Browse publications by year: 2021

Fulltext Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol

Uzzaman MN, Chan SC, Shunmugam RH, Engkasan JP, Agarwal D, Habib GMM, et al.

BMJ Open, 2021 10 12;11(10):e050362.
PMID: 34642195 DOI: 10.1136/bmjopen-2021-050362

INTRODUCTION: Chronic respiratory diseases (CRDs) are common and disabling conditions that can result in social isolation and economic hardship for patients and their families. Pulmonary rehabilitation (PR) improves functional exercise capacity and health-related quality of life (HRQoL) but practical barriers to attending centre-based sessions or the need for infection control limits accessibility. Home-PR offers a potential solution that may improve access. We aim to systematically review the clinical effectiveness, completion rates and components of Home-PR for people with CRDs compared with Centre-PR or Usual care.
METHODS AND ANALYSIS: We will search PubMed, CINAHL, Cochrane, EMBASE, PeDRO and PsycInfo from January 1990 to date using a PICOS search strategy (Population: adults with CRDs; Intervention: Home-PR; Comparator: Centre-PR/Usual care; Outcomes: functional exercise capacity and HRQoL; Setting: any setting). The strategy is to search for 'Chronic Respiratory Disease' AND 'Pulmonary Rehabilitation' AND 'Home-PR', and identify relevant randomised controlled trials and controlled clinical trials. Six reviewers working in pairs will independently screen articles for eligibility and extract data from those fulfilling the inclusion criteria. We will use the Cochrane risk-of-bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the quality of evidence. We will perform meta-analysis or narrative synthesis as appropriate to answer our three research questions: (1) what is the effectiveness of Home-PR compared with Centre-PR or Usual care? (2) what components are used in effective Home-PR studies? and (3) what is the completion rate of Home-PR compared with Centre-PR?
ETHICS AND DISSEMINATION: Research ethics approval is not required since the study will review only published data. The findings will be disseminated through publication in a peer-reviewed journal and presentation in conferences.
PROSPERO REGISTRATION NUMBER: CRD42020220137.

MeSH terms: Adult; Humans; Quality of Life; Respiration Disorders*; Meta-Analysis as Topic; Exercise; Treatment Outcome; Pulmonary Disease, Chronic Obstructive*
Fulltext Challenges and strategies for implementing Chinese medicine during COVID-19 in Malaysia

Teo CS, Tan PM, Shu CSI, Choo ZX, Te KK

Integr Med Res, 2021;10:100783.
PMID: 34642627 DOI: 10.1016/j.imr.2021.100783

Background: Implementing Chinese medicine (CM) for COVID-19 in Malaysia is challenging for local CM practitioners. The successful experience of CM in China can only be partially adopted in Malaysia due to differences in the national health care system and legislation, geographical health disparities and cultural diversity. Despite all the challenges, Malaysian CM practitioners have managed to thrive and found a Malaysian CM solution amid COVID-19.
Methods: A literature review was conducted using various databases and gray literature from inception to August 15, 2021, to evaluate the challenges faced by Malaysian CM practitioners and the corresponding strategies in Malaysia's country context during COVID-19.
Results: A total of 9 challenges and issues faced by Malaysian CM practitioners during COVID-19 were identified. Their corresponding strategies were further categorized into 3 phases, namely, preparation, development and implementation. The strategies were appraised using the SWOT analysis method, and 17 factors were identified. Strength analysis includes personalized CM prescriptions with online consultations in Malaysia. Limited research input for CM in COVID-19 and the inadequate research capacity of local CM institutions are discussed in threat analysis.
Conclusion: Various approaches have been implemented by Malaysian CM practitioners to provide safe, qualified and effective CM services for COVID-19 at the community level, aiming to reduce the national health care burden. A public-private partnership initiative can bridge the knowledge gap and optimize the role of CM in the health emergency system. This Malaysian CM solution can provide insights to interested countries to capitalize on the potential contribution of Traditional and Complementary Medicine (T&CM) in the era of COVID-19.
Fulltext Missed by RTK, caught by PCR, unimagined chest Radiograph

Mazlan MZ, Mohamad I, Deris ZZ

Vis J Emerg Med, 2021 Oct;25:101194.
PMID: 34642642 DOI: 10.1016/j.visj.2021.101194
Physicians' perceived barriers and enablers for deprescribing among older patients at public primary care clinics: a qualitative study

Tangiisuran B, Rajendran V, Sha'aban A, Daud NAA, Nawi SNM

Int J Clin Pharm, 2021 Oct 12.
PMID: 34642869 DOI: 10.1007/s11096-021-01336-w

Background Increased harmful effects of medication resulting from polypharmacy, especially among older patients, is a significant concern globally. Hence, continuous medication review and withdrawal of inappropriate medications are essential to improve patient safety. Objective To explore physicians' perceived barriers and enablers of deprescribing among older patients in the public primary healthcare setting. Setting Public primary care clinics in the northern states of Malaysia. Methods A semi-structured, face-to-face interview was conducted among physicians working in eight primary care clinics in northern Malaysia using a purposive sampling approach. Interviews were conducted using validated topic guides. All the responses were recorded, transcribed verbatim, validated, and analysed for the emerging themes using thematic analysis. Main outcome measure Physicians perceived barriers and enablers of deprescribing among geriatric patients. Results A total of eleven physicians were interviewed. Seven emerging themes were identified, which are categorised under barriers and enablers of deprescribing. The barriers were patient-specific, prescriber-specific, and healthcare provision and system. Prescriber deprescribing competencies, medication-specific outcomes, availability of empirical evidence, and pharmacist's role were the enablers identified. Conclusion Patient-specific barriers were identified as a significant challenge for deprescribing. Improving competencies on deprescribing was the repeatedly adduced enabler by physicians. The development of targeted educational training can help to reduce the obstacles faced by prescribers.
Fulltext Genome and Ecology of a Novel Alteromonas Podovirus, ZP6, Representing a New Viral Genus, Mareflavirus

Wang Z, Zhang F, Liang Y, Zheng K, Gu C, Zhang W, et al.

Microbiol Spectr, 2021 10 31;9(2):e0046321.
PMID: 34643440 DOI: 10.1128/Spectrum.00463-21

Alteromonas is a ubiquitous, abundant, copiotrophic and phytoplankton-associated marine member of the Gammaproteobacteria with a range extending from tropical waters to polar regions and including hadal zones. Here, we describe a novel Alteromonas phage, ZP6, that was isolated from surface coastal waters of Qingdao, China. ZP6 contains a linear, double-stranded, 38,080-bp DNA molecule with 50.1% G+C content and 47 putative open reading frames (ORFs). Three auxiliary metabolic genes were identified, encoding metal-dependent phosphohydrolase, diaminopurine synthetase, and nucleotide pyrophosphohydrolase. The first two ORFs facilitate the replacement of adenine (A) by diaminopurine (Z) in phage genomes and help phages to evade attack from host restriction enzymes. The nucleotide pyrophosphohydrolase enables the host cells to stop programmed cell death and improves the survival rate of the host in a nutrient-depleted environment. Phylogenetic analysis based on the amino acid sequences of whole genomes and comparative genomic analysis revealed that ZP6 is most closely related to Enhodamvirus but with low similarity (shared genes, <30%, and average nucleotide sequence identity, <65%); it is distinct from other bacteriophages. Together, these results suggest that ZP6 could represent a novel viral genus, here named Mareflavirus. Combining its ability to infect Alteromonas, its harboring of a diaminopurine genome-biosynthetic system, and its representativeness of an understudied viral group, ZP6 could be an important and novel model system for marine virus research. IMPORTANCE Alteromonas is an important symbiotic bacterium of phytoplankton, but research on its bacteriophages is still at an elementary level. Our isolation and genome characterization of a novel Alteromonas podovirus, ZP6, identified a new viral genus of podovirus, namely, Mareflavirus. The ZP6 genome, with a diaminopurine genome-biosynthetic system, is different from those of other isolated Alteromonas phages and will bring new impetus to the development of virus classification and provide important insights into novel viral sequences from metagenomic data sets.

MeSH terms: Bacteriophages/classification; Bacteriophages/genetics*; Bacteriophages/growth & development; Bacteriophages/isolation & purification*; China; Phylogeny; Seawater/virology; Open Reading Frames; Genome, Viral*; Myoviridae/classification; Myoviridae/genetics*; Myoviridae/isolation & purification*; Alteromonas/virology*
Autobiographical memory impairment among Rohingya refugee people: roles of direct and indirect trauma exposures and PTSD symptom severity

Khan S, Haque S

Cogn Emot, 2021 12;35(8):1573-1587.
PMID: 34644246 DOI: 10.1080/02699931.2021.1990018

Literature indicates that trauma exposure leads to autobiographical memory (AM) impairment, but the differential effects of direct and indirect trauma on memory remain unclear. We investigated AMs of 100 Rohingya refugees (Meanage = 35.79; SDage = 15.36) recruited from camps in Bangladesh and communities in Malaysia. Each participant retrieved ten memories to word cues and rated to what extent those memories were self-defining on a 5-point scale. They also completed the PTSD-8 scale and a trauma checklist reporting the types of traumatic events they experienced. Results showed that participants with frequent exposure to direct and indirect trauma recalled more traumatic memories. Surprisingly, more direct-trauma memories appeared to be specific than indirect trauma and non-trauma memories. As expected, individuals who scored higher on the PTSD-8 scale recalled more non-specific AMs. Rohingyas in Bangladesh who migrated months before data collection, thus retaining recent trauma experiences , retrieved more non-specific memories than those in Malaysia who migrated years ago. The direct trauma memories of the Malaysian cohort were more self-defining than their counterparts. The participant's ability to recall more direct trauma memories with specificity could be attributed to the repeated recall of those memories to the relevant authorities of the host countries to justify their refugee status.

MeSH terms: Humans; Mental Recall; Refugees*; Stress Disorders, Post-Traumatic*; Cohort Studies; Memory, Episodic*
Fulltext The current burden of Japanese encephalitis and the estimated impacts of vaccination: Combining estimates of the spatial distribution and transmission intensity of a zoonotic pathogen

Moore SM

PLoS Negl Trop Dis, 2021 10;15(10):e0009385.
PMID: 34644296 DOI: 10.1371/journal.pntd.0009385

Japanese encephalitis virus (JEV) is a major cause of neurological disability in Asia and causes thousands of severe encephalitis cases and deaths each year. Although Japanese encephalitis (JE) is a WHO reportable disease, cases and deaths are significantly underreported and the true burden of the disease is not well understood in most endemic countries. Here, we first conducted a spatial analysis of the risk factors associated with JE to identify the areas suitable for sustained JEV transmission and the size of the population living in at-risk areas. We then estimated the force of infection (FOI) for JE-endemic countries from age-specific incidence data. Estimates of the susceptible population size and the current FOI were then used to estimate the JE burden from 2010 to 2019, as well as the impact of vaccination. Overall, 1,543.1 million (range: 1,292.6-2,019.9 million) people were estimated to live in areas suitable for endemic JEV transmission, which represents only 37.7% (range: 31.6-53.5%) of the over four billion people living in countries with endemic JEV transmission. Based on the baseline number of people at risk of infection, there were an estimated 56,847 (95% CI: 18,003-184,525) JE cases and 20,642 (95% CI: 2,252-77,204) deaths in 2019. Estimated incidence declined from 81,258 (95% CI: 25,437-273,640) cases and 29,520 (95% CI: 3,334-112,498) deaths in 2010, largely due to increases in vaccination coverage which have prevented an estimated 314,793 (95% CI: 94,566-1,049,645) cases and 114,946 (95% CI: 11,421-431,224) deaths over the past decade. India had the largest estimated JE burden in 2019, followed by Bangladesh and China. From 2010-2019, we estimate that vaccination had the largest absolute impact in China, with 204,734 (95% CI: 74,419-664,871) cases and 74,893 (95% CI: 8,989-286,239) deaths prevented, while Taiwan (91.2%) and Malaysia (80.1%) had the largest percent reductions in JE burden due to vaccination. Our estimates of the size of at-risk populations and current JE incidence highlight countries where increasing vaccination coverage could have the largest impact on reducing their JE burden.

MeSH terms: Animals; Asia/epidemiology; Demography; Encephalitis Virus, Japanese/genetics; Encephalitis Virus, Japanese/immunology*; Encephalitis, Japanese/epidemiology; Encephalitis, Japanese/prevention & control*; Encephalitis, Japanese/transmission; Encephalitis, Japanese/virology; Humans; Vaccination; Japanese Encephalitis Vaccines/administration & dosage*; Japanese Encephalitis Vaccines/immunology
Fulltext Prevalence and management of aphids (Hemiptera: Aphididae) in different wheat genotypes and their impact on yield and related traits

Hafeez F, Abbas M, Zia K, Ali S, Farooq M, Arshad M, et al.

PLoS One, 2021;16(10):e0257952.
PMID: 34644343 DOI: 10.1371/journal.pone.0257952

Wheat (Triticum aestivum L.) production is significantly altered by the infestation of sucking insects, particularly aphids. Chemical sprays are not recommended for the management of aphids as wheat grains are consumed soon after crop harvests. Therefore, determining the susceptibility of different wheat genotypes and selecting the most tolerant genotype could significantly lower aphid infestation. This study evaluated the susceptibility of six different wheat genotypes ('Sehar-2006', 'Shafaq-2006', 'Faisalabad-2008', 'Lasani-2008', 'Millat-2011' and 'Punjab-2011') to three aphid species (Rhopalosiphum padi Linnaeus, Schizaphis graminum Rondani, Sitobion avenae Fabricius) at various growth stages. Seed dressing with insecticides and plant extracts were also evaluated for their efficacy to reduce the incidence of these aphid species. Afterwards, an economic analysis was performed to compute cost-benefit ratio and assess the economic feasibility for the use of insecticides and plant extracts. Aphids' infestation was recorded from the seedling stage and their population gradually increased as growth progressed towards tillering, stem elongation, heading, dough and ripening stages. The most susceptible growth stage was heading with 21.89 aphids/tiller followed by stem elongation (14.89 aphids/tiller) and dough stage (13.56 aphids/tiller). The genotype 'Punjab-2011' recorded the lower aphid infestation than 'Faisalabad-2008', 'Sehar-2006', 'Lasani-2008' and 'Shafaq-2006'. Rhopalosiphum padi appeared during mid-February, whereas S. graminum and S. avenae appeared during first week of March. Significant differences were recorded for losses in number of grains/spike and 1000-grain weight among tested wheat genotypes. The aphid population had non-significant correlation with yield-related traits. Hicap proved the most effective for the management of aphid species followed by Hombre and Husk among tested seed dressers, while Citrullus colocynthis L. and Moringa oleifera Lam. plant extracts exhibited the highest efficacy among different plant extracts used in the study. Economic analysis depicted that use of Hombre and Hicap resulted in the highest income and benefit cost ratio. Therefore, use of genotype Punjab-2011' and seed dressing with Hombre and Hicap can be successfully used to lower aphid infestation and get higher economic returns for wheat crop.

MeSH terms: Insect Control/methods*; Pest Control, Biological/methods*; Phenotype; Triticum/genetics*; Genetic Predisposition to Disease
Fulltext Safety and efficacy of very low carbohydrate diet in patients with diabetic kidney disease-A randomized controlled trial

Zainordin NA, Eddy Warman NA, Mohamad AF, Abu Yazid FA, Ismail NH, Chen XW, et al.

PLoS One, 2021;16(10):e0258507.
PMID: 34644368 DOI: 10.1371/journal.pone.0258507

INTRODUCTION: There is limited data on the effects of low carbohydrate diets on renal outcomes particularly in patients with underlying diabetic kidney disease. Therefore, this study determined the safety and effects of very low carbohydrate (VLCBD) in addition to low protein diet (LPD) on renal outcomes, anthropometric, metabolic and inflammatory parameters in patients with T2DM and underlying mild to moderate kidney disease (DKD).
MATERIALS AND METHODS: This was an investigator-initiated, single-center, randomized, controlled, clinical trial in patients with T2DM and DKD, comparing 12-weeks of low carbohydrate diet (<20g daily intake) versus standard low protein (0.8g/kg/day) and low salt diet. Patients in the VLCBD group underwent 2-weekly monitoring including their 3-day food diaries. In addition, Dual-energy x-ray absorptiometry (DEXA) was performed to estimate body fat percentages.
RESULTS: The study population (n = 30) had a median age of 57 years old and a BMI of 30.68kg/m2. Both groups showed similar total calorie intake, i.e. 739.33 (IQR288.48) vs 789.92 (IQR522.4) kcal, by the end of the study. The VLCBD group showed significantly lower daily carbohydrate intake 27 (IQR25) g vs 89.33 (IQR77.4) g, p<0.001, significantly higher protein intake per day 44.08 (IQR21.98) g vs 29.63 (IQR16.35) g, p<0.05 and no difference in in daily fat intake. Both groups showed no worsening of serum creatinine at study end, with consistent declines in HbA1c (1.3(1.1) vs 0.7(1.25) %) and fasting blood glucose (1.5(3.37) vs 1.3(5.7) mmol/L). The VLCBD group showed significant reductions in total daily insulin dose (39(22) vs 0 IU, p<0.001), increased LDL-C and HDL-C, decline in IL-6 levels; with contrasting results in the control group. This was associated with significant weight reduction (-4.0(3.9) vs 0.2(4.2) kg, p = <0.001) and improvements in body fat percentages. WC was significantly reduced in the VLCBD group, even after adjustments to age, HbA1c, weight and creatinine changes. Both dietary interventions were well received with no reported adverse events.
CONCLUSION: This study demonstrated that dietary intervention of very low carbohydrate diet in patients with underlying diabetic kidney disease was safe and associated with significant improvements in glycemic control, anthropometric measurements including weight, abdominal adiposity and IL-6. Renal outcomes remained unchanged. These findings would strengthen the importance of this dietary intervention as part of the management of patients with diabetic kidney disease.

MeSH terms: Adipose Tissue/physiology; Adult; Aged; Blood Glucose/analysis; Creatinine/blood; Diabetes Mellitus, Type 2/complications; Diabetic Nephropathies/complications; Diabetic Nephropathies/diet therapy*; Diabetic Nephropathies/pathology; Female; Hemoglobin A, Glycosylated/analysis; Humans; Cholesterol, HDL/blood; Cholesterol, LDL/blood; Male; Middle Aged; Severity of Illness Index; Absorptiometry, Photon; Body Mass Index; Treatment Outcome
Telemedicine acceptance during the COVID-19 pandemic: User satisfaction and strategic healthcare marketing considerations

Sabbir MM, Taufique KMR, Nomi M

Health Mark Q, 2021 10 13;38(2-3):168-187.
PMID: 34645357 DOI: 10.1080/07359683.2021.1986988

A lot remains unexplored regarding the antecedents and outcomes of telemedicine acceptance from health service marketing perspective. This study addresses this gap by integrating the Health Belief Model and the Unified Theory of Acceptance and Use of Technology model in the context of generation Y and Z's response to the COVID-19 pandemic. Data collected from 293 respondents were analyzed using structural equation modeling. The results confirm theoretical rigor of integrating two models examining the antecedents and user satisfaction as an outcome of telemedicine acceptance. The findings also suggest marketing strategies for implementing telemedicine during pandemic. Future research directions are highlighted.
Fulltext Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

Lim MX, Fong KK, Yeap TB

BMJ Case Rep, 2021 Oct 13;14(10).
PMID: 34645636 DOI: 10.1136/bcr-2021-245639

COVID-19 presents with a spectrum of severity, ranging from asymptomatic or mild symptoms to those with acute respiratory distress syndrome. Corticosteroids are widely used for their efficacy in reducing inflammatory responses. However, its use may be limited to patients with immunosuppression. An adjunct therapy for cytokine storm in COVID-19 is extracorporeal blood purification therapies using high adsorptive filters, such as oXiris, to remove cytokines. We share our experience in using continuous renal replacement therapy with oXiris haemofilter as a temporising measure to high-dose corticosteroids in managing cytokine storm in a deteriorating COVID-19 patient with concomitant bacterial infection.

MeSH terms: Adrenal Cortex Hormones; Bacterial Infections*; Humans; Respiratory Distress Syndrome, Adult*
Fulltext α-Fe2O3/graphene oxide powder and thin film nanocomposites as peculiar photocatalysts for dye removal from wastewater

Khoshnam M, Farahbakhsh J, Zargar M, Mohammad AW, Benamor A, Ang WL, et al.

Sci Rep, 2021 Oct 13;11(1):20378.
PMID: 34645890 DOI: 10.1038/s41598-021-99849-x

In this study, hematite graphene oxide (αFe2O3-GO) powder nanocomposites and thin-film hematite graphene oxide (αFe2O3-GO) were synthesized for application in the removal of Rhodamine B (RhB) from textile wastewater. αFe2O3-GO nanomaterials were placed onto the FTO substrate to form a thin layer of nanocomposites. Different analysis including XRD, FTIR, Raman spectra, XPS, and FESEM were done to analyze the morphology, structure, and properties of the synthesized composites as well as the chemical interactions of αFe2O3 with GO. The photocatalytic performance of two synthesized composites was compared with different concentrations of αFe2O3-GO. The results showed that powder nanocomposites are more effective than thin-film composites for the removal of RhB dye. αFe2O3-GO-5% powder nanocomposites removed over 64% of dye while thin-film nanocomposites had less removal efficiencies with just under 47% removal rate. The reusability test was done for both materials in which αFe2O3-GO-5% powder nanocomposites removed a higher rate of dye (up to 63%) in more cycles (6 cycles).
Publisher Correction: The chloroplast-associated protein degradation pathway controls chromoplast development and fruit ripening in tomato

Ling Q, Sadali NM, Soufi Z, Zhou Y, Huang B, Zeng Y, et al.

Nat Plants, 2021 Oct;7(10):1433.
PMID: 34646008 DOI: 10.1038/s41477-021-01018-5
Fulltext The Adverse Cardiovascular Effects and Cardiotoxicity of Kratom (Mitragyna speciosa Korth.): A Comprehensive Review

Leong Bin Abdullah MFI, Singh D

Front Pharmacol, 2021;12:726003.
PMID: 34646135 DOI: 10.3389/fphar.2021.726003

Background: Kratom or Mitragyna speciosa (Korth.) has received overwhelming attention recently due to its alleged pain-relieving effects. Despite its potential therapeutic value, kratom use has been linked to many occurrences of multiorgan toxicity and cardiotoxicity. Accordingly, the current narrative review aimed to provide a detailed account of kratom's adverse cardiovascular effects and cardiotoxicity risk, based on in vitro studies, poison center reports, coroner and autopsy reports, clinical case reports, and clinical studies. Methods: An electronic search was conducted to identify all research articles published in English from 1950 to 2021 using the major research databases, such as Google Scholar, Web of Science, PubMed, Scopus, Mendeley, EMBASE, Cochrane Library, and Medline. We then analyzed the literature's discussion of adverse cardiovascular effects, toxicity, and mortality related to kratom use. Results: Our findings revealed that, although in vitro studies have found kratom preparations' most abundant alkaloid-mitragynine-to cause a prolonged QTc interval and an increased risk of torsades de pointes, a clinical study examining humans' regular consumption of kratom did not report such a risk. However, this latter study did show that regular kratom use could induce an increased QTc interval in a dose-dependent manner. A few case reports also highlighted that kratom consumption is associated with ventricular arrhythmia and cardiopulmonary arrest, but this association could have ensued when kratom was co-administered with another substance. Similarly, analyses of national poison data showed that kratom's most common adverse acute cardiovascular effects include tachycardia and hypertension. Meanwhile, coroner and autopsy reports indicated that kratom's cardiovascular sequelae encompass coronary atherosclerosis, myocardial infarction, hypertensive cardiovascular disease, left ventricular hypertrophy, cardiac arrhythmia, cardiomegaly, cardiomyopathy, focal band necrosis in the myocardium, and myocarditis. Given the available data, we deduced that all cardiac eventualities reported in the literature could have been compounded by polysubstance use and unresolved underlying medical illnesses. Conclusion: Although kratom use has been associated with death and cardiotoxicity, especially at higher doses and when associated with other psychoactive drugs, the dearth of data and methodological limitations reported in existing studies do not allow a definitive conclusion, and further studies are still necessary to address this issue.
Fulltext Exogenous ethylene application on postharvest oil palm fruit bunches improves crude palm oil quality

Chew CL, Tan BA, Low JYS, Mohd Hakimi NIN, Kua SF, Lim CM

Food Sci Nutr, 2021 Oct;9(10):5335-5343.
PMID: 34646505 DOI: 10.1002/fsn3.2423

Quality and food safety are of paramount importance to the palm oil industry. In this work, we investigated the practicability of ethylene gas exogenous application on post-harvested oil palm fruit bunches to improve the crude palm oil (CPO) quality. The bunches were first exposed to ethylene gas for 24 hr to induce abscission of palm fruits from bunches. The detached fruits were then subjected to heat treatment, mechanical extraction, clarification and drying to produce CPO. Critical quality parameters of CPO produced, that is free fatty acid, deterioration of the bleachability index and triacylglycerol showed improvement with ethylene gas treatment. Contaminant content that is phosphorus, chloride, iron, and copper also showed a reduction in the CPO derived from ethylene-treated bunches. These findings corresponded with low levels of contaminants such as 3-monochloropropane-1,2-diol esters and glycidyl esters in refined oil. The implementation strategy and practicability of this method is herein proposed and discussed. Ethylene application not only improves the CPO quality, but could potentially enhance the process sustainability of palm oil mills.
Fulltext The effects of dual modification on functional, microstructural, and thermal properties of tapioca starch

Javadian N, Mohammadi Nafchi A, Bolandi M

Food Sci Nutr, 2021 Oct;9(10):5467-5476.
PMID: 34646517 DOI: 10.1002/fsn3.2506

The aim of this study was to investigate the effects of dual modification on the functional, microstructural, and thermal properties of tapioca starch. Tapioca starch was first hydrolyzed by 0.14 M HCl for 0, 6, 12, 18, and 24 hr and then hydroxypropylated by adding 0%, 10%, 20%, and 30% (v/w) propylene oxide. The degree of hydroxypropylation, solubility, water absorption, rheological, thermal, and microstructure characterization of dually modified tapioca starch was determined. Hydroxypropylation did not cause any considerable changes in the starch granular size and shape of tapioca starch. Acid hydrolysis disrupts the starch granules, and the starches with smaller sizes were produced. The degree of molar substitution (DS) of dual modified starches ranged from 0.118 to 0.270. The dual modified starches significantly had higher solubility than native starch (p
Fulltext Review of proposed different irradiation methods to inactivate food-processing viruses and microorganisms

Shahi S, Khorvash R, Goli M, Ranjbaran SM, Najarian A, Mohammadi Nafchi A

Food Sci Nutr, 2021 Oct;9(10):5883-5896.
PMID: 34646553 DOI: 10.1002/fsn3.2539

Coronaviruses, which have been enveloped nonsegmented positive-sense RNA viruses, were first mentioned in the mid-1960s and can attack people as well as a wide range of animals (including mammals and birds). Three zoonotic coronaviruses have been identified as the cause of large-scale epidemics over the last two decades: Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), and swine acute diarrhea syndrome (SADS). Epithelial cells in the respiratory and gastrointestinal tract are the principal targeted cells, and viral shedding occurs via these systems in diverse ways such as through fomites, air, or feces. Patients infected with the novel coronavirus (2019-nCoV) reported having visited the Wuhan seafood wholesale market shortly before disease onset. The clinical data on established 2019-nCoV cases reported so far indicate a milder disease course than that described for patients with SARS-CoV or MERS-CoV. This study aimed to review radiation inactivation of these viruses in the food industry in three sections: visible light, ionizing radiation (alpha ray, beta ray, X-ray, gamma ray, neutron, plasma, and ozone), and nonionizing radiation (microwave, ultraviolet, infrared, laser light, and radiofrequency). Due to the obvious possibility of human-to-human and animal-to-human transmission, using at least one of these three methods in food processing and packaging during coronavirus outbreaks will be critical for preventing further outbreaks at the community level.
Fulltext Isolated Traumatic Bitemporal Hemianopia

Ahmad Fauzi S, Nor Sharina Y, Ibrahim M

Cureus, 2021 Aug;13(8):e17593.
PMID: 34646645 DOI: 10.7759/cureus.17593

Bitemporal hemianopia is a rare presentation following severe head injury, which causes a delay in detection of the visual symptoms. This is a case of traumatic bitemporal hemianopia in a 20-year-old gentleman after an alleged motorbike accident. He was intubated following a severe head injury. The ophthalmologic assessment was performed after he regained consciousness and complained of acute blurring of vision in bilateral eyes. The visual acuity was 2/60 on the right eye and 4/60 on the left eye. Bilateral eyes anterior and posterior segments examination were unremarkable. Confrontation visual field testing discovered bitemporal hemianopia. Plain computed tomography (CT) scan of the brain showed right frontal bone fracture extending to the right orbital roof, superomedial wall of the right orbit, bilateral lamina papyracea, ethmoidal air cells, roof and bilateral walls of sphenoid sinus. He was treated conservatively by the ophthalmology team. Subsequent follow-ups showed improvement of visual acuity which were 6/6 on the right eye and 6/6 on the left eye. Humphrey visual field test confirmed the persistence of bitemporal hemianopia. His good visual acuity does not correlate with the severity of the field defect. Therefore, surveillance for bitemporal scotoma is necessary for all head injuries with severe midline facial bone fractures.
Fulltext Retinal Racemose Hemangioma With Optic Neuropathy in a Child

Ahmad Tarmizi NN, Bastion MC, Abdul Aziz RA, Md Din N, Mohd Khialdin S

Cureus, 2021 Aug;13(8):e17620.
PMID: 34646671 DOI: 10.7759/cureus.17620

The aim of this study is to report an unusual case of retinal racemose haemangioma (RRH) in a child resulting in optic neuropathy and its optical coherence tomography angiography (OCT-A) findings. This is a retrospective case report. For almost a year, a 13-year-old girl experienced gradual, painless, generalized blurred vision in her right eye. Visual acuity was 6/60 with a positive relative afferent pupillary defect (RAPD) in her right eye. The right-eye fundus showed enlarged and tortuous retinal vessels extending from the optic disc to all four quadrants, including the juxta foveal region. OCT analysis revealed distortion in the region of enlarged vessels with minimal retinal fluid while OCT-A of the macula area demonstrated dilated and tortuous vessels in the superficial layers of the retina. Right intra-orbital vascular channels surrounding the optic nerve with optic nerve atrophy and gliosis were detected on magnetic resonance imaging angiography/venography (MRA/MRV). The cerebral angiogram reported an abnormal tangle of small vessels within the right orbit that received supply from a dilated right ophthalmic artery indicating the presence of retro-orbital arteriovenous malformation (AVM). She was then referred to the neurosurgeon and a decision was made not to embolize or resect the dilated vessel as this might lead to occlusion of the ophthalmic artery and thus worsen her vision. RRH may present in the paediatric age group, and optic nerve atrophy is one of the disease manifestations. OCT-A is a less invasive diagnostic option compared to fundus fluorescein angiography (FFA) for diagnosis and monitoring of disease progression.
Fulltext Melioidosis-related mycotic aneurysm: Three cases

Tong TK, Shan G, Sibangun FJ, Keung BLD

IDCases, 2021;26:e01295.
PMID: 34646734 DOI: 10.1016/j.idcr.2021.e01295

Background: Melioidosis-related mycotic aneurysm (MA) is rare but a potentially life-threatening disease with high morbidity and mortality rate.
Case presentation: We report a case series of mycotic aneurysm caused by Burkholderia pseudomallei and the subsequent outcomes. Here, we illustrate their clinical characteristics, laboratory results, radiological findings, mode of therapies and clinical outcomes.
Conclusion: Melioidosis-associated MA may manifest in an atypical presentation. Its outcome is often lethal if antimicrobial therapy and surgical intervention are not offered promptly.

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