Displaying publications 1 - 20 of 198 in total

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  1. Awan AAY, Berenguer MC, Bruchfeld A, Fabrizi F, Goldberg DS, Jia J, et al.
    Ann Intern Med, 2023 Dec;176(12):1648-1655.
    PMID: 38079642 DOI: 10.7326/M23-2391
    DESCRIPTION: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO.

    METHODS: The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence.

    RECOMMENDATIONS: The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.

  2. Shaibullah S, Shuhaimi N, Ker DS, Mohd-Sharif N, Ho KL, Teh AH, et al.
    Commun Biol, 2023 Sep 08;6(1):920.
    PMID: 37684342 DOI: 10.1038/s42003-023-05265-4
    Burkholderia pseudomallei is a highly versatile pathogen with ~25% of its genome annotated to encode hypothetical proteins. One such hypothetical protein, BPSL1038, is conserved across seven bacterial genera and 654 Burkholderia spp. Here, we present a 1.55 Å resolution crystal structure of BPSL1038. The overall structure folded into a modified βαββαβα ferredoxin fold similar to known Cas2 nucleases. The Cas2 equivalent catalytic aspartate (D11) pairs are conserved in BPSL1038 although B. pseudomallei has no known CRISPR associated system. Functional analysis revealed that BPSL1038 is a nuclease with endonuclease activity towards double-stranded DNA. The DNase activity is divalent ion independent and optimum at pH 6. The concentration of monovalent ions (Na+ and K+) is crucial for nuclease activity. An active site with a unique D11(X20)SST motif was identified and proposed for BPSL1038 and its orthologs. Structure modelling indicates the catalytic role of the D11(X20)SST motif and that the arginine residues R10 and R30 may interact with the nucleic acid backbone. The structural similarity of BPSL1038 to Cas2 proteins suggests that BPSL1038 may represent a sub-family of nucleases that share a common ancestor with Cas2.
  3. Howell J, Seaman C, Wallace J, Xiao Y, Scott N, Davies J, et al.
    Hepatology, 2023 Sep 01;78(3):976-990.
    PMID: 37125643 DOI: 10.1097/HEP.0000000000000430
    Hepatitis B (HBV) is a major cause of global morbidity and mortality, and the leading cause of liver cancer worldwide. Significant advances have recently been made toward the development of a finite HBV treatment that achieves permanent loss of HBsAg and HBV DNA (so-called "HBV cure"), which could provide the means to eliminate HBV as a public health threat. However, the HBV cure is just one step toward achieving WHO HBV elimination targets by 2030, and much work must be done now to prepare for the successful implementation of the HBV cure. In this review, we describe the required steps to rapidly scale-up future HBV cure equitably. We present key actions required for successful HBV cure implementation, integrated within the World Health Organization (WHO) Global Health Sector Strategy (GHSS) 2022-2030 framework. Finally, we highlight what can be done now to progress toward the 2030 HBV elimination targets using available tools to ensure that we are preparing, but not waiting, for the cure.
  4. Hussain SM, Shahzad F, Katbar NM, Jamshed W, Eid MR, Kamel A, et al.
    Heliyon, 2023 Jul;9(7):e17668.
    PMID: 37483748 DOI: 10.1016/j.heliyon.2023.e17668
    The goal of this research is to investigate the effects of Ohmic heating, heat generation, and viscous dissipative flow on magneto (MHD) boundary-layer heat transmission flowing of Jeffrey nanofluid across a stretchable surface using the Koo-Kleinstreuer-Li (KKL) model. Engine oil serves as the primary fluid and is suspended with copper oxide nanomolecules. The governing equations that regulate the flowing and heat transmission fields are partial-differential equations (PDEs) that are then converted to a model of non-linear ordinary differential equations (ODEs) via similarity transformation. The resultant ODEs are numerically resolved using a Keller box technique via MATLAB software that is suggested. Diagrams and tables are used to express the effects of various normal liquids, nanomolecule sizes, magneto parameters, Prandtl, Deborah, and Eckert numbers on the velocity field and temperature field. The outcomes display that the copper oxide-engine oil nanofluid has a lower velocity, drag force, and Nusselt number than the plain liquid, although the introduction of nanoparticles raises the heat. The heat transference rate is reduced by Eckert number, size of nanomolecules, and magneto parameter rising. Whilst, Deborah number is shown to enhance both the drag-force factor and the heat transfer rate. Furthermore, the discoveries reported are advantageous to upgrading incandescent lighting bulbs, heating, and cooling equipment, filament-generating light, energy generation, multiple heating devices, and other similar devices.
  5. Mohamed R, Yip C, Singh S
    Eur J Gastroenterol Hepatol, 2023 Jul 01;35(7):742-752.
    PMID: 37161976 DOI: 10.1097/MEG.0000000000002548
    BACKGROUND: Viral hepatitis B and C (HBV, HCV) and non-alcoholic fatty liver disease (NAFLD) are the commonest etiologies of liver-related deaths in Malaysia. Herein, this study aims to explore and understand the knowledge and attitudes of the public toward liver-related health and diseases in Malaysia.

    METHODS: A cross-sectional, self-reported, web-based questionnaire was conducted among 500 adults between February and March 2020. Questionnaire items pertained to the knowledge and attitudes toward liver-related health and diseases.

    RESULTS: Half of the respondents were aged ≥35 years and 52.0% were males. Gaps in knowledge included the lack of awareness of different types of hepatitis, including the potential transmission risks and complications of HBV and HCV. About half acknowledged liver fibrosis and cirrhosis as key determinants of liver-related disease progression. A higher proportion rightly recognized the diagnostic test for HCV (40.8%) than HBV (30.0%) despite more being aware of HBV than HCV. Less than one-third were aware of the risk factors, screening tests, and complications of NAFLD. Despite the majority (92.8%) agreeing that regular screening was important for liver health, only 67.0% attended recent health screening and one-fifth were unlikely to seek medical consultation upon exposure to viral hepatitis risk factors. Reasons for this low urgency included the perception of being healthy, cost-related concerns, and societal discrimination.

    CONCLUSION: Robust education efforts are needed to raise awareness and empower the community with knowledge of liver-related diseases, particularly viral hepatitis and NAFLD in Malaysia.

  6. Zain SM, Pung YF, Mohamed R
    J Diabetes Metab Disord, 2023 Jun;22(1):237-243.
    PMID: 37255815 DOI: 10.1007/s40200-022-01119-8
    BACKGROUND: Elevated circulating vaspin levels is linked with type 2 diabetes mellitus (T2DM) and obesity. The genetic basis of the association between vaspin rs2236242 and T2DM and obesity is still being investigated. We executed a meta-analysis to evaluate the magnitude of effect caused by vaspin rs2236242 on T2DM and obesity.

    METHODS: We searched Pubmed, Embase, MEDLINE, Scopus, Web of Science, and Google Scholar for relevant articles published up to 19 February 2022. Data were extracted and summary estimates of the association between vaspin rs2236242 and T2DM and obesity were assessed. Odds ratios (ORs) and confidence intervals (CIs) were used to measure the effect.

    RESULTS: This meta-analysis included 2206 cases and 2715 controls in the T2DM cohort, meanwhile 271 cases and 444 controls in the obesity cohort. The pooled estimates revealed no link between vaspin rs2236242 and T2DM, but allele-A was significantly higher in the controls of the obesity cohort, showing that this single nucleotide polymorphism (SNP) has a reduced obesity risk effect. Sensitivity analysis revealed no studies that would modify the estimates or the heterogeneity. Begg and Mazumdar's and Egger's tests indicated no substantial publication bias.

    CONCLUSION: Our meta-analysis provides evidence of significant association between vaspin rs2236242 and reduced risk of obesity but not T2DM.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-022-01119-8.

  7. Kim DY, Toan BN, Tan CK, Hasan I, Setiawan L, Yu ML, et al.
    Clin Mol Hepatol, 2023 Apr;29(2):277-292.
    PMID: 36710606 DOI: 10.3350/cmh.2022.0212
    Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
  8. Hishamuddin MS, Lee SY, Syazwan SA, Ramlee SI, Lamasudin DU, Mohamed R
    3 Biotech, 2023 Mar;13(3):78.
    PMID: 36761338 DOI: 10.1007/s13205-023-03479-1
    Members of Aquilaria Lam. (Thymelaeaceae) are evergreen trees that are widely distributed in the Indomalesia region. Aquilaria is highly prized for its unique scented resin, agarwood, which is often the subject of unlawful trade activities. Survival of the tree is heavily threatened by destructive harvesting and agarwood poaching, leading to its protection under the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Unfortunately, an efficient species identification method, which is crucial to aid in the conservation efforts of Aquilaria is lacking. Here, we described our search for a suitable specific DNA barcode for Aquilaria species using eight complete plastome sequences. We identified five highly variable regions (HVR) (matK-rps16, ndhF-rpl32, psbJ-petA, trnD, and trnT-trnL) in the plastomes. These regions were further analyzed using the neighbor-joining (NJ) method to assess their ability at discriminating the eight species. Coupled with in silico primer design, two potential barcoding regions, psbJ-petA and trnT-trnL, were identified. Their strengths in species delimitation were evaluated individually and in combination, via DNA barcoding analysis. Our findings showed that the combined dataset, psbJ-petA + trnT-trnL, effectively resolved members of the genus Aquilaria by clustering all species into their respective clades. In addition, we demonstrated that the newly proposed DNA barcode was capable at identifying the species of origin of six commercial agarwood samples that were included as unknown samples. Such achievement offers a new technical advancement, useful in the combat against illicit agarwood trades and in assisting the conservation of these valuable species in natural populations.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13205-023-03479-1.

  9. Khairul-Fahmy N, Ismail J, Koay BT, Md-Zakariah MZ, Mansor S, Zulkifli N, et al.
    BMC Nephrol, 2023 Feb 24;24(1):42.
    PMID: 36829106 DOI: 10.1186/s12882-023-03085-6
    Antibody-mediated rejection (AMR) still persists as the major hurdle towards successful renal allograft survival. This paper aims to report on the HLA antibody landscape of renal transplant candidates in Malaysia. A total of 2,219 adult samples from 2016 to 2019 were analysed for anti-HLA antibodies using solid-phase assay. Our findings highlight the prevalence and risk factors for antibodies against HLA antigens in renal transplant settings, which could be beneficial for selecting compatible recipients from deceased organ donors. To the best of our knowledge, this study is the first to demonstrate that ethnic Malay and Chinese showed significantly higher prevalence of anti-HLA antibodies. Based on our multivariate analysis: (i) female gender was associated with higher risk for panel reactive antibodies (PRAs) against Class I, Class II, and Class I and II (p 
  10. Azzeri A, Dahlui M, Mohamed R, McDonald SA, Jaafar H, Shabaruddin FH
    Front Public Health, 2023;11:1114560.
    PMID: 36935675 DOI: 10.3389/fpubh.2023.1114560
    INTRODUCTION: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to sofosbuvir/daclatasvir (SOF/DAC) is available through compulsory licensing, with access to sofosbuvir/velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes but has higher drug acquisition costs compared to SOF/DAC. A stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL.

    METHODS: This study aimed to conduct a 5-year budget impact analysis of the proposed stratified treatment cascade for HCV treatment in Malaysia. A disease progression model that was developed based on model-predicted HCV epidemiology data was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. Healthcare costs associated with DAA therapy and disease stage monitoring were included to estimate the downstream cost implications.

    RESULTS: The stratified treatment cascade with 109 in Scenario B was found to be cost-saving compared to Scenario A. The cumulative savings for the stratified treatment cascade was USD 1.4 million over 5 years.

    DISCUSSION: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can result in a budget impact reduction in overall healthcare expenditure in Malaysia.

  11. Husain S, Mohamed R, Abd Halim KB, Mohd Mutalip SS
    J Biomol Struct Dyn, 2023;41(15):7158-7173.
    PMID: 36039769 DOI: 10.1080/07391102.2022.2117244
    BRCA1-associated protein 1 (BAP1) is a nuclear-localized Ubiquitin C-terminal hydrolase (UCH) that functions as a tumour suppressor, and although BAP1 has been linked to cancer, the molecular mechanism by which BAP1 regulates cancer and its crystal structure have not been elucidated. In this study, computational approaches were used to identify the protein model of BAP1 and its potential inhibitors. The structure of the BAP1 model was constructed through homology modeling and the generated BAP1 model was observed to exhibit good quality protein model as the distribution of its amino acids in the Ramachandran's plot corresponded to 87.7% in the most favoured regions. Docking and simulating of the ubiquitin on the BAP1 model structure revealed the rearrangement of F228, F50, and H169 residues of the BAP1 and switching of BAP1's conformation into a productive state. Our screening results of potential BAP1 inhibitors against the FDA approved drugs shortlisted two potential inhibitors, which are FDA1065 and FDA755. We then performed molecular dynamics simulations and Molecular mechanics Poisson-Boltzmann surface area (MMPBSA) analysis on both inhibitors and found that only the BAP1-FDA755 formed a stable complex and the FDA755 ligand remained its position inside the active site of the BAP1 with a total binding energy of (-51.77 ± 3.49 kcal/mol). We speculate that the presence of methyl group in FDA755 play an important role in stabilizing the BAP1-FDA755 complex.Communicated by Ramaswamy H. Sarma.
  12. Martin P, Awan AA, Berenguer MC, Bruchfeld A, Fabrizi F, Goldberg DS, et al.
    Kidney Int, 2022 Dec;102(6):1228-1237.
    PMID: 36411019 DOI: 10.1016/j.kint.2022.07.012
    Infection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy or with a kidney transplant. Since the publication of the Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2018, advances in HCV management, particularly in the field of antiviral therapy and treatment of HCV-associated glomerular diseases, coupled with increased usage of HCV-positive kidney grafts, have prompted a reexamination of the 2018 guideline. As a result, the Work Group performed a comprehensive review and revised the 2018 guidance. This Executive Summary highlights key aspects of the updated guideline recommendations for 3 chapters: Chapter 2: Treatment of HCV infection in patients with CKD; Chapter 4: Management of HCV-infected patients before and after kidney transplantation; and Chapter 5: Diagnosis and management of kidney diseases associated with HCV infection.
  13. Shahzad F, Jamshed W, Eid MR, Safdar R, Putri Mohamed Isa SS, El Din SM, et al.
    Sci Rep, 2022 Nov 17;12(1):19817.
    PMID: 36396776 DOI: 10.1038/s41598-022-24294-3
    Solar radiation, which is emitted by the sun, is required to properly operate photovoltaic cells and solar water pumps (SWP). A parabolic trough surface collector (PTSC) installation model was created to investigate the efficacy of SWP. The thermal transfer performance in SWP is evaluated thru the presence of warmth radiation and heat cause besides viscid dissipation. This evaluation is performed by measuring the thermal transmission proportion of the selected warmth transmission liquid in the PTSC, known as a hybrid nano-fluid. Entropy analysis of Oldroyd-B hybrid nano-fluid via modified Buongiorno's model was also tested. The functions of regulating parameters are quantitatively observed by using the Keller-box approach in MATLAB coding. Short terms define various parameters for tables in velocity, shear pressure and temperature, gravity, and Nusselt numbers. In the condition of thermal radiation and thermal conductivity at room temperature, the competence of SWP is proven to be enhanced. Unlike basic nano-fluids, hybrid nano-fluids are an excellent source of heat transfer. Additionally, with at least 22.56% and 35.01% magnitude, the thermal efficiency of AA7075-Ti-6Al-4 V/EO is higher than AA7075-EO.
  14. Low WF, Ngeow YF, Chook JB, Tee KK, Ong SK, Peh SC, et al.
    Expert Rev Mol Med, 2022 Nov 16;25:e11.
    PMID: 36380484 DOI: 10.1017/erm.2022.38
    Hepatitis B virus (HBV) infection led to 66% liver deaths world-wide in year 2015. Thirty-seven per cent of these deaths were the result of chronic hepatitis B (CHB)-associated hepatocellular carcinoma (HCC). Although early diagnosis of HCC improves survival, early detection is rare. Methylation of HBV DNA including covalently closed circular DNA (cccDNA) is more often encountered in HCC cases than those in CHB and cirrhosis. Three typical CpG islands within the HBV genome are the common sites for methylation. The HBV cccDNA methylation affects the viral replication and protein expression in the course of infection and may associate with the disease pathogenesis and HCC development. We review the current findings in HBV DNA methylation that provide insights into its role in HCC diagnosis.
  15. Mohd Mortar NA, Abdullah MMAB, Abdul Razak R, Abd Rahim SZ, Aziz IH, Nabiałek M, et al.
    Materials (Basel), 2022 Oct 28;15(21).
    PMID: 36363159 DOI: 10.3390/ma15217567
    Geopolymers have been intensively explored over the past several decades and considered as green materials and may be synthesised from natural sources and wastes. Global attention has been generated by the use of kaolin and calcined kaolin in the production of ceramics, green cement, and concrete for the construction industry and composite materials. The previous findings on ceramic geopolymer mix design and factors affecting their suitability as green ceramics are reviewed. It has been found that kaolin offers significant benefit for ceramic geopolymer applications, including excellent chemical resistance, good mechanical properties, and good thermal properties that allow it to sinter at a low temperature, 200 °C. The review showed that ceramic geopolymers can be made from kaolin with a low calcination temperature that have similar properties to those made from high calcined temperature. However, the choice of alkali activator and chemical composition should be carefully investigated, especially under normal curing conditions, 27 °C. A comprehensive review of the properties of kaolin ceramic geopolymers is also presented, including compressive strength, chemical composition, morphological, and phase analysis. This review also highlights recent findings on the range of sintering temperature in the ceramic geopolymer field which should be performed between 600 °C and 1200 °C. A brief understanding of kaolin geopolymers with a few types of reinforcement towards property enhancement were covered. To improve toughness, the role of zirconia was highlighted. The addition of zirconia between 10% and 40% in geopolymer materials promises better properties and the mechanism reaction is presented. Findings from the review should be used to identify potential strategies that could develop the performance of the kaolin ceramic geopolymers industry in the electronics industry, cement, and biomedical materials.
  16. Jamshed W, Eid MR, Safdar R, Pasha AA, Mohamed Isa SSP, Adil M, et al.
    Sci Rep, 2022 Jul 07;12(1):11484.
    PMID: 35798787 DOI: 10.1038/s41598-022-15685-7
    In solar heating, ventilation, and air conditioning (HVAC), communications are designed to create new 3D mathematical models that address the flow of rotating Sutterby hybrid nanofluids exposed to slippery and expandable seats. The heat transmission investigation included effects such as copper and graphene oxide nanoparticles, as well as thermal radiative fluxing. The activation energy effect was used to investigate mass transfer with fluid concentration. The boundary constraints utilized were Maxwell speed and Smoluchowksi temperature slippage. With the utilization of fitting changes, partial differential equations (PDEs) for impetus, energy, and concentricity can be decreased to ordinary differential equations (ODEs). To address dimensionless ODEs, MATLAB's Keller box numerical technique was employed. Graphene oxide Copper/engine oil (GO-Cu/EO) is taken into consideration to address the performance analysis of the current study. Physical attributes, for example, surface drag coefficient, heat move, and mass exchange are mathematically processed and shown as tables and figures when numerous diverse factors are varied. The temperature field is enhanced by an increase in the volume fraction of copper and graphene oxide nanoparticles, while the mass fraction field is enhanced by an increase in activation energy.
  17. Redouane F, Jamshed W, Devi SSU, Prakash M, Nasir NAAM, Hammouch Z, et al.
    Sci Rep, 2022 Feb 10;12(1):2302.
    PMID: 35145142 DOI: 10.1038/s41598-022-06134-6
    MHD Natural convection, which is one of the principal types of convective heat transfer in numerous research of heat exchangers and geothermal energy systems, as well as nanofluids and hybrid nanofluids. This work focuses on the investigation of Natural convective heat transfer evaluation inside a porous triangular cavity filled with silver-magnesium oxide/water hybrid nanofluid [H2O/Ag-MgO]hnf under a consistent magnetic field. The laminar and incompressible nanofluid flow is taken to account while Darcy-Forchheimer model takes account of the advection inertia effect in the porous sheet. Controlled equations of the work have been approached nondimensional and resolved by Galerkin finite element technique. The numerical analyses were carried out by varying the Darcy, Hartmann, and Rayleigh numbers, porosity, and characteristics of solid volume fraction and flow fields. Further, the findings are reported in streamlines, isotherms and Nusselt numbers. For this work, the parametric impact may be categorized into two groups. One of them has an effect on the structural factors such as triangular form and scale on the physical characteristics of the important outputs such as fluidity and thermal transfer rates. The significant findings are the parameters like Rayleigh and slightly supported by Hartmann along with Darcy number, minimally assists by solid-particle size and rotating factor as clockwise assists the cooler flow at the center and anticlockwise direction assists the warmer flow. Clear raise in heat transporting rate can be obtained for increasing solid-particle size.
  18. Lee MH, Ahn SH, Chan HLY, Choudhry A, Alvani Gani R, Mohamed R, et al.
    J Viral Hepat, 2022 02;29(2):156-170.
    PMID: 34817896 DOI: 10.1111/jvh.13636
    There are limited data to provide better understanding of the knowledge/awareness of general population towards liver health in Asia. We sought to identify the knowledge gaps and attitudes towards liver health and liver diseases as well as evaluate associated individual-level and macro-level factors based on contextual analysis. An online survey assessing knowledge, awareness and attitudes towards liver health and disease was conducted among 7500 respondents across 11 countries/territories in Asia. A liver index was created to measure the respondents' knowledge level and the degree of awareness and attitudes. Multilevel logistic regression was performed to identify individual factors and contextual effects that were associated with liver index. The overall liver index (0-100-point scale) was 62.4 with 6 countries/territories' liver indices greater than this. In the multilevel model, the inclusion of geographical information could explain for 9.6% of the variation. Residing in a country/territory with higher HBV prevalence (80% IOR: 1.20-2.79) or higher HCV death rate (80% IOR: 1.35-3.13) increased the individual probability of obtaining a high overall liver index. Individual factors like age, gender, education, household income, disease history and health screening behaviour were also associated with liver index (all p-values<0.001). The overall liver index was positively associated with the two macro-level factors viz. HBV prevalence and HCV death rate. There is a need to formulate policies especially in regions of lower HBV prevalence and HCV death rate to further improve the knowledge, awareness and attitudes of the general public towards liver diseases.
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