Browse publications by year: 2023

Virtual screening of bioactive anti-SARS-CoV natural products and identification of 3β,12-diacetoxyabieta-6,8,11,13-tetraene as a potential inhibitor of SARS-CoV-2 virus and its infection related pathways by MD simulation and network pharmacology

Huq AKMM, Roney M, Imran S, Khan SU, Uddin MN, Htar TT, et al.

J Biomol Struct Dyn, 2023;41(23):13923-13936.
PMID: 36786766 DOI: 10.1080/07391102.2023.2176926

Since the first prevalence of COVID-19 in 2019, it still remains the most devastating pandemic throughout the world. The current research aimed to find potential natural products to inhibit the novel coronavirus and associated infection by MD simulation and network pharmacology approach. Molecular docking was performed for 39 natural products having potent anti-SARS-CoV activity. Five natural products showed high binding interaction with the viral main protease for the SARS-CoV-2 virus, where 3β,12-diacetoxyabieta-6,8,11,13 tetraene showed stable binding in MD simulation until 100 ns. Both 3β,12-diacetoxyabieta-6,8,11,13 tetraene and tomentin A targeted 11 common genes that are related to COVID-19 and interact with each other. Gene ontology development analysis further showed that all these 11 genes are attached to various biological processes. The KEGG pathway analysis also showed that the proteins that are targeted by 3β,12-diacetoxyabieta-6,8,11,13 tetraene and tomentin A are associated with multiple pathways related to COVID-19 infection. Furthermore, the ADMET and MDS studies reveals 3β,12-diacetoxyabieta-6,8,11,13 as the best-suited compound for oral drug delivery.Communicated by Ramaswamy H. Sarma.
Synthesis and perspectives from the Ottawa 2022 conference on the assessment of competence

Boursicot K, Kemp S, Norcini J, Nadarajah VD, Humphrey-Murto S, Archer E, et al.

Med Teach, 2023 Sep;45(9):978-983.
PMID: 36786837 DOI: 10.1080/0142159X.2023.2174420

INTRODUCTION: The Ottawa Conference on the Assessment of Competence in Medicine and the Healthcare Professions was first convened in 1985 in Ottawa. Since then, what has become known as the Ottawa conference has been held in various locations around the world every 2 years. It has become an important conference for the community of assessment - including researchers, educators, administrators and leaders - to share contemporary knowledge and develop international standards for assessment in medical and health professions education.
METHODS: The Ottawa 2022 conference was held in Lyon, France, in conjunction with the AMEE 2022 conference. A diverse group of international assessment experts were invited to present a symposium at the AMEE conference to summarise key concepts from the Ottawa conference. This paper was developed from that symposium.
RESULTS AND DISCUSSION: This paper summarises key themes and issues that emerged from the Ottawa 2022 conference. It highlights the importance of the consensus statements and discusses challenges for assessment such as issues of equity, diversity, and inclusion, shifts in emphasis to systems of assessment, implications of 'big data' and analytics, and challenges to ensure published research and practice are based on contemporary theories and concepts.

MeSH terms: Humans; Medicine*; Professional Competence*
Fulltext Interim prosthesis design and socket preservation for a non-salvageable traumatic injury in a young adult: a minimalistic approach to traumatic injuries in children

Kaur K

BMJ Case Rep, 2023 Feb 14;16(2).
PMID: 36787931 DOI: 10.1136/bcr-2022-251154

Long-term prognosis of complicated traumatic injuries depends on precise treatment planning. Establishing a balance between a patient's age, prognosis, financial hurdles, and treatment needs is challenging. This case highlights the need for meticulous and realistic treatment planning to achieve long-term favourable outcomes in traumatic injuries in young adults.A young child sustained a traumatic injury that caused avulsion of #21 and intrusion along with palatal luxation of #11. The child reported to the dental clinic with intraoral swelling and pain a week after the injury. Socket preservation was done so that uniform bone contour could be achieved for implant placement at a later stage. We modified a 'Hollywood appliance' as an interim prosthesis to ensure that the ridge was not immediately loaded where socket preservation was done.After a follow-up of 3 years, there is significant bone deposition and the child is satisfied with aesthetics.

MeSH terms: Alveolar Ridge Augmentation*; Child; Dental Care; Humans; Prognosis; Prosthesis Design; Tooth Extraction; Young Adult
Factors affecting central macular thickness of diabetic macular oedema patients after an induction treatment of intravitreal ranibizumab

Nursyafiqah MT, Siti-Azrin AH, Yaacob NM, Wan-Nor-Asyikeen WA, Zunaina E

Trop Med Int Health, 2023 Apr;28(4):300-307.
PMID: 36787961 DOI: 10.1111/tmi.13862

OBJECTIVE: Intravitreal ranibizumab is one of the anti-vascular endothelial growth factors used for the treatment of diabetic macular oedema, not always successfully. We aimed to identify the factors affecting the changes of central macular thickness after induction treatment with intravitreal ranibizumab, to predict the treatment effect and facilitate early treatment decisions.
METHODS: Cross-sectional study involving a retrospective record review of diabetic macular oedema patients who received an induction treatment of three monthly 0.5 mg intravitreal ranibizumab injections between 2016 and 2019. Central macular thickness was measured at baseline and 3 months post-treatment. Linear regression was applied to identify the factors associated with the changes of central macular thickness.
RESULTS: A total of 153 diabetic macular oedema patients were involved in this study. Their mean age was 57.5 ± 7.7 years, 54.9% were female. The mean change of central macular thickness from baseline to 3 months after completed induction treatment of intravitreal ranibizumab was 155.5 ± 137.8 μm. Factors significantly associated with changes of central macular thickness were baseline central macular thickness [b = 0.73; 95% (CI): 0.63, 0.84; p = <0.001] and presence of subretinal fluid [b = 35.43; 95% CI: 3.70, 67.16; p = 0.029].
CONCLUSION: Thicker baseline central macular thickness and presence of subretinal fluid were the factors significantly associated with greater changes of central macular thickness in diabetic macular oedema patients after receiving three injections of intravitreal ranibizumab.

MeSH terms: Ranibizumab/therapeutic use; Aged; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Retrospective Studies; Visual Acuity; Angiogenesis Inhibitors/therapeutic use; Vascular Endothelial Growth Factor A/therapeutic use; Intravitreal Injections
Programmed Cell Death Protein 1 (PD-1) in Relation to PANoptosis: Immune Pharmacological Targets for Management of Breast Adenocarcinoma

Maitra S, Bhattacharya D, Paul S, Chowdhury PG, Mandal D, Haldar PK, et al.

Endocr Metab Immune Disord Drug Targets, 2023;23(13):1571-1585.
PMID: 36788687 DOI: 10.2174/1871530323666230213121803

Programmed cell death protein 1 or Programmed death-1 (PD-1) and Programmed Cell Death Ligand 1 (PD-L1) research have tremendously been taken into great consideration in the field of cancer immune pharmacology. Cancer immunotherapy has been convoyed by a capable outcome over the past few years. PD-1 and PD-L1 play a pivotal role in attenuating immune involvement, modulating the activity of T-cells, and promoting different types of programmed cell death. Participation of antigen-specific T cells and regulatory T cells and their acute mutations during cancer cell invasion and migration may lead to challenges for three programmed cell death methods, namely, pyroptosis, apoptosis, and necroptosis called "PANoptosis". This review aimed to explore the correlation between the PD-1/PD-L1 pathway in "PANoptosis" using available recently published literature with several schematic representations. Hopefully, the review will facilitate the biomedical scientist targeting cancer immune pharmacological aspect for the management of Breast Adenocarcinoma shortly.
Fulltext It is Time to Incorporate Artificial Intelligence in Radiology Residency Programs

Ng KH, Tan CH

Korean J Radiol, 2023 Mar;24(3):177-179.
PMID: 36788774 DOI: 10.3348/kjr.2022.1023
MeSH terms: Artificial Intelligence; Humans; Internship and Residency*; Radiography; Radiology*
Fulltext Shoulder Agony: A Painful Glenoid Cyst

Md Yusoff BAH, Ramlan MKR, Mohd Don AF, Muhammed Ali Noor MI, Mohamad N

Cureus, 2023 Jan;15(1):e33726.
PMID: 36788828 DOI: 10.7759/cureus.33726

A ganglion cyst is a benign cystic lesion that can occur intraosseously. It is commonly a multiloculated lesion that consists of fibrous tissue with mucoid change and is usually located in the subchondral bone adjacent to the joint. Here, we present a rare case of a 33-year-old woman who presented to our orthopedic clinic with a five-year history of shoulder pain that gradually worsened. The pain was worst after any activity involving the right shoulder, and it also occurred at night and disturbed her sleep. Physical examination showed that the patient had limitations on the extreme range of movement. MRI revealed a subchondral bone cyst at the glenoid fossa. The ganglion cyst was subsequently curetted and packed with a bone graft from the iliac bone. Postoperatively, the pain resolved and the patient's range of movement improved. At the six-month follow-up, new bone formation over the void area caused by the cyst was observed on MRI.
Fulltext An Unexpected Reaction to Topical Garlic Medicament - A Case Report of Irritant Contact Dermatitis Successfully Managed in Primary Care

Jamaluddin J, Jamil SN

Cureus, 2023 Jan;15(1):e33657.
PMID: 36788861 DOI: 10.7759/cureus.33657

Irritant contact dermatitis (ICD) is a common skin condition in primary care. The frequent cause of ICD includes hair dye, nail polish, paints, cleaners, soap, and detergent. We present a case of ICD caused by topical garlic medicament, successfully identified and managed in primary care. A 20-year-old woman presented with a sudden onset of multiple painful localized blisters on the right antecubital fossa. She reported applying raw garlic paste to the area one day before the clinic visit to treat mild itchiness. She had no known allergies or medical illnesses. Otherwise, there were no rashes elsewhere or oral and genital ulcers. She was not on any regular medication or taking traditional medication. Examination revealed multiple bullae on the antecubital fossa with perilesional erythema. The lesion was sharply bordered within the contact areas, was asymmetric, and did not spread elsewhere. The clinical history of immediate bullae formation after direct contact with garlic was consistent with ICD due to garlic medicament. The lesions were managed with regular dressings. At one week follow-up, the lesions had healed well. She was advised to avoid further application of topical garlic medicines. Although Allium sativum (garlic) has been used either topical or orally as a medicinal treatment worldwide for thousands of years to treat various conditions, it still has the potential to cause irritant dermatitis when applied to skin and mucosa. Patients and healthcare providers should be cautious of the potential side effects, such as ICD, when using garlic for medicinal purposes.
Fulltext Ocular Jarisch-Herxheimer Reaction in the Treatment of Ocular Syphilis: A Case Report and Review of the Literature

Abd Manan N, Musa AA, Lott PW, Zahari M, Tajunisah I

Cureus, 2023 Jan;15(1):e33696.
PMID: 36788917 DOI: 10.7759/cureus.33696

Jarisch-Herxheimer reaction (JHR) is a transient clinical phenomenon in patients with syphilis who receive antibiotic treatment. A 31-year-old man with an underlying HIV infection presented with worsening vision in the right eye two days after being treated with oral doxycycline for presumed left-eye neuroretinitis. Prior history revealed two episodes of penile discharge and ulcers that were not investigated. Examination showed bilateral optic disc swelling with right eye placoid chorioretinitis around the macula. Optical coherence tomography (OCT) demonstrated right macular edema and left macular thinning. Blood investigations confirmed syphilis infection. Subsequently, the patient was scheduled for a contrasted brain CT with oral steroid coverage due to underlying allergies. His vision incidentally improved soon after the short course of steroids. Repeated OCT demonstrated marked improvement of right macular edema, which we believe was secondary to JHR initiated by the earlier doxycycline treatment. Following oral steroid addition, improvement in vision and ocular findings were seen. At six-month post-treatment, there was right macular atrophy as a sequela of the macular edema. Ophthalmologists should be aware of ocular-related JHR complications, particularly in potentiating macular atrophy following macular edema upon initiating antibiotic treatment in syphilitic disease.
Fulltext Japan's Advocacy for Human Security in Global Politics: Case Study of Japan's Grant Assistance for Grass-Roots Human Security Projects (GGP) in the State of Sabah, Malaysia, 2000-2021

Dollah R, Peters D, Hassan WSW, Omar MA, Rahim MSA, Jafar A

East Asia (Piscataway), 2023;40(2):151-174.
PMID: 36788944 DOI: 10.1007/s12140-023-09399-4

After World War II, Japan became a major recipient of foreign aid from the USA. As Japan's economy improved in the 1960s, it played a significant role as a global aid donor in world politics through its Official Development Assistance (ODA). This commitment continued into the 1990s when Japan, as one of the leading proponents of the concept of human security, began providing humanitarian aid to more countries across the globe. To better understand the notion of human security in international politics, this paper examines Japan's endorsement of the concept in its foreign policy strategy. This paper provides an overview and critical assessment of Japan's Grant Assistance for Grass-Roots Human Security Projects (GGP) in the state of Sabah in East Malaysia from 2000 to 2021. This paper argues that different contexts and circumstances in the state of Sabah require further study, especially for understanding Japan's focus and concern in the area of basic human security needs, as enshrined in the GGP philosophy. Despite Japan's GGP objective as part of its foreign policy to promote human development, the execution of its foreign aid in Sabah does have issues. This paper concludes that the implementation of Japan's GGP necessitates greater inclusion, particularly for other vulnerable groups and underdeveloped areas in Sabah. Despite Japan's GGP objective as part of its foreign policy to promote human development, the execution of its foreign aid in Sabah does have issues. This paper concludes that the implementation of Japan's GGP necessitates greater inclusion, particularly for other vulnerable groups and underdeveloped areas in Sabah.
Fulltext Donkey whey protein and peptides regulate gut microbiota community and physiological functions of D-galactose-induced aging mice

Zhou X, Tian X, Song L, Luo L, Ma Z, Zhang F

Food Sci Nutr, 2023 Feb;11(2):752-764.
PMID: 36789044 DOI: 10.1002/fsn3.3111

The prolongation of life span has attracted more and more attention in the current world. Gut microbiota is considered one of the most critical elements and is essential in regulating life span and quality. The effects of donkey whey protein (DWP) and donkey whey hydrolysate (DWPP) on physiological functions and gut microbiota of D-galactose-induced aging mice were investigated to find new strategies for resisting aging. Our results showed that DWP and DWPP could increase the body weight gain velocity, superoxide dismutase (SOD) activity, and thymus index, whereas decrease the level of reactive oxygen species (ROS) and malondialdehyde (MDA), and improve the aging of the body in the liver congestion, oozy draw focal sclerosis of chronic inflammation. The effects of medium and high concentrations of DWP and low and medium concentrations of DWPP were the same as the vitamin C (Vc)-positive control group. It was found that both DWP and DWPP could change α-diversity; the relative abundance of Lactobacillus increased, whereas the relative abundance of Helicobacter and Stenotrophomonas decreased after being treated with DWP and DWPP. The correlation between intestinal microflora and physiological indexes showed that chao1, ACE, and observed species indexes in the α index were positively correlated with weight gain velocity, SOD activity, and thymus index. The relative abundance of Lactobacillus was positively correlated with SOD and thymus index but negatively correlated with MDA. The relative abundance of Stenotrophomonas was opposite to that of Lactobacillus. The Anaerobiospirillum, Fusobacterium, and Dubosiella had a significant positive correlation with the weight gain velocity. The study provided a deeper more profound understanding of the potential use of DWP and DWPP in senescence delays.
Fulltext Language and COVID-19: A discourse analysis of resistance to lockdown in Indonesia

Na'imah, Muassomah, Mubaraq Z, Hendriani S, Hussin M, Ischak R, et al.

Heliyon, 2023 Mar;9(3):e13551.
PMID: 36789390 DOI: 10.1016/j.heliyon.2023.e13551

Communities in Indonesia were resistant to lockdown policies, Large-Scale Social Restrictions (PSBB) and the Enactment of Restrictions on Community Activities (PPKM). Both policies were implemented numerous times in the country during the COVID-19 pandemic, and these caused widespread unrest. Language with the terms PSBB and PPKM, which several times extended suddenly, not informed to the community, inconsistent in its implementation, makes the community feel mad, neglected the needs of their life, and severe rejections. This research was conducted with a qualitative approach sourced from primary and secondary data. Primary data were obtained from electronic media news that shows public resistance and government policies published through the official government web. Meanwhile, secondary data were obtained from journal articles discussing community resistance related to policies to prevent the spread of the COVID-19 pandemic. The results showed that various terms translated from the term lockdown to the time PSBB and PPKM had consequences for policy misalignment with community expectations. The switching of language from lockdown to PSBB and PPKM has caused resistance in the community because it has allowed the government to be economically irresponsible. Therefore, the government needs to inform and be responsible, so that policies can run effectively.
Rapid and nondestructive analysis of lipstick on different substrates using ATR-FTIR spectroscopy and chemometrics

Ka Khei L, Verma R, Tan ELY, Low KH, Ismail D, Mohamad Asri MN

J Forensic Sci, 2023 Feb 15.
PMID: 36789805 DOI: 10.1111/1556-4029.15223

Lipstick can be an important piece of evidence in crimes like murders, rapes, and suicides. Due to its prevalence, it can be an important corroborative evidence in crime reconstruction. The analysis of such evidence can provide an evidentiary link between the suspect, the victim, object, or the crime scene. We report the use of nondestructive ATR-FTIR spectroscopy combined with chemometrics for the classification of 10 brands of lipsticks with nine samples each. Chemometric method of partial least square-discriminant analysis (PLS-DA) has been employed to interpret the data and classify the samples into their respective classes. The PLS-DA model provides an AUC figure above 0.99 in all brands except one; for which it is slightly less at 0.94. We have also tested the traces of these lipstick samples on different substrates treating them as unknowns in the already trained PLS-DA model. 100% of the samples on nine substrates viz. a cotton, nylon, plastic, dry tissue, denim (blue jeans), wet tissue, nitrile gloves, white paper, and polyester were correctly attributed to their source brand. In conclusion, the results suggest that ATR-FTIR combined with the chemometrics is a rapid, nondestructive, and accurate method for the discrimination and source attribution of lipstick. This study has potential for use in actual forensic casework conditions.
Fulltext Numerical solution of magnetohydrodynamics effects on a generalised power law fluid model of blood flow through a bifurcated artery with an overlapping shaped stenosis

Zain NM, Ismail Z

PLoS One, 2023;18(2):e0276576.
PMID: 36780455 DOI: 10.1371/journal.pone.0276576

This paper presents a numerical analysis of blood flow in a diseased vessel within the presence of an external magnetic field. The blood flow was considered to be incompressible and fully developed, in that the non-Newtonian nature of the fluid was characterised as a generalised power law model for shear-thinning, Newtonian, and shear-thickening fluids. The impact of a transverse directed external magnetic field on blood flow through a stenosed bifurcated artery was investigated. The arterial geometry was considered as a bifurcated channel with overlapping shaped stenosis. The problem was treated mathematically using the Galerkin Least-Squares (GLS) method. The implementation of this numerical method managed to overcome the numerical instability faced by the classical Galerkin technique when adopted to a highly viscous flow. The benefit of GLS in circumventing the Ladyzhenskaya-Babuška-Brezzi (LBB) condition was utilized by evaluating both the velocity and pressure components at corner nodes of a unstructured triangular element. The non-linearity that emerged from the convective terms was then treated using the Newton-Raphson method, while the numerical integrals were computed using a Gaussian quadrature rule with six quadrature points. The findings obtained from this study were then compared with available results from the literature as well as Comsol multiphysics software to verify the accuracy and validity of the numerical algorithms. It was found that the application of magnetic field was able to overcome flow reversal by 39% for a shear-thinning fluid, 26% for a Newtonian fluid, and 27% for a shear-thickening fluid. The negative pressure and steep wall shear stress which occurs at the extremities of an overlapping stenosis throat were diminished by rise in magnetic intensity. This prevented thrombosis occurrence and produced a uniform calm flow.

MeSH terms: Arteries; Blood Flow Velocity/physiology; Computer Simulation; Constriction, Pathologic; Hemodynamics*; Humans; Models, Cardiovascular*; Stress, Mechanical
Fulltext Scaling up evidence-based approaches to tuberculosis screening in prisons

Charalambous S, Velen K, Rueda Z, Croda J, Herce ME, Shenoi SV, et al.

Lancet Public Health, 2023 Apr;8(4):e305-e310.
PMID: 36780916 DOI: 10.1016/S2468-2667(23)00002-6

People deprived of liberty have among the highest rates of tuberculosis globally. The incidence of tuberculosis is ten times greater than the incidence of tuberculosis in the general population. In 2021, WHO updated its guidance to strongly recommend systematic screening for tuberculosis in prisons and penitentiary systems. Which case-finding strategies should be adopted, and how to effectively implement these strategies in these settings, will be crucial questions facing ministries of health and justice. In this Viewpoint, we review the evidence base for tuberculosis screening and diagnostic strategies in prisons, highlighting promising approaches and knowledge gaps. Drawing upon past experiences of implementing active case-finding and care programmes in settings with a high tuberculosis burden, we discuss challenges and opportunities for improving the tuberculosis diagnosis and treatment cascade in these settings. We argue that improved transparency in reporting of tuberculosis notifications and outcomes in prisons and renewed focus and resourcing from WHO and other stakeholders will be crucial for building the commitment and investments needed from countries to address the continued crisis of tuberculosis in prisons.

MeSH terms: Humans; Mass Screening; Prisoners*; Prisons; Incidence
Quantifying an influence of green credit on digital technology innovation: financial perspective of a China's case study

Ke W, Lu S

Environ Sci Pollut Res Int, 2023 Apr;30(17):49744-49759.
PMID: 36781669 DOI: 10.1007/s11356-023-25691-5

This paper examines the impact of green credit (GC) on digital technology innovation based on Chinese enterprises using panel data from 1990 to 2016. The study collected panel data from the 40 Chinese firms listed on the Beijing and Wuhan stock markets. Manufacturing companies were selected because they mainly contribute to green credit from pre- and post-policy periods. First, in the "two high and one surplus" sectors, the application of China's Green Credit 2012 could significantly increase total factor digital technology innovation by 1.21%. Results show a considerable drop in the variable values of digital technology innovation, 61.3%; green credit policy, 10.45%; leverage, 21.0%; and green innovation, 85.4%. The results of the absolute value of standard error after matching is much lower than 20.0%, demonstrating that the variable features of the two sets of samples are similar. In conclusion, GC's impact on the FDI of capital was asymmetrical, reflecting various impacts on businesses with various types of property rights and sizes.

MeSH terms: Beijing; China; Commerce; Humans; Asian Continental Ancestry Group; Policy; Inventions/economics
Quantifying health-related quality of life in Malaysian type 2 diabetes: focusing on complication types and severity

Tan MHP, Ong SC, Vasan Thakumar A, Mustafa N

Qual Life Res, 2023 Jul;32(7):1925-1941.
PMID: 36781810 DOI: 10.1007/s11136-023-03360-x

PURPOSE: There is a knowledge gap of health utility values for Type 2 Diabetes Mellitus (T2DM) complications in Malaysia. This study aimed to estimate EQ-5D-5L utility values and evaluate health-related quality of life (HRQoL) for Malaysian T2DM associated with complications and clinical characteristics.
METHODS: A cross-sectional study was conducted on T2DM patients at a tertiary hospital outpatient using the Malay and English version of the EQ-5D-5L questionnaire. Health utility values were derived using the Malaysian EQ-5D-5L value set. Ordinary least squares (OLS) multivariable regression model was used to estimate the health utility decrements associated with T2DM-related complications and clinical characteristics.
RESULTS: A total of 513 T2DM patients were recruited. Overall, pain was the most affected of all five EQ-5D-5L dimensions. Patients with foot ulcer, amputation, severe heart failure and frequent hypoglycemia reported more problems collectively in all EQ-5D-5L dimensions. Older age, lower education level, longer duration of T2DM, urine protein creatine index (UPCI) > 0.02 g/mmol, and injection therapy were significantly associated with lower EQ-5D-5L utility values (p

MeSH terms: Cross-Sectional Studies; Health Status; Heart Failure*; Humans; Hypoglycemia*; Quality of Life/psychology; Surveys and Questionnaires
Integrated comparative metabolite profiling via NMR and GC-MS analyses for tongkat ali (Eurycoma longifolia) fingerprinting and quality control analysis

Serag A, Zayed A, Mediani A, Farag MA

Sci Rep, 2023 Feb 13;13(1):2533.
PMID: 36781893 DOI: 10.1038/s41598-023-28551-x

Tongkat ali commonly known as Malaysian Ginseng (Eurycoma longifolia) is a herbal root worldwide available in nutraceuticals, either as a crude powder or capsules blended with other herbal products. Herein, a multiplexed metabolomics approach based on nuclear magnetic resonance (NMR) and solid-phase microextraction combined with gas chromatography-mass spectrometry (SPME-GC-MS) was applied for authentic tongkat ali extract vs some commercial products quality control analysis. NMR metabolite fingerprinting identified 15 major metabolites mostly ascribed to sugars, organic and fatty acids in addition to quassinoids and cinnamates. Following that, multivariate analysis as the non-supervised principal component analysis (PCA) and supervised orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied revealing that differences were related to fatty acids and 13,21-dihydroeurycomanone being more enriched in authentic root. SPME-GC-MS aroma profiling led to the identification of 59 volatiles belonging mainly to alcohols, aldehydes/furans and sesquiterpene hydrocarbons. Results revealed that aroma of commercial products showed relatively different profiles being rich in vanillin, maltol, and methyl octanoate. Whereas E-cinnamaldehyde, endo-borneol, terpinen-4-ol, and benzaldehyde were more associated to the authentic product. The present study shed the light for the potential of metabolomics in authentication and standardization of tongkat ali and identification of its true flavor composition.

MeSH terms: Gas Chromatography-Mass Spectrometry; Magnetic Resonance Spectroscopy; Quality Control
Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies

Briggs AM, Jordan JE, Sharma S, Young JJ, Chua J, Foster HE, et al.

Health Policy Plan, 2023 Feb 13;38(2):129-149.
PMID: 35876078 DOI: 10.1093/heapol/czac061

Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care.
Adaptation of coastal defence structure as a mechanism to alleviate coastal erosion in monsoon dominated coast of Peninsular Malaysia

Dong WS, Ariffin EH, Saengsupavanich C, Mohd Rashid MA, Mohd Shukri MH, Ramli MZ, et al.

J Environ Manage, 2023 May 01;333:117391.
PMID: 36774836 DOI: 10.1016/j.jenvman.2023.117391

The complexity of the coastal environment and the advent of climate change cause coastal erosion, which is incontrovertibly a significant concern worldwide, including Peninsular Malaysia, where, the coast is threatened by severe erosion linked to anthropogenic factors and monsoonal wind-driven waves. Consequently, the Malaysian government implemented a mitigation plan using several coastal defence systems to overcome the coastal erosion problem. This study assesses coastal erosion management strategies along a monsoon-dominated coasts by evaluating the efficacy of coastal protection structures against the coast. To this end, we analysed 244 km of the coastline of Terengganu, a federal state located on the east coast of Peninsular Malaysia. Due to a higher frequency of storms and the ensuing inception of high wave energy environments during the northeast monsoon (relative to southwest monsoon), the study area is the most impacted region in Malaysia with regard to coastal erosion. Fifty-five (55) coastal defence structures were detected along the Terengganu coastline. The Digital Shoreline Analysis System (DSAS) was utilised to compute changes in the rate statistics for various historical shoreline positions along the Terengganu coast to assess the efficacy of the defence structures. Additionally, this study acquired the perception of the existing coastal management strategies through an interview session with the concerned stakeholders. The rate statistics revealed the effectiveness and impact of the coastal defence structure on the coastline. Assessing the functionality of the coastal defence structures shed light on the present scenario of coastal erosion management. Greater efficacy and lower impact of coastal defence structures are prescribed for coastal erosion management strategies across the monsoon-dominated coast.

MeSH terms: Acclimatization*; Malaysia; Wind; Cyclonic Storms*; Climate Change

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