Browse publications by year: 2021

Fulltext Reply to Ivy et al. Comment on "Khairul Zaman et al. Eco-Friendly Coagulant versus Industrially Used Coagulants: Identification of Their Coagulation Performance, Mechanism and Optimization in Water Treatment Process. Int. J. Environ. Res. Public Health 2021, 18, 9164"

Khairul Zaman N, Rohani R, Izni Yusoff I, Kamsol MA, Basiron SA, Abd Rashid AI

Int J Environ Res Public Health, 2021 12 02;18(23).
PMID: 34886441 DOI: 10.3390/ijerph182312716

We appreciate very much the interest of Ivy et al. in our work [...].
Fulltext Speak like a Native English Speaker or Be Judged: A Scoping Review

Tan KH, Jospa MEAW, Mohd-Said NE, Awang MM

Int J Environ Res Public Health, 2021 Dec 03;18(23).
PMID: 34886478 DOI: 10.3390/ijerph182312754

This review aims to examine the discrimination and prejudices toward the accent of non-native English speakers and cyberbullying as the ripple effect of these negative consequences. Following Arksey and O'Malley's framework of conducting a scoping review, 60 studies from 2012 to 2021 were retrieved from the ERIC and Google Scholar databases. The studies were reviewed from two aspects: (1) psychological impact on speakers with a non-native English accent, (2) attitudes toward non-native English accents from the victim's and perpetrator's perspectives. The findings suggested that speaking with a non-native English accent drew negative cognitive, affective, and behavioral experiences. Biases toward non-native English accents were due to the general derogatory perception of an accent and the comprehensibility of speakers' accent and pronunciation. "Accent acceptability" can be inculcated at all levels of education, not only through multicultural education but also through the concerted effort of policy makers and practitioners to seriously address this social issue. Accent awareness can dispel unwarranted and undesirable judgements of non-native English accent speakers. Future studies should be conducted on the effects of social and mental health experiences, particularly of non-native ESL and EFL teachers, given that this may be the only profession required to teach "live" during the pandemic and thus be subjected to public praise or ridicule.

MeSH terms: Language; Speech Intelligibility; Speech Perception*; Cultural Diversity; Multilingualism*
Fulltext LMDI Decomposition Analysis of E-Waste Generation in the ASEAN

Choi G, Kim T, Kim M

Int J Environ Res Public Health, 2021 12 06;18(23).
PMID: 34886589 DOI: 10.3390/ijerph182312863

The economies of ASEAN member states are growing rapidly, and electrical and electronic waste (E-waste) generated from them are also showing a rapid increase. In this context, this study conducted an LMDI decomposition analysis on the amount of E-waste generated in ASEAN member countries from 2015 to 2019 and decomposed it into E-waste intensity, economic growth, and population effects. Then, based on analysis results, policy implications are suggested to improve their E-waste management. According to the analysis results, ASEAN countries can be classified into three groups. The first group includes Indonesia, the Philippines, Singapore, Thailand; economic growth was the main driving factor of E-waste increase in these countries. However, E-waste had also decreased due to the effect of E-waste intensity. The second group includes countries where economic growth was not the only driving factor for E-waste increase, but also where E-waste had increased due to the effect of E-waste intensity. These countries include Cambodia, Malaysia, and Viet Nam. Finally, the third group consists of countries where the effect of E-waste intensity is the main driving factor, including Brunei Darussalam, Lao PDR, and Myanmar. This research shows that ASEAN countries need policies that can effectively deal with the threat of E-waste as a result of high economic growth and policies that can improve intensity by reducing the generation of E-waste.
Fulltext Chinese parents' intentions to vaccinate their children against SARS-CoV-2 infection and vaccine preferences

Lin Y, Hu Z, Zhao Q, Alias H, Danaee M, Wong LP

Hum Vaccin Immunother, 2021 Dec 02;17(12):4806-4815.
PMID: 34892992 DOI: 10.1080/21645515.2021.1999143

This study aims to determine the intention of Chinese parents to vaccinate their children against SARS-CoV-2. Secondly, preferences for foreign- or domestically made COVID-19 vaccines were also explored. A nationwide, cross-sectional, self-administered online survey based on the Health Belief Model (HBM) and new vaccine concerns was used. Participants were eligible if they were residents of China with children aged 12 years old or younger. A total of 2,026 parents responded to the survey. Half reported a probable intent (50.7%) and 26.9% reported a definite intent. The results of the data analysis of partial least squares structural equation modeling (PLS-SEM) found that perceived cost barriers (B = -0.210, p

MeSH terms: Child; China; Cross-Sectional Studies; Humans; Parents; Vaccination; Vaccines*; Intention
Fulltext "Take action for bone health"

Lee JK

J Orthop Surg (Hong Kong), 2021 12 12;29(3):23094990211059857.
PMID: 34892999 DOI: 10.1177/23094990211059857
"Micronuclei and Disease" special issue: Aims, scope, and synthesis of outcomes

Fenech M, Knasmueller S, Knudsen LE, Kirsch-Volders M, Deo P, Franzke B, et al.

Mutat Res Rev Mutat Res, 2021 06 05;788:108384.
PMID: 34893149 DOI: 10.1016/j.mrrev.2021.108384

The purpose of the "Micronuclei and Disease" special issue (SI) is to: (i) Determine the level of evidence for association of micronuclei (MN), a biomarker of numerical and structural chromosomal aberrations, with risk of specific diseases in humans; (ii) Define plausible mechanisms that explain association of MN with each disease; (iii) Identify knowledge gaps and research needed to translate MN assays into clinical practice. The "MN and Disease" SI includes 14 papers. The first is a review of mechanisms of MN formation and their consequences in humans. 11 papers are systematic reviews and/or meta-analyses of the association of MN with reproduction, child health, inflammation, auto-immune disease, glycation, metabolic diseases, chronic kidney disease, cardiovascular disease, eleven common cancers, ageing and frailty. The penultimate paper focuses on effect of interventions on MN frequency in the elderly. A road map for translation of MN data into clinical practice is the topic of the final paper. The majority of reviewed studies were case-control studies in which the ratio of mean MN frequency in disease cases relative to controls, i.e. the mean ratio (MR), was calculated. The mean of these MR values, estimated by meta-analyses, for lymphocyte and buccal cell MN in non-cancer diseases were 2.3 and 3.6 respectively, and for cancers they were 1.7 and 2.6 respectively. The highest MR values were observed in studies of cancer cases in which MN were measured in the same tissue as the tumour (MR = 4.9-10.8). This special issue is an important milestone in the evidence supporting MN as a reliable genomic biomarker of developmental and degenerative disease risk. These advances, together with results from prospective cohort studies, are helping to identify diseases in which MN assays can be practically employed in the clinical setting to better identify high risk patients and to prioritise them for preventive therapy.
Loss of Y chromosome: An emerging next-generation biomarker for disease prediction and early detection?

Guo X, Li J, Xue J, Fenech M, Wang X

Mutat Res Rev Mutat Res, 2021 07 05;788:108389.
PMID: 34893154 DOI: 10.1016/j.mrrev.2021.108389

As human life expectancy increases substantially and aging is the primary risk factor for most chronic diseases, there is an urgent need for advancing the development of post-genomic era biomarkers that can be used for disease prediction and early detection (DPED). Mosaic loss of Y chromosome (LOY) is the state of nullisomy Y in sub-groups of somatic cells acquired from different post-zygotic development stages and onwards throughout the lifespan. Multiple large-cohort based epidemiology studies have found that LOY in blood cells is a significant risk factor for future mortality and various diseases in males. Many features intrinsic to LOY analysis may be leveraged to enhance its use as a non-invasive, sensitive, reliable, high throughput-biomarker for DPED. Here, we review the emerging literatures in LOY studies and highlight ten strengths for using LOY as a novel biomarker for genomics-driven DPED diagnostics. Meanwhile, the current limitations in this area are also discussed. We conclude by identifying some important knowledge gaps regarding the consequences of malsegregation of the Y chromosome and propose further steps that are required before clinical implementation of LOY. Taken together, we think that LOY has substantial potential as a biomarker for DPED, despite some hurdles that still need to be addressed before its integration into healthcare becomes acceptable.
Roadmap for translating results from the micronucleus assay into clinical practice: From observational studies to randomized controlled trials

Bonassi S, Fenech M

Mutat Res Rev Mutat Res, 2021 07 07;788:108390.
PMID: 34893155 DOI: 10.1016/j.mrrev.2021.108390

According to the definition delivred by the WHO, a biomarker, independently from its role that may be indicative of exposure, response or effect, is inevitably linked to a clinical outcome or to a disease. The presence of a continuum from early biological events to therapy, and prognosis is the unifying mechanism that justifies this conclusion. Traditionally, the technical and inter-individual variability of the assays, together with the long duration between early pathogenetic events and the disease, prevented clinical applications to these biomarkers. These limitations became less important with the emerging of personalized preventive medicine because of the focus on disease prediction and prevention, and the recommended use of all data concerning measurable patient's features. Several papers have been published on the best validation procedures for translating biomarkers to real life. The history of cholesterol concentration is extensively discussed as a reliable example of a biomarker that - after a long and controversial validation process - is currently used in clinical practice. The frequency of micronucleated cells is a reliable biomarker for the pathogenesis of cancer and other non-communicable diseases, and the link with clinical outcomes is substantiated by epidemiological evidence and strong mechanistic basis. Available literature concerning the use of the micronucleus assay in clinical studies is discussed, and a suitable three-levels road-map driving this biomarker towards clinical practice is presented. Under the perspective of personalized medicine, the use of the micronucleus assays can play a decisive role in addressing preventive and therapeutic strategies of chronic diseases. In many cases the MN assay is either currently used in clinical practice or classified as adequate to consider translation into practice. The roadmap to clinical validation of the micronucleus assay finds inspiration from the history of biomarkers such as cholesterol, which clearly showed that the evidence from prospective studies or RCTs is critical to achieve the required level of trust from the healthcare profession. (307 words).
Fulltext Inflammatory cytokine storms severity may be fueled by interactions of micronuclei and RNA viruses such as COVID-19 virus SARS-CoV-2. A hypothesis

Kirsch-Volders M, Fenech M

Mutat Res Rev Mutat Res, 2021;788:108395.
PMID: 34893160 DOI: 10.1016/j.mrrev.2021.108395

In this review we bring together evidence that (i) RNA viruses are a cause of chromosomal instability and micronuclei (MN), (ii) those individuals with high levels of lymphocyte MN have a weakened immune response and are more susceptible to RNA virus infection and (iii) both RNA virus infection and MN formation can induce inflammatory cytokine production. Based on these observations we propose a hypothesis that those who harbor elevated frequencies of MN within their cells are more prone to RNA virus infection and are more likely, through combined effects of leakage of self-DNA from MN and RNA from viruses, to escalate pro-inflammatory cytokine production via the cyclic GMP-AMP synthase (cGAS), stimulator of interferon genes (STING) and the Senescence Associated Secretory Phenotype (SASP) mechanisms to an extent that is unresolvable and therefore confers high risk of causing tissue damage by an excessive and overtly toxic immune response. The corollaries from this hypothesis are (i) those with abnormally high MN frequency are more prone to infection by RNA viruses; (ii) the extent of cytokine production and pro-inflammatory response to infection by RNA viruses is enhanced and possibly exceeds threshold levels that may be unresolvable in those with elevated MN levels in affected organs; (iii) reduction of MN frequency by improving nutrition and life-style factors increases resistance to RNA virus infection and moderates inflammatory cytokine production to a level that is immunologically efficacious and survivable.

MeSH terms: Humans; Chromosomal Instability; Micronuclei, Chromosome-Defective*
Comparison of three different skin substitutes in promoting wound healing in an ovine model

Subramaniam T, Shaiful Hadi N, Sulaiman S, Fauzi MB, Hj Idrus RB, Chowdhury SR, et al.

Burns, 2021 Aug 20.
PMID: 34893370 DOI: 10.1016/j.burns.2021.08.012

Skin substitutes are designed dressings intended to promote wound closure. In previous in vitro and in vivo studies on small animal, an acellular skin patch made of collagen hydrogel with dermal fibroblast conditioned medium (Col-DFCM), a collagen sponge scaffold with freshly harvested skin cells (OTC), and a platelet-rich-plasma gel with freshly harvested skin cells (PRP) have been developed and tested for immediate treatment of full-thickness wound. However, to determine the safety and efficacy of these skin patches for clinical applications, further study in a large animal model is needed. The aim of this study is to evaluate the potential of Col-DFCM, OTC and PRP in treating full-thickness wound in an ovine model via histological analysis and immunohistochemistry staining were performed, with the untreated (NT) group serving as the control. Gross examination was conducted on day 7, 14 and 21 to determine the wound closure rate. The findings of percentage of wound size reduction showed that the wound healed fastest in the presence of Col-DFCM (91.34 ± 23.35%) followed by OTC (84.49 ± 23.13%), PRP (77.73 ± 20.9%) and NT group (73.94 ± 23.71%). Histological evaluation with Hematoxylin & Eosin (H & E) and Masson's trichrome staining was used to study the structure of the wound area. The results showed that OTC treated wound was more mature as indicated by the presence of a thinner epidermis followed by the Col-DFCM, PRP and NT group. Immunohistochemistry analysis also confirmed the integrity and maturity of the regenerated skin, with positive expression of cytokeratin 10 (CK10) and involucrin in the epidermal layer. In conclusion, Col-DFCM, OTC and PRP treatments promote healing of full-thickness wound and have the potential to be used clinically for rapid treatment of full-thickness wound.
Fulltext A novel sequence-based predictor for identifying and characterizing thermophilic proteins using estimated propensity scores of dipeptides

Charoenkwan P, Chotpatiwetchkul W, Lee VS, Nantasenamat C, Shoombuatong W

Sci Rep, 2021 Dec 10;11(1):23782.
PMID: 34893688 DOI: 10.1038/s41598-021-03293-w

Owing to their ability to maintain a thermodynamically stable fold at extremely high temperatures, thermophilic proteins (TTPs) play a critical role in basic research and a variety of applications in the food industry. As a result, the development of computation models for rapidly and accurately identifying novel TTPs from a large number of uncharacterized protein sequences is desirable. In spite of existing computational models that have already been developed for characterizing thermophilic proteins, their performance and interpretability remain unsatisfactory. We present a novel sequence-based thermophilic protein predictor, termed SCMTPP, for improving model predictability and interpretability. First, an up-to-date and high-quality dataset consisting of 1853 TPPs and 3233 non-TPPs was compiled from published literature. Second, the SCMTPP predictor was created by combining the scoring card method (SCM) with estimated propensity scores of g-gap dipeptides. Benchmarking experiments revealed that SCMTPP had a cross-validation accuracy of 0.883, which was comparable to that of a support vector machine-based predictor (0.906-0.910) and 2-17% higher than that of commonly used machine learning models. Furthermore, SCMTPP outperformed the state-of-the-art approach (ThermoPred) on the independent test dataset, with accuracy and MCC of 0.865 and 0.731, respectively. Finally, the SCMTPP-derived propensity scores were used to elucidate the critical physicochemical properties for protein thermostability enhancement. In terms of interpretability and generalizability, comparative results showed that SCMTPP was effective for identifying and characterizing TPPs. We had implemented the proposed predictor as a user-friendly online web server at http://pmlabstack.pythonanywhere.com/SCMTPP in order to allow easy access to the model. SCMTPP is expected to be a powerful tool for facilitating community-wide efforts to identify TPPs on a large scale and guiding experimental characterization of TPPs.

MeSH terms: Machine Learning; Algorithms; Amino Acid Sequence*; Amino Acids; Dipeptides/metabolism; Dipeptides/chemistry*; Heat-Shock Proteins/metabolism; Heat-Shock Proteins/chemistry*; Models, Molecular; Protein Conformation; Structure-Activity Relationship; Reproducibility of Results; Computational Biology/methods*; Databases, Protein; Propensity Score
Fulltext In vivo assessment of reversing Cisplatin-Induced nephrotoxicity using Jatropha mollissima crude extract and its potential cytotoxicity

Omer Iqbal M, Bashir Yahya E, Andleeb S, Masood Ahmed M, Umar Javaid M, Shakeel W, et al.

Saudi J Biol Sci, 2021 Dec;28(12):7373-7378.
PMID: 34867040 DOI: 10.1016/j.sjbs.2021.08.057

Jatropha mollissima is one of the ancient plants that known in Africa, Asia and Latin America for its high medicinal value. Previously we showed that the ethanolic leaves extract of J. mollissima was able to reverse the aminoglycoside antibiotics induced nephrotoxicity in only two weeks of administration. Here, we evaluated the phytochemicals, antioxidant and in vivo cytotoxicity of the ethanolic leaves extract in addition to the ability of reversing Cisplatin-induced nephrotoxicity in wistar albino rats. The results of phytochemical analysis showed the presence of flavonoids, phenols, tannins and saponins, with significantly high antioxidant activity. The treated rats did not show any cytotoxic signs; no anatomical, physiological and/or histopathological changes compared with the control group. Kidney, spleen and liver tissues appeared normal after two weeks administration of the maximum dose, with a possible alteration in distal tubules, proximal tubules and glomerulus of the kidney tissues. The results of nephrotoxicity and kidney function suggest promising potential for J. mollissima in kidney damage treatment.
Fulltext Antioxidant Potential of Red Palm-Pressed Mesocarp Olein

Teh SS, Mah SH, Lau HLN, Teng KT, Loganathan R

J Oleo Sci, 2021 Dec 03;70(12):1719-1729.
PMID: 34759109 DOI: 10.5650/jos.ess21147

Oxidative stress occurs due to the imbalance amount of the free radicals and antioxidants in human body which often associated with numerous chronic diseases. The antioxidant properties of red palm-pressed mesocarp olein (PPMO) have not been widely studied. Therefore, antioxidant properties of PPMO relative to commercially available edible oils, namely red palm olein (RPO), palm olein (PO), extra virgin olive oil (OO) and extra virgin coconut oil (CNO) were studied. PPMO exhibited significant higher phytonutrients which more than 2-fold compared to the edible oils. Overall, antioxidant screening indicated that PPMO has significantly higher antioxidant activities than RPO, PO and CNO in term of DPPH, H2O2, NO scavenging and FIC; and significantly higher H2O2 and FIC than OO. The outcomes of this study reveal that PPMO is as good as commercially available edible oil, also a good source for food applications and dietary nutritional supplements. More importantly, the utilization of PPMO could mitigate oil palm waste problem and results in positive environmental impact.

MeSH terms: Olive Oil/pharmacology; Antioxidants*; Free Radical Scavengers; Dietary Supplements; Phytochemicals/analysis
Fulltext In vivo Toxicity Assessment of Refined Red Palm-pressed Mesocarp Olein in Sprague-Dawley Rats

Jin Y, Teh SS, Lau HLN, Mah SH

J Oleo Sci, 2021 Dec 03;70(12):1749-1759.
PMID: 34759114 DOI: 10.5650/jos.ess21215

Refined red palm-pressed mesocarp olein (PPMO) is recovered from palm-pressed mesocarp fiber, which is a by-product from palm oil mill. Its utilization in food industry is extremely limited even though it contains various phytonutrients. Thus, this study aimed to evaluate its toxicity effects by using the male Sprague-Dawley rat model. The rats were administered with a single dose of 2 g/kg PPMO in an acute toxicity study while administered with 2, 1, or 0.5 g/kg PPMO daily for 28 days in a sub-chronic toxicity study. The mortality, oral LD50 value, clinical observation, body and organ weight, hematological and biochemical analyses, pathological and histopathological examinations were assessed. The overall outcomes indicated that PPMO is non-toxic up to 2 g/kg and considered safe to be used in food application, especially as functional food ingredient and supplement attributed to its phytonutrients. Besides, this study provides an insight in alternative utilization of the wastes from palm oil mill.

MeSH terms: Animals; Body Weight/drug effects; Lethal Dose 50; Male; Organ Size/drug effects; Rats, Sprague-Dawley; Dietary Supplements; Toxicity Tests, Acute/methods*; Toxicity Tests, Chronic/methods*; Rats; Functional Food; Food Safety; Solid Waste; Hazard Analysis and Critical Control Points/methods*; Phytochemicals
Drone versus ambulance for blood products transportation: an economic evaluation study

Zailani MA, Azma RZ, Aniza I, Rahana AR, Ismail MS, Shahnaz IS, et al.

BMC Health Serv Res, 2021 Dec 05;21(1):1308.
PMID: 34863156 DOI: 10.1186/s12913-021-07321-3

BACKGROUND: Medical transportation is an essential step in health care services, and includes ground, air and water transportation. Among the important uses of medical transportation is the delivery of blood products in the event of a clinical emergency. Drone technology is the latest technological advancement that may revolutionize medical transportation globally. Nonetheless, its economic evaluation is scant and insufficient, whilst its cost-effectiveness remains controversial. The aim of this study was to compare the cost-effectiveness of drone transportation versus the ambulance.
METHODS: The setting of the study was within a developing nation. An economic evaluation study of drone versus ambulance for emergency blood products transportation between the Sabah Women and Children Hospital (SWACH) and the Queen Elizabeth II Hospital (QEH2) on Borneo Island was conducted using the Cost-Effectiveness Analysis (CEA) technique. The total cost of each mode of transportation was calculated using the Activity Based Costing (ABC) method. Travel time was used as a denominator to estimate the Incremental Cost Effectiveness Ratio (ICER).
RESULTS: For one clinical emergency in SWACH, a round trip of blood products transportation from SWACH to QEH2 costs RM1,266.02 (USD307.09) when using the ambulance, while the drone costs RM1,313.28 (USD319.36). The travel time for the drone was much shorter (18 min) compared to the ambulance (34 min). The Cost-Effectiveness Ratio (CER) of ambulance transportation was RM37.23 (USD9.05) per minute whilst the CER of drone transportation was RM72.96 (USD17.74) per minute. The ICER of drone versus ambulance was - 2.95, implying an increase of RM2.95 in cost for every minute saved using a drone instead of an ambulance.
CONCLUSION: Although drone transportation of blood products costs more per minute compared to the ambulance, the significantly shorter transport time of the drone offset its cost. Thus, we believe there is good economic potential for drone usage for blood products transportation in developing nations particularly if the drone price decreases and its operational lifespan increases. Our limitation of a non-clinical denominator used in this study leads to the recommendation for use of clinical outcomes in future studies.
Functional near-infrared spectroscopy during the verbal fluency task of English-Speaking adults with mood disorders: A preliminary study

Husain SF, McIntyre RS, Tang TB, Abd Latif MH, Tran BX, Linh VG, et al.

J Clin Neurosci, 2021 Dec;94:94-101.
PMID: 34863469 DOI: 10.1016/j.jocn.2021.10.009

Functional near-infrared spectroscopy (fNIRS) provides a direct and objective assessment of cerebral cortex function. It may be used to determine neurophysiological differences between psychiatric disorders with overlapping symptoms, such as major depressive disorder (MDD) and bipolar disorder (BD). Therefore, this preliminary study aimed to compare fNIRS signals during the verbal fluency task (VFT) of English-speaking healthy controls (HC), patients with MDD and patients with BD. Fifteen HCs, 15 patients with MDD and 15 patients with BD were recruited. Groups were matched for age, gender, ethnicity and education. Relative oxy-haemoglobin and deoxy-haemoglobin changes in the frontotemporal cortex was monitored with a 52-channel fNIRS system. Integral values of the frontal and temporal regions were derived as a measure cortical haemodynamic response magnitude. Both patient groups had lower frontal and temporal region integral values than HCs, and patients with MDD had lower frontal region integral value than patients with BD. Moreover, patients could be differentiated from HCs using the frontal and temporal integral values, and patient groups could be differentiated using the frontal region integral values. VFT performance, clinical history and symptom severity were not associated with integral values. These results suggest that prefrontal cortex haemodynamic dysfunction occurs in mood disorders, and it is more extensive in MDD than BD. The fNIRS-VFT paradigm may be a potential tool for differentiating MDD from BD in clinical settings, and these findings need to be verified in a larger sample of English-speaking patients with mood disorders.
Traditional fermented foods as vehicle of non-dairy probiotics: Perspectives in South East Asia countries

Rodzi NARM, Lee LK

Food Res Int, 2021 12;150(Pt B):110814.
PMID: 34863504 DOI: 10.1016/j.foodres.2021.110814

Food fermentation is a food processing technology that utilizes the growth and metabolic activity of microorganisms for the stabilization and transformation of food materials. Notwithstanding, the technology has evolved beyond food preservation into a tool for creating desirable organoleptic, nutritional, and functional attributes in food products. This narrative review outlines a compilation of traditional fermented foods which available in the South East Asia (SEA) regions as a source vehicle for non-dairy probiotics. The nutritional values of traditional fermented foods are well-appreciated, especially in the resource-poor regions. The sensory and organoleptic preferences of traditional fermented foods as means of dietary routine variations were demonstrated. Furthermore, the evidence underlying its potent impacts on public health promotion and disease prevention is outlined. Lastly, the challenges and future prospects for the integration of traditional fermented foods practice are elucidated.

MeSH terms: Far East; Health Promotion; Probiotics*
Multivariate Analysis on Orofacial Odontogenic Infection in Northern Peninsular Malaysia

Ching YC, Poh NM, Ee KS, Feng LX, Mun YK, Mei TM

J Oral Maxillofac Surg, 2021 Nov 13.
PMID: 34863695 DOI: 10.1016/j.joms.2021.11.007

PURPOSE: This regional 2-center study was designed 1) to analyze the clinical features of all patients with odontogenic orofacial infection as per type of visit, 2) to analyze the clinical features of diabetic patients compared with nondiabetic patients, and 3) to identify potential variables that may associate with long length of stay (LOS) of patients admitted for orofacial odontogenic infection in Northern Peninsular Malaysia.
PATIENTS AND METHODS: All adult patients with orofacial odontogenic infections who attended the Oral and Maxillofacial Department of Hospital Raja Permaisuri Bainun and Hospital Sultan Abdul Halim from March 2015 to February 2019 were included. Data on patients' demography, medical history, smoking status, clinical presentation, and LOS were collected. Multivariate logistic regression analysis was performed using the dichotomous dependent variable, namely, short LOS (LOS <5 days) and long LOS (LOS ≥5 days).
RESULTS: A total of 355 patients were reported with the mean age of 39.93 ± 15.95 years old. Multivariate analysis revealed that diabetes (adjusted odds ratio = 4.387, 95% confidence interval = 1.453 to 13.241, P value = .009) and multiple space involvement (adjusted odds ratio = 4.859, 95% confidence interval = 1.280, 18.454, P value = .020) were responsible for long LOS.
CONCLUSIONS: Judicious treatment is recommended when treating patients of such infection that involved multiple spaces with underlying diabetes mellitus.
Fulltext Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with renal cell carcinoma

Kanesvaran R, Porta C, Wong A, Powles T, Ng QS, Schmidinger M, et al.

ESMO Open, 2021 Dec;6(6):100304.
PMID: 34864348 DOI: 10.1016/j.esmoop.2021.100304

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of renal cell carcinoma was published in 2019 with an update planned for 2021. It was therefore decided by both the ESMO and the Singapore Society of Oncology (SSO) to convene a special, virtual guidelines meeting in May 2021 to adapt the ESMO 2019 guidelines to take into account the ethnic differences associated with the treatment of renal cell carcinomas in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with renal cell carcinoma representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate.
Diagnostic reference level for adult pelvic examination in several hospitals of Taif and Kharaj city, Saudi Arabia

Osman H, Raafat BM, Faizo NL, Ahmed RM, Alamri S, Alghamdi AJ, et al.

Appl Radiat Isot, 2021 Nov 27;180:110049.
PMID: 34864437 DOI: 10.1016/j.apradiso.2021.110049

The current study was aimed to estimate the entrance surface air kerma (ESAK, mGy) for adult patients undergoing conventional radiography of Anteroposterior pelvis examination, and finally to establish a local diagnostic reference level (DRL). A total of 500 patients were exposed to diagnostic radiation in four hospitals (coded A, B, C, and D) in Taif and Kharaj city, Saudi Arabia, with different X-ray equipment specifications. Patient demographic data like age (y), body mass index (BMI) in kg/m2 as well as exposure factors and X-ray tube output were recorded. ESAK (mGy) was first calculated using the exposure data and tube output values, then the ESAK values were used to estimate entrance surface dose (ESD). The average BMI was 23.9 kg/m2. The mean tube potential used in A, B, C, and D hospitals and the corresponding estimated ESD were found to be 74.2, 69.8, 73, 76,7 kVp, and 2.54, 2.64, 2.94, 3.03 mGy respectively. The correlation coefficient between ESAK and BMI was found to be 0.98. When compared to computed radiography (CR), the conventional X-ray digital radiography reduces the radiation exposure in pelvic imaging by a factor of 1.18. The third quartile of median proposed a lower than the DRL of the previous studies.

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