Browse publications by year: 2021

  1. Sharma VK, Sharma PP, Mazumder B, Bhatnagar A, Subramaniyan V, Fuloria S, et al.
    J Biomater Sci Polym Ed, 2021 08;32(11):1420-1449.
    PMID: 33941041 DOI: 10.1080/09205063.2021.1925389
    Mucoadhesive microspheres have their own significant amongst the various sustained release drug delivery systems. The prolonged residence time of these delivery devices at drug absorption site results in steep concentration gradient and enhanced bioavailability. In this study, the mucilage of Isabgol husk was applied as polymeric backbone to develop gliclazide loaded microspheres by crosslinking with glutaraldehyde. The formulations were studied for surface morphology, swelling behavior, particle size, in vitro release, release kinetics, in vitro mucoadhesion and gamma scintigraphy in rabbits. The release of gliclazide from microspheres was controlled by swelling of crosslinked microspheres followed by diffusion. Gamma scintigraphic images acquired for microspheres retention in gastrointestinal track of rabbits indicated the residence of formulation upto 24 h after oral administration. Gliclazide retained its integrity in polymeric matrix of microspheres as observed by Fourier transform infrared spectroscopy, differential scanning calorimetry and powder X-ray diffractometry. The sustained release of gliclazide and prolonged retention of microspheres in gastrointestinal track disclosed the rationality of mucoadhesive Isabgol husk microspheres in controlling the hyperglycemia in diabetes.
  2. Chew CC, Chan HK, Chang CT, Hss AS, Hassali MA
    BMC Pediatr, 2021 05 03;21(1):216.
    PMID: 33941117 DOI: 10.1186/s12887-021-02691-3
    BACKGROUND: Caregivers' knowledge, practice and adherence in medication administration who care for children with chronic illness requiring long-term pharmacological treatments are factors associating with children medication safety at home. This study aimed to determine the medication-related knowledge, administration practice and adherence among caregivers of chronically ill children in Malaysia. This cross-sectional study was conducted at the paediatric outpatient clinic of a tertiary public hospital. Caregivers of chronically ill children, who engaged in medication administration at home for at least 3 months, were conveniently recruited. Their medication-related knowledge and administration practice were evaluated based on a checklist, while their adherence to medication administration was assessed using a validated 5-point scale. The associated factors were also explored.

    RESULTS: Of the 141 participants, most were mothers (90.8%) and had a full-time job (55.3%). Most of them had adequate medication-related knowledge (71.6%) and an appropriate administration practice (83.0%). The majority of them (83.0%) also rated themselves as adherent to medication administration. The participants with a child above 5 years of age (91.2%) were found to have a better practice than those with younger children (75.3%) in medication administration (p = 0.012). However, those with a child taking two (adjusted OR: 12.53) or three (adjusted OR: 8.29) medications, getting their refills from private health institutions apart from this hospital (adjusted OR = 7.06) and having multiple illnesses (adjusted OR = 21.25) were more likely to be not adherent to medication administration.

    CONCLUSION: Caregivers of chronically ill children in Malaysia generally have sufficient knowledge and an appropriate practice of medication administration at home. Yet, strategies to improve the adherence to medication administration, particularly in those who care for children with complicated health conditions, are warranted.

    MeSH terms: Child; Chronic Disease; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Pregnancy; Surveys and Questionnaires; Caregivers*; Medication Adherence*
  3. Tan CS, Lokman S, Rao Y, Kok SH, Ming LC
    J Pharm Policy Pract, 2021 May 03;14(1):40.
    PMID: 33941265 DOI: 10.1186/s40545-021-00322-x
    Over the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed "private contractors" who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.
    MeSH terms: Ambulatory Care Facilities; Consultants; Critical Care; Delivery of Health Care; Patient Care; Health Personnel; Humans; Insurance Carriers; Malaysia; Public Facilities; Vaccination; Hospitals, Private; Insurance Coverage; Health Care Sector; Policy; Pandemics
  4. Hussin FS, Chay SY, Hussin ASM, Wan Ibadullah WZ, Muhialdin BJ, Abd Ghani MS, et al.
    Sci Rep, 2021 05 03;11(1):9417.
    PMID: 33941803 DOI: 10.1038/s41598-021-88436-9
    This study aimed to enhance natural gamma aminobutyric acid (GABA) production in yoghurt by the addition of simple sugars and commercial prebiotics without the need for pyridoxal 5'-phosphate (PLP) cofactor. The simple sugars induced more GABA production (42.83-58.56 mg/100 g) compared to the prebiotics (34.19-40.51 mg/100 g), with glucose promoting the most GABA production in yoghurt (58.56 mg/100 g) surpassing the control sample with added PLP (48.01 mg/100 g). The yoghurt prepared with glucose also had the highest probiotic count (9.31 log CFU/g). Simulated gastrointestinal digestion of this GABA-rich yoghurt showed a non-significant reduction in GABA content and probiotic viability, demonstrating the resistance towards a highly acidic environment (pH 1.2). Refrigerated storage up to 28 days improved GABA production (83.65 mg/100 g) compared to fresh GABA-rich yoghurt prepared on day 1. In conclusion, the addition of glucose successfully mitigates the over-use of glutamate and omits the use of PLP for increased production of GABA in yoghurt, offering an economical approach to produce a probiotic-rich dairy food with potential anti-hypertensive effects.
  5. Hazir B, Haberal HB, Asci A, Muneer A, Gudeloglu A
    Int J Impot Res, 2021 May 03.
    PMID: 33941879 DOI: 10.1038/s41443-021-00442-7
    Our study aimed to assess the methodological strengths and weaknesses of erectile dysfunction clinical practice guidelines (CPGs) for individuals using the AGREE II tool. Erectile dysfunction related CPGs were identified from three databases: the National Guideline Clearinghouse, the Guidelines International Network, and PubMed between 2000 and 2020. We designed an independent assessment for each of the erectile dysfunction related CPGs using the AGREE II tool. Four appraisers performed these assessments. The literature search identified 8 CPGs that met our inclusion criteria. The evaluation of the AGREE II domains of each individual revealed that the median scores of domains related to applicability were quite low (39%). Also, the median scores of domains related to the rigour of development and the stakeholder involvement were relatively low (53% and 63%). We determined the highest median scores in three AGREE II domains: clarity of presentation (80.5%), editorial independence (77%), and scope and purpose (89.5%). We found that the European Association of Urology (EAU), the American Urological Association (AUA), and the British Society for Sexual Medicine (BSSM) guidelines had >60% in >4 domains and that their average AGREE II scores were over 70%. In the Canadian Diabetic Association (CDA) and the Japanese Society for Sexual Medicine (JSSM) guidelines, we found that >4 domains were >60%, but their average AGREE II scores were below 70%. The British Medical Journal (BMJ), the Canadian Urologic Association (CUA), and the Malaysian Urologic Association (MUA) guidelines had >60% in <3 domains. We highly recommended EAU, AUA and BSSM guidelines, while we moderately recommended CDA and JSSM guidelines. BMJ, CUA and MUA guidelines were weakly recommended. The quality of the guidelines for erectile dysfunction was variable according to AGREE II. We noted significant deficiencies in the methodological quality of the CPGs developed by different organisations in the areas of applicability and rigour of development.
    MeSH terms: Canada; Diabetes Mellitus; Ethnic Groups; Humans; Erectile Dysfunction; Japan; Male; Publications; United States; Urology; PubMed
  6. Sawal I, Ahmad S, Tariq W, Tahir MJ, Essar MY, Ahmed A
    J Med Virol, 2021 09;93(9):5228-5230.
    PMID: 33942326 DOI: 10.1002/jmv.27031
    MeSH terms: Humans
  7. Tanveer M, Ahmed A, Siddiqui A, Gudi SK
    J Med Virol, 2021 Sep;93(9):5236-5238.
    PMID: 33942340 DOI: 10.1002/jmv.27045
    MeSH terms: Humans; Measles/epidemiology*; Pakistan; Pandemics*
  8. Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Mohd Ripin Z
    J Occup Health, 2021 Jan;63(1):e12220.
    PMID: 33942440 DOI: 10.1002/1348-9585.12220
    OBJECTIVE: Prolonged exposure to hand-arm vibration (HAV) at the workplace is associated with hand-arm vascular syndrome (HAVS). This study aimed to determine the prevalence and the factors associated with the vascular and neurological complications of HAVS among tire shop workers in Kelantan, Malaysia.

    METHODS: A cross-sectional study involving 200 tire shop workers from two districts in Kelantan was conducted. Data were collected at the field using Malay Translated HAVS questionnaire, and hand-arm vibration was measured. Multiple logistic regression analysis was used to determine the associated factors.

    RESULTS: The prevalence of vascular and neurological complications of HAVS among the tire shop workers was 12.5% (95% CI: 10.16, 14.84) and 37.0% (95% CI: 30.31, 43.69), respectively. From multiple logistic regression analysis, only A(8) of HAV exposure was significantly associated with the development of vascular complications and A(8) of HAV exposure, age. and body mass index were significantly associated with the development of neurological complications of HAVS.

    CONCLUSION: This study has identified that HAVS is a significant problem among workers exposed to HAV in a warm environment. A(8) of HAV exposure is significantly associated with the development of both vascular and neurological complications. Therefore, there is a need for better control of vibration exposure in Malaysia.

    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Nervous System Diseases/etiology; Nervous System Diseases/epidemiology*; Occupational Diseases/etiology; Occupational Diseases/epidemiology*; Surveys and Questionnaires; Transportation*; Vascular Diseases/etiology; Vascular Diseases/epidemiology*; Vibration/adverse effects; Prevalence; Logistic Models; Occupational Exposure/adverse effects; Workplace/statistics & numerical data; Hand-Arm Vibration Syndrome/complications*
  9. Ibrahim B, Suppiah S, Ibrahim N, Mohamad M, Hassan HA, Nasser NS, et al.
    Hum Brain Mapp, 2021 06 15;42(9):2941-2968.
    PMID: 33942449 DOI: 10.1002/hbm.25369
    Resting-state fMRI (rs-fMRI) detects functional connectivity (FC) abnormalities that occur in the brains of patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). FC of the default mode network (DMN) is commonly impaired in AD and MCI. We conducted a systematic review aimed at determining the diagnostic power of rs-fMRI to identify FC abnormalities in the DMN of patients with AD or MCI compared with healthy controls (HCs) using machine learning (ML) methods. Multimodal support vector machine (SVM) algorithm was the commonest form of ML method utilized. Multiple kernel approach can be utilized to aid in the classification by incorporating various discriminating features, such as FC graphs based on "nodes" and "edges" together with structural MRI-based regional cortical thickness and gray matter volume. Other multimodal features include neuropsychiatric testing scores, DTI features, and regional cerebral blood flow. Among AD patients, the posterior cingulate cortex (PCC)/Precuneus was noted to be a highly affected hub of the DMN that demonstrated overall reduced FC. Whereas reduced DMN FC between the PCC and anterior cingulate cortex (ACC) was observed in MCI patients. Evidence indicates that the nodes of the DMN can offer moderate to high diagnostic power to distinguish AD and MCI patients. Nevertheless, various concerns over the homogeneity of data based on patient selection, scanner effects, and the variable usage of classifiers and algorithms pose a challenge for ML-based image interpretation of rs-fMRI datasets to become a mainstream option for diagnosing AD and predicting the conversion of HC/MCI to AD.
  10. Atchison S, Shilling H, Balgovind P, Machalek DA, Hawkes D, Garland SM, et al.
    J Appl Microbiol, 2021 Nov;131(5):2592-2599.
    PMID: 33942451 DOI: 10.1111/jam.15126
    AIM: Validate the Roche, MagNAPure96 (MP96) nucleic acid extraction platform for Seegene Anyplex II HPV28 (Anyplex28) detection of Human Papillomavirus.

    METHODS AND RESULTS: Comparisons were made for Anyplex28 genotyping from 115 cervical samples extracted on the Hamilton, STARlet and the MP96. Two DNA concentrations were used for the MP96, one matched for sample input to the STARlet and another 5× concentration (laboratory standard). Agreement of HPV detection was 89·8% (κ = 0·798; P = 0·007), with HPV detected in 10 more samples for the MP96. There was a high concordance of detection for any oncogenic HPV genotype (κ = 0·77; P = 0·007) and for any low-risk HPV genotype (κ = 0·85; P = 0·008). DNA extracted at laboratory standard had a lower overall agreement 85·2% (κ = 0·708; P 

    MeSH terms: DNA, Viral/genetics; Genotype; Humans; Nucleic Acids*; Sensitivity and Specificity; Papillomaviridae/genetics; Papillomavirus Infections*; Genotyping Techniques
  11. Tchervenkov CI, Herbst C, Jacobs JP, Al-Halees Z, Edwin F, Dearani JA, et al.
    World J Pediatr Congenit Heart Surg, 2021 05;12(3):394-405.
    PMID: 33942697 DOI: 10.1177/21501351211003520
    The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.
    MeSH terms: Certification; Child; Cardiac Surgical Procedures*; Humans; Societies, Medical; Thoracic Surgery*
  12. Samy AL, Kamaruzzaman SB, Chinna K, Shunnmugam B, Krishnaswamy S, Low WY
    Australas J Ageing, 2021 Dec;40(4):423-429.
    PMID: 33942961 DOI: 10.1111/ajag.12958
    OBJECTIVE: This study aimed to determine the psychometric properties of the Bahasa Malaysia (BM) version of the Older Americans Resources and Services-Instrumental Activities of Daily Living (OARS-IADL) questionnaire among older persons in Malaysia.

    METHODS: The English version of OARS-IADL was translated to BM. The psychometric properties of the BM version of OARS-IADL were tested among older persons attending a health-care facility.

    RESULTS: Two hundred and seventy-one older persons participated in the study. The mean age of participants was 67.7 ± 6.1 years. Internal consistency of the items was good (Cronbach's alpha, >0.7). Exploratory factor analysis revealed a single dimension with item factor loadings of >0.5. Confirmatory factor analysis results confirmed a single-factor model (AVE > 50%, CR > 0.7 and CR > AVE).

    CONCLUSION: The BM version of the OARS-IADL questionnaire is a valid and reliable instrument that can be used to assess the IADL among older persons in Malaysia.

  13. Byrd KA, Pincus L, Pasqualino MM, Muzofa F, Cole SM
    Matern Child Nutr, 2021 Oct;17(4):e13192.
    PMID: 33942983 DOI: 10.1111/mcn.13192
    Inadequate nutrient intakes are prevalent among many populations in sub-Saharan Africa and increasing fish consumption among pregnant/lactating women and children is one strategy to improve diets and address nutrient deficiencies. We report the nutrient content of two fish-based recipes-fish powder and fish chutney-that contain dried small fish available in local markets in Zambia. The contribution of a serving of each recipe to the recommended daily intakes of iron, zinc, calcium and docosahexaenoic acid (DHA) for pregnant/lactating women and children 6-24 months was calculated because these nutrients are commonly deficient in African diets. We found that one 10-g serving of fish powder provides 20% or more of the daily calcium recommendation and 37% or more of the daily DHA recommendation for both pregnant/lactating women and children. A 30-g serving of fish chutney provides over 40% of the daily calcium recommendation for pregnant women and over 50% for lactating women. Additionally, we investigated the nutrient density (nutrients per kilocalorie) of the fish powder and compared it with the nutrient density of a small-quantity lipid-based nutrient supplement plus (SQ-LNS-plus). SQ-LNS-plus is designed to enhance children's diets by providing micronutrients and DHA. Fish powder is similar to SQ-LNS-plus in iron and zinc density and even higher in calcium and DHA density. Consuming dried small fish as part of a daily meal can be a viable strategy for combatting nutrient deficiencies in the first 1000 days.
    MeSH terms: Animals; Child; Docosahexaenoic Acids; Female; Humans; Infant; Lactation*; Pregnancy; Micronutrients*; Dietary Supplements
  14. Saxena K, Gunjal S
    J Orofac Orthop, 2021 May 04.
    PMID: 33944974 DOI: 10.1007/s00056-021-00301-6
    PURPOSE: To determine the effect of WhatsApp (Facebook Inc., Menlo Park, CA, USA) and electronic mail reminders on oral hygiene compliance of orthodontic patients.

    METHODS: A randomized, parallel group, double blinded study was conducted on 54 patients undergoing orthodontic treatment at a university clinic. They were randomized to 3 groups, i.e., WhatsApp (W) group, electronic mail (email) (E) group and control (C) group with 18 subjects in each group. Group (W) and group (E) received oral health messages once a week through WhatsApp and email reminders, respectively, while group (C) did not receive any reminders. Plaque was measured at baseline (T0), after 4 weeks (T1), and after 8 weeks (T2). For each subject, intraoral photographs were taken after application of a plaque-disclosing agent; and the area covered by plaque was measured on teeth 12, 13, 43, 22, 23 and 33 by planimetry. Data were analyzed using SPSS (version 22, IBM Corp., Armonk, NY, USA). Mixed analysis of variance (ANOVA) was used to compare plaque scores between and within the groups.

    RESULTS: A total of 54 subjects (14 males and 40 females) with mean age of 22.43 years completed the study. At the end of 8 weeks, no statistically significant difference in the mean plaque score was found between the groups at the different time intervals (p = 0.201).

    CONCLUSION: WhatsApp and email reminders did not significantly influence the oral hygiene compliance of orthodontic patients.

    MeSH terms: Adult; Analysis of Variance; Dental Care; Female; Humans; Male; Oral Health; Oral Hygiene; Patient Compliance; Universities; Photography, Dental; Electronic Mail; Young Adult; Social Media
  15. Tam LS, Tanaka Y, Handa R, Li Z, Lorenzo JP, Louthrenoo W, et al.
    Int J Rheum Dis, 2021 Jun;24(6):733-745.
    PMID: 33945214 DOI: 10.1111/1756-185X.14124
    AIM: To update previous guidance of the Asia Pacific League of Associations for Rheumatology (APLAR) on the management of patients with rheumatic and musculoskeletal diseases (RMD) during the coronavirus disease 2019 (COVID-19) pandemic.

    METHODS: Research questions were formulated focusing on diagnosis and treatment of adult patients with RMD within the context of the pandemic, including the management of RMD in patients who developed COVID-19. MEDLINE was searched for eligible studies to address the questions, and the APLAR COVID-19 task force convened 2 meetings through video conferencing to discuss its findings and integrate best available evidence with expert opinion. Consensus statements were finalized using the modified Delphi process.

    RESULTS: Agreement was obtained around key aspects of screening for or diagnosis of COVID-19; management of patients with RMD without confirmed COVID-19; and management of patients with RMD with confirmed COVID-19. The task force achieved consensus on 25 statements covering the potential risk of acquiring COVID-19 in RMD patients, advice on RMD medication adjustment and continuation, the roles of telemedicine and vaccination, and the impact of the pandemic on quality of life and on treatment adherence.

    CONCLUSIONS: Available evidence primarily from descriptive research supported new recommendations for aspects of RMD care not covered in the previous document, particularly with regard to risk factors for complicated COVID-19 in RMD patients, modifications to RMD treatment regimens in the context of the pandemic, and COVID-19 vaccination in patients with RMD.

    MeSH terms: Humans; Immunosuppressive Agents/therapeutic use*; Rheumatic Diseases/drug therapy*; Rheumatic Diseases/epidemiology; Rheumatology; Comorbidity; Antirheumatic Agents/therapeutic use*; Consensus*; Pandemics*
  16. Hasan SS, Kow CS, Mustafa ZU, Merchant HA
    Expert Rev Respir Med, 2021 08;15(8):1049-1055.
    PMID: 33945381 DOI: 10.1080/17476348.2021.1925546
    Objectives: The question remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths.Methods: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13 April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI).Results: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 - 1.43, n = 652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high dose methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42).Conclusions: In determining equipotent doses for an acute short-course pulse therapy of corticosteroids, the biological half-life of steroids should also be accounted for besides the potency factor. A short duration (3-5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
    MeSH terms: Dexamethasone; Glucocorticoids/therapeutic use; Humans
  17. Bainomugisa A, Meumann EM, Rajahram GS, Ong RT, Coin L, Paul DC, et al.
    Microb Genom, 2021 05;7(5).
    PMID: 33945455 DOI: 10.1099/mgen.0.000573
    Tuberculosis is a leading public health priority in eastern Malaysia. Knowledge of the genomic epidemiology of tuberculosis can help tailor public health interventions. Our aims were to determine tuberculosis genomic epidemiology and characterize resistance mutations in the ethnically diverse city of Kota Kinabalu, Sabah, located at the nexus of Malaysia, Indonesia, Philippines and Brunei. We used an archive of prospectively collected Mycobacterium tuberculosis samples paired with epidemiological data. We collected sputum and demographic data from consecutive consenting outpatients with pulmonary tuberculosis at the largest tuberculosis clinic from 2012 to 2014, and selected samples from tuberculosis inpatients from the tertiary referral centre during 2012-2014 and 2016-2017. Two hundred and eight M. tuberculosis sequences were available for analysis, representing 8 % of cases notified during the study periods. Whole-genome phylogenetic analysis demonstrated that most strains were lineage 1 (195/208, 93.8 %), with the remainder being lineages 2 (8/208, 3.8 %) or 4 (5/208, 2.4 %). Lineages or sub-lineages were not associated with patient ethnicity. The lineage 1 strains were diverse, with sub-lineage 1.2.1 being dominant (192, 98 %). Lineage 1.2.1.3 isolates were geographically most widely distributed. The greatest diversity occurred in a border town sub-district. The time to the most recent common ancestor for the three major lineage 1.2.1 clades was estimated to be the year 1966 (95 % HPD 1948-1976). An association was found between failure of culture conversion by week 8 of treatment and infection with lineage 2 (4/6, 67 %) compared with lineage 1 strains (4/83, 5 %) (P<0.001), supporting evidence of greater virulence of lineage 2 strains. Eleven potential transmission clusters (SNP difference ≤12) were identified; at least five included people living in different sub-districts. Some linked cases spanned the whole 4-year study period. One cluster involved a multidrug-resistant tuberculosis strain matching a drug-susceptible strain from 3 years earlier. Drug resistance mutations were uncommon, but revealed one phenotype-genotype mismatch in a genotypically multidrug-resistant isolate, and rare nonsense mutations within the katG gene in two isolates. Consistent with the regionally mobile population, M. tuberculosis strains in Kota Kinabalu were diverse, although several lineage 1 strains dominated and were locally well established. Transmission clusters - uncommonly identified, likely attributable to incomplete sampling - showed clustering occurring across the community, not confined to households or sub-districts. The findings indicate that public health priorities should include active case finding and early institution of tuberculosis management in mobile populations, while there is a need to upscale effective contact investigation beyond households to include other contacts within social networks.
    MeSH terms: Adolescent; Adult; Female; Genotype; Humans; Malaysia/epidemiology; Male; Mutation; Mycobacterium tuberculosis/classification; Mycobacterium tuberculosis/genetics*; Phylogeny; Public Health; Sputum; Tuberculosis/epidemiology*; Tuberculosis/transmission; Tuberculosis, Pulmonary/epidemiology; Cluster Analysis; Genome, Bacterial; Molecular Epidemiology*; Tuberculosis, Multidrug-Resistant/epidemiology; Genomics*; Young Adult
  18. Alkhawaldeh AAK, Jaber JJ, Boughaci D, Ismail N
    PLoS One, 2021;16(5):e0250242.
    PMID: 33945537 DOI: 10.1371/journal.pone.0250242
    Corporate governance is the way of governing a firm in order to increase its accountability and to avoid any massive damage before it occurs. The aim of this paper is to investigate the impact of capital structure, firms' size, and competitive advantages of firms as control variables on credit ratings. We investigate the role of corporate governance in improving the firms' credit rating using a sample of Jordanian listed firms. We split firms into four categories according to WVB credit rating. We use both the binary logistic regression (LR) and the ordinal logistic regression (OLR) to model credit ratings in Jordanian environment. The empirical results show that the control variables are strong determinants of credit ratings. When we evaluate the relationship between the governance variables and credit ratings, we found interesting results. The board stockholders and board expertise are moderately significant. The board independence and role duality are weakly significant, while board size is insignificant.
    MeSH terms: Accounting/economics*; Commerce/economics; Commerce/organization & administration; Jordan; Professional Corporations/economics*; Professional Corporations/organization & administration; Organizational Culture; Models, Economic
  19. Wong LP, Wu Q, Hao Y, Chen X, Chen Z, Alias H, et al.
    Int Health, 2021 May 04.
    PMID: 33945613 DOI: 10.1093/inthealth/ihab023
    BACKGROUND: We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.

    METHODS: An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.

    RESULTS: The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.

    CONCLUSIONS: Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

    MeSH terms: Adult; Cross-Sectional Studies; Disease Outbreaks; Health Facilities; Hospitals; Humans; Local Government; Patient Acceptance of Health Care; Quarantine; Confidence Intervals; Odds Ratio; Coronavirus; Coronavirus Infections; Internet; Trust
  20. Kumar SS, Ghosh P, Kataria N, Kumar D, Thakur S, Pathania D, et al.
    Chemosphere, 2021 Oct;280:130601.
    PMID: 33945900 DOI: 10.1016/j.chemosphere.2021.130601
    In the current scenario, alternative energy sources are the need of the hour. Organic wastes having a larger fraction of biodegradable constituents present a sustainable bioenergy source. It has been reported that the calorific value of biogas generated by anaerobic digestion (AD) is 21-25 MJ/m3 with the treatment which makes it an excellent replacement of natural gas and fossil fuels and can reduce more than 80% greenhouse gas emission to the surroundings. However, there are some limitations associated with the AD process for instance ammonia build-up at the first stage reduces the rate of hydrolysis of biomass, whereas, in the last stage it interferes with methane formation. Owing to special physicochemical properties such as high activity, high reactive surface area, and high specificity, tailor-made conductive nanoparticles can improve the performance of the AD process. In the AD process, H2 is used as an electron carrier, referred as mediated interspecies electron transfer (MIET). Due to the diffusion limitation of these electron carriers, the MIET efficiency is relatively low that limits the methanogenesis. Direct interspecies electron transfer (DIET), which enables direct cell-to-cell electron transport between bacteria and methanogen, has been considered an alternative efficient approach to MIET that creates metabolically favorable conditions and results in faster conversion of organic acids and alcohols into methane. This paper discusses in detail the application of conductive nanoparticles to enhance the AD process efficiency. Interaction between microbes in anaerobic conditions for electron transfer with the help of CNPs is discussed. Application of a variety of conductive nanomaterials as an additive is discussed with their potential biogas production and treatment enhancement in the anaerobic digestion process.
    MeSH terms: Anaerobiosis; Electron Transport; Methane; Bioreactors*; Nanoparticles*
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