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Fulltext A Review of CFD Modelling and Performance Metrics for Osmotic Membrane Processes

Toh KY, Liang YY, Lau WJ, Fimbres Weihs GA

Membranes (Basel), 2020 Oct 15;10(10).
PMID: 33076290 DOI: 10.3390/membranes10100285

Simulation via Computational Fluid Dynamics (CFD) offers a convenient way for visualising hydrodynamics and mass transport in spacer-filled membrane channels, facilitating further developments in spiral wound membrane (SWM) modules for desalination processes. This paper provides a review on the use of CFD modelling for the development of novel spacers used in the SWM modules for three types of osmotic membrane processes: reverse osmosis (RO), forward osmosis (FO) and pressure retarded osmosis (PRO). Currently, the modelling of mass transfer and fouling for complex spacer geometries is still limited. Compared with RO, CFD modelling for PRO is very rare owing to the relative infancy of this osmotically driven membrane process. Despite the rising popularity of multi-scale modelling of osmotic membrane processes, CFD can only be used for predicting process performance in the absence of fouling. This paper also reviews the most common metrics used for evaluating membrane module performance at the small and large scales.
A case report of improvement on ADHD symptoms after fecal microbiota transplantation with gut microbiome profiling pre- and post-procedure

Hooi SL, Dwiyanto J, Rasiti H, Toh KY, Wong RKM, Lee JWJ

Curr Med Res Opin, 2022 Nov;38(11):1977-1982.
PMID: 36164761 DOI: 10.1080/03007995.2022.2129232

BACKGROUND: Recent studies demonstrate the association of the gut microbiome in regulating interactions between the central nervous system and intestinal function. Individuals with attention-deficit hyperactivity disorder (ADHD) have been shown to have unique gut microbial signature, with depletion of beneficial commensal microbes. Fecal microbiota transplant (FMT) restores the imbalanced gut microbiome and may replete missing microbes to increase production of hormones and neurotransmitters regulating human behavior and cognition.
RESEARCH DESIGN & METHODS: Here, we present an interesting case of a 22-year-old woman treated with FMT primarily to treat recurrent Clostridioides difficile infection, which coincidentally alleviated her ADHD symptoms. We also present the pre- and post-FMT gut microbiota profiles conducted using shotgun metagenomic sequencing on the patient's fecal samples to thereby highlight potential microbial-associated mechanisms associated with the relief of ADHD symptoms.
RESULTS & CONCLUSIONS: Our case report provides preliminary evidence regarding the use of FMT in a patient with C. difficile and ADHD. We speculate that gut microbiome modulation, in particular the gain or loss of specific microbial species and pathways involving the metabolism of SCFAs, tryptophan and GABA, may merit further exploration as a potential therapeutic strategy for ADHD.
Social demographics determinants for resistome and microbiome variation of a multiethnic community in Southern Malaysia

Dwiyanto J, Huët MAL, Hussain MH, Su TT, Tan JBL, Toh KY, et al.

NPJ Biofilms Microbiomes, 2023 Aug 12;9(1):55.
PMID: 37573460 DOI: 10.1038/s41522-023-00425-0

The prevalence of antibiotic-resistant bacteria in Southeast Asia is a significant concern, yet there is limited research on the gut resistome and its correlation with lifestyle and environmental factors in the region. This study aimed to profile the gut resistome of 200 individuals in Malaysia using shotgun metagenomic sequencing and investigate its association with questionnaire data comprising demographic and lifestyle variables. A total of 1038 antibiotic resistance genes from 26 classes were detected with a mean carriage rate of 1.74 ± 1.18 gene copies per cell per person. Correlation analysis identified 14 environmental factors, including hygiene habits, health parameters, and intestinal colonization, that were significantly associated with the resistome (adjusted multivariate PERMANOVA, p
Fulltext Landscape analysis of health technology assessment (HTA): systems and practices in Asia

Teerawattananon Y, Rattanavipapong W, Lin LW, Dabak SV, Gibbons B, Isaranuwatchai W, et al.

Int J Technol Assess Health Care, 2019;35(6):416-421.
PMID: 31594553 DOI: 10.1017/S0266462319000667

This paper explores the characteristics of health technology assessment (HTA) systems and practices in Asia. Representatives from nine countries were surveyed to understand each step of the HTA pathway. The analysis finds that although there are similarities in the processes of HTA and its application to inform decision making, there is variation in the number of topics assessed and the stakeholders involved in each step of the process. There is limited availability of resources and technical capacity and countries adopt different means to overcome these challenges by accepting industry submissions or adapting findings from other regions. Inclusion of stakeholders in the process of selecting topics, generating evidence, and making funding recommendations is critical to ensure relevance of HTA to country priorities. Lessons from this analysis may be instructive to other countries implementing HTA processes and inform future research on the feasibility of implementing a harmonized HTA system in the region.
Real-world data for health technology assessment for reimbursement decisions in Asia: current landscape and a way forward

Lou J, Kc S, Toh KY, Dabak S, Adler A, Ahn J, et al.

Int J Technol Assess Health Care, 2020 Oct;36(5):474-480.
PMID: 32928330 DOI: 10.1017/S0266462320000628

There is growing interest globally in using real-world data (RWD) and real-world evidence (RWE) for health technology assessment (HTA). Optimal collection, analysis, and use of RWD/RWE to inform HTA requires a conceptual framework to standardize processes and ensure consistency. However, such framework is currently lacking in Asia, a region that is likely to benefit from RWD/RWE for at least two reasons. First, there is often limited Asian representation in clinical trials unless specifically conducted in Asian populations, and RWD may help to fill the evidence gap. Second, in a few Asian health systems, reimbursement decisions are not made at market entry; thus, allowing RWD/RWE to be collected to give more certainty about the effectiveness of technologies in the local setting and inform their appropriate use. Furthermore, an alignment of RWD/RWE policies across Asia would equip decision makers with context-relevant evidence, and improve timely patient access to new technologies. Using data collected from eleven health systems in Asia, this paper provides a review of the current landscape of RWD/RWE in Asia to inform HTA and explores a way forward to align policies within the region. This paper concludes with a proposal to establish an international collaboration among academics and HTA agencies in the region: the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) working group, which seeks to develop a non-binding guidance document on the use of RWD/RWE to inform HTA for decision making in Asia.