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Time-based changes in authorship trend in research-intensive universities in Malaysia

Abu Kassim NL, Mohd Bakri SK, Nusrat F, Salim E, Manjurul Karim M, Rahman MT

Account Res, 2024 Dec;31(1):56-71.
PMID: 35758245 DOI: 10.1080/08989621.2022.2094256

Considering the fact that publications serve as an important criterion to evaluate the scientific accomplishments of an individual within respective fields in academia, there has been an increasing trend to publish scientific articles whereby multiple authors are defined as primary, co-, or corresponding authors according to the roles performed. This article analyzes the authorship pattern in 4,561 papers (including 60 single-authored papers) from 1990 till 2020 of 94 academics who hold a position as professors and are affiliated with the Faculty of Medicine at three different research universities in Malaysia. Only 708 papers (15.5% of 4,561 papers) were authored by less than three authors. In 3,080 papers (67.5% of 4,561 papers), those academics appeared as coauthors. Using different years as cutoff periods, it was observed that the appearance as coauthor in the papers had steeply risen around the years: 2006, 2007, 2008 and onwards. The increased number of authors in the multi-author papers and the appearance of the selected academics as coauthors reflect the extent of boosting of collaborative research in that period which corresponds to the adoption of the "publish or perish policy" by the Ministry of Higher Education in Malaysia.
How low back pain is managed-a mixed methods study in 32 countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series

Sharma S, Pathak A, Parker R, Costa LOP, Ghai B, Igwesi-Chidobe C, et al.

J Orthop Sports Phys Ther, 2024 Apr 11.
PMID: 38602844 DOI: 10.2519/jospt.2024.12406

BACKGROUND: The Lancet Series of Low Back Pain (LBP) highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs, and (2) how that care is delivered. METHODS: An online mixed-methods study. A Consortium for LBP in LMICs (n=65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with five years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using deductive and inductive coding and developed a thematic framework. FINDINGS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women; 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and patient partners (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The Thematic Framework comprised of eight themes: (1) Self-management is ubiquitous; (2) Medicines are the cornerstone; (3) Traditional therapies have a place; (4) Society plays an important role; (5) Imaging use is very common; (6) Reliance on passive approaches; (7) Social determinants influence LBP care pathway; and (8) Health systems are ill-prepared to address LBP burden. INTERPRETATION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines. FUNDING: The lead author's Fellowship was supported by the International Association for the Study of Pain.
Evaluating Bacillus flexus as bioremediators for ammonia removal in shrimp culture water and wastewater and characterizing microbial communities in shrimp pond sludge

Jasmin MY, Isa NM, Kamarudin MS, Lim KC, Karim M

Braz J Microbiol, 2024 Jan 27.
PMID: 38280093 DOI: 10.1007/s42770-024-01246-9

The accumulation of nitrogen compounds in shrimp farming water and effluent presents a major challenge. Ammonia is a form of nitrogen that limits shrimp growth due to its potential toxicity and effects on shrimp health and water quality. This study is aimed at identifying promising bioremediators from shrimp pond sludge to mitigate ammonia levels in both culture water and wastewater and at determining major bacterial communities in sludge using metagenomic analysis. A sludge sample was collected from a shrimp pond in Selangor, Malaysia, to isolate potential ammonia-removing bacteria. Out of 64 isolated strains, Bacillus flexus SS2 showed the highest growth in synthetic basal media (SBM) containing ammonium sulfate at a concentration of 70 mg/L as the sole nitrogen source. The strain was then incubated in SBM with varying pH levels and showed optimal growth at pH 6.5-7. After 24 h of incubation, B. flexus SS2 reduced the ammonia concentration from an initial concentration of 5 to 0.01 mg/L, indicating a 99.61% reduction rate, which was highest in SBM at pH 7. Moreover, the strain showed ammonia removal ability at concentrations ranging from 5 to 70 mg/L. Metagenomic analysis revealed that Proteobacteria was the most abundant phylum in the sludge, followed by Cyanobacteria, Actinobacteria, Chloraflexi, Firmicutes, and Campilobacterota. Bacillus flexus SS2 belongs to the Bacillota phylum and has the potential to serve as a bioremediator for removing ammonia from shrimp culture water and wastewater.
Fulltext Efficacy of Single and Multi-Strain Probiotics on In Vitro Strain Compatibility, Pathogen Inhibition, Biofilm Formation Capability, and Stress Tolerance

Puvanasundram P, Chong CM, Sabri S, Yusoff MSM, Lim KC, Karim M

Biology (Basel), 2022 Nov 10;11(11).
PMID: 36358345 DOI: 10.3390/biology11111644

Compatibility of each strain in a multi-strain probiotic (MSP), along with its properties, becomes a strong base for its formulation. In this study, single-strain probiotics (SSPs) and multi-strain probiotics (MSPs) were evaluated in vitro for strain compatibility, microbial antagonism, biofilm formation capacity, and stress tolerance. Bacillus amyloliquefaciens L11, Enterococcus hirae LAB3, and Lysinibacillus fusiformis SPS11 were chosen as MSP1 candidates because they showed much stronger antagonism to Aeromonas hydrophila and Streptococcus agalactiae than a single probiotic. MSP 2 candidates were Lysinibacillus fusiformis strains SPS11, A1, and Lysinibacillus sphaericus strain NAS32 because the inhibition zone produced by MSP 2 against Vibrio harveyi and Vibrio parahaemolyticus was much higher than that produced by its constituent SSPs. MSP1 in the co-culture assay reduced (p < 0.05) A. hydrophila count from 9.89 ± 0.1 CFU mL−1 to 2.14 ± 0.2 CFU mL−1. The biofilm formation of both MSPs were significantly higher (p < 0.05) than its constituent SSPs and the pathogens. The SSPs in both MSPs generally showed resistance to high temperatures (80, 90, and 100 °C) and a wide range of pH (2 to 9). This in vitro assessment study demonstrates that MSP1 and 2 have the potential to be further explored as multi-strain probiotics on selected aquatic species.
A review of history of CAD/CAM system application in the production of transtibial prosthetic socket in developing countries (from 1980 to 2019)

Afiqah Hamzah N, Razak NAA, Sayuti Ab Karim M, Gholizadeh H

Proc Inst Mech Eng H, 2021 Dec;235(12):1359-1374.
PMID: 34304625 DOI: 10.1177/09544119211035200

The development of the CAD/CAM (Computer-aided design and computer-aided manufacturing) system has globally changed the fabrication and delivery of prosthetics and orthotics. Furthermore, since the introduction of CAD/CAM in the 1980s, many successful CAD/CAM system are available in the market today. However, less than 20% of amputees have access to digital fabrication technology and large portion of the amputees are from the developing countries. This review designed to examine selected studies from 1980 to 2019 on CAD/CAM systems in the production of transtibial prosthetic sockets. A review was conducted based on articles gathered from Web of Science, Pubmed and Science Direct. From the findings, 92 articles found related to CAD/CAM-derived transtibial prosthetic socket (TPS). After a further screening of the articles, 20 studies were chosen and only one study was done in a developing country. The results showed an increase interest in CAD/CAM application in Transtibial prosthetic socket (TPS) production for both developed and developing countries, yet the technology has not fully utilised in the developing countries. Factors such as resources, accessibility, knowledge-gap and lack of experienced prosthetists remain the major causes of the lack of CAD/CAM system studies. Large-scale trials are required to employ digital fabrication in the developing regions, consequently advancing the production of high-quality CAD-CAM-derived TPS where most prosthetic and orthotics are needed.
Review on diagnosis and molecular characterization of Toxoplasma gondii in humans and animals

Uddin AHMM, Hossain D, Ahsan MI, Atikuzzaman M, Karim MR

Trop Biomed, 2021 Dec 01;38(4):511-539.
PMID: 35001919 DOI: 10.47665/tb.38.4.091

Toxoplasma gondii is an obligate intracellular protozoon which causes toxoplasmosis, an important zoonotic disease that is endemic worldwide. Common sources of T. gondii infection in humans are food or water contaminated with oocysts and raw or undercooked meat with cysts. In animals, common sources of infection include feed, water, or litter contaminated with oocysts. The diagnosis and molecular characterization of T. gondii infection in humans and animals is crucial due to public and veterinary health importance. Various traditional and serological methods have been used in clinical practice for toxoplasmosis diagnosis, but interpreting the results remains a challenge. Several molecular techniques have also been used for the detection and genetic characterization of T. gondii , but primarily in research settings. In this paper, we review the techniques that are currently used for the diagnosis and genetic characterization of T. gondii in humans and animals, along with their advantages and disadvantages. The techniques reviewed have laid the groundwork for the future development of more effective and precise detection and characterization of T. gondii . These advances will contribute to a better understanding of epidemiology, prevention and control of toxoplasmosis. Thus, this review would be of particular interest to clinical physicians, veterinarians and researchers.
Influence of Symbiotic Probiont Strains on the Growth of Amphora and Chlorella and Its Potential Protections Against Vibrio spp. in Artemia

Rosland NA, Ikhsan N, Min CC, Yusoff FM, Karim M

Curr Microbiol, 2021 Nov;78(11):3901-3912.
PMID: 34522979 DOI: 10.1007/s00284-021-02642-2

The emerging aquaculture industry is in need of non-antibiotic-based disease control approaches to minimize the risk of antibiotic-resistant bacteria. Bacterial infections mainly caused by Vibrio spp. have caused mass mortalities of fish especially during the larval stages. The objectives of this study were to verify the potential of symbiotic probiont strains, isolated from microalgae (Amphora, Chlorella, and Spirulina) for suppressing the growth of Vibrio spp. and at the same time ascertain their abilities to enhance microalgal biomass by mutualistic interactions through microalgae-bacteria symbiosis. In addition, in vivo studies on Artemia bioencapsulated with probiont strains (single strain and mix strains) and microalgae were evaluated. The selected potential probionts were identified as Lysinibacillus fusiformis strain A-1 (LFA-1), Bacillus sp. strain A-2 (BA-2), Lysinibacillus fusiformis strain Cl-3 (LFCl-3), and Bacillus pocheonensis strain S-2 (BPS-2) using 16s rRNA. The cell densities of Amphora culture supplemented with BA-2 and Chlorella culture supplemented with LFCl-3 were higher than those of the controls. Artemia bioencapsulated with mix strains (LFA-1 + BA-2 + LFCl-3 + BPS-2) and Amphora demonstrated the highest survival rate compared to the controls, after being challenged with V. harveyi (60 ± 4%) and V. parahaemolyticus (78 ± 2%). Our study postulated that BA-2 and LFCl-3 were found to be good promoting bacteria for microalgal growth and microalgae serve as a vector to transport probiotic into Artemia. Moreover, mixture of potential probionts is beneficial for Artemia supplementation in conferring protection to Artemia nauplii against pathogenic Vibrios.
Fulltext The Efficacy of Moina micrura Enriched with Probiotic Bacillus pocheonensis in Enhancing Survival and Disease Resistance of Red Hybrid Tilapia (Oreochromis spp.) Larvae

Samat NA, Yusoff FM, Rasdi NW, Karim M

Antibiotics (Basel), 2021 Aug 16;10(8).
PMID: 34439039 DOI: 10.3390/antibiotics10080989

The administration of probiotics via live feeds, such as Artemia and rotifers, has gained significant attention. Moreover, indiscriminate use of antibiotics in conventional aquaculture practices in order to prevent or control disease outbreaks has resulted in the occurrence of residues and antimicrobial resistance. Thus, the application of eco-friendly feed additives, such as probiotics, as a safer alternative has received increasing attention in recent years. However, only minimal information on the administration of probiotics via freshwater cladoceran Moina micrura is available despite being commonly used for larval and post-larval feeding of freshwater crustaceans and fish. Thus, this study aimed to evaluate the application of Bacillus pocheonensis strain S2 administered via M. micrura to red hybrid tilapia (Oreochromis spp.) larvae. Bacillus pocheonensis that has been previously isolated from Spirulina sp. was subjected to preliminary in vitro evaluation of antagonistic properties. The agar well-diffusion assay revealed that this probiont could inhibit the growth of Streptococcus agalactiae and Aeromonas hydrophila. The size of inhibition zones ranged from 8.8 ± 0.2 to 18.2 ± 0.4 mm. Moina micrura was later used as a biological model in preliminary in vivo bacterial challenge assays to evaluate the efficacy of B. pocheonensis in protecting the host from diseases. Moina micrura was pre-enriched with B. pocheonensis at 104 and 106 CFU mL-1 before S. agalactiae and A. hydrophila were introduced into the culture. The study revealed that B. pocheonensis at 104 CFU mL-1 was able to significantly enhance the survival of M. micrura after being challenged with both pathogens (63 ± 3%) in comparison to the control group. The relative percentage survival (RPS) of M. micrura was highest (p < 0.05) when treated with B. pocheonensis at both concentrations 104 and 106 CFU mL-1 (38.33) after being challenged against S. agalactiae. To assess the efficacy of B. pocheonensis in protecting red hybrid tilapia against streptococcosis, the larvae were fed with either unenriched (control) Moina or probiont-enriched Moina daily for 10 days. A significantly (p < 0.05) higher survival rate (77 ± 3%) was observed in larvae fed with probiont-enriched M. micrura compared to other treatments, and the RPS was recorded at 62.90. In addition, the S. agalactiae load was suppressed in larvae fed probiont-enriched M. micrura (6.84±0.39 CFU mL-1) in comparison to the control group (7.78±0.09 CFU mL-1), indicating that the probiont might have contributed to the improvement of tilapia health and survival. This study illustrated that M. micrura was suitable to be used as a vector for probiotics in freshwater fish larvae as an alternative to hazardous antibiotics for disease control.
Fulltext A Review on the Biotechnological Applications of the Operational Group Bacillus amyloliquefaciens

Ngalimat MS, Yahaya RSR, Baharudin MMA, Yaminudin SM, Karim M, Ahmad SA, et al.

Microorganisms, 2021 Mar 17;9(3).
PMID: 33802666 DOI: 10.3390/microorganisms9030614

Bacteria under the operational group Bacillus amyloliquefaciens (OGBa) are all Gram-positive, endospore-forming, and rod-shaped. Taxonomically, the OGBa belongs to the Bacillus subtilis species complex, family Bacillaceae, class Bacilli, and phylum Firmicutes. To date, the OGBa comprises four bacterial species: Bacillus amyloliquefaciens, Bacillus siamensis, Bacillus velezensis and Bacillus nakamurai. They are widely distributed in various niches including soil, plants, food, and water. A resurgence in genome mining has caused an increased focus on the biotechnological applications of bacterial species belonging to the OGBa. The members of OGBa are known as plant growth-promoting bacteria (PGPB) due to their abilities to fix nitrogen, solubilize phosphate, and produce siderophore and phytohormones, as well as antimicrobial compounds. Moreover, they are also reported to produce various enzymes including α-amylase, protease, lipase, cellulase, xylanase, pectinase, aminotransferase, barnase, peroxidase, and laccase. Antimicrobial compounds that able to inhibit the growth of pathogens including non-ribosomal peptides and polyketides are also produced by these bacteria. Within the OGBa, various B. velezensis strains are promising for use as probiotics for animals and fishes. Genome mining has revealed the potential applications of members of OGBa for removing organophosphorus (OPs) pesticides. Thus, this review focused on the applicability of members of OGBa as plant growth promoters, biocontrol agents, probiotics, bioremediation agents, as well as producers of commercial enzymes and antibiotics. Here, the bioformulations and commercial products available based on these bacteria are also highlighted. This review will better facilitate understandings of members of OGBa and their biotechnological applications.
Fulltext Biostimulatory Effects of Low-Intensity Pulsed Ultrasound on Rate of Orthodontic Tooth Movement and Associated Pain, Applied at 3-Week Intervals: A Split-Mouth Study

Qamruddin I, Alam MK, Mahroof V, Karim M, Fida M, Khamis MF, et al.

Pain Res Manag, 2021;2021:6624723.
PMID: 34035871 DOI: 10.1155/2021/6624723

Objective: Low-intensity pulsed ultrasound (LIPUS) is a noninvasive modality to stimulate bone remodeling (BR) and the healing of hard and soft tissues. This research evaluates the biostimulatory effect of LIPUS on the rate of orthodontic tooth movement (OTM) and associated pain, when applied at 3-week intervals.
Methods: Twenty-two patients (11 males and 11 females; mean age 19.18 ± 2.00 years) having Angle's Class II division 1 malocclusion needing bilateral extractions of maxillary first bicuspids were recruited for this split-mouth randomized clinical trial. After the initial stage of alignment and leveling with contemporary edgewise MBT (McLaughlin-Bennett-Trevisi) prescription brackets (Ortho Organizers, Carlsbad, Calif) of 22 mil, followed by extractions of premolars bilaterally, 6 mm nickel-titanium spring was used to retract the canines separately by applying 150 g force on 0.019 × 0.025-in stainless steel working archwires. LIPUS (1.1 MHz frequency and 30 mW/cm2 intensity output) was applied for 20 minutes extraorally and reapplied after 3 weeks for 2 more successive visits over the root of maxillary canine on the experimental side whereas the other side was placebo. A numerical rating scale- (NRS-) based questionnaire was given to the patients on each visit to record their weekly pain experience. Impressions were also made at each visit before the application of LIPUS (T1, T2, and T3). Models were scanned with a CAD/CAM scanner (Planmeca, Helsinki, Finland). Mann-Whitney U test was applied for comparison of canine movement and pain intensity between both the groups.
Results: No significant difference in the rate of canine movement was found among the experimental (0.90 mm ± 0.33 mm) and placebo groups (0.81 mm ± 0.32 mm). There was no difference in pain reduction between experimental and placebo groups (p > 0.05).
Conclusion: Single-dose application of LIPUS at 3-week intervals is ineffective in stimulating the OTM and reducing associated treatment pain.
Fulltext Antimicrobial activities of Bacillus velezensis strains isolated from stingless bee products against methicillin-resistant Staphylococcus aureus

Baharudin MMA, Ngalimat MS, Mohd Shariff F, Balia Yusof ZN, Karim M, Baharum SN, et al.

PLoS One, 2021;16(5):e0251514.
PMID: 33974665 DOI: 10.1371/journal.pone.0251514

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have reached epidemic proportions globally. Therefore, there is an urgent need for a continuous supply of antibiotics to combat the problem. In this study, bacteria initially identified as species belonging to the Bacillus amyloliquefaciens operational group were re-identified based on the housekeeping gene, gyrB. Cell-free supernatants (CFS) from the strains were used for antimicrobial tests using the agar well diffusion assay against MRSA and various types of pathogenic bacteria. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and physicochemical characteristics of the CFS were determined. Based on gyrB sequence analysis, five strains (PD9, B7, PU1, BP1 and L9) were identified as Bacillus velezensis. The CFS of all B. velezensis strains showed broad inhibitory activities against Gram-negative and -positive as well as MRSA strains. Strain PD9 against MRSA ATCC 33742 was chosen for further analysis as it showed the biggest zone of inhibition (21.0 ± 0.4 mm). The MIC and MBC values obtained were 125 μl/ml. The crude antimicrobial extract showed bactericidal activity and was stable at various temperatures (40-80°C), pH (4-12), surfactants (Tween 20, Tween 80, SDS and Triton X-100) and metal ions (MgCI2, NaCI2, ZnNO3 and CuSO4) when tested. However, the crude extract was not stable when treated with proteinase K. All these properties resembled the characteristics of peptides. The antimicrobial compound from the selected strain was purified by using solvent extraction method and silica gel column chromatography. The purified compound was subjected to High Performance Liquid Chromatography which resulted in a single peak of the anti-MRSA compound being detected. The molecular weight of the anti-MRSA compound was determined by using SDS-PAGE and zymogram. The size of the purified antimicrobial peptide was approximately ~ 5 kDa. The antimicrobial peptide produced from B. velezensis strain PD9 is a promising alternative to combat the spread of MRSA infections in the future.
Fulltext Enhancement of Live Food Nutritional Status with Essential Nutrients for Improving Aquatic Animal Health: A Review

Samat NA, Yusoff FM, Rasdi NW, Karim M

Animals (Basel), 2020 Dec 21;10(12).
PMID: 33371528 DOI: 10.3390/ani10122457

At the present time, no artificial larval diet is capable of entirely fulfilling the dietary requirements of several larval fish and crustacean species. Zooplankton live food is the basic foundation of fish larviculture, and successful rearing of fish larvae still heavily depends on an adequate supply of nutritious live food. Despite being important, the production protocols of copepods and cladocerans (Moina) are still underdeveloped in hatcheries. Rotifers and Artemia are the most commonly used live foods. However, these live foods are evidently lacking in crucial nutrient constituents. Hence, through nutrient enrichment, live food with the nutritional profile that meets the requirements of fish larvae can be produced. With the aim to maximize the effectiveness of production to optimize profitability, it is important to evaluate and improve culture techniques for the delivery of micro- and macro-nutrients as feed supplements to larvae in aquaculture systems. Bioencapsulation and enrichment are the evolving techniques in aquaculture that are commonly employed to enhance the nutritional quality of live food by integrating nutrients into them, which subsequently improves the growth, survival, and disease resistance of the consuming hosts. This review aims to highlight some of the approaches and methods used to improve the nutritional quality of live food by modifying their nutrient composition, which could have immense promise in the enhancement of aquatic animal health.
Characterization of Enterococcus hirae Isolated from the Intestine of Seabass (Lates Calcarifer) as a New Potential Probiotic against Pathogenic Vibrios

Masduki F, Y JM, Min CC, Karim M

Curr Microbiol, 2020 Dec;77(12):3962-3968.
PMID: 33025182 DOI: 10.1007/s00284-020-02228-4

In this study, we aimed to isolate, identify and characterize lactic acid bacteria (LAB) from the intestine of juvenile seabass (Lates calcarifer) as a new potential probiotic. Four strains of LABs were isolated from the intestines of ten healthy seabass juveniles. In the in vitro screening process using spot lawn assay, one isolate labeled as LAB3 showed inhibitory activity against Vibrio harveyi (ATCC 35,084). Strain LAB3 was determined to belong to the gram positive bacteria group with cocci shape and was identified as Enterococcus hirae using 16S rDNA analysis. This bacterium was able to grow at pH ranging from pH 2 to 10 with the best growth at pH 7. This strain was also able to grow at 0-4% NaCl after 24 h incubation and grew best at 1.5% NaCl. Enterococcus hirae strain LAB3 of the present study is worthy to be further characterized as a potential probiotic for use in seabass culture.
Fulltext Effective Dose Estimation of Patients Administered with 18F-FDG and Ga-68 DOTATATE in PET/CT Examination Associated with Gender and Weight

Kamal, I., Said, M. A., Bathumalai, J., Abdul Razak, H. R., Abdul Karim, M. K.

Physics and Technology in Medicine, 2020;1(1):15-21.
MyJurnal

The whole-body fluorodeoxyglucose F18 (18F-FDG) and gallium-68 (Ga-68 DOTATATE) are the most common radiopharmaceutical use in PET/CT imaging for cancer staging. Although radiopharmaceutical for PET/CT examination has been acknowledged for its safety and efficacy, the internal dosimetry and effective dose (ED) from the examinations are rarely discussed. Hence, this study aimed to evaluate radiation ED for whole-body radiopharmaceuticals PET/CT concerning patients’ gender and their weight. A total of 82 oncology patients (44 males and 38 females) were collected retrospectively from Institut Kanser Negara, Putrajaya. Data, such as 18F-FDG and Ga-68 DOTATATE activity and patient demography (weight, height, age), were recorded and analyzed. Effective doses from both internal and external exposure were calculated using the coefficient
provided by the International Commission on Radiological Protection (ICRP) report. The total ED of 18F-FDG for male patients was 20.2 ± 8.6 mSv and for female patients were 19.0 ± 8.2 mSv while total whole-body ED for Ga-68 DOTATATE for male patients was 18.5 ± 7.0 mSv and 17.0 ± 5.6 mSv for female patients. The ratio for ED between male and female were 1:1 for both examinations ranged from 12.0 – 23 mSv. From this study, it indicated that the ED of Ga-68 DOTATATE was far lower when compared to the ED of 18F-FDG by a factor of 0.7. Therefore, it is crucial to optimize the PET/CT protocol dose in order to uphold the dose as low as reasonably achievable (ALARA).
Fulltext Entrance Surface Dose Measurement and Lifetime Attribute Risk Analysis from Postero-anterior Chest X-ray Imaging via Direct and Indirect Measurement

Kamal, I., Salehhon, N., Hashim, S., Musa, Y., Abdul Karim, M. K.

Physics and Technology in Medicine, 2020;1(2):20-26.
MyJurnal

The aimed of this study is to estimate the entrance surface dose (ESD) of routine chest X-ray (CXR) examination and to compare the direct and indirect measurement. This study also extended to relate with the patients body thickness and established lifetime attributable risk (LAR) of the examinations. A total of 101 CXR examinations in posteroanterior (PA) projections were selected
as subjects and data, such as patient habitus and scanning acquisition parameters were recorded. The mean ESD value obtained from the TLD-100 and the software calculation was 0.31 mGy and 0.17 mGy, respectively. The percentage deviation obtained ranged from 25.5% to 61.3%. In comparison with the national diagnostic reference level (DRL), the mean values of ESD obtained from this study were lower by a factor of 3. Furthermore, it was observed that the mean absorbed dose of the adrenals, kidneys, lungs, oesophagus, and heart walls were lower as compared to the ESD value. The examinations were only associated with very low risk of cancer incidence and mortality. Hence, the results of this study suggested a need for standardisations of the personnel training to perform X-ray examinations according to ALARA principles.
Effect of iterative reconstruction algorithm levels on noise index and figure-of-merit in CT pulmonary angiography examinations

Harun HH, Karim MKA, Abbas Z, Sabarudin A, Muniandy SC, Ibahim MJ

J Xray Sci Technol, 2020;28(5):893-903.
PMID: 32741801 DOI: 10.3233/XST-200699

PURPOSE: To evaluate the influence of iterative reconstruction (IR) levels on Computed Tomography (CT) image quality and to establish Figure of Merit (FOM) value for CT Pulmonary Angiography (CTPA) examinations.
METHODS: Images of 31 adult patients who underwent CTPA examinations in our institution from March to April 2019 were retrospectively collected. Other data, such as scanning parameters, radiation dose and body habitus information from the subjects were also recorded. Six different levels of IR were applied to the volume data of the subjects. Five circles of the region of interest (ROI) were drawn in five different arteries namely, pulmonary trunk, right pulmonary artery, left pulmonary artery, ascending aorta and descending aorta. The mean Signal-to-noise ratio (SNR) was obtained, and the FOM was calculated in a fraction of the SNR2 divided by volume-weighted CT dose index (CTDIvol) and SNR2 divided by the size-specific dose estimates (SSDE).
RESULTS: Overall, we observed that the mean value of CTDIvol and SSDE were 13.79±7.72 mGy and 17.25±8.92 mGy, respectively. Notably, SNR values significantly increase with increase of the IR level (p
A comparative study of radiation doses between phantom and patients via CT angiography of the intra-/extra-cranial, pulmonary, and abdominal/pelvic arteries

Karim MKA, Sabarudin A, Muhammad NA, Ng KH

Radiol Phys Technol, 2019 Dec;12(4):374-381.
PMID: 31468370 DOI: 10.1007/s12194-019-00532-8

This study aimed to evaluate effective dose and size-specific dose estimate (SSDE) of computed tomography angiography (CTA) examination using an anthropomorphic phantom. We included three CTA examination protocols to evaluate the intra- and extra-cranial arteries, pulmonary artery (CTPA), and abdominal vessels. Patient SSDEs were measured retrospectively to estimate patient dose, relative to the bodyweight of the patient and volume CT dose index (CTDIvol). Our findings revealed that the highest dose was absorbed by the left lobe of the thyroid gland during intra-/extra-cranial CTA and CTPA, that is, 14.11 ± 0.24 mGy and 16.20 ± 3.95 mGy, respectively. However, the highest absorbed dose in abdominal/pelvic CTA was the gonads (8.98 ± 0.30 mGy), while other radiosensitive organs in intra- and extra-cranial CTA, CTPA, and abdominal/pelvic CTA did not demonstrate significant differences between organs/structures with p value 0.88, 0.11, and 0.54, respectively. The estimated effective dose in intra-/extra-cranial CTA was lower in patients (0.80 ± 0.60 mSv) than in the phantom (0.83 mSv), but it was the opposite for CTPA, with the effective dose being higher in patients (7.54 ± 3.09 mSv) than in the phantom (6.68 mSv). Similar to the effective dose, only CTPA SSDEs were significantly higher in men than in women (19.74 ± 4.79 mGy versus 7.9 mGy). Effective dose and SSDE are clinically relevant parameters that can help estimate a more accurate patient dose based on a patient's size.
Correction to: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al.

Hepatol Int, 2019 11;13(6):826-828.
PMID: 31595462 DOI: 10.1007/s12072-019-09980-1

The article Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update, written by [Shiv Sarin], was originally published electronically on the publisher's internet portal (currently SpringerLink) on June 06, 2019 without open access.
Fulltext Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al.

Hepatol Int, 2019 Jul;13(4):353-390.
PMID: 31172417 DOI: 10.1007/s12072-019-09946-3

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the 'Golden Therapeutic Window', extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here.
Quorum sensing is required for full virulence of Vibrio campbellii towards tiger grouper (Epinephelus fuscoguttatus) larvae

Noor NM, Defoirdt T, Alipiah N, Karim M, Daud H, Natrah I

J Fish Dis, 2019 Apr;42(4):489-495.
PMID: 30742313 DOI: 10.1111/jfd.12946

The link between quorum sensing in Vibrio campbellii and its virulence towards tiger grouper (Epinephelus fuscoguttatus) was investigated using V. campbellii wild type and quorum-sensing mutants with inactive quorum sensing or constitutively maximal quorum-sensing activity, and signal molecule synthase mutants. The results showed that wild-type V. campbellii is pathogenic to grouper larvae, causing more than 50% mortality after 4 days of challenge. Furthermore, the mortality of larvae challenged with the mutant with maximally active quorum sensing was significantly higher than that of larvae challenged with the wild type, whereas a higher survival was observed in the larvae challenged to the mutant with a completely inactive quorum-sensing system. Grouper larvae challenged with either the signal molecule synthase triple mutant, the harveyi autoinducer-1 (HAI-1) synthase mutant and the autoinducer-2 (AI-2) synthase mutant showed higher survival than larvae challenged with the wild type. In contrast, larvae challenged with the cholerae autoinducer-1 (CAI-1) synthase mutant showed high mortality. This indicates that HAI-1 and AI-2, but not CAI-1, are required for full virulence of V. campbellii towards grouper larvae. Our data suggest that quorum-sensing inhibition could be an effective strategy to control V. campbellii infections in tiger grouper.

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