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From data collection to downstream data use: Malaysia's experience with ICD-11

Ooi ECW, Md Isa Z, Abdul Manaf MR, Ahmad Fuad AS, Sidek HF, Mustapa MN, et al.

Health Inf Manag, 2024 Nov 23.
PMID: 39578964 DOI: 10.1177/18333583241295717

BACKGROUND: The transition of systems to the International Statistical Classification of Diseases 11th Version (ICD-11) allows access to comprehensive data that accurately portray the complexity of morbidity and mortality data in Malaysia.
OBJECTIVE: To demonstrate Malaysia's experience in implementing ICD-11, from data collection to downstream data use applications.
METHOD AND IMPLEMENTATION: We describe improvements to existing data source systems and downstream data applications. For non-HIS and HIS (ICD-10) systems, data were manually entered into the health management information system equipped with ICD-11 or automatically mapped from ICD-10 to ICD-11. Following these system improvements, we collected and reported ICD-11 data from all hospitals nationwide, regardless of the individual systems' status in ICD-11 use.
DISCUSSION: Lessons learnt related to legacy systems; ICD-11 releases and system updates; mapping; reporting; human resources and related applications.
CONCLUSION: With careful planning, standardisation of the collection and use of ICD-11 data can be accomplished with limited resources and in a complex environment with heterogeneous systems.
IMPLICATIONS: Use of ICD-11 data in downstream data applications improves data quality to answer specific business or research questions.
Plastic Roads in Asia: Current Implementations and Should It Be Considered?

Abd Karim SB, Norman S, Koting S, Simarani K, Loo SC, Mohd Rahim FA, et al.

Materials (Basel), 2023 Aug 08;16(16).
PMID: 37629806 DOI: 10.3390/ma16165515

The rapid economic and industrial growth experienced in the Asian region has significantly increased waste production, particularly single-use plastic. This surge in waste poses a significant challenge for these countries' municipal solid waste management systems. Consequently, there is a pressing need for progressive and effective solutions to address the plastic waste issue. One promising initiative involves utilizing used plastic to produce components for asphalt pavement. The concept of plastic road technology has gained traction in Asia, with 32 countries displaying varying levels of interest, ranging from small-scale laboratory experiments to large-scale construction projects. However, as a relatively new technology, plastic road implementation requires continuous and comprehensive environmental and health risk assessments to ascertain its viability as a reliable green technology. This review paper presents the current findings and potential implementation of plastic-modified asphalt in Asian countries, with particular attention given to its environmental and human health impacts. While plastic asphalt roads hold promise in waste reduction, improved asphalt properties, and cost savings, it is imperative to thoroughly consider the environmental and health impacts, quality control measures, recycling limitations, and long-term performance of this road construction material. Further research and evaluation are needed to fully understand the viability and sustainability of plastic asphalt roads. This will enable a comprehensive assessment of its potential benefits and drawbacks, aiding in developing robust guidelines and standards for its implementation. By addressing these considerations, it will be possible to optimize the utilization of plastic waste in road construction and contribute to a greener and more sustainable future.
Fulltext Prognostic Value of TNFR2 and STAT3 among High-Grade Serous Ovarian Cancer Survivors According to Platinum Sensitivity

Silva Raju J, Abd Aziz NH, Atallah GA, Teik CK, Shafiee MN, Mohd Saleh MF, et al.

Diagnostics (Basel), 2021 Mar 16;11(3).
PMID: 33809542 DOI: 10.3390/diagnostics11030526

This study's goal was to determine the protein expression level of tumour necrosis factor receptor 2 (TNFR2) and signal transducer and activator of transcription 3 (STAT3) in high-grade serous ovarian cancer (HGSC) tissues in relation to the platinum-based chemotherapy response and the prognosis outcome. A total of 25 HGSC patients underwent primary surgical debulking followed by first-line adjuvant platinum-based chemotherapy. Tissue microarray (TMA) slides were constructed utilising archived formalin fixed paraffin embedded (FFPE). The protein expression of TNFR2 and STAT3 were analysed using immunohistochemistry (IHC) staining and subsequently were correlated to the clinicopathological characteristics, platinum sensitivity as well as the duration of progression-free survival. About 14 out of 25 patients (56.0%) were platinum-sensitive. The progression free survival was significantly longer in the platinum-sensitive (PS) group when compared to those with the platinum-resistant group (PR), p = 0.0001. Among patients with TNFR2 strong expression on ovarian tissue, there was a significantly longer progression-free survival interval of 540 days in the PS group compared to PR, p = 0.0001. Patients with STAT3 expression also showed significantly better progression-free survival of 660 days in the PS group when compared to the PR group, p = 0.0001. In conclusion, patients with strong TNFR2 and STAT3 expression in the ovarian tissue had significantly longer progression-free survival interval in the PS group. Nevertheless, further research with a larger number of tissues may be required to demonstrate further significant differences.
Correction: Pattern of macronutrients intake among type-2 diabetes mellitus (T2DM) patients in Malaysia

Md Isa Z, Ismail NH, Mohd Tamil A, Jaafar MH, Ismail R, Mohamed Noor Khan NA, et al.

BMC Nutr, 2023 Feb 07;9(1):27.
PMID: 36750888 DOI: 10.1186/s40795-023-00687-z
Fulltext Depressive symptoms among adults: Baseline findings of PURE Malaysia cohort study

Mohd Tamil A, Ismail NH, Jaafar MH, Md Isa Z, Ismail R, Mat Nasir N, et al.

Heliyon, 2024 Jan 15;10(1):e23042.
PMID: 38192831 DOI: 10.1016/j.heliyon.2023.e23042

INTRODUCTION: In Malaysia, the prevalence of depression has increased from 1.8 % to 2.3 % within a decade. Thus, this study was performed to identify depressive symptoms and its associated factors among Malaysian adults.
METHODS: A cross-sectional study was conducted among the adult population aged 35-70 residing in rural and urban areas in Malaysia. Depressive symptoms were assessed using the short form Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Composite International Diagnostic Interview (CIDI) questionnaire. Logistic regression models were fitted to identify the associated factors related to depressive symptoms.
RESULTS: About 3.7 % (95 % CI: 2.33-4.83) of the respondents reported having depressive symptoms. Younger adults aged 35-40 years old (AOR: 3.087; 95 % CI: 2.021-4.717), females (AOR: 2.318; 95 % CI: 1.669-3.219), widows and divorcees (AOR: 2.294; 95 % CI: 1.085-4.848), smokers (AOR: 1.843; 95 % CI: 1.334-2.545) and alcohol consumers (AOR: 1.843; 95 % CI: 1.264-2.688) showed a higher odds compared to their other counterparts. Underweight individuals (AOR: 1.899; 95 % CI: 1.177-3.065) and those diagnosed either with hypertension (AOR: 1.442; 95 % CI: 1.11-1.873), diabetes (AOR: 1.554; 95 % CI: 1.133-2.13), angina (AOR: 2.73; 95 % CI: 1.596-4.67), COPD (AOR: 4.187; 95 % CI: 1.528-11.472) or asthma (AOR: 1.906; 95 % CI: 1.309-2.774) were more likely to have depressive symptoms. Additionally, individuals with difficulty trusting people (AOR: 1.477; 95 % CI: 1.024-2.13) and those reported to experience either home or work-related stress (AOR: 2.584; 95 % CI: 2.003-3.331) were more prone to have depressive symptoms.
CONCLUSION: In this broad population-based study, about 3.7 % (95 % CI: 2.33-4.83) of respondents reported having depressive symptoms. Timely and well targeted collaborative intervention on the identified risk factors by the relevant authorities, would mitigate their effect on the quality of life and retard the progression into depression, especially among younger adults.
Fulltext Data on LC-MS profile of Brucea javanica (L.) Merr. and the NMR data of its major indole alkaloids

Mohd Yousof NSA, Mohmad Misnan N, Abdul Karim AH, Zainol M, Mohd Abd Razak MR, Md Jelas NH, et al.

Data Brief, 2024 Feb;52:109895.
PMID: 38161655 DOI: 10.1016/j.dib.2023.109895

This article presents two types of phytochemical data obtained from Brucea javanica (L.) Merr. roots, a medicinal plant belonging to the Simaroubaceae family. The high-resolution LC-MS dataset comprised the chemical profile of dichloromethane extract, which was utilised to annotate 35 chemical constituents. For annotations, the measured spectral data were compared with the in-silico spectral data generated from 920 molecular structures previously reported in Simaroubaceae. Indole alkaloids, quassinoids, aliphatics and lignan were the chemical groups identified in the root extract. The second dataset provides NMR spectra (1H, 13C, COSY, HMQC and HMBC) for the six indole alkaloids previously detected in LC-MS analysis and isolated through centrifugal partition chromatography. The chemical structures of all compounds were confirmed based on NMR data as bruceolline J (compound 7), canthin-6-one-N-oxide (compound 10), bruceolline E (compound 15), 5-methoxycanthin-6-one (compound 16), canthin-6-one (compound 20), and 1‑hydroxy-11-methoxycanthin-6-one (compound 22). This phytochemical data was generated to support an ongoing anti-cancer and anti-dengue study.
Fulltext Validation of Faecal Pyruvate Kinase Isoenzyme Type M2 (Faecal M2PK Quick) Test in Detection of Colorectal Adenoma and Adenocarcinoma Among High-Risk Malaysian Population

Mohd Suan MA, Ng YZ, Henry GF, Md Said R, Kollanthavelu S, Mustapha MI, et al.

Asian Pac J Cancer Prev, 2023 Sep 01;24(9):3183-3186.
PMID: 37774070 DOI: 10.31557/APJCP.2023.24.9.3183

BACKGROUND: Colorectal neoplasia is a multistep process that can lead to the development of colorectal cancer. Colonoscopy is the gold standard for diagnosis and screening of colorectal cancer, but its uptake is often hindered by unpleasant experiences and logistic obstacles. Therefore, non-invasive biomarker tests such as the M2-pyruvate kinase (M2PK) test have been explored as a potential screening tool.
OBJECTIVE: This study aims to evaluate the efficacy of the M2PK Quick Stool Test (ScheBo®) in detecting colorectal adenoma and adenocarcinoma in high-risk Malaysian populations using colonoscopy as the comparison.
METHODS: A prospective, cross-sectional, multicenter study was conducted from December 2017 to December 2019 in four hospitals in Malaysia. Participants were eligible if they met any of the following criteria: personal or family history of colorectal polyps or cancer, inherited syndromes, altered bowel habits, rectal bleeding, unintended weight loss, loss of appetite, abdominal pain or cramps, or unexplained iron deficiency, or an Asia-Pacific Colorectal Screening score of 4-7. Participants provided a stool sample that was tested for M2PK using the M2PK Quick Test. Participants then underwent a colonoscopy, and any lesions found were biopsied and sent for histopathological examination.
RESULTS: A total of 562 participants were included in the study, of whom 89 had a positive M2PK test. Presence of adenoma and/or dysplastic lesions were confirmed in 14.4% and adenocarcinoma in 3.0% of the participants. The M2PK Quick Stool Test showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 58.8%, 85.5%, 11.2% and 98.5%, respectively in detecting colorectal adenocarcinoma. For detection of colorectal adenoma, this test yielded a sensitivity, specificity, PPV and NPV of 27.3%, 86.3%, 27.0% and 86.5%, respectively.
CONCLUSIONS: The M2PK Quick Stool Test showed a moderate accuracy in detecting colorectal adenocarcinoma and adenomas in the studied population.
Fulltext Chemical, Nutrient and Physicochemical Properties of Brown Seaweed, Sargassum polycystum C. Agardh (Phaeophyceae) Collected from Port Dickson, Peninsular Malaysia

Nazarudin MF, Alias NH, Balakrishnan S, Wan Hasnan WNI, Noor Mazli NAI, Ahmad MI, et al.

Molecules, 2021 Aug 27;26(17).
PMID: 34500650 DOI: 10.3390/molecules26175216

Recent increased interest in seaweed is motivated by attention generated in their bioactive components that have potential applications in the functional food and nutraceutical industries. In the present study, nutritional composition, metabolite profiles, phytochemical screening and physicochemical properties of freeze-dried brown seaweed, Sargassum polycystum were evaluated. Results showed that the S. polycystum had protein content of 8.65 ± 1.06%, lipid of 3.42 ± 0.01%, carbohydrate of 36.55 ± 1.09% and total dietary fibre content of 2.75 ± 0.58% on dry weight basis. The mineral content of S. polycystum including Na, K, Ca, Mg Fe, Se and Mn were 8876.45 ± 0.47, 1711.05 ± 0.07, 1079.75 ± 0.30, 213.85 ± 0.02, 277.6 ± 0.12, 4.70 ± 0.00 and 4.45 ± 0.00 mg 100/g DW, respectively. Total carotenoid, chlorophyll a and b content in S. polycystum were detected at 45.28 ± 1.77, 141.98 ± 1.18 and 111.29 µg/g respectively. The total amino acid content was 74.90 ± 1.45%. The study revealed various secondary metabolites and major constituents of S. polycystum fibre to include fucose, mannose, galactose, xylose and rhamnose. The metabolites extracted from the seaweeds comprised n-hexadecanoic acid, 1,2-benzenedicarboxylic acid, mono(2-ethylhexyl) ester, benzenepropanoic acid, 3,5-bis(1,1-dimethylethyl)-4-hydroxy- methyl ester, 1-dodecanol, 3,7,11-trimethyl-, which were the most abundant. The physicochemical properties of S. polycystum such as water-holding and swelling capacity were comparable to several commercial fibre-rich products. In conclusion, results of this study indicate that S. polycystum is a potential candidate as functional food sources for human consumption and its cultivation needs to be encouraged.
Medical aesthetic awareness among public in Malaysia and the factors that may influence it: A cross-sectional study

Allan YTH, Richard KFN, Nur Dianah F, Prathishaa J, Syafiqa Nur 'Ukail S, Ernieda Md H, et al.

Malays Fam Physician, 2024;19:37.
PMID: 39210975 DOI: 10.51866/oa.458

INTRODUCTION: Medical aesthetic practice is growing rapidly in Malaysia due to rising market demand, yet public understanding of these practices remains limited. This study evaluated the awareness and attitudes towards medical aesthetics among Malaysians.
METHODS: A cross-sectional survey was conducted among individuals aged > 18 years old in Malaysia from December 2021 to May 2022. The survey was distributed both online and in public settings. The survey comprised of respondents' sociodemographic, perception of physical attractiveness, knowledge and attitude towards medical aesthetic practices. The factors influencing respondents' attitudes towards medical aesthetic practices in the country were analysed using binary logistic regression, with the significance level set at P<0.05.
RESULTS: A total of 382 respondents participated in this study with average age of 30.81 (±9.38) years, ranging from 18 to 68 years. The majority were women (77.5%), Malay (53.7%) and Muslim (57.1%). Although most respondents had no prior experience in medical aesthetic treatment (68.1%), 76.2% respondents demonstrated good knowledge and 70.2% had positive attitude towards these services. Additionally, 53.9% of the respondents highly valued the importance of physical attractiveness. The Buddhists and Hindus exhibited more positive attitude than the Muslims. Conversely, those who placed higher importance on physical attractiveness were 0.5 times less likely to develop a positive attitude towards medical aesthetic services.
CONCLUSION: In conclusion, despite limited experience in medical aesthetic treatments and practice, most Malaysians possess good knowledge and positive attitudes towards medical aesthetics, indicating a growing interest and potential willingness to consider these services for enhancing their appearance.
Remodeling in Aortic Stenosis With Reduced and Preserved Ejection Fraction: Insight on Motion Abnormality Via 3D + Time Personalized LV Modeling in Cardiac MRI

Chuah SH, Tan LK, Md Sari NA, Chan BT, Hasikin K, Lim E, et al.

J Magn Reson Imaging, 2024 Apr;59(4):1242-1255.
PMID: 37452574 DOI: 10.1002/jmri.28915

BACKGROUND: Increased afterload in aortic stenosis (AS) induces left ventricle (LV) remodeling to preserve a normal ejection fraction. This compensatory response can become maladaptive and manifest with motion abnormality. It is a clinical challenge to identify contractile and relaxation dysfunction during early subclinical stage to prevent irreversible deterioration.
PURPOSE: To evaluate the changes of regional wall dynamics in 3D + time domain as remodeling progresses in AS.
STUDY TYPE: Retrospective.
POPULATION: A total of 31 AS patients with reduced and preserved ejection fraction (14 AS_rEF: 7 male, 66.5 [7.8] years old; 17 AS_pEF: 12 male, 67.0 [6.0] years old) and 15 healthy (6 male, 61.0 [7.0] years old).
FIELD STRENGTH/SEQUENCE: 1.5 T Magnetic resonance imaging/steady state free precession and late-gadolinium enhancement sequences.
ASSESSMENT: Individual LV models were reconstructed in 3D + time domain and motion metrics including wall thickening (TI), dyssynchrony index (DI), contraction rate (CR), and relaxation rate (RR) were automatically extracted and associated with the presence of scarring and remodeling.
STATISTICAL TESTS: Shapiro-Wilk: data normality; Kruskal-Wallis: significant difference (P
Fulltext The Role of Maternal Serum Ferritin in Gestational Diabetes Mellitus in Southeast Asia

Badaruddin I', Norbani A, Chin JY, Md Said ES, Selvarajoo U, Mohammad Khaidir NT, et al.

Cureus, 2024 Oct;16(10):e72155.
PMID: 39583387 DOI: 10.7759/cureus.72155

Introduction Gestational diabetes mellitus (GDM) poses a significant health concern due to the numerous risks it presents to both the mother and fetus. While serum ferritin typically declines in cases of iron deficiency anemia, which is common during pregnancy, it may increase in the presence of inflammation. This study aims to evaluate the significance of serum ferritin in the context of GDM, considering its multifaceted role in these interconnected conditions. Methodology This cross-sectional study included pregnant women attending an obstetrics clinic for an oral glucose tolerance test at Hospital Canselor Tuanku Muhriz in Kuala Lumpur, Malaysia. With consent, demographic data, risk factors for GDM, and blood samples were collected. Blood samples were analyzed for serum ferritin, fasting blood glucose, two-hour post-glucose levels, and full blood count. The assessment of risk factors for GDM and the diagnosis of GDM adhered to Malaysian guidelines. The Mann-Whitney U test was employed to compare variables between the GDM and non-gestational diabetes mellitus (non-GDM) groups. Additionally, univariate and multivariate regression analyses were conducted to investigate the role of serum ferritin in GDM. All analyses were performed using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021; IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05. Results Among 172 pregnant women with an average gestational age of 23.6 weeks, the incidence of GDM was higher in those with risk factors (84.8%) compared to non-GDM participants (75.5%). Women with GDM had a slightly higher mean serum ferritin level (50.24 ± 29.00 ng/mL) than those without GDM (45.00 ± 58.69 ng/mL). However, ferritin levels did not significantly differ between the GDM and non-GDM groups (p = 0.669) or between those with and without risk factors (p = 0.374). While a higher BMI (OR: 0.832, p = 0.017) and ferritin (OR: 1.022, p = 0.031) levels independently predicted GDM, the predictive value of ferritin was borderline significant when combined with glucose tests (area under the curve = 0.689, p = 0.051). Conclusions Higher maternal serum ferritin levels in the mid-trimester are associated with increased BMI and GDM. However, maternal serum ferritin is most effective at predicting the incidence of GDM when used alongside standard glucose measurements, especially in women with elevated BMI.
Laboratory-based assessment of geotechnical characteristics of organic waste-amended soil for landfill biocover

Rahim S, Isa MH, Shams S, Jeludin M, Abdul Rahman EK, Hj Md Juani R, et al.

Environ Sci Pollut Res Int, 2024 Dec;31(58):66029-66043.
PMID: 39612092 DOI: 10.1007/s11356-024-35580-0

A landfill biocover is essential for addressing environmental concerns, especially in waste management, as it plays a crucial role in mitigating the release of methane gas. This study investigates the geotechnical characteristics of soil amended with organic wastes for landfill biocover applications. Various organic waste amendments, viz., rice husk, crushed coconut coir, and compost, were examined at different percentages (0%, 25%, 50%, and 75%) compared with conventional landfill cover material, i.e. natural clay, as biocovers. Laboratory experiments analysed geotechnical characteristics, including organic content, Atterberg limit, compaction, consolidation, and desiccation cracking. The study revealed that organic waste amendment significantly impacted the geotechnical characteristics of landfill biocover, enhancing organic content and porosity and reducing permeability and desiccation susceptibility. Soils amended with organic content support methanotrophic bacteria growth and reduce methane emissions in landfills. The most promising biocovers were identified as 75CR (crushed coconut coir/wastewater sludge/clay in percentage ratio of 70:5:25), followed by 75CT (compost/wastewater sludge/clay in percentage ratio of 70:5:25), and 25RH (rice husk/wastewater sludge/clay in percentage ratio of 20:5:75). Biocovers offer sustainable landfill alternatives, underscoring the need to understand their geotechnical characteristics for successful installation in landfills.
Fulltext The record-setting flood of 2014 in kelantan: challenges and recommendations from an emergency medicine perspective and why the medical campus stood dry

Baharuddin KA, Abdull Wahab SF, Nik Ab Rahman NH, Nik Mohamad NA, Tuan Kamauzaman TH, Md Noh AY, et al.

Malays J Med Sci, 2015 Mar-Apr;22(2):1-7.
PMID: 26023289

Floods are considered an annual natural disaster in Kelantan. However, the record-setting flood of 2014 was a 'tsunami-like disaster'. Hospital Universiti Sains Malaysia was the only fully functioning hospital in the state and had to receive and manage cases from the hospitals and clinics throughout Kelantan. The experiences, challenges, and recommendations resulting from this disaster are highlighted from an emergency medicine perspective so that future disaster preparedness is truly a preparation. The history of how the health campus was constructed with the collaboration of Perunding Alam Bina and Perkins and Willis of Chicago is elaborated.
Navigating Immune Landscapes: Insights From A Prospective Study

Badaruddin IA, Othman H, Wan Shuaib WMA, Che Yusof MZ, Othman S, Anuar Ali MN, et al.

Asia Pac J Public Health, 2024 Nov;36(8):806-809.
PMID: 39318114 DOI: 10.1177/10105395241282621
Fulltext Knowledge, Attitude, and Practices regarding Leptospirosis among Visitors to a Recreational Forest in Malaysia

Shafie NJ, Abdul Halim NS, Nor Zalipah M, Mohd Amin NAZ, Syed Esa SM, Md-Nor S, et al.

Am J Trop Med Hyg, 2021 Jan 18;104(4):1290-1296.
PMID: 33534768 DOI: 10.4269/ajtmh.20-0306

Leptospirosis is a zoonotic disease and a worldwide public health problem that affects mainly high-risk groups. Characterizing knowledge, attitude, and practice (KAP) among high-risk groups is important to develop appropriate prevention programs. Here, we performed a cross-sectional study among 300 visitors of a recreational forest in Malaysia to examine leptospirosis KAP and demographics. These variables were integrated to create knowledge and practice scores for each respondent. All respondents had heard about leptospirosis, and 87% of them correctly identified it as a disease. The majority of respondents had high knowledge (63%), positive attitude, and good practice (68%) toward prevention of the disease. However, there were gaps in knowledge, with 78% of the respondents indicating eating without washing hands as the major cause of leptospirosis transmission. Our final model identified that higher knowledge score was associated with higher practice score. Our results indicate that it is important to increase knowledge, especially on transmission routes of leptospirosis, among visitors in recreational areas. Moreover, more attention needs to be paid to promote good practice habits among visitors, targeting those at higher risk of being infected by leptospirosis to prevent potential outbreaks in the recreational areas.
Fulltext A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia

Rahman NH, Keng Sheng C, Kamauzaman TH, Md Noh AY, Wahab SF, Zaini IZ, et al.

Int J Emerg Med, 2013;6(1):37.
PMID: 24135122 DOI: 10.1186/1865-1380-6-37

We performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia.
Fulltext Development of DNA-Based Lateral Flow Assay for Detection of LDLR Gene Mutation for Familial Hypercholesterolemia

Saidi LK, Md Rani ZZ, Sulaiman SA, Jamal R, Ismail A, Alim AA, et al.

Malays J Med Sci, 2024 Jun;31(3):92-106.
PMID: 38984253 DOI: 10.21315/mjms2024.31.3.6

BACKGROUND: The techniques for detecting single nucleotide polymorphisms (SNP) require lengthy and complex experimental procedures and expensive instruments that may only be available in some laboratories. Thus, a deoxyribonucleic acid (DNA)-based lateral flow assay (LFA) was developed as a point-of-care test (POCT) diagnostic tool for genotyping. In this study, single nucleotide variation (E101K) in the low-density lipoprotein receptor (LDLR) gene leading to familial hypercholesterolemia (FH) was chosen as a model.
METHODS: Hypercholesterolemic individuals (n = 103) were selected from the Malaysian Cohort project (UKM Medical Molecular Biology Institute) while the control samples were selected from the Biobank (UKM Medical Molecular Biology Institute). The DNA samples were isolated from whole blood. Polymerase chain reaction (PCR) amplification process was performed using bifunctional labelled primers specifically designed to correspond to the variant that differentiates wild-type and mutant DNA for visual detection on LFA. The variant was confirmed using Sanger sequencing, and the sensitivity and specificity of the LFA detection method were validated using the Agena MassARRAY® technique.
RESULTS: Out of 103 hypercholesterolemic individuals, 5 individuals (4.8%) tested positive for E101K, LDLR mutation and the rest, including healthy control individuals, tested negative. This result was concordant with Sanger sequencing and Agena MassARRAY®. These five individuals could be classified as Definite FH, as the DNA diagnosis was confirmed. The sensitivity and specificity of the variant detection by LFA is 100% compared to results using the genotyping method using Agena MassARRAY®.
CONCLUSION: The developed LFA can potentially be used in the POC setting for detecting the E101K variant in the LDLR gene. This LFA can also be used to screen family members with E101K variant in the LDLR gene and is applicable for other SNP's detection.
Current Scenario in Associating Clinical COVID-19 Biomarkers for Developing Surveillance Platforms

Lakshmipriya T, Gopinath SCB, Chen Y, Sasidharan S, Subramaniam S, Gunny AAN, et al.

Curr Med Chem, 2025 Jan 09.
PMID: 39806951 DOI: 10.2174/0109298673331044241031100627

The novel coronavirus that caused the epidemic and pandemic resulting in the acute respiratory illness known as coronavirus disease 2019 (COVID-19) has plagued the world. This is unlike other coronavirus outbreaks that have occurred in the past, such as Middle East respiratory syndrome (MERS) or severe acute respiratory syndrome (SARS). COVID-19 has spread more quickly and posed special challenges due to the lack of appropriate treatments and vaccines. Real-time polymerase chain reaction (RTPCR) and rapid antibody tests (surveillance tests) are the two most used tests (confirmation tests). However, the latter takes hours to complete, and the former may produce false positives. Scientists have invested significant effort to create a COVID-19 diagnostic system that is both highly sensitive and reasonably priced. Early detection of COVID-19 is a major area of focus for sensing devices based on nanomaterials. This overview enhanced insights into potential coronavirus biomarkers and, compared to earlier studies, introduced new avenues. Further, it covers the development of COVID-19 diagnostic systems from an analytical point of view, including clinical markers and their subsequent applications with biosensors.
Fulltext The cadmium tolerance and bioaccumulation mechanism of Tetratostichococcus sp. P1: insight from transcriptomics analysis

Sahabudin E, Kubo S, Yuzir MAM, Othman N, Nadia Md Akhir F, Suzuki K, et al.

Bioengineered, 2024 Dec;15(1):2314888.
PMID: 38375815 DOI: 10.1080/21655979.2024.2314888

Cadmium (Cd) has become a severe issue in relatively low concentration and attracts expert attention due to its toxicity, accumulation, and biomagnification in living organisms. Cd does not have a biological role and causes serious health issues. Therefore, Cd pollutants should be reduced and removed from the environment. Microalgae have great potential for Cd absorption for waste treatment since they are more environmentally friendly than existing treatment methods and have strong metal sorption selectivity. This study evaluated the tolerance and ability of the microalga Tetratostichococcus sp. P1 to remove Cd ions under acidic conditions and reveal mechanisms based on transcriptomics analysis. The results showed that Tetratostichococcus sp. P1 had a high Cd tolerance that survived under the presence of Cd up to 100 µM, and IC50, the half-maximal inhibitory concentration value, was 57.0 μM, calculated from the change in growth rate based on the chlorophyll content. Long-term Cd exposure affected the algal morphology and photosynthetic pigments of the alga. Tetratostichococcus sp. P1 removed Cd with a maximum uptake of 1.55 mg g-1 dry weight. Transcriptomic analysis revealed the upregulation of the expression of genes related to metal binding, such as metallothionein. Group A, Group B transporters and glutathione, were also found upregulated. While the downregulation of the genes were related to photosynthesis, mitochondria electron transport, ABC-2 transporter, polysaccharide metabolic process, and cell division. This research is the first study on heavy metal bioremediation using Tetratostichococcus sp. P1 and provides a new potential microalga strain for heavy metal removal in wastewater.[Figure: see text]Abbreviations:BP: Biological process; bZIP: Basic Leucine Zipper; CC: Cellular component; ccc1: Ca (II)-sensitive cross complementary 1; Cd: Cadmium; CDF: Cation diffusion facilitator; Chl: Chlorophyll; CTR: Cu TRansporter families; DAGs: Directed acyclic graphs; DEGs: Differentially expressed genes; DVR: Divinyl chlorophyllide, an 8-vinyl-reductase; FPN: FerroportinN; FTIR: Fourier transform infrared; FTR: Fe TRansporter; GO: Gene Ontology; IC50: Growth half maximal inhibitory concentration; ICP: Inductively coupled plasma; MF: molecular function; NRAMPs: Natural resistance-associated aacrophage proteins; OD: Optical density; RPKM: Reads Per Kilobase of Exon Per Million Reads Mapped; VIT1: Vacuolar iron transporter 1 families; ZIPs: Zrt-, Irt-like proteins.
Fulltext Strategies, challenges and opportunities in the implementation of COVID-19 field hospitals: a scoping review

Hamis AA, Md Bukhori AB, Heng PP, Jane Ling MY, Shaharuddin MA, A Fauzi NAF, et al.

BMJ Open, 2023 Mar 14;13(3):e067227.
PMID: 36918252 DOI: 10.1136/bmjopen-2022-067227

OBJECTIVES: COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted implementation strategies and maximise field hospital functionality to address the issue of overflow of patients with COVID-19. This scoping review was based on the main research question, 'What are the implementation strategies, challenges and opportunities in managing the field hospital during the COVID-19 pandemic?', and aimed to consolidate all recent evidence on COVID-19 field hospital implementation approaches, challenges and potentialities.
DESIGN: Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
DATA SOURCES: PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.
ELIGIBILITY CRITERIA: Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.
DATA EXTRACTION AND SYNTHESIS: Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.
RESULTS: Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.
CONCLUSIONS: The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.

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