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Coupling SWAT and Bi-LSTM for improving daily-scale hydro-climatic simulation and climate change impact assessment in a tropical river basin

Yang S, Tan ML, Song Q, He J, Yao N, Li X, et al.

J Environ Manage, 2023 Mar 15;330:117244.
PMID: 36621311 DOI: 10.1016/j.jenvman.2023.117244

Global climate change has led to an increase in both the frequency and magnitude of extreme events around the world, the risk of which is especially imminent in tropical regions. Developing hydrological models with better capabilities to simulate streamflow, especially peak flow, is urgently needed to facilitate water resource planning and management as well as climate change mitigation efforts in the tropics. In view of the need, this paper explores the feasibility of improving streamflow simulation performance in the tropical Kelantan River Basin (KRB) of Peninsular Malaysia through coupling a conceptual process-based hydrological model - Soil and Water Assessment Tool (SWAT) with a deep learning model - Bidirectional Long Short-Term Memory (Bi-LSTM) in two ways. All SWAT parameters were set as their default values in one hybrid model (SWAT-D-LSTM), whereas three most sensitive SWAT parameters were calibrated in the other hybrid model (SWAT-T-LSTM). Comparison of daily streamflow simulation results have shown that SWAT-T-LSTM consistently performs better than SWAT-D-LSTM as well as the stand-alone SWAT and Bi-LSTM model throughout the simulation period. Particularly, SWAT-T-LSTM performs considerably better than the other three models in simulating daily peak flow. Based on the latest projection results of five GCMs from the Sixth Phase of the Coupled Model Intercomparison Project (CMIP6) under three emission scenarios (SSP1-2.6, SSP2-4.5, SSP5-8.5), the best-performed SWAT-T-LSTM was run to assess the potential impacts of climate change on streamflow in the KRB. Ensemble assessment results have concluded that both average and extreme streamflow is much likely to increase considerably in the already wet northeast monsoon season from November to January, which has surely raised the alarm for more frequent flood occurrence in the KRB.
Fulltext Swin-textural: A novel textural features-based image classification model for COVID-19 detection on chest computed tomography

Tuncer I, Barua PD, Dogan S, Baygin M, Tuncer T, Tan RS, et al.

Inform Med Unlocked, 2023;36:101158.
PMID: 36618887 DOI: 10.1016/j.imu.2022.101158

BACKGROUND: Chest computed tomography (CT) has a high sensitivity for detecting COVID-19 lung involvement and is widely used for diagnosis and disease monitoring. We proposed a new image classification model, swin-textural, that combined swin-based patch division with textual feature extraction for automated diagnosis of COVID-19 on chest CT images. The main objective of this work is to evaluate the performance of the swin architecture in feature engineering.
MATERIAL AND METHOD: We used a public dataset comprising 2167, 1247, and 757 (total 4171) transverse chest CT images belonging to 80, 80, and 50 (total 210) subjects with COVID-19, other non-COVID lung conditions, and normal lung findings. In our model, resized 420 × 420 input images were divided using uniform square patches of incremental dimensions, which yielded ten feature extraction layers. At each layer, local binary pattern and local phase quantization operations extracted textural features from individual patches as well as the undivided input image. Iterative neighborhood component analysis was used to select the most informative set of features to form ten selected feature vectors and also used to select the 11th vector from among the top selected feature vectors with accuracy >97.5%. The downstream kNN classifier calculated 11 prediction vectors. From these, iterative hard majority voting generated another nine voted prediction vectors. Finally, the best result among the twenty was determined using a greedy algorithm.
RESULTS: Swin-textural attained 98.71% three-class classification accuracy, outperforming published deep learning models trained on the same dataset. The model has linear time complexity.
CONCLUSIONS: Our handcrafted computationally lightweight swin-textural model can detect COVID-19 accurately on chest CT images with low misclassification rates. The model can be implemented in hospitals for efficient automated screening of COVID-19 on chest CT images. Moreover, findings demonstrate that our presented swin-textural is a self-organized, highly accurate, and lightweight image classification model and is better than the compared deep learning models for this dataset.
Fulltext A Participatory, Needs-Based Approach to Breastfeeding Training for Confinement Centres

Foong SC, Foong WC, Tan ML, Ho JJ, Omer-Salim A

Int J Environ Res Public Health, 2022 Sep 01;19(17).
PMID: 36078639 DOI: 10.3390/ijerph191710914

With a focus on traditional practices rather than evidence-based practices, breastfeeding support is sub-optimal in confinement centres (CCs). We used a participatory, needs-based approach to develop a training module for CC staff adopting Kern's six-step approach as our conceptual framework. Of 46 identified CCs, 25 accepted our invitation to a dialogue aimed at establishing relationships and understanding their needs. An interactive training workshop was developed from the dialogue's findings. The workshop, attended by 32 CCs (101 participants), was conducted four times over a four-month period. Questions raised by the participants reflected deficits in understanding breastfeeding concepts and erroneous cultural beliefs. Correct answers rose from 20% pre-test to 51% post-test. Post-workshop feedback showed that participants appreciated the safe environment to ask questions, raise concerns and correct misconceptions. An interview conducted 14 months later showed that while some CCs improved breastfeeding support, others made no change due to conflict between breastfeeding and traditional postnatal practices, which was aggravated by a lack of support due to the COVID-19 pandemic. A participatory approach established a trustful learning environment, helping CCs appreciate the value of learning and adopting new concepts. However, cultural perceptions take time to change, hence continuous training and support are vital for sustained changes.
A computational framework for the multiphysics simulation of microbubble-mediated sonothrombolysis using a forward-viewing intravascular transducer

Tan ZQ, Ooi EH, Chiew YS, Foo JJ, Ng EYK, Ooi ET

Ultrasonics, 2023 May;131:106961.
PMID: 36812819 DOI: 10.1016/j.ultras.2023.106961

Sonothrombolysis is a technique that utilises ultrasound waves to excite microbubbles surrounding a clot. Clot lysis is achieved through mechanical damage induced by acoustic cavitation and through local clot displacement induced by acoustic radiation force (ARF). Despite the potential of microbubble-mediated sonothrombolysis, the selection of the optimal ultrasound and microbubble parameters remains a challenge. Existing experimental studies are not able to provide a complete picture of how ultrasound and microbubble characteristics influence the outcome of sonothrombolysis. Likewise, computational studies have not been applied in detail in the context of sonothrombolysis. Hence, the effect of interaction between the bubble dynamics and acoustic propagation on the acoustic streaming and clot deformation remains unclear. In the present study, we report for the first time the computational framework that couples the bubble dynamic phenomena with the acoustic propagation in a bubbly medium to simulate microbubble-mediated sonothrombolysis using a forward-viewing transducer. The computational framework was used to investigate the effects of ultrasound properties (pressure and frequency) and microbubble characteristics (radius and concentration) on the outcome of sonothrombolysis. Four major findings were obtained from the simulation results: (i) ultrasound pressure plays the most dominant role over all the other parameters in affecting the bubble dynamics, acoustic attenuation, ARF, acoustic streaming, and clot displacement, (ii) smaller microbubbles could contribute to a more violent oscillation and improve the ARF simultaneously when they are stimulated at higher ultrasound pressure, (iii) higher microbubbles concentration increases the ARF, and (iv) the effect of ultrasound frequency on acoustic attenuation is dependent on the ultrasound pressure. These results may provide fundamental insight that is crucial in bringing sonothrombolysis closer to clinical implementation.
Operational nuclear research reactors in the Asia-Pacific with potential for medical radionuclide production

Tan HY, Wong YH, Kasbollah A, Md Shah MN, Perkins AC, Yeong CH

Nucl Med Commun, 2023 Apr 01;44(4):227-243.
PMID: 36808108 DOI: 10.1097/MNM.0000000000001665

Personalised cancer treatment is of growing importance and can be achieved via targeted radionuclide therapy. Radionuclides with theranostic properties are proving to be clinically effective and are widely used because diagnostic imaging and therapy can be accomplished using a single formulation that avoids additional procedures and unnecessary radiation burden to the patient. For diagnostic imaging, single photon emission computed tomography (SPECT) or positron emission tomography (PET) is used to obtain functional information noninvasively by detecting the gamma (γ) rays emitted from the radionuclide. For therapeutics, high linear energy transfer (LET) radiations such as alpha (α), beta (β - ) or Auger electrons are used to kill cancerous cells in close proximity, whereas sparing the normal tissues surrounding the malignant tumour cells. One of the most important factors that lead to the sustainable development of nuclear medicine is the availability of functional radiopharmaceuticals. Nuclear research reactors play a vital role in the production of medical radionuclides for incorporation into clinical radiopharmaceuticals. The disruption of medical radionuclide supplies in recent years has highlighted the importance of ongoing research reactor operation. This article reviews the current status of operational nuclear research reactors in the Asia-Pacific region that have the potential for medical radionuclide production. It also discusses the different types of nuclear research reactors, their operating power, and the effects of thermal neutron flux in producing desirable radionuclides with high specific activity for clinical applications.
Biotechnological enhancement of lactic acid conversion from pretreated palm kernel cake hydrolysate by Actinobacillus succinogenes 130Z

Rahim NA, Luthfi AAI, Bukhari NA, Tan JP, Abdul PM, Manaf SFA

Sci Rep, 2023 Apr 08;13(1):5787.
PMID: 37031272 DOI: 10.1038/s41598-023-32964-z

The aim of this study was to establish an improved pretreatment and fermentation method i.e. immobilized cells for high recovery of fermentable sugars from palm kernel cake (PKC) and its effects on fermentability performance by Actinobacillus succinogenes 130Z in the conversion of the fermentable sugar to lactic acid. The effects of oxalic acid concentrations (1-6% w/v) and residence times (1-5 h) on the sugar recovery were initially investigated and it was found that the highest mannose concentration was 25.1 g/L at the optimum hydrolysis conditions of 4 h and 3% (w/v) oxalic acid. The subsequent enzymatic saccharification of the pretreated PKC afforded the highest enzymatic digestibility with the recovered sugars amounting to 25.18 g/L and 9.14 g/L of mannose and glucose, respectively. Subsequently, the fermentability performance of PKC hydrolysate was evaluated and compared in terms of cultivation phases (i.e. mono and dual-phases), carbonate loadings (i.e. magnesium and sodium carbonates), and types of sugars (i.e. glucose and mannose). The highest titer of 19.4 g/L lactic acid was obtained from the fermentation involving A. succinogenes 130Z in dual-phase cultivation supplemented with 30 g/L of magnesium carbonate. Lactic acid production was further enhanced by using immobilized cells with coconut shell-activated carbon (CSAC) of different sizes (A, B, C, and D) in the repeated batch cultivation of dual-phase fermentation producing 31.64 g/L of lactic acid. This work sheds light on the possibilities to enhance the utilization of PKC for lactic acid production via immobilized A. succinogenes 130Z.
Fulltext The Association of Self-Perception of Aging and Quality of Life in Older Adults: A Systematic Review

Velaithan V, Tan MM, Yu TF, Liem A, Teh PL, Su TT

Gerontologist, 2024 Apr 01;64(4).
PMID: 37029753 DOI: 10.1093/geront/gnad041

BACKGROUND AND OBJECTIVES: Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above.
RESEARCH DESIGN AND METHODS: A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being.
RESULTS: Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health.
DISCUSSION AND IMPLICATIONS: These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.
Cost-effectiveness analysis of the SMART quit clinic program in smokers with cardiovascular disease in Thailand

Grant A, Tan CJ, Wattanasirichaigoon S, Rungruanghiranya S, Thongphiew A, Thavorn K, et al.

Tob Induc Dis, 2023;21:47.
PMID: 37035838 DOI: 10.18332/tid/161024

INTRODUCTION: The SMART Quit Clinic Program (FAHSAI Clinic) has been implemented in Thailand since 2010; however, it remains unclear whether the benefits gained from this program justify its costs. We assessed its cost-effectiveness compared to usual care in a population of Thai smokers with cardiovascular disease (CVD) from a societal perspective.
METHODS: We conducted a cost-utility analysis using a Markov model to simulate lifetime costs and quality-adjusted life years (QALYs) of Thai smokers aged ≥35 years receiving smoking cessation services offered from FAHSAI Clinic or usual care over a horizon of 50 years. The model used a 6-month continuous abstinence rate from a multicenter prospective study of 24 FAHSAI Clinics. A series of sensitivity analyses including probabilistic sensitivity analysis were conducted to assess robustness of study findings. Cost data are presented in US$ for 2020.
RESULTS: The FAHSAI Clinic was dominant as it was less costly ($9537.92 vs $10964.19) and more effective (6.06 vs 5.96 QALYs) compared with usual care over the 50-year time horizon. Changes in risks of stroke and coronary heart disease among males had the largest impact on the cost-effectiveness findings. The probability that FAHSAI Clinic was cost-effective was 99.8% at a willingness-to-pay threshold of $5120.
CONCLUSIONS: The FAHSAI Clinic smoking cessation program was clinically superior and cost-saving compared to usual care for Thai patients with CVD in all scenarios. A budget impact analysis is needed to estimate the financial impact of adopting this program within the Thai healthcare system.
Fulltext Large animal models for cardiac remuscularization studies: A methodological review

Yu Y, Tham SK, Roslan FF, Shaharuddin B, Yong YK, Guo Z, et al.

Front Cardiovasc Med, 2023;10:1011880.
PMID: 37008331 DOI: 10.3389/fcvm.2023.1011880

Myocardial infarction is the most common cause of heart failure, one of the most fatal non-communicable diseases worldwide. The disease could potentially be treated if the dead, ischemic heart tissues are regenerated and replaced with viable and functional cardiomyocytes. Pluripotent stem cells have proven the ability to derive specific and functional cardiomyocytes in large quantities for therapy. To test the remuscularization hypothesis, the strategy to model the disease in animals must resemble the pathophysiological conditions of myocardial infarction as in humans, to enable thorough testing of the safety and efficacy of the cardiomyocyte therapy before embarking on human trials. Rigorous experiments and in vivo findings using large mammals are increasingly important to simulate clinical reality and increase translatability into clinical practice. Hence, this review focus on large animal models which have been used in cardiac remuscularization studies using cardiomyocytes derived from human pluripotent stem cells. The commonly used methodologies in developing the myocardial infarction model, the choice of animal species, the pre-operative antiarrhythmics prophylaxis, the choice of perioperative sedative, anaesthesia and analgesia, the immunosuppressive strategies in allowing xenotransplantation, the source of cells, number and delivery method are discussed.
Expression Profiles of Immune-Related Genes and Apoptosis Study of Avian Intraepithelial-Natural Killer Cells in Chickens Inoculated with Vaccine Strain of Newcastle Disease Virus (NDV) and Challenged with Virulent NDV

Hamisu TM, Aliyu HB, Tan SW, Hair-Bejo M, Omar AR, Ideris A

Avian Dis, 2022 Sep 22.
PMID: 36198006 DOI: 10.1637/aviandiseases-D-22-00029

In spite of the available information on the role of natural killer (NK) cells in several viral infections, the interactions between chicken intraepithelial-NK (IEL-NK) cells and Newcastle disease virus (NDV) are poorly understood. In this study, we investigated these interactions following the inoculation of chickens with NDV vaccine strain LaSota and subsequent challenge with velogenic NDV (vNDV) genotype VII (GVII) and VIII (GVIII), through quantification of IEL-NK cell's apoptosis and expression profiling of its surface receptors. Specific-pathogen-free chickens were randomly divided into six groups, as follows: one group of an uninfected control, one group infected with NDV LaSota, two groups each infected with either GVII or GVIII, and two groups inoculated with NDV LaSota and challenged with either GVII (LaSota-genotype VII [LSGVII]) or GVIII (LaSota-genotype VIII [LSGVIII]). Avian intraepithelial lymphocytes (IEL) were isolated from the duodenal loops, and CD3- cells were characterized. Immunophenotyping and apoptosis analysis of CD3-/CD25+/CD45+IEL NK cells were conducted using a flow cytometer. In addition, a gene expression study was conducted using real-time quantitative PCR. Data were analyzed using two-way analysis of variance. The results showed that vNDV GVII or GVIII caused apoptosis of IEL-NK cells; however, following inoculation of LSGVII or LSGVIII, the effect of vNDV GVII and GVIII to cause a reduction in the population of viable IEL-NK cells was significantly reduced. Furthermore, the expression profiles of activating receptors CD69, NK-lysin, and IFN-γ, were generally upregulated in chickens inoculated with LSGVII or LSGVIII. In contrast, B-NK, an inhibitory receptor, was downregulated in these treatment groups. In NDV GVII- and GVIII-challenged groups, however, B-NK was upregulated, whereas the other receptors were generally downregulated. The findings of this study showed that NDV vaccine strain LaSota may prevent apoptosis and cause upregulation of activating receptors of chicken IEL-NK cells in velogenic virus-challenged settings.
Fulltext First Report of Leaf Spot on Basella rubra Caused by Fusarium proliferatum in Malaysia

Khoo YW, Khaw YS, Tan HT, Li SF, Chong KP

Plant Dis, 2022 Jul 22.
PMID: 35869589 DOI: 10.1094/PDIS-04-22-0847-PDN

Basella rubra (family Basellaceae), locally known as 'Remayong Merah', is the edible perennial vine served as leafy vegetable in Malaysia. In May 2021, B. rubra's leaves with circular to subcircular purple spots (ranging from 1-10 mm wide) were collected in Lido (5°56'44.6"N 116°04'46.5"E), Sabah province. The disease severity was about 60% with 20% disease incidence on fifty plants. As disease developed, the spots grew larger and necrosis were formed within the purple spots. Small pieces (5 x 5 mm) of five diseased spots were excised, and then surface sterilized based on Khoo et al. (2022b) before plating on water agar at 25°C. Once obtained the pure cultures from all diseased spots, they were incubated on potato dextrose agar at 25°C. After 7 days, white aerial mycelium with light violet pigmentation on lower side were observed on PDA. Then, the fungi were cultured on Carnation leaf agar (CLA) at 25°C and 12-h light/dark photoperiod for 10 days. Thin-walled slender and slightly curved macroconidia (n= 20) with 3 to 5 septa were ranged from 2.3 to 2.6 µm wide by 26.8 to 44.5 µm long in size. Oval microconidia (n= 20) with no septa were 2 to 2.2 µm wide by 9.5 to 15 µm long in size. Chlamydospores were absent. Monophialids with false head were observed. Isolate Lido and Lido02 were kept in the Laboratory of Genetics, Faculty of Science and Natural Resources, Universiti Malaysia Sabah for public request. Their genomic DNA were extracted from fresh mycelia of isolates based on Khoo et al. (2022a). EF1/EF2, RPB1-Fa/RPB1-G2R and RPB2-5f2/RPB2-7cr (Jiang et al. 2021) were used to amplify the translation elongation factor 1-α (TEF1) region, RNA polymerase largest subunit gene (RPB1) and RNA polymerase second largest subunit gene (RPB2) based on PCR condition in Khoo et al. (2022b). The isolate's sequences were deposited in GenBank as OM048109, OM634654 (TEF1), OM634655, OM634657 (RPB1) and OM634656, OM634658 (RPB2). They were 99 to 100% homology to TEF1 of isolate DPCT0102-2 (LC581453) (657/657 bp), RPB1 of strain ZJ05 (MT560605) (1558/1558 bp) and RPB2 of isolate GR_FP248 (MT305154) (1867/1869 bp) sequences. These sequences were polyphasic identified at the Fusarium MLST (https://fusarium.mycobank.org/), and were more than 99% similarity to Gibberella fujikuroi species complex (NRRL 25200). Gibberella fujikuroi and Fusarium fujikuroi are synonymous with Fusarium proliferatum (Leslie and Summerell 2006). The pathogen was identified as F. proliferatum based on morphological characterization, molecular data and phylogenetic analysis. Two non-wounded leaves of three one-month-old B. rubra seedlings were inoculated with mycelium plug (10 x 10 mm). Additional three B. rubra seedlings received sterile PDA agar plug (10 x 10 mm) to serve as controls. They were incubated in a glasshouse at room temperature 25°C with a relative humidity of 80 to 90%. After 8 days of inoculation, all inoculated leaves exhibited the symptoms as observed in the field, while the controls showed no symptoms, thus confirming the Koch's postulates. The experiment was repeated two more times. The reisolated pathogens were identified as F. proliferatum via PDA macroscopically, CLA microscopically and PCR amplification. F. proliferatum was reported previously causing leaf spot disease on Cymbidium orchids (Wang et al. 2018), tobacco (Li et al. 2017) and tomato (Gao et al. 2017). To our knowledge, this is the first report of F. proliferatum causing leaf spot on B. rubra in Malaysia. Infections of leaves reduce plant vigor and marketability. The identification of leaf spot caused by F. proliferatun will enable plant health authorities and farmers to identify practices to minimize disease on this important crop.
Fulltext First report of Epicoccum sorghinum causing leaf spot on Basella alba in Malaysia

Khoo YW, Tan HT, Khaw YS, Li SF, Chong KP

Plant Dis, 2022 Jul 22.
PMID: 35869587 DOI: 10.1094/PDIS-02-22-0309-PDN

Basella alba (family Basellaceae) is a perennial vine that serves as an edible leaf vegetable in Malaysia. In May 2021, red spots were observed on leaf samples of B. alba in Lido, Sabah Province (5°56'39.1"N, 116°04'47.6"E). The disease severity was about 20% with 10% incidence. The spots enlarged and coalesced into larger necrotic spots. Small pieces (5 x 5 mm) of infected leaves were excised from three plants, and then surface disinfected based on Khoo et al. (2022). One fungal isolate (Lido01) was isolated and cultured on potato dextrose agar (PDA) at 25°C. A single isolate with cottony aerial mycelia and pink concentric rings was observed on the upper surface of the culture. Unicellular and multicellular chlamydospores were observed, and measured 7.1 to 14.3. × 17.8 to 74.5 μm. Conidia were unicellular, hyaline, oval, and measured 3.8 to 5.2 x 1.7 to 2.7 μm (n= 20). Pycnidia were spheroid, and measured 66.2 to 114.3 x 44.1 to 86.1 μm (n= 20). Genomic DNA was extracted from fresh mycelia according to the extraction method of Khoo et al. (2022a and 2022b). ITS1/ITS4, LR0R/LR7, ACT512F/ACT783R, and T10/Bt2b primers were used to amplify the internal transcribed spacer (ITS), large subunit (LSU), actin (ACT), and tubulin (TUB) genes, respectively (O'Donnell and Cigelnik, 1997; Chen et al. 2021). PCR products were Sanger sequenced by Apical Scientific Sdn. Bhd. (Serdang, Malaysia). Sequences of isolate Lido01 were deposited in GenBank as OM501130 (ITS), OM501128 (LSU), OM513916 (ACT) and OM513917 (TUB). Respective gene sequences of this isolate showed 100% homology to ITS sequence of isolate BPL01 (OM453926) (507/507 bp), LSU sequence of isolate BPL01 (OM453925) (1328/1328 bp), ACT sequence of isolate CZ01 (MN956831) (275/275 bp) and TUB sequence of isolate BJ-F1 (MF987525) (556/556 bp). The sequences of Lido01 established a supported clade (99% bootstrap value) to the related Epicoccum sorghinum type sequences, according to phylogenetic analysis using maximum likelihood based on the concatenated ITS, ACT, and TUB sequences. Morphological characters also matched the description of E. sorghinum (Li et al. 2020). Koch's postulates were tested as described by Chai et al. (2017) with modification by spray inoculation (106 spores/ml) on the leaves of three healthy one-month-old B. alba, while sterilized distilled water served as the control treatment. Monitoring and incubation were performed in a greenhouse based on Iftikhar et al. (2022). All inoculated leaves developed symptoms as described above by 8 days post-inoculation, whereas no symptoms occurred on controls, thus fulfilling Koch's postulates. The experiment was repeated twice. The reisolated pathogen was morphologically and genetically identical to E. sorghinum. E. sorghinum was reported causing leaf spot on Brassica parachinensis (Yu et al. 2019), Camellia sinensis (Bao et al. 2019), Myrica rubra (Li et al. 2020), Oryza sativa (Liu et al. 2020) and Zea mays (Chen et al. 2021). To our knowledge, this is the first report of E. sorghinum causing leaf spot on B. alba in Malaysia. Our findings have expanded the geographic range and host range of E. sorghinum in Malaysia, though the host range of this isolate is not known.
Fulltext DeepPulmoTB: A benchmark dataset for multi-task learning of tuberculosis lesions in lung computerized tomography (CT)

Tan Z, Madzin H, Norafida B, ChongShuang Y, Sun W, Nie T, et al.

Heliyon, 2024 Feb 29;10(4):e25490.
PMID: 38370224 DOI: 10.1016/j.heliyon.2024.e25490

Tuberculosis (TB) remains a significant global health challenge, characterized by high incidence and mortality rates on a global scale. With the rapid advancement of computer-aided diagnosis (CAD) tools in recent years, CAD has assumed an increasingly crucial role in supporting TB diagnosis. Nonetheless, the development of CAD for TB diagnosis heavily relies on well-annotated computerized tomography (CT) datasets. Currently, the available annotations in TB CT datasets are still limited, which in turn restricts the development of CAD tools for TB diagnosis to some extent. To address this limitation, we introduce DeepPulmoTB, a CT multi-task learning dataset explicitly designed for TB diagnosis. To demonstrate the advantages of DeepPulmoTB, we propose a novel multi-task learning model, DeepPulmoTBNet (DPTBNet), for the joint segmentation and classification of lesion tissues in CT images. The architecture of DPTBNet comprises two subnets: SwinUnetR for the segmentation task, and a lightweight multi-scale network for the classification task. Furthermore, to enhance the model's capacity to capture TB lesion features, we introduce an improved iterative optimization algorithm that refines feature maps by integrating probability maps obtained in previous iterations. Extensive experiments validate the effectiveness of DPTBNet and the practicality of the DeepPulmoTB dataset.
Fulltext Barriers And Challenges Of Multidisciplinary Teams In Oncology Management: A Scoping Review Protocol

Law NLW, Hong LW, Tan SSN, Foo CJ, Lee D, Voon PJ

BMJ Open, 2024 Feb 10;14(2):e079559.
PMID: 38341218 DOI: 10.1136/bmjopen-2023-079559

INTRODUCTION: Multidisciplinary teams (MDTs) are integral to oncology management, involving specialised healthcare professionals who collaborate to develop individualised treatment plans for patients. However, as cancer care grows more complex, MDTs must continually adapt to better address patient needs. This scoping review will explore barriers and challenges MDTs have encountered in the past decade; and propose strategies for optimising their utilisation to overcome these obstacles and improve patient care.
METHODS AND ANALYSIS: The scoping review will follow Arksey and O'Malley's framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis.
ETHICS AND DISSEMINATION: The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field.
TRIAL REGISTRATION DETAILS: The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.
Fulltext The association of weight loss from anti-obesity medications or bariatric surgery and apnea-hypopnea index in obstructive sleep apnea

Locke BW, Gomez-Lumbreras A, Tan CJ, Nonthasawadsri T, Veettil SK, Patikorn C, et al.

Obes Rev, 2024 Apr;25(4):e13697.
PMID: 38342767 DOI: 10.1111/obr.13697

INTRODUCTION: Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea-hypopnea index (AHI).
METHODS: PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA. The association between percentage weight loss and AHI change between randomization and last follow-up was evaluated using meta-regression.
PROSPERO: CRD42022378853.
RESULTS: Ten eligible trials (n = 854 patients) were included. Four (n = 211) assessed bariatric surgery, and 6 (n = 643) assessed pharmacologic interventions over a median follow-up of 13 months (interquartile range 6-26 months). The linear best estimate of the change in AHI is 0.45 events per hour (95% Confidence Interval 0.18 to 0.73 events per hour) for every 1% body weight lost.
CONCLUSIONS: Weight loss caused by medication or surgery caused a proportionate improvement of the AHI. Providers could consider extrapolating from this relationship when advising patients of the expected effects of other pharmacologic or surgical interventions without direct evidence in OSA.
Fulltext Effectiveness of digital tools for smoking cessation in Asian countries: a systematic review

Goh KW, Ming LC, Al-Worafi YM, Tan CS, Hermansyah A, Rehman IU, et al.

Ann Med, 2024 Dec;56(1):2271942.
PMID: 38346353 DOI: 10.1080/07853890.2023.2271942

AIM: The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries.
METHODS: Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries.
RESULTS: A total of 25 studies of varying designs were eligible for this study collectively involving a total of n = 22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study.
CONCLUSION: Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions.
Fulltext Advancement of biorefinery-derived platform chemicals from macroalgae: a perspective for bioethanol and lactic acid

Tong KTX, Tan IS, Foo HCY, Lam MK, Lim S, Lee KT

Biomass Convers Biorefin, 2022 Mar 17.
PMID: 35316983 DOI: 10.1007/s13399-022-02561-7

The extensive growth of energy and plastic demand has raised concerns over the depletion of fossil fuels. Moreover, the environmental conundrums worldwide integrated with global warming and improper plastic waste management have led to the development of sustainable and environmentally friendly biofuel (bioethanol) and biopolymer (lactic acid, LA) derived from biomass for fossil fuels replacement and biodegradable plastic production, respectively. However, the high production cost of bioethanol and LA had limited its industrial-scale production. This paper has comprehensively reviewed the potential and development of third-generation feedstock for bioethanol and LA production, including significant technological barriers to be overcome for potential commercialization purposes. Then, an insight into the state-of-the-art hydrolysis and fermentation technologies using macroalgae as feedstock is also deliberated in detail. Lastly, the sustainability aspect and perspective of macroalgae biomass are evaluated economically and environmentally using a developed cascading system associated with techno-economic analysis and life cycle assessment, which represent the highlights of this review paper. Furthermore, this review provides a conceivable picture of macroalgae-based bioethanol and lactic acid biorefinery and future research directions that can be served as an important guideline for scientists, policymakers, and industrial players.
Recent advances in extruded polylactic acid-based composites for food packaging: A review

Han Lyn F, Ismail-Fitry MR, Noranizan MA, Tan TB, Nur Hanani ZA

Int J Biol Macromol, 2024 May;266(Pt 2):131340.
PMID: 38574927 DOI: 10.1016/j.ijbiomac.2024.131340

This review article provides a comprehensive overview of recent progress in polylactic acid (PLA) extrusion, emphasizing its applications in food packaging. PLA has witnessed a significant rise in demand, particularly within the food packaging sector. A notable increase in research publications has been observed in recent years, exploring the extrusion of PLA and PLA-based composite films. In comparison to conventional techniques such as solvent casting, extrusion offers advantages in scalability and environmental sustainability, especially for industrial-scale production. The benefits of this method include faster drying times, enhanced flexibility, consistent film thickness, and less structural defects. Extensive research has focused on the effect of various PLA blends on film properties, including flexibility, elongation, and barrier properties against water vapour and gases. Furthermore, the incorporation of compounds such as antioxidants, antimicrobials, and natural pigments has enabled the development of active and intelligent PLA-based packaging. This article summarizes the types of additives employed to enhance the physicochemical properties of extruded PLA and film performance. Additionally, this article explores the diverse applications of extruded PLA in active and intelligent packaging for various food products.
Fulltext Health state utility values ranges across varying stages and severity of type 2 diabetes-related complications: A systematic review

Tan MHP, Ong SC, Tahir NAM, Ali AM, Mustafa N

PLoS One, 2024;19(4):e0297589.
PMID: 38574169 DOI: 10.1371/journal.pone.0297589

INTRODUCTION: Health state utility values (HSUV) for Type 2 diabetes mellitus (T2DM) complications are useful in economic evaluations to determine cost effectiveness of an intervention. However, there is a lack of reference ranges for different severity and stages of individual complications. This study aimed to provide an overview of HSUV decrement ranges for common T2DM complications focusing on different severity and stages of complications.
METHOD: A systematic search was conducted in MEDLINE, SCOPUS, WEB OF SCIENCE. (Jan 2000 to April 2022). Included studies for HSUV estimates were from outpatient setting, regardless of treatment types, complication stages, regions and HRQoL instruments. Health Related Quality of Life (HRQoL) outcomes was to be presented as HSUV decrement values, adjusted according to social demographics and comorbidities. Adjusted HSUV decrements were extracted and compiled according to individual complications. After which, subsequently grouped into mild or severe category for comparison.
RESULTS: Searches identified 35 studies. The size of the study population ranged from 160 to 14,826. The HSUV decrement range was widest for cerebrovascular disease (stroke): -0.0060 to -0.0780 for mild stroke and -0.035 to -0.266 for severe stroke; retinopathy: mild (-0.005 to -0.0862), moderate (-0.0030 to -0.1845) and severe retinopathy (-0.023 to -0.2434); amputation: (-0.1050 to -0.2880). Different nature of complication severity defined in studies could be categorized into: those with acute nature, chronic with lasting effects, those with symptoms at early stage or those with repetitive frequency or episodes.
DISCUSSION: Overview of HSUV decrement ranges across different stages of each T2DM diabetes-related complications shows that chronic complications with lasting impact such as amputation, severe stroke with sequelae and severe retinopathy with blindness were generally associated with larger HSUV decrement range. Considerable heterogeneities exist across the studies. Promoting standardized complication definitions and identifying the most influential health state stages on HSUV decrements may assist researchers for future cost-effectiveness studies.
Fulltext Prevalence, Risk Factors, and Management of Metabolic Acidosis in Chronic Kidney Disease Patients: A Multicenter Retrospective Study in Malaysia

Chan JYM, Islahudin F, Mohd Tahir NA, Makmor-Bakry M, Tan CHH

Cureus, 2024 Mar;16(3):e56314.
PMID: 38628987 DOI: 10.7759/cureus.56314

Background Metabolic acidosis in chronic kidney disease (CKD) patients has lately gained attention due to the growing evidence of its treatment benefits. This study aims to provide baseline data on the prevalence, risk factors, and current management of metabolic acidosis among the pre-dialysis adult Malaysian CKD population. Methodology This multicenter cross-sectional retrospective study involved pre-dialysis CKD patients above 18 years old on regular nephrology clinic follow-up at three Malaysian government hospitals with nephrology subspecialty. Demographic data, clinical information, laboratory data, and a list of concomitant medications were collected. Factors associated with the occurrence of metabolic acidosis were identified via multiple logistic regression. Results Six hundred and fifty-seven CKD patients were screened for this study, in which only 39.4% (n=259) had available bicarbonate levels. From this, a total of 86.1% (n=223) had metabolic acidosis. Higher estimated glomerular filtration rate (odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93-1.00, p=0.043) and those with cardiovascular disease (OR 0.33, 95% CI 0.15-0.73; p=0.007) were significantly associated with lower odds of metabolic acidosis. There were 43.0% (n=96) on alkali therapy with sodium bicarbonate solution being the most common (n=91, 94.8%). Among those receiving alkali therapy, only 19.8% (n=19) achieved bicarbonate levels of ≥ 22 mEq/L. Conclusion Our study showed that metabolic acidosis was highly prevalent, although few achieved target levels despite supplementation, supporting the need for focused management of metabolic acidosis in the CKD population.

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