Browse publications by year: 2021

  1. Kow CS, Hasan SS
    Inflammopharmacology, 2021 Aug;29(4):1075-1090.
    PMID: 34241782 DOI: 10.1007/s10787-021-00839-2
    This paper aims to summarize through meta-analyses the overall vaccine effectiveness of the BNT162b2 mRNA vaccine from observational studies. A systematic literature search with no language restriction was performed in electronic databases to identify eligible observational studies which reported the adjusted effectiveness of the BNT162b2 mRNA vaccine to prevent RT-PCR confirmed COVID-19. Meta-analyses with the random-effects model were used to calculate the pooled hazard ratio (HR) and pooled incidence rate ratio (IRR) at 95% confidence intervals, and the vaccine effectiveness was indicated as (pooled HR - 1)/HR or (pooled IRR - 1)/IRR. Nineteen studies were included for this meta-analysis. The meta-analysis revealed significant protective effect against RT-PCR confirmed COVID-19 ≥ 14 days after the first dose, with vaccine effectiveness of 53% (95% confidence interval 32-68%), and ≥ 7 days after the second dose, with vaccine effectiveness of 95% (95% confidence interval: 96-97%). Despite its effectiveness, reporting vaccine safety data by relevant stakeholders should be encouraged as BNT162b2 mRNA is a new vaccine that has not gained full approval. There have been limited data about vaccine effectiveness among immunocompromised patients; thus, the vaccine should be used cautiously in this patient population.
    MeSH terms: Humans; Treatment Outcome; Pragmatic Clinical Trials as Topic/methods*; Observational Studies as Topic/methods*
  2. Khalil M, Fahmi A, Nizardo NM, Amir Z, Mohamed Jan B
    Langmuir, 2021 Jul 09.
    PMID: 34242029 DOI: 10.1021/acs.langmuir.1c01271
    An investigation on the application of thermosensitive core-shell Fe3O4@PNIPAM nanogels in enhanced oil recovery was successfully performed. Here, the unique core-shell architecture was fabricated by conducting the polymerization at the surface of 3-butenoic acid-functionalized Fe3O4 nanoparticles and characterized using X-ray diffraction (XRD), 1H NMR, vibration sample magnetometer (VSM), and high-resolution transmission electron microscopy (HR-TEM). According to the results, this core-shell structure was beneficial for achieving the desired high viscosity and low nanofluid mobility ratio at high temperatures, which is essential for enhanced oil recovery (EOR) application. The results demonstrated that the nanogels exhibited a unique temperature-dependent flow behavior due to the PNIPAM shell's ability to transform from a hydrated to a dehydrated state above its low critical solution temperature (LCST). At such conditions, the nanogels exhibited a significantly low mobility ratio (M = 0.86), resulting in an even displacement front during EOR and leads to higher oil production. Based on the result obtained from sand pack flooding, about 25.75% of an additional secondary oil recovery could be produced when the nanofluid was injected at a temperature of 45 °C. However, a further increase in the flooding temperature could result in a slight reduction in oil recovery due to the precipitation of some of the severely aggregated nanogels at high temperatures.
  3. Lim VC, Justine EV, Yusof K, Wan Mohamad Ariffin WNS, Goh HC, Fadzil KS
    PLoS One, 2021;16(7):e0253740.
    PMID: 34242233 DOI: 10.1371/journal.pone.0253740
    Protected areas in Malaysia have always been managed using top-down approach that often exclude the local communities, who are the main users of ecosystem services, from the planning and management. However, a newly established multiple-use marine park in Malaysia, Tun Mustapha Park (TMP), aims for inclusivity in managing the park. This research explores different participatory approaches (i.e. participatory mapping and Photovoice) to understand the ecosystem services and the dynamics surrounding the services in TMP. Community-based organisations and a mariculture farm in TMP were invited to participate in this work. The participants mapped the ecosystem services and provided in-depth qualitative data that supported the maps, besides highlighting ecological, sociocultural and economic issues surrounding the ecosystem services. Furthermore, the participants provided suggestions and recommendations that carry political effects. Therefore, the participatory approaches employed here had provided rich visual and spatial data to enhance the ecosystem-based management of TMP besides empowering the participants to voice out for their communities. The results generated from this work were also further utilised to fill in the gaps of knowledge in a separate ecosystem service assessment matrix. However, the output from participatory approaches should not be considered as the ultimate outcome but rather as supplement to the planning and management of TMP due to potential human errors and biases. Although the participatory approaches came with limitations and challenges that may have affected the findings here, these nonetheless had provided support to the capability of local communities to provide information crucial for management of protected areas as well as room for improvement for further work.
    MeSH terms: Adult; Aged; Conservation of Natural Resources/methods*; Female; Humans; Malaysia; Male; Middle Aged; Ecosystem*; Community-Based Participatory Research/methods*; Young Adult
  4. Lau MN, Kamarudin Y, Zakaria NN, Sivarajan S, Mohd Tahir NNZ, Bahar AD, et al.
    PLoS One, 2021;16(7):e0254478.
    PMID: 34243187 DOI: 10.1371/journal.pone.0254478
    Flipped classroom may overcome weaknesses of live demonstration in teaching orthodontic wire-bending. This study aims to compare the effectiveness between flipped classroom and live demonstration in transferring skills for fabricating Adams clasp. Forty third-year undergraduate dental students were assigned to two groups. The students in group LD (n = 20) attended a live demonstration while students in group FC (n = 20) attended a flipped classroom. Both groups were taught on skills to fabricate Adams clasp in a standardised way. Each student from both groups were asked to submit an Adams clasp for a blinded quality assessment by two trained and calibrated assessors using a 18-item rubric, followed by validated students' satisfaction questionnaires to evaluate their perceived satisfaction on the teaching method received. A crossover study was then conducted three weeks later where LD attended a flipped classroom while FC attended a live demonstration. Students' satisfaction questionnaires were again collected from each student for blinded analysis. Mean scores for the quality of Adams clasp were 9.775 and 9.125 for LD and FC, respectively. No significant difference was detected between the two groups. Statistically significant association was found for one statement on the questionnaire, "I found the classroom arrangements conducive for the wire-bending activity" (p = 0.010). No significant differences were found between the two groups for other statements (p > 0.05). In conclusion, within the limitations of the study, flipped classroom is equally effective as conventional live demonstration in transferring orthodontic wire-bending skills for fabrication of Adams clasp. However, students perceived the classroom arrangements during the flipped classroom significantly more conducive for teaching orthodontic wire-bending.
    MeSH terms: Female; Humans; Male; Orthodontic Wires*; Surveys and Questionnaires; Cross-Over Studies; Problem-Based Learning/methods
  5. Ngan OMY, Sanip S
    Asia Pac J Public Health, 2021 11;33(8):983-984.
    PMID: 34243675 DOI: 10.1177/10105395211031367
    MeSH terms: Hong Kong/epidemiology; Humans; Malaysia/epidemiology; Transients and Migrants*; Pandemics
  6. Nair P, Gill JS, Sulaiman AH, Koh OH, Francis B
    Asia Pac J Public Health, 2021 11;33(8):940-944.
    PMID: 34243684 DOI: 10.1177/10105395211032094
    MeSH terms: Aged; Aged, 80 and over; Humans; Nursing Homes; Risk Factors; Pandemics*
  7. Chiong F, Wasef MS, Liew KC, Cowan R, Tsai D, Lee YP, et al.
    BMC Infect Dis, 2021 Jul 09;21(1):671.
    PMID: 34243714 DOI: 10.1186/s12879-021-06372-5
    BACKGROUND: Pseudomonas aeruginosa bacteraemia (PAB) is associated with high mortality. The benefits of infectious diseases consultation (IDC) has been demonstrated in Staphylococcal aureus bacteraemia and other complex infections. Impact of IDC in PAB is unclear. This study aimed to evaluate the impact of IDC on the management and outcomes in patients with PAB.

    METHODS: This is a retrospective cohort single-centre study from 1 November 2006 to 29 May 2019, in all adult patients admitted with first episode of PAB. Data collected included demographics, clinical management and outcomes for PAB and whether IDC occurred. In addition, 29 Pseudomonas aeruginosa (PA) stored isolates were available for Illumina whole genome sequencing to investigate if pathogen factors contributed to the mortality.

    RESULTS: A total of 128 cases of PAB were identified, 71% received IDC. Patients who received IDC were less likely to receive inappropriate duration of antibiotic therapy (4.4%; vs 67.6%; p 

    MeSH terms: Adult; Aged; Anti-Bacterial Agents/therapeutic use*; Female; Humans; Male; Middle Aged; Prospective Studies; Pseudomonas aeruginosa*; Pseudomonas Infections/drug therapy*; Pseudomonas Infections/mortality; Pseudomonas Infections/surgery; Referral and Consultation*; Retrospective Studies; Cohort Studies; Odds Ratio; Bacteremia/drug therapy*; Bacteremia/mortality; Bacteremia/surgery; Treatment Outcome
  8. Biswas R, Lugo A, Genitsaridi E, Trpchevska N, Akeroyd MA, Cederroth CR, et al.
    Prog Brain Res, 2021;263:1-24.
    PMID: 34243884 DOI: 10.1016/bs.pbr.2021.04.005
    INTRODUCTION: Tinnitus is a symptom and not a disease in its own right. A number of medical conditions are known to increase the risk of developing tinnitus. Most known risk factors are otological or neurological, but general health and lifestyle can also precipitate the condition. Understanding these modifiable risk factors can help to identify vulnerable groups and can inform preventive actions to reduce likelihood of developing tinnitus. Smoking, alcohol consumption, body mass index (BMI) and caffeine intake are all lifestyle risk factors hypothesized to be related to tinnitus. Nonetheless, research findings in support of those relationships are somewhat mixed.

    METHODS: A systematic review was conducted to identify all relevant studies on the specific risk factors. Findings were summarized using a narrative synthesis and meta-analysis, where possible.

    RESULTS: Overall 384 studies were included, mostly using cross-sectional designs. Findings indicated significantly increased risk of tinnitus among current (based on 26 studies) and ever smokers (based on 16 studies) and among obese people (based on seven studies), but no effect of alcohol consumption (based on 11 studies). With respect to caffeine intake or coffee drinking, only three studies examined this risk factor and so we were unable to draw conclusions.

    CONCLUSION: Our results contribute to quantifying the relationship between tinnitus and specific lifestyle-related risk factors, and we highlight some of the gaps and inconsistencies across published studies.

    MeSH terms: Cross-Sectional Studies; Humans; Life Style; Risk Factors; Smoking; Body Mass Index
  9. Genitsaridi E, Kypraios T, Edvall NK, Trpchevska N, Canlon B, Hoare DJ, et al.
    Prog Brain Res, 2021;263:59-80.
    PMID: 34243891 DOI: 10.1016/bs.pbr.2021.04.006
    The spatial percept of tinnitus is hypothesized as an important variable for tinnitus subtyping. Hearing asymmetry often associates with tinnitus laterality, but not always. One of the methodological limitations for cross-study comparisons is how the variables for hearing asymmetry and tinnitus spatial perception are defined. In this study, data from two independent datasets were combined (n=833 adults, age ranging from 20 to 91 years, 404 males, 429 females) to investigate characteristics of subgroups with different tinnitus spatial perception focusing on hearing asymmetry. Three principle findings emerged. First, a hearing asymmetry variable emphasizing the maximum interaural difference most strongly discriminated unilateral from bilateral tinnitus. Merging lateralized bilateral tinnitus (perceived in both ears but worse in one side) with unilateral tinnitus weakened this relationship. Second, there was an association between unilateral tinnitus and ipsilateral asymmetric hearing. Third, unilateral and bilateral tinnitus were phenotypically distinct, with unilateral tinnitus being characterized by older age, asymmetric hearing, more often wearing one hearing aid, older age at tinnitus onset, shorter tinnitus duration, and higher percentage of time being annoyed by tinnitus. We recommend that careful consideration is given to the definitions of hearing asymmetry and tinnitus spatial perception in order to improve the comparability of findings across studies.
    MeSH terms: Adult; Aged; Aged, 80 and over; Female; Hearing; Humans; Functional Laterality; Male; Middle Aged; Young Adult
  10. Wong QY, Tang ASO, Loh WH, Yong XM, Samuel D, Law WC, et al.
    Am J Case Rep, 2021 Jul 10;22:e932852.
    PMID: 34244464 DOI: 10.12659/AJCR.932852
    BACKGROUND Tuberculosis is prevalent, especially in low-income countries. The most devastating manifestation of tuberculosis is central nervous system (CNS) involvement, albeit rare. CASE REPORT We report a rare case of a 26-year-old woman with morbid obesity and hepatitis C who had cerebral tuberculoma and was treated with an extended duration of anti-tuberculosis multi-drug therapy. This patient was initially diagnosed with disseminated tuberculosis of the lungs, liver, and peritoneum. After 4 months of anti-tuberculosis treatment, she developed new right temporal hemianopia and new cerebral tuberculoma, which was identified on repeated magnetic resonance imaging (MRI) and was attributed to tuberculosis-immune reconstitution inflammatory syndrome. The anti-tuberculosis treatment was continued; however, she gained large amounts of weight, which resulted in the failure of the anti-tuberculosis treatment of the cerebral tuberculoma. We decided to adjust the anti-tuberculosis drug dosage using her total body weight, and she responded well, with a decrease in size of the cerebral tuberculoma. The anti-tuberculosis treatment was subsequently stopped after 3 years because of clinical and imaging improvement. CONCLUSIONS This case illustrates the challenges faced in the treatment of cerebral tuberculoma, which, in this case, included a high body mass index affecting drug dosage and confounding an inadequate treatment response as seen on interim MRI, resulting in prolonged duration of anti-tuberculosis treatment. Persistent enhancement seen on brain MRI does not equate to treatment failure.
    MeSH terms: Adult; Antitubercular Agents/therapeutic use; Female; Humans; Magnetic Resonance Imaging; Tuberculosis*
  11. Abdullah HSTSH, Chia PW, Omar D, Chuah TS
    Sci Rep, 2021 07 09;11(1):14227.
    PMID: 34244589 DOI: 10.1038/s41598-021-93662-2
    Herbicide resistance is a worldwide problem in weed control. This prompts researchers to look for new modes of action to slow down the evolution of herbicide-resistant weeds. This research aims to determine the herbicidal action of thiazolo[3,2-a]pyrimidines derivatives, which are well known as antihypertensive drugs. The phytotoxic effects of ten compounds were investigated using leaf disc discoloration test and seed germination bioassay. At concentrations of 125 to 250 mg/L, the 5-(3-Fluoro-phenyl)-7-methyl-5H-thiazolo[3,2-a]pyrimidine-6-carboxylic acid ethyl ester (c) was highly active against Oldenlandia verticillata and Eleusine indica. At application rates of 1.25 to 2.5 kg ai/ha, formulated c demonstrated selective post-emergence and pre-emergence herbicidal activity against O. verticillata, E. indica and Cyperus iria. In the crop tolerance test, formulated c outperformed the commercial herbicide diuron, with aerobic Oryza sativa being the most tolerant, followed by Zea mays, and Brassica rapa. The addition of calcium chloride partially nullified compound c's inhibitory effects on weed shoot growth, indicating that it has potential as a calcium channel blocker. Compound c acted by triggering electrolyte leakage without affecting photosystem II. These findings imply that c could be explored further as a template for developing new herbicides with novel modes of action.
    MeSH terms: Antihypertensive Agents/pharmacology*; Calcium Channel Blockers/pharmacology*; Zea mays/drug effects; Environment; Herbicides/pharmacology*; Oryza/drug effects; Eleusine/drug effects; Oldenlandia/drug effects; Photosystem II Protein Complex/drug effects
  12. Venugopal A, Marya A, Karobari MI
    Br Dent J, 2021 07;231(1):3.
    PMID: 34244625 DOI: 10.1038/s41415-021-3238-y
  13. Raghvan HPN, Fatokun O
    Int J Pharm Pract, 2021 Oct 18;29(5):435-442.
    PMID: 34244775 DOI: 10.1093/ijpp/riab036
    OBJECTIVES: It is known that community pharmacists in Malaysia underreport adverse drug reactions (ADRs). In order to improve ADR reporting, a theory-based understanding of the factors associated with the community pharmacists' reporting behaviour is important. This study used the theory of planned behaviour (TPB) to identify the predictors of behavioural intention to report ADRs to the regulatory authority among community pharmacists in Malaysia and to assess the relative importance of the predictors.

    METHODS: A questionnaire-based study was conducted among 188 randomly selected community pharmacists in the state of Johor, Malaysia. The questionnaire included four main TPB constructs (intention, attitude, subjective norms and perceived behavioural control) and related measures, including perceived moral obligation, past reporting behaviour and sociodemographic variables. Descriptive and hierarchical regression analyses were conducted.

    KEY FINDINGS: A total of 164 questionnaires were collected. The mean score of intention to report ADRs was 15.43 (SD = 2.99). The final model of the hierarchical regression analysis showed that attitude towards ADR reporting (P = 0.004), subjective norm (P = 0.010) and perceived moral obligation (P = 0.014) were significant predictors of intention to report ADRs. Attitude was the most significant predictor, followed by subjective norm and perceived moral obligation.

    CONCLUSIONS: Interventions targeting community pharmacists' attitude, subjective norms and perceived moral obligations towards ADR reporting, with a specific focus on attitude would likely have a positive impact on improving ADR reporting in Malaysia.

    MeSH terms: Attitude of Health Personnel; Humans; Malaysia; Pharmacists*; Surveys and Questionnaires; Intention; Drug-Related Side Effects and Adverse Reactions*
  14. Cheng HP, Wong JSL, Selveindran NM, Hong JYH
    Endocrine, 2021 09;73(3):499-506.
    PMID: 34244903 DOI: 10.1007/s12020-021-02810-1
    AIMS: Malaysia implemented nationwide lockdown from 18th March till 3rd May 2020 to mitigate the spread of coronavirus disease (COVID-19). This study aimed to examine the impact of the lockdown on glycaemic control and lifestyle changes in children and adolescents with type 1 (T1DM) and 2 diabetes mellitus (T2DM) aged less than 18 years old.

    METHODS: In this cross-sectional study, interviews and a standardised questionnaire comparing lifestyle changes before and during the lockdown were performed in follow-up clinic visits after the lockdown. Anthropometry measurements and glycated haemoglobin (HbA1c) values were compared 3 months prior and after the lockdown.

    RESULTS: Participants were 93 patients with T1DM (11.08 ± 3.47 years) and 30 patients with T2DM (13.81 ± 2.03 years). Male gender, T2DM and pubertal adolescents were found to have a significant deterioration in glycaemic control. A significant increment of HbA1c was observed in patients with T2DM (8.5 ± 0.40 vs 9.9 ± 0.46%), but not in patients with T1DM (8.6 ± 0.28 vs 8.7 ± 0.33%). Contrarily, there was an improved glycaemic control in pre-pubertal T1DM children likely due to parental supervision during home confinement. Weight and BMI SDS increased in T1DM patients but surprisingly reduced in T2DM patients possibly due to worsening diabetes control. Reduced meal frequency mainly due to skipping breakfast, reduced physical activity level scores, increased screen time and sleep duration were observed in both groups.

    CONCLUSIONS: Adverse impact on glycaemic control and lifestyle were seen mostly in patients with T2DM and pubertal adolescent boys.

    MeSH terms: Adolescent; Child; Communicable Disease Control; Cross-Sectional Studies; Diabetes Mellitus, Type 2*; Hemoglobin A, Glycosylated/analysis; Humans; Life Style; Male
  15. Sadiq M, Hsu CC, Zhang Y, Chien F
    Environ Sci Pollut Res Int, 2021 Dec;28(47):67167-67184.
    PMID: 34245412 DOI: 10.1007/s11356-021-15064-1
    This research aims to look into the effect of COVID-19 on emerging stock markets in seven of the Association of Southeast Asian Nations' (ASEAN-7) member countries from March 21, 2020 to April 31, 2020. This paper uses a ST-HAR-type Bayesian posterior model and it highlights the stock market of this ongoing crisis, such as, COVID-19 outbreak in all countries and related industries. The empirical results shown a clear evidence of a transition during COVID-19 crisis regime, also crisis intensity and timing differences. The most negatively impacted industries were health care and consumer services due to the Covid-19 drug-race and international travel restrictions. More so, study results estimated that only a small number of sectors are affected by COVID-19 fear including  health care, consumer services, utilities, and technology, significance at the 1%, 5%, and 10%, that measure current volatility's reliance on weekly and monthly variables. Secondly, it is found that there is almost no chance that the COVID-19 pandemic would positively affect the stock market performance in all the countries, mainly Indonesia and Singapore were the countries most affected. Thirdly, results shown that Thailand's stock market output has dropped by 15%. Results shows that COVID-19 fear causes an eventual reason of public attention towards stock market volatility. The study presented comprehensive way forwards to stabilize movement of ASEAN equity market's volatility index and guided the policy implications to key stakeholders that can better help to mitigate drastic impacts of COVID-19 fear on the performance of equity markets.
    MeSH terms: Bayes Theorem; Fear; Humans; Investments; Pandemics
  16. Wang W, Zhang J, Lew B
    J Relig Health, 2021 Dec;60(6):4537-4555.
    PMID: 34245434 DOI: 10.1007/s10943-021-01329-z
    This study examined the mediating effects of psychological strain (Strain Theory) as a possible explanation for the relationship between religiosity and suicidality among Chinese young adults. A questionnaire was administered that included the Religious Orientation-Revised Scale (RO-RS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strains Scale (PSS). Using cluster sampling, we recruited 13,250 college students across seven provinces in China. Both univariate and multivariate analyses were used to identify the main determinants of suicidality. We further explored the mediation effect of psychological strains on the relationship between religion and suicidality. We found that non-believers obtained the lowest PSS. Believers of Islam and other religions obtained higher RO-RS scores compared to non-religious participants. Psychological strain imposed a complete effect between religiosity and suicidality. A positive relationship between religion and suicidality was present among the participants of the study. Individuals who are affiliated with a religion are considered as a marginalized population in China, which may lead to psychological strains, further increasing the risk of suicidality.
    MeSH terms: China; Humans; Islam; Religion; Religion and Psychology*; Suicide*; Young Adult; Suicidal Ideation
  17. Govindasamy V, Rajendran A, Lee ZX, Ooi GC, Then KY, Then KL, et al.
    Cell Biol Int, 2021 Oct;45(10):1999-2016.
    PMID: 34245637 DOI: 10.1002/cbin.11652
    Ageing and age-related diseases share some basic origin that largely converges on inflammation. Precisely, it boils down to a common pathway characterised by the appearance of a fair amount of proinflammatory cytokines known as inflammageing. Among the proposed treatment for antiageing, MSCs gained attention in recent years. Since mesenchymal stem cells (MSCs) can differentiate itself into a myriad of terminal cells, previously it was believed that these cells migrate to the site of injury and perform their therapeutic effect. However, with the more recent discovery of huge amounts of paracrine factors secreted by MSCs, it is now widely accepted that these cells do not engraft upon transplantation but rather unveil their benefits through excretion of bioactive molecules namely those involved in inflammatory and immunomodulatory activities. Conversely, the true function of these paracrine changes has not been thoroughly investigated all these years. Hence, this review will describe in detail on ways MSCs may capitalize its paracrine properties in modulating antiageing process. Through a comprehensive literature search various elements in the antiageing process, we aim to provide a novel treatment perspective of MSCs in antiageing related clinical conditions.
    MeSH terms: Aging*; Animals; Hematopoietic Stem Cells/cytology*; Humans; Therapeutics*; Paracrine Communication*; Mesenchymal Stem Cell Transplantation/methods*; Immunomodulation*
  18. Malijan RPB, Mechan F, Braganza JC, Valle KMR, Salazar FV, Torno MM, et al.
    Parasit Vectors, 2021 Jul 07;14(1):357.
    PMID: 34233742 DOI: 10.1186/s13071-021-04853-9
    BACKGROUND: A small number of human cases of the zoonotic malaria Plasmodium knowlesi have been reported in Palawan Island, the Philippines. Identification of potential vector species and their bionomics is crucial for understanding human exposure risk in this setting. Here, we combined longitudinal surveillance with a trap-evaluation study to address knowledge gaps about the ecology and potential for zoonotic spillover of this macaque malaria in Palawan Island.

    METHODS: The abundance, diversity and biting behavior of human-biting Anopheles mosquitoes were assessed through monthly outdoor human landing catches (HLC) in three ecotypes representing different land use (forest edge, forest and agricultural area) across 8 months. Additionally, the host preference and biting activity of potential Anopheles vectors were assessed through comparison of their abundance and capture time in traps baited with humans (HLC, human-baited electrocuting net-HEN) or macaques (monkey-baited trap-MBT, monkey-baited electrocuting net-MEN). All female Anopheles mosquitoes were tested for the presence of Plasmodium parasites by PCR.

    RESULTS: Previously incriminated vectors Anopheles balabacensis and An. flavirostris accounted for > 95% of anophelines caught in longitudinal surveillance. However, human biting densities were relatively low (An. balabacensis: 0.34-1.20 per night, An. flavirostris: 0-2 bites per night). Biting densities of An. balabacensis were highest in the forest edge, while An. flavirostris was most abundant in the agricultural area. The abundance of An. balabacensis and An. flavirostris was significantly higher in HLC than in MBT. None of the 357 female Anopheles mosquitoes tested for Plasmodium infection were positive.

    CONCLUSIONS: The relatively low density and lack of malaria infection in Anopheles mosquitoes sampled here indicates that exposure to P. knowlesi in this setting is considerably lower than in neighboring countries (i.e. Malaysia), where it is now the primary cause of malaria in humans. Although anophelines had lower abundance in MBTs than in HLCs, An. balabacensis and An. flavirostris were caught by both methods, suggesting they could act as bridge vectors between humans and macaques. These species bite primarily outdoors during the early evening, confirming that insecticide-treated nets are unlikely to provide protection against P. knowlesi vectors.

    MeSH terms: Animals; Anopheles/parasitology*; Anopheles/physiology*; Behavior, Animal*; Bites and Stings*; Female; Humans; Longitudinal Studies; Macaca; Malaria/transmission; Philippines; Seasons*; Plasmodium knowlesi/genetics*; Plasmodium knowlesi/isolation & purification; Mosquito Vectors/parasitology*; Mosquito Vectors/physiology
  19. Ang CY, Dhaliwal JS, Muharram SH, Akkawi ME, Hussain Z, Rahman H, et al.
    BMJ Open, 2021 07 07;11(7):e048609.
    PMID: 34233993 DOI: 10.1136/bmjopen-2021-048609
    INTRODUCTION: Antimicrobial resistance (AMR) is a global public and patient safety issue. With the high AMR risk, ensuring that the next generation of dentists that have optimal knowledge and confidence in the area of AMR is crucial. A systematic approach is vital to design an AMR content that is comprehensive and clinically relevant. The primary objective of this research study will be to implement a consensus-based approach to elucidate AMR content and curriculum priorities for professional dentistry programmes. This research aims to establish consensus along with eliciting opinion on appropriate AMR topics to be covered in the Bachelor of Dental Surgery syllabus.

    METHODS AND ANALYSIS: A three-phase approach to validate content for curriculum guidelines on AMR will be adopted. First, literature review and content analysis were conducted to find out the available pertinent literature in dentistry programmes. A total of 23 potential literature have been chosen for inclusion within this study following literature review and analysis in phase 1. The materials found will be used to draft curriculum on antimicrobials for dentistry programmes. The next phase involves the validation of the drafted curriculum content by recruiting local and foreign experts via a survey questionnaire. Finally, Delphi technique will be conducted to obtain consensus on the important or controversial modifications to the revised curriculum.

    ETHICS AND DISSEMINATION: An ethics application is currently under review with the Institute of Health Science Research Ethics Committee, Universiti Brunei Darussalam. All participants are required to provide a written consent form. Findings will be used to identify significant knowledge gaps on AMR aspect in a way that results in lasting change in clinical practice. Moreover, AMR content priorities related to dentistry clinical practice will be determined in order to develop need-based educational resource on microbes, hygiene and prudent antimicrobial use for dentistry programmes.

    MeSH terms: Curriculum; Dentistry; Humans; Drug Resistance, Bacterial
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