020 11 16;10(1):19891.
    PMID: 33199760 DOI: 10.1038/s41598-020-76886-6
    Cell therapy using intramuscular injections of autologous bone-marrow mononuclear cells (BM-MNCs) improves clinical symptoms and can prevent limb amputation in atherosclerotic peripheral arterial disease (PAD) patients with critical limb ischemia (CLI). The purpose of this study was to evaluate the effects of the number of implanted BM-MNCs on clinical outcomes in atherosclerotic PAD patients with CLI who underwent cell therapy. This study was a retrospective observational study with median follow-up period of 13.5 years (range, 6.8-15.5 years) from BM-MNC implantation procedure. The mean number of implanted cells was 1.2 ± 0.7 × 109 per limb. There was no significant difference in number of BM-MNCs implanted between the no major amputation group and major amputation group (1.1 ± 0.7 × 109 vs. 1.5 ± 0.8 × 109 per limb, P = 0.138). There was also no significant difference in number of BM-MNCs implanted between the no death group and death group (1.5 ± 0.9 × 109 vs. 1.8 ± 0.8 × 109 per patient, P = 0.404). Differences in the number of BM-MNCs (mean number, 1.2 ± 0.7 × 109 per limb) for cell therapy did not alter the major amputation-free survival rate or mortality rate in atherosclerotic PAD patients with CLI. A large number of BM-MNCs will not improve limb salvage outcome or mortality.
    MeSH terms: Aged; Bone Marrow Cells/cytology*; Extremities/physiopathology*; Female; Follow-Up Studies; Humans; Ischemia/pathology; Ischemia/therapy*; Male; Prognosis; Retrospective Studies; Transplantation, Autologous; Bone Marrow Transplantation/methods*; Limb Salvage*; Cell- and Tissue-Based Therapy/methods*
  3. Kiew R, Chung-Lu L
    PhytoKeys, 2020;166:57-77.
    PMID: 33199961 DOI: 10.3897/phytokeys.166.55778
    The Klang Gates Quartz Ridge (KGQR) is proposed for protection as National Heritage and as a UNESCO World Heritage Site because of its spectacular size, exceptional beauty and significant biodiversity. The checklist of vascular plants documents 314 species that comprise a unique combination that grows on lowland quartz and that is distinct from the surrounding lowland equatorial rain forest by the absence of orchids, palms, gingers and tree canopy families. The Rubiaceae, Gramineae, Moraceae, Apocynaceae, Melastomataceae and Polypodiaceae are the most speciose families. The summit vegetation at 200-400 m elevation is dominated by Baeckea frutescens (Myrtaceae) and Rhodoleia championii (Hamamelidaceae) and shows similarities to the plant community on rocky mountain peaks above 1500 m. About 11% of its species are endemic in Peninsular Malaysia and four are endemic to KGQR: Aleisanthia rupestris (Rubiaceae), Codonoboea primulina (Gesneriaceae), Spermacoce pilulifera (Rubiaceae), and Ilex praetermissa (Aquifoliaceae). All four are provisionally assessed as Critically Endangered. Two, Eulalia milsumi (Gramineae) and Sonerila prostrata (Melastomataceae), are endemic to KGQR and a few neighbouring smaller quartz dykes. They are assessed as Endangered. The KGQR is a fragile habitat and conservation management is urgently required to halt the spread of the aggressive alien grass, Pennisetum polystachion and to prevent further habitat degradation from visitors. Based on KGQR being a threatened habitat, its biodiverse flora, and endangered species, it qualifies as an Important Plant Area.
    MeSH terms: Animals; Beauty; Quartz; Trees; Rubiaceae; Ginger; Myrtaceae; Apocynaceae; Aquifoliaceae; Moraceae; Ilex; Pennisetum; Melastomataceae; Endangered Species; Checklist; Rainforest
  4. Oyewande AA, Iqbal B, Abdalla LF, Karim F, Khan S
    Cureus, 2020 Oct 14;12(10):e10947.
    PMID: 33200060 DOI: 10.7759/cureus.10947
    Obesity and diabetes both mediate their effects through insulin resistance and frequently co-exist. Insulin resistance is one of the key factors in the development of the metabolic syndrome. Adult females tend to develop obesity more frequently than males. One of the factors causing this difference is the pattern of changes that occur as females age from pre-menopausal to the post-menopausal stage, causing a change in the pattern of accumulation of fats. Several studies have explored and described the association between obesity and metabolic syndrome and their effect on type II diabetes. We conducted our literature search using PubMed and Google Scholar as our primary databases. We selected a total of 49 articles for review after applying the inclusion and exclusion criteria and removing the duplicate articles. We chose the full-text articles that were published in the English language only. The selected studies were randomized controlled trials and review papers. The reviewed articles showed that visceral fat, central obesity, and fasting blood sugar of post-menopausal is higher than in pre-menopausal women and needs adequate management. More studies are needed in the future to explore the patterns of the metabolic changes in obese females to provide early and better management of diabetes and prevent related complications.
  5. Shah K, Arfan M, Mahariq I, Ahmadian A, Salahshour S, Ferrara M
    Results Phys, 2020 Dec;19:103560.
    PMID: 33200064 DOI: 10.1016/j.rinp.2020.103560
    This work is the consideration of a fractal fractional mathematical model on the transmission and control of corona virus (COVID-19), in which the total population of an infected area is divided into susceptible, infected and recovered classes. We consider a fractal-fractional order

    SIR

    type model for investigation of Covid-19. To realize the transmission and control of corona virus in a much better way, first we study the stability of the corresponding deterministic model using next generation matrix along with basic reproduction number. After this, we study the qualitative analysis using "fixed point theory" approach. Next, we use fractional Adams-Bashforth approach for investigation of approximate solution to the considered model. At the end numerical simulation are been given by matlab to provide the validity of mathematical system having the arbitrary order and fractal dimension.
    MeSH terms: Disease Susceptibility; Humans; Models, Theoretical; Fractals; Coronavirus; Coronavirus Infections; Basic Reproduction Number
  6. Chua SC, Show PL, Chong FK, Ho YC
    Water Sci Technol, 2020 Nov;82(9):1833-1847.
    PMID: 33201847 DOI: 10.2166/wst.2020.409
    Increasing agricultural irrigation to counteract a soil moisture deficit has resulted in the production of hazardous agricultural wastewater with high turbidity and chemical oxygen demand (COD). An innovative, sustainable, and effective solution is needed to overcome the pollution and water scarcity issues caused by the agricultural anthropogenic processes. This research focused on a sustainable solution that utilized a waste (broken lentil) as natural coagulant for turbidity and COD removal in agricultural wastewater treatment. The efficiency of the lentil extract (LE), grafted lentil extract (LE-g-DMC) and aluminium sulphate (alum) coagulants was optimized through the response surface methodology. Three-level Box-Behnken design was used to statistically visualize the complex interactions of pH, concentration of coagulants and settling time. LE achieved a significant 99.55% and 79.87% removal of turbidity and COD at pH 4, 88.46 mg/L of LE and 6.9 minutes of settling time, whereas LE-g-DMC achieved 99.83% and 80.32% removal of turbidity and COD at pH 6.7, 63.08 mg/L of LE-g-DMC and 5 minutes of settling time. As compared to alum, LE-g-DMC required approximately 30% less concentration. Moreover, LE and LE-g-DMC also required 75% and 65% less settling time as compared to the alum. Both LE and LE-g-DMC produced flocs with excellent settling ability (5.77 mg/L and 4.48 mL/g) and produced a significant less volume of sludge (10.60 mL/L and 8.23 mL/L) as compared with the alum. The economic analysis and assessments have proven the feasibility of both lentil-based coagulants in agricultural wastewater treatment.
    MeSH terms: Alum Compounds; Sewage; Waste Disposal, Fluid; Water Purification*; Lens Plant*; Biological Oxygen Demand Analysis; Waste Water
  7. Bardhan M, Novera TM, Tabassum M, Islam MA, Jawad AH, Islam MA
    Water Sci Technol, 2020 Nov;82(9):1932-1949.
    PMID: 33201856 DOI: 10.2166/wst.2020.451
    In this study, activated carbon (AC) was prepared from agro-waste betel nut husks (BNH) through the chemical activation method. Different characterization techniques described the physicochemical nature of betel nut husks activated carbon (BNH-AC) through Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), scanning electron microscopy (SEM), and pH point of zero charge. Later, the produced AC was used for methylene blue (MB) adsorption via numerous batch experimental parameters: initial concentrations of MB dye (25-250 mg/L), contact time (0.5-24 hours) and initial pH (2-12). Dye adsorption isotherms were also assessed at three temperatures where the maximum adsorption capacity (381.6 mg/g) was found at 30 °C. The adsorption equilibrium data were best suited to the non-linear form of the Freundlich isotherm model. Additionally, non-linear pseudo-second-order kinetic model was better fitted with the experimental value as well. Steady motion of solute particles from the boundary layer to the BNH-AC's surface was the possible reaction dynamics concerning MB adsorption. Thermodynamic study revealed that the adsorption process was spontaneous and exothermic in nature. Saline water emerged as an efficient eluent for the desorption of adsorbed dye on AC. Therefore, the BNH-AC is a very promising and cost-effective adsorbent for MB dye treatment and has high adsorption capacity.
    MeSH terms: Adsorption; Areca; Charcoal; Hydrogen-Ion Concentration; Kinetics; Sodium Hydroxide; Thermodynamics; Spectroscopy, Fourier Transform Infrared
  8. Smallhorn-West P, Gordon S, Stone K, Ceccarelli D, Malimali S, Halafihi T, et al.
    PLoS One, 2020;15(11):e0241146.
    PMID: 33201891 DOI: 10.1371/journal.pone.0241146
    Despite increasing threats to Tonga's coral reefs from stressors that are both local (e.g. overfishing and pollution) and global (e.g. climate change), there is yet to be a systematic assessment of the status of the country's coral reef ecosystem and reef fish fishery stocks. Here, we provide a national ecological assessment of Tonga's coral reefs and reef fish fishery using ecological survey data from 375 sites throughout Tonga's three main island groups (Ha'apai, Tongatapu and Vava'u), represented by seven key metrics of reef health and fish resource status. Boosted regression tree analysis was used to assess and describe the relative importance of 11 socio-environmental variables associated with these key metrics of reef condition. Mean live coral cover across Tonga was 18%, and showed a strong increase from north to south correlated with declining sea surface temperature, as well as with increasing distance from each provincial capital. Tongatapu, the southernmost island group, had 2.5 times greater coral cover than the northernmost group, Vava'u (24.9% and 10.4% respectively). Reef fish species richness and density were comparable throughout Tongatapu and the middle island group, Ha'apai (~35 species/transect and ~2500 fish/km2), but were significantly lower in Vava'u (~24 species/transect and ~1700 fish/km2). Spatial patterns in the reef fish assemblage were primarily influenced by habitat-associated variables (slope, structural complexity, and hard coral cover). The biomass of target reef fish was greatest in Ha'apai (~820 kg/ha) and lowest in Vava'u (~340 kg/ha), and was negatively associated with higher human influence and fishing activity. Overall mean reef fish biomass values suggest that Tonga's reef fish fishery can be classified as moderately to heavily exploited, with 64% of sites having less than 500 kg/ha. This study provides critical baseline ecological information for Tonga's coral reefs that will: (1) facilitate ongoing management and research; and (2) enable accurate reporting on conservation targets locally and internationally.
    MeSH terms: Animals; Biophysics; Conservation of Natural Resources/methods; Fisheries; Fishes/physiology*; Humans; Temperature; Tonga; Ecosystem; Biomass; Anthozoa/physiology*; Biodiversity; Coral Reefs*
  9. Choi EK, Lee YS, Chern AKC, Jiampo P, Chutinet A, Hanafy DA, et al.
    Open Heart, 2020 11;7(2).
    PMID: 33184127 DOI: 10.1136/openhrt-2020-001343
    BACKGROUND AND PURPOSE: Real-world data about treatment convenience and satisfaction in Asian non-valvular atrial fibrillation (NVAF) patients after switching from vitamin K antagonists (VKAs) to non-VKA oral anticoagulants were evaluated.

    METHODS: In this non-interventional study involving 49 sites across five countries in Southeast Asia and South Korea, 379 stable NVAF patients who switched from VKA therapy to dabigatran during routine clinical practice were recruited and followed up for 6 months. Treatment convenience and satisfaction were evaluated using Perception on Anticoagulant Treatment Questionnaire-2 (PACT-Q2). Through post hoc analysis, factors associated with improved treatment convenience scores at visit 2 were described.

    RESULTS: Treatment convenience and satisfaction significantly improved after switching from VKAs to dabigatran at visit 2 and visit 3 (convenience: p<0.001 each vs baseline; satisfaction: p=0.0174 (visit 2), p=0.0004 (visit 3) compared with baseline). Factors predictive of higher (>80th percentile) response on treatment convenience were female sex, younger age (<75 years), higher baseline stroke risk, higher creatinine clearance and absence of concomitant hypertension, stroke or gastrointestinal diseases.

    CONCLUSION: Dabigatran was associated with a significant improvement in treatment convenience and satisfaction after switching from VKAs when used for stroke prevention in NVAF patients from Southeast Asia and South Korea.

    MeSH terms: Dabigatran/administration & dosage*; Dabigatran/adverse effects; Aged; Anticoagulants/administration & dosage*; Anticoagulants/adverse effects; Antithrombins/administration & dosage*; Antithrombins/adverse effects; Asia/epidemiology; Atrial Fibrillation/diagnosis; Atrial Fibrillation/drug therapy*; Atrial Fibrillation/epidemiology; Female; Humans; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Time Factors; Vitamin K/antagonists & inhibitors*; Treatment Outcome; Patient Satisfaction*; Stroke/diagnosis; Stroke/epidemiology; Stroke/prevention & control*; Drug Substitution*
  10. Colella JP, Agwanda BR, Anwarali Khan FA, Bates J, Carrión Bonilla CA, de la Sancha NU, et al.
    Science, 2020 11 13;370(6518):773-774.
    PMID: 33184198 DOI: 10.1126/science.abe4813
    MeSH terms: Specimen Handling*; Tissue Banks*
  11. May Z, Alam MK, Mahmud MS, Rahman NAA
    PLoS One, 2020;15(11):e0242022.
    PMID: 33186372 DOI: 10.1371/journal.pone.0242022
    Damage assessment is a key element in structural health monitoring of various industrial applications to understand well and predict the response of the material. The big uncertainty in carbon fiber composite materials response is because of variability in the initiation and propagation of damage. Developing advanced tools to design with composite materials, methods for characterizing several damage modes during operation are required. While there is a significant amount of work on the analysis of acoustic emission (AE) from different composite materials and many loading cases, this research focuses on applying an unsupervised clustering method for separating AE data into several groups with distinct evolution. In this paper, we develop an adaptive sampling and unsupervised bivariate data clustering techniques to characterize the several damage initiations of a composite structure in different lay-ups. An adaptive sampling technique pre-processes the AE features and eliminates redundant AE data samples. The reduction of unnecessary AE data depends on the requirements of the proposed bivariate data clustering technique. The bivariate data clustering technique groups the AE data (dependent variable) with respect to the mechanical data (independent variable) to assess the damage of the composite structure. Tensile experiments on carbon fiber reinforced composite laminates (CFRP) in different orientations are carried out to collect mechanical and AE data and demonstrate the damage modes. Based on the mechanical stress-strain data, the results show the dominant damage regions in different lay-ups of specimens and the definition of the different states of damage. In addition, the states of the damage are observed using Scanning Electron Microscope (SEM) analysis. Based on the AE data, the results show that the strong linear correlation between AE and mechanical energy, and the classification of various modes of damage in all lay-ups of specimens forming clusters of AE energy with respect to the mechanical energy. Furthermore, the validation of the cluster-based characterization and improvement of the sensitivity of the damage modes classification are observed by the combined knowledge of AE and mechanical energy and time-frequency spectrum analysis.
    MeSH terms: Acoustics; Composite Resins/chemistry*; Materials Testing/methods; Stress, Mechanical; Cluster Analysis
  12. Tilley A, Dos Reis Lopes J, Wilkinson SP
    PLoS One, 2020;15(11):e0234760.
    PMID: 33186386 DOI: 10.1371/journal.pone.0234760
    Small-scale fisheries are responsible for landing half of the world's fish catch, yet there are very sparse data on these fishing activities and associated fisheries production in time and space. Fisheries-dependent data underpin scientific guidance of management and conservation of fisheries systems, but it is inherently difficult to generate robust and comprehensive data for small-scale fisheries, particularly given their dispersed and diverse nature. In tackling this challenge, we use open source software components including the Shiny R package to build PeskAAS; an adaptable and scalable digital application that enables the collation, classification, analysis and visualisation of small-scale fisheries catch and effort data. We piloted and refined this system in Timor-Leste; a small island developing nation. The features that make PeskAAS fit for purpose are that it is: (i) fully open-source and free to use (ii) component-based, flexible and able to integrate vessel tracking data with catch records; (iii) able to perform spatial and temporal filtering of fishing productivity by fishing method and habitat; (iv) integrated with species-specific length-weight parameters from FishBase; (v) controlled through a click-button dashboard, that was co-designed with fisheries scientists and government managers, that enables easy to read data summaries and interpretation of context-specific fisheries data. With limited training and code adaptation, the PeskAAS workflow has been used as a framework on which to build and adapt systematic, standardised data collection for small-scale fisheries in other contexts. Automated analytics of these data can provide fishers, managers and researchers with insights into a fisher's experience of fishing efforts, fisheries status, catch rates, economic efficiency and geographic preferences and limits that can potentially guide management and livelihood investments.
    MeSH terms: Animals; Data Collection; Developing Countries; Fisheries; Government; Software; Ecosystem; Timor-Leste; Workflow; Islands
  13. Rahman ME, Bin Halmi MIE, Bin Abd Samad MY, Uddin MK, Mahmud K, Abd Shukor MY, et al.
    Int J Environ Res Public Health, 2020 Nov 11;17(22).
    PMID: 33187288 DOI: 10.3390/ijerph17228339
    Constructed wetlands (CWs) are affordable and reliable green technologies for the treatment of various types of wastewater. Compared to conventional treatment systems, CWs offer an environmentally friendly approach, are low cost, have fewer operational and maintenance requirements, and have a high potential for being applied in developing countries, particularly in small rural communities. However, the sustainable management and successful application of these systems remain a challenge. Therefore, after briefly providing basic information on wetlands and summarizing the classification and use of current CWs, this study aims to provide and inspire sustainable solutions for the performance and application of CWs by giving a comprehensive review of CWs' application and the recent development of their sustainable design, operation, and optimization for wastewater treatment. To accomplish this objective, thee design and management parameters of CWs, including macrophyte species, media types, water level, hydraulic retention time (HRT), and hydraulic loading rate (HLR), are discussed. Besides these, future research on improving the stability and sustainability of CWs are highlighted. This article provides a tool for researchers and decision-makers for using CWs to treat wastewater in a particular area. This paper presents an aid for informed analysis, decision-making, and communication. The review indicates that major advances in the design, operation, and optimization of CWs have greatly increased contaminant removal efficiencies, and the sustainable application of this treatment system has also been improved.
    MeSH terms: Costs and Cost Analysis; Wetlands*; Waste Water/analysis
  14. Wong XZ, Gan CC, Mohamed R, Yahya R, Ganapathy S, Tan SS, et al.
    BMC Nephrol, 2020 11 13;21(1):480.
    PMID: 33187498 DOI: 10.1186/s12882-020-02154-4
    BACKGROUND: Hepatitis C virus (HCV) infects more than 71 million people worldwide and chronic HCV infection increases the risk of liver cirrhosis and failure. Haemodialysis (HD) is one of the renal replacement therapies with risk of HCV transmission. Anti-HCV antibodies are the serological screening test for HCV infection that does not detect active phase of infection. Majority HCV infected HD patients in Malaysia do not have further HCV RNA performed due to high cost and thus HCV treatment is less frequently offered. HCV Core Antigen (HCV Ag) can potentially be used to diagnose active HCV infection in HD population in comparison to HCV RNA, at lower cost.

    METHODS: We conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.

    RESULTS: We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04 ± 11.62 years, HD vintage of 14.1 ± 9.7 years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p  3000 IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p 

    MeSH terms: Adult; Aged; Cross-Sectional Studies; Dialysis; Follow-Up Studies; Renal Dialysis; Hepatitis C; Humans; Liver Cirrhosis; Malaysia; Male; Middle Aged; Predictive Value of Tests; RNA; Silver; Prevalence; Hepacivirus; Renal Replacement Therapy; Hepatitis C Antigens; Hepatitis C Antibodies; Hepatitis C, Chronic
  15. Thampy HK, Ramani S, McKimm J, Nadarajah VD
    Clin Teach, 2020 Aug;17(4):430-432.
    PMID: 33189096 DOI: 10.1111/tct.13216
  16. Kobayashi MJ, Ng KKS, Lee SL, Muhammad N, Tani N
    Am J Bot, 2020 11;107(11):1491-1503.
    PMID: 33190268 DOI: 10.1002/ajb2.1557
    PREMISE: Leaf phenology is an essential developmental process in trees and an important component in understanding climate change. However, little is known about the regulation of leaf phenology in tropical trees.

    METHODS: To understand the regulation by temperature of leaf phenology in tropical trees, we performed daily observations of leaf production under rainfall-independent conditions using saplings of Shorea leprosula and Neobalanocarpus heimii, both species of Dipterocarpaceae, a dominant tree family of Southeast Asia. We analyzed the time-series data obtained using empirical dynamic modeling (EDM) and conducted growth chamber experiments.

    RESULTS: Leaf production by dipterocarps fluctuated in the absence of fluctuation in rainfall, and the peaks of leaf production were more frequent than those of day length, suggesting that leaf production cannot be fully explained by these environmental factors, although they have been proposed as regulators of leaf phenology in dipterocarps. Instead, EDM suggested a causal relationship between temperature and leaf production in dipterocarps. Leaf production by N. heimii saplings in chambers significantly increased when temperature was increased after long-term low-temperature treatment. This increase in leaf production was observed even when only nighttime temperature was elevated, suggesting that the effect of temperature on development is not mediated by photosynthesis.

    CONCLUSIONS: Because seasonal variation in temperature in the tropics is small, effects on leaf phenology have been overlooked. However, our results suggest that temperature is a regulator of leaf phenology in dipterocarps. This information will contribute to better understanding of the effects of climate change in the tropics.

    MeSH terms: Asia, Southeastern; Seasons; Temperature; Trees; Plant Leaves; Dipterocarpaceae*
  17. Singh D, Narayanan S, Abdullah MFIL, Vicknasingam B
    J Ethn Subst Abuse, 2020 Nov 16.
    PMID: 33190622 DOI: 10.1080/15332640.2020.1845899
    Out-of-treatment HIV positive opiate users often engage in risky injecting and sexual behaviors. We sought the self-reported experiences on whether or not kratom (Mitragyna speciosa Korth.) use was associated with a reduction in HIV risk behaviors among them. A convenience sample consisting of thirty-two HIV positive opiate users participated in the study. Of this, three-fifths (n = 20/32) used kratom to suppress opiate withdrawal, increase energy, as a heroin substitute, to reduce heroin dependence and self-treat psychological problems. More than one-third (38%) in the sample claimed that kratom use reduced their risky injecting and sexual behaviors. Given the small sample size, the perceived association between kratom use and the reduction in HIV risk behaviors could not be established more convincingly. However, the findings provide the basis for a broader-based study to evaluate the potential of kratom in curtailing HIV risk behaviors among HIV positive opiate users.
  18. Dellemin NA, Zahari Z, Ahmad Hassali MA, Rashid SA
    Pak J Pharm Sci, 2020 May;33(3):1057-1061.
    PMID: 33191229
    Recent years, the prevalence of paracetamol allergy becomes great concerns. However, data on knowledge, attitude and perception towards allergic reactions of paracetamol are lacking. This study aimed to investigate knowledge, attitude, and perception towards allergic reactions of paracetamol (KAP-ARP). A cross-sectional survey was conducted using a validated self-administered questionnaire around Pasar Siti Khadijah, Kelantan from February 2016 to January 2017 among the general population. A total of 177 respondents participated in this study. The mean percentage scores for knowledge, attitude and perception towards allergic reactions of paracetamol were 31.7% (SD 23.6), 53.1% (SD 19.2) and 53.3% (SD 23.9), respectively. This study revealed that respondents demonstrated a poor level of knowledge, a fair level of attitude and negative perception towards allergic reactions of paracetamol. These results may lay a basis for conducting a study of knowledge, attitude and perception towards allergic reactions among general population in other different setting or around Malaysia.
    MeSH terms: Acetaminophen/adverse effects*; Adolescent; Adult; Cross-Sectional Studies; Drug Hypersensitivity/etiology*; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Middle Aged; Surveys and Questionnaires; Risk Factors; Risk Assessment; Analgesics, Non-Narcotic/adverse effects*; Young Adult
  19. Abdullah A, Ng CJ, Liew SM, Ambigapathy S, V P, Chinna K
    BMJ Open, 2020 Nov 14;10(11):e039864.
    PMID: 33191262 DOI: 10.1136/bmjopen-2020-039864
    OBJECTIVE: Limited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factors that are associated with it.

    DESIGN: A cross-sectional study was conducted from January to March 2018; data on patients' sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47).

    SETTING: Patients were recruited from four primary care clinics in Perak, Malaysia.

    PARTICIPANTS: Adult patients diagnosed with T2DM who attended the study clinics during the study period.

    PRIMARY OUTCOME VARIABLE: Patients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy.

    RESULTS: The prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients' ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy.

    CONCLUSION: The prevalence of limited health literacy is high among patients with T2DM in Perak, Malaysia. Strategies to improve health literacy in these patients must consider the influences of English fluency, attendance at diabetes education sessions and social support, and may need to adopt a universal approach to addressing limited health literacy.

    MeSH terms: Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Surveys and Questionnaires; Prevalence; Health Literacy*
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