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Detection in Malaysia of a Borrelia sp. From Haemaphysalis hystricis (Ixodida: Ixodidae)

Khoo JJ, Lim FS, Tan KK, Chen FS, Phoon WH, Khor CS, et al.

J Med Entomol, 2017 09 01;54(5):1444-1448.
PMID: 28874019 DOI: 10.1093/jme/tjx131

Spirochetes from the Borrelia genus are known to cause diseases in humans, namely Lyme disease and relapsing fever. These organisms are commonly transmitted to humans by arthropod vectors including ticks, mite, and lice. Here, we report the molecular detection of a Borrelia sp. from a Haemaphysalis hystricis Supino tick collected from wildlife in an Orang Asli settlement in Selangor, Malaysia. Phylogenetic analyses of partial 16s rRNA and flaB gene sequences revealed that the Borrelia sp. is closely related to the relapsing fever group borreliae, Borrelia lonestari, Borrelia miyamotoi, and Borrelia theileri, as well as a number of uncharacterized Borrelia sp. from ticks in Portugal and Japan. To our knowledge, this is the first report of a Borrelia sp. detected in H. hystricis, and in Malaysia. The zoonotic potential of this Borrelia sp. merits further investigation.
Temporal changes in arthropod activity in tropical anthropogenic forests

Brandon-Mong GJ, Littlefair JE, Sing KW, Lee YP, Gan HM, Clare EL, et al.

Bull. Entomol. Res., 2018 Dec;108(6):792-799.
PMID: 29441836 DOI: 10.1017/S000748531800010X

Arthropod communities in the tropics are increasingly impacted by rapid changes in land use. Because species showing distinct seasonal patterns of activity are thought to be at higher risk of climate-related extirpation, global warming is generally considered a lower threat to arthropod biodiversity in the tropics than in temperate regions. To examine changes associated with land use and weather variables in tropical arthropod communities, we deployed Malaise traps at three major anthropogenic forests (secondary reserve forest, oil palm forest, and urban ornamental forest (UOF)) in Peninsular Malaysia and collected arthropods continuously for 12 months. We used metabarcoding protocols to characterize the diversity within weekly samples. We found that changes in the composition of arthropod communities were significantly associated with maximum temperature in all the three forests, but shifts were reversed in the UOF compared with the other forests. This suggests arthropods in forests in Peninsular Malaysia face a double threat: community shifts and biodiversity loss due to exploitation and disturbance of forests which consequently put species at further risk related to global warming. We highlight the positive feedback mechanism of land use and temperature, which pose threats to the arthropod communities and further implicates ecosystem functioning and human well-being. Consequently, conservation and mitigation plans are urgently needed.
Genetic diversity of secreted protein with an altered thrombospondin repeat (SPATR) of Plasmodium knowlesi clinical isolates from Malaysia

Azlan UW, Lau YL, Hamid MHA, Jelip J, Ooi CH, Mudin RN, et al.

Trop Biomed, 2022 Dec 01;39(4):504-510.
PMID: 36602208 DOI: 10.47665/tb.39.4.006

The Plasmodium knowlesi secreted protein with an altered thrombospondin repeat (PkSPATR) is an important protein that helps in the parasite's invasion into the host cell. This protein has been regarded as one of the potential vaccine candidates against P. knowlesi infection. This study investigates the genetic diversity and natural selection of PkSPATR gene of P. knowlesi clinical isolates from Malaysia. PCR amplification of the full length PkSPATR gene was performed on 60 blood samples of infected P. knowlesi patients from Peninsular Malaysia and Malaysian Borneo. The amplified PCR products were cloned and sequenced. Sequence analysis of PkSPATR from Malaysia showed higher nucleotide diversity (CDS p: 0.01462) than previously reported Plasmodium vivax PvSPATR (p = 0.0003). PkSPATR from Peninsular Malaysia was observed to have slightly higher diversity (CDS p: 0.01307) than those from Malaysian Borneo (CDS p: 0.01212). Natural selection analysis on PkSPATR indicated significant purifying selection. Multiple amino acid sequence alignment revealed 69 polymorphic sites. The phylogenetic tree and haplotype network did not show any distinct clustering of PkSPATR. The low genetic diversity level, natural selection and absence of clustering implied functional constrains of the PkSPATR protein.
Stress distributions in maxillary central incisors restored with various types of post materials and designs

Madfa AA, Kadir MR, Kashani J, Saidin S, Sulaiman E, Marhazlinda J, et al.

Med Eng Phys, 2014 Jul;36(7):962-7.
PMID: 24834856 DOI: 10.1016/j.medengphy.2014.03.018

Different dental post designs and materials affect the stability of restoration of a tooth. This study aimed to analyse and compare the stability of two shapes of dental posts (parallel-sided and tapered) made of five different materials (titanium, zirconia, carbon fibre and glass fibre) by investigating their stress transfer through the finite element (FE) method. Ten three-dimensional (3D) FE models of a maxillary central incisor restored with two different designs and five different materials were constructed. An oblique loading of 100 N was applied to each 3D model. Analyses along the centre of the post, the crown-cement/core and the post-cement/dentine interfaces were computed, and the means were calculated. One-way ANOVAs followed by post hoc tests were used to evaluate the effectiveness of the post materials and designs (p=0.05). For post designs, the tapered posts introduced significantly higher stress compared with the parallel-sided post (p<0.05), especially along the centre of the post. Of the materials, the highest level of stress was found for stainless steel, followed by zirconia, titanium, glass fibre and carbon fibre posts (p<0.05). The carbon and glass fibre posts reduced the stress distribution at the middle and apical part of the posts compared with the stainless steel, zirconia and titanium posts. The opposite results were observed at the crown-cement/core interface.
Evaluation of a motorised patient transfer device based on perceived workload, technology acceptance, and emotional states

Law MJJ, Ridzwan MIZ, Ripin ZM, Abd Hamid IJ, Law KS, Karunagaran J, et al.

Disabil Rehabil Assist Technol, 2024 Apr;19(3):938-950.
PMID: 36334271 DOI: 10.1080/17483107.2022.2134472

PURPOSE: The high prevalence of musculoskeletal disorders (MSDs) among healthcare workers is partly attributed to the low adoption of patient transfer assistive devices. This study aimed to evaluate the nurses' perceived workload, technology acceptance, and emotional states during the use of the sliding board (SB) and mechanical intervention in the form of a Motorised Patient Transfer Device (MPTD).
METHODS: The SB and MPTD activities were performed by seven nurses on a simulated patient. The nurses' facial expressions were recorded during the trial. The NASA Task Load Index and technology acceptance questionnaire were also assessed.
RESULTS: The MPTD significantly reduced the mean overall NASA-TLX score by 68.7% (p = 0.004) and increased the overall acceptance score (median = 8.30) by 21.2% (p = 0.016) when compared to the SB (median = 6.85). All the subjects reported positive feelings towards MPTD. However, facial expression analysis showed that the nurses had a significantly higher peak density of fear while using MPTD (p = 0.016). Besides, there was no improvement in the negative valence and contempt emotion compared to the SB.
CONCLUSION: Overall, nurses showed positive perceptions and acceptance of MPTD even when they experienced negative emotions.IMPLICATIONS FOR REHABILITATIONThe Motorised Patient Transfer Device (MPTD) reduced the perceived workload of nurses and showed a higher acceptance level compared to the commonly used baseline device (SB).Factors that attributed to the nurses' negative emotions can be used to improve technology and patient transfer processes.More training should be given to familiarise the health practitioners with the new assistive device to reduce their fear of technology.
Digestive Tract Tuberculosis Guideline

Tahiri M, Goh KL, Abbas Z, Epstein D, Min-Hu C, Mulder CJJ, et al.

J Clin Gastroenterol, 2023 Aug 01;57(7):643-650.
PMID: 37428083 DOI: 10.1097/MCG.0000000000001819
Solving the taxonomic identity of Hipposideros cineraceus sensu lato (Chiroptera: Hipposideridae) in the Thai-Malay Peninsula, with the description of a new species

Wongwaiyut P, Karapan S, Saekong P, Francis CM, Guillén-Servent A, Senawi J, et al.

Zootaxa, 2023 May 03;5277(3):401-442.
PMID: 37518310 DOI: 10.11646/zootaxa.5277.3.1

A new species of small Hipposideros in the bicolor group is described based on specimens from Thailand and Malaysia. It can be distinguished from other small Hipposideros in Southeast Asia by a combination of external, craniodental, and bacular morphology, as well as echolocation call frequency. The new species has a distinct rounded swelling on the internarial septum of the noseleaf, with a forearm length of 35.3-42.6 mm, greatest skull length of 15.94-17.90 mm, and a call frequency of maximum energy of 132.3-144.0 kHz. Although clearly different in morphology, the new species forms a sister clade with H. kunzi and H. bicolor in the phylogenetic trees based on mitochondrial DNA. In addition, this study reports echolocation and genetic data, with a confirmed record of H. einnaythu from Thailand for the first time. The new species most closely resembles H. einnaythu. However, it differs in the details of the noseleaf and craniodental morphology, and it has a genetic distance of 9.6% and 10.4% based on mitochondrial COI and ND2, respectively. It is currently documented from five localities: two in peninsular Thailand, at Hala Forest in Yala Province, and Phru To Daeng Swamp Forest in Narathiwat Province, one from peninsular Malaysia at Krau Wildlife Reserve in Pahang, and another two in Sabah, Malaysian Borneo at Gunung Kinabalu, and near Madai Caves. However, it is likely that many previous records of "H. cineraceus" from Borneo refer to this species. Most records of the species are from lowland evergreen rainforest, though one record from Sabah was at 1800m. The roosting sites for this new species are currently unknown. Future research with a combination of data such as genetics, echolocation and morphology would be necessary to further determine the species geographic distribution in Southeast Asia.
High-dose pulse methylprednisolone vs. dexamethasone standard therapy for severe and critical COVID-19 pneumonia: Efficacy assessment in a retrospective single-centre experience from Malaysia

Soo CI, Poon KV, Ayub A, You HW, Tan CX, Loh KJJ, et al.

Med J Malaysia, 2024 Jan;79(1):15-20.
PMID: 38287752

INTRODUCTION: The use of dexamethasone (DXM) has been associated with decreased mortality in the patients with hypoxemia during the coronavirus disease-2019 (COVID-19) pandemic, while the outcomes with methylprednisolone (MTP) have been mixed. This real-life study aimed to evaluate the outcomes of patients with severe respiratory failure due to COVID-19 who were treated with high doses of MTP.
MATERIALS AND METHODS: This retrospective cohort study enrolled hospitalised patients between May 2021 and August 2021, aged 18 years and above, with severe respiratory failure defined by a ratio of oxygen saturation to fraction of inspired oxygen (SF ratio) of less than 235. The treatment protocol involved administering high-dose MTP for 3 days, followed by DXM, and the outcomes were compared with those of patients who received DXM alone (total treatment duration of 10 days for both groups).
RESULTS: A total of 99 patients were enrolled, with 79 (79.8%) receiving pulse MTP therapy and 20 (20.2%) being treated with DXM only. The SF ratio significantly improved from a mean of 144.49 (±45.16) at baseline to 208 (±85.19) at 72 hours (p < 0.05), with a mean difference of 63.51 (p < 0.001) in patients who received ≤750 mg of MTP. Additionally, in patients who received >750 mg of MTP, the SF ratio improved from a baseline mean of 130.39 (±34.53) to 208.44 (±86.61) at 72 hours (p < 0.05), with a mean difference of 78.05 (p = 0.001). In contrast, patients who received DXM only demonstrated an SF ratio of 132.85 (±44.1) at baseline, which changed minimally to 133.35 (±44.4) at 72 hours (p = 0.33), with a mean difference of 0.50 (p = 0.972). The incidence of nosocomial infection was higher in the MTP group compared with the DXM group (40.5% vs. 35%, p = 0.653), with a relative risk of 1.16 (95% CI: 0.60-2.23).
CONCLUSION: MTP did not demonstrate a significant reduction in intubation or intensive care unit admissions. Although a high dose of MTP improved gas exchange in patients with severe and critical COVID-19, it did not provide an overall mortality benefit compared to standard treatment.
Comprehensive risk assessment of the patient transfer task using the walking belt and floor lift

Law MJJ, Ripin ZM, Hamid IJA, Law KS, Karunagaran J, Abdul Halim NSS, et al.

Disabil Rehabil Assist Technol, 2025 Jan 11.
PMID: 39798113 DOI: 10.1080/17483107.2025.2450007

Purpose: Work-related musculoskeletal disorders (WMSDs) during bed-to-wheelchair and wheelchair-to-commode transfers are a significant concern, yet prior assessments often focused on specific subtasks, overlooking potential cumulative risks. Methods: This study employed Xsens Inertial Measurement Units (IMUs) and force plates integrated with an automated Rapid Entire Body Assessment (REBA) system to provide a continuous and comprehensive evaluation of WMSDs risks associated with the use of a walking belt and a floor lift. Results: The continuous assessment revealed peak REBA scores ranging from 8.81 to 9.19, categorizing tasks such as applying the sling, repositioning the patient from supine to sitting, and adjusting the wheelchair footrest as high-risk. During bed-to-wheelchair transfers, the floor lift significantly reduced the mean peak REBA score by 1.73 points (95% CI [1.23, 2.24], p
Compound heterozygous mutations in TTC7A cause familial multiple intestinal atresias and severe combined immunodeficiency

Yang W, Lee PP, Thong MK, Ramanujam TM, Shanmugam A, Koh MT, et al.

Clin Genet, 2015 Dec;88(6):542-9.
PMID: 25534311 DOI: 10.1111/cge.12553

Familial multiple intestinal atresias is an autosomal recessive disease with or without combined immunodeficiency. In the last year, several reports have described mutations in the gene TTC7A as causal to the disease in different populations. However, exact correlation between different genotypes and various phenotypes are not clear. In this study, we report identification of novel compound heterozygous mutations in TTC7A gene in a Malay girl with familial multiple intestinal atresias and severe combined immunodeficiency (MIA-SCID) by whole exome sequencing. We found two mutations in TTC7A: one that destroyed a putative splicing acceptor at the junction of intron 17/exon 18 and one that introduced a stop codon that would truncate the last two amino acids of the encoded protein. Reviewing the recent reports on TTC7A mutations reveals correlation between the position and nature of the mutations with patient survival and clinical manifestations. Examination of public databases also suggests carrier status for healthy individuals, making a case for population screening on this gene, especially in populations with suspected frequent founder mutations.
Clinical spectrum of children receiving palliative care in Malaysian Hospitals

Chong LA, Khalid F, Khoo TB, Teh SH, Kuan GL, Aina Mariana AM, et al.

Med J Malaysia, 2017 02;72(1):32-36.
PMID: 28255137 MyJurnal

INTRODUCTION: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services.
METHODS: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out.
RESULTS: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be 'Congenital malformations, deformations and chromosomal abnormalities' 117 (37.1%), 'Diseases of nervous system' 76 (24.1%) and 'Neoplasms' 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with 'Diseases of nervous system' were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients.
CONCLUSION: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative.
Palatability of black soldier fly larvae in valorizing mixed waste coconut endosperm and soybean curd residue into larval lipid and protein sources

Lim JW, Mohd-Noor SN, Wong CY, Lam MK, Goh PS, Beniers JJA, et al.

J Environ Manage, 2019 Feb 01;231:129-136.
PMID: 30340132 DOI: 10.1016/j.jenvman.2018.10.022

The black soldier fly larvae (BSFL) have been widely extolled for the application in managing various solid organic wastes. Owing to the saprophagous nature of BSFL, a rapid valorization of solid organic wastes can be accomplished with the simultaneous production of valuable biochemical compounds derived from larval biomass. In the present works, the mixed waste coconut endosperm (w-CE) and soybean curd residue (SC-r) substrates with increasing protein nutritional constituent were administered to BSFL. The correlations between protein from larval feed substrates and nutritional profiles of BSFL biomasses were ultimately unveiled. The protein from larval feed substrates could be increased by increasing of SC-r portion against w-CE. At the w-CE:SC-r ratio of 3:2, the highest larval total weight gained and growth rate were attained; indicating an optimum protein nutritional constituent in mixed organics (12.4%) that could enhance the BSFL palatability. Further increment of protein nutritional constituent in mixed organics was found acidifying the residual larval feed substrate progressively, undermining the growth of BSFL. By feeding the BSFL with optimum mixed organics, the maximum accumulations of larval lipid and protein could be achieved. Transesterification of extracted lipid had demonstrated high in monounsaturated fatty acids (73%) which was suitable for biodiesel. The BSFL palatability was finally confirmed from the bioconversion viewpoint of mixed organic wastes. Again, achieving the highest bioconversion efficiency of 14% into larval biomass after accounting the metabolic loss of 54%. Therefore, a total of 68% of mixed w-CE and SC-r could be successfully bioconverted.
First description of male worms of Enterobius (Colobenterobius) serratus (Nematoda: Oxyuridae), the pinworm parasite of proboscis monkeys

Hasegawa H, Frias L, Peter S, Hasan NH, Stark DJ, Lynn MS, et al.

Zootaxa, 2020 Jan 14;4722(3):zootaxa.4722.3.6.
PMID: 32230627 DOI: 10.11646/zootaxa.4722.3.6

Males of Enterobius (Colobenterobius) serratus Hasegawa et al., 2003 (Nematoda: Oxyuridae) are described for the first time based on six individuals collected from the feces of proboscis monkeys, Nasalis larvatus, in the Lower Kinabatangan Wildlife Sanctuary, Sabah, Malaysian Borneo. The males show identical cephalic morphology to females, being readily distinguishable from their congeners by the serrated inner margins of the lips. The bicolored esophageal corpus, long thin spicule and developed spicular pouch with paired muscular bands are also remarkable characteristics, presumably shared by other Asian members of the subgenus.
Purification of Plasmodium and Babesia- infected erythrocytes using a non-woven fabric filter

Tao ZY, Liu WP, Dong J, Feng XX, Yao DW, Lv QL, et al.

Trop Biomed, 2020 Dec 01;37(4):911-918.
PMID: 33612745 DOI: 10.47665/tb.37.4.911

The purification of parasite-infected erythrocytes from whole blood containing leucocytes is crucial for many downstream genetic and molecular assays in parasitology. Current methodologies to achieve this are often costly and time consuming. Here, we demonstrate the successful application of a cheap and simple Non-Woven Fabric (NWF) filter for the purification of parasitized red blood cells from whole blood. NWF filtration was applied to the malaria-parasitized blood of three strains of mice, and one strain of rat, and to Babesia gibsoni parasitized dog blood. Before and after filtration, the white blood cell (WBC) removal rates and red blood cell (RBC) recovery rates were measured. After NWF filter treatment of rodent malaria-infected blood, the WBC removal rates and RBC recovery rates were, for Kunming mice: 99.51%±0.30% and 86.12%±8.37%; for BALB/C mice: 99.61%±0.15% and 80.74%±7.11%; for C57 mice: 99.71%±0.12% and 84.87%±3.83%; for Sprague-Dawley rats: 99.93%±0.03% and 83.30%±2.96%. Microscopy showed WBCs were efficiently removed from infected dog blood samples, and there was no obvious morphological change of B. gibsoni parasites. NWF filters efficiently remove leukocytes from malaria parasite-infected mouse and rat blood, and are also suitable for filtration of B. gibsoni-infected dog blood.
Rational design of aromatic surfactants for graphene/natural rubber latex nanocomposites with enhanced electrical conductivity

Mohamed A, Ardyani T, Abu Bakar S, Sagisaka M, Umetsu Y, Hamon JJ, et al.

J Colloid Interface Sci, 2018 Apr 15;516:34-47.
PMID: 29360058 DOI: 10.1016/j.jcis.2018.01.041

HYPOTHESIS: Graphene nanoplatelets (GNPs) can be dispersed in natural rubber matrices using surfactants. The stability and properties of these composites can be optimized by the choice of surfactants employed as stabilizers. Surfactants can be designed and synthesized to have enhanced compatibility with GNPs as compared to commercially available common surfactants. Including aromatic groups in the hydrophobic chain termini improves graphene compatibility of surfactants, which is expected to increase with the number of aromatic moieties per surfactant molecule. Hence, it is of interest to study the relationship between molecular structure, dispersion stability and electrical conductivity enhancement for single-, double-, and triple-chain anionic graphene-compatible surfactants.
EXPERIMENTS: Graphene-philic surfactants, bearing two and three chains phenylated at their chain termini, were synthesized and characterized by proton nuclear magnetic resonance (1H NMR) spectroscopy. These were used to formulate and stabilize dispersion of GNPs in natural rubber latex matrices, and the properties of systems comprising the new phenyl-surfactants were compared with commercially available surfactants, sodium dodecylsulfate (SDS) and sodium dodecylbenzenesulfonate (SDBS). Raman spectroscopy, field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), and high-resolution transmission electron microscopy (HRTEM) were used to study structural properties of the materials. Electrical conductivity measurements and Zeta potential measurements were used to assess the relationships between surfactant architecture and nanocomposite properties. Small-angle neutron scattering (SANS) was used to study self-assembly structure of surfactants.
FINDINGS: Of these different surfactants, the tri-chain aromatic surfactant TC3Ph3 (sodium 1,5-dioxo-1,5-bis(3-phenylpropoxy)-3-((3phenylpropoxy)carbonyl) pentane-2-sulfonate) was shown to be highly graphene-compatible (nanocomposite electrical conductivity = 2.22 × 10-5 S cm-1), demonstrating enhanced electrical conductivity over nine orders of magnitude higher than neat natural rubber-latex matrix (1.51 × 10-14 S cm-1). Varying the number of aromatic moieties in the surfactants appears to cause significant differences to the final properties of the nanocomposites.
Fulltext Dominance style only partially predicts differences in neophobia and social tolerance over food in four macaque species

Amici F, Widdig A, MacIntosh AJJ, Francés VB, Castellano-Navarro A, Caicoya AL, et al.

Sci Rep, 2020 Dec 16;10(1):22069.
PMID: 33328593 DOI: 10.1038/s41598-020-79246-6

Primates live in complex social systems with social structures ranging from more to less despotic. In less despotic species, dominance might impose fewer constraints on social choices, tolerance is greater than in despotic species and subordinates may have little need to include novel food items in the diet (i.e. neophilia), as contest food competition is lower and resources more equally distributed across group members. Here, we used macaques as a model to assess whether different dominance styles predict differences in neophilia and social tolerance over food. We provided familiar and novel food to 4 groups of wild macaques (N = 131) with different dominance styles (Macaca fuscata, M. fascicularis, M. sylvanus, M. maura). Our study revealed inter- and intra-specific differences in individuals' access to food, which only partially reflected the dominance styles of the study subjects. Contrary to our prediction, social tolerance over food was higher in more despotic species than in less despotic species. Individuals with a higher dominance rank and being better socially integrated (i.e. higher Eigenvector centrality) were more likely to retrieve food in all species, regardless of their dominance style. Partially in line with our predictions, less integrated individuals more likely overcame neophobia (as compared to more integrated ones), but only in species with more tolerance over food. Our study suggests that individual characteristics (e.g. social integration or personality) other than dominance rank may have a stronger effect on an individual's access to resources.
Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group

Daly RM, Iuliano S, Fyfe JJ, Scott D, Kirk B, Thompson MQ, et al.

J Nutr Health Aging, 2022;26(6):637-651.
PMID: 35718874 DOI: 10.1007/s12603-022-1801-0

Sarcopenia and frailty are highly prevalent conditions in older hospitalized patients, which are associated with a myriad of adverse clinical outcomes. This paper, prepared by a multidisciplinary expert working group from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR), provides an up-to-date overview of current evidence and recommendations based on a narrative review of the literature for the screening, diagnosis, and management of sarcopenia and frailty in older patients within the hospital setting. It also includes suggestions on potential pathways to implement change to encourage widespread adoption of these evidence-informed recommendations within hospital settings. The expert working group concluded there was insufficient evidence to support any specific screening tool for sarcopenia and recommends an assessment of probable sarcopenia/sarcopenia using established criteria for all older (≥65 years) hospitalized patients or in younger patients with conditions (e.g., comorbidities) that may increase their risk of sarcopenia. Diagnosis of probable sarcopenia should be based on an assessment of low muscle strength (grip strength or five times sit-to-stand) with sarcopenia diagnosis including low muscle mass quantified from dual energy X-ray absorptiometry, bioelectrical impedance analysis or in the absence of diagnostic devices, calf circumference as a proxy measure. Severe sarcopenia is represented by the addition of impaired physical performance (slow gait speed). All patients with probable sarcopenia or sarcopenia should be investigated for causes (e.g., chronic/acute disease or malnutrition), and treated accordingly. For frailty, it is recommended that all hospitalized patients aged 70 years and older be screened using a validated tool [Clinical Frailty Scale (CFS), Hospital Frailty Risk Score, the FRAIL scale or the Frailty Index]. Patients screened as positive for frailty should undergo further clinical assessment using the Frailty Phenotype, Frailty Index or information collected from a Comprehensive Geriatric Assessment (CGA). All patients identified as frail should receive follow up by a health practitioner(s) for an individualized care plan. To treat older hospitalized patients with probable sarcopenia, sarcopenia, or frailty, it is recommended that a structured and supervised multi-component exercise program incorporating elements of resistance (muscle strengthening), challenging balance, and functional mobility training be prescribed as early as possible combined with nutritional support to optimize energy and protein intake and correct any deficiencies. There is insufficient evidence to recommend pharmacological agents for the treatment of sarcopenia or frailty. Finally, to facilitate integration of these recommendations into hospital settings organization-wide approaches are needed, with the Spread and Sustain framework recommended to facilitate organizational culture change, with the help of 'champions' to drive these changes. A multidisciplinary team approach incorporating awareness and education initiatives for healthcare professionals is recommended to ensure that screening, diagnosis and management approaches for sarcopenia and frailty are embedded and sustained within hospital settings. Finally, patients and caregivers' education should be integrated into the care pathway to facilitate adherence to prescribed management approaches for sarcopenia and frailty.
Lactobacillus probiotics restore vaginal and gut microbiota of pregnant women with vaginal candidiasis

Ang XY, Roslan NS, Ahmad N, Yusof SM, Abdullah N, Nik Ab Rahman NN, et al.

Benef Microbes, 2023 Nov 23;14(5):421-431.
PMID: 38350486 DOI: 10.1163/18762891-20220103

The development of probiotics has now included the areas along the gut-vaginal axis. We thus aimed to investigate the effects of lactobacilli probiotic to modulate and restore vaginal and gut microbiota of pregnant women with vaginal candidiasis (VC). A randomised, double-blind and placebo-controlled study was performed in 78 pregnant women with VC. Patients were randomised to either the probiotic (SynForU-HerCare) or placebo which were administered at baseline and continued for 8-weeks (two capsules/day of 9.5 log cfu/capsule). Microbiota profiles were assessed at time points of weeks-0, 4 and 8 for high vaginal swab and faecal samples. Shannon diversity index showed that after 8-weeks amid VC, a shift in microbial community compositional changes occurred in the high vaginal region at both genus (P=0.025) and species (P=0.044) levels, where the administration of probiotic prevented such a shift. These changes were mainly attributed to a decreased in abundance of Lactobacillus (P=0.042) accompanied by increased abundance of Prevotella (P=0.002) and Atopobium (P=0.002) in the placebo group while the probiotic group remained unchanged over time. The administration of probiotics also prevented a reduced abundance of faecal phylum Firmicutes after 8-weeks as seen in the placebo group (P<0.0001), which also showed reduction at subsequent taxonomic levels of class, family, genera and species. VC has not only altered the microbiota of vagina regions but also gut microbiota profiles, causing lessening of gut microbiota that are crucial for gut nutrient availability, protection and immunity. The administration of lactobacilli probiotics has prevented such a shift, leading to better modulated gut and vaginal microenvironment amid VC. The study was registered at ClinicalTrials.gov: identifier number NCT03940612.
Celiac disease care differs significantly between high- and low-middle-income countries: a global survey of celiac experts from 63 countries

Agarwal S, Prasad S, Agarwal A, Raja Ali RA, Leffler DA, Green PHR, et al.

J Gastroenterol Hepatol, 2025 Jan;40(1):142-152.
PMID: 39528309 DOI: 10.1111/jgh.16793

BACKGROUND AND AIM: Celiac disease (CeD) is increasingly diagnosed but significant disparities exist in awareness, practices, resources, and legislation worldwide. We conducted a global online survey with CeD experts to assess this disparity internationally.
METHODS: A 55 questions survey encompassing nine domains relevant to CeD care (awareness, gluten-free [GF] foods availability/cost/quality, GF labeling, CeD dietician availability, insurance for CeD patients, medical training, research funding, patient support groups, and unmet needs) was generated and sent to CeD experts worldwide electronically. Countries were stratified based on per capita income as high-income (HIC) and lower-income countries (LIC) (including upper-middle-, lower-middle-, and low-income countries). Survey responses were summarized as a single score using principal component analysis.
RESULTS: Valid responses were obtained from 131(37.4%) [HIC: 71; LIC: 60] of contacted CeD experts from 63 countries. Compared with HIC, LIC experts perceived worse availability (HIC:80% vs LIC: 47%; P
Probiotic enhanced immunity and mental wellbeing of generally healthy women: a randomised, placebo-controlled and double-blind study

Nisaa AA, Mageswary U, Pei X, Kadir MN, Oon CE, Rajendran D, et al.

Benef Microbes, 2025 Feb 24.
PMID: 40008414 DOI: 10.1163/18762891-bja00061

The elucidation of the gut-brain axis underscores the critical role of probiotics in enhancing mental wellbeing through immunomodulatory mechanisms. We thus aimed to investigate the effects of a probiotic Lactiplantibacillus plantarum Probio87 (orally administered one sachet/day; 9 log cfu/sachet) or placebo for 12-weeks, on immunity and brain health, via possible mechanisms of inflammation and neurotransmitter functions in a generally healthy women population. A parallel, randomised, double-blind and placebo-controlled study was performed in generally healthy women (n = 112). Women were randomised to either the probiotic (n = 58, mean age 38.38 ± 0.85 years) or placebo (n = 54, mean age 38.91 ± 0.98 years) for 12-weeks. Immunity and mental wellbeing profiles were evaluated via questionnaires and blood gene expression profiles. Over the study period, the Probio87 group demonstrated a better impact on general women's health as compared to the control group, as measured by the Women's Health Questionnaire (WHQ), particularly in domains related to depressed mood, somatic symptoms, anxiety, sexual health, sleep, and menstrual health. The probiotic effects were exhibited later, typically after 6-weeks of intervention, taking over placebo effects that primarily faded off during early stages of the intervention. Regarding immunity, women in the Probio87 group exhibited upregulation of more immunity-related genes than those in the placebo group, primarily associated with NK cells and anti-inflammatory effects via IL-10. Additionally, Probio87 provided gut-brain axis benefits by enhancing the actions of neurotransmitters serotonin and GABA, while also balancing hunger and satiety. The probiotic Lactiplantibacillus plantarum Probio87 significantly improved general health, mood, anxiety, and sleep in a generally healthy women population over 12 weeks. It enhanced immune function through increased expression of immunity-related genes and positively modulated neurotransmitters involved in brain health. All these findings supported from our WHQ data, where the administration of probiotic improved domains related to depressed mood, anxiety, sexual behaviour and sleep problems. The study is registered at ClinicalTrials.gov under identifier number: NCT05302687.

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