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  1. Koh HM, Chong PF, Tan JN, Chidambaram SK, Chua HJ
    J Clin Pharm Ther, 2021 Jun;46(3):800-806.
    PMID: 33768612 DOI: 10.1111/jcpt.13356
    WHAT IS KNOWN AND OBJECTIVE: Hydroxychloroquine and protease inhibitors were widely used as off-label treatment options for COVID-19 but the safety data of these drugs among the COVID-19 population are largely lacking. Drug-induced QTc prolongation is a known adverse reaction of hydroxychloroquine, especially during chronic treatment. However, when administered concurrently with potential pro-arrhythmic drugs such as protease inhibitors, the risk of QTc prolongation imposed on these patients is not known. We aim to investigate the incidence of QTc prolongation events and potential factors associated with its occurrence in COVID-19 population.

    METHODS: We included 446 SARS-CoV-2 RT-PCR-positive patients taking at least one treatment drug for COVID-19 within a period of one month (March-April 2020). In addition to COVID-19-related treatment (HCQ/PI), concomitant drugs with risks of QTc prolongation were considered. We defined QTc prolongation as QTc interval of ≥470 ms in postpubertal males, and ≥480 ms in postpubertal females.

    RESULTS AND DISCUSSION: QTc prolongation events occurred in 28/446 (6.3%) patients with an incidence rate of 1 case per 100 person-days. A total of 26/28 (93%) patients who had prolonged QTc intervals received at least two pro-QT drugs. Multivariate analysis showed that HCQ and PI combination therapy had five times higher odds of QTc prolongation as compared to HCQ-only therapy after controlling for age, cardiovascular disease, SIRS and the use of concurrent QTc-prolonging agents besides HCQ and/or PI (OR 5.2; 95% CI, 1.11-24.49; p = 0.036). Independent of drug therapy, presence of SIRS resulted in four times higher odds of QTc prolongation (OR 4.3; 95% CI, 1.66-11.06; p = 0.003). In HCQ-PI combination group, having concomitant pro-QT drugs led to four times higher odds of QTc prolongation (OR 3.8; 95% CI, 1.53-9.73; p = 0.004). Four patients who had prolonged QTc intervals died but none were cardiac-related deaths.

    WHAT IS NEW AND CONCLUSION: In our cohort, hydroxychloroquine monotherapy had low potential to increase QTc intervals. However, when given concurrently with protease inhibitors which have possible or conditional risk, the odds of QTc prolongation increased fivefold. Interestingly, independent of drug therapy, the presence of systemic inflammatory response syndrome (SIRS) resulted in four times higher odds of QTc prolongation, leading to the postulation that some QTc events seen in COVID-19 patients may be due to the disease itself. ECG monitoring should be continued for at least a week from the initiation of treatment.

  2. Lau TV, Puah SM, Tan JMA, Puthucheary SD, Chua KH
    Braz J Microbiol, 2021 Jun;52(2):517-529.
    PMID: 33768508 DOI: 10.1007/s42770-021-00457-8
    Flagellar-mediated motility is a crucial virulence factor in many bacterial species. A dual flagellar system has been described in aeromonads; however, there is no flagella-related study in the emergent human pathogen Aeromonas dhakensis. Using 46 clinical A. dhakensis, phenotypic motility, genotypic characteristics (flagellar genes and sequence types), biochemical properties and their relationship were investigated in this study. All 46 strains showed swimming motility at 30 °C in 0.3% Bacto agar and carried the most prevalent 6 polar flagellar genes cheA, flgE, flgG, flgH, flgL, and flgN. On the contrary, only 18 strains (39%) demonstrated swarming motility on 0.5% Eiken agar at 30 °C and they harbored 11 lateral flagellar genes lafB, lafK, lafS, lafT, lafU, flgCL, flgGL, flgNL, fliEL, fliFL, and fliGL. No association was found between biochemical properties and motility phenotypes. Interestingly, a significant association between swarming and strains isolated from pus was observed (p = 0.0171). Three strains 187, 277, and 289 isolated from pus belonged to novel sequence types (ST522 and ST524) exhibited fast swimming and swarming profiles, and they harbored > 90% of the flagellar genes tested. Our findings provide a fundamental understanding of flagellar-mediated motility in A. dhakensis.
  3. Makhtar ST, Tan SW, Nasruddin NA, Abdul Aziz NA, Omar AR, Mustaffa-Kamal F
    BMC Vet Res, 2021 Mar 23;17(1):128.
    PMID: 33757494 DOI: 10.1186/s12917-021-02837-6
    BACKGROUND: Morbilliviruses are categorized under the family of Paramyxoviridae and have been associated with severe diseases, such as Peste des petits ruminants, canine distemper and measles with evidence of high morbidity and/or could cause major economic loss in production of livestock animals, such as goats and sheep. Feline morbillivirus (FeMV) is one of the members of Morbilliviruses that has been speculated to cause chronic kidney disease in cats even though a definite relationship is still unclear. To date, FeMV has been detected in several continents, such as Asia (Japan, China, Thailand, Malaysia), Europe (Italy, German, Turkey), Africa (South Africa), and South and North America (Brazil, Unites States). This study aims to develop a TaqMan real-time RT-PCR (qRT-PCR) assay targeting the N gene of FeMV in clinical samples to detect early phase of FeMV infection.

    RESULTS: A specific assay was developed, since no amplification was observed in viral strains from the same family of Paramyxoviridae, such as canine distemper virus (CDV), Newcastle disease virus (NDV), and measles virus (MeV), and other feline viruses, such as feline coronavirus (FCoV) and feline leukemia virus (FeLV). The lower detection limit of the assay was 1.74 × 104 copies/μL with Cq value of 34.32 ± 0.5 based on the cRNA copy number. The coefficient of variations (CV) values calculated for both intra- and inter-assay were low, ranging from 0.34-0.53% and 1.38-2.03%, respectively. In addition, the clinical sample evaluation using this assay showed a higher detection rate, with 25 (35.2%) clinical samples being FeMV-positive compared to 11 (15.5%) using conventional RT-PCR, proving a more sensitive assay compared to the conventional RT-PCR.

    CONCLUSIONS: The TaqMan-based real-time RT-PCR assay targeting the N gene described in this study is more sensitive, specific, rapid, and reproducible compared to the conventional RT-PCR assay targeting the N gene, which could be used to detect early infection in cats.

  4. Zhang H, Zhang F, Song J, Tan ML, Kung HT, Johnson VC
    Environ Res, 2021 11;202:111702.
    PMID: 34284019 DOI: 10.1016/j.envres.2021.111702
    This study aims to analyze the pollution characteristics and sources of heavy metal elements for the first time in the Zhundong mining area in Xinjiang using the linear regression model. Additionaly, the health risks with their probability and infleuencing factors on different groups of people's were also evaluated using Monte Carlo (MC) simulation approach. The results shows that 89.28% of Hg was from coal combustion, 40.28% of Pb was from transportation, and 19.54% of As was from atmospheric dust. The main source of Cu and Cr was coal dust, Hg has the greatest impact on potential ecological risks. which accounted for 60.2% and 81.46% of the Cu and Cr content in soil, respectively. The all samples taken from Pb have been Extremely polluted (100%). 93.3% samples taken from As have been Extremely polluted. The overall potential ecological risk was moderate. Adults experienced higher non-carcinogenic risks of heavy metals from their diets than children. Interestingly, body weight was the main factor affecting the adult's health risks. This research provides more comprehensive information for better soil management, soil remediation, and soil pollution control in the Xinjiang mining areas.
  5. Tiyasha T, Tung TM, Bhagat SK, Tan ML, Jawad AH, Mohtar WHMW, et al.
    Mar Pollut Bull, 2021 Sep;170:112639.
    PMID: 34273614 DOI: 10.1016/j.marpolbul.2021.112639
    Dissolved oxygen (DO) is an important indicator of river health for environmental engineers and ecological scientists to understand the state of river health. This study aims to evaluate the reliability of four feature selector algorithms i.e., Boruta, genetic algorithm (GA), multivariate adaptive regression splines (MARS), and extreme gradient boosting (XGBoost) to select the best suited predictor of the applied water quality (WQ) parameters; and compare four tree-based predictive models, namely, random forest (RF), conditional random forests (cForest), RANdom forest GEneRator (Ranger), and XGBoost to predict the changes of dissolved oxygen (DO) in the Klang River, Malaysia. The total features including 15 WQ parameters from monitoring site data and 7 hydrological components from remote sensing data. All predictive models performed well as per the features selected by the algorithms XGBoost and MARS in terms applied statistical evaluators. Besides, the best performance noted in case of XGBoost predictive model among all applied predictive models when the feature selected by MARS and XGBoost algorithms, with the coefficient of determination (R2) values of 0.84 and 0.85, respectively, nonetheless the marginal performance came up by Boruta-XGBoost model on in this scenario.
  6. Koondhar MA, Tan Z, Alam GM, Khan ZA, Wang L, Kong R
    J Environ Manage, 2021 Oct 15;296:113242.
    PMID: 34271346 DOI: 10.1016/j.jenvman.2021.113242
    China is the world's largest fossil fuel consumer and carbon emitter country. In September 2020, China pledged to reduce carbon emissions, and achieve carbon neutrality by 2060. Therefore, this study aimed to contribute to the literature and show the pictorial nexus of bioenergy and fossil fuel consumption, carbon emission, and agricultural bioeconomic growth, a new pathway towards carbon neutrality. For this study, time-series data from 1971 to 2019 were used to analyze the autoregressive distributed lag (ARDL) bound testing and novel dynamic autoregressive distributed lag (DYNARDL) simulation models. Initially, the unit root tests results showed that all variables were stationarity at the level and first difference. The presence of cointegration between selected variables was confirmed by the results from ARDL bound test. In addition, the results of long-run and short-run nexus show an increase in bioenergy consumption that caused an increase in agricultural bioeconomic growth both in the long and short-run nexus. A decrease in fossil fuel consumption was shown to result in increased agricultural bioeconomic growth with respect to both long- and short-term effects. Furthermore, the results of the novel dynamic ARDL simulation model demonstrated that a 10% positive shock from bioenergy consumption caused an increase in agricultural bioeconomic growth, while at the same time, a 10% negative shock in bioenergy consumption led to a decrease. A 10% negative shock from fossil fuels caused an increase in agricultural bioeconomic growth, whereas a 10% positive shock from fossil fuels led to a decrease. Therefore, this study suggests that China needs to switch from fossil fuel and other non-renewable energy consumption to sources of bioenergy and other renewable energy consumption to achieve carbon neutrality by 2060.
  7. Rashid SA, Norman N, Teo SH, Tong WY, Leong CR, Tan WN, et al.
    World J Microbiol Biotechnol, 2021 Aug 16;37(9):152.
    PMID: 34398332 DOI: 10.1007/s11274-021-03118-y
    β-lactam antibiotics are the most frequently prescribed class of drugs worldwide, due to its efficacy and good safety profile. However, the emergence of β-lactamase producing bacterial strains eliminated the use of β-lactam antibiotics as a chemotherapeutic choice. To restore their usability, a non-antibiotic adjuvant in conjunction with β-lactam antibiotics is now being utilised. Cholic acid potentially acts as an adjuvant since it can blunt the pro-inflammatory activity in human. Our main objective is to scrutinise the inhibition of β-lactamase-producing bacteria by adjuvant cholic acid, synergism of the test drugs and the primary mechanism of enzymatic reaction. Antibacterial effect of the cholic acid-ampicillin (CA-AMP) on 7 β-lactamase positive isolates were evaluated accordingly to disc diffusion assay, antibiotic susceptibility test, as well as checkerboard analysis. Then, all activities were compared with ampicillin alone, penicillin alone, cholic acid alone and cholic acid-penicillin combination. The CA-AMP displayed notable antibiotic activity on all test bacteria and depicted synergistic influence by representing low fractional inhibitory concentration index (FIC ≤ 0.5). According to kinetic analyses, CA-AMP behaved as an uncompetitive inhibitor against beta lactamase, with reducing values of Michaelis constant (Km) and maximal velocity (Vmax) recorded. The inhibitor constant (Ki) of CA-AMP was equal to 4.98 ± 0.3 µM, which slightly lower than ampicillin (5.00 ± 0.1 µM).
  8. Ibrahim AF, Tan MP, Teoh GK, Muda SM, Chong MC
    Exp Aging Res, 2021 Jul 06.
    PMID: 34229584 DOI: 10.1080/0361073X.2021.1939563
    BACKGROUND: Social disengagement among older persons may result from accumulated physical impact and social stressors experienced throughout life. Conversely, interventions that enhance social participation addresses social isolation with positive influences on health. This article, therefore, aimed to review the range of published studies that evaluated the health benefits of interventions on social participation among community-dwelling older persons.

    METHOD: We conducted a search using the databases CINAHL, MEDLINE, EBSCOhost, PubMed, ProQuest, SAGE, ScienceDirect, SpringerLink, Web of Science, and Open repository/archive.

    RESULTS: Twenty-five studies from Asia, Europe and America were selected. Included articles described randomized controlled trials (9), quasi-experimental studies (9), mixed-methods studies (2), participatory action research (3), and community-based intervention research (2). Social interventions described are group or cultural activities, personal/group monitoring and discussion, and communications devices. Intervention designed utilized theories, models, concepts, principles, and evidence from published literature.

    CONCLUSION: Most social intervention studies evaluating health outcomes have been conducted in North America and Western Europe. Group-based activities were most commonly employed, but personal/group discussions, home visits and technology-based interactions have also been used. While social isolation is now a widely accepted risk factor for ill-health, research evidence for improvement of health through reduction of social isolation remains limited.

  9. Lim H, Chuah JA, Chek MF, Tan HT, Hakoshima T, Sudesh K
    Int J Biol Macromol, 2021 Sep 01;186:414-423.
    PMID: 34246679 DOI: 10.1016/j.ijbiomac.2021.07.041
    Polyhydroxyalkanoates (PHAs) are biopolyesters synthesized by microorganisms as intracellular energy reservoirs under stressful environmental conditions. PHA synthase (PhaC) is the key enzyme responsible for PHA biosynthesis, but the importance of its N- and C-terminal ends still remains elusive. Six plasmid constructs expressing truncation variants of Aquitalea sp. USM4 PhaC (PhaC1As) were generated and heterologously expressed in Cupriavidus necator PHB-4. Removal of the first six residues at the N-terminus enabled the modulation of PHA composition without altering the PHA content in cells. Meanwhile, deletion of 13 amino acids from the C-terminus greatly affected the catalytic activity of PhaC1As, retaining only 1.1-7.4% of the total activity. Truncation(s) at the N- and/or C-terminus of PhaC1As gradually diminished the incorporation of comonomer units, and revealed that the N-terminal region is essential for PhaC1As dimerization whereas the C-terminal region is required for stabilization. Notably, transmission electron microscopy analysis showed that PhaC modification affected the morphology of intracellular PHA granules, which until now is only known to be regulated by phasins. This study provided substantial evidence and highlighted the significance of both the N- and C-termini of PhaC1As in regulating intracellular granule morphology, activity, substrate specificity, dimerization and stability of the synthase.
  10. Chiu CJ, Li ML, Chang CM, Wu CH, Tan MP
    BMC Geriatr, 2021 07 10;21(1):420.
    PMID: 34246236 DOI: 10.1186/s12877-021-02300-z
    BACKGROUND: Prolonged life expectancy is associated with increased prevalence of chronic diseases. The aim of this study was to determine the different disability trajectories for the top ten leading causes of death in Taiwan .

    METHODS: A total of 2,431 participants aged 50-96 in 1996 from the Taiwan longitudinal study on aging (TLSA) who died from 1996 to 2016 were analyzed. Integration of Cause of Death Data and TLSA helped sort out participants who had died from the ten leading causes of death. The level of physical disability was evaluated with the Activities of Daily Living Scale (ADLs), ranging from 0 to 6 points, in 1996, 1999, 2003, 2007, and 2011. A multilevel model was used to investigate the levels and rates of change in disability development before death.

    RESULTS: The outcome of the research showed that the earliest group to experience physical limitation was individuals living with diabetes. The groups with the highest ADL scores were participants with diabetes, cerebrovascular disease, and hypertension-related diseases. Most groups reach ADL scores ≥ 1 (mild-level) during 4-6 years before death except chronic hepatitis and cirrhosis and injury.

    CONCLUSIONS: People who had died from the ten leading causes of death experienced different disability trajectories before death. The trajectory of the participants who had died from diabetes showed a unique pattern with the earliest occurrence and more severe deterioration in terms of development of disabilities. Disability trajectories provide a prediction of survival status for middle-aged and older adults associated with the ten leading causes of death.

  11. Goodson M, McLellan E, Rosli R, Tan MP, Kamaruzzaman S, Robinson L, et al.
    Front Public Health, 2021;9:637484.
    PMID: 34368037 DOI: 10.3389/fpubh.2021.637484
    Background: The number of people living with dementia worldwide is increasing, particularly in low- and middle-income countries (LMICs) where little is known about existing post-diagnostic care and support. This study aimed to better understand healthcare provision for people living with dementia in Malaysia, and to identify priorities for providing timely, quality, and accessible care and support to all. Methods: This is a qualitative interview study on care providers and facilitators (health and community care professionals, paid carers, traditional medicine practitioners, faith healers, community leaders, non-governmental organisations). A topic guide, piloted in Malaysia and peer reviewed by all LMIC partners, elicited the understanding of dementia and dementia care and barriers and facilitators to care for people living with dementia and carers, and perceptions of key priorities for developing efficient, feasible, and sustainable dementia care pathways. Verbatim transcription of audio-recorded interviews was followed by iterative, thematic data analysis. Results: Twenty interviews were conducted (11 healthcare professionals, 4 traditional medicine practitioners, and 5 social support providers). The findings indicate that dementia care and support services exist in Malaysia, but that they are not fully utilised because of variations in infrastructure and facilities across the country. Despite a locally recognised pathway of care being available in an urban area, people with dementia still present to the healthcare system with advanced disease. The interviewees linked this to a public perception that symptoms of dementia, in particular, are normal sequelae of ageing. Earlier detection of dementia is commonly opportunistic when patients present to GPs, government clinic staff, and general physicians with other ailments. Dementia may only be identified by practitioners who have some specialist interest or expertise in it. Workforce factors that hindered early identification and management of dementia included lack of specialists, overburdened clinics, and limited knowledge of dementia and training in guideline use. Post-diagnostic social care was reported to be largely the domain of families, but additional community-based support was reported to be available in some areas. Raising awareness for both the public and medical professionals, prevention, and more support from the government are seen as key priorities to improve dementia management. Conclusions: This qualitative study provides novel insight into the availability, delivery, and use of post-diagnostic care and support in Malaysia from the perspective of care providers. The respondents in this study perceived that while there was a provision for dementia care in the hospital and community settings, the different care sectors are largely unaware of the services each provides. Future work should explore how care provision across different service sectors and providers can be supported to better facilitate patient access and referral between primary, secondary, and social care. The importance of supporting families to understand dementia and its progression, and strategies to help them care for relatives was emphasised. There is also a need for broad workforce training and development, at both the postgraduate and undergraduate levels, as well as improved general awareness in the community to encourage earlier help-seeking for symptoms of dementia. This will enable the use of preventive strategies and access to specialist services to optimise care and quality of life for people living with dementia in Malaysia.
  12. Rosarior VL, Lim PS, Wong WK, Yue CS, Yam HC, Tan SA
    Trop Life Sci Res, 2021 Jun;32(2):45-63.
    PMID: 34367514 DOI: 10.21315/tlsr2021.32.2.4
    Clove (Syzygium aromaticum) is an exotic culinary spice that has been used for centuries due to its known antimicrobial and antioxidant properties. The main aim of this study is to compare the antimicrobial activity and antioxidant capacity of clove ethanolic extract (CEE) and commercial clove essential oil (CEO) at a standardised eugenol content. Disk diffusion assay showed that CEE (2000 μg) was able to exhibit broad-spectrum inhibition against both Gram negative and Gram positive Urinary Tract Infections (UTIs)-causing pathogens: Proteus mirabilis (19.7 ± 0.6 mm) > Staphylococcus epidermidis (18 mm) > Staphylococcus aureus (14.7 ± 0.6 mm) > Escherichia coli (12.7 ± 0.6 mm) > Klebsiella pneumoniae (12.3 ± 0.6 mm) (according to the size of inhibition zone). Interestingly, the comparison between CEE and commercial CEO revealed that the former demonstrated stronger antimicrobial and antioxidative properties at similar eugenol concentration. The EC50 of DPPH (1,1-diphenyl-2-picrylhydrazyl), ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and reducing power assay for CEE were determined as 0.037 mg/mL, 0.68 mg/mL and 0.44 mg/mL, respectively. Besides eugenol, High Performance Liquid Chromatography (HPLC) analyses identified the presence of kaempferol, gallic acid and catechin in CEE. As a conclusion, we concluded that there was a possible synergistic effect between eugenol and the others active compounds especially kaempferol which led to the observed bioactivities in CEE.
  13. Kwan YP, Teo MHY, Lim JCW, Tan MS, Rosellinny G, Wahli W, et al.
    Cancers (Basel), 2021 Jun 30;13(13).
    PMID: 34208965 DOI: 10.3390/cancers13133279
    Although less common, melanoma is the deadliest form of skin cancer largely due to its highly metastatic nature. Currently, there are limited treatment options for metastatic melanoma and many of them could cause serious side effects. A better understanding of the molecular mechanisms underlying the complex disease pathophysiology of metastatic melanoma may lead to the identification of novel therapeutic targets and facilitate the development of targeted therapeutics. In this study, we investigated the role of leucine-rich α-2-glycoprotein 1 (LRG1) in melanoma development and progression. We first established the association between LRG1 and melanoma in both human patient biopsies and mouse melanoma cell lines and revealed a significant induction of LRG1 expression in metastatic melanoma cells. We then showed no change in tumour cell growth, proliferation, and angiogenesis in the absence of the host Lrg1. On the other hand, there was reduced melanoma cell metastasis to the lungs in Lrg1-deficient mice. This observation was supported by the promoting effect of LRG1 in melanoma cell migration, invasion, and adhesion. Mechanistically, LRG1 mediates melanoma cell invasiveness in an EGFR/STAT3-dependent manner. Taken together, our studies provided compelling evidence that LRG1 is required for melanoma metastasis but not growth. Targeting LRG1 may offer an alternative strategy to control malignant melanoma.
  14. Mou B, Liu Y, Yang W, Song S, Shen C, Lai OM, et al.
    Food Chem, 2021 Dec 01;364:130426.
    PMID: 34175616 DOI: 10.1016/j.foodchem.2021.130426
    Present work investigated the effects of processing (homogenization, sterilization) and cold storage on physicochemical properties, in vitro digestion and Caco-2 cellular uptake of bovine milk. Extreme heat sterilization and low temperature storage have significant impact on particle size and phospholipidome of bovine milk. In addition, cold storage of bovine milks led to formation of β' polymorphs crystals and endothermic peak with Toffset higher than body temperature. Processing and cold storage also increased the initial digestibility but reduced the overall digestibility of bovine milk. This might be related to the decreased particle size of the milk fat globules, changed in the phospholipidome of the MFGM and formation of β' polymorphs crystals in frozen milk. It is interesting to note that PE has relatively faster digestion meanwhile SM has relatively slower digestion. HTST milk which demonstrated lesser changed in terms of phospholipidome demonstrated highest cellular uptakes of most fatty acids.
  15. Sandhu AK, Toh LS, Lee YK, Tan ATB, Ratnasingam J, Thiagarajan N, et al.
    Patient Prefer Adherence, 2021;15:1383-1395.
    PMID: 34188455 DOI: 10.2147/PPA.S314641
    PURPOSE: The English Satisfaction Questionnaire for Osteoporosis Prevention (SQOP) is validated in Malaysia. However, Malay is the national language of Malaysia spoken by the majority of Malaysians. The aim of this study was to cross-culturally adapt and validate the Malay Satisfaction Questionnaire for Osteoporosis Prevention (SQOP-M) in Malaysia.

    PATIENTS AND METHODS: This study was carried out from March to October 2018 at a tertiary hospital in Kuala Lumpur. The SQOP was translated from English to Malay according to international guidelines. Malay-speaking postmenopausal women ≥50 years were recruited and randomized into control and intervention groups. The intervention group received an osteoporosis prevention information booklet and a 15-minute pharmacist counselling session. All patients were asked to answer the SQOP-M questionnaire at baseline and two weeks later. The control group received the intervention after the study was completed.

    RESULTS: Overall, 230/348 patients were recruited (C=115, I=115, response rate=66.1%). Exploratory factor analysis extracted four domains. Cronbach's α ranged from 0.230 to 0.938. Kappa measurement of agreement values ranged from 0.124 to 0.627, where 10/23 (43.5%) items were in moderate to substantial agreement. Wilcoxon signed rank test values were statistically significant (p<0.005) for 4/23 items. Item 17 was an optional question and excluded from analysis. Total satisfaction score was significantly higher for intervention group patients [76.9 (47.6-53.9) vs 50.4 (47.6-53.9), p<0.001] indicating higher satisfaction compared to control group.

    CONCLUSION: The SQOP-M was found to be valid and reliable in assessing patient satisfaction of osteoporosis screening and prevention services provided to Malay-speaking patients in Malaysia.

  16. Shaharudin SM, Ismail S, Hassan NA, Tan ML, Sulaiman NAF
    Front Public Health, 2021;9:604093.
    PMID: 34195166 DOI: 10.3389/fpubh.2021.604093
    Novel coronavirus (COVID-19) was discovered in Wuhan, China in December 2019, and has affected millions of lives worldwide. On 29th April 2020, Malaysia reported more than 5,000 COVID-19 cases; the second highest in the Southeast Asian region after Singapore. Recently, a forecasting model was developed to measure and predict COVID-19 cases in Malaysia on daily basis for the next 10 days using previously-confirmed cases. A Recurrent Forecasting-Singular Spectrum Analysis (RF-SSA) is proposed by establishing L and ET parameters via several tests. The advantage of using this forecasting model is it would discriminate noise in a time series trend and produce significant forecasting results. The RF-SSA model assessment was based on the official COVID-19 data released by the World Health Organization (WHO) to predict daily confirmed cases between 30th April and 31st May, 2020. These results revealed that parameter L = 5 (T/20) for the RF-SSA model was indeed suitable for short-time series outbreak data, while the appropriate number of eigentriples was integral as it influenced the forecasting results. Evidently, the RF-SSA had over-forecasted the cases by 0.36%. This signifies the competence of RF-SSA in predicting the impending number of COVID-19 cases. Nonetheless, an enhanced RF-SSA algorithm should be developed for higher effectivity of capturing any extreme data changes.
  17. Nik Mohamed Kamal NNS, Abdul Aziz FA, Tan WN, Fauzi AN, Lim V
    Molecules, 2021 Jun 09;26(12).
    PMID: 34207699 DOI: 10.3390/molecules26123518
    Pancreatic cancer is an aggressive disease that progresses in a relatively symptom-free manner; thus, is difficult to detect and treat. Essential oil is reported to exhibit pharmacological properties, besides its common and well-known function as aromatherapy. Therefore, this study herein aimed to investigate the anti-proliferative effect of essential oil extracted from leaves of Garcinia atroviridis (EO-L) against PANC-1 human pancreatic cancer cell line. The cell growth inhibitory concentration at 50% (IC50) and selective index (SI) values of EO-L analyses were determined as 78 µg/mL and 1.23, respectively. Combination index (CI) analysis revealed moderate synergism (CI values of 0.36 to 0.75) between EO-L and 2 deoxy-d-glucose (2-DG) treatments. The treatments of PANC-1 cells with EO-L, 2-DG and EOL+2DG showed evidence of depolarization of mitochondrial membrane potential, cell growth arrest and apoptosis. The molecular mechanism causing the anti-proliferative effect between EO-L and 2-DG is potentially through pronounced up-regulation of P53 (4.40-fold), HIF1α (1.92-fold), HK2 (2.88-fold) and down-regulation of CYP3A5 (0.11-fold), as supported by quantitative mRNA expression analysis. Collectively, the current data suggest that the combination of two anti-proliferative agents, EO-L and 2-DG, can potentially be explored as therapeutic treatments and as potentiating agents to conventional therapy against human pancreatic cancer.
  18. Kong BH, Yap CA, Razif MFM, Ng ST, Tan CS, Fung SY
    Food Technol Biotechnol, 2021 Jun;59(2):201-208.
    PMID: 34316281 DOI: 10.17113/ftb.59.02.21.7151
    RESEARCH BACKGROUND: Ophiocordyceps sinensis, a highly valued medicinal fungus, is close to extinction due to overexploitation. Successful cultivation of O. sinensis fruiting body (OCS02®) shows that the cultivar has a promising nutritional value and numerous bioactive compounds. Antioxidant and antiproliferative properties and biologically active proteins of the OCS02® are investigated for possible development into nutraceuticals.

    EXPERIMENTAL APPROACH: The chemical composition of the OCS02® cold water extract was determined, and the antioxidant activities were examined using ferric reducing, DPPH• and O2 •- scavenging assays. Tetrazolium dye (MTT) cytotoxic assay was performed to assess the antiproliferative activity of the extract. Bioactive proteins in the active fraction of the extract were identified using liquid chromatography (LC) and tandem-mass spectrometry (MS/MS).

    RESULTS AND CONCLUSIONS: The OCS02® extract exhibited strong O2 •- scavenging (expressed as Trolox equivalents (18.4±1.1) mol/g) and potent cytotoxic activities against adenocarcinomic human alveolar basal epithelial (A549) cells (IC50=(58.2±6.8) µg/mL). High molecular mass polysaccharides, proteins and protein-polysaccharide complexes could have contributed to the antioxidant and cytotoxic selectivity of the OCS02®. LC-MS/MS analysis identified several potential cytotoxic proteases and an oxalate decarboxylase protein which may exhibit protection effects on kidneys.

    NOVELTY AND SCIENTIFIC CONTRIBUTIONS: The findings demonstrate the potential of OCS02® to be developed into functional food due to its promising superoxide anion radical scavenging capacity, cytotoxic effect and presence of biopharmaceutically active proteins.

  19. Rajendran Royan NR, Leong JS, Chan WN, Tan JR, Shamsuddin ZSB
    Polymers (Basel), 2021 Jul 13;13(14).
    PMID: 34301046 DOI: 10.3390/polym13142289
    As one of the fastest-growing additive manufacturing (AM) technologies, fused deposition modelling (FDM) shows great potential in printing natural fibre-reinforced composites (NFRC). However, several challenges, such as low mechanical properties and difficulty in printing, need to be overcome. Therefore, the effort to improve the NFRC for use in AM has been accelerating in recent years. This review attempts to summarise the current approaches of using NFRC as a feeder for AM. The effects of fibre treatments, composite preparation methods and addition of compatibilizer agents were analysed and discussed. Additionally, current methods of producing feeders from NFRCs were reviewed and discussed. Mechanical property of printed part was also dependent on the printing parameters, and thus the effects of printing temperature, layer height, infill and raster angle were discussed, and the best parameters reported by other researchers were identified. Following that, an overview of the mechanical properties of these composites as reported by various researchers was provided. Next, the use of optimisation techniques for NFRCs was discussed and analysed. Lastly, the review provided a critical discussion on the overall topic, identified all research gaps present in the use of NFRC for AM processes, and to overcome future challenges.
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