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  1. Accumulation of heavy metals in stormwater biofiltration systems augmented with zeolite and fly ash
    Hermawan AA, Teh KL, Talei A, Chua LHC
    J Environ Manage, 2021 Nov 01;297:113298.
    PMID: 34280854 DOI: 10.1016/j.jenvman.2021.113298
    The discharge of high levels of heavy metals into the environment is of concern due to its toxicity to aquatic life and potential human health impacts. Biofiltration systems have been used in urban environments to address nutrient contamination, but there is also evidence that such systems can be effective in reducing heavy metals concentration in stormwater. However, the accumulation pattern of heavy metals and lifespan of such systems, which are important in engineering design, have not been thoroughly explored. This study investigated the accumulation patterns of lead (Pb), copper (Cu), zinc (Zn), manganese (Mn), and iron (Fe), which are common in urban runoff, in non-vegetated filtration columns using three different types of filter media, namely sand (S), and mixtures of sand with fly ash (sand-fly ash mix, SF), and with zeolite (sand-zeolite mix, SZ). The columns were assessed in terms of infiltration rate, the mass of heavy metals accumulation at different depths, and formation of crust layer (schmutzdecke) at the surface. The results show that most of the heavy metals accumulated at the top 5-10 cm of the filter media. However, Zn was found adsorbed to a depth of 15 cm in S and SZ columns, while Mn and Fe were present in column S throughout the entire 30 cm depth of the filter media. The presence especially of Zn, Mn, and Fe in the deeper portions of the filter media before the top 5 cm layer reached its maximum adsorption capacity, hints that transport to the deeper layers is not necessarily dependent on saturation of the upper layers for these heavy metals. SF accumulated heavy metals most at the top 5 cm of the filter media layer, and retained twice the mass of heavy metals in the crust layer, compared to S and SZ columns. SF also yielded the lowest value of infiltration rate of 31 mm/h. Considering both metals accumulation and clogging potential of the filter media, the periodic maintenance of these systems is suggested to be approximately between 1.5 and 3 years.
    Matched MeSH terms: Humans
  2. Dermatomyositis and nasopharyngeal carcinoma
    Low QJ, Hon SA, Garry Siow PW, Lim TH, Lee RA, Tan YA, et al.
    QJM, 2020 Oct 01;113(10):753-754.
    PMID: 31995198 DOI: 10.1093/qjmed/hcaa014
    Matched MeSH terms: Humans
  3. Kayser-Fleischer rings and Wilson's disease
    Low QJ, Siaw C, Lee RA, Cheo SW
    QJM, 2020 Sep 01;113(9):693-694.
    PMID: 31917404 DOI: 10.1093/qjmed/hcaa005
    Matched MeSH terms: Humans
  4. Immune reconstitution inflammatory syndrome and human immunodeficiency virus infection
    Cheo SW, Ahmad Akbar RZ, Abd Rahman F, Abdul Rashid WNF', Tan YA, Low QJ
    QJM, 2020 Nov 01;113(11):809-812.
    PMID: 32275748 DOI: 10.1093/qjmed/hcaa122
    Matched MeSH terms: Humans
  5. Effect of physical exercise on some hematological parameters in female athletes in Bangladesh
    Alam T, Rahman SM, Alam T, Habib N, Umar BU, Banna QR, et al.
    JNMA J Nepal Med Assoc, 2014 Jul-Sep;52(195):892-6.
    PMID: 26982662
    Long term physical training has been considered to adversely affect the performance of athletes especially the females. It may be due to the iron depletion caused by hemolysis or hemodilution results from plasma volume expansion. This study aims to assess the effect of heavy exercise on hemoglobin concentration and some other hematological parameters in female athletes.
    Matched MeSH terms: Humans
  6. Fulltext Changes in the upper airway, hyoid bone and craniofacial morphology between patients treated with headgear activator and Herbst appliance: A retrospective study on lateral cephalometry
    Gu M, Savoldi F, Chan EYL, Tse CSK, Lau MTW, Wey MC, et al.
    Orthod Craniofac Res, 2021 Aug;24(3):360-369.
    PMID: 33217159 DOI: 10.1111/ocr.12442
    BACKGROUND: The present study compared the treatment changes in the upper airway, hyoid bone position and craniofacial morphology between two groups of children with skeletal class II malocclusion treated with the headgear activator (HGA) and Herbst appliance (Herbst).

    SETTING AND SAMPLE POPULATION: Orthodontic population from the Faculty of Dentistry of the University of Hong Kong.

    METHODS: Thirty-four skeletal class II patients treated with the HGA (17 patients, mean age 10.6 ± 1.5 years) and the Herbst (17 patients, mean age 11.0 ± 1.4 years) were matched for sex, age, overjet, skeletal class and mandibular divergence. The patients received lateral cephalometric radiographs (LCRs) at the beginning of treatment (T1 ), after treatment (T2 ) and at follow-up (T3 ). In the HGA group, patients underwent LCRs 7 months before the beginning of treatment (T0 ), which were used as growth reference for intra-group comparison. Paired Student's t tests were used for intra- and inter-group comparisons (α = .05).

    RESULTS: Treatment changes (T2 -T1 ) did not differ significantly between the groups. However, at follow-up (T3 -T1 ) the Herbst group showed a smaller increase than the HGA group in the vertical position of the hyoid bone relative to the Frankfort plane (P = .013) and mandibular plane (P = .013).

    CONCLUSIONS: There were no significant differences in the upper airway, hyoid bone position and craniofacial morphology between the groups at the end of treatment. However, the Herbst may provide better long-term control of the vertical position of the hyoid bone than the HGA in children with skeletal class II malocclusion.

    Matched MeSH terms: Humans
  7. Clinical Study on Plant Galactagogue Worldwide in Promoting Women's Lactation: a Scoping Review
    Kwan SH, Abdul-Rahman PS
    Plant Foods Hum Nutr, 2021 Sep;76(3):257-269.
    PMID: 34292494 DOI: 10.1007/s11130-021-00901-y
    Human milk is recommended by the World Health Organization (WHO) for the general well-being of infants. However, many mothers face an insufficient milk supply to breastfeed their children. Galactagogue, in particular, plant galactagogue, serves as a method to promote lactation. This in-depth review examines the evidence supporting different plants' galactagogic activity through clinical studies around the globe. A scoping review approach was adopted to establish the research questions, and define the findings, selection and analysis of the study. This scoping review highlights and compiles the clinical research performed globally involving plant galactagogue to better inform the medical practitioners, lactation consultants, nursing mothers, communities and relevant personnel on practicing, guidelines, policymaking and research. In general, a total of 1041 research publications were retrieved from different global bibliographic databases, of which only 13 articles were retained for analysis after applying the exclusion criteria. A total of 14 types of plants have undergone clinical studies in the past decade to verify their galactagogic activity. All but two showed a positive effect on promoting milk production. There were 42 articles categorised as excluded studies. The category includes review articles, surveys, case reports, introductory articles of regional plant galactagogue and preclinical studies, which involves animal testing and the studies exploring other issues related to plant galactagogue. The findings demonstrate that there is a significant research gap on the plant galactagogue using clinical studies. More clinical research is necessary to identify and verify the efficacy of various types of plant galactagogue for the benefit of humankind.
    Matched MeSH terms: Humans
  8. Fulltext Placental histopathological changes in COVID-19 in term patients admitted to labor and delivery
    Ahmad MFB, Das S
    Am J Obstet Gynecol, 2021 09;225(3):353-354.
    PMID: 34062121 DOI: 10.1016/j.ajog.2021.05.040
    Matched MeSH terms: Humans
  9. Aerosol deposition and airflow dynamics in healthy and asthmatic human airways during inhalation
    Chen WH, Chang CM, Mutuku JK, Lam SS, Lee WJ
    J Hazard Mater, 2021 08 15;416:125856.
    PMID: 34492805 DOI: 10.1016/j.jhazmat.2021.125856
    Inhalation of aerosols such as pharmaceutical aerosols or virus aerosol uptake is of great concern to the human population. To elucidate the underlying aerosol dynamics, the deposition fractions (DFs) of aerosols in healthy and asthmatic human airways of generations 13-15 are predicted. The Navier-stokes equations governing the gaseous phase and the discrete phase model for particles' motion are solved using numerical methods. The main forces responsible for deposition are inertial impaction forces and complex secondary flow velocities. The curvatures and sinusoidal folds in the asthmatic geometry lead to the formation of complex secondary flows and hence higher DFs. The intensities of complex secondary flows are strongest at the generations affected by asthma. The DF in the healthy airways is 0%, and it ranges from 1.69% to 52.93% in the asthmatic ones. From this study, the effects of the pharmaceutical aerosol particle diameters in the treatment of asthma patients can be established, which is conducive to inhibiting the inflammation of asthma airways. Furthermore, with the recent development of COVID-19 which causes pneumonia, the predicted physics and effective simulation methods of bioaerosols delivery to asthma patients are vital to prevent the exacerbation of the chronic ailment and the epidemic.
    Matched MeSH terms: Humans
  10. Conservative management of juvenile spongiotic gingivitis: a series of ten cases
    DeSeta M, Baldwin D, Siddik D, Hullah E, Harun N, Yee R, et al.
    Br Dent J, 2020 09;229(5):287-291.
    PMID: 32918012 DOI: 10.1038/s41415-020-2023-7
    Introduction This case series highlights the condition juvenile spongiotic gingivitis; how to recognise it, where it lies in a list of differential diagnoses and why conservative management is the authors' recommended treatment.Case series The authors present ten cases that were successfully managed conservatively on the Joint Oral Medicine Paediatric Dentistry Clinic at Guy's and St Thomas' NHS Foundation Trust over a six-year period. Follow-ups reached up to 5 years and 11 months to date, with no adverse outcomes observed in any of the cases.Conclusion The pathogenesis of this benign condition and its ideal management is not well understood. Recurrence can occur after surgical treatment and the condition is likely to spontaneously resolve or regress with age. Therefore, particularly in asymptomatic cases, conservative management is recommended.
    Matched MeSH terms: Humans
  11. Shear Wave Elastography: A Review on the Confounding Factors and Their Potential Mitigation in Detecting Chronic Kidney Disease
    Lim WTH, Ooi EH, Foo JJ, Ng KH, Wong JHD, Leong SS
    Ultrasound Med Biol, 2021 08;47(8):2033-2047.
    PMID: 33958257 DOI: 10.1016/j.ultrasmedbio.2021.03.030
    Early detection of chronic kidney disease is important to prevent progression of irreversible kidney damage, reducing the need for renal transplantation. Shear wave elastography is ideal as a quantitative imaging modality to detect chronic kidney disease because of its non-invasive nature, low cost and portability, making it highly accessible. However, the complexity of the kidney architecture and its tissue properties give rise to various confounding factors that affect the reliability of shear wave elastography in detecting chronic kidney disease, thus limiting its application to clinical trials. The objective of this review is to highlight the confounding factors presented by the complex properties of the kidney, in addition to outlining potential mitigation strategies, along with the prospect of increasing the versatility and reliability of shear wave elastography in detecting chronic kidney disease.
    Matched MeSH terms: Humans
  12. Intensive blood pressure-lowering strategy should also be offered to older patients
    Kow CS, Hasan SS
    J Hypertens, 2021 04 01;39(4):812-813.
    PMID: 33649284 DOI: 10.1097/HJH.0000000000002778
    Matched MeSH terms: Humans
  13. Fulltext Insights from CREDENCE trial indicate an acute drop in estimated glomerular filtration rate during treatment with canagliflozin with implications for clinical practice
    Oshima M, Jardine MJ, Agarwal R, Bakris G, Cannon CP, Charytan DM, et al.
    Kidney Int, 2021 04;99(4):999-1009.
    PMID: 33316282 DOI: 10.1016/j.kint.2020.10.042
    Canagliflozin slows the progression of chronic kidney disease in patients with type 2 diabetes and induces a reversible acute drop in estimated glomerular filtration rate (eGFR), believed to be a hemodynamic effect. Predictors of the initial drop and its association with long-term eGFR trajectories and safety outcomes are unknown. To assess this, we performed a post-hoc analysis of 4289 participants in the CREDENCE trial with type 2 diabetes and chronic kidney disease equally split into treatment and placebo groups who had eGFR measured at both baseline and week three. The eGFR was categorized at week three as greater than a 10% decline; between 0 and 10% decline; and no decline. Long-term eGFR trajectories and safety outcomes were estimated in each category of acute eGFR change by linear mixed effects models and Cox regression after adjustment for baseline characteristics and medications use. Significantly more participants in the canagliflozin (45%) compared to the placebo (21%) group experienced an acute drop in eGFR over 10%. An over 30% drop occurred infrequently (4% of participants with canagliflozin and 2% with placebo). The odds ratio for a drop in eGFR over 10% with canagliflozin compared to placebo was significant at 3.03 (95% confidence interval 2.65, 3.47). Following the initial drop in eGFR, multivariable adjusted long-term eGFR trajectories, as well as overall and kidney safety profiles, in those treated with canagliflozin were similar across eGFR decline categories. Thus, although acute drops in eGFR over 10% occurred in nearly half of all participants following initiation of canagliflozin, the clinical benefit of canagliflozin was observed regardless. Additionally, safety outcomes were similar among subgroups of acute eGFR drop.
    Matched MeSH terms: Humans
  14. Inner myometrial laceration: Case report and literature review
    Zakaria ZA, Mohammad Razin NS, Abas S
    J Obstet Gynaecol Res, 2020 Nov;46(11):2442-2445.
    PMID: 32808401 DOI: 10.1111/jog.14435
    Inner myometrial laceration is a rarely encountered intrapartum uterine trauma, which usually present as post-partum hemorrhage (PPH). The diagnosis can only be confirmed by direct examination of the uterine cavity but it should be suspected in PPH with good uterine contraction. Discussed here are the characteristics and management of the reported cases including two women managed at our center.
    Matched MeSH terms: Humans
  15. IMoCC - Measure of cultural competence among medical students in the Malaysian context
    Chandratilake M, Nadarajah VD, Mohd Sani RMB
    Med Teach, 2021 Jul;43(sup1):S53-S58.
    PMID: 32248710 DOI: 10.1080/0142159X.2020.1741530
    Cultural beliefs and practices impact heavily on health outcomes of patients. Doctors' ability to deal with such issues in clinical practice, i.e. cultural competence, is widely studied in the west. It has yet to be given due importance in non-western contexts. This study aimed to develop a valid and reliable measure of cultural competence in the Malaysian cultural context and to assess cultural competence among Malaysian medical students. Thirty-five cultural issues faced by Malaysian doctors were identified with a series of interviews to develop a preliminary tool. The responses of students to these cultural issues were evaluated against the extent of inquiry and advocacy based on a theoretical framework of cultural competence. The responses were subjected to statistical analysis to determine the internal structure of the tool and to reduce the number of items in the tool. The final tool (IMU Measure of Cultural Competence - IMoCC) comprised of 22 issues, which deemed to be reliable in the second round of testing. In both tools, student cohorts demonstrated an acceptable level of cultural competence with room for improvement. However, they appeared to learn how to deal with cultural issues primarily through informal means and not in the formal curriculum.
    Matched MeSH terms: Humans
  16. Transfer of knowledge, skills and confidence from a faculty development programme for health professions educators into practice
    Chia CF, Nadarajah VD, Lim V, Kutzsche S
    Med Teach, 2021 Jul;43(sup1):S46-S52.
    PMID: 32552199 DOI: 10.1080/0142159X.2020.1776239
    BACKGROUND: Faculty development programmes should incorporate the transfer of knowledge, skills, and confidence from the training to educational practice. However, there is a risk that transfer may fail due to inadequate integration of knowledge, skills, and confidence. The study evaluated transfer levels, guided by learned principles from a faculty development programme.

    METHOD: The submitted self-reports on a pedagogical intervention of 92 out of 190 health professions educators who participated in a mandatory teaching and learning training programme, were analysed by a mixed-method approach guided by a structured conceptual framework.

    RESULTS: Overall 93.4% reported the successful transfer of learning. Participants incorporated sustainable changed practice (level A, 57.6%), showed reflection on the impact of changed practice (level B, 21.7%), and performed effect analysis (level C, 14.1%). The rest planned application of learning (level D, 4.4%) and identified gaps in current practice or developed an idea for educational intervention but did not implement (level E, 2.2%).

    CONCLUSION: The majority of participants transferred their learning. Faculty development programmes must ensure successful transfer of knowledge, skills, and confidence from the training to educational practice to ensure sustainable development of teaching and learning practices.

    Matched MeSH terms: Humans
  17. Twelve tips for developing a global community of scholars in health professions education
    Ramani S, McKimm J, Findyartini A, Nadarajah VD, Hays R, Chisolm MS, et al.
    Med Teach, 2021 Aug;43(8):966-971.
    PMID: 33108740 DOI: 10.1080/0142159X.2020.1839034
    Scholarship in Health Professions Education is not just original research, it also includes study of educational processes, and application of new knowledge to practice. The pathways to successful scholarship are not always clear to novice educators. In this article, we describe strategies to establish a Community of Scholars (CoS), where more experienced and senior members guide junior members in scholarship to advance the field. Drawing on Lave and Wenger's concepts of Communities of Practice (CoP), we describe twelve practical tips, which include generation of a shared vision, formation of a global community of scholars, engagement in scholarly initiatives, and development of a professional identity, categorised under three major steps: establish, grow, and sustain the community. The tips embrace inclusivity for diverse cultural contexts which further provide opportunities for Health Professions Educators, interested in forming communities of practice, to work on scholarly outputs and add value to the professional arena.
    Matched MeSH terms: Humans
  18. Fulltext Asia-Pacific perspectives on the COVID-19 pandemic
    Pawankar R, Thong BY, Tiongco-Recto M, Wang JY, Abdul Latiff AH, Thien F, et al.
    Allergy, 2021 09;76(9):2998-2901.
    PMID: 33948966 DOI: 10.1111/all.14894
    Matched MeSH terms: Humans
  19. The under-reporting of elder abuse and neglect: a Malaysian perspective
    Yunus RM
    J Elder Abuse Negl, 2021 04 27;33(2):145-150.
    PMID: 33906576 DOI: 10.1080/08946566.2021.1919271
    This commentary highlights the issue of under-reporting of elder abuse and neglect (EAN) in the Malaysian context. It attempts to elucidate the findings of the 2018 National Health and Morbidity Survey (NHMS) related to the trend of reporting among EAN victims, and offer some recommendations.
    Matched MeSH terms: Humans
  20. Fulltext Implementation of Kinetic and Kinematic Variables in Ergonomic Risk Assessment Using Motion Capture Simulation: A Review
    Yunus MNH, Jaafar MH, Mohamed ASA, Azraai NZ, Hossain MS
    Int J Environ Res Public Health, 2021 08 06;18(16).
    PMID: 34444087 DOI: 10.3390/ijerph18168342
    Work-related musculoskeletal disorders (WMSDs) are among the most common disorders in any work sector and industry. Ergonomic risk assessment can reduce the risk of WMSDs. Motion capture that can provide accurate and real-time quantitative data has been widely used as a tool for ergonomic risk assessment. However, most ergonomic risk assessments that use motion capture still depend on the traditional ergonomic risk assessment method, focusing on qualitative data. Therefore, this article aims to provide a view on the ergonomic risk assessment and apply current motion capture technology to understand classical mechanics of physics that include velocity, acceleration, force, and momentum in ergonomic risk assessment. This review suggests that using motion capture technologies with kinetic and kinematic variables, such as velocity, acceleration, and force, can help avoid inconsistency and develop more reliable results in ergonomic risk assessment. Most studies related to the physical measurement conducted with motion capture prefer to use non-optical motion capture because it is a low-cost system and simple experimental setup. However, the present review reveals that optical motion capture can provide more accurate data.
    Matched MeSH terms: Humans
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