Browse publications by year: 2023

  1. Jamil Al-Obaidi MM, Desa MNM
    J Neurosci Res, 2023 Nov;101(11):1687-1698.
    PMID: 37462109 DOI: 10.1002/jnr.25232
    Coronaviruses are prevalent in mammals and birds, including humans and bats, and they often spread through airborne droplets. In humans, these droplets then interact with angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), which are the main receptors for the SARS-CoV-2 virus. It can infect several organs, including the brain. The blood-brain barrier (BBB) is designed to maintain the homeostatic neural microenvironment of the brain, which is necessary for healthy neuronal activity, function, and stability. It prevents viruses from entering the brain parenchyma and does not easily allow chemicals to pass into the brain while assisting numerous compounds in exiting the brain. The purpose of this review was to examine how COVID-19 influences the BBB along with the mechanisms that indicate the BBB's deterioration. In addition, the cellular mechanism through which SARS-CoV-2 causes BBB destruction by binding to ACE2 was evaluated and addressed. The mechanisms of the immunological reaction that occurs during COVID-19 infection that may contribute to the breakdown of the BBB were also reviewed. It was discovered that the integrity of the tight junction (TJs), basement membrane, and adhesion molecules was damaged during COVID-19 infection, which led to the breakdown of the BBB. Therefore, understanding how the BBB is disrupted by COVID-19 infection will provide an indication of how the SARS-CoV-2 virus is able to reach the central nervous system (CNS). The findings of this research may help in the identification of treatment options for COVID-19 that can control and manage the infection.
    MeSH terms: Animals; Brain/metabolism; Humans; Mammals/metabolism
  2. Rauff-Adedotun AA, Lee IL, Abd Talib N, Shaari N, Yahaya ZS, Meor Termizi FH
    Parasitol Res, 2023 Sep;122(9):2193-2205.
    PMID: 37462745 DOI: 10.1007/s00436-023-07920-5
    Blastocystis is a unicellular, anaerobic protist inhabiting the intestinal tract of diverse animal hosts, including human. Information regarding Blastocystis in small ruminants, namely goats and sheep, is limited globally; thus, this study was carried out to investigate the distribution and determinants of Blastocystis in ruminant livestock animals from Penang, Malaysia. Fecal samples from 127 cattle, 149 goats, and 100 sheep were examined for Blastocystis by in vitro cultivation using modified Jones' medium, while DNA barcoding was used for subtyping. Overall, 23.1% (87/376) of animals screened were positive for Blastocystis sp. The prevalence of infection was significantly higher in goats than in cattle and sheep, while the female gender, semi-intensive farming system, and the Northeast Penang Island district were identified as potential risk factors for Blastocystis infection. Blastocystis sp. ST5, ST14, and ST25 were identified in cattle; ST5, ST10, ST13, and ST14 in goats; and ST4, ST5, ST14, and ST15 in sheep. ST5 and ST14 were found to be the most abundant and widespread subtypes in the study area. To the best of our knowledge, this is the first report of ST4 from sheep and ST13 from goats, thus serving as an update to the host range of Blastocystis sp. ST4 and ST13. The isolation of ST4 and ST5 in this study suggests that ruminant livestock animals could serve as reservoirs of human infection.
    MeSH terms: Animals; Cattle; Feces; Female; Goats; Humans; Malaysia/epidemiology; Phylogeny; Sheep; Genetic Variation; Prevalence; Livestock
  3. Noor NM, Mustaffa Z, Nizam A, Mohd Zim MA, Ng LWC, Mirza FT
    BMJ Open, 2023 Jul 18;13(7):e068776.
    PMID: 37463801 DOI: 10.1136/bmjopen-2022-068776
    INTRODUCTION: The prevalence of chronic obstructive pulmonary disease (COPD) has been on the rise, with acute exacerbation of COPD associated with the highest burden and multiple pulmonary and systemic consequences. People with COPD have been found to have an abnormal response of systemic inflammation. To date, although limited, there are studies that suggest negative associations between inflammatory markers and important clinical outcomes such as exercise capacity and muscle force. This protocol aims to systematically review the evidence for (i) the associations between inflammatory markers and lung function, muscle force and exercise capacity and (ii) the influence of other factors (eg, hospitalisation, exercise programme) on the level of inflammatory markers in people with COPD.

    METHODS AND ANALYSIS: Scopus, PubMed, Cochrane, Web of Science and ProQuest will be searched from database inception to February 2023 using PEO search strategy (Population: adults with COPD; Exposure: inflammatory markers; Outcomes: lung function, muscle force and exercise capacity). Four reviewers working in pairs will independently screen articles for eligibility and extract data that fulfilled the inclusion criteria. Depending on the design of the included studies, either Cochrane risk-of-bias version 2 or the Newcastle-Ottawa Scale tools will be used to rate the methodological quality of the included studies. Effect sizes reported in each individual study will be standardised to Cohen's d and a random effects model will be used to calculate the pooled effect size for the association.

    ETHICS AND DISSEMINATION: Ethical approval is unnecessary as this study will only use publicly available data. The findings will be disseminated through publication in peer-reviewed journals and conferences.

    PROSPERO REGISTRATION NUMBER: CRD42022284446.

    MeSH terms: Humans; Lung; Muscles; Quality of Life; Exercise Tolerance*; Pulmonary Disease, Chronic Obstructive*
  4. Kai L, Tan WH, Saari EM
    JMIR Serious Games, 2023 Aug 22;11:e42878.
    PMID: 37463860 DOI: 10.2196/42878
    BACKGROUND: As the gaming industry grows around the world, playing pervasive games is becoming an important mode of entertainment. A pervasive game is one in which the game experience extends into the actual world or where the fictive world of the game merges with the physical world. How pervasive games can adapt to the ever-changing nature of technology and design in current society requires a comprehensive review.

    OBJECTIVE: In this systematic review, we aimed to measure and analyze 4 dimensions of pervasive games through development, technology, experience, and evaluation. Moreover, we also aimed to discover and interpret their relationship with game, interaction, experience, and service design.

    METHODS: We first chose 3 well-known databases, Web of Science, Scopus, and EBSCO, and searched from 2013 to April 2022. A strictly thorough Boolean search for research keywords such as "pervasive game," "design," and "interactive" resulted in 394 relevant articles. These articles were identified, screened, and checked for eligibility to find valid and useful articles, which were then categorized and analyzed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method.

    RESULTS: The systematic selection was finally left with 40 valid and valuable articles. After categorization and analysis, all articles were classified according to 4 main themes, which were design and development (11/40, 28%), interaction and technology (15/40, 38%), users and experience (9/40, 23%), and evaluation and service (5/40, 13%). These 4 main areas can be subdivided into several smaller areas.

    CONCLUSIONS: In the 4 areas of game design, interaction design, experience design, and service design, many scholars have studied pervasive games and made contributions. Although the development and technology of pervasive games have evolved with the times, there is still a need to strengthen emerging design concepts within pervasive games.

  5. Davis OC, Dickie AC, Mustapa MB, Boyle KA, Browne TJ, Gradwell MA, et al.
    Sci Rep, 2023 Jul 18;13(1):11561.
    PMID: 37464016 DOI: 10.1038/s41598-023-38605-9
    Unmyelinated non-peptidergic nociceptors (NP afferents) arborise in lamina II of the spinal cord and receive GABAergic axoaxonic synapses, which mediate presynaptic inhibition. However, until now the source of this axoaxonic synaptic input was not known. Here we provide evidence that it originates from a population of inhibitory calretinin-expressing interneurons (iCRs), which correspond to lamina II islet cells. The NP afferents can be assigned to 3 functionally distinct classes (NP1-3). NP1 afferents have been implicated in pathological pain states, while NP2 and NP3 afferents also function as pruritoceptors. Our findings suggest that all 3 of these afferent types innervate iCRs and receive axoaxonic synapses from them, providing feedback inhibition of NP input. The iCRs also form axodendritic synapses, and their targets include cells that are themselves innervated by the NP afferents, thus allowing for feedforward inhibition. The iCRs are therefore ideally placed to control the input from non-peptidergic nociceptors and pruritoceptors to other dorsal horn neurons, and thus represent a potential therapeutic target for the treatment of chronic pain and itch.
    MeSH terms: Animals; Nociceptors*; Synapses; Posterior Horn Cells; Mice; Calbindin 2
  6. Khaw WF, Chan YM, Nasaruddin NH, Alias N, Tan L, Ganapathy SS
    BMC Public Health, 2023 Jul 18;23(1):1383.
    PMID: 37464344 DOI: 10.1186/s12889-023-16309-z
    BACKGROUND: In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method.

    METHODS: This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia.

    RESULTS: In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%).

    CONCLUSIONS: NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia.

    MeSH terms: Cause of Death; Cerebrovascular Disorders*; Humans; Life Expectancy; Cost of Illness; Quality-Adjusted Life Years; Mortality, Premature
  7. Al-Ahmad M, Ali A, Khalaf M, Alterki A, Rodriguez-Bouza T
    BMC Pulm Med, 2023 Jul 18;23(1):266.
    PMID: 37464395 DOI: 10.1186/s12890-023-02556-8
    BACKGROUND: The clinical heterogeneity of chronic rhinosinusitis (CRS) and bronchial asthma is attributable to different underlying inflammatory profiles. However, the similarity between CRS with nasal polyps (CRSwNP) and type-2 asthma pathophysiology speculates that one biological therapy could affect both comorbidities. Despite dupilumab, a monoclonal antibody that targets IL-4α and IL-13 receptors, being used in patients with nasal polyps and severe asthma, real-life data about its efficacy in improving the quality of life and patient symptoms is still lacking. This study's primary objective was to evaluate dupilumab treatment's effect on the frequency of olfactory symptoms and health-related quality of life tests as measured by the Sino-nasal outcome test (SNOT-22) in patients with NP. The secondary objective was the effect of dupilumab on asthma symptom control as measured by the asthma control test (ACT).

    METHODS: A prospective study was conducted of 166 patients with CRSwNP, with or without asthma. The following variables were collected at baseline and after at least six months of continuous dupilumab therapy; SNOT-22, olfactory symptoms frequency, and ACT score.

    RESULTS: Asthma prevalence in patients with CRSwNP was high (59.63%), and being female with a history of frequent use of oral corticosteroid (OCS) courses and repeated unsuccessful nasal and para-nasal surgeries for polyposis increased the likelihood of having underlying asthma by 2, 1 and 4 times more, respectively. Additionally, being asthmatic required a longer duration of dupilumab treatment. However, both the health-related quality of life and olfactory symptoms improved equally in both groups.

    CONCLUSION: Even with associated comorbid asthma in patients with CRSwNP, treatment with dupilumab could improve the quality of life, olfactory symptoms, and asthma symptom control.

    MeSH terms: Chronic Disease; Female; Humans; Male; Prospective Studies; Quality of Life
  8. Shanableh S, Zainal H, Alomar M, Palaian S
    J Pharm Policy Pract, 2023 Jul 18;16(1):92.
    PMID: 37464445 DOI: 10.1186/s40545-023-00593-6
    BACKGROUND: Pharmacovigilance (PV) is an essential component of patient safety and pharmacists are expected to be aware of the PV processes and willing to report ADRs. This study assessed the hospital pharmacists' knowledge, attitude, and practice toward PV, barriers faced by them in ADR reporting, and factors influencing ADR reporting.

    METHOD: A cross-sectional nationwide questionnaire survey was conducted among randomly chosen hospital pharmacists across UAE from March to July 2022. The filled questionnaires were assessed both descriptively [median (IQR scores), maximum 5 for Likert type and 1 for knowledge questions] and inferentially using the Mann-Whitney U test (for dichotomous variables) and the Kruskal-Wallis test (for variables with more than two responses) at alpha value = 0.05. Post hoc analyses and correlations were performed wherever applicable.

    RESULTS: Of the 342 respondents, the majority were knowledgeable about the concepts of PV (93.3%; n = 319) and ADRs (86.8%; n = 297). The overall median (IQR) knowledge score was 5 (3-7)/9. Knowledge levels within 'qualification groups' varied significantly (p-value 

  9. Javaid MU, Rehman N, Mirza MZ, Ibrahim AM
    J Healthc Leadersh, 2023;15:121-128.
    PMID: 37465199 DOI: 10.2147/JHL.S420584
    INTRODUCTION: Past studies have neglected the role of resources that enhance motivation, such as health-specific leadership (H-SL) and social support colleagues (SSC), in dealing with the prerequisites of psychological health of workers, especially the duo of stress and burnout.

    OBJECTIVE: This empirical study aimed to identify the impact of psychosocial job demands (emotional demands) and psychosocial job resources (health-specific leadership and social support of colleagues) on the psychological health (stress, burnout) of 284 Malaysian industrial workers (who participated both times).

    METHODS: The Hierarchical regression analysis was employed to examine all study hypotheses and a time lagged study design was used with a lag of three months between T1 and T2 for data collection.

    RESULTS: The survey data found a significant impact of emotional demands on stress and burnout, while we found insignificant findings of health-specific leadership and social support from colleagues on workers' psychological health.

    FUTURE DIRECTIONS: Future studies should consider the different formations of psychosocial job resources and higher dimensions of health promotion leadership.

  10. Padil, Putra MD, Hidayat M, Kasiamdari RS, Mutamima A, Iwamoto K, et al.
    RSC Adv, 2023 Jul 12;13(31):21403-21413.
    PMID: 37465575 DOI: 10.1039/d3ra01556d
    Tetraselmis chuii is a potential microalgae that is in consideration for producing bioethanol owing to its large content of carbohydrates. The glucose production from T. chuii through an enzymatic process with cellulase and xylanase (pretreatment process) and α-amylase and glucoamylase (saccharification process) was studied. The mechanism of the enzymatic process was developed and the kinetic models were then evaluated. For the pretreatment process, enzymes with 30% concentration reacted at 30 °C for 40 min resulted in 35.9% glucose yield. For the saccharification process, the highest glucose yield of 90.03% was obtained using simultaneous α-amylase (0.0006%) and glucoamylase (0.01%) enzymes at 55 °C and for 40 min. The kinetic models fitted well with the experimental data. The model also revealed that the saccharification process performed better than the pretreatment process with a higher kinetic constant and lower activation energy. The proposed kinetic model plays an important role in implementing processes at a larger scale.
  11. Bong May Ing J, Singh DKA, Tan MP, Adam Bujang M, Tiong IK, Whitney J, et al.
    Australas J Ageing, 2023 Dec;42(4):624-637.
    PMID: 37465973 DOI: 10.1111/ajag.13227
    OBJECTIVES: Southeast Asia (SEA) is a rapidly ageing and a diversely populated region that requires strategies to maintain its populations' physical activity and sense of well-being. While the benefits of group exercise programs are known, the characteristics and types of exercises in terms of their effectiveness for physical function and fidelity of the programs have yet to be defined within this population.

    METHODS: Ovid, MEDLINE, Scopus, PEDro (Physiotherapy Evidence Database), EBSCOHOST, Cochrane library and Open Grey databases were searched to identify relevant studies. Methodological quality was assessed using the PEDro Scale and the Newcastle Ottawa Scale (NOS). Meta-analysis was undertaken when the same outcome measures were reported in a minimum of two studies with appropriate data. (PROSPERO: CRD42020177317).

    RESULTS: Eleven studies with 900 participants were included, out of which 395 participants were allocated to group exercise programs and 383 completed the program. Culturally adapted Thai dance programs and multicomponent exercise programs were the most-commonly reported group exercises. The Timed Up and Go test (TUG) and attendance rates were the most-frequently reported outcomes. Meta-analysis demonstrated significant improvement in physical function assessed using the Timed Up and Go test (Random effect model -1.27 s, 95% CI -1.65, -0.88, I2  = 74%). In two studies, adherence (81% and 94%) and dropout rates (4% and 19%) were reported.

    CONCLUSIONS: Group-based exercise programs in Southeast Asia consisting mostly of culturally adapted Thai dance programs and multicomponent exercise programs appear to have positive effects on physical function. However, better descriptions of fidelity, including adherence, are required in future studies.

    MeSH terms: Aged; Asia, Southeastern; Postural Balance*; Exercise Therapy; Humans; Time and Motion Studies; Physical Therapy Modalities; Independent Living*
  12. Khalil M, Hanif MA, Rashid U, Ahmad J, Alsalme A, Tsubota T
    Environ Sci Pollut Res Int, 2023 Jul;30(34):81333-81351.
    PMID: 35710971 DOI: 10.1007/s11356-022-21367-8
    The hazardous dyes on mixing with water resources are affecting many life forms. Granite stone is popular worldwide for decorating floors, making other forms of decorative materials and items. Granite stone powder waste can be obtained free of cost from marble factories as factories spend on the disposal of this waste. In the present study, novel granite stone powder waste composite has been prepared and utilized for the effective removal of Terasil dye. Two types of granite including gray granite and white granite were used in pure, calcinized, and chemically modified forms. Freundlich adsorption isotherm model best explained the adsorption mechanism of dye removal using granite composites as compared to other adsorption isothermal models. Characterization techniques like scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy were used for the determination of morphological features and functional groups of granite composites. The obtained results were statistically analyzed using analysis of variance (ANOVA) along with the post hoc Tukey test. An extraordinarily high Terasil dye uptake capacity (more than 400 mg/g) was exhibited by granite composites prepared using sodium metasilicate. The synthesized novel nano-constructed composites provided a viable strategy as compared to the pure granite stone for dye removal from wastewater water.
    MeSH terms: Adsorption; Coloring Agents/chemistry; Hydrogen-Ion Concentration; Kinetics; Powders; Waste Disposal, Fluid/methods; Spectroscopy, Fourier Transform Infrared; Waste Water*
  13. Adebusoye FT, Awuah WA, Swaminathan N, Ghosh S, Wellington J, Abdul-Rahman T, et al.
    Neurosurgery, 2023 Aug 01;93(2):e30-e31.
    PMID: 37192472 DOI: 10.1227/neu.0000000000002527
    MeSH terms: Humans; Neurosurgery*; Neurosurgical Procedures
  14. Ahmad S, Drag MH, Mohamad Salleh S, Cai Z, Nielsen MO
    Physiol Genomics, 2023 Sep 01;55(9):392-413.
    PMID: 37458462 DOI: 10.1152/physiolgenomics.00128.2022
    We have previously demonstrated that pre- and early postnatal malnutrition in sheep induced depot- and sex-specific changes in adipose morphological features, metabolic outcomes, and transcriptome in adulthood, with perirenal (PER) as the major target followed by subcutaneous (SUB) adipose tissue. We aimed to identify coexpressed and hub genes in SUB and PER to identify the underlying molecular mechanisms contributing to the early nutritional programming of adipose-related phenotypic outcomes. Transcriptomes of SUB and PER of male and female adult sheep with different pre- and early postnatal nutrition histories were used to construct networks of coexpressed genes likely to be functionally associated with pre- and early postnatal nutrition histories and phenotypic traits using weighted gene coexpression network analysis. The modules from PER showed enrichment of cell cycle regulation, gene expression, transmembrane transport, and metabolic processes associated with both sexes' prenatal nutrition. In SUB (only males), a module of enriched adenosine diphosphate metabolism and development correlated with prenatal nutrition. Sex-specific module enrichments were found in PER, such as chromatin modification in the male network but histone modification and mitochondria- and oxidative phosphorylation-related functions in the female network. These sex-specific modules correlated with prenatal nutrition and adipocyte size distribution patterns. Our results point to PER as a primary target of prenatal malnutrition compared to SUB, which played only a minor role. The prenatal programming of gene expression and cell cycle, potentially through epigenetic modifications, might be underlying mechanisms responsible for observed changes in PER expandability and adipocyte-size distribution patterns in adulthood in both sexes.
    MeSH terms: Animals; Female; Male; Obesity/genetics; Pregnancy; Sheep; Subcutaneous Fat/metabolism; Adiposity
  15. Deng N, Soh KG, Abdullah B, Huang D, Xiao W, Liu H
    PLoS One, 2023;18(7):e0288340.
    PMID: 37459333 DOI: 10.1371/journal.pone.0288340
    BACKGROUND: The literature has proven that plyometric training (PT) improves various physical performance outcomes in sports. Even though PT is one of the most often employed strength training methods, a thorough analysis of PT and how it affects technical skill performance in sports needs to be improved.

    METHODS: This study aimed to compile and synthesize the existing studies on the effects of PT on healthy athletes' technical skill performance. A comprehensive search of SCOPUS, PubMed, Web of Science Core Collection, and SPORTDiscus databases was performed on 3rd May 2023. PICOS was employed to establish the inclusion criteria: 1) healthy athletes; 2) a PT program; 3) compared a plyometric intervention to an active control group; 4) tested at least one measure of athletes' technical skill performance; and 5) randomized control designs. The methodological quality of each individual study was evaluated using the PEDro scale. The random-effects model was used to compute the meta-analyses. Subgroup analyses were performed (participant age, gender, PT length, session duration, frequency, and number of sessions). Certainty or confidence in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

    RESULTS: Thirty-two moderate-high-quality studies involving 1078 athletes aged 10-40 years met the inclusion criteria. The PT intervention lasted for 4 to 16 weeks, with one to three exercise sessions per week. Small-to-moderate effect sizes were found for performance of throwing velocity (i.e., handball, baseball, water polo) (ES = 0.78; p < 0.001), kicking velocity and distance (i.e., soccer) (ES = 0.37-0.44; all p < 0.005), and speed dribbling (i.e., handball, basketball, soccer) (ES = 0.85; p = 0.014), while no significant effects on stride rate (i.e., running) were noted (ES = 0.32; p = 0.137). Sub-analyses of moderator factors included 16 data sets. Only training length significantly modulated PT effects on throwing velocity (> 7 weeks, ES = 1.05; ≤ 7 weeks, ES = 0.29; p = 0.011). The level of certainty of the evidence for the meta-analyzed outcomes ranged from low to moderate.

    CONCLUSION: Our findings have shown that PT can be effective in enhancing technical skills measures in youth and adult athletes. Sub-group analyses suggest that PT longer (> 7 weeks) lengths appear to be more effective for improving throwing velocity. However, to fully determine the effectiveness of PT in improving sport-specific technical skill outcomes and ultimately enhancing competition performance, further high-quality research covering a wider range of sports is required.

    MeSH terms: Adolescent; Adult; Humans; Exercise; Muscle Strength; Athletic Performance*; Athletes
  16. A MH, C A R N, S M C, S R, P M, R H WS, et al.
    PLoS One, 2023;18(7):e0288325.
    PMID: 37459344 DOI: 10.1371/journal.pone.0288325
    INTRODUCTION: The current and simpler healthy eating concept 'Malaysian Healthy Plate', was introduced in 2016. This study aims to determine the prevalence of ever-never heard, understanding, and practice of this concept and also the associated factors to never-heard of Malaysian Health Plate after three years of the implementation.

    METHODOLOGY: This study utilized the data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional survey that applied two-stage stratified cluster sampling. Questionnaires pertained to ever heard, knowledge, and practised of Malaysian Healthy Plate were asked along with another questionnaire. Complex sample analysis was applied to fit with the study design.

    RESULTS: Estimated 16.9 million (79.6%) adults in Malaysia were never heard of the Malaysian Healthy Plate Concept in 2019. Never heard of this concept was significantly associated with sex (men, aOR 0.265), ethnicity (other ethnicities, aOR 1.79), an education level (no education, aOR 9.59; primary, aOR 3.50; secondary, aOR 1.70), occupation (private, aOR 2.16; self-employed, aOR 2.31; retirees, aOR 1.69; student, aOR 2.31; unpaid workers, aOA 2.35; not working, aOR 2.86), non-diabetes aOR 1.43, and low fruit and vegetable intake person aOR 1.86. Meanwhile, another 20.4% or an estimated 4.3 million adults who were ever heard of Malaysian Healthy Plate. Among those who are ever heard, 80.8% (3.5 million) correctly interpreted or understood the concept and among those who ever heard and understood the concept, only 70.5% (2.5 million) have been practising it daily or occasionally.

    CONCLUSIONS: Four-fifth of adults never heard of the 'Malaysian Healthy Plate' and among those who ever heard, the understanding and practising of the concept were probably unsatisfactory. Multisectoral collaboration is an urge to fasten the promotion to spark awareness and educate the public to practice the concept to promote healthy eating and a healthier nation.

    MeSH terms: Adult; Cross-Sectional Studies; Health Surveys; Humans; Malaysia/epidemiology; Male; Surveys and Questionnaires; Prevalence; Healthy Diet*
  17. Mohd Mokhtar MA, Azhar ZI, Jamaluddin SF, Cone DC, Shin SD, Shaun GE, et al.
    Prehosp Emerg Care, 2023;27(7):875-885.
    PMID: 37459651 DOI: 10.1080/10903127.2023.2237107
    OBJECTIVE: Asia is experiencing a demographic shift toward an aging population at an unrivaled rate. This can influence the characteristics and outcomes of trauma. We aim to examine different characteristics of older adult trauma patients compared to younger adult trauma patients and describe factors that affect the outcomes in Asian countries.

    METHODS: This is a retrospective, international, multicenter study of trauma across participating centers in the Pan Asian Trauma Outcome Study (PATOS) registry, which included trauma cases aged ≥18 years, brought to the emergency department (ED) by emergency medical services (EMS) from October 2015 to November 2018. Data of older adults (≥65 years) and younger adults (<65 years) were analyzed and compared. The primary outcome measure was in-hospital mortality, and secondary outcomes were disability at discharge and hospital and intensive care unit (ICU) length of stays.

    RESULTS: Of 39,804 trauma patients, 10,770 (27.1%) were older adults. Trauma occurred more among older adult women (54.7% vs 33.2%, p 

    MeSH terms: Adolescent; Adult; Aged; Emergency Medical Services*; Female; Humans; Male; Registries; Retrospective Studies; Trauma Centers; Injury Severity Score; Outcome Assessment (Health Care)
  18. Bellato A, Arora I, Kochhar P, Ropar D, Hollis C, Groom MJ
    Cortex, 2023 Sep;166:306-321.
    PMID: 37459680 DOI: 10.1016/j.cortex.2023.06.002
    INTRODUCTION: Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) may be characterized by different profiles of visual attention orienting. However, there are also many inconsistent findings emerging from the literature, probably due to the fact that the potential effect of autonomic arousal (which has been proposed to be dysregulated in these conditions) on oculomotor performance has not been investigated before. Moreover, it is not known how visual attention orienting is affected by the co-occurrence of ADHD and autism in people with a double diagnosis.

    METHODS: 99 children/adolescents with or without ADHD and/or autism (age 10.79 ± 2.05 years, 65% boys) completed an adapted version of the gap-overlap task (with baseline and overlap trials only). The social salience and modality of stimuli were manipulated between trials. Eye movements and pupil size were recorded. We compared saccadic reaction times (SRTs) between diagnostic groups and investigated if a trial-by-trial association existed between pre-saccadic pupil size and SRTs.

    RESULTS: Faster orienting (shorter SRT) was found for baseline compared to overlap trials, faces compared to non-face stimuli and-more evidently in children without ADHD and/or autism-for multi-modal compared to uni-modal stimuli. We also found a linear negative association between pre-saccadic pupil size and SRTs, in autistic participants (without ADHD), and a quadratic association in children with ADHD (without autism), for which SRTs were slower when intra-individual pre-saccadic pupil size was smallest or largest.

    CONCLUSION: Our findings are in line with previous literature and indicate a possible effect of dysregulated autonomic arousal on oculomotor mechanisms in autism and ADHD, which should be further investigated in future research studies with larger samples, to reliably investigate possible differences between children with single and dual diagnoses.

    MeSH terms: Adolescent; Arousal; Child; Eye Movements; Female; Humans; Male
  19. Bourtsalas ACT, Yepes IM, Tian Y
    J Environ Manage, 2023 Oct 15;344:118604.
    PMID: 37459814 DOI: 10.1016/j.jenvman.2023.118604
    This study analyzes the regional implications of China's 2017 import ban on plastic waste by examining U.S. census data. A statistically significant decrease in total U.S. plastic waste exports was found, dropping from about 1.4 million tons to 0.6 million tons in the post-ban period. California remained the top exporter, throughout both pre- and post-ban periods, while South Carolina exhibited the highest per capita exports. Malaysia emerged as the largest importer of U.S. plastic waste, followed by Vietnam, Indonesia, and Thailand. The ban also led to a change in the composition of the exported plastic waste. Ethylene polymers increased from 32.6% of total exports in the pre-ban period to 46.9% in the post-ban period. Other plastics (vinyl chloride polymers, styrene polymers, and for plastics not elsewhere specified or included) decreased from 67.4% of total exports in the pre-ban period to 53.1% in the post-ban period. Moreover, we found that exporting plastic waste has significant environmental and human health impacts. For example, the Global Warming Potential (GWP) decreased from 20 million tons CO2-eq in the scenario where 100% of plastics are exported, or 25 million tons exported from the U.S. since 2002, to -11.1 million tons CO2-eq in the scenario where 100% of plastics are treated domestically. Transportation exacerbates these impacts for exported waste scenarios, increasing to 5.4 million tons CO2-eq when plastics are exported by ship while decreasing to 0.9 million tons CO2-eq for domestic treatment. Although exporting plastic waste is initially cost-effective, our study highlights that investing in domestic waste management can yield significant long-term benefits, considering the environmental and public health impacts. Therefore, it is crucial to prioritize context-specific solutions to address the challenges of the evolving global plastic waste landscape.
    MeSH terms: China; Humans; Plastics*; Polyethylenes; Polystyrenes; Waste Management*; Recycling
  20. Ahmad Sobri MZ, Khoo KS, Sahrin NT, Ardo FM, Ansar S, Hossain MS, et al.
    Chemosphere, 2023 Oct;338:139526.
    PMID: 37459926 DOI: 10.1016/j.chemosphere.2023.139526
    The depletion of fossil fuel sources and increase in energy demands have increased the need for a sustainable alternative energy source. The ability to produce hydrogen from microalgae is generating a lot of attention in both academia and industry. Due to complex production procedures, the commercial production of microalgal biohydrogen is not yet practical. Developing the most optimum microalgal hydrogen production process is also very laborious and expensive as proven from the experimental measurement. Therefore, this research project intended to analyse the random time series dataset collected during microalgal hydrogen productions while using various low thermally pre-treated palm kernel expeller (PKE) waste via machine learning (ML) approach. The analysis of collected dataset allowed the derivation of an enhanced kinetic model based on the Gompertz model amidst the dark fermentative hydrogen production that integrated thermal pre-treatment duration as a function within the model. The optimum microalgal hydrogen production attained with the enhanced kinetic model was 387.1 mL/g microalgae after 6 days with 1 h thermally pre-treated PKE waste at 90 °C. The enhanced model also had better accuracy (R2 = 0.9556) and net energy ratio (NER) value (0.71) than previous studies. Finally, the NER could be further improved to 0.91 when the microalgal culture was reused, heralding the potential application of ML in optimizing the microalgal hydrogen production process.
    MeSH terms: Fermentation; Fossil Fuels; Hydrogen/analysis; Biomass; Biofuels; Microalgae*
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