Browse publications by year: 2021

  1. Zainal Abidin SAI, Paterson IC, Hunt S, Lambert DW, Higginbotham S, Pink RC
    PLoS One, 2021;16(11):e0256812.
    PMID: 34762649 DOI: 10.1371/journal.pone.0256812
    Transforming growth factor-beta 1 (TGF-β1), a pro-fibrotic tumour-derived factor promotes fibroblast differentiation in the tumour microenvironment and is thought to contribute to the development of pro-tumourigenic cancer-associated fibroblasts (CAFs) by promoting myofibroblast differentiation. miRNA dysregulation has been demonstrated in myofibroblast transdifferentiation and CAF activation, however, their expression varies among cell types and with the method of fibroblast induction. Here, the expression profile of miRNA in human primary oral fibroblasts treated with TGF-β1, to derive a myofibroblastic, CAF-like phenotype, was determined compared to untreated fibroblasts. Myofibroblast transdifferentiation was determined by the expression of alpha-smooth muscle actin (α-SMA) and fibronectin-1 extra domain A (FN-EDA1) using quantitative real-time PCR (qRT-PCR) and western blot. The formation of stress fibres was assessed by fluorescence microscopy, and associated changes in contractility were assessed using collagen contraction assays. Extracellular vesicles (EVs) were purified by using size exclusion chromatography and ultracentrifugation and their size and concentration were determined by nanoparticle tracking analysis. miRNA expression profiling in oral fibroblasts treated with TGF-β1 and their extracellular vesicles was carried out using tiling low-density array cards. The Database for Annotation, Visualization, and Integrated Discovery (DAVID) was used to perform functional and pathway enrichment analysis of target genes. In this study, TGF-β1 induced a myofibroblastic phenotype in normal oral fibroblasts as assessed by expression of molecular markers, the formation of stress fibres and increased contractility. TaqMan Low-Density Array (TLDA) analysis demonstrated that miR-503 and miR-708 were significantly upregulated, while miR-1276 was significantly downregulated in TGF-β1-treated oral fibroblasts (henceforth termed experimentally-derived CAF, eCAF). The gene functional enrichment analysis showed that the candidate miRNAs have the potential to modulate various pathways; including the Ras associated protein 1 (Rap1), PI3K-Akt, and tumour necrosis factor (TNF) signalling pathways. In addition, altered levels of several miRNAs were detected in eCAF EV, including miR-142 and miR-222. No differences in size or abundance of EV were detected between eCAF and normal oral fibroblast (NOF). Little overlap was observed between changes in cellular and EV miRNA profiles, suggesting the possibility of selective loading of EV miRNA. The study reveals miRNA expression signature could be involved in myofibroblast transdifferentiation and the miRNA cargo of their EV, providing novel insight into the involvement of miRNA in CAF development and function.
  2. Amoah J, Said S, Rampal L, Manaf R, Ibrahim N, Owusu-Agyei S, et al.
    PLoS One, 2021;16(11):e0259581.
    PMID: 34762713 DOI: 10.1371/journal.pone.0259581
    BACKGROUND: Cardiovascular diseases (CVDs) are the number cause of death worldwide. In Ghana CVD has been the leading cause of death since 2001. The prevalence of CVD risk factors among adolescents in Ghana has been increasing. This study seeks to develop, implement and evaluate the effects of a behavioral modification intervention program to reduce CVD risk factors among secondary school students in Brong Ahafo, Ghana.

    METHODS: A cluster-randomized controlled trial was conducted with schools as clusters over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14-19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using the multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention study.

    RESULTS: The GLMM analyses showed the intervention was effective in attaining 0.77(p<0.001), 0.72(p<0.001), 0.47(p<0.001), 0.56(p<0.001), and 0.39(p = 0.045) higher total physical activity, fruits, vegetables, seafood, and water scores respectively for the intervention group over the control group. The intervention was also significant in reducing -0.15(p<0.001),-0.23(p<0.001),-0.50(p<0.001),-0.32(p<0.001),-0.90(p<0.001),-0.87(p<0.001),-0.38(p<0.001), -0.63(p<0.001), -1.63(p<0.001), 0.61(p<0.001), and -1.53(p = 0.005) carbohydrates, fats and oils, fried eggs, fried chicken, carbonated drinks, sugar, sweet snacks, salted fish, weight, BMI, and diastolic BP. The odds of quitting alcohol use in the intervention group were 1.06 times more than the control group. There was no significant effect on reducing smoking and systolic BP.

    CONCLUSION: There is an urgent need for the intervention program to be integrated into the existing curriculum structure of secondary school schools. Implementing the intervention will allow for longer and more consistent impact on the reduction of CVD risk factors among secondary school students.

    MeSH terms: Adolescent; Animals; Blood Pressure; Carbohydrates; Carbonated Beverages; Cardiovascular Diseases/prevention & control*; Chickens; Clinical Trials as Topic; Eggs; Fats; Female; Humans; Male; Oils; Risk Factors; School Health Services; Schools; Students/statistics & numerical data*; Vegetables; Program Evaluation; Cluster Analysis; Randomized Controlled Trials as Topic; Control Groups; Young Adult
  3. Vyas T, Rapalli VK, Chellappan DK, Dua K, Dubey SK, Singhvi G
    Life Sci, 2021 Dec 15;287:120148.
    PMID: 34785190 DOI: 10.1016/j.lfs.2021.120148
    BACKGROUND: Biofilms are microcolonies of microbes that form communities with a variety of microbes, exhibit the same gene composition but differ in gene expression. Biofilm-associated infections have been in existence for a long, however, biofilm-associated skin disorders have not been investigated much.

    OBJECTIVES: Biofilms, which are made mostly of the matrix can be thought of as communities of microbes that are more virulent and more difficult to eradicate as compared to their planktonic counterparts. Currently, several formulations are available in the market which have the potential to treat biofilm-assisted skin disorders. However, the existing pharmacotherapies are not competent enough to cure them effectively and entirely, in several cases.

    KEY FINDINGS: Especially with the rising resistance towards antibiotics, it has become particularly challenging to ameliorate these disorders completely. The new approaches are being used to combat biofilm-associated skin disorders, some of them being photodynamic therapy, nanotherapies, and the use of novel drug delivery systems. The focus of attention, however, is nanotherapy. Micelles, solid lipid nanoparticles, quatsomes, and many others are being considered to find a better solution for the biofilm-associated skin disorders.

    SIGNIFICANCE: This review is an attempt to give a perspective on these new approaches for treating bacterial biofilms associated with skin disorders.

    MeSH terms: Animals; Anti-Bacterial Agents/administration & dosage*; Anti-Bacterial Agents/metabolism; Humans; Skin Diseases/drug therapy*; Skin Diseases/metabolism; Skin Diseases/physiopathology; Drug Delivery Systems/methods*; Drug Delivery Systems/trends; Treatment Outcome; Biofilms/drug effects*; Biofilms/growth & development; Nanotechnology/methods*; Nanotechnology/trends
  4. Idris S, Daud S, Ahmad Sani N, Tee Mei Li S
    Am J Case Rep, 2021 Nov 17;22:e933438.
    PMID: 34785630 DOI: 10.12659/AJCR.933438
    BACKGROUND Adnexal torsion is a gynecologic emergency that dictates immediate surgical intervention. Twisted ovarian cysts are rare in adolescents, but they can cause significant distress to patients. Idiopathic ovarian torsion is uncommon in adolescents and the incidence is reportedly higher in women aged 20 to 40 years. Most twisted cysts in adolescents are benign. In the past, oophorectomy was commonly performed for a torsed ovary, but currently there is a trend toward ovary preservation. The diagnosis of twisted ovarian cyst is based on pathognomonic symptoms and findings from a focused clinical examination and ultrasound. Because the differential diagnosis includes acute appendicitis and gastroenteritis, referral to a gynecologist may be delayed. CASE REPORT We present the case of a huge, twisted ovarian cyst in a 16-year-old girl who presented with an acute abdomen. The initial diagnosis was acute appendicitis, which delayed her referral to a gynecologist. An emergency laparotomy and left salpingo-oophorectomy were performed. The histopathology of the ovarian cyst was reported as serous cystadenoma. CONCLUSIONS The optimal management of a twisted ovarian cyst in adolescents is the subject of much debate. Here, we review the literature on ovarian torsion in children and adolescents. The patient in the case we present had a twisted ovarian cyst that was managed with salpingo-oophorectomy.
    MeSH terms: Adolescent; Child; Female; Humans; Ovariectomy; Torsion Abnormality/diagnosis; Torsion Abnormality/surgery
  5. Ranjbari M, Shams Esfandabadi Z, Zanetti MC, Scagnelli SD, Siebers PO, Aghbashlo M, et al.
    J Clean Prod, 2021 May 15;297:126660.
    PMID: 34785869 DOI: 10.1016/j.jclepro.2021.126660
    The COVID-19 pandemic has immensely impacted the economic, social, and environmental pillars of sustainability in human lives. Due to the scholars' increasing interest in responding to the urgent call for action against the pandemic, the literature of sustainability research considering COVID-19 consequences is very fragmented. Therefore, a comprehensive review of the COVID-19 implications for sustainability practices is still lacking. This research aims to analyze the effects of COVID-19 on the triple bottom line (TBL) of sustainability to support the future sustainable development agenda. To achieve that, the following research questions are addressed by conducting a systematic literature review: (i) what is the current status of research on the TBL of sustainability considering COVID-19 implications? (ii) how does COVID-19 affect the TBL of sustainability? and (iii) what are the potential research gaps and future research avenues for sustainable development post COVID-19? The results manifest the major implications of the COVID-19 outbreak for the triple sustainability pillars and the sustainable development agenda from the economic, social, and environmental points of view. The key findings provide inclusive insights for governments, authorities, practitioners, and policy-makers to alleviate the pandemic's negative impacts on sustainable development and to realize the sustainability transition opportunities post COVID-19. Finally, five research directions for sustainable development corresponding to the United Nations' sustainable development goals (SDGs) post COVID-19 are provided, as follows: (1) sustainability action plan considering COVID-19 implications: refining sustainability goals and targets and developing measurement framework; (2) making the most of sustainability transition opportunities in the wake of COVID-19: focus on SDG 12 and SDG 9; (3) innovative solutions for economic resilience towards sustainability post COVID-19: focus on SDG 1, SDG 8, and SDG 17; (4) in-depth analysis of the COVID-19 long-term effects on social sustainability: focus on SDG 4, SDG 5, and SDG 10; and (5) expanding quantitative research to harmonize the COVID-19-related sustainability research.
  6. Wong SK, Chin KY, Ima-Nirwana S
    Drug Des Devel Ther, 2021;15:4615-4632.
    PMID: 34785890 DOI: 10.2147/DDDT.S331027
    Andrographolide is the major compound found in the medicinal plant, Andrographis paniculata (Burm.f.) Nees, which accounts for its medicinal properties. Both the plant extract and compound have been reported to exhibit potential cardiovascular activities. This review summarises related studies describing the biological activities and target mechanisms of A. paniculata and andrographolide in vivo and in vitro. The current evidence unambiguously indicated the protective effects provided by A. paniculata and andrographolide administration against myocardial injury. The intervention ameliorates the symptoms of myocardial injury by interfering with the inductive phase of a) inflammatory response mediated by nuclear factor-kappa B (NF-κB), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) signalling molecules; b) oxidative stress via activation of nuclear factor erythroid 2-related factor (Nrf-2) and reduction of enzymes responsible for generating reactive oxygen and nitrogen species; c) intrinsic and extrinsic mechanisms in apoptosis regulated by upstream insulin-like growth factor-1 receptor (IGF-1R) and peroxisome proliferator-activated receptor-alpha (PPAR-α); d) profibrotic growth factors thus reducing cardiac fibrosis, improving endothelial function and fibrinolytic function. In conclusion, A. paniculata and andrographolide possess therapeutic potential in the management of myocardial injury, which requires further validation in human clinical trials.
  7. Rahman T, Khandakar A, Hoque ME, Ibtehaz N, Kashem SB, Masud R, et al.
    IEEE Access, 2021;9:120422-120441.
    PMID: 34786318 DOI: 10.1109/ACCESS.2021.3105321
    The coronavirus disease 2019 (COVID-19) after outbreaking in Wuhan increasingly spread throughout the world. Fast, reliable, and easily accessible clinical assessment of the severity of the disease can help in allocating and prioritizing resources to reduce mortality. The objective of the study was to develop and validate an early scoring tool to stratify the risk of death using readily available complete blood count (CBC) biomarkers. A retrospective study was conducted on twenty-three CBC blood biomarkers for predicting disease mortality for 375 COVID-19 patients admitted to Tongji Hospital, China from January 10 to February 18, 2020. Machine learning based key biomarkers among the CBC parameters as the mortality predictors were identified. A multivariate logistic regression-based nomogram and a scoring system was developed to categorize the patients in three risk groups (low, moderate, and high) for predicting the mortality risk among COVID-19 patients. Lymphocyte count, neutrophils count, age, white blood cell count, monocytes (%), platelet count, red blood cell distribution width parameters collected at hospital admission were selected as important biomarkers for death prediction using random forest feature selection technique. A CBC score was devised for calculating the death probability of the patients and was used to categorize the patients into three sub-risk groups: low (<=5%), moderate (>5% and <=50%), and high (>50%), respectively. The area under the curve (AUC) of the model for the development and internal validation cohort were 0.961 and 0.88, respectively. The proposed model was further validated with an external cohort of 103 patients of Dhaka Medical College, Bangladesh, which exhibits in an AUC of 0.963. The proposed CBC parameter-based prognostic model and the associated web-application, can help the medical doctors to improve the management by early prediction of mortality risk of the COVID-19 patients in the low-resource countries.
  8. Aborujilah A, Elsebaie AFM, Mokhtar SA
    IEEE Access, 2021;9:131120-131133.
    PMID: 34786319 DOI: 10.1109/ACCESS.2021.3069255
    Recently, COVID-19 has infected a lot of people around the world. The healthcare systems are overwhelmed because of this virus. The intensive care unit (ICU) as a part of the healthcare sector has faced several challenges due to the poor information quality provided by current ICUs' medical equipment management. IoT has raised the ability for vital data transfer in the healthcare sector of the new century. However, most of the existing paradigms have adopted IoT technology to track patients' health statuses. Therefore, there is a lack of understanding on how to utilize such technology for ICUs' medical equipment management. This paper proposes a novel IoT-based paradigm called IoT Based Paradigm for Medical Equipment Management Systems (IoT MEMS) to manage medical equipment of ICUs efficiently. It employs IoT technology to enhance the information flow between medical equipment management systems (THIS) and ICUs during the COVID-19 outbreak to ensure the highest level of transparency and fairness in reallocating medical equipment. We described in detail the theoretical and practical aspects of IoT MEMS. Adopting IoT MEMS will enhance hospital capacity and capability in mitigating COVID-19 efficiently. It will also positively influence the information quality of (THIS) and strengthen trust and transparency among the stakeholders.
  9. Lee SL, Sidhu J, Ng CY
    Euroasian J Hepatogastroenterol, 2021 11 18;11(2):97-99.
    PMID: 34786364 DOI: 10.5005/jp-journals-10018-1350
    Cervical adenocarcinoma accounts for 25% of invasive cervical cancer which frequently metastasize distantly to the lungs, liver, bone, and brain. Metastases to the common bile duct from cervical cancer are exceedingly rare with few reported cases in the literature. Diagnosis of bile duct metastases from cervical cancer can be established with endoscopic ultrasound-guided fine-needle aspiration cytology, biliary cytobrushing, or direct cholangioscopy with biopsy, and this would guide further therapies such as endoscopic biliary drainage and systemic chemotherapy. We hereby present a rare case of obstructive jaundice from metastatic biliary stricture with "beaded" appearance in a patient with cervical adenocarcinoma. How to cite this article: Lee SL, Sidhu J, Ng CY. Metastatic Biliary Stricture with "Beaded" Appearance from Cervical Adenocarcinoma. Euroasian J Hepato-Gastroenterol 2021;11(2):97-99.
  10. Chau JHF, Lee KM, Pang YL, Abdullah B, Juan JC, Leo BF, et al.
    PMID: 34786623 DOI: 10.1007/s11356-021-17243-6
    Textile dyeing wastewater becomes one of the root causes of environmental pollution. Titanium dioxide (TiO2) is one of the photocatalysts that shows prominent organic dye photodegradation ability. In this study, a porous tungsten oxide (WO3)/TiO2 composite was prepared through ultrasonic-assisted solvothermal technique with varying amounts of WO3 ranging from 0.25 to 5 weight % (wt.%). The prepared 0.50 wt.% WO3/TiO2 (0.50WTi) composite exhibited the highest photodegradation activity (4.39 × 10-2 min-1) and complete mineralization in chemical oxygen demand (COD) reading towards 30 mg.L-1 of Reactive Black 5 (RB5) dye under 60 min of light irradiation. Effects of large surface area, small crystallite size, high pore volume and size, and low electron-hole pair recombination rate attributed to the superiority of 0.50WTi. Besides, 0.50WTi could be reused, showing 86.50% of RB5 photodegradation at the fifth cycle. Scavenger study demonstrated that photogenerated hole (h+) was the main active species of 0.50WTi to initiate the RB5 photodegradation. Cytotoxicity assessment determined the readings of half-maximal inhibitory concentration (IC50) were 1 mg.mL-1 and 0.61 mg.mL-1 (24 and 72 h of incubations) for the 0.50WTi composite.
  11. Li X, Nian BB, Tan CP, Liu YF, Xu YJ
    J Sci Food Agric, 2021 Nov 17.
    PMID: 34786719 DOI: 10.1002/jsfa.11659
    BACKGROUND: Deep-frying oil has been found to cause inflammatory bowel disease (IBD). However, the molecular mechanism of the effect of deep-frying palm oil on IBD still remains undetermined.

    RESULTS: In the present study, bioinformatics and cell biology were used to investigate the functions and signal pathway enrichments of differentially expressed genes. The bioinformatics analysis of three original microarray datasets (GSE73661, GSE75214 and GSE126124) in the NCBI-Gene Expression Omnibus database showed 17 down-regulated genes (logFC  0) existed in the enteritis tissue. Meanwhile, pathway enrichment and protein-protein interaction network analysis suggested that IBD is relevant to cytotoxicity, inflammation and apoptosis. Furthermore, Caco-2 cells were treated with the main oxidation products of deep-frying oil-total polar compounds (TPC) and its components (polymerized triglyceride, oxidized triglycerides and triglyceride degradation products) isolated from deep-frying oil. The flow cytometry experiment revealed that TPC and its components could induce apoptosis, especially for oxidized triglyceride. A quantitative polymerase chain reaction analysis demonstrated that TPC and its component could induce Caco-2 cell apoptosis through AQP8/CXCL1/TNIP3/IL-1.

    CONCLUSION: The present study provides fundamental knowledge for understanding the effects of deep-frying oils on the cytotoxic and inflammatory of Caco-2 cells, in addition to clarifying the molecular function mechanism of deep-frying oil in IBD. © 2021 Society of Chemical Industry.

  12. Fairozekhan AT, Mohamed S, Mohammed F, Kumaresan R, Bugshan ASM, B SC, et al.
    Braz Dent J, 2021 11 18;32(4):116-126.
    PMID: 34787247 DOI: 10.1590/0103-6440202103821
    Novel Coronavirus Disease 2019 (COVID-19) has caused serious repercussions both physically and mentally. The crisis has laid an enormous workload on the global healthcare fraternity. This article has attempted to study the emotional and psychological status of the medical and dental fraternity across seven Asian countries (India, Malaysia, the Gulf Cooperation countries (GCC) and, others) and also deduce the degree of mental preparedness as they spearhead the war against COVID-19. A cross-sectional, descriptive online survey was carried out among potential participants from online forums and other health-related social communities. Bivariate analysis with descriptive statistics was applied to decipher the results. A total of 788 complete responses were analyzed. The response rate was 77.1%. Results revealed the perception of the Healthcare Professionals about COVID-19 and its implications in their personal and professional lives. Many categories from psychological and emotional standpoints were analyzed. Older HCPs (above 35 years) reported high levels of stress at the workplace (p = 0.002). About 43.5% of the HCPs from India reported that they have not received any specialized training on containing COVID-19 or any contagious disease. Intense emotional stress was reported by the HCPs when colleagues get infected. The medical professionals (61.7%) exhibited more work stress compared to their dental counterparts. Analyzing the psychological and emotional status of HCPs is imperative especially in this COVID-19 situation. Similar analyses are crucial to gauge the quality of our healthcare system and take necessary actions like training the workforce, revamping the infrastructure, and regulating the workflow.
    MeSH terms: Cross-Sectional Studies; Delivery of Health Care; Humans; Perception; Pandemics*
  13. Huong AKC, Tay KG, Ngu XTI
    Healthc Inform Res, 2021 Oct;27(4):298-306.
    PMID: 34788910 DOI: 10.4258/hir.2021.27.4.298
    OBJECTIVES: Different complex strategies of fusing handcrafted descriptors and features from convolutional neural network (CNN) models have been studied, mainly for two-class Papanicolaou (Pap) smear image classification. This paper explores a simplified system using combined binary coding for a five-class version of this problem.

    METHODS: This system extracted features from transfer learning of AlexNet, VGG19, and ResNet50 networks before reducing this problem into multiple binary sub-problems using error-correcting coding. The learners were trained using the support vector machine (SVM) method. The outputs of these classifiers were combined and compared to the true class codes for the final prediction.

    RESULTS: Despite the superior performance of VGG19-SVM, with mean ± standard deviation accuracy and sensitivity of 80.68% ± 2.00% and 80.86% ± 0.45%, respectively, this model required a long training time. There were also false-negative cases using both the VGGNet-SVM and ResNet-SVM models. AlexNet-SVM was more efficient in terms of running speed and prediction consistency. Our findings also showed good diagnostic ability, with an area under the curve of approximately 0.95. Further investigation also showed good agreement between our research outcomes and that of the state-of-the-art methods, with specificity ranging from 93% to 100%.

    CONCLUSIONS: We believe that the AlexNet-SVM model can be conveniently applied for clinical use. Further research could include the implementation of an optimization algorithm for hyperparameter tuning, as well as an appropriate selection of experimental design to improve the efficiency of Pap smear image classification.

  14. Alishaq M, Jeremijenko A, Nafady-Hego H, Al Ajmi JA, Elgendy M, Thomas AG, et al.
    BMC Public Health, 2021 11 11;21(1):2070.
    PMID: 34763694 DOI: 10.1186/s12889-021-12134-4
    BACKGROUND: There is controversy regarding the role of in-person attendance in schools and transmission of the SARS-CoV-2 pandemic. Several studies have demonstrated no increase in transmission, while some have reported large outbreaks with in-person attendance. We determined the incidence and risk factors for SARS-CoV-2 infection among school staff after one school term.

    METHODS: Nasopharyngeal swabs (NPS) for SARS-CoV-2 RT-PCR and blood for SARS-CoV-2 antibody testing were obtained from staff at a large international school in Qatar at the beginning of the 2020-2021 school year and repeated at the end of the first term.

    RESULTS: A total of 376 staff provided samples for testing. At the beginning of the 2020-2021 school year, the PCR positivity for SARS-CoV-2 was 13%, while seropositivity was 30.1%. A majority of those who tested positive either by PCR or serologically, were non-teaching staff. At the end of the first school term four months later, only 3.5% of the initially antibody-negative staff had seroconverted. In multivariable logistic regression analysis, male gender (OR 11.48, 95%CI 4.77-27.64), non-teaching job category (OR 3.09, 95%CI 1.10-8.64), contact with a confirmed case (OR 20.81, 95%CI 2.90-149.18), and presence of symptoms in the preceding 2 weeks [1-2 symptoms OR 4.82, 95%CI 1.79-12.94); ≥3 symptoms OR 42.30, 95%CI 3.76-476.43) independently predicted SARS-CoV-2 infection in school staff before school starting.

    CONCLUSION: Male gender, non-teaching job, presence of symptoms, and exposure to a confirmed case were associated with higher risk of infection. These data can help policymakers in determining the optimal strategy for school reopening.

    MeSH terms: Humans; Male; Schools; Polymerase Chain Reaction; Pandemics
  15. Tan KK, Tan JY, Wong JE, Teoh BT, Tiong V, Abd-Jamil J, et al.
    Sci Rep, 2021 11 11;11(1):22105.
    PMID: 34764315 DOI: 10.1038/s41598-021-01223-4
    The COVID-19 pandemic first emerged in Malaysia in Jan 2020. As of 12th Sept 2021, 1,979,698 COVID-19 cases that occurred over three major epidemic waves were confirmed. The virus contributing to the three epidemic waves has not been well-studied. We sequenced the genome of 22 SARS-CoV-2 strains detected in Malaysia during the second and the ongoing third wave of the COVID-19 epidemic. Detailed phylogenetic and genetic variation analyses of the SARS-CoV-2 isolate genomes were performed using these newly determined sequences and all other available sequences. Results from the analyses suggested multiple independent introductions of SARS-CoV-2 into Malaysia. A new B.1.524(G) lineage with S-D614G mutation was detected in Sabah, East Malaysia and Selangor, Peninsular Malaysia on 7th October 2020 and 14th October 2020, respectively. This new B.1.524(G) group was not the direct descendant of any of the previously detected lineages. The new B.1.524(G) carried a set of genetic variations, including A701V (position variant frequency = 0.0007) in Spike protein and a novel G114T mutation at the 5'UTR. The biological importance of the specific mutations remained unknown. The sequential appearance of the mutations, however, suggests that the spread of the new B.1.524(G) lineages likely begun in Sabah and then spread to Selangor. The findings presented here support the importance of SARS-CoV-2 full genome sequencing as a tool to establish an epidemiological link between cases or clusters of COVID-19 worldwide.
    MeSH terms: Humans; Malaysia/epidemiology; Phylogeny; Genetic Variation; Genome, Viral; Pandemics
  16. Uthoff A, Bustos A, Metral G, Cronin J, Dolcetti J, Rumpf MC
    Sports Health, 2021 11 15;14(1):92-98.
    PMID: 34781770 DOI: 10.1177/19417381211055696
    BACKGROUND: Adding wearable resistance (WR) to training results in superior performance compared with unloaded conditions. However, it is unclear if adding WR during warm-up influences training load (TL) in the subsequent session. The aim of this research was to track TL in soccer players during the transition from late preseason to early in-season and examine whether adding WR to the lower leg during a warm-up influenced TL measures during warm-ups and on-field training sessions after WR was removed.

    HYPOTHESIS: The addition of WR worn on the lower legs during an on-field warm-up would lead to decreases in relatively high-intensity external TL metrics, such as distance covered >6.11 m∙s-1 and acceleration and deceleration >/<3 m∙s-2 and increases in internal TL during the warm-up, yet would have little effect on the subsequent training session when WR was removed.

    STUDY DESIGN: Matched-pair randomized design.

    LEVEL OF EVIDENCE: Level 3.

    METHODS: A total of 28 soccer players were allocated to either a WR training (WRT = 14) or unloaded (control [CON] = 14) group. Both groups performed the same warm-up and on-field training for 8 weeks, with the WRT group wearing 200 g to 600 g loads on their lower leg during the warm-up. External TL was measured via global positioning system data and internal TL was assessed using session rating of perceived exertion (sRPE × time per session).

    RESULTS: No statistically significant between-group differences (P ≥ 0.05) were identified for any TL measurement during either warm-ups or training sessions. Lower leg WR resulted in trivial to moderate effects for all external TL metrics (-16.9% to 2.40%; d = -0.61 to 0.14) and sRPE (-0.33%; d = -0.03) during the warm-up and trivial to small effects on all external TL metrics (-8.95% to -0.36%; d = -0.45 to -0.30) and sRPE (3.39%; d = 0.33) during training sessions.

    CONCLUSION: Warming up with lower leg WR negatively affects neither the quality and quantity of the warm-up nor the subsequent training session once WR is removed.

    CLINICAL RELEVANCE: Using WR on the lower leg during on-field warm-ups may be a means to "microdose" strength training while not unduly increasing TL. However, further research is needed to determine the influence of WR on strength qualities.

    MeSH terms: Physical Exertion; Humans; Soccer*; Warm-Up Exercise*; Physical Conditioning, Human*
  17. Prabhu SP, Nileshwar A, Krishna HM, Prabhu M
    Niger J Clin Pract, 2021 Nov;24(11):1682-1688.
    PMID: 34782509 DOI: 10.4103/njcp.njcp_30_20
    Background: Stroke volume variation (SVV) is a dynamic indicator of preload, which is a determinant of cardiac output. Aims: Aim of this study was to evaluate the relationship between changes in SVV and cardiac index (CI) in patients with normal left ventricular function undergoing major open abdominal surgery.

    Patients and Methods: Patients undergoing major open abdominal surgery were monitored continuously with FloTrac® to measure SVV and CI along with standard monitoring. Both SVV and CI were noted at baseline and every 10 min thereafter till the end of surgery and were observed for concurrence between the measurements.

    Results: 1800 pairs of measurement of SVV and CI were obtained from 60 patients. Mean SVV and CI (of all patients) measured at different time points of measurement showed that as SVV increased with time, the CI dropped correspondingly. When individual readings of CI and SVV were plotted against each other, the scatter was found to be wide, reiterating the lack of agreement between the two parameters (R2 = 0.035). SVV >13% suggesting hypovolemia was found at 207 time points. Of these, 175 had a CI >2.5 L/min/m2 and only 32 patients had a CI <2.5 L/min/m2.

    Conclusion: SVV, a dynamic index of fluid responsiveness can be used to monitor patients expected to have large fluid shifts during major abdominal surgery. It is very specific and has a high negative predictive value. When SVV increases, CI is usually maintained. Since many factors affect SVV and CI, any increase in SVV >13%, must be correlated with other parameters before administration of the fluid challenge.

    MeSH terms: Abdomen; Blood Pressure; Fluid Therapy*; Hemodynamics; Humans; Stroke Volume; Digestive System Surgical Procedures*
  18. Habeeb D, Noman F, Alkahtani AA, Alsariera YA, Alkawsi G, Fazea Y, et al.
    Comput Intell Neurosci, 2021;2021:3971834.
    PMID: 34782832 DOI: 10.1155/2021/3971834
    Recognizing vehicle plate numbers is a key step towards implementing the legislation on traffic and reducing the number of daily traffic accidents. Although machine learning has advanced considerably, the recognition of license plates remains an obstacle, particularly in countries whose plate numbers are written in different languages or blended with Latin alphabets. This paper introduces a recognition system for Arabic and Latin alphabet license plates using a deep-learning-based approach in conjugation with data collected from two specific countries: Iraq and Malaysia. The system under study is proposed to detect, segment, and recognize vehicle plate numbers. Moreover, Iraqi and Malaysian plates were used to compare these processes. A total of 404 Iraqi images and 681 Malaysian images were tested and used for the proposed techniques. The evaluation took place under various atmospheric environments, including fog, different contrasts, dirt, different colours, and distortion problems. The proposed approach showed an average recognition rate of 85.56% and 88.86% on Iraqi and Malaysian datasets, respectively. Thus, this evidences that the deep-learning-based method outperforms other state-of-the-art methods as it can successfully detect plate numbers regardless of the deterioration level of image quality.
    MeSH terms: Accidents, Traffic; Machine Learning
  19. Chan PL, Le LV, Ishikawa N, Easterbrook P
    Glob Health Med, 2021 Oct 31;3(5):253-261.
    PMID: 34782866 DOI: 10.35772/ghm.2021.01065
    Chronic hepatitis C (HCV) infection is a major global public health threat and in 2019 there were an estimated 58 million infected globally and 290,000 deaths. Elimination of viral hepatitis B/C as a public health threat by 2030 is defined as a 90% incidence reduction and a 65% mortality reduction. The Western Pacific region is one of the most affected regions with 10 million people living with HCV, one-fifth of the global burden. We review progress towards HCV elimination in the Western Pacific region since 2015. Key developments in the region, which comprises of 37 high-and-middle-income countries, include the following: 20 countries have national hepatitis action plans, 19 have conducted recent disease burden and investment cases, 10 have scaled-up hepatitis services at primary health care level, and in 11 countries, domestic financing including social health insurance support DAA costs. We highlight six countries' experience in navigating the path towards HCV elimination: Cambodia, China, Malaysia, Mongolia, Philippines, and Viet Nam. Future initiatives to accelerate elimination are expanding access to community-based testing using HCV point-of-care tests among at-risk and general populations; adopting decentralized and integrated HCV one-stop services at harm reduction sites, detention settings and primary care; expanding treatment to include children and adolescents; address stigma and discrimination; and ensuring sustainable financing through domestic resources to scale-up testing, treatment and prevention. The COVID-19 pandemic has a significant impact on hepatitis response across the region on community and facility-based testing, treatment initiation, monitoring and cancer screening, which is projected to delay elimination goals.
  20. Bisht A, Hemrajani C, Rathore C, Dhiman T, Rolta R, Upadhyay N, et al.
    Drug Deliv Transl Res, 2021 Nov 15.
    PMID: 34782995 DOI: 10.1007/s13346-021-01092-4
    Azelaic acid (AzA) is a USFDA bioactive prescribed against acne vulgaris. It possesses delivery challenges like poor aqueous solubility, low skin-penetrability, and dose-dependent side effects, which could be overcome by its synergistic combination with tea tree oil (TTO) as a microemulsion (ME)-based hydrogel composite. AzA-TTO ME was prepared to employ pseudo-ternary phase diagram construction. The best AzA-TTO ME was of uniform size (polydispersity index  90%), and negative zeta potential (-1.42 ± 0.25% mV) values. ME hydrogel composite with optimum rheological and textural attributes showed better permeation, retention, and skin-compliant characteristics, vis-a-vis marketed formulation (Aziderm™) when evaluated in Wistar rat skin. In vitro antibacterial efficacy in bacterial strains, i.e., Staphylococcus aureus, Propionibacterium acne, and Staphylococcus epidermidis, was evaluated employing agar well plate diffusion and broth dilution assay. ME hydrogel has shown an increase in zone of inhibition by two folds and a decrease in minimum inhibitory concentration (MIC) by eightfold against P. acnes vis-a-vis AzA. Finally, ME hydrogel composite exhibited a better reduction in the papule density (93.75 ± 1.64%) in comparison to Aziderm™ 72.69 ± 4.67%) on acne as developed in rats by inducing testosterone. Thus, the developed AzA-TTO ME hydrogel composite promises an efficacious and comparatively safer drug delivery system for the topical therapy of acne vulgaris.
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