Displaying publications 1 - 20 of 1459 in total

  1. Jaddi NS, Abdullah S
    PLoS ONE, 2019;14(1):e0208308.
    PMID: 30608936 DOI: 10.1371/journal.pone.0208308
    Optimization of an artificial neural network model through the use of optimization algorithms is the common method employed to search for an optimum solution for a broad variety of real-world problems. One such optimization algorithm is the kidney-inspired algorithm (KA) which has recently been proposed in the literature. The algorithm mimics the four processes performed by the kidneys: filtration, reabsorption, secretion, and excretion. However, a human with reduced kidney function needs to undergo additional treatment to improve kidney performance. In the medical field, the glomerular filtration rate (GFR) test is used to check the health of kidneys. The test estimates the amount of blood that passes through the glomeruli each minute. In this paper, we mimic this kidney function test and the GFR result is used to select a suitable step to add to the basic KA process. This novel imitation is designed for both minimization and maximization problems. In the proposed method, depends on GFR test result which is less than 15 or falls between 15 and 60 or is more than 60 a particular action is performed. These additional processes are applied as required with the aim of improving exploration of the search space and increasing the likelihood of the KA finding the optimum solution. The proposed method is tested on test functions and its results are compared with those of the basic KA. Its performance on benchmark classification and time series prediction problems is also examined and compared with that of other available methods in the literature. In addition, the proposed method is applied to a real-world water quality prediction problem. The statistical analysis of all these applications showed that the proposed method had a ability to improve the optimization outcome.
  2. Tan SY, Arshad H, Abdullah A
    PLoS ONE, 2019;14(1):e0207191.
    PMID: 30605474 DOI: 10.1371/journal.pone.0207191
    Mobile Augmented Reality (MAR) requires a descriptor that is robust to changes in viewing conditions in real time application. Many different descriptors had been proposed in the literature for example floating-point descriptors (SIFT and SURF) and binary descriptors (BRIEF, ORB, BRISK and FREAK). According to literature, floating-point descriptors are not suitable for real-time application because its operating speed does not satisfy real-time constraints. Binary descriptors have been developed with compact sizes and lower computation requirements. However, it is unclear which binary descriptors are more appropriate for MAR. Hence, a distinctive and efficient accuracy measurement of four state-of-the-art binary descriptors, namely, BRIEF, ORB, BRISK and FREAK were performed using the Mikolajczyk dataset and ALOI dataset to identify the most appropriate descriptor for MAR in terms of computation time and robustness to brightness, scale and rotation changes. The obtained results showed that FREAK is the most appropriate descriptor for MAR application as it able to produce an application that are efficient (shortest computation time) and robust towards scale, rotation and brightness changes.
  3. Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al.
    PLoS ONE, 2019;14(1):e0207472.
    PMID: 30605462 DOI: 10.1371/journal.pone.0207472
    High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.
    Study name: National Health and Morbidity Survey (NHMS-2015)
  4. Muazu Musa R, P P Abdul Majeed A, Taha Z, Chang SW, Ab Nasir AF, Abdullah MR
    PLoS ONE, 2019;14(1):e0209638.
    PMID: 30605456 DOI: 10.1371/journal.pone.0209638
    k-nearest neighbour (k-NN) has been shown to be an effective learning algorithm for classification and prediction. However, the application of k-NN for prediction and classification in specific sport is still in its infancy. The present study classified and predicted high and low potential archers from a set of physical fitness variables trained on a variation of k-NN algorithms and logistic regression. 50 youth archers with the mean age and standard deviation of (17.0 ± 0.56) years drawn from various archery programmes completed a one end archery shooting score test. Standard fitness measurements of the handgrip, vertical jump, standing broad jump, static balance, upper muscle strength and the core muscle strength were conducted. Multiple linear regression was utilised to ascertain the significant variables that affect the shooting score. It was demonstrated from the analysis that core muscle strength and vertical jump were statistically significant. Hierarchical agglomerative cluster analysis (HACA) was used to cluster the archers based on the significant variables identified. k-NN model variations, i.e., fine, medium, coarse, cosine, cubic and weighted functions as well as logistic regression, were trained based on the significant performance variables. The HACA clustered the archers into high potential archers (HPA) and low potential archers (LPA). The weighted k-NN outperformed all the tested models at itdemonstrated reasonably good classification on the evaluated indicators with an accuracy of 82.5 ± 4.75% for the prediction of the HPA and the LPA. Moreover, the performance of the classifiers was further investigated against fresh data, which also indicates the efficacy of the weighted k-NN model. These findings could be valuable to coaches and sports managers to recognise high potential archers from a combination of the selected few physical fitness performance indicators identified which would subsequently save cost, time and energy for a talent identification programme.
  5. Nikitina L, Paidi R, Furuoka F
    PLoS ONE, 2019;14(1):e0210668.
    PMID: 30640925 DOI: 10.1371/journal.pone.0210668
    Quantitative applied linguistics research often takes place in restricted settings of an intact language classroom, workplace, phonetics laboratory or longitudinal sample. In such settings the samples tend to be small, which raises several methodological problems. The main aim of the current paper is to give a detailed explanation of methodological and practical implications inherent in a robust statistical method called bootstrapped quantile regression (BQR) analysis. Importantly for applied linguistics research, the BQR method could help to deal with methodological difficulties inherent in small sample studies. The current study employed a moderately small sample (N = 27) of students learning the Japanese language in a Malaysian public university. It examined the relationships between the students' language learning motivation (specifically, integrative orientation), the students' images or stereotypes about Japan and their global attitudes toward the target language country and its people. The findings indicated that there was a statistically significant relationship between the students' attitudes toward the target language country and their integrative orientation. In addition, these attitudes were found to be the most constant determinant of the integrative orientation. Besides the applied linguistics research, the BQR method can be used in a variety of the human sciences research where a sample size is small.
  6. A Hamid MS, Sazlina SG
    PLoS ONE, 2019;14(1):e0209746.
    PMID: 30625165 DOI: 10.1371/journal.pone.0209746
    BACKGROUND: Childhood overweight and obesity has emerged as a major public health threat worldwide with challenges in its management. This review assessed the effectiveness of interventions for childhood overweight and obesity.

    METHODS: A systematic literature search was conducted using CINAHL, EMBASE, Ovid MEDLINE, PsycINFO and SPORTDiscus databases to retrieve articles published from 1st January 2000 to 31st December 2017. Randomised controlled trials (RCTs) and quasi-experimental studies comparing different strategies in managing overweight and obesity among schoolchildren (6 to 12 years of age) were included. The main outcomes of interest were reductions in weight related variables included anthropometry and body composition measurements. All variables were analysed using random effects meta-analyses.

    RESULTS: Fourteen studies were reviewed, 13 were RCTs and one was a quasi-experimental study. The risk of bias for randomisation was low risk for all of RCTs except for one, which was unclear. The risk of bias for randomisation was high for the quasi-experimental study. Most interventions incorporated lifestyle changes and behavioural strategies such as coping and problem solving skills with family involvement. The meta-analyses did not show significant effects of the intervention in reducing weight related outcomes when compared with controls.

    CONCLUSION: Meta-analyses of the selected studies did not show significant effects of the interventions on weight related outcomes among overweight and obese schoolchildren when compared with controls. The role of interdisciplinary team approaches with family involvement using behaviour and lifestyle strategies to curb obesity among schoolchildren is important.

  7. Mamman M, Hanapi ZM, Abdullah A, Muhammed A
    PLoS ONE, 2019;14(1):e0210310.
    PMID: 30682038 DOI: 10.1371/journal.pone.0210310
    The increasing demand for network applications, such as teleconferencing, multimedia messaging and mobile TV, which have diverse requirements, has resulted in the introduction of Long Term Evolution (LTE) by the Third Generation Partnership Project (3GPP). LTE networks implement resource allocation algorithms to distribute radio resource to satisfy the bandwidth and delay requirements of users. However, the scheduling algorithm problem of distributing radio resources to users is not well defined in the LTE standard and thus considerably affects transmission order. Furthermore, the existing radio resource algorithm suffers from performance degradation under prioritised conditions because of the minimum data rate used to determine the transmission order. In this work, a novel downlink resource allocation algorithm that uses quality of service (QoS) requirements and channel conditions to address performance degradation is proposed. The new algorithm is formulated as an optimisation problem where network resources are allocated according to users' priority, whereas the scheduling algorithm decides on the basis of users' channel status to satisfy the demands of QoS. Simulation is used to evaluate the performance of the proposed algorithm, and results demonstrate that it performs better than do all other algorithms according to the measured metrics.
  8. Yeow TP, Aun ES, Hor CP, Lim SL, Khaw CH, Aziz NA
    PLoS ONE, 2019;14(1):e0211210.
    PMID: 30682116 DOI: 10.1371/journal.pone.0211210
    It remains widely perceived that early-onset Type 2 Diabetes (T2D) in children and adolescents is rare and clinically distinct from Type 1 Diabetes (T1D). We studied the challenges of classifying subtypes of early-onset diabetes using clinical features and biomarkers, and management of these patients. We reviewed retrospectively the record of patients < 25 years old who attended the diabetes clinic in Penang General Hospital, Malaysia between 1st December 2012 and 30th June 2015. We examined their clinical features, C-peptide and pancreatic autoantibodies. Comparisons were made between T1D and T2D for magnitude, demographics, metabolic status and complications. We studied 176 patients with a mean age of 20 ± 3.7 years, 43.2% had T1D, 13.6% had T2D, and 13.6% had mixed features of both. When tested, pancreatic autoantibodies were positive in 59.4% of the T1D. T2D presented two years later than T1D at 14.3 years, 20% were asymptomatic at presentation, and 50% required insulin supplementation despite fasting c-peptide of > 250 pmol/L. HbA1C of ≤ 8.0% (64 mmol/mol) was achieved in 30.3% of T1D, 58.3% of T2D on OAD and 16.7% of T2D on insulin. The T2D had greater cardiovascular risk with higher body mass index, more dyslipidaemia, higher blood pressure and earlier onset of nephropathy. The overlapping clinical features, variable autoimmunity, and beta-cell loss complicate classification of young diabetes. Pancreatic autoantibodies and C-peptide did not always predict diabetes subtypes nor respond to insulin. The poor metabolic control and high cardiovascular risk burden among the T2D highlight the need for population-based study and focused intervention.
  9. Teh LCL, Caddell R, Allison EH, Finkbeiner EM, Kittinger JN, Nakamura K, et al.
    PLoS ONE, 2019;14(1):e0210241.
    PMID: 30682056 DOI: 10.1371/journal.pone.0210241
    Sustainability standards for seafood mainly address environmental performance criteria and are less concerned with the welfare of fisheries workers who produce the seafood. Yet human rights violations such as slavery and human trafficking are widespread in fisheries around the world, and underscore the need for certification bodies and other seafood supply chain actors to improve social performance, in addition to addressing environmental challenges. Calls for socially responsible seafood have referenced human rights law and policy frameworks to shape the guiding principles of socially responsible seafood and to provide the legal machinery to implement these aspirations, but practical guidance on how to achieve this is lacking. To provide clarity on this challenge, we reviewed the literature concerning human rights in the seafood supply chain, and prepared an analysis of opportunities and challenges to implement socially responsible seafood through relevant human rights, legal and policy instruments. We observe that human rights laws are generally framed in favour of addressing violations of civil and political rights, but there remains considerable scope for applying economic, social and cultural (ESC) rights in this context. Other challenges include weakly defined ESC rights infringements, a lack of straightforward mechanisms to enforce human rights entitlements, and practical difficulties such as resources to support and secure rights. On the positive side, governments can draw on international instruments to inspire national policies and legislation to eliminate illegalities from the seafood supply chain. However, for socially responsible seafood principles to translate into tangible actions, these objectives must be rooted in clear legal obligations and be supported by sufficient national capacity and political will.
  10. Aldoghachi AF, Tor YS, Redzun SZ, Lokman KAB, Razaq NAA, Shahbudin AF, et al.
    PLoS ONE, 2019;14(1):e0211241.
    PMID: 30677092 DOI: 10.1371/journal.pone.0211241
    BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a neurotrophin found in abundance in brain regions such as the hippocampus, cortex, cerebellum and basal forebrain. It has been associated with the risk of susceptibility to major depressive disorder (MDD). This study aimed to determine the association of three BDNF variants (rs6265, rs1048218 and rs1048220) with Malaysian MDD patients.

    METHODS: The correlation of these variants to the plasma BDNF level among Malaysian MDD patients was assessed. A total of 300 cases and 300 matched controls recruited from four public hospitals within the Klang Valley of Selangor State, Malaysia and matched for age, sex and ethnicity were screened for BDNF rs6265, rs1048218 and rs1048220 using high resolution melting (HRM).

    FINDINGS: BDNF rs1048218 and BDNF rs1048220 were monomorphic and were excluded from further analysis. The distribution of the alleles and genotypes for BDNF rs6265 was in Hardy-Weinberg equilibrium for the controls (p = 0.13) but was in Hardy Weinberg disequilibrium for the cases (p = 0.011). Findings from this study indicated that having BDNF rs6265 in the Malaysian population increase the odds of developing MDD by 2.05 folds (95% CI = 1.48-3.65). Plasma from 206 cases and 206 controls were randomly selected to measure the BDNF level using enzyme-linked immunosorbent assay (ELISA). A significant decrease in the plasma BDNF level of the cases as compared to controls (p<0.0001) was observed. However, there was no evidence of the effect of the rs6265 genotypes on the BDNF level indicating a possible role of other factors in modulating the BDNF level that warrants further investigation.

    CONCLUSION: The study indicated that having the BDNF rs6265 allele (A) increase the risk of developing MDD in the Malaysian population suggesting a possible role of BDNF in the etiology of the disorder.

  11. Hariono M, Choi SB, Roslim RF, Nawi MS, Tan ML, Kamarulzaman EE, et al.
    PLoS ONE, 2019;14(1):e0210869.
    PMID: 30677071 DOI: 10.1371/journal.pone.0210869
    Dengue virus Type 2 (DENV-2) is predominant serotype causing major dengue epidemics. There are a number of studies carried out to find its effective antiviral, however to date, there is still no molecule either from peptide or small molecules released as a drug. The present study aims to identify small molecules inhibitor from National Cancer Institute database through virtual screening. One of the hits, D0713 (IC50 = 62 μM) bearing thioguanine scaffold was derivatised into 21 compounds and evaluated for DENV-2 NS2B/NS3 protease inhibitory activity. Compounds 18 and 21 demonstrated the most potent activity with IC50 of 0.38 μM and 16 μM, respectively. Molecular dynamics and MM/PBSA free energy of binding calculation were conducted to study the interaction mechanism of these compounds with the protease. The free energy of binding of 18 calculated by MM/PBSA is -16.10 kcal/mol compared to the known inhibitor, panduratin A (-11.27 kcal/mol), which corroborates well with the experimental observation. Results from molecular dynamics simulations also showed that both 18 and 21 bind in the active site and stabilised by the formation of hydrogen bonds with Asn174.
  12. Contreras-Jodar A, Nayan NH, Hamzaoui S, Caja G, Salama AAK
    PLoS ONE, 2019;14(2):e0202457.
    PMID: 30735497 DOI: 10.1371/journal.pone.0202457
    The aim of the study is to identify the candidate biomarkers of heat stress (HS) in the urine of lactating dairy goats through the application of proton Nuclear Magnetic Resonance (1H NMR)-based metabolomic analysis. Dairy does (n = 16) in mid-lactation were submitted to thermal neutral (TN; indoors; 15 to 20°C; 40 to 45% humidity) or HS (climatic chamber; 37°C day, 30°C night; 40% humidity) conditions according to a crossover design (2 periods of 21 days). Thermophysiological traits and lactational performances were recorded and milk composition analyzed during each period. Urine samples were collected at day 15 of each period for 1H NMR spectroscopy analysis. Principal component analysis (PCA) and partial least square-discriminant analysis (PLS-DA) assessment with cross validation were used to identify the goat urinary metabolome from the Human Metabolome Data Base. HS increased rectal temperature (1.2°C), respiratory rate (3.5-fold) and water intake (74%), but decreased feed intake (35%) and body weight (5%) of the lactating does. No differences were detected in milk yield, but HS decreased the milk contents of fat (9%), protein (16%) and lactose (5%). Metabolomics allowed separating TN and HS urinary clusters by PLS-DA. Most discriminating metabolites were hippurate and other phenylalanine (Phe) derivative compounds, which increased in HS vs. TN does. The greater excretion of these gut-derived toxic compounds indicated that HS induced a harmful gastrointestinal microbiota overgrowth, which should have sequestered aromatic amino acids for their metabolism and decreased the synthesis of neurotransmitters and thyroid hormones, with a negative impact on milk yield and composition. In conclusion, HS markedly changed the thermophysiological traits and lactational performances of dairy goats, which were translated into their urinary metabolomic profile through the presence of gut-derived toxic compounds. Hippurate and other Phe-derivative compounds are suggested as urinary biomarkers to detect heat-stressed dairy animals in practice.
  13. Sufyan M, Abd Rahim N, Tan C, Muhammad MA, Sheikh Raihan SR
    PLoS ONE, 2019;14(2):e0211642.
    PMID: 30763331 DOI: 10.1371/journal.pone.0211642
    The incessantly growing demand for electricity in today's world claims an efficient and reliable system of energy supply. Distributed energy resources such as diesel generators, wind energy and solar energy can be combined within a microgrid to provide energy to the consumers in a sustainable manner. In order to ensure more reliable and economical energy supply, battery storage system is integrated within the microgrid. In this article, operating cost of isolated microgrid is reduced by economic scheduling considering the optimal size of the battery. However, deep discharge shortens the lifetime of battery operation. Therefore, the real time battery operation cost is modeled considering the depth of discharge at each time interval. Moreover, the proposed economic scheduling with battery sizing is optimized using firefly algorithm (FA). The efficacy of FA is compared with other metaheuristic techniques in terms of performance measurement indices, which are cost of electricity and loss of power supply probability. The results show that the proposed technique reduces the cost of microgrid and attain optimal size of the battery.
  14. Shari NI, Zainal NZ, Guan NC, Ahmad Sabki Z, Yahaya NA
    PLoS ONE, 2019;14(2):e0212788.
    PMID: 30807594 DOI: 10.1371/journal.pone.0212788
    OBJECTIVES: Acceptance and action questionnaire (AAQ II) is a scale used to assess psychological inflexibility. The aim of this study is to translate AAQ II into Malay language and evaluate the psychometric properties of AAQ II Malay version.

    METHODS: The AAQ II which has been translated into Malay language via back translation procedure was distributed to 101 cancer patients and 100 non-cancer patients. The evaluation of psychometric properties in this study included content validity index, internal consistency, parallel reliability, exploratory factor analysis, concurrent validity, sensitivity and specificity of AAQ II Malay version.

    RESULTS: AAQ II Malay version has established good content validity index, acceptable internal consistency with Cronbach's alpha value of 0.91, excellent parallel reliability and adequate concurrent validity. Exploratory factor analysis (EFA) results demonstrated AAQ II Malay version is a unidimensional factor instrument. The result of sensitivity and specificity of AAQ II Malay version indicated cancer patients who scored more than 17.5 were having significant psychological inflexibility.

    CONCLUSION: AAQ II Malay version is a reliable and valid instrument to measure psychological inflexibility among cancer patient in Malaysia.

  15. Granados-García V, Flores YN, Díaz-Trejo LI, Méndez-Sánchez L, Liu S, Salinas-Escudero G, et al.
    PLoS ONE, 2019;14(2):e0212558.
    PMID: 30807590 DOI: 10.1371/journal.pone.0212558
    AIM: This systematic review and meta-analysis characterizes the prevalence of hepatitis C virus (HCV) infection among intravenous drug users (IDUs) in upper middle-income countries.

    METHODS: Five databases were searched from 1990-2016 for studies that took place in countries with a GDP per capita of $7,000 to $13,000 USD. The data extraction was performed based on information regarding prevalence, sample size, age of participants, duration of intravenous drug use (IDU), recruitment location, dates of data collection, study design, sampling scheme, type of tests used in identifying antibody reactivity to HCV, and the use of confirmatory tests. The synthesis was performed with a random effects model. The Cochrane statistical Q-test was used to evaluate the statistical heterogeneity of the results.

    RESULTS: The 33 studies included in the analysis correspond to a sample of seven countries and 23,342 observations. The point prevalence value estimates and confidence intervals of the random effects model were 0.729 and 0.644-0.800, respectively for all seven countries, and were greatest for China (0.633; 0.522-0.732) as compared to Brazil (0.396; 0.249-0.564). Prevalence for Montenegro (0.416; 0.237-0.621) and Malaysia (0.475; 0.177-0.792) appear to be intermediate. Mexico (0.960) and Mauritania (0.973) had only one study with the largest prevalence. A clear association was not observed between age or duration of IDU and prevalence of HCV, but the data from some groups may indicate a possible relationship. The measures of heterogeneity (Q and I2) suggest a high level of heterogeneity in studies conducted at the country level and by groups of countries.

    CONCLUSIONS: In this systematic review and meta-analysis, we found that the pooled prevalence of HCV was high (0.729) among a group of seven upper middle income countries. However, there was significant variation in the prevalence of HCV observed in China (0.633) and Brazil (0.396).

  16. Zaki R, Roffeei SN, Hii YL, Yahya A, Appannan M, Said MA, et al.
    PLoS ONE, 2019;14(2):e0212497.
    PMID: 30818394 DOI: 10.1371/journal.pone.0212497
    An early warning system for dengue is meant to predict outbreaks and prevent dengue cases by aiding timely decision making and deployment of interventions. However, only a system which is accepted and utilised by the public would be sustainable in the long run. This study aimed to explore the perception and attitude of the Malaysian public towards a dengue early warning system. The sample consisted of 847 individuals who were 18 years and above and living/working in the Petaling District, an area adjacent to Kuala Lumpur, Malaysia. A questionnaire consisting of personal information and three sub-measures of; i) perception, ii) attitude towards dengue early warning and iii) response towards early warning; was distributed to participants. We found that most of the respondents know about dengue fever (97.1%) and its association with climate factors (90.6%). Most of them wanted to help reduce the number of dengue cases in their area (91.5%). A small percentage of the respondents admitted that they were not willing to be involved in public activities, and 64% of them admitted that they did not check dengue situations or hotspots around their area regularly. Despite the high awareness on the relationship between climate and dengue, about 45% of respondents do not know or are not sure how this can be used to predict dengue. Respondents would like to know more about how climate data can be used to predict a dengue outbreak (92.7%). Providing more information on how climate can influence dengue cases would increase public acceptability and improve response towards climate-based warning system. The most preferred way of communicating early warning was through the television (66.4%). This study shows that the public in Petaling District considers it necessary to have a dengue warning system to be necessary, but more education is required.
  17. Mohd-Tahir NA, Li SC
    PLoS ONE, 2019;14(2):e0212832.
    PMID: 30817790 DOI: 10.1371/journal.pone.0212832
    INTRODUCTION: Renin-angiotensin system inhibitors (RAS) drugs have a proteinuria-reducing effect that could prevent the progression of kidney disease in diabetic patients. Our study aimed to assess the budget impact based on healthcare payer perspective of increasing uptake of RAS drugs into the current treatment mix of standard anti-hypertensive treatments to prevent progression of kidney disease in patient's comorbid with hypertension and diabetes.

    METHODS: A Markov model of a Malaysian hypothetical cohort aged ≥30 years (N = 14,589,900) was used to estimate the total and per-member-per-month (PMPM) costs of RAS uptake. This involved an incidence and prevalence rate of 9.0% and 10.53% of patients with diabetes and hypertension respectively. Transition probabilities of health stages and costs were adapted from published data.

    RESULTS: An increasing uptake of RAS drugs would incur a projected total treatment cost ranged from MYR 4.89 billion (PMPM of MYR 27.95) at Year 1 to MYR 16.26 billion (PMPM of MYR 92.89) at Year 5. This would represent a range of incremental costs between PMPM of MYR 0.20 at Year 1 and PMPM of MYR 1.62 at Year 5. Over the same period, the care costs showed a downward trend but drug acquisition costs were increasing. Sensitivity analyses showed the model was minimally affected by the changes in the input parameters.

    CONCLUSION: Mild impact to the overall healthcare budget has been reported with an increased utilization of RAS. The long-term positive health consequences of RAS treatment would reduce the cost of care in preventing deterioration of kidney function, thus offsetting the rising costs of purchasing RAS drugs. Optimizing and increasing use of RAS drugs would be considered an affordable and rational strategy to reduce the overall healthcare costs in Malaysia.

  18. Ong TH, Chitra E, Ramamurthy S, Ling CCS, Ambu SP, Davamani F
    PLoS ONE, 2019;14(2):e0213079.
    PMID: 30818374 DOI: 10.1371/journal.pone.0213079
    Staphylococcus epidermidis, is a common microflora of human body that can cause opportunistic infections associated with indwelling devices. It is resistant to multiple antibiotics necessitating the need for naturally occurring antibacterial agents. Malaysian propolis, a natural product obtained from beehives exhibits antimicrobial and antibiofilm properties. Chitosan-propolis nanoparticles (CPNP) were prepared using Malaysian propolis and tested for their effect against S. epidermidis. The cationic nanoparticles depicted a zeta potential of +40 and increased the net electric charge (zeta potential) of S. epidermidis from -17 to -11 mV in a concentration-dependent manner whereas, ethanol (Eth) and ethyl acetate (EA) extracts of propolis further decreased the zeta potential from -17 to -20 mV. Confocal laser scanning microscopy (CLSM) depicted that CPNP effectively disrupted biofilm formation by S. epidermidis and decreased viability to ~25% compared to Eth and EA with viability of ~60-70%. CPNP was more effective in reducing the viability of both planktonic as well as biofilm bacteria compared to Eth and EA. At 100 μg/mL concentration, CPNP decreased the survival of biofilm bacteria by ~70% compared to Eth or EA extracts which decreased viability by only 40%-50%. The morphology of bacterial biofilm examined by scanning electron microscopy depicted partial disruption of biofilm by Eth and EA extracts and significant disruption by CPNP reducing bacterial number in the biofilm by ~90%. Real time quantitative PCR analysis of gene expression in treated bacteria showed that genes involved in intercellular adhesion such as IcaABCD, embp and other related genes were significantly downregulated by CPNP. In addition to having a direct inhibitory effect on the survival of S. epidermidis, CPNP showed synergism with the antibiotics rifampicin, ciprofloxacin, vancomycin and doxycycline suggestive of effective treatment regimens. This would help decrease antibiotic treatment dose by at least 4-fold in combination therapies thereby opening up ways of tackling antibiotic resistance in bacteria.
  19. Neoh BK, Wong YC, Teh HF, Ng TLM, Tiong SH, Ooi TEK, et al.
    PLoS ONE, 2019;14(3):e0213591.
    PMID: 30856213 DOI: 10.1371/journal.pone.0213591
    To investigate limiters of photosynthate assimilation in the carbon-source limited crop, oil palm (Elaeis guineensis Jacq.), we measured differential metabolite, gene expression and the gas exchange in leaves in an open field for palms with distinct mesocarp oil content. We observed higher concentrations of glucose 1-phosphate, glucose 6-phosphate, sucrose 6-phosphate, and sucrose in high-oil content palms with the greatest difference being at 11:00 (p-value ≤0.05) immediately after the period of low morning light intensity. Three important photosynthetic genes were identified using differentially expressed gene analysis (DEGs) and were found to be significantly enriched through Gene Ontology (GO) and pathway enrichment: chlorophyll a-b binding protein (CAB-13), photosystem I (PSI), and Ferredoxin-NADP reductase (FNR), particularly for sampling points at non-peak light (11:00 and 19:00), ranging from 3.3-fold (PSI) and 5.6-fold (FNR) to 10.3-fold (CAB-13). Subsequent gas exchange measurements further supported increased carbon assimilation through higher level of internal CO2 concentration (Ci), stomatal conductance (gs) and transpiration rate (E) in high-oil content palms. The selection for higher expression of key photosynthesis genes together with CO2 assimilation under low light is likely to be important for crop improvement, in particular at full maturity and under high density planting regimes where light competition exists between palms.
  20. Chen JE, Barbrook AC, Cui G, Howe CJ, Aranda M
    PLoS ONE, 2019;14(2):e0211936.
    PMID: 30779749 DOI: 10.1371/journal.pone.0211936
    Modern transformation and genome editing techniques have shown great success across a broad variety of organisms. However, no study of successfully applied genome editing has been reported in a dinoflagellate despite the first genetic transformation of Symbiodinium being published about 20 years ago. Using an array of different available transformation techniques, we attempted to transform Symbiodinium microadriaticum (CCMP2467), a dinoflagellate symbiont of reef-building corals, with the view to performing subsequent CRISPR-Cas9 mediated genome editing. Plasmid vectors designed for nuclear transformation containing the chloramphenicol resistance gene under the control of the CaMV p35S promoter as well as several putative endogenous promoters were used to test a variety of transformation techniques including biolistics, electroporation and agitation with silicon carbide whiskers. Chloroplast-targeted transformation was attempted using an engineered Symbiodinium chloroplast minicircle encoding a modified PsbA protein expected to confer atrazine resistance. We report that we have been unable to confer chloramphenicol or atrazine resistance on Symbiodinium microadriaticum strain CCMP2467.
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