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  1. Fulltext The Authentication and Grading of Edible Bird's Nest by Metabolite, Nutritional, and Mineral Profiling
    Mohamad Ibrahim R, Mohamad Nasir NN, Abu Bakar MZ, Mahmud R, Ab Razak NA
    Foods, 2021 Jul 07;10(7).
    PMID: 34359444 DOI: 10.3390/foods10071574
    Edible bird's nest (EBN) produced by Aerodramus fuciphagus has a high demand for nutritional and medicinal application throughout the world. The present study was to evaluate the authentication of a man-made house EBN, which are half cup and stripe-shaped by FTIR. Next, both samples were compared according to their metabolite, nutritional, and mineral composition. The results indicated that the FTIR spectra of both EBN samples were identical and similar to the reference, suggesting the authenticity of the EBN used. The metabolites that contribute to the possible medicinal properties of EBN were found by using GC-MS. The results of the proximate analysis, followed by the standard AOAC method, inferred that both EBN shapes to be rich in crude protein and carbohydrate contents. However, the proximate composition between the half cup and stripe-shaped EBN showed significant differences. Major mineral elements detected were calcium and sodium, and magnesium contents were significantly different between both EBN. Additionally, the half cup and stripe-shaped EBN had a low level of heavy metal content than the maximum regulatory limit as set by the Malaysian Food Act 1983. This study concludes that the nutritional composition varied between the samples and thus suggests that nutrient content should be considered as criteria for the grading requirement of commercialized EBN.
  2. Effect of tocotrienol on the activities of cytosolic glutathione-dependent enzymes in rats treated with 2-acetylaminofluorene
    Shamaan NA, Wan Ngah WZ, Ibrahim R, Jarien Z, Top AG, Abdul Kadir K
    Biochem Pharmacol, 1993 Apr 06;45(7):1517-9.
    PMID: 8471073
    The effect of tocotrienol on the activities of glutathione S-transferases (GSTs), glutathione reductase (GR) and glutathione peroxidase (GPx) in rats given 2-acetylaminofluorene (AAF) was investigated over a 20 week period. Liver and kidney GST and liver GR activities were significantly increased after AAF administration. Kidney GPx activities were significantly affected; activity assayed with cumene hydroperoxide (cu-OOH) was increased but activity assayed with H2O2 was reduced. Supplementation of the diet with tocotrienol in the AAF-treated rats reduced the increase in enzyme activities. Tocotrienol on its own had no effect on the enzyme activities.
  3. Clinical symptoms of chronic rhinosinusitis with nasal polyps (eosinophilic and non-eosinophilic) are related to sinus computed tomography but not to endoscopic findings
    Mamat Nasir MSN, Aziz ME, Tuan Sharif SE, Ibrahim R, Abdullah B
    Acta Otorrinolaringol Esp (Engl Ed), 2021 May 24.
    PMID: 34045046 DOI: 10.1016/j.otorri.2021.03.003
    BACKGROUND: In the clinical assessment of chronic rhinosinusitis with nasal polyps (CRSwNP), evaluation of symptoms, nasoendoscopy findings and sinus computed tomography (CT) scan staging is employed in the management plan. Although prior studies have been done to assess the correlation of the three modalities in CRSwNP, such evaluation in patients with eosinophilic and non-eosinophilic types of CRSwNP requires further investigation. The aim of this study was to correlate the sinus CT scan staging to symptom and endoscopic scores in both types of CRSwNP.

    MATERIAL AND METHOD: Patients with CRSwNP were classified into 2 types, eosinophilic and non-eosinophilic. Both types were assessed by Sino-Nasal Outcome Test 22 (SNOT-22) symptom score, nasal endoscopy Lund Kennedy grading (LK) score and sinus CT Lund Mackay (LM) staging score. All three modalities were correlated.

    RESULTS: Forty-four patients were recruited for this study. There was significant correlation between sinus CT and symptom scores in the eosinophilic (r=.51, p=.031) and the non-eosinophilic (r=.76, pr=.12, p=.641) and the non-eosinophilic (r=.22, p=.276) types. There was also no significant correlation between sinus CT and nasoendoscopic scores in the eosinophilic (r=.20, p=.418) and the non-eosinophilic (r=.14, p=.508) types.

    CONCLUSIONS: Sinus CT staging correlates well with the symptom score for both the eosinophilic and the non-eosinophilic types of CRSwNP. The good correlation suggests both modalities are a reliable guide for their evaluation and management planning.

  4. Fulltext Viability reduction and Rac1 gene downregulation of heterogeneous ex-vivo glioma acute slice infected by the oncolytic Newcastle disease virus strain V4UPM
    Mustafa Z, Shamsuddin HS, Ideris A, Ibrahim R, Jaafar H, Ali AM, et al.
    Biomed Res Int, 2013;2013:248507.
    PMID: 23586025 DOI: 10.1155/2013/248507
    Oncolytic viruses have been extensively evaluated for anticancer therapy because this virus preferentially infects cancer cells without interfering with normal cells. Newcastle Disease Virus (NDV) is an avian virus and one of the intensively studied oncolytic viruses affecting many types of cancer including glioma. Nevertheless, the capability of NDV infection on heterogeneous glioma tissue in a cerebrospinal fluid atmosphere has never been reported. Recently, Rac1 is reported to be required for efficient NDV replication in human cancer cells and established a link between tumourigenesis and sensitivity to NDV. Rac1 is a member of the Rho GTPases involved in the regulation of the cell migration and cell-cycle progression. Rac1 knockdown leads to significant inhibition of viral replication. In this work, we demonstrated that NDV treatment led to significant reduction of tumour tissue viability of freshly isolated heterogeneous human brain tumour slice, known as an ex vivo glioma acute slice (EGAS). Analysis of gene expression indicated that reduced tissue viability was associated with downregulation of Rac1. However, the viability reduction was not persistent. We conclude that NDV treatment induced EGAS viability suppression, but subsequent downregulation of Rac1 gene may reduce the NDV replication and lead to regrowth of EGAS tissue.
  5. Newcastle diseases virus strain V4UPM displayed oncolytic ability against experimental human malignant glioma
    Zulkifli MM, Ibrahim R, Ali AM, Aini I, Jaafar H, Hilda SS, et al.
    Neurol Res, 2009 Feb;31(1):3-10.
    PMID: 18937888 DOI: 10.1179/174313208X325218
    Newcastle disease virus (NDV) is a virus of paramyxovirus family and lately has been studied for the treatment of cancer in human. In this study, we successfully determined the oncolysis potential of NDV vaccine, V4UPM tested on the human glioblastoma multiform cell line (DBTRG.05MG) and human glioblastoma astrocytoma cell line (U-87MG) in vitro and in vivo. The V4UPM strain is a modified V4 strain developed as thermostable feed pellet vaccine for poultry.
  6. Loneliness as a risk factor for hypertension in later life
    Momtaz YA, Hamid TA, Yusoff S, Ibrahim R, Chai ST, Yahaya N, et al.
    J Aging Health, 2012 Jun;24(4):696-710.
    PMID: 22422758 DOI: 10.1177/0898264311431305
    The present study aims to determine the impact of loneliness on hypertension in later life.
  7. Fulltext Moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being among elderly Malays
    Abolfathi Momtaz Y, Hamid TA, Ibrahim R, Yahaya N, Abdullah SS
    Psychogeriatrics, 2012 Mar;12(1):43-53.
    PMID: 22416828 DOI: 10.1111/j.1479-8301.2011.00381.x
    Research has found that physical health decline in later life is associated with poor psychological well-being. This study aimed to examine the possible moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being.
  8. Fulltext A novel fractional-order dead-time compensating controller for the wireless networks
    Devan PAM, Ibrahim R, Omar M, Bingi K, Nagarajapandian M, Abdulrab H
    Sci Rep, 2023 Oct 17;13(1):17658.
    PMID: 37848485 DOI: 10.1038/s41598-023-44515-7
    Wireless technology is becoming increasingly critical in industrial environments in recent years, and the popular wireless standards are WirelessHART, ZigBee, WLAN and ISA100.11a, commonly used in closed-loop systems. However, wireless networks in closed-loop control experience packet loss or drops, system delay and data threats, leading to process instability and catastrophic system failure. To prevent such issues, it is necessary to implement dead-time compensation control. Traditional techniques like model predictive and predictive PI controllers are frequently employed. However, these methods' performance is sluggish in wireless networks, with processes having long dead times and set-point variations, potentially affecting network and process performance. Therefore, this paper proposes a fractional calculus-based predictive PI compensator for wired and wireless networks in the process control industries. The proposed technique has been simulated and evaluated on industrial process models, including pressure, flow, and temperature, where measurement and control are carried out wirelessly. The wireless network's performance has been evaluated based on packet loss, reduced throughput, and increased system latency. The proposed compensator outperformed traditional methods, demonstrating superior set-point tracking, disturbance rejection, and delay compensation characteristics in the performance evaluations of the first, second, and third-order systems. Overall, the findings indicate that the proposed compensator enhances wireless networks' performance in the process control industry and improves system stability and reliability by reducing almost half of the overshoot and settling an average of 8.3927% faster than the conventional techniques in most of the systems.
  9. Fulltext A Novel Hybrid Harris Hawk-Arithmetic Optimization Algorithm for Industrial Wireless Mesh Networks
    Devan PAM, Ibrahim R, Omar M, Bingi K, Abdulrab H
    Sensors (Basel), 2023 Jul 07;23(13).
    PMID: 37448072 DOI: 10.3390/s23136224
    A novel hybrid Harris Hawk-Arithmetic Optimization Algorithm (HHAOA) for optimizing the Industrial Wireless Mesh Networks (WMNs) and real-time pressure process control was proposed in this research article. The proposed algorithm uses inspiration from Harris Hawk Optimization and the Arithmetic Optimization Algorithm to improve position relocation problems, premature convergence, and the poor accuracy the existing techniques face. The HHAOA algorithm was evaluated on various benchmark functions and compared with other optimization algorithms, namely Arithmetic Optimization Algorithm, Moth Flame Optimization, Sine Cosine Algorithm, Grey Wolf Optimization, and Harris Hawk Optimization. The proposed algorithm was also applied to a real-world industrial wireless mesh network simulation and experimentation on the real-time pressure process control system. All the results demonstrate that the HHAOA algorithm outperforms different algorithms regarding mean, standard deviation, convergence speed, accuracy, and robustness and improves client router connectivity and network congestion with a 31.7% reduction in Wireless Mesh Network routers. In the real-time pressure process, the HHAOA optimized Fractional-order Predictive PI (FOPPI) Controller produced a robust and smoother control signal leading to minimal peak overshoot and an average of a 53.244% faster settling. Based on the results, the algorithm enhanced the efficiency and reliability of industrial wireless networks and real-time pressure process control systems, which are critical for industrial automation and control applications.
  10. Fulltext Transformation of Children's Paintings into Public Art to Improve Public Spaces and Enhance People's Happiness
    Luo N, Ibrahim R, Abidin SZ
    Int J Environ Res Public Health, 2022 Dec 14;19(24).
    PMID: 36554658 DOI: 10.3390/ijerph192416780
    Characteristics of children's paintings have been suggested considered for application in public art since they are known to positively evoke a sense of well-being when people see them. This study aims to understand the impact of artistic features from children's drawings on people's well-being; then analyzing the adaptive design principles of 3D public art featuring children's paintings on people's happiness; and finally, exploring the influence of 3D public art featuring children's paintings on improving public spaces and enhancing people's well-being. The results lead to proposing a conceptual framework for public artworks in public spaces for improving people's happiness. The proposed conceptual framework recommends that, by applying the visual and thinking features of children's paintings to public art, artists can design high-quality artworks suitable for a city, which could improve people's happiness in public spaces. This study recommends further research into how public art can promote public spaces and shape the urban culture. It contributes to enhancing the quality of public art and public spaces, and inspiring a sense of well-being among citizens through the use of appropriate public art. The results are significant because they will help artists to create more high-quality public artworks for urban public spaces in order to evoke people's happiness.
  11. Fulltext Carbon Nanotube-Quicklime Nanocomposites Prepared Using a Nickel Catalyst Supported on Calcium Oxide Derived from Carbonate Stones
    Ibrahim R, Hussein MZ, Yusof NA, Abu Bakar F
    Nanomaterials (Basel), 2019 Aug 31;9(9).
    PMID: 31480466 DOI: 10.3390/nano9091239
    Carbon nanotube-quicklime nanocomposites (CQNs) have been synthesized via the chemical vapor deposition (CVD) of n-hexane using a nickel metal catalyst supported on calcined carbonate stones at temperatures of 600-900 °C. The use of a Ni/CaO(10 wt%) catalyst required temperatures of at least 700 °C to obtain XRD peaks attributable to carbon nanotubes (CNTs). The CQNs prepared using a Ni/CaO catalyst of various Ni contents showed varying diameters and the remaining catalyst metal particles could still be observed in the samples. Thermogravimetric analysis of the CQNs showed that there were two major weight losses due to the amorphous carbon decomposition (300-400 °C) and oxidation of CNTs (400-600 °C). Raman spectroscopy results showed that the CQNs with the highest graphitization were synthesized using Ni/CaO (10 wt%) at 800 °C with an IG/ID ratio of 1.30. The cyclic voltammetry (CV) of screen-printed carbon electrodes (SPCEs) modified with the CQNs showed that the performance of nanocomposite-modified SPCEs were better than bare SPCEs. When compared to carboxylated multi-walled carbon nanotubes or MWNT-COOH-modified SPCEs, the CQNs synthesized using Ni/CaO (10 wt%) at 800 °C gave higher CV peak currents and comparable electron transfer, making it a good alternative for screen-printed electrode modification.
  12. Racial and socioeconomic disparities in sexual activity among older married Malaysians
    Momtaz YA, Hamid TA, Ibrahim R, Akahbar SA
    Arch Gerontol Geriatr, 2014 Jan-Feb;58(1):51-5.
    PMID: 24021247 DOI: 10.1016/j.archger.2013.08.003
    Sexuality as an important part of life has not been well studied in Malaysia, particularly among older adults. The main aim of this study was to investigate the racial and socioeconomic differences in sexual activity among older married Malaysians. Data for this study consisting of 1036 older married adults aged 60 years and older were obtained from the nationwide community-based cross-sectional survey entitled "Determinants of Wellness among Older Malaysian: A Health Promotion Perspective", conducted in 2010. Data were analyzed using SPSS version 21 for Windows. The results showed that 57.3% (95% CI: 54.3-60.3) of the respondents (61.6% of men and 50.6% of women) had engaged in sexual intercourse during the last 12 months. The adjusted multivariate logistic regression analysis revealed that ethnicity and educational attainment were independently and significantly associated with sexual activity, after controlling for the possible confounding effects of chronic medical conditions and demographic characteristics. The findings from this study do support the notion that sexuality is a lifelong need and cultural teachings and formal education may have important role in maintaining the quality of sexuality in later life.
  13. Fulltext Psychosocial Work Environment and Teachers' Psychological Well-Being: The Moderating Role of Job Control and Social Support
    Ibrahim RZAR, Zalam WZM, Foster B, Afrizal T, Johansyah MD, Saputra J, et al.
    Int J Environ Res Public Health, 2021 07 08;18(14).
    PMID: 34299757 DOI: 10.3390/ijerph18147308
    Nowadays, the issue of teachers' psychological well-being causes serious concern, especially in Malaysia. Many studies related to psychological well-being have focused on students rather than on the health and well-being of teachers. Thus, the current study investigated the determinants of psychological well-being (depression, anxiety and stress) from the psychosocial work environment (job control, job demands and social support), and examined the moderating role of job control and social support in the relationship between job demands and psychological well-being among teachers. The design of this study was quantitative research through a survey questionnaire. The sample consisted of 335 high school teachers (23.3%-male; 76.7%-female) who responded to measuring scales of job demands, job control, social support, depression, anxiety and stress, and socio-demographic profile. The data were analyzed using two statistical methods, namely descriptive and inferential statistics. The hierarchical linear regression model was used to analyze the data by assisting the statistical software, i.e., SPSS-23. The results showed that job demands, job control and social support significantly predicted teachers' psychological well-being. Furthermore, the effect of job demands on teachers' depression and anxiety was partially moderated by job control and social support. In conclusion, this study has successfully identified the significant predictors of teachers' psychological well-being and the role of job control and social support as a moderating variable to teachers' psychological well-being in Malaysia. The result provides insights and contributes to the literature of teachers' psychological well-being determinants and involves Malaysian respondents with a collectivistic eastern culture.
  14. Fulltext The effect of emotional focused intervention on spousal emotional abuse and marital satisfaction among elderly married couples: a randomized controlled trial
    Hazrati M, Hamid TA, Ibrahim R, Hassan SA, Sharif F, Bagheri Z
    Int J Community Based Nurs Midwifery, 2017 Oct;5(4):329-334.
    PMID: 29043279
    BACKGROUND: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples.

    METHODS: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples (114 participants) who were eligible for study were assigned in two groups by block randomization (29 in the experimental and 28 in the control group(.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn't receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire (MMEAQ) and Marital Satisfaction Questionnaire for Older People (MSQFOP). Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P≤0.05 was measured as significant.

    RESULTS: The mean duration of marriage was 39.56±9.64 years. In the experimental group, the abusive behaviors decreased significantly (P<0.001) at times 2 and 3 compared with time 1, and marital satisfaction improved significantly only at time 3 (P<0.001). These differences were not significant in the control group.

    CONCLUSION: Emotion-focused couple-based interventions are helpful in reducing the spousal emotional abuse and improving marital satisfaction in among the elderly couples. Trial Registration Number: 2013111715426N1.
  15. The Efficiency of a Multicomponent Training for Prospective Memory Among Healthy Older Adults: A Single-Blind, Randomized Controlled Within-Participants Cross-Over Trial
    Farzin A, Ibrahim R, Madon Z, Basri H
    Am J Phys Med Rehabil, 2018 09;97(9):628-635.
    PMID: 29595585 DOI: 10.1097/PHM.0000000000000931
    OBJECTIVE: The main objective of the present trial was to evaluate the efficiency of a preventative multicomponent prospective memory training among healthy older adults.

    DESIGN: This study was a two-arm within-participants trial with 4- and 12-wk follow-ups. Allocation ratio was 1:1, and pretraining and posttraining measurements were included. A total number of 25 healthy older adults were enrolled (mean = 63.32, SD = 4.44). Participants were randomly allocated into two conditions: (a) prospective memory training: participants underwent a multicomponent prospective memory training, and (b) control: participants were not contacted during the training phase. After the training phase was finished, participants crossed over to undergo the condition they did not experience before. The differences between pretraining and posttraining measures of prospective memory, activities of daily living, negative mood (depression), and anxiety were assessed. All changes in the measurements were analyzed using general linear method. This trial is registered at https://www.isrctn.com (#ISRCTN57600070).

    RESULTS: Multicomponent prospective memory training program was significantly effective on both subjective and objective prospective memory performances among healthy older adults. Moreover, the training had significant positive effects on activities of daily living (independence) among participants. In addition, negative mood and anxiety levels were reduced after the training was finished.

    CONCLUSIONS: This multicomponent prospective memory training improved prospective memory performance and activities of daily living and reduce negative mood (depression) and anxiety levels among healthy older adults.

  16. Fulltext Challenges faced and lessons learned A multi-component prospective memory training program for Malaysian older adults
    Farzin A, Ibrahim R, Madon Z, Basri H
    Dement Neuropsychol, 2018 7 11;12(2):189-195.
    PMID: 29988335 DOI: 10.1590/1980-57642018dn12-020012
    The surrounding circumstances and environments of Malaysian older adults could make conducting interventions (mainly in terms of clinical or randomized controlled trials) a challenge. Working with older adults and facing cultural issues could be challenging.

    Objective: This paper illustrates a significant perspective of some of the challenges faced while conducting a randomized controlled trial exploring the impact of a multi-component intervention that included strategy- and process-based prospective memory (PM) training among Malaysian older adults.

    Methods: The current study was a randomized controlled trial (RCT) and therefore the challenges were presented in accordance with the CONSORT statement style.

    Results: A discussion on how these issues were addressed is provided.

    Conclusion: Some suggestions were presented to help researchers plan and create interventions for similar studies and to support a practical method of addressing all related challenges.

  17. Application of the European quality indicators for psychosocial dementia care in long-term care facilities in the Asia-Pacific region: a pilot study
    Jeon YH, Chien WT, Ha JY, Ibrahim R, Kirley B, Tan LL, et al.
    Aging Ment Health, 2018 10;22(10):1279-1286.
    PMID: 28714742 DOI: 10.1080/13607863.2017.1351521
    OBJECTIVES: An Asia-Pacific regional collaboration group conducted its first multi-country research project to determine whether or not European quality indicators (QIs) for psychosocial care in dementia could be implemented as a valid tool in residential aged care across seven Asia-Pacific sites (Australia, Hong Kong Special Administrative Region, Mainland China, Malaysia, Singapore, South Korea, and Thailand).

    METHOD: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs.

    RESULTS: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation.

    CONCLUSION: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.

  18. Fulltext Smoking and cognitive impairment among older persons in Malaysia
    Momtaz YA, Ibrahim R, Hamid TA, Chai ST
    Am J Alzheimers Dis Other Demen, 2015 Jun;30(4):405-11.
    PMID: 25260596 DOI: 10.1177/1533317514552318
    INTRODUCTION: Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function.

    METHODOLOGY: Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010.

    RESULTS: Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25).

    CONCLUSION: Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias.

  19. Fulltext Middle East Respiratory Syndrome (MERS) Virus-Pathophysiological Axis and the Current Treatment Strategies
    Alnuqaydan AM, Almutary AG, Sukamaran A, Yang BTW, Lee XT, Lim WX, et al.
    AAPS PharmSciTech, 2021 Jun 08;22(5):173.
    PMID: 34105037 DOI: 10.1208/s12249-021-02062-2
    Middle East respiratory syndrome (MERS) is a lethal respiratory disease with its first case reported back in 2012 (Jeddah, Saudi Arabia). It is a novel, single-stranded, positive-sense RNA beta coronavirus (MERS-CoV) that was isolated from a patient who died from a severe respiratory illness. Later, it was found that this patient was infected with MERS. MERS is endemic to countries in the Middle East regions, such as Saudi Arabia, Jordan, Qatar, Oman, Kuwait and the United Arab Emirates. It has been reported that the MERS virus originated from bats and dromedary camels, the natural hosts of MERS-CoV. The transmission of the virus to humans has been thought to be either direct or indirect. Few camel-to-human transmissions were reported earlier. However, the mode of transmission of how the virus affects humans remains unanswered. Moreover, outbreaks in either family-based or hospital-based settings were observed with high mortality rates, especially in individuals who did not receive proper management or those with underlying comorbidities, such as diabetes and renal failure. Since then, there have been numerous reports hypothesising complications in fatal cases of MERS. Over the years, various diagnostic methods, treatment strategies and preventive measures have been strategised in containing the MERS infection. Evidence from multiple sources implicated that no treatment options and vaccines have been developed in specific, for the direct management of MERS-CoV infection. Nevertheless, there are supportive measures outlined in response to symptom-related management. Health authorities should stress more on infection and prevention control measures, to ensure that MERS remains as a low-level threat to public health.
  20. Fulltext The remodelling index risk stratifies patients with hypertensive left ventricular hypertrophy
    Le TT, Lim V, Ibrahim R, Teo MT, Bryant J, Ang B, et al.
    Eur Heart J Cardiovasc Imaging, 2021 05 10;22(6):670-679.
    PMID: 32255186 DOI: 10.1093/ehjci/jeaa040
    AIMS: Hypertensive left ventricular hypertrophy (LVH) is associated with increased cardiovascular events. We previously developed the remodelling index (RI) that incorporated left ventricular (LV) volume and wall-thickness in a single measure of advanced hypertrophy in hypertensive patients. This study examined the prognostic potential of the RI in reference to contemporary LVH classifications.

    METHODS AND RESULTS: Cardiovascular magnetic resonance was performed in 400 asymptomatic hypertensive patients. The newly derived RI (EDV3t, where EDV is LV end-diastolic volume and t is the maximal wall thickness across 16 myocardial segments) stratified hypertensive patients: no LVH, LVH with normal RI (LVHNormal-RI), and LVH with low RI (LVHLow-RI). The primary outcome was a composite of all-cause mortality, acute coronary syndromes, strokes, and decompensated heart failure. LVHLow-RI was associated with increased LV mass index, fibrosis burden, impaired myocardial function and elevated biochemical markers of myocardial injury (high-sensitive cardiac troponin I), and wall stress. Over 18.3 ± 7.0 months (601.3 patient-years), 14 adverse events occurred (2.2 events/100 patient-years). Patients with LVHLow-RI had more than a five-fold increase in adverse events compared to those with LVHNormal-RI (11.6 events/100 patient-years vs. 2.0 events/100 patient-years, respectively; log-rank P 

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