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  1. Tan MS, Cheah PL, Chin AV, Looi LM, Chang SW
    Comput Biol Med, 2021 12;139:104947.
    PMID: 34678481 DOI: 10.1016/j.compbiomed.2021.104947
    Alzheimer's Disease (AD) is a neurodegenerative disease that affects cognition and is the most common cause of dementia in the elderly. As the number of elderly individuals increases globally, the incidence and prevalence of AD are expected to increase. At present, AD is diagnosed clinically, according to accepted criteria. The essential elements in the diagnosis of AD include a patients history, a physical examination and neuropsychological testing, in addition to appropriate investigations such as neuroimaging. The omics-based approach is an emerging field of study that may not only aid in the diagnosis of AD but also facilitate the exploration of factors that influence the development of the disease. Omics techniques, including genomics, transcriptomics, proteomics and metabolomics, may reveal the pathways that lead to neuronal death and identify biomolecular markers associated with AD. This will further facilitate an understanding of AD neuropathology. In this review, omics-based approaches that were implemented in studies on AD were assessed from a bioinformatics perspective. Current state-of-the-art statistical and machine learning approaches used in the single omics analysis of AD were compared based on correlations of variants, differential expression, functional analysis and network analysis. This was followed by a review of the approaches used in the integration and analysis of multi-omics of AD. The strengths and limitations of multi-omics analysis methods were explored and the issues and challenges associated with omics studies of AD were highlighted. Lastly, future studies in this area of research were justified.
  2. Rohhimi W, Tan JW, Liew KY, Jacquet A, Harith HH, Israf DA, et al.
    PMID: 34694946 DOI: 10.1080/08923973.2021.1992633
    CONTEXT: The airway epithelial barrier can be disrupted by house dust mite (HDM) allergens leading to allergic airway inflammation. Zerumbone, a natural monocyclic sesquiterpene, was previously found to possess anti-asthmatic effect by modulating Th1/Th2 cytokines. However, the protective role of zerumbone on epithelial barrier function remains to be fully explored.

    OBJECTIVE: To investigate the effect of zerumbone on HDM extract-induced airway epithelial barrier dysfunction.

    MATERIALS AND METHODS: Human bronchial epithelial cells 16HBE14o- were incubated with 100 μg/mL HDM extract and treated with non-cytotoxic concentrations of zerumbone (6.25 μM, 12.5 μM, and 25 μM) for 24 h. The epithelial junctional integrity and permeability were evaluated through transepithelial electrical resistance (TEER) and fluorescein isothiocynate (FITC)-Dextran permeability assays, respectively. The localization of junctional proteins, occludin and zona occludens (ZO)-1, was studied using immunofluorescence (IF) while the protein expression was measured by western blot.

    RESULTS: Zerumbone inhibited changes in junctional integrity (6.25 μM, p ≤ .05; 12.5 μM, p ≤ .001; 25 μM, p ≤ .001) and permeability (6.25 μM, p ≤ .05; 12.5 μM, p ≤ .01; 25 μM, p ≤ .001) triggered by HDM extract in a concentration-dependent manner. This protective effect could be explained by the preservation of occludin (12.5 μM, p ≤ .01 and 25 μM, p ≤ .001) and ZO-1 (12.5 μM, p ≤ .05 and 25 μM, p ≤ .001) localization, rather than the prevention of their cleavage.

    DISCUSSION AND CONCLUSION: Zerumbone attenuates HDM extract-induced epithelial barrier dysfunction which supports its potential application for the treatment of inflammation-driven airway diseases such as asthma.

  3. Goh GS, Yue WM, Guo CM, Tan SB, Chen JL
    Clin Spine Surg, 2021 Mar 01;34(2):66-72.
    PMID: 33633059 DOI: 10.1097/BSD.0000000000001020
    STUDY DESIGN: This study carried out a retrospective review of prospectively collected registry data.

    OBJECTIVE: This study aimed to determine whether (1) utilization rates; (2) demographics and preoperative statuses; and (3) clinical outcomes differ among Chinese, Malays, and Indians undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

    SUMMARY OF BACKGROUND DATA: There is a marked racial disparity in spine surgery outcomes between white and African American patients. Comparative studies of ethnicity have mostly been carried out in American populations, with an underrepresentation of Asian ethnic groups. It is unclear whether these disparities exist among Chinese, Malays, and Indians.

    METHODS: A prospectively maintained registry was reviewed for 753 patients who underwent primary MIS-TLIF for degenerative spondylolisthesis between 2006 and 2013. The cohort was stratified by race. Comparisons of demographics, functional outcomes, and patient satisfaction were performed preoperatively and 1 month, 3 months, 6 months, and 2 years postoperatively.

    RESULTS: Compared with population statistics, there was an overrepresentation of Chinese (6.6%) and an underrepresentation of Malays (5.0%) and Indians (3.5%) who underwent MIS-TLIF. Malays and Indians were younger and had higher body mass index at the time of surgery compared with Chinese. After adjusting for age, sex, and body mass index, Malays had significantly worse back pain and Indians had poorer Short-Form 36 Physical Component Summary compared with Chinese preoperatively. Chinese also had a better preoperative Oswestry Disability Index compared with the other races. Although significant differences remained at 1 month, there was no difference in outcomes up to 2 years postoperatively, except for a lower Physical Component Summary in Indians compared with Chinese at 2 years. The rate of minimal clinically important difference attainment, satisfaction, and expectation fulfillment was also comparable. At 2 years, 87.0% of Chinese, 76.9% of Malays, and 91.7% of Indians were satisfied.

    CONCLUSION: The variations in demographics, preoperative statuses, and postoperative outcomes between races should be considered when interpreting outcome studies of lumbar spine surgery in Asian populations.

    LEVEL OF EVIDENCE: Level III-nonrandomized cohort study.

  4. Tan FHP, Hadri NAB, Najimudin N, Watanabe N, Azzam G
    Geriatr Gerontol Int, 2021 Dec;21(12):1125-1130.
    PMID: 34699118 DOI: 10.1111/ggi.14296
    AIM: Alzheimer's disease (AD) is the most pervasive neurodegenerative disorder in societies globally. Till now, the mechanism behind this disease is still equivocal. Amyloid-beta42 protein (Aβ42), the most toxic and aggressive Aβ species, is the main focus of this study. The naturally occurring ethyl caffeate (EC) is associated with various medicinal properties. Here, EC was tested for its protective properties against Aβ42's toxic effects.

    METHODS: As treatment of Aβ42 has been shown to cause neuronal cell death, EC was first screened with Aβ42-incubated PC12 neuronal cells. Next, the compound was tested on the Drosophila melanogaster AD model using the rough eye phenotype assay, lifespan assay and negative geotaxis assay.

    RESULTS: EC ameliorated PC12 cells from cell death linked to Aβ42 exposure. Using Drosophila expressing human Aβ42, feeding of EC was able to partially rescue the rough eye phenotype, lengthen the lifespan of AD Drosophila and enhanced the mobility of middle-aged AD Drosophila.

    CONCLUSION: Overall, the results of this study showed that EC might possess therapeutic properties for AD. Geriatr Gerontol Int 2021; 21: 1125-1130.

  5. Li G, Lee WJ, Tan CP, Lai OM, Wang Y, Qiu C
    Food Funct, 2021 Nov 29;12(23):11732-11746.
    PMID: 34698749 DOI: 10.1039/d1fo01883c
    Pickering water-in-oil (W/O) emulsions were fabricated by using medium-long chain diacylglycerol (MLCD)-based solid lipid nanoparticles (SLNs) and the connection between the characteristics of the SLNs and the colloidal stability of the emulsions was established. Via melt-emulsification and ultrasonication, MLCD-based SLNs with particle sizes of 120-300 nm were obtained with or without other surfactants. The particle size of the SLNs was influenced by the chemical properties of the surfactants, and surfactants decreased the contact angle of SLNs at the oil-water interface. Gelation was observed in SLNs modified by sodium stearoyl lactylate and lecithin, whereas the addition of Tween 20 resulted in a homogeneous SLN solution. The adsorption of surfactants onto SLN surfaces caused the production of higher amounts of α crystals accompanied by delayed crystallization onset which contributed to the reduction of particle size, interfacial tension and oil wetting ability. The W/O emulsions with higher rigidity and physical stability can be obtained by varying surfactant types and by increasing SLN mass ratios to 60%, whereby more SLNs are adsorbed at the droplet surface as a Pickering stabilizer. This study provides useful insights for the development of diacylglycerol-based SLNs and Pickering W/O emulsions which have great potential for food, cosmetic and pharmaceutical applications.
  6. Guo M, Tan CL, Wu L, Peng J, Ren R, Chiu CH
    PMID: 34682476 DOI: 10.3390/ijerph182010729
    With the development of the network economy, especially the promotion and popularization of mobile networks, traditional offline businesses are further integrated with online businesses, promoting the development of business online strategies. However, with the growth of enterprises' business, their negative externalities on the environment have gradually become prominent, further affecting sustainable consumption. The relationships between businesses, the environment, and consumption have become the focus of attention. China's fast-growing bottled water companies face similar challenges. The pollution that occurs due to bottled water packaging poses great threats to consumers. Hence, this study extended the Theory of Planned Behavior (TPB) by integrating three risk aspects, namely, water pollution risk perception (WPRP), non-degradable package pollution risk perception (NPPRP), and false information risk perception (FIRP), to examine the consumers' perceptions toward these risk aspects before purchasing bottled water online. This study employed a cross-sectional approach to collect data from online consumers via a survey method. A total of 401 valid samples were collected and then analyzed via a structural equation model using the AMOS statistical package. The results showed that attitude (AT), subjective norm (SN), and perceived behavior control (PBC) toward online bottled water purchase had significant and positive effects on the consumers' purchase intentions (PIs). However, under the influence of risk perception, the consumers' attitudes, SNs and PBC became suppressed by WPRP, and SN became suppressed due to the impact of FIRP. Furthermore, the negative impacts of NPPRP and FIRP on PI were partially mediated by AT, SN and PBC. Meanwhile, WPRP imposed the most significant direct effect on PI. The study results will help businesses to develop better online strategies to reduce the risk perception of bottled water and provide theoretical value and practical guidance for realizing sustainable consumption.
  7. Liu H, Gu H, Kutbi EH, Tan SC, Low TY, Zhang C
    Int J Clin Pract, 2021 Nov;75(11):e14764.
    PMID: 34469629 DOI: 10.1111/ijcp.14764
    PURPOSE: Many studies have investigated the association between serum IGF-1 and IGFBP levels with gastric cancer (GC), but the results remained inconclusive. In this work, we performed a systematic review and meta-analysis to examine the precise association of serum levels of IGF-1 and IGFBP with GC.

    METHODS: A comprehensive systematic search was carried out in PubMed/MEDLINE, SCOPUS, Web of Science, and EMBASE databases for (nested) case-control studies that reported the levels of IGF-1 and IGFBP in GC cases and healthy controls, from inception until October 2020. Weighted mean difference (WMD) was calculated for estimating combined effect size. Subgroup analysis was performed to identify the source of heterogeneity among studies.

    RESULTS: We found eight and five eligible studies (with 1541 participants) which provided data for IGF-1 and IGFBP, respectively. All studies on IGFBP reported the IGFBP-3 isoform. The pooled results indicate that GC patients had significantly lower serum IGF-1 [WMD = -26.21 ng/mL (95% CI, -45.58 to -6.85; P = .008)] and IGFBP-3 [WMD = -0.41 ng/mL (95% CI, -0.80 to -0.01; P = .04; I2  = 89.9%; P 

  8. Buhari AM, Ooi CP, Baskaran VM, Phan RCW, Wong K, Tan WH
    J Imaging, 2020 Nov 30;6(12).
    PMID: 34460527 DOI: 10.3390/jimaging6120130
    Several studies on micro-expression recognition have contributed mainly to accuracy improvement. However, the computational complexity receives lesser attention comparatively and therefore increases the cost of micro-expression recognition for real-time application. In addition, majority of the existing approaches required at least two frames (i.e., onset and apex frames) to compute features of every sample. This paper puts forward new facial graph features based on 68-point landmarks using Facial Action Coding System (FACS). The proposed feature extraction technique (FACS-based graph features) utilizes facial landmark points to compute graph for different Action Units (AUs), where the measured distance and gradient of every segment within an AU graph is presented as feature. Moreover, the proposed technique processes ME recognition based on single input frame sample. Results indicate that the proposed FACS-baed graph features achieve up to 87.33% of recognition accuracy with F1-score of 0.87 using leave one subject out cross-validation on SAMM datasets. Besides, the proposed technique computes features at the speed of 2 ms per sample on Xeon Processor E5-2650 machine.
  9. Tan H, Wong KY, Nyakuma BB, Kamar HM, Chong WT, Wong SL, et al.
    Environ Sci Pollut Res Int, 2022 Jan;29(5):6710-6721.
    PMID: 34458973 DOI: 10.1007/s11356-021-16171-9
    In this study, a systematic procedure for establishing the relationship between particulate matter (PM) and microbial counts in four operating rooms (ORs) was developed. The ORs are located in a private hospital on the western coast of Peninsular Malaysia. The objective of developing the systematic procedure is to ensure that the correlation between the PMs and microbial counts are valid. Each of the procedures is conducted based on the ISO, IEST, and NEBB standards. The procedures involved verifying the operating parameters are air change rate, room differential pressure, relative humidity, and air temperature. Upon verifying that the OR parameters are in the recommended operating range, the measurements of the PMs and sampling of the microbes were conducted. The TSI 9510-02 particle counter was used to measure three different sizes of PMs: PM 0.5, PM 5, and PM 10. The MAS-100ECO air sampler was used to quantify the microbial counts. The present study confirms that PM 0.5 does not have an apparent positive correlation with the microbial count. However, the evident correlation of 7% and 15% were identified for both PM 5 and PM 10, respectively. Therefore, it is suggested that frequent monitoring of both PM 5 and PM 10 should be practised in an OR before each surgical procedure. This correlation approach could provide an instantaneous estimation of the microbial counts present in the OR.
  10. Ahmedy F, Mohd Tuah N, Mohamad Hashim N, Sybil Shah S, Ahmedy I, Tan SF
    J Multidiscip Healthc, 2021;14:2391-2396.
    PMID: 34511922 DOI: 10.2147/JMDH.S320543
    Purpose: To collectively identify the clinical characteristics determining the risk of developing spasticity after stroke.

    Patients and Methods: A cross-sectional study was conducted at a single rehabilitation outpatient clinic from June to December 2019. Inclusion criteria were stroke duration of over four weeks, aged 18 years and above. Exclusion criteria were presence of concurrent conditions other than stroke that could also lead to spasticity. Recruited patients were divided into "Spasticity" and "No spasticity" groups. Univariate analysis was deployed to identify significant predictive spasticity factors between the two groups followed by a two-step clustering approach for determining group of characteristics that collectively contributes to the risk of developing spasticity in the "Spasticity" group.

    Results: A total of 216 post-stroke participants were recruited. The duration after stroke (p < 0.001) and the absence of hemisensory loss (p = 0.042) were two significant factors in the "Spasticity" group revealed by the univariate analysis. From a total of 98 participants with spasticity, the largest cluster of individuals (40 patients, 40.8%) was those within less than 20 months after stroke with moderate stroke and absence of hemisensory loss, while the smallest cluster was those within less than 20 months after severe stroke and absence of hemisensory loss (21 patients, 21.4%).

    Conclusion: Analyzing collectively the significant factors of developing spasticity may have the potential to be more clinically relevant in a heterogeneous post-stroke population that may assist in the spasticity management and treatment.

  11. Tan TH, Wong TH, Khoo CH, Mahaletchumy T, Ng CS, Ghazali MW
    Med J Malaysia, 2021 09;76(5):685-690.
    PMID: 34508375
    Over the past decade, 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PETCT) has emerged as an important imaging modality in the management of lymphoma. Since the introduction of Deauville scoring system (2009) and the Lymphoma Response Assessment Criteria (2014), clinicians are now sharing a common language in the management of lymphoma. In Malaysia, nearly a third of PET-CT request is related to lymphoma imaging. Though there are extensive publications regarding these scoring systems and assessment criteria for lymphoma, there are hardly any literature on the reporting format for the 18F-FDG PET-CT in this disease. The variable reporting formats have on many occasions caused confusion not only to the referring clinicians but also to nuclear medicine physicians. Thus, a working committee comprising experienced nuclear medicine physicians and haematologists in Malaysia have agreed and made a joint recommendation on the standard reporting format for 18F-FDG PET-CT in Lymphoma. This recommendation will minimize inter-observer discrepancies in reporting, facilitate the understanding of the report of the referring clinicians as well as facilitate counseling between patients and clinicians in the management of the disease.
  12. Tan TL, Chiew SC, Laang ST, Umabalan, Khor SH, Lee LY
    Med J Malaysia, 2021 09;76(5):630-636.
    PMID: 34508367
    INTRODUCTION: Pseudomonas aeruginosa is known to be the epitome of nosocomial infections associated with high morbidity and mortality. The dearth of local pseudomonal studies has prompted us to conduct this study with the following objectives: (1) to examine the local pseudomonal bacteraemia (PB) epidemiology and clinical characteristics, (2) to compare the 30-day mortality among PB of different onsets and (3) to determine the predictors of 30-day mortality outcome.

    METHODS: This retrospective study was conducted in Hospital Seri Manjung, Perak, Malaysia. All cases of blood culture proven PB that occurred between 1st January 2015 and 31st December 2019 were reviewed. Subjects below 12 year old and whose index blood cultures grew more than one organism were excluded. Demographic, clinical and treatment data were collected using pre-tested data collection forms and analysed using SPSS version 20.0.

    RESULTS: Among the 59 subjects included, healthcare associated (HCA) infections were the most prevalent, next to hospital onset (HO) and community onset (CO) infections. The commonest underlying comorbidities were cardiovascular disease, diabetes mellitus, and chronic kidney disease. Respiratory tract was the most frequently implicated source amongst all, while the urinary tract was more frequently implicated as the source of infection among HCA cases. Seventeen patients were admitted to ICU, and they were predominantly from the HO group. Despite having a higher rate of adequate empirical antibiotics administered, the HO group reported the lowest 30-day survival rate. Multiple logistic regression analysis demonstrated the following were independent predictors of 30-day mortality: requiring mechanical ventilator support, requiring central venous line insertion, not requiring surgery, and receiving inappropriate definite antibiotics.

    CONCLUSION: The incidence of community onset PB was appreciably low, as cases were predominantly HCA and HO in origin. Significant morbidities were observed among pseudomonal infections, with HO infections portending the worst prognosis. Lastly, prognostic factors for determining the mortality caused by PB depended more on the severity of sepsis than the timeliness of appropriate antibiotics.

  13. Yoon TL, Yeap ZQ, Tan CS, Chen Y, Chen J, Yam MF
    PMID: 34627017 DOI: 10.1016/j.saa.2021.120440
    A proof-of-concept medicinal herbs identification scheme using machine learning classifiers is proposed in the form of an automated computational package. The scheme makes use of two-dimensional correlation Fourier Transformed Infrared (FTIR) fingerprinting maps derived from the FTIR of raw herb spectra as digital input. The prototype package admits a collection of 11 machine learning classifiers to form a voting pool. A common set of oversampled dataset containing 5 different herbal classes is used to train the pool of classifiers on a one-verses-others manner. The collections of trained models, dubbed the voting classifiers, are deployed in a collective manner to cast their votes to support or against a given inference fingerprint whether it belongs to a particular class. By collecting the votes casted by all voting classifiers, a logically designed scoring system will select out the most probable guess of the identity of the inference fingerprint. The same scoring system is also capable of discriminating an inference fingerprint that does not belong to any of the classes the voting classifiers are trained for as the 'others' type. The proposed classification scheme is stress-tested to evaluate its performance and expected consistency. Our experimental runs show that, by and large, a satisfactory performance of the classification scheme of up to 90 % accuracy is achieved, providing a proof-of-concept viability that the proposed scheme is a feasible, practical, and convenient tool for herbal classification. The scheme is implemented in the form of a packaged Python code, dubbed the "Collective Voting" (CV) package, which is easily scalable, maintained and used in practice.
  14. Chan YF, Sam IC, Nayan E, Tan XH, Yogarajah T
    J Med Virol, 2021 Oct 07.
    PMID: 34617599 DOI: 10.1002/jmv.27381
    Enterovirus D68 (EV-D68) is an emerging respiratory pathogen since the 2014 outbreak in USA. A low level of virus circulation has been reported in Kuala Lumpur, Malaysia in the past. However, the extent of the infection in Malaysia is not known. In the present study, we determine the seroepidemiology of EV-D68 in Kuala Lumpur, Malaysia before and after the USA outbreak in Aug 2014. A luciferase-based seroneutralization test was developed using a clone-derived prototype Fermon strain carrying a nanoluciferase marker. We screened the neutralization capacity of 450 serum samples from children and adults (1-89 years old) collected between 2013 to 2015. EV-D68 seropositivity increased with age, with children aged 1-3 showing significantly lower seroprevalence compared to adults. Multivariate analysis showed that older age groups 13-49 years (odds ratio [OR] 4.78 [95% CI 2.69-8.49], p<0.0001) and >50 years (OR 3.83 [95% CI 2.19-6.68], p<0.0001) were more likely to be EV-D68 seropositive than children <13 years. Sampling post-Sept 2014 compared to pre-Sept 2014 also predicted seropositivity (OR 1.66 [95% CI 1.04-2.65]). Presence of neutralizing antibodies against EV-D68 in the study population suggests that EV-D68 was circulating prior to 2014. A higher seropositivity post-Sept 2014 suggests that Malaysia also experienced an upsurge in EV-D68 infections after the USA outbreaks in Aug 2014. A low seropositivity rate observed in children, especially those aged 1-3 years old, suggests that they are at risk and should be prioritized for future vaccination. This article is protected by copyright. All rights reserved.
  15. Rohizat NS, Ripain AHA, Lim CS, Tan CL, Zakaria R
    Sci Rep, 2021 Oct 04;11(1):19688.
    PMID: 34608217 DOI: 10.1038/s41598-021-99189-w
    Hybrids plasmonic nanoparticles (NPs) and unique 2D graphene significantly enhanced the photoresponse of the photodetectors. The metallic NPs that exhibit localized surface plasmon resonance (LSPR) improves strong light absorption, scattering and localized electromagnetic field by the incident photons depending on the optimum condition of NPs. We report high-performance photodetectors based on reduced graphene oxide (rGO) integrated with monometallic of Au and Ag nanoparticles via a familiar fabrication technique using an electron beam evaporation machine. Under 680 nm illumination of light, our rGO photodetector exhibited the highest performance for Au-rGO with the highest responsivity of 67.46 AW-1 and the highest specific detectivity (2.39 × 1013 Jones). Meanwhile, Ag-rGO achieved the highest responsivity of 17.23 AW-1, specific detectivity (7.17 × 1011 Jones) at 785 nm. The response time are 0.146 µs and 0.135 µs for Au-rGO and Ag-rGO respectively for both wavelengths. The proposed photodetector with combining monometallic and graphene provide a new strategy to construct reliable and next-generation optoelectronic devices at VIS-NIR region.
  16. Lee SL, Ong TJ, Mazlan-Kepli W, Mageswaran A, Tan KH, Abd-Malek AM, et al.
    World J Cardiol, 2021 Sep 26;13(9):483-492.
    PMID: 34621493 DOI: 10.4330/wjc.v13.i9.483
    BACKGROUND: The quality of warfarin therapy can be determined by the time in the therapeutic range (TTR) of international normalized ratio (INR). The estimated minimum TTR needed to achieve a benefit from warfarin therapy is ≥ 60%.

    AIM: To determine TTR and the predictors of poor TTR among atrial fibrillation patients who receive warfarin therapy.

    METHODS: A retrospective observational study was conducted at a cardiology referral center in Selangor, Malaysia. A total of 420 patients with atrial fibrillation and under follow-up at the pharmacist led Warfarin Medication Therapeutic Adherence Clinic between January 2014 and December 2018 were included. Patients' clinical data, information related to warfarin therapy, and INR readings were traced through electronic Hospital Information system. A data collection form was used for data collection. The percentage of days when INR was within range was calculated using the Rosendaal method. The poor INR control category was defined as a TTR < 60%. Predictors for poor TTR were further determined by using logistic regression.

    RESULTS: A total of 420 patients [54.0% male; mean age 65.7 (10.9) years] were included. The calculated mean and median TTR were 60.6% ± 20.6% and 64% (interquartile range 48%-75%), respectively. Of the included patients, 57.6% (n = 242) were in the good control category and 42.4% (n = 178) were in the poor control category. The annual calculated mean TTR between the year 2014 and 2018 ranged from 59.7% and 67.3%. A high HAS-BLED score of ≥ 3 was associated with poor TTR (adjusted odds ratio, 2.525; 95% confidence interval: 1.6-3.9, P < 0.001).

    CONCLUSION: In our population, a high HAS-BLED score was associated with poor TTR. This could provide an important insight when initiating an oral anticoagulant for these patients. Patients with a high HAS-BLED score may obtain less benefit from warfarin therapy and should be considered for other available oral anticoagulants for maximum benefit.

  17. Mat S, Tan MP, Mohktar MS, Kamaruzzaman SB, Ibrahim F
    Eur J Clin Nutr, 2021 Oct 07.
    PMID: 34620997 DOI: 10.1038/s41430-021-01020-2
    OBJECTIVE: To evaluate the role of PhA in diabetes in a large population of older adults with a high prevalence of diabetes in order to gain new insights on the potential diagnostic and prognostic role of PhA in individuals with diabetes.

    DESIGN: Cross-sectional study.

    SETTING: Teaching Hospital.

    PARTICIPANTS: 1085 individuals aged 55 years or over.

    MEASUREMENTS: Phase Angle was obtained using bioimpedance analysis with the Bodystat QuadScan® 4000. Diabetes mellitus was considered present with fasting hyperglycaemia (serum fasting glucose >6.66 mmol/l), HbA1c > 42 mmol/mol (6.1%), or self-reported Diabetes or the consumption of glucose-lowering agents.

    RESULTS: The mean age of the (standard deviation) of the 1,085 participants was 68.11 (7.12) years and 60.7% were women. Among male participants, individuals with PhA within the lowest quartile (PhA ≤4.9) were significantly more likely to have diabetes mellitus [odds Ratio (95% confidence interval, CI), 2.02 (1.17-3.47)] following adjustments for age, body mass index and other comorbidities. The above relationship was attenuated following further adjustment hypoglycaemic medications. Men on oral hypoglycaemic agents had significantly reduced PhA [mean difference (95% CI), -0.44 (-0.67 to -0.22)]. No significant relationship between PhA and diabetes existed among women.

    CONCLUSION: The association between lower PhA (≤4.9) in men aged 55 and over and diabetes which is accounted for by oral hypoglycaemic agents. The mechanisms underlying this relationship remain unclear. This relationship should also be evaluated further to determine the potential of PhA as a prognostic tool for diabetes.

  18. Khaw YS, Tan HT, Sopawong A, Shaharuddin NA, Omar AR, Yusoff FM
    Biology (Basel), 2021 Aug 19;10(8).
    PMID: 34440031 DOI: 10.3390/biology10080799
    Microalgal biomass is one of the crucial criteria in microalgal studies. Many reported methods, even the well-established protocol on microalgal dry weight (DW) determination, vary greatly, and reliable comparative assessment amongst published results could be problematic. This study aimed to determine the best condition of critical parameters in marine microalgal DW determination for laboratory-scale culture using four different marine microalgal species. These parameters included the washing process, grades of glass microfiber filter (GMF), GMF pretreatment conditions, washing agent (ammonium formate) concentrations, culture: washing agent ratios (v:v) and washing cycles. GMF grade GF/A with precombustion at 450 °C provided the most satisfactory DW and the highest ash-free dry weight (AFDW)/DW ratio. Furthermore, 0.05 M ammonium formate with 1:2 culture: washing agent ratio and a minimum of two washing cycles appeared to be the best settings of microalgal DW determination. The present treatment increased the AFDW/DW ratio of the four respective microalgae by a minimum of 19%. The findings of this study could serve as a pivotal reference in developing a standardized protocol of marine microalgal DW determination to obtain veracious and reliable marine microalgal DW.
  19. Ang CW, Tan L, Qu Z, West NP, Cooper MA, Popat A, et al.
    ACS Biomater Sci Eng, 2022 Oct 10;8(10):4196-4206.
    PMID: 34464089 DOI: 10.1021/acsbiomaterials.1c00807
    Pretomanid and MCC7433, a novel nitroimidazopyrazinone analog, are promising antitubercular agents that belong to the bicyclic nitroimidazole family. Despite possessing high cell permeability, they suffer from poor aqueous solubility and require specialized formulations in order to be orally bioavailable. To address this limitation, we investigated the use of mesoporous silica nanoparticles (MCM-41) as drug carriers. MCM-41 nanoparticles were synthesized using a sol-gel method, and their surface was further modified with amine and phosphonate groups. A simple rotary evaporation method was used to incorporate the compounds of interest into the nanoparticles, leading to a high encapsulation efficiency of ≥86% with ∼10% loading (w/w). An overall significant improvement of solubility was also observed, and the pharmacological activity of pretomanid and MCC7433 was fully retained when tested in vitro against Mycobacterium tuberculosis using these nanocarriers. Amino-functionalized MCM-41 nanoparticles were found to enhance the systemic exposure of MCC7433 in mice (1.3-fold higher Cmax) compared to MCC7433 alone. The current work highlights the potential of using nanoparticles such as mesoporous silica as a carrier for oral delivery of poorly soluble antibacterial agents against tuberculosis.
  20. Tan HY, Goh ZY, Loh KH, Then AY, Omar H, Chang SW
    PeerJ, 2021;9:e11825.
    PMID: 34434645 DOI: 10.7717/peerj.11825
    Background: Despite the high commercial fisheries value and ecological importance as prey item for higher marine predators, very limited taxonomic work has been done on cephalopods in Malaysia. Due to the soft-bodied nature of cephalopods, the identification of cephalopod species based on the beak hard parts can be more reliable and useful than conventional body morphology. Since the traditional method for species classification was time-consuming, this study aimed to develop an automated identification model that can identify cephalopod species based on beak images.

    Methods: A total of 174 samples of seven cephalopod species were collected from the west coast of Peninsular Malaysia. Both upper and lower beaks were extracted from the samples and the left lateral views of upper and lower beak images were acquired. Three types of traditional morphometric features were extracted namely grey histogram of oriented gradient (HOG), colour HOG, and morphological shape descriptor (MSD). In addition, deep features were extracted by using three pre-trained convolutional neural networks (CNN) models which are VGG19, InceptionV3, and Resnet50. Eight machine learning approaches were used in the classification step and compared for model performance.

    Results: The results showed that the Artificial Neural Network (ANN) model achieved the best testing accuracy of 91.14%, using the deep features extracted from the VGG19 model from lower beak images. The results indicated that the deep features were more accurate than the traditional features in highlighting morphometric differences from the beak images of cephalopod species. In addition, the use of lower beaks of cephalopod species provided better results compared to the upper beaks, suggesting that the lower beaks possess more significant morphological differences between the studied cephalopod species. Future works should include more cephalopod species and sample size to enhance the identification accuracy and comprehensiveness of the developed model.

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