Displaying publications 1 - 20 of 27 in total

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  1. Bakar MAAA, Ker PJ, Tang SGH, Baharuddin MZ, Lee HJ, Omar AR
    Front Vet Sci, 2023;10:1174700.
    PMID: 37415964 DOI: 10.3389/fvets.2023.1174700
    Bacteria- or virus-infected chicken is conventionally detected by manual observation and confirmed by a laboratory test, which may lead to late detection, significant economic loss, and threaten human health. This paper reports on the development of an innovative technique to detect bacteria- or virus-infected chickens based on the optical chromaticity of the chicken comb. The chromaticity of the infected and healthy chicken comb was extracted and analyzed with International Commission on Illumination (CIE) XYZ color space. Logistic Regression, Support Vector Machines (SVMs), K-Nearest Neighbors (KNN), and Decision Trees have been developed to detect infected chickens using the chromaticity data. Based on the X and Z chromaticity data from the chromaticity analysis, the color of the infected chicken's comb converged from red to green and yellow to blue. The development of the algorithms shows that Logistic Regression, SVM with Linear and Polynomial kernels performed the best with 95% accuracy, followed by SVM-RBF kernel, and KNN with 93% accuracy, Decision Tree with 90% accuracy, and lastly, SVM-Sigmoidal kernel with 83% accuracy. The iteration of the probability threshold parameter for Logistic Regression models has shown that the model can detect all infected chickens with 100% sensitivity and 95% accuracy at the probability threshold of 0.54. These works have shown that, despite using only the optical chromaticity of the chicken comb as the input data, the developed models (95% accuracy) have performed exceptionally well, compared to other reported results (99.469% accuracy) which utilize more sophisticated input data such as morphological and mobility features. This work has demonstrated a new feature for bacteria- or virus-infected chicken detection and contributes to the development of modern technology in agriculture applications.
  2. Chen YH, Lee HJ, Lee MT, Wu YT, Lee YH, Hwang LL, et al.
    Proc Natl Acad Sci U S A, 2018 11 06;115(45):E10720-E10729.
    PMID: 30348772 DOI: 10.1073/pnas.1807991115
    Adequate pain management remains an unmet medical need. We previously revealed an opioid-independent analgesic mechanism mediated by orexin 1 receptor (OX1R)-initiated 2-arachidonoylglycerol (2-AG) signaling in the ventrolateral periaqueductal gray (vlPAG). Here, we found that low-frequency median nerve stimulation (MNS) through acupuncture needles at the PC6 (Neiguan) acupoint (MNS-PC6) induced an antinociceptive effect that engaged this mechanism. In mice, MNS-PC6 reduced acute thermal nociceptive responses and neuropathy-induced mechanical allodynia, increased the number of c-Fos-immunoreactive hypothalamic orexin neurons, and led to higher orexin A and lower GABA levels in the vlPAG. Such responses were not seen in mice with PC6 needle insertion only or electrical stimulation of the lateral deltoid, a nonmedian nerve-innervated location. Directly stimulating the surgically exposed median nerve also increased vlPAG orexin A levels. MNS-PC6-induced antinociception (MNS-PC6-IA) was prevented by proximal block of the median nerve with lidocaine as well as by systemic or intravlPAG injection of an antagonist of OX1Rs or cannabinoid 1 receptors (CB1Rs) but not by opioid receptor antagonists. Systemic blockade of OX1Rs or CB1Rs also restored vlPAG GABA levels after MNS-PC6. A cannabinoid (2-AG)-dependent mechanism was also implicated by the observations that MNS-PC6-IA was prevented by intravlPAG inhibition of 2-AG synthesis and was attenuated in Cnr1-/- mice. These findings suggest that PC6-targeting low-frequency MNS activates hypothalamic orexin neurons, releasing orexins to induce analgesia through a CB1R-dependent cascade mediated by OX1R-initiated 2-AG retrograde disinhibition in the vlPAG. The opioid-independent characteristic of MNS-PC6-induced analgesia may provide a strategy for pain management in opioid-tolerant patients.
  3. Cho SJ, Lee J, Lee HJ, Jo HY, Sinniah M, Kim HY, et al.
    Int J Biol Sci, 2016;12(7):824-35.
    PMID: 27313496 DOI: 10.7150/ijbs.14408
    Rapid diagnostic tests (RDTs) can detect anti-malaria antibodies in human blood. As they can detect parasite infection at the low parasite density, they are useful in endemic areas where light infection and/or re-infection of parasites are common. Thus, malaria antibody tests can be used for screening bloods in blood banks to prevent transfusion-transmitted malaria (TTM), an emerging problem in malaria endemic areas. However, only a few malaria antibody tests are available in the microwell-based assay format and these are not suitable for field application. A novel malaria antibody (Ab)-based RDT using a differential diagnostic marker for falciparum and vivax malaria was developed as a suitable high-throughput assay that is sensitive and practical for blood screening. The marker, merozoite surface protein 1 (MSP1) was discovered by generation of a Plasmodium-specific network and the hierarchical organization of modularity in the network. Clinical evaluation revealed that the novel Malaria Pf/Pv Ab RDT shows improved sensitivity (98%) and specificity (99.7%) compared with the performance of a commercial kit, SD BioLine Malaria P.f/P.v (95.1% sensitivity and 99.1% specificity). The novel Malaria Pf/Pv Ab RDT has potential for use as a cost-effective blood-screening tool for malaria and in turn, reduces TTM risk in endemic areas.
  4. Chou YH, Hor CC, Lee MT, Lee HJ, Guerrini R, Calo G, et al.
    Addict Biol, 2020 Oct 19.
    PMID: 33078457 DOI: 10.1111/adb.12971
    Neurons containing neuropeptide S (NPS) and orexins are activated during stress. Previously, we reported that orexins released during stress, via orexin OX1 receptors (OX1 Rs), contribute to the reinstatement of cocaine seeking through endocannabinoid/CB1 receptor (CB1 R)-mediated dopaminergic disinhibition in the ventral tegmental area (VTA). Here, we further demonstrated that NPS released during stress is an up-stream activator of this orexin-endocannabinoid cascade in the VTA, leading to the reinstatement of cocaine seeking. Mice were trained to acquire cocaine conditioned place preference (CPP) by context-pairing cocaine injections followed by the extinction training with context-pairing saline injections. Interestingly, the extinguished cocaine CPP in mice was significantly reinstated by intracerebroventricular injection (i.c.v.) of NPS (1 nmol) in a manner prevented by intraperitoneal injection (i.p.) of SHA68 (50 mg/kg), an NPS receptor antagonist. This NPS-induced cocaine reinstatement was prevented by either i.p. or intra-VTA microinjection (i.vta.) of SB-334867 (15 mg/kg, i.p. or 15 nmol, i.vta.) and AM 251 (1.1 mg/kg, i.p. or 30 nmol, i.vta.), antagonists of OX1 Rs and CB1 Rs, respectively. Besides, NPS (1 nmol, i.c.v.) increased the number of c-Fos-containing orexin neurons in the lateral hypothalamus (LH) and increased orexin-A level in the VTA. The latter effect was blocked by SHA68. Furthermore, a 30-min restraint stress in mice reinstated extinguished cocaine CPP and was prevented by SHA68. These results suggest that NPS is released upon stress and subsequently activates LH orexin neurons to release orexins in the VTA. The released orexins then reinstate extinguished cocaine CPP via an OX1 R- and endocannabinoid-CB1 R-mediated signaling in the VTA.
  5. Dass RM, Kim E, Kim HK, Lee JY, Lee HJ, Rhee SJ
    Korean J Pain, 2019 Jul 01;32(3):223-227.
    PMID: 31257831 DOI: 10.3344/kjp.2019.32.3.223
    Radiofrequency neurolysis (RFN) of the genicular nerves has recently become accepted as an effective technique to alleviate knee pain particularly in patients with knee osteoarthritis (OA) or postoperative pain. However, genicular nerve RFN can produce high procedure and equipment costs, longer procedural times, procedure-related pain, and failure rate of over 25%. We are presenting two cases of alcohol neurolysis of the genicular nerve using fluoroscopy and ultrasonography in patients with knee OA or persistent postsurgical pain of the knee. Alcohol neurolysis of the genicular nerve with dual imaging modality can be a cheap, safe and effective method in patients with chronic knee pain.
  6. Du JC, Chang MH, Yeh CJ, Lee MT, Lee HJ, Chuang SH, et al.
    Ann Neurol, 2023 Sep 30.
    PMID: 37776102 DOI: 10.1002/ana.26805
    OBJECTIVE: The SLIT and NTRK-like 1 (SLITRK1) gene mutation and striatal cholinergic interneurons (ChIs) loss are associated with Tourette syndrome (TS). ChIs comprise only 1 to 2% of striatal neurons but project widely throughout the stratum to impact various striatal neurotransmission, including TS-related dopaminergic transmission. Here, we link striatal Slitrk1, ChI function, and dopaminergic transmission and their associations with TS-like tic behaviors.

    METHODS: Slitrk1-KD mice were induced by bilaterally injecting Slitrk1 siRNA into their dorsal striatum. Control mice received scrambled siRNA injection. Their TS-like tic behaviors, prepulse inhibition, sensory-motor function and dopamine-related behaviors were compared. We also compared dopamine and ACh levels in microdialysates, Slitrk protein and dopamine transporter levels, and numbers of Slitrk-positive ChIs and activated ChIs in the striatum between two mouse groups, and electrophysiological properties between Slitrk-positive and Slitrk-negative striatal ChIs.

    RESULTS: Slitrk1-KD mice exhibit TS-like haloperidol-sensitive stereotypic tic behaviors, impaired prepulse inhibition, and delayed sensorimotor response compared with the control group. These TS-like characteristics correlate with lower striatal Slitrk1 protein levels, fewer Slitrk1-containing ChIs, and fewer activated ChIs in Slitrk1-KD mice. Based on their electrophysiological properties, Slitrk1-negative ChIs are less excitable than Slitrk1-positive ChIs. Slitrk1-KD mice have lower evoked acetylcholine and dopamine levels, higher tonic dopamine levels, and downregulated dopamine transporters in the striatum, increased apomorphine-induced climbing behaviors, and impaired methamphetamine-induced hyperlocomotion compared with controls.

    INTERPRETATION: Slitrk1 is pivotal in maintaining striatal ChIs activity and subsequent dopaminergic transmission for normal motor functioning. Furthermore, conditional striatal Slitrk1-KD mice may serve as a translational modality with aspects of TS phenomenology. ANN NEUROL 2023.

  7. Emami SD, Dashtabi MM, Lee HJ, Arabanian AS, Rashid HAA
    Sci Rep, 2017 Oct 06;7(1):12747.
    PMID: 28986584 DOI: 10.1038/s41598-017-13200-x
    This paper presents short wavelength operation of tunable thulium-doped mode-locked lasers with sweep ranges of 1702 to 1764 nm and 1788 to 1831 nm. This operation is realized by a combination of the partial amplified spontaneous emission suppression method, the bidirectional pumping mechanism and the nonlinear polarization rotation (NPR) technique. Lasing at emission bands lower than the 1800 nm wavelength in thulium-doped fiber lasers is achieved using mode confinement loss in a specially designed photonic crystal fiber (PCF). The enlargement of the first outer ring air holes around the core region of the PCF attenuates emissions above the cut-off wavelength and dominates the active region. This amplified spontaneous emission (ASE) suppression using our presented PCF is applied to a mode-locked laser cavity and is demonstrated to be a simple and compact solution to widely tunable all-fiber lasers.
  8. Gamel MMA, Lee HJ, Rashid WESWA, Ker PJ, Yau LK, Hannan MA, et al.
    Materials (Basel), 2021 Aug 30;14(17).
    PMID: 34501032 DOI: 10.3390/ma14174944
    Generally, waste heat is redundantly released into the surrounding by anthropogenic activities without strategized planning. Consequently, urban heat islands and global warming chronically increases over time. Thermophotovoltaic (TPV) systems can be potentially deployed to harvest waste heat and recuperate energy to tackle this global issue with supplementary generation of electrical energy. This paper presents a critical review on two dominant types of semiconductor materials, namely gallium antimonide (GaSb) and indium gallium arsenide (InGaAs), as the potential candidates for TPV cells. The advantages and drawbacks of non-epitaxy and epitaxy growth methods are well-discussed based on different semiconductor materials. In addition, this paper critically examines and summarizes the electrical cell performance of TPV cells made of GaSb, InGaAs and other narrow bandgap semiconductor materials. The cell conversion efficiency improvement in terms of structural design and architectural optimization are also comprehensively analyzed and discussed. Lastly, the practical applications, current issues and challenges of TPV cells are critically reviewed and concluded with recommendations for future research. The highlighted insights of this review will contribute to the increase in effort towards development of future TPV systems with improved cell conversion efficiency.
  9. Gamel MMA, Ker PJ, Lee HJ, Rashid WESWA, Hannan MA, David JPR, et al.
    Sci Rep, 2021 Apr 08;11(1):7741.
    PMID: 33833263 DOI: 10.1038/s41598-021-86175-5
    The optimization of thermophotovoltaic (TPV) cell efficiency is essential since it leads to a significant increase in the output power. Typically, the optimization of In0.53Ga0.47As TPV cell has been limited to single variable such as the emitter thickness, while the effects of the variation in other design variables are assumed to be negligible. The reported efficiencies of In0.53Ga0.47As TPV cell mostly remain 
  10. Hasnul Hadi MH, Ker PJ, Thiviyanathan VA, Tang SGH, Leong YS, Lee HJ, et al.
    Sensors (Basel), 2021 Oct 16;21(20).
    PMID: 34696079 DOI: 10.3390/s21206866
    For most natural or naturally-derived liquid products, their color reflects on their quality and occasionally affects customer preferences. To date, there are a few subjective and objective methods for color measurement which are currently utilized by various industries. Researchers are also improving these methods and inventing new methods, as color is proven to have the ability to provide various information on the condition and quality of the liquid. However, a review on the methods, especially for amber-colored liquid, has not been conducted yet. This paper presents a comprehensive review on the subjective and objective methods for color measurement of amber-colored liquids. The pros and cons of the measurement methods, the effects of the color on customer preferences, and the international industry standards on color measurements are reviewed and discussed. In addition, this study elaborates on the issues and challenges related to the color measurement techniques as well as recommendations for future research. This review demonstrates that the existing color measurement technique can determine the color according to the standards and color scales. However, the efforts toward minimizing the complexity of the hardware while maximizing the signal processing through advanced computation are still lacking. Therefore, through this critical review, this review can hopefully intensify the efforts toward finding an optimized method or technique for color measurement of liquids and thus expedite the development of a portable device that can measure color accurately.
  11. Hasnul Hadi MH, Ker PJ, Lee HJ, Leong YS, Hannan MA, Jamaludin MZ, et al.
    Sensors (Basel), 2021 Nov 02;21(21).
    PMID: 34770602 DOI: 10.3390/s21217292
    The color of transformer oil can be one of the first indicators determining the quality of the transformer oil and the condition of the power transformer. The current method of determining the color index (CI) of transformer oil utilizes a color comparator based on the American Society for Testing and Materials (ASTM) D1500 standard, which requires a human observer, leading to human error and a limited number of samples tested per day. This paper reports on the utilization of ultra violet-blue laser at 405- and 450-nm wavelengths to measure the CI of transformer oil. In total, 20 transformer oil samples with CI ranging from 0.5 to 7.5 were measured at optical pathlengths of 10 and 1 mm. A linear regression model was developed to determine the color index of the transformer oil. The equation was validated and verified by measuring the output power of a new batch of transformer oil samples. Data obtained from the measurements were able to quantify the CI accurately with root-mean-square errors (RMSEs) of 0.2229 for 405 nm and 0.4129 for 450 nm. This approach shows the commercialization potential of a low-cost portable device that can be used on-site for the monitoring of power transformers.
  12. Ho A, Zuan ATK, Mendes LW, Lee HJ, Zulkeflee Z, van Dijk H, et al.
    Microb Ecol, 2022 Nov;84(4):1154-1165.
    PMID: 34716776 DOI: 10.1007/s00248-021-01908-3
    Oil palm (OP) plantations are gradually replacing tropical rainforest in Malaysia, one of the largest palm oil producers globally. Conversion of lands to OP plantations has been associated with compositional shifts of the microbial community, with consequences on the greenhouse gas (GHG) emissions. While the impact of the change in land use has recently been investigated for microorganisms involved in N2O emission, the response of the aerobic methanotrophs to OP agriculture remains to be determined. Here, we monitored the bacterial community composition, focusing on the aerobic methanotrophs, in OP agricultural soils since 2012, 2006, and 1993, as well as in a tropical rainforest, in 2019 and 2020. High-affinity methane uptake was confirmed, showing significantly lower rates in the OP plantations than in the tropical rainforest, but values increased with continuous OP agriculture. The bacterial, including the methanotrophic community composition, was modified with ongoing OP agriculture. The methanotrophic community composition was predominantly composed of unclassified methanotrophs, with the canonical (Methylocystis) and putative methanotrophs thought to catalyze high-affinity methane oxidation present at higher relative abundance in the oldest OP plantation. Results suggest that the methanotrophic community was relatively more stable within each site, exhibiting less temporal variations than the total bacterial community. Uncharacteristically, a 16S rRNA gene-based co-occurrence network analysis revealed a more complex and connected community in the OP agricultural soil, which may influence the resilience of the bacterial community to disturbances. Overall, we provide a first insight into the ecology and role of the aerobic methanotrophs as a methane sink in OP agricultural soils.
  13. Ismail A, Ryu J, Yim DG, Kim G, Kim SS, Lee HJ, et al.
    Food Sci Anim Resour, 2023 Sep;43(5):840-858.
    PMID: 37701741 DOI: 10.5851/kosfa.2023.e39
    This study was designed to compare the quality changes in mackerel fillets stored under different conditions by using hyperspectral imaging (HSI) techniques. Fillets packaged in vacuum were stored for six days under five different conditions: refrigerated at 4°C (R group); iced at 5±3°C (I group); kept at an ambient of 17±2°C (A group); frozen at -18°C for 24 h and thawed in a refrigerator at 4°C for 5 h on the sampling day (FTR group); FTR thawed in tap water instead of thawing in a refrigerator (FTW group). The FTR group had the lowest total bacterial count, drip loss, 2-thiobarbituric acid reactive substances, volatile basic nitrogen, and texture profile analysis values among groups during the entire storage period (p<0.05). Scanning electron microscopy revealed that the FTR group had less damage, while the other groups had shrunken muscle tissues. HSI integrated with the partial least squares model yielded reliable and efficient results, with high R2cv values, for several quality parameters of the mackerel fillets. Overall, the FTR group, involving freezing and thawing in a refrigerator, appears to be the most favorable option for maintaining the quality of mackerel fillets, which could be practically implemented in the industry. HSI is a suitable and effective technique for determining the quality of mackerel fillets stored under different conditions.
  14. Jung YH, Kim S, Yang TH, Lee HJ, Seung D, Park YC, et al.
    Bioprocess Biosyst Eng, 2012 Nov;35(9):1497-503.
    PMID: 22644062 DOI: 10.1007/s00449-012-0739-8
    Oil palm fronds are the most abundant lignocellulosic biomass in Malaysia. In this study, fronds were tested as the potential renewable biomass for ethanol production. The soaking in aqueous ammonia pretreatment was applied, and the fermentability of pretreated fronds was evaluated using simultaneous saccharification and fermentation. The optimal pretreatment conditions were 7 % (w/w) ammonia, 80 °C, 20 h of pretreatment, and 1:12 S/L ratio, where the enzymatic digestibility was 41.4 % with cellulase of 60 FPU/g-glucan. When increasing the cellulase loading in the hydrolysis of pretreated fronds, the enzymatic digestibility increased until the enzyme loading reached 60 FPU/g-glucan. With 3 % glucan loading in the SSF of pretreated fronds, the ethanol concentration and yield based on the theoretical maximum after 12 and 48 h of the SSF were 7.5 and 9.7 g/L and 43.8 and 56.8 %, respectively. The ethanol productivities found at 12 and 24 h from pretreated fronds were 0.62 and 0.36 g/L/h, respectively.
  15. Kanesvaran R, Porta C, Wong A, Powles T, Ng QS, Schmidinger M, et al.
    ESMO Open, 2021 Dec;6(6):100304.
    PMID: 34864348 DOI: 10.1016/j.esmoop.2021.100304
    The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of renal cell carcinoma was published in 2019 with an update planned for 2021. It was therefore decided by both the ESMO and the Singapore Society of Oncology (SSO) to convene a special, virtual guidelines meeting in May 2021 to adapt the ESMO 2019 guidelines to take into account the ethnic differences associated with the treatment of renal cell carcinomas in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with renal cell carcinoma representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate.
  16. Kanesvaran R, Castro E, Wong A, Fizazi K, Chua MLK, Zhu Y, et al.
    ESMO Open, 2022 Aug;7(4):100518.
    PMID: 35797737 DOI: 10.1016/j.esmoop.2022.100518
    The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of prostate cancer was published in 2020. It was therefore decided, by both the ESMO and the Singapore Society of Oncology (SSO), to convene a special, virtual guidelines meeting in November 2021 to adapt the ESMO 2020 guidelines to take into account the differences associated with the treatment of prostate cancer in Asia. These guidelines represent the consensus opinions reached by experts in the treatment of patients with prostate cancer representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with prostate cancer across the different regions of Asia.
  17. Khanh NP, Tan SW, Yeap SK, Lee HJ, Choi KS, Hair-Bejo M, et al.
    J Comp Pathol, 2018 May;161:43-54.
    PMID: 30173857 DOI: 10.1016/j.jcpa.2018.04.006
    Infectious bronchitis viruses (IBVs) circulating in Malaysia are classified into two groups as Malaysian QX-like and variant strains. In this study, the pathogenicity of IBS130/2015 (QX-like) and IBS037A/2014 (variant) IBVs in 1-day-old and 30-day-old specific pathogen free (SPF) chickens was characterized. Both strains caused respiratory and kidney infections based on immunohistochemistry (IHC), real-time quantitative polymerase chain reaction (qPCR) and a ciliostasis study; however, the results showed that the QX-like strain was more pathogenic, caused higher mortality and showed higher tissue tropism for the kidney than the variant strain. In contrast, despite causing low or no mortality depending on the age of the infected chickens, the Malaysian variant strain showed high tissue tropism for the respiratory tract compared with the QX-like strain. IHC and qPCR indicated the presence of both IBV strains in the epithelial lining of villi in the jejunum and the caecal tonsil; however, no pathological changes were detected in these organs. Both the Malaysian QX-like and variant IBV strains are able to infect the respiratory tract and kidney of chickens irrespective of age.
  18. Klionsky DJ, Abdelmohsen K, Abe A, Abedin MJ, Abeliovich H, Acevedo Arozena A, et al.
    Autophagy, 2016;12(1):1-222.
    PMID: 26799652 DOI: 10.1080/15548627.2015.1100356
  19. Klionsky DJ, Abdel-Aziz AK, Abdelfatah S, Abdellatif M, Abdoli A, Abel S, et al.
    Autophagy, 2021 Jan;17(1):1-382.
    PMID: 33634751 DOI: 10.1080/15548627.2020.1797280
    In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.
  20. Lee HJ, Pok LSL, Ng CM, Yahya F, Sockalingam S, Tee YC, et al.
    Int J Rheum Dis, 2020 Aug;23(8):1088-1093.
    PMID: 32597545 DOI: 10.1111/1756-185X.13897
    INTRODUCTION: Fatigue is an important yet infrequently evaluated component in patients with rheumatoid arthritis (RA) and may have a major impact on quality of life.

    OBJECTIVES: To evaluate fatigue, identify factors associated with fatigue and assess the effect of fatigue on health-related quality of life (HRQoL) in a multi-ethnic cohort of RA patients.

    METHODS: A cross-sectional study was performed in patients who fulfilled European League Against Rheumatism/ American College of Rheumatology 2010 criteria for RA. Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) questionnaire was used to assess fatigue. Potential factors for fatigue were categorized into RA-related (gender, seropositivity [rheumatoid factor and/or anti-citrullinated protein antibody], disease duration, visual analog scale pain score, Disease Activity Score of 28 joints - erythrocyte sedimentation rate [DAS28-ESR], ESR, hemoglobin level, functional disability [Health Assessment Questionnaire - Disability Index, HAQ-DI score], EQ-5D-3L, concomitant prednisolone use and number of conventional synthetic disease-modifying anti-rheumatic drugs [csDMARDs] used) and non-RA-related (age, body mass index, ethnicity and number of co-morbidities).

    RESULTS: A total of 214 patients (86.9% female) were included; the median age was 62 (25-91) years and 67.3% were seropositive. Seventy-six (33.5%) patients had moderate disease activity, 12 (5.6%) had high disease activity and 152 (71%) patients had mild difficulties to moderate disability HAQ-DI scores. Median of total FACIT-F score was 113.2 (36.3-160.0). Joint factors of younger age, longer disease duration, higher HAQ score (increased functional disability), and lower EQ-5D (poorer HRQoL) were significantly associated with higher levels of fatigue (all P 

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