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  1. Between the devil and the deep blue sea: Trends, drivers, and impacts of coastal reclamation in Malaysia and way forward
    Chee SY, Tan ML, Tew YL, Sim YK, Yee JC, Chong AKM
    Sci Total Environ, 2023 Feb 01;858(Pt 2):159889.
    PMID: 36328260 DOI: 10.1016/j.scitotenv.2022.159889
    Cities all over the world are edging further into the ocean. Coastal reclamation is a global conservation issue with implications for ocean life, ecosystems, and human well-being. Using Malaysia as a case study, the coastal reclamation trends over three decades (1991-2021) were mapped using Landsat images and Normalized Difference Water Index (NDWI) via the Google Earth Engine platform. The changes in drivers and impacts of these coastal expansions throughout the decades were also reviewed. Twelve out of the 14 states in Malaysia had planned, active, or completed reclamations on their shorelines. Between 1991 and 2021, an absolute area of 82.64 km2 has been or will be reclaimed should all the projects be completed. The most reported driver for coastal expansion in Malaysia is for development and modernization (41 %), followed by rise in human population (20 %), monetary gains from the development of prime land (15 %), and agriculture and aquaculture activities (9 %). Drivers such as reduction of construction costs, financial advantage of prime land, oil and gas, advancement of technology, and tourism (Malaysia My Second Home (MM2H)) had only started occurring within the last decade, while others have been documented since the 1990's. Pollution is the most reported impact (24 %) followed by disruption of livelihoods, sources of income and human well-being (21 %), destruction of natural habitats (17 %), decrease in biodiversity (11 %), changes in landscapes (10 %), erosion / accretion (8 %), threat to tourism industry (6 %), and exposure to wave surges (3 %). Of these, changes in landscape, shoreline alignment, seabed contour, and coastal groundwater, as well as wave surges had only started to surface as impacts in the last two decades. Efforts to protect existing natural coastal and marine ecosystems, restore degraded ones, and fund endeavours that emphasize nature is needed to support sustainable development goals for the benefit of future generations.
  2. Newly regenerated dopaminergic neurons in 6-OHDA-lesioned adult zebrafish brain proliferate in the Olfactory bulb and telencephalon, but migrate to, differentiate and mature in the diencephalon
    Vijayanathan Y, Hamzah NM, Lim SM, Lim FT, Tan MP, Majeed ABA, et al.
    Brain Res Bull, 2022 Nov;190:218-233.
    PMID: 36228872 DOI: 10.1016/j.brainresbull.2022.10.001
    In order to understand the biological processes underlying dopaminergic neurons (DpN) regeneration in a 6-hydroxydopamine(6-OHDA)-induced adult zebrafish-based Parkinson's disease model, this study investigated the specific phases of neuroregeneration in a time-based manner. Bromodeoxyuridine (BrdU) was administered 24 h before the harvest of brain tissues at day three, five, seven, nine, 12 and 14 postlesion. Potential migration of proliferative cells was tracked over 14 days postlesion through double-pulse tracking [BrdU and 5-ethynyl-2'-deoxyuridine (EdU)] of cells and immunohistostaining of astrocytes [glial fibrillary acidic protein (GFAP)]. Gene expression of foxa2 and nurr1 (nr4a2a) at day three, nine, 14, 18, 22 and 30 postlesion was quantified using qPCR. Protein expression of foxa2 at day three, seven, 14 and 22 postlesion was validated using the western blot technique. Double labelling [EdU and tyrosine hydroxylase (TH)] of proliferative cells was performed to ascertain their fate after the neuroregeneration processes. It was found that whilst cell proliferation remained unchanged in the area of substantial DpN loss, the ventral diencephalon (vDn), there was a transient increase of cell proliferation in the olfactory bulb (OB) and telencephalon (Tel) seven days postlesion. BrdU-immunoreactive (ir)/ EdU-ir cells and activated astrocytes were later found to be significantly increased in the vDn and its nearby area (Tel) 14 days postlesion. There was a significant but transient downregulation of foxa2 at day three and nine postlesion, and nr4a2a at day three, nine and 14 postlesion. The expression of both genes remained unchanged in the OB and Tel. There was a transient downregulation of foxa2 protein expression at day three and seven postlesion. The significant increase of EdU-ir/ TH-ir cells in the vDn 30 days postlesion indicates maturation of proliferative cells (formed between day five-seven postlesion) into DpN. The present findings warrant future investigation of critical factors that govern the distinctive phases of DpN regeneration.
  3. Fulltext Distinct gut microbiota composition among older adults with myocardial ageing
    Wong JJ, Purbojati RW, Tan RS, Pettersson S, Koh AS
    ESC Heart Fail, 2022 Dec;9(6):4366-4368.
    PMID: 36071622 DOI: 10.1002/ehf2.14139
  4. Fulltext Editorial: Model-informed drug development and evidence-based translational pharmacology
    Zhao J, Zhu X, Tan S, Chen C, Kaddoumi A, Guo XL, et al.
    Front Pharmacol, 2022;13:1086551.
    PMID: 36578539 DOI: 10.3389/fphar.2022.1086551
  5. Fulltext Does culture moderate the relationships between rumination and symptoms of posttraumatic stress disorder and depression?
    Li H, Lee B, Reyneke T, Haque S, Abdullah SZ, Tan BKW, et al.
    PLoS One, 2022;17(11):e0278328.
    PMID: 36445879 DOI: 10.1371/journal.pone.0278328
    Brooding rumination is positively associated with symptoms of both depression and posttraumatic stress disorder (PTSD). However, non-clinical cross-cultural research indicates that culture may influence these associations. This study aimed to examine the moderating effect of cultural group (Australian versus Malaysian) on the associations between brooding rumination and symptoms of depression and PTSD. European Australians (n = 109) and Malaysians of varying Asian heritages (n = 144) completed an online questionnaire containing the Hospital Anxiety and Depression Scale, PTSD checklist for DSM-5 and the Ruminative Response Scale-Short Form. First, Malaysian participants had higher brooding rumination than Australian participants. Second, higher levels of brooding rumination were positively associated with depression and PTSD symptom severity. Third, contrary to our expectations, cultural group did not moderate the relationships between brooding rumination and symptoms of depression and PTSD. If replicable, these results suggest that existing assessment and treatment approaches that target brooding rumination may apply to Malaysian individuals with depression and PTSD.
  6. Fulltext Development of an effective clustering algorithm for older fallers
    Goh CH, Wong KK, Tan MP, Ng SC, Chuah YD, Kwan BH
    PLoS One, 2022;17(11):e0277966.
    PMID: 36441703 DOI: 10.1371/journal.pone.0277966
    Falls are common and often lead to serious physical and psychological consequences for older persons. The occurrence of falls are usually attributed to the interaction between multiple risk factors. The clinical evaluation of falls risks is time-consuming as a result, hence limiting its availability. The purpose of this study was, therefore, to develop a clustering-based algorithm to determine falls risk. Data from the Malaysian Elders Longitudinal Research (MELoR), comprising 1411 subjects aged ≥55 years, were utilized. The proposed algorithm was developed through the stages of: data pre-processing, feature identification and extraction with either t-Distributed Stochastic Neighbour Embedding (t-SNE) or principal component analysis (PCA)), clustering (K-means clustering, Hierarchical clustering, and Fuzzy C-means clustering) and characteristics interpretation with statistical analysis. A total of 1279 subjects and 9 variables were selected for clustering after the data pre-possessing stage. Using feature extraction with the t-SNE and the K-means clustering algorithm, subjects were clustered into low, intermediate A, intermediate B and high fall risk groups which corresponded with fall occurrence of 13%, 19%, 21% and 31% respectively. Slower gait, poorer balance, weaker muscle strength, presence of cardiovascular disorder, poorer cognitive performance, and advancing age were the key variables identified. The proposed fall risk clustering algorithm grouped the subjects according to features. Such a tool could serve as a case identification or clinical decision support tool for clinical practice to enhance access to falls prevention efforts.
  7. Fulltext First Report of Curvularia lunata Causing Leaf Spot on Oryza sativa in Sabah, Malaysian Borneo
    Khoo YW, Rosina B, Amiruddin S, Tan HT, Khaw YS, Li S, et al.
    Plant Dis, 2022 Dec 21.
    PMID: 36541883 DOI: 10.1094/PDIS-08-22-1939-PDN
    Rice (Oryza sativa L.) has been farmed in Malaysia since ancient times and is one of the most important commercial crops (Ma'arup et al. 2020). Throughout January to August 2022, chlorotic spots with brown halos ranging 2 to 10 mm wide were found on upper leaves of rice variety Mahsuri in the vegetative stage with a severity and incidence of approximately 60% and 100%, respectively in Kampung Tagas, Sabah, Malaysian Borneo (06°09'41.8"N, 116°13'45.1"E). As the disease developed, the spots coalesced into larger chlorotic spots. Three leaf pieces (5 x 5 mm) were excised from lesion margins, surface sterilized based on Khoo et al. (2022a), before plating on water agar (WA) at 25°C. Purification of fungi was conducted on WA using hyphal tip isolation. When three pure cultures were obtained, the fungi were cultured on potato dextrose agar (PDA) and WA for 7 days in 12 h light and 12 h dark at 25°C for the macro- and micro-morphological characterization, respectively. The colonies of the three isolates on PDA were initially gray, later becoming dark. Conidia (n=30) were fusiform, smooth-walled, dark-brown, and melanized with three transverse septa, measuring 7.3 to 11.4 × 16.2 to 27.2 µm. The isolates were named Tagas01, Tagas02, Tagas03. Genomic DNA was extracted from fresh mycelia of the pathogens based on the extraction method described by Khoo et al. (2022b). The primers ITS1/ITS4 (White et al. 1990), GPD1/GPD2 (Berbee et al. 1991), and EF1-983F/EF1-2218R (Schochet al. 2009) were used to amplify the internal transcribed spacer (ITS) region of rDNA, partial fragments of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and translation elongation factor (EF-1α) region, respectively based on PCR conditions as described previously (Khoo et al. 2022a). The sequences were deposited in GenBank under accession numbers OP268402, OP271304, OP271305 (677/677 bp) (ITS), OP270699, OP270703, OP270704 (609/613 bp) (GAPDH), OP270700-OP270702 (928/930 bp) (EF-1α). They were 99.35-100% similar to the Curvularia lunata ITS (HF934911), GAPDH (LT715821), and Curvularia dactyloctenicola EF-1α (MF490858) type sequences. Although C. dactyloctenicolais related to C. lunata, the conidia of the former are much wider making them easier to differentiate (Marin-Felix et al. 2017). Phylogenetic analysis using maximum likelihood based on the combined ITS, GAPDH and EF-1α sequences indicated that the isolate formed a supported clade to C. lunata. The pathogens were identified as C. lunata based on morphological and molecular characterization. Koch's postulates were performed. Three replicate healthy rice at the vegetative stage were sprayed with a spore suspension of 1 × 106 spore/ml in distilled sterilized water, prepared from 1-week-old fungal culture, grown in the dark on WA. Three replicate rice plants were sprayed with distilled sterilized water as control. Plants were covered with transparent polyethylene bags to keep moisture, and kept in a greenhouse at ~27°C. Bags were removed after 4 days of incubation. Monitoring and incubation were performed in greenhouse based on Iftikhar et al. (2022). The pathogenicity test was also performed using isolate Tagas02 and Tagas03. All inoculated leaves developed symptoms as described after 6 days post-inoculation, whereas no symptoms occurred on controls. The experiments were repeated twice. The reisolated fungi were identical to the pathogen morphologically and molecularly, thus fulfilling Koch's postulates. C. lunata has been reported in Peninsular Malaysia (Lee et al. 2012). This is the first report of C. lunata causing leaf spot on Oryza sativa in Sabah, Malaysian Borneo. This illness not only reduces yields and lowers milling quality, but it may also be mistaken for rice blast, necessitating needless fungicide spraying.
  8. Fulltext Creep Behavior of A356 Aluminum Alloy Reinforced with Multi-Walled Carbon Nanotubes by Stir Casting
    Shan L, Tan CY, Shen X, Ramesh S, Kolahchi R, Hajmohammad MH, et al.
    Materials (Basel), 2022 Dec 15;15(24).
    PMID: 36556764 DOI: 10.3390/ma15248959
    Lightweight aluminum alloy components are often used to manufacture a variety of engineering components in many industries. In recent years, researchers have studied the effect of improving the mechanical properties of metal alloys by incorporating nano-carbon into its structure. In this study, the effect of the addition of 0.2, 0.5, and 1 wt% of multi-walled carbon nanotubes (MWCNTs) on the stress-strain behavior and creep phenomenon of an A356 aluminum alloy were studied. The effect of nickel coating on 0.2 wt% MWCNTs was also investigated. Samples were prepared using the stir-casting method. The results revealed that the grain size became finer when MWCNT nano-particulates were introduced. Although the MWCNTs were distributed homogeneously in the A356 matrix, as confirmed by FESEM analysis, there were some agglomerations observed in a specific area with dimensions smaller than 100 nm. Nevertheless, the addition of MWCNTs was found to be beneficial in enhancing the hardness of alloys containing 0.2 wt%, 0.2 wt% nickel-coated, 0.5 wt%, and 1 wt% MWCNTs by 9%, 24%, 32%, and 15%, respectively, as compared with the unreinforced A345 matrix. It was also found that the 0.5 wt% MWCNT-A356 matrix exhibited an improvement in the creep lifetime by more than two orders of magnitude.
  9. Cellulose hydrogel development from unbleached oil palm biomass pulps for dermal drug delivery
    Wong LC, Poh JH, Tan WT, Khor BK, Murugaiyah V, Leh CP, et al.
    Int J Biol Macromol, 2023 Jan 01;224:483-495.
    PMID: 36273545 DOI: 10.1016/j.ijbiomac.2022.10.138
    Hydrogels are an attractive platform for drug delivery to the skin. Current cellulose hydrogel developments commonly focus on readily available bleached woody cellulose. Considering the detrimental environmental impacts of bleaching reagents, unbleached non-woody biomass was proposed as an alternative. Herein, this study aims to develop hydrogel from native cellulose extracted from oil palm empty fruit bunches for dermal drug delivery with an emphasis on evaluating the effect of alkali solvent compositions on hydrogel formation. Unbleached dissolving pulps were solubilized in alkali solvents containing sodium hydroxide (NaOH) (6-8%w/v) and urea (4-6%w/v) before crosslinking. Hydrogels were loaded with ibuprofen for skin permeation studies. Light brownish hydrogels formed are aesthetically acceptable and biodegradable with low cytotoxicity. NaOH content has a dominant role over urea where thinner and deformable crosslinked network walls in a porous hydrogel structure are associated with high NaOH content. Synergistic effects (cellulose solubility: 94 %; swelling ratio: ~2800 %) were observed at 7%w/v NaOH and 4%w/v urea with low toxicity. Most hydrogels showed >80 % of ibuprofen permeated into the skin and this increased with the swelling ratio of hydrogels. Unbleached cellulose pulps have excellent potential for hydrogel fabrication with outstanding physicomechanical properties for dermal drug delivery.
  10. Fulltext High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis
    Tan RSJ, Ng KT, Xin CE, Atan R, Yunos NM, Hasan MS
    J Cardiothorac Vasc Anesth, 2022 Sep;36(9):3576-3586.
    PMID: 35715291 DOI: 10.1053/j.jvca.2022.05.011
    OBJECTIVES: The clinical efficacy of corticosteroids remains unclear. The primary aim of this systematic review and meta-analysis was to evaluate the use of high-dose versus low- dose corticosteroids on the mortality rate of COVID-19 patients.

    DESIGN: Systematic review and meta-analysis.

    SETTING: Electronic search for randomized controlled trials and observational studies (MEDLINE, EMBASE, CENTRAL).

    PARTICIPANTS: Hospitalized adults ≥ 18 years old who were SARS-CoV-2 PCR positive.

    INTERVENTIONS: High-dose and low-dose corticosteroids.

    MEASUREMENTS AND MAIN RESULTS: A total of twelve studies (n=2759 patients) were included in this review. The pooled analysis demonstrated no significant difference in mortality rate between the high-dose and low-dose corticosteroids groups (n=2632; OR: 1.07 [95%CI 0.67, 1.72], p=0.77, I2=76%, trial sequential analysis=inconclusive). No significant differences were observed in the incidence of intensive care unit (ICU) admission rate (n=1544; OR: 0.77[95%CI 0.43, 1.37], p=0.37, I2= 72%), duration of hospital stay (n=1615; MD: 0.53[95%CI -1.36, 2.41], p=0.58, I2=87%), respiratory support (n=1694; OR: 1.51[95%CI 0.77, 2.96], p=0.23, I2=84%), duration of mechanical ventilation (n=419; MD: -1.44[95%CI -4.27, 1.40], p=0.32, I2=93%), incidence of hyperglycemia (n=516, OR: 0.91[95%CI 0.58, 1.43], p=0.68, I2=0%) and infection rate (n=1485, OR: 0.86[95%CI 0.64, 1.16], p=0.33, I2=29%).

    CONCLUSION: The meta-analysis demonstrated high-dose corticosteroids did not reduce mortality rate. However, high-dose corticosteroids did not pose higher risk of hyperglycemia and infection rate for COVID-19 patients. Due to the inconclusive trial sequential analysis, substantial heterogeneity and low level of evidence, future large-scale randomized clinical trials are warranted to improve the certainty of evidence for the use of high-dose compared to low-dose corticosteroids in COVID-19 patients.

  11. Fulltext The Formation of 3-Monochloropropanediol Esters and Glycidyl Esters during Heat-Induced Processing Using an Olive-Based Edible Oil
    Ji Y, Lan D, Wang W, Goh KM, Tan CP, Wang Y
    Foods, 2022 Dec 16;11(24).
    PMID: 36553815 DOI: 10.3390/foods11244073
    With the prevalence of edible diacylglycerol (DAG) oil, which is beneficial to human, the generation of 3-monochloropropanediol esters (3-MCPDE) and glycidyl esters (GE) as well as the stability of physical properties during heat-induced processing still need to be explored. In this study, the experiment used olive-based edible oil with different contents of DAG (40, 60, and 80%) to make crackers and fry chicken. They were heated at 160 and 180 °C to determine the changes in 3-MCPDE and GE, the crackers’ hardness and gumminess, and the physical properties of the oil. During baking and frying, 3-MCPDE decreased, while the content of GE slightly increased with the prolonged heating duration. Finally, 3-MCPDE and GE were lower than 1.25 mg/kg and 1.00 mg/kg, respectively. The AV increased proportionally as duration increased and POV was below 0.30 g/100 g. In general, the changes in 3-MCPDE and GE were related to the heating temperature and duration, and not significantly (p > 0.05) related to the content of DAG.
  12. Fulltext Artificial Intelligence (AI) in Breast Imaging: A Scientometric Umbrella Review
    Tan XJ, Cheor WL, Lim LL, Ab Rahman KS, Bakrin IH
    Diagnostics (Basel), 2022 Dec 09;12(12).
    PMID: 36553119 DOI: 10.3390/diagnostics12123111
    Artificial intelligence (AI), a rousing advancement disrupting a wide spectrum of applications with remarkable betterment, has continued to gain momentum over the past decades. Within breast imaging, AI, especially machine learning and deep learning, honed with unlimited cross-data/case referencing, has found great utility encompassing four facets: screening and detection, diagnosis, disease monitoring, and data management as a whole. Over the years, breast cancer has been the apex of the cancer cumulative risk ranking for women across the six continents, existing in variegated forms and offering a complicated context in medical decisions. Realizing the ever-increasing demand for quality healthcare, contemporary AI has been envisioned to make great strides in clinical data management and perception, with the capability to detect indeterminate significance, predict prognostication, and correlate available data into a meaningful clinical endpoint. Here, the authors captured the review works over the past decades, focusing on AI in breast imaging, and systematized the included works into one usable document, which is termed an umbrella review. The present study aims to provide a panoramic view of how AI is poised to enhance breast imaging procedures. Evidence-based scientometric analysis was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline, resulting in 71 included review works. This study aims to synthesize, collate, and correlate the included review works, thereby identifying the patterns, trends, quality, and types of the included works, captured by the structured search strategy. The present study is intended to serve as a "one-stop center" synthesis and provide a holistic bird's eye view to readers, ranging from newcomers to existing researchers and relevant stakeholders, on the topic of interest.
  13. Fulltext Use of a Novel Anti-Infective Noble Metal Alloy-Coated Titanium Orthopedic Nail in Patients with Open Fractures: A Case Series from Malaysia
    Karupiah T, Yong AP, Ong ZW, Tan HK, Tang WC, Salam HB
    Antibiotics (Basel), 2022 Dec 07;11(12).
    PMID: 36551422 DOI: 10.3390/antibiotics11121763
    Fracture-related infection is a serious complication in orthopedic surgery with severe consequences for the patient. We evaluated whether a novel noble metal nail-coating technology can prevent bacterial adhesion and biofilm formation without interfering with bony union. In this retrospective, single-center case series, we described the incidence of fracture-related infections and bony union achievement in patients who had Gustilo type IIIa or IIIb femoral or tibial fractures treated with noble metal alloy-coated titanium nails. Patients were treated between January 2017 and January 2019 at the Sultanah Aminah Hospital, Johor Bahru, Malaysia. Information on fracture-related infections and bone healing assessments was collected from patient records. Additionally, three independent experts retrospectively reviewed patient X-ray images from follow-up visits to further evaluate bony union achievement. Thirty-five patients were included. Infection developed in 3/35 (8.6%) patients; all cases were resolved by antibiotic therapy. Radiographs were available for 32 patients; these confirmed the presence of bone healing in 30/32 (93.8%) patients. However, according to patient records, bony union was achieved in all patients. No safety issues were recorded. This case series suggests that a noble metal alloy-coated titanium nail can prevent infection and facilitate bony union achievement in patients undergoing surgery for severe open fractures.
  14. An integrated life-cycle greenhouse gas protocol accounting on oil palm trunk and empty fruit bunch biofuel production
    Chew ZL, Tan EH, Palaniandy SA, Woon KS, Phuang ZX
    Sci Total Environ, 2023 Jan 15;856(Pt 1):159007.
    PMID: 36167122 DOI: 10.1016/j.scitotenv.2022.159007
    Improper discard of oil palm trunk and empty fruit bunch renders massive greenhouse gases. Turning these palm wastes into solid biofuels could aid in carbon reduction. The embodied environmental impacts of the solid biofuel densification process are neglected in carbon emission quantification studies applying Greenhouse Gas Protocol while the significance of classifying the system's direct and indirect carbon emissions were overlooked in those utilising life cycle assessment. Despite the prospect of both methodologies to complement their limitations for carbon emissions quantification, no study integrates both methodologies to investigate direct and indirect emissions systematically from a life cycle perspective. An integrated framework of life cycle assessment and Greenhouse Gas Protocol is developed to quantify the direct and indirect carbon emissions of oil palm trunk and empty fruit bunch densification from cradle-to-gate for three pellet plants in Indonesia and Malaysia. The emissions are categorised into three emission scopes: Scope 1, Scope 2, and Scope 3 according to the Greenhouse Gas Protocol, integrated with avoided emissions which are quantified via life cycle assessment. The pellet plants generate 534.7-732.3 kg CO2-eq/tonnepellet per hour, in which Scope 1 (i.e., direct emissions) is the major emission scope due to high emissions from wastewater production and drying fuel combustion. Washing equipment (169.2-439.0 kg CO2-eq/tonnepellet per hour) and burners (87.1-214.5 kg CO2-eq/tonnepellet per hour) are the hotspots found in the pellet plants. Producing empty fruit bunch pellets could reduce 62.0-74.1 % of emissions than landfilling the empty fruit bunch. Empty fruit bunch pellet and oil palm trunk pellet are recommended to co-fire with coal to phase down coal usage in achieving COP26 pledge. This study provides data-driven insights for quantifying carbon emissions through the integrated framework and could be a reference in future life cycle carbon footprint studies of the biomass densification process.
  15. Fulltext Mental distress along the cascade of care in managing hypertension
    Ang CW, Tan MM, Bärnighausen T, Reininghaus U, Reidpath D, Su TT
    Sci Rep, 2022 Sep 23;12(1):15910.
    PMID: 36151113 DOI: 10.1038/s41598-022-20020-1
    Hypertension might be a contributing factor of mental illness. The aim of this study was to investigate the association between different levels of hypertension care and mental distress among hypertensive individuals in Malaysia. We constructed a hypertension care cascade using data of 6531 hypertensive individuals aged ≥ 35 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory. We examined the association between the status of hypertension care and mental distress using multiple logistic regressions. Respondents who had not been screened for hypertension and those who had uncontrolled blood pressure (BP) had higher odds of depression, anxiety and, stress compared to those who had been screened and those who had controlled BP, respectively. Respondents who were not taking antihypertensive medication had lower odds of depression and anxiety compared to those who were on medication. There was an association between different levels of hypertension care and mental distress. The application of a hypertension care cascade may help improve the provision of mental health support in primary care clinics. Specific mental health interventions could be provided for patients with particular needs along the cascade.
  16. Fulltext A Narrative Review on Means to Promote Oxygenation and Angiogenesis in Oral Wound Healing
    Ngeow WC, Tan CC, Goh YC, Deliberador TM, Cheah CW
    Bioengineering (Basel), 2022 Nov 02;9(11).
    PMID: 36354548 DOI: 10.3390/bioengineering9110636
    Oral mucosa serves as the primary barrier against pathogen invasions, mechanical stresses, and physical trauma. Although it is generally composed of keratinocytes and held in place by desmosomes, it shows variation in tissue elasticity and surface keratinization at different sites of the oral cavity. Wound healing undergoes four stages of tissue change sequences, namely haemostasis, inflammation, proliferation, and remodelling. The wound healing of oral hard tissue and soft tissue is largely dependent on the inflammatory response and vascular response, which are the targets of many research. Because of a less-robust inflammatory response, favourable saliva properties, a unique oral environment, and the presence of mesenchymal stem cells, oral wounds are reported to demonstrate rapid healing, less scar formation, and fewer inflammatory reactions. However, delayed oral wound healing is a major concern in certain populations with autoimmune disorders or underlying medical issues, or those subjected to surgically inflicted injuries. Various means of approach have been adopted to improve wound tissue proliferation without causing excessive scarring. This narrative review reappraises the current literature on the use of light, sound, mechanical, biological, and chemical means to enhance oxygen delivery to wounds. The current literature includes the use of hyperbaric oxygen and topical oxygen therapy, ultrasounds, lasers, platelet-rich plasma (PRP)/platelet-rich fibrin (PRF), and various chemical agents such as hyaluronic acid, astaxanthin, and Centella asiatica to promote angiogenesis in oral wound healing during the proliferation process. The arrival of a proprietary oral gel that is reported to improve oxygenation is highlighted.
  17. High Sural Nerve Trifurcation: A Rare Anatomical Variation
    Tan EK, Alias A, Yeak R, Jaafar MS, Nizlan NM
    Cureus, 2022 Oct;14(10):e30606.
    PMID: 36426341 DOI: 10.7759/cureus.30606
    The sural nerve is a commonly encountered anatomical structure in foot and ankle surgeries. Knowledge of its location and course is imperative in performing surgeries within its vicinity to avoid neurological deficits. We herein report a rare anatomical variation of the sural nerve where it trifurcates above the level of the lateral malleolus that was discovered in a patient who underwent internal fixation for a trimalleolar ankle fracture with ipsilateral navicular fracture. This study aimed to raise awareness on a unique anatomical variation of the sural nerve in order to reduce the risk of iatrogenic injury.
  18. Fulltext Chitosan and its derivatives as polymeric anti-viral therapeutics and potential anti-SARS-CoV-2 nanomedicine
    Tan RSL, Hassandarvish P, Chee CF, Chan LW, Wong TW
    Carbohydr Polym, 2022 Aug 15;290:119500.
    PMID: 35550778 DOI: 10.1016/j.carbpol.2022.119500
    The coronavirus pandemic, COVID-19 has a global impact on the lives and livelihoods of people. It is characterized by a widespread infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where infected patients may develop serious medical complications or even face death. Development of therapeutic is essential to reduce the morbidity and mortality of infected patients. Chitosan is a versatile biomaterial in nanomedicine and exhibits anti-microbial, anti-cancer and immunomodulatory properties. This review highlights the progress in chitosan design and application pertaining to the anti-viral effects of chitosan and chitosan derivatives (hydroxypropyl trimethylammonium, sulfate, carboxymethyl, bromine, sialylglycopolymer, peptide and phosphonium conjugates) as a function of molecular weight, degree of deacetylation, type of substituents and their degree and site of substitution. The physicochemical attributes of these polymeric therapeutics are identified against the possibility of processing them into nanomedicine which can confer a higher level of anti-viral efficacy. The designs of chitosan for the purpose of targeting SARS-CoV-2, as well as the ever-evolving strains of viruses with a broad spectrum anti-viral activity to meet pandemic preparedness at the early stages of outbreak are discussed.
  19. Fulltext The Dark Side of Mobile Learning via Social Media: How Bad Can It Get?
    Loh XK, Lee VH, Loh XM, Tan GW, Ooi KB, Dwivedi YK
    Inf Syst Front, 2022;24(6):1887-1904.
    PMID: 34658660 DOI: 10.1007/s10796-021-10202-z
    As the COVID-19 pandemic continues to spread at an unprecedented rate, many universities around the world halted physical forms of teaching and learning to stop the spread of the virus. As a result, many university students were forced to utilize online learning through channels such as mobile social media. Due to the novelty of this situation, there are many unknowns particularly with the negative influences of mobile learning via social media on university students. Thus, this study looks to examine this subject matter from the perspective of the stimulus-organism-response theory. The uniquely developed research model included four stimuli (i.e., social overload, information overload, life invasion, and privacy invasion), two organisms (i.e., technostress and exhaustion) as well as a response in terms of reduced intention to use mobile learning via social media. The responses were collected from 384 university students via an online survey and analyzed with the Partial-Least-Square-Structural-Equation-Modelling. It was found that the antecedents for both technostress and exhaustion were able to account for more than half of their respective variances. Furthermore, technostress and exhaustion were significant facilitators of the students' reduced intention to use mobile learning via social media. In addition to the practical insights for stakeholders in the education industry, this study also posited several theoretical implications for researchers.
  20. Fulltext Case series of gallstone ileus with one- or two-stage surgery
    Chuah JS, Tan JH, Khairudin KB, Ling LLL, Mat TNBT
    Ann Hepatobiliary Pancreat Surg, 2022 May 31;26(2):199-203.
    PMID: 35272270 DOI: 10.14701/ahbps.21-139
    Gallstone ileus is an uncommon cause of intestinal obstruction. It may present with typical symptoms of intestinal obstruction with or without biliary sepsis. Its management strategies vary depending on the patient and operative factors. Enterotomy and stone removal alone versus synchronous cholecystectomy and fistula disconnection at the same stage, often pose a debate among surgeons. The decision for operative strategies largely depends on the surgeon's experience, patient's physiology, and operative difficulties. As literature on gall stone ileus remains insufficient at a regional level, we report four cases of gallstone ileus managed with different approaches. Three patients were managed in a staged-manner, whereas one patient received a definitive procedure performed at index surgery. Clinical challenges and associated operative strategies are discussed. Findings of the current study were compared to those of the literature. The need for a definitive fistula disconnection and repair or cholecystectomy following stone removal in these patients was subsequently discussed.
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